Surprise Valley Healthcare District
Day of Reckoning
By Barbara March
The head nurse and a licensed vocational nurse at the Surprise Valley Health Care District (SVHCD) have been fired in the wake of a blistering state health department survey charging the district’s skilled nursing facility with failure to comply with both state and federal regulations.
“It is our opinion that the administration of this facility is inadequate to guarantee the health, safety and well being of the residents of the skilled nursing facility,” Yvonne Mulcahy of the California Department of Public Health informed district board members, hospital administration staff and members of the public at the conclusion of the state’s review of the hospital’s skilled nursing facility in May.
Board members present were Bunne Hartmann, Jim Laacke and Cindy Linker.
Immediately following the report, Director of Nursing Audrey Wood and LVN Laura Gorzel were terminated and charged with violating district policy and failure to comply with federal and state regulations.
Mulcahy and her team cited the skilled nursing facility with negligence and failure to provide a safe environment for residents, staff and the public. Resident patients were not being treated with respect and dignity in their personal care, there was a failure to establish a conservator for a patient, failure to have a registered nurse sign and certify that a patient’s assessment was accurate and complete, and failure to revise a patient’s health care plan to accurately reflect treatment.
Specifically referring to patients’ bed sores, the critical report charges that health care plans were not revised to include a change of condition or the ordered treatment of a dressing change every three days. Weekly skin assessments were not completed for all residents.
In addition, the state team said the skilled nursing staff failed to administer medications and treatments as ordered for several residents.
Mulcahy read a precise list of patients’ identifying numbers and the specific violations for each patient, making it clear to the district board that closure of the skilled nursing facility was a valid possibility, according to a member of the public present at the interview who requested anonymity based on the sensitive nature of the subject.
The state health department’s findings are the result of 10 investigations of the skilled nursing facility last year and another three earlier this year.
The hospital district’s administration was put on notice last year by the state to correct the same deficiencies that they are being told to rectify this year -- that’s why the state is threatening closure, according to sources familiar with the investigation.
Ignored or down-played in the past by the district administration, the state’s review far exceeds patient care and includes poor food handling, infection control, sanitation, deteriorated decking on a patio used by skilled nursing residents, floors in need of repair, duct tape as a replacement for a faucet handle, improper storage of combustible materials, penetrations in the ceiling of the boiler room, failure to hold or document disaster drills, failure to test or document testing of the sprinkler system, failure to document inspection of kitchen hood fire suppression, use of portable space heaters, an inaccessible exit, and improper use of extension cords and power strips.
Required by the state, the district has submitted two plans of correction, one for the skilled nursing facility and the other for health, safety and fire regulations.
If the plans are accepted the survey team will return to ensure the plans are being carried out according to state regulations. If the plans are not satisfactory the hospital risks closure.
“We damn well better have things fixed and programs underway toward a solution before then,” said Laacke. “Health and safety come first.”
Monday, July 9, 2012
Modoc-gate
Modoc County’s Financial Woes
May Be Turning the Corner
It may be premature to celebrate, but if current signs of progress are an indication, Modoc County may be on the road to financial recovery -- if the current Board of Supervisors doesn’t stumble over its political rhetoric.
In mid-2009 it was revealed that county officials had been illegally using money from the treasury in a “musical chairs” scheme to pay down various department debts, including the Modoc Medical Center, to the amount of an estimated $20 million.
Since then the $20 million figure has been reduced to an estimated $13 million still owed the treasury. In the wake of the treasury misappropriation the county came close to insolvency.
On a positive note:
Over objections of one of its more recent chief administrative officers and a minority of the Board of Supervisors, a $10 million performance bond claim was filed with insurance carries naming numerous officials as responsible for the treasury misappropriation and the cause of the near financial collapse.
Although it took an inordinate amount of time for the county act, a suit against its former outside auditors has been filed seeking damages and reimbursement of payments made to the firm by the county. The lawsuit came after the State Controller’s Office ordered new audits.
Of those county politicians on the Board of Supervisors during the misappropriation period going back to at least 1999, one member was defeated for re-election, another chose not to seek re-election and a third’s term runs out in January.
Two recent supervisors seeking re-election who were not on the board during the misappropriation period but apparently did little to advance the cause of financial recovery in the opinion of voters -- Loren “Shorty” Crabtree and Jeff Bullock -- were defeated in the last primary.
Since this series of events there have been various indications that can be seen as constructive moves.
The county has retained a Redding attorney to represent it in pursuing a performance bond insurance settlement.
A “pay ourselves back” plan has been offered to the governing SCO apparently with little comment.
The Attorney General’s Office has made at least two trips to Modoc County to interview various officials in the state’s probe into the treasury misappropriation.
If the AG investigation leads to charges and indictments of county officials that action could lend credence to the county’s performance bond claim with the insurance carriers.
While still undecided or debated, a proposal to move the county counsel job to the district attorney’s office is being considered by the Board of Supervisors. The move could save the county money if not improve legal services.
Three new supervisors will be sworn in the first of 2013 once the run-off to replace Crabtree is decided in November’s general election.
Modoc County’s Financial Woes
May Be Turning the Corner
It may be premature to celebrate, but if current signs of progress are an indication, Modoc County may be on the road to financial recovery -- if the current Board of Supervisors doesn’t stumble over its political rhetoric.
In mid-2009 it was revealed that county officials had been illegally using money from the treasury in a “musical chairs” scheme to pay down various department debts, including the Modoc Medical Center, to the amount of an estimated $20 million.
Since then the $20 million figure has been reduced to an estimated $13 million still owed the treasury. In the wake of the treasury misappropriation the county came close to insolvency.
On a positive note:
Over objections of one of its more recent chief administrative officers and a minority of the Board of Supervisors, a $10 million performance bond claim was filed with insurance carries naming numerous officials as responsible for the treasury misappropriation and the cause of the near financial collapse.
Although it took an inordinate amount of time for the county act, a suit against its former outside auditors has been filed seeking damages and reimbursement of payments made to the firm by the county. The lawsuit came after the State Controller’s Office ordered new audits.
Of those county politicians on the Board of Supervisors during the misappropriation period going back to at least 1999, one member was defeated for re-election, another chose not to seek re-election and a third’s term runs out in January.
Two recent supervisors seeking re-election who were not on the board during the misappropriation period but apparently did little to advance the cause of financial recovery in the opinion of voters -- Loren “Shorty” Crabtree and Jeff Bullock -- were defeated in the last primary.
Since this series of events there have been various indications that can be seen as constructive moves.
The county has retained a Redding attorney to represent it in pursuing a performance bond insurance settlement.
A “pay ourselves back” plan has been offered to the governing SCO apparently with little comment.
The Attorney General’s Office has made at least two trips to Modoc County to interview various officials in the state’s probe into the treasury misappropriation.
If the AG investigation leads to charges and indictments of county officials that action could lend credence to the county’s performance bond claim with the insurance carriers.
While still undecided or debated, a proposal to move the county counsel job to the district attorney’s office is being considered by the Board of Supervisors. The move could save the county money if not improve legal services.
Three new supervisors will be sworn in the first of 2013 once the run-off to replace Crabtree is decided in November’s general election.
An Analysis
The Ironies of Municipal Debt
The “B” Word or Not The “B” Word
By Ray A. March
The recent vote by the City of Stockton to pursue bankruptcy is a reminder that Modoc County has come precariously close to doing the same.
Whether or not the county eventually goes the bankruptcy route is dependent on a number of factors that can be either self-inflicted or brought on by state agencies demanding repayment of funds illegally spent by the county.
The basic difference between Stockton and Modoc County is a definition of debt.
Stockton, according to news reports, is insolvent. The city missed a number of large payments to Wells Fargo which financed the new and unoccupied city hall and three or four parking garages.
Wells Fargo did not call in the loans, which would have triggered bankruptcy for the city. Instead, the Stockton city council made that decision itself.
Modoc County differs from Stockton because it never bothered to finance its debt. It just illegally borrowed from the county treasury to cover deficit spending primarily at the Modoc Medical Center. Consequently, there are no creditors like Wells Fargo pushing the county into bankruptcy.
This is where state agencies come into play.
The money county officials used to cover the hospital debt came from the treasury but it wasn’t the county’s to use. It was what’s called mandated money, or funds provided by state agencies specifically for county-level services.
That makes the state agencies a type of creditor. When Modoc County makes the debt assignments the state agencies will, in fact, become creditors. (See accompanying question and answer interview with Auditor Darcy Locken).
As with Stockton, creditors have the potential of pushing a municipality into bankruptcy. State agencies carry that threat if they decide to call back the illicitly spent treasury money because Modoc County does not have that money to pay back.
As Modoc County’s financial scandal plays out, if the state agencies -- and this includes the State Controller’s Office, Attorney General, state departments and legislators -- do not push for bankruptcy and allow their funds to be used illegally, other counties will no doubt make demands on the state to also misuse their treasuries.
This is where the AG investigation becomes important -- to Modoc County if there is ever to be accountability for the misappropriation -- but also to the state. If Modoc County gets away with its treasury raid nothing can stop other California counties from doing the same thing.
The county seems to take the position of letting the state agencies figure this out for themselves, as inferred in the Locken interview.
More on this will emerge once the Board of Supervisors officially assigns the county’s debt to various county departments, including Modoc Medical Center, but also CalWorks and the tax fund.
If the county does admit to the state agencies that it has been illegally using their money, the agencies -- conceivably -- would be compelled to ask that their funds be returned and that could trigger bankruptcy for Modoc County.
The Ironies of Municipal Debt
The “B” Word or Not The “B” Word
By Ray A. March
The recent vote by the City of Stockton to pursue bankruptcy is a reminder that Modoc County has come precariously close to doing the same.
Whether or not the county eventually goes the bankruptcy route is dependent on a number of factors that can be either self-inflicted or brought on by state agencies demanding repayment of funds illegally spent by the county.
The basic difference between Stockton and Modoc County is a definition of debt.
Stockton, according to news reports, is insolvent. The city missed a number of large payments to Wells Fargo which financed the new and unoccupied city hall and three or four parking garages.
Wells Fargo did not call in the loans, which would have triggered bankruptcy for the city. Instead, the Stockton city council made that decision itself.
Modoc County differs from Stockton because it never bothered to finance its debt. It just illegally borrowed from the county treasury to cover deficit spending primarily at the Modoc Medical Center. Consequently, there are no creditors like Wells Fargo pushing the county into bankruptcy.
This is where state agencies come into play.
The money county officials used to cover the hospital debt came from the treasury but it wasn’t the county’s to use. It was what’s called mandated money, or funds provided by state agencies specifically for county-level services.
That makes the state agencies a type of creditor. When Modoc County makes the debt assignments the state agencies will, in fact, become creditors. (See accompanying question and answer interview with Auditor Darcy Locken).
As with Stockton, creditors have the potential of pushing a municipality into bankruptcy. State agencies carry that threat if they decide to call back the illicitly spent treasury money because Modoc County does not have that money to pay back.
As Modoc County’s financial scandal plays out, if the state agencies -- and this includes the State Controller’s Office, Attorney General, state departments and legislators -- do not push for bankruptcy and allow their funds to be used illegally, other counties will no doubt make demands on the state to also misuse their treasuries.
This is where the AG investigation becomes important -- to Modoc County if there is ever to be accountability for the misappropriation -- but also to the state. If Modoc County gets away with its treasury raid nothing can stop other California counties from doing the same thing.
The county seems to take the position of letting the state agencies figure this out for themselves, as inferred in the Locken interview.
More on this will emerge once the Board of Supervisors officially assigns the county’s debt to various county departments, including Modoc Medical Center, but also CalWorks and the tax fund.
If the county does admit to the state agencies that it has been illegally using their money, the agencies -- conceivably -- would be compelled to ask that their funds be returned and that could trigger bankruptcy for Modoc County.
Examining County’s Financial Status
Q & A With Auditor Locken
Editor’s Note: This article first appeared in the Modoc Independent News. In that story there was a typo that indicated Auditor Darcy Locken needed approval of the Board of supervisors to “assign” debt. That typo has been corrected to read she does not need the Board’s approval.
One of the key components in Modoc County’s financial recovery are new and updated audit reports ordered by the State Controller’s Office (SCO) in late 2009 when it was discovered the county’s treasury was being illegally used.
So far two outside audits for the fiscal years 2007-08 and 2008-09 have been completed, according to Auditor Darcy Locken. The SCO has accepted the 2007-08 audit and received the 2008-09 last month for review.
The 2009-10 audit is nearly complete and will be issued within the next 30 days. The audit for the last fiscal is under contract and scheduled to be underway this month and issued either later this year or in January.
(See accompanying story The Ironies of Municipal Debt).
Q. Have you assigned the treasury deficits? And has the BOS approved the assigning of the debt?
Locken: I am working on the 2010/11 close now, which includes "assigning the debt," but I'm not done and don't have final numbers. I do not need the Board of Supervisors’ approval to "assign" the debt. It's an accounting function.
Q. What are the outstanding -- or larger -- individual account deficits?
Locken: If you mean the negative funds, the hospital at about $13 million.
Q. Yes, negative funds, meaning which individual accounts and their amounts have been assigned debt in addition to the hospital account?
Locken: The hospital fund is negative, so it doesn't get "assigned" debt, it is the debt. Other large negative funds include CalWorks and the tax fund.
Q. Has the SCO noted the treasury deficit problem, including any note that Modoc has not complied with state law?
Locken: The audits note the deficiencies, and the SCO accepted them.
Q. So, the SCO has not notified those state agencies affected by the misuse of treasury funds?
Locken: I don't know whether they have or not. I'm not sure they have a duty to. Our audits are available to everyone, including those state departments.
Q. Are state and federal agencies, where applicable, aware that their funds have been used for purposes different than they were intended?
Locken: They all have access to the audits.
Q. It’s inferred from your answer that neither you nor any county staff have informed the state agencies that are affected by the treasury debt?
Locken: Various agencies are aware, either because of the media coverage or because they were contacted by our department heads. The county as a whole has not sent official notifications to anyone.
Q. Have any of these agencies made demand for immediate repayment, or a plan be presented for repayment?
Locken: Not to my knowledge.
Q. Wouldn’t this indicate that the affected agencies have not been notified of the treasury misuse?
Locken: Not necessarily. All of the state and federal agencies have reporting requirements. County departments submit reports showing what funds have been expended for their programs. I imagine that as long as the departments are continuing the programs, and any funds with time limits are being spent within those limits (which we have), the state and fed departments are happy. That's basically what Auerbach vs. Los Angeles Board of Supervisors says.
Q. What, if any, impact or influence will the status of these audits have on the county’s credit rating -- if it has a credit rating?
Locken: We don't have a credit rating. The negative audits can't do any damage because there's nothing to damage.
Q. From your answer it’s inferred that Modoc County actually never formally applied for a credit rating.
Locken: We didn't follow through with the formal application process but we did ask for an informal review by at least one of the leading credit rating agencies. The result of the informal review was, try again later. This was before the 07/08 and 08/09 audits were completed.
Q & A With Auditor Locken
Editor’s Note: This article first appeared in the Modoc Independent News. In that story there was a typo that indicated Auditor Darcy Locken needed approval of the Board of supervisors to “assign” debt. That typo has been corrected to read she does not need the Board’s approval.
One of the key components in Modoc County’s financial recovery are new and updated audit reports ordered by the State Controller’s Office (SCO) in late 2009 when it was discovered the county’s treasury was being illegally used.
So far two outside audits for the fiscal years 2007-08 and 2008-09 have been completed, according to Auditor Darcy Locken. The SCO has accepted the 2007-08 audit and received the 2008-09 last month for review.
The 2009-10 audit is nearly complete and will be issued within the next 30 days. The audit for the last fiscal is under contract and scheduled to be underway this month and issued either later this year or in January.
(See accompanying story The Ironies of Municipal Debt).
Q. Have you assigned the treasury deficits? And has the BOS approved the assigning of the debt?
Locken: I am working on the 2010/11 close now, which includes "assigning the debt," but I'm not done and don't have final numbers. I do not need the Board of Supervisors’ approval to "assign" the debt. It's an accounting function.
Q. What are the outstanding -- or larger -- individual account deficits?
Locken: If you mean the negative funds, the hospital at about $13 million.
Q. Yes, negative funds, meaning which individual accounts and their amounts have been assigned debt in addition to the hospital account?
Locken: The hospital fund is negative, so it doesn't get "assigned" debt, it is the debt. Other large negative funds include CalWorks and the tax fund.
Q. Has the SCO noted the treasury deficit problem, including any note that Modoc has not complied with state law?
Locken: The audits note the deficiencies, and the SCO accepted them.
Q. So, the SCO has not notified those state agencies affected by the misuse of treasury funds?
Locken: I don't know whether they have or not. I'm not sure they have a duty to. Our audits are available to everyone, including those state departments.
Q. Are state and federal agencies, where applicable, aware that their funds have been used for purposes different than they were intended?
Locken: They all have access to the audits.
Q. It’s inferred from your answer that neither you nor any county staff have informed the state agencies that are affected by the treasury debt?
Locken: Various agencies are aware, either because of the media coverage or because they were contacted by our department heads. The county as a whole has not sent official notifications to anyone.
Q. Have any of these agencies made demand for immediate repayment, or a plan be presented for repayment?
Locken: Not to my knowledge.
Q. Wouldn’t this indicate that the affected agencies have not been notified of the treasury misuse?
Locken: Not necessarily. All of the state and federal agencies have reporting requirements. County departments submit reports showing what funds have been expended for their programs. I imagine that as long as the departments are continuing the programs, and any funds with time limits are being spent within those limits (which we have), the state and fed departments are happy. That's basically what Auerbach vs. Los Angeles Board of Supervisors says.
Q. What, if any, impact or influence will the status of these audits have on the county’s credit rating -- if it has a credit rating?
Locken: We don't have a credit rating. The negative audits can't do any damage because there's nothing to damage.
Q. From your answer it’s inferred that Modoc County actually never formally applied for a credit rating.
Locken: We didn't follow through with the formal application process but we did ask for an informal review by at least one of the leading credit rating agencies. The result of the informal review was, try again later. This was before the 07/08 and 08/09 audits were completed.
Subscribe to:
Posts (Atom)