Storms at Hillcrest
A week ago the Gazette reported on problems at Hillcrest, Red Willow County's wholly owned Nursing Home. What do they call it now -- Long Term Care? Hillcrest is dear to my heart in part because it is where my parents and Grannie Annie's mother spent their last days. Clean, wonderful, shall we say sainted, nurses caring for the patients. In my heart a wonderful asset for the residents in this area.
I am angry in part for the bad publicity and the frustration that must engender for the personnel who serve so well at Hillcrest. Housekeeping, laundry, kitchen, personal care of residents above and beyond the call of duty. They deserve better!
Now our Hillcrest is reportedly in financial trouble. So much so that one of the Commissioners advocated selling the facility because in his words "I don't want it (Hillcrest) to go away, but a private owner could operate it at a profit." Unpaid bills for care of residents. Hummm. Who has been watching the shop?
A bit of history. When Hillcrest was established, yes by far-sighted commissioners, a manager was hired and all financial transactions went through the county treasurer and were signed off weekly by the county board of commissioners. Evidently that system was a bit unwieldy so the commissioners appointed a board to hire and fire the manager and manage the affairs of the home. It is a system that has worked well over the years.
During my eight years of being county commissioner I took a strong interest in the affairs, the management and finances, of the well-run Hillcrest. The manager at the time managed operations very effectively but was lacking somewhat in people skills. Disgruntled employees would bend my ear and the manager and I would then have a little visit. If the problem of the day was unsolved then it would go to the regular meeting of the Hillcrest board for resolution. It was during that time when the vacant lower floor of the building was remodeled to provide assistant living and residential apartments rented to persons who had loved ones living above or just needed lesser amounts of care than was the venue for the long term operation, the main mission, of the home. A licensed children's day care was also instituted in that unused lower area to provide care for employee's dependents, working moms. Super ideas that also provided additional financial streams of income for the facility.
Then the longtime manager elected to retire and his assistant was elevated to manager. The home continued to thrive. This commissioner was un-elected and I departed the scene. Evidently there were new persons appointed, by the County Board, to the Hillcrest Board. Relations with the manager soured and she was fired over some sort of billing issue. Had I been still on the County Board I would have jacked up that Hillcrest Board and replaced them all. It was not to be.
This is to recognize that getting reimbursement for medical services rendered is a frustrating problem in today's world. Long term care insurance is a great help. Medicare won't do much long term and Medicaid is shall we say frugal. That leaves family to make up the difference. In my opinion that is the best use of funds a person accumulates over a lifetime. Pay the nursing home who has for sure earned it. The Gazette article pointed to cases of large amounts of money unpaid for services already rendered and possibly it is time for Hillcrest board members to bend on the families involved to do their moral duty and pay up. In the end though Nebraska Statute charges the care of indigent people to the county. That still doesn't make it right that greedy family members refuse to take care of their elderly members.
I am reminded of how a family in the neighborhood of my youth manipulated the system. The mother had passed and dad in his old age needed full time care. The family transferred all assets to the three surviving children so the old man was destitute except for his social security checks.
Living in Hillcrest it was necessary for "the county" to make up the difference even though his sons and daughters were well off. Obviously no conscience.
In years since Nebraska created legislation to prevent similar abuse so that now all asset transfers have to be completed two years prior to the ailing elder person being declared destitute and "on the county" to pay long term care expenses.
Having the privilege of sitting on various governing boards I can share some observations. Some managers will spend inordinate amounts of attention to buttering up their governing boards to secure their uncritical loyalty so the board okay's the manager's every whim. Not healthy.
Some managers will sit down with the governing board, present a problem, and brainstorm a best solution which in turn is still the manager's job to implement. Best. It is not the job of a governing board to micro-manage but it is incumbent on each member to keep in close touch with the organization being overseen and insist on resolution of problems by their manager.
The dynamics of the present Hillcrest board/manager relations I know not since I left my county commissioner job but obviously the current results and financial situation at Hillcrest is unacceptable.
Come on Hillcrest management, board, and county commissioners do your job.
Preserve this jewel of a nursing home that is providing a service so vital to our community!
That is how I saw it.