City's appeal board reconsidering Citizens, Montevue subdivision

The sale of the Citizens Care and Rehabilitation Center and Montevue Assisted Living Facility land is still pending. 

The county's nursing home posted losses in July and August, the second and third consecutive months it has failed to break even.

Citizens Care and Rehabilitation Center lost $227,699 between July and August, while Montevue Assisted Living saw a $377,788 deficit, for a combined shortfall of $605,487 across the two months, according to financial statements for the facilities.

The well-known financial struggles at the two centers underpinned county commissioners' June decision to sell the centers to Aurora Health Management, a for-profit company.

However, the recent lackluster performance of Citizens follows a couple of months of surpluses.

Those who oppose the facility sales, which haven't gone to closing, argue the centers can become self-sustaining if properly managed. They have looked carefully for signs of a financial turnaround as they seek to show the centers could stay in county ownership without burdening taxpayers.

Melanie Cox, a former nursing home officer who disagrees with privatizing Citizens and Montevue, said the most recent financial reports concern her. However, she stands by her assertion that if billing rates were adjusted, the facilities could break even in as soon as two years.

The batch of reports released this week gives the first glimpse of the centers' finances under Aurora's leadership, the Millersville-based company that started operating the facilities in August on a month-to-month contract with the county.

Both Cox and Lori Depies, county manager, said one month does not provide enough data for a good evaluation of Aurora's management. But Cox said the reports do raise questions about occupancy levels at Citizens, a 170-bed nursing home.

Her analysis of the county's reports show the average daily occupancy at Citizens fell from June to July and only partially rebounded in August. She said the drop-off partially explains the two months' losses.

She noted that revenue at Montevue, a 75-bed assisted living center, also fell sharply from June to July, and she said an increase in vacancies could be responsible for the decline.

Depies said Aurora has been making a push to collect unpaid debts and set the facilities on course to fiscal stability. However, in their first month, Aurora representatives were getting familiar with the centers and doing some recalibrating. For instance, Aurora raised the percentage of payments owed to Citizens that are deemed uncollectible each month. The adjustment created a spike from July to August in expenses due to bad debt, Depies said.

"I'm not surprised not to see any big shifts in the financial picture," Depies said of the reports. "Aurora spent August really getting their hands around things."

But because Aurora is introducing changes, the fiscal 2014 budget projections for the centers might be off the mark. Depies said it's too soon to tell whether Citizens will need help beyond the roughly $690,000 subsidy the county has budgeted for it in fiscal 2014.

Cox will eagerly await the next round of financial reports, she said.

"I would hope that September would show a major improvement both in revenue and expense management."

Follow Bethany Rodgers on Twitter: @BethRodgersFNP.

(32) comments

bmclearen

Young was elected, in part, to manage the county and not just to sell out the parts that were not making money. Anybody could sell something that is not making money, but it takes a professional manager to fix ta problem. Looks like Young is taking the easy way out by selling instead of providing needed management that could possibly correct the negative cash flow that we are told Montevue has been experiencing. Perhaps our next elected officials will provide better management for our county.

dbjanda1

Darth---So zero cents on the dollar is better than something on the dollar ???...You sound like Obama...Me

dbjanda1

How can the BoCC criticize the homes operating at a loss when they sold them at a loss ???...Me

darththevader

Your math needs help. Giving the place away would be better than a loss

democratdave

Your morals need help. Helping people is better than a monetary loss.

KellyAlzan

You're right. But that's not what Ba'Lane is doing. He is receiving a kick back for this deal. He is not "giving the place away", he is personally profiting. Great morals, huh?

usgov

The Tea bagging BoCC doesn't believe the county should subsidized old, vulnerable and frail people that couldn't save adequately for their twilight years.

watson4sherlock

But they are happy to pay over $12 million to finance a county jail. [beam]

catherine

I have stated this before in another article thread-if the billing to insurance, private pay, etc. is/has not been done correctly, then those in the billing office need to be replaced by people who are trained in this to get the money that is due to the facility. There are plenty of good accounting folks who are available in our county that need work, so it would be a win win.
I have rec'd a credit letter for my mother's stay, yes a credit not a bill. She left there last Thanksgiving .... I rec'd the letter today. I was told that there are "a lot of them" and they will "have to be investigated"... So if the prior company didn't do the billing correctly, the county should demand a refund for services NOT being performed. I asked why send a credit statement out if it "may" not be correct and the gal didn't have an answer except that they will investigate. So my theory that I have been saying all along has been proven, get the right billing/accounting folks in there and I bet the deficit would be fixed or at the very least shrunk.

watson4sherlock

They have a year to bill Medicaid so if it hasn't been done correctly who says it's not on purpose so they can collect after they have the title?

catherine

I am not sure what you are saying in reply to my experience. Mom had medicare and private insurance as well as the days she was in the hospital she paid the full cost out of pocket. The EOBS have already been rec'd by us, there is no balance due, insurance has already paid. Just seems to me that it proves that billing is not being done correctly so how can anyone believe any of the numbers that are presented? A very sad situation

MCEDDE21

Catherine and Watson: You have put your fingers on a very real problem. Since my earliest involvement (in January of this year) I knew of the ongoing Accounts Receivable crisis at Montevue/Citizens--due to a persistently high turnover rate and a resulting shortage of trained personnel in the finance office. While the Board of Trustees demanded action, the LW Consulting Administrator did nothing.

As the months went by, BoCC President Blaine Young (who signs the checks) refused to replace LWC, as the Trustees had requested. In June, after the debts (owed to the COUNTY) had spiraled past $5.6 Million, LWC simply wrote off 20% and in July/August, Aurora (the new management, at last!) wrote off another 20% for a total loss (to the COUNTY) of $2.4 Million! But still, the uncollected bills have continued to pile up and Blaine/Aurora have failed to resolve the problem.

Already, there are clear and questionable tax implications of these write-offs which would seem to inure to the benefit of the new, profit-seeking owners. In addition, as Catherine and Watson have pointed out, there may be other problems lurking within individual patient accounts, to include over-billing or, perhaps, other errors.

We know that the taxpayers are getting fleeced by this deal already--to the tune of more than $25 Million. When things come to settlement, though, the books will be closed (forever), Neither the taxpayers, nor Individual patients whose bills were paid by insurance, Medicare, or other payers, may ever know how badly we've been taken.

alovelyplace

On Sept. 30th, 2013 Blaine Young once again targeted Montevue /Citizens on WFMD Sound off, stating its not a core government function. THAT same day, the County issued an RFP to retrofit the bathrooms of county owned senior housing, Bell Court.
Can government naysayers and the BoCC explain the ideology behind owning 28 apartments over a care home? Mr. Smith?

Bell Court: http://www.frederickcountymd.gov/?NID=381

The RFP to retrofit 28 baths at county owned low income Senior Housing Bell Court Apartments. http://od.lk/a7f

Facebook: https://www.facebook.com/photo.php?fbid=564103306976653&set=a.186427331410921.54385.183339988386322&type=1

watson4sherlock

Does the money come from federal cofers instead of county funds?

watson4sherlock

If it can't make a profit why would a private company want to buy it?

Perhaps the loss is necessary to prove it should be sold.

Sorry if a conspiracy theory disturbs you but facts are facts.

puddintane245

Nothing new here. Same group of complainers. Always a conspiracy, what is this group to do once Baline is no longer in office, they will have to find some other way to fill their miserable day.

briancaps

Which side are you on sell or don't sell?

president8444

Jan gardner and Gray why did you have this built? Sel it Blaine.two losses , enough.Gray resign now, trouble maker and a Jan follower.

teadoffinfrederickcounty

I (an everyone I know) anxiously await the sale of both facilities.

jerseygrl42

Its not a sale...its a giveaway and if aurora can't manage it properly while the spotlite is on them what will happen after the fact and while the taxpayers are pumping yet another $10 million in aurora's hands

briancaps

Why would you be in favor of a sale by the county still has to pay $3.5 million year one $3.25 million year 2 $2.25 million year 3 and $1.7 million year 4. If Melanie Cox is correct The county will save money by not selling. Why would a for profit company, Aurora Health Management, want to buy two facilities losing $300.000 a month? They see an opportunity to cut costs and save money, which would mean lower quality of care for residents.

vmdigioia

"Melanie Cox, a former nursing home officer who disagrees with privatizing Citizens and Montevue, said the most recent financial reports concern her.
However, she stands by her assertion that if billing rates were adjusted, the facilities could break even in as soon as two years."

Melanie should be concerned with the past financial reports with the same amount of fervor . . . she wants two more years to operate with losses as great as the past?

Regardless of who owns/runs the facilities -- if they cannot operate and maintain the two homes with efficient and quality care within reasonable costs -- then they should lose the contract

MCEDDE21

What happened to the "glowing reviews" that Young and Depies were crowing about just three weeks ago? (Please see my LTE, "The Self-Adulation of County Officials", http://www.fredericknewspost.com/news/politics_and_government/levels_of_government/bocc/article_56e24113-71b1-5c55-8162-be6cc611b82b.html)

Our Board of Trustees ensured the regular, monthly reporting of financial and health care quality data prior to their dissolution in June. Since then, three months of silence...

Prior to the Board's dissolution, we got to see the Homes' steady progress toward stability and profitability, in spite of Blaine Young's obstructionism. Now, reports emerge from FCG, (proclaiming the wisdom of their approach) and the other from Aurora, decrying their desperate financial straits.

Both Aurora and FCG have serious conflicts of interest, which may well explain the contradictory reports and the three months of silence. But, if even ONE of those reports is accurate then, either: A. The County should not sell; or B. Aurora shouldn't buy.

Newthinking7

The county should lodge charges against that group xavier who they hired to run it a few years back.
they are the ones who set this up to fail.

Newthinking7

No surpise there. No one wants to go there anymore. It was noted to be a fantastic place for years.
There was waiting lists. No more. I personaly have spoken to individuals who have chosen not to go there in light of the sale.
When you had a standard of excelence and then decide to downgrade the quality by adding profit margins into it ,, what would you expect.
Out sourcing does not work guys.
Private industry is not interested in the product, only the profit.

briancaps

Excellent comment Aurora Health Management operates 7 other facilities with profits of over $1 million dollars in 2012. There all goal is to make Citizens/Montevue by cutting highest cost staffing resulting lower quality care for residents.

darththevader

Yoy leave out the part that there is no profit without a quality product. Private industry knows this

watson4sherlock

I guess the nursing care facilities are not a quality product because they are lossing money so why would any private industry want to buy them?

watson4sherlock

Services are publically operated because they operate at a loss and need tax payer support. Few takers on the toll road MD200.

alovelyplace

Do you know of anyone steered away from a request for admission to Citizens or Montevue Care Homes in June, July or August of this year? If so, please contact alovelyplace@mac.com or visit and message the page, Stop the Sale of Montevue/Citizens home: https://www.facebook.com/StopTheSaleOfMontevueCitizens
Thank you!

alovelyplace

Also this month, the Meals on Wheels program, which our BOCC contracted a significant portion under contract to Morrison Services to provide was moved this month to the Frederick County Detention Center's work Release program. A savings, reported by staff of nearly 46% than the cost of the BoCC's contract arrangement that eliminated county cafe service providers at the homes..

alovelyplace

Wait a minute..."Her analysis of the county's reports show the average daily occupancy at Citizens fell from June to July and only partially rebounded in August."? Miss Kitty, caller to WFMD Blaine Young Show fell and went to the ER in August. She asked FMH to send to Citizen and was told by hospital staff that Citizens was full! Listen for yourself: http://youtu.be/NalTDHXfylg.

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