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County agrees to cover Hillcrest cash-flow problem

Tuesday, June 19, 2012

McCOOK, Nebraska -- Red Willow County, Nebraska, commissioners will offer the county-owned nursing home a "parachute" if a cash flow problem becomes critical.

Commissioners agreed during their regular weekly meeting Monday to authorize the transfer of up to $300,000 from the county's inheritance tax fund to Hillcrest Nursing Home's operations budget, if it becomes necessary.

At their July 2 meeting, county commissioners Steve Downer, Vesta Dack and chairman Earl McNutt will further discuss and most likely adopt a resolution authorizing that transfer.

Randy Dean, a member of the nursing home's board of trustees, said that the cash flow problem started with the termination of a billing clerk in February. "No Medicare and Medicaid billings were done, and the (nursing home) administrator was not doing anything to get it done," Dean said.

"It is not a legal issue," Dean emphasized. "It's a shortfall ... a cash flow problem," said Jerry Rothmeyer, who has been acting as interim nursing home administrator since Peggy Rogers resigned the administrator's position on May 16.

Dean said the nursing home was three months behind in billing Medicare for reimbursement of services provided to Hillcrest residents who are Medicare recipients -- approximately $225,000 per month -- and Medicaid billing had not been done correctly. Red Willow County attorney Paul Wood simplified the situation, "You don't send out bills -- there goes your cash flow."

Rothmeyer said the situation "is being straightened out now; it takes a little bit of time."

Dean said the nursing home has hired a "first-class, experienced person" now for the billing clerk position. He explained, "Medicare has a very complicated process for billing -- not everyone can do it. It's the most complicated part of our billing."

Dean admitted, "We'll get by .... although we're going to lose some money on this, no doubt," on bills not submitted in a timely manner.

Rothmeyer told commissioners that the nursing home has made its payroll, and Dean said it has enough money in its construction fund to cover the renovation going on now. The nursing home will also have to pay a $163,000 bond payment due in December.

Dean and Rothmeyer were originally asking commissioners to authorize the transfer before the end of June, but the process by which county officials would have to open the budget to make the transfer from the inheritance tax fund and the requirement that it be paid back within the same fiscal year does not leave enough time before the fiscal year ends June 30. The transfer itself cannot be made until July 1 (or July 2, the first working day in July and in the new fiscal year), McNutt said.

Dean and Rothmeyer agreed that authorizing the transfer next month/next fiscal year would be satisfactory, each emphasizing that they may not need the transfer, or only a portion of it. "It's nice to know we've got this back-up if we need it," Dean said.

The county has $658,000 in its inheritance tax fund, and will add $130,000 to that when the roads department repays that amount (transferred until a highway allocation is received) yet this month.

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This is a facility that is quality and much needed in our county. I support the commissioners if they need to transfer funds to keep it open.

-- Posted by dennis on Tue, Jun 19, 2012, at 4:10 PM

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