Dear Friends and Neighbors,
Warren County officials responsible for the nursing home sale are angry.
They are angry at citizens collecting signatures for the Westmount Nursing Home petition. They are angry over material distributed by a local citizen who is leading the petition drive. They are angry I sent this petition and material out in two emails.
There are citizens concerned about the sale.
If there is cause for anger it should not be directed at the citizens getting signatures for the petition and executing their legal rights. They have concerns about the nursing home sale and are doing what they think is right.
Instead the county should take a good hard look at its own actions, which allowed the permissive referendum (petition) and left many questions unanswered throughout this process.
This email reviews in detail the steps Warren County has taken to sell the Westmount nursing home and what led to the petition initiative:
(I) The Petition – How did it come about?
(II) Nursing Home Timeline – Key dates and decisions
(III) Special Health Services meeting w/Centers Health Care (Centers)
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(I) The Petition – How did it come about?
The nursing home sale process is being guided by the county administrator (who is an attorney), the county attorney and outside counsel ($62,000 for services).
- December 6, 2012: The Westmount Nursing Home RFP was released by the county.
- February 20, 2015: The County passes resolution 89 of 2015* a local law that authorizes the sale of the nursing home through the RFP process and opens the door to the “permissive referendum”, i.e. the petition.
* Note: A local law “Authorizing Private Sale, Without Bidding, Public Advertisement or Auction, … Determining the Real Property is Not required for Public Use” (http://www.warrencountyny.gov/docs/R089%202015.pdf)
Why did the county wait to the end of the process, after the contract has already been signed with Centers, to pass this needed local law?
Why would the county leave the nursing home deficit out of the 2015 budget knowing the sale would not be finalized in 2015?
The county took out any deficit for the nursing home in the 2015 budget as if the nursing home sale was finalized. Even though the county knew this sale was never going to be finalized in time to impact the 2015 budget.
The County had been negotiating with Centers since 2013 and in April 2014 a resolution was passed that identified Centers as the company selected by the county board. Had the county passed the local law authorizing the RFP back in 2014, the petition would not be taking place now. If that had happened then it would have made some sense to leave the nursing home deficit out of the 2015 budget.
Now county officials are panicked. They have started a campaign to discredit the petition effort by saying there has been “misinformation” distributed. I’d ask you to decide for yourself if you think this is true. See below.
(II) The Nursing Home Sale – Timeline
The RFP – December 2012:
The RFP was a good document. I supported it in 2012 and I support it now. The RFP went out on December 6, 2012 and proposals were due February 7, 2013. Click here for the RFP – http://www.empirestatebidsystem.com/closed-bids/Warren-County/Sale-of-Warren-County-Skilled-Nursing-Facility.asp?tn=144182;
Three Companies Presented – March 18, 2013:
Three companies presented initial proposals at the Health Services Committee on March 18, 2013. Here are the meeting notes – http://www.warrencountyny.gov/gov/comm/health_services/03-18-13.pdf.
Two companies emerged as favorites with the supervisors. Specialty Care (now Centers Health Care) out of the Bronx, NY and Fort Hudson the one local firm to bid on the nursing home.
Here is one report in The Post Star about Fort Hudson’s proposal for a health care campus – http://poststar.com/news/local/fort-hudson-health-system-proposes-health-campus-as-part-of/article_3a3a61de-9013-11e2-a319-001a4bcf887a.html. Note – The health care campus was an important part of the RFP. It is seldom discussed today.
Negotiating Team – Spring 2013:
A negotiating team was assigned to negotiate the nursing home deal. I was not on it. The negotiations were closed and confidential. I was willing to sign a confidentiality agreement in order to receive updates. The answer was no.
This is significant because I’ve been criticized by some for bringing information to light late in the process. I was not involved in the confidential negotiations and only brought in after the negotiating team selected Centers.
After the confidential negotiations concluded the negotiating team announced that Centers was their choice and the other companies were no longer candidates. There was only one company the board could now vote for – Specialty Care (now Centers Health Care).
Those of us who supported Fort Hudson never had a chance to vet them publicly and vote for them. The full board never got to weigh in on Centers vs Fort Hudson.
Impact of the Cogen on negotiations – 2013:
Selling the cogen as part of the nursing home sale was not a deal point in the RFP. The cogen was only mentioned as a power source in the RFP, and taking over the cogen payments was not a criteria of the sale.
The negotiating team stated the cogen was not a factor with Fort Hudson going away. Fort Hudson disagreed publicly saying the cogen was a factor (reported in The Post Star – http://poststar.com/news/local/cogen-plant-affected-nursing-home-bidding/article_c94a7336-c673-11e3-a48a-001a4bcf887a.html.
It remains unclear to this day the role the cogeneration plant played in the negotiations.
Sale put on hold to audit Cogen – 2013/2014:
The county put the nursing home sale on hold in 2013 while it hired a third party engineering firm EnerNoc to audit the cogen. This audit took place in the second half of 2013 and EnerNoc presented to the full board their report on April 3, 2014.
The EnerNoc report confirmed what local engineers have been saying for years – the cogen did not create energy savings and cost taxpayers millions of dollars. EnerNoc specifically reviewed the Siemens Year 8 annual report and gave it a critical review.
The County pays annually for the Siemens reports, but the board never voted on the year 8 or year 9 reports. The board had approved years 1 – 7. Based on the EnerNoc audit some supervisors felt years 8 and 9 should go to a vote in order to vote NO.
Negotiations Resume – Second Half 2014:
In a Special Board Meeting on May 7, 2014 the board voted to proceed with negotiations with Centers – Resolution 222 of 2014. Click here for Resolution 222 of 2014 – http://www.warrencountyny.gov/gov/resolutions/2014/default.php?meeting=1399457825
Negotiations continued. All through the negotiation I kept asking myself why would anyone buy the cogen? It is now clear Fort Hudson would not buy it – and they are out, but it is part of the deal with Centers – and they are in.
Warren County passes the 2015 budget – November 21, 2014:
The county had been projecting millions in losses going forward from the nursing home. Yet the county board passed the 2015 budget without any budget deficit for the nursing home. Even though the county knew this sale was never going to be finalized in time to impact the 2015 budget. The nursing home sales in Washington and Essex Counties took more than a year to get Department of Health (DOH) approvals. It will be no different for Warren County.
Health Services committee approves contracts – November 25, 2014:
In November 2014 two contracts emerged – one for the Assets ($800,000 for the nursing home) and one for the land ($1.5 million for the land). Two separate LLC’s were created for the purchase. These contracts were reviewed in a Health Services Committee meeting on November 25, 2014. I voiced a number of concerns about these agreements. Here is a link to these concerns – http://www.westcottupny.com/wp-content/uploads/2013/01/LEGAL-CONCERNS-WESTMOUNT-COGEN-2.pdf.
Contracts approved – December 2014:
In December 2014 the board voted to sign the contracts with the LLC’s that were set up for the nursing home sale. Click here for Resolution 638 of 2014: http://www.warrencountyny.gov/gov/resolutions/2014/12.19.2014/R638%202014.pdf
Supervisors Beaty, Westcott meet with Westmount – February 18, 2015:
Through the end of 2014, and all through the process of selling the nursing home, the county was projecting the Westmount nursing home would lose millions of dollars.
On February 18, Supervisor Betty and I met with Westmount Administrator Lloyd Cote and Comptroller Betsy Hinkel. In this meeting we were told Westmount would actually run a $700,000 surplus in 2014. This was the first time we had heard this.
County revises Westmount budget numbers – February 20, 2015:
In November 2014 the estimated nursing home loss was a combined $2.5 million over 2014/2015.
On February 20, 2015 a revised budget reported this combined 2-year loss for 2014/2015 would go to $700,000.
A positive difference of $1.8 million. [It is worth noting the Siemens payments over these two years will be $900,000 – $1 million.]
Much of this improved budget status was due to Intergovernmental Transfer (IGT) payments that came into the county in July and August of 2014.
Why were we just hearing about these new budget numbers and why weren’t these IGT payments reflected in the budget numbers used during the 2015 budget process?
Contract contingent on Resolution 89 of 2015 – February 20, 2015:
Resolution 89 of 2015 is a local law “Authorizing Private Sale, Without Bidding, Public Advertisement or Auction, … Determining the Real Property is Not required for Public Use.” Click here for Resolution 89 of 2015 – http://www.warrencountyny.gov/docs/R089%202015.pdf
The passing of this resolution opened the door to the permissive referendum, i.e. petition.
Citizens initiate Petition – March 2015:
Here are the documents assembled for this effort:
Westmount Petition: http://www.westcottupny.com/wp-content/uploads/2013/05/Westmount-Petition1.pdf; Travis Whitehead FAQS: http://www.westcottupny.com/wp-content/uploads/2013/05/Westmount-Petition-FAQ1.pdf
Here was the Warren County Response stating there was misinformation released by Travis Whitehead: http://www.warrencountyny.gov/westmount/westmountSale.php;
The county is taking the position there will be grim financial repercussions if the nursing home sale is postponed at this time. They are concerned about this petition stopping the sale.
(III) Special Health Services committee meeting with Centers Health Care (Centers) March 16, 2015:
In response to information and questions being distributed the county held on March 16, 2015 a special Health Services committee meeting with Centers representatives. It is captured on video – http://www.warrencountyny.gov/gov/comm/video.php?video_id=x-YnOU–VVY&department=health_services.
Below I’ve coded and commented on sections. The meeting started at 11 am. So if it says 11:15 am then the video is at the 15 minute mark on YouTube:
11:15 am: Mr. Kenneth (Kenny) Rozenberg, CEO, Centers Health Care. This section includes introductions and company information. Note – You will see Mr. Rozenberg and his team are professional, intelligent and credible.
11:27 am: Exchange between Mr. Rozenberg and Lloyd Cote, Administrator at Westmount. Mr. Rozenberg did not know Mr. Cote’s name.
Note – I felt this was worth noting. Mr. Rozenberg is buying Westmount and Mr. Cote is the Westmount administrator. Mr. Cote was seated up-front at the meeting with Mr. Rozenberg. Mr. Cote stated in a Feb. 18 meeting he would be going to work for Centers after the sale (Supervisor Beaty and Betsy Hinkel were also in attendance for this meeting).
11:31 am and 1:14 pm: Two employees from Fulton Center share their positive experiences at the nursing home owned by Centers. Note – These were two credible accounts.
12:09 pm and 1:04 pm: Two Warren County citizens share personal accounts and concerns related to care at Fulton Center. Note – These were two credible accounts.
12:30 pm: Mr. Rozenberg explains what Centers would do as owners of Westmount saying “you can quote me” on these plans for Westmount. Note – This clearly outlines his plans for Westmount nursing home. I liked that Mr. Rozenberg was very candid and clear. He certainly knows the nursing home business and how to make them profitable.
1:17 pm: Mordy Eisenberg from Centers discusses quality measures in response to concerns from citizens about Centers facilities based on published reports on www.Medicaid.gov and other nursing home sites. A few important quotes by representatives of Centers:
“Quality scores would likely decline just by virtue of proper documentation
even though the actual quality in the facility is the same.”
“Aggressive training and education at the facility of the proper capture of these clinical measures and you can see the quality scores on these measures declined.”
“I think it is important to understand with case mix up, reimbursement up,
quality scores will go down.”
“Don’t confuse quality measures with quality care …”
Note – This is a very important discussion. Please listen to their explanations. Why this is so important is because those leading the petition effort are basing it on independent documentation from www.medicaid.gov and other nursing home sources that list declining quality scores. Personally, I’m having a hard time understanding the notion that declining scores are actually a good thing, and that because Centers is making improvements the scores have declined.
1:23 pm: In an exchange with Mr. Cote, Mr. Rozenberg states “you just don’t know how to do it” …
1:29 pm: I pointed out the current Westmount administrator Mr. Cote has been able to get the case mix up, while quality ratings have not declined.
Note – I was taken aback by this. Mr. Cote has been in the nursing home business for decades. He does know his stuff.
1:46 pm: Discussion on a report in the New York Times and comments made in the article about over use of Psychotropic drugs. Source: http://www.nytimes.com/2014/12/16/nyregion/death-in-bronx-shows-vulnerability-of-states-nursing-home-residents.html.
Note – Mr. Rozenberg called into question the credibility of the journalist that wrote the story. Centers listed in their presentation specific reasons why they call into question the “facts” used in this story. Even though Mr. Rozenberg felt the reporter was unfair and the information presented was not accurate, I did not find it funny when he said he’d “autograph” the NY Times article. I understand Mr. Rozenberg was trying to make light of what was called a “hit piece” by the NY Times reporter, but the tragic death in the story was real and nothing to joke about.
2:04 pm: Discussion about the ownership structure for Westmount. In this discussion are questions about Mr. Rozenberg’s relationship with Suffolk Center that has had alleged abuses in press reports. Mr. Rozenberg makes clear what his relationship is with Suffolk Center. That he does not own that nursing home. That he is not involved in the operations of Suffolk Center.
2:18 pm: Mr. Rozenberg spoke about the “transparency” of his relationship with Suffolk Center and comments made by his representative at a prior meeting saying, “That’s what happens when you send your lackeys and they give bad information …”
Note – Calling an employee a lackey and saying tomorrow he may not have a job is not funny. In a Feb. 20 meeting, Mr. Rozenberg’s employee stated “Kenny is merely a consultant” at Suffolk Center. On March 16 documentation was presented to Mr. Rozenberg that listed him as a Director/Officer at Suffolk Center. This came from www.Medicaid.gov and other nursing home sites – something Mr. Rozenberg said was a “typo.” It was determined Mr. Rozenberg is owner of the Suffolk Center building and land the Suffolk Center facility is on. Centers has their logo on the front awning of the Suffolk Center nursing home – something that was explained on Feb. 20 as a “marketing program”. It appears Mr. Rozenberg is more than “merely a consultant” and his employee was chastised.
2:44 pm: County Attorney discusses the pending referendum and impact on the sale.
Note – This section is important in order to understand the impact should the petition succeed. Rather than summarize it, I asked the county attorney to put it in an email. Click on the attached link – http://www.westcottupny.com/wp-content/uploads/2013/01/County-Attorney-email.docx.
2:48 pm: Mr. Rozenberg discusses how there have been “a lot of misconceptions” …
Note – I appreciate that Mr. Rozenberg and his representatives attended this meeting to address questions and concerns. He said at one point that Centers had been through this a “million” times … but for many of us we have not. This was only the third time I’ve had the opportunity to meet with Centers and two of those times have been in the past month. This was the first time I felt my questions regarding Centers had been answered directly in this process. Centers was asked to participate in the 2/11 night meeting that we organized ahead of the Feb. 20 vote but had declined.
3:00 pm. County Administrator and County Attorney discussed further what would happen if the referendum were successful.
3:10 pm: Warren County citizen speaks about his wife’s quality care at Westmount saying this is the “rest of the story.”
Here is Don Lehman’s account in The Post Star – http://poststar.com/blogs/don_lehman/westmount-meeting-video-online/article_b4808998-ccb9-11e4-8da9-37609ea1dba8.html.
Warren County Board Meeting – March 20, 2015:
At the board meeting this past Friday (March 20) the county administrator stated the “misinformation” on the nursing home buyer had been addressed at the special Health Services committee meeting on March 16. He did not provide details on what misinformation had been specifically addressed.
My opinion is there were legitimate questions asked at the March 16 meeting based on information obtained from credible sources including www.medicaid.gov, other nursing home reports, and press reports that generated questions. In the March 16 meeting, Mr. Rozenberg and his team were professional, responsive and patient in addressing these questions and issues.
The county administrator also took the opportunity at the board meeting to address the alleged “misinformation” in the material distributed by Mr. Whitehead. The meeting notes and video for this board meeting have not yet been posted. Once they are I will report further on this exchange and include links so you can see for yourself this discussion.
Mark Westcott