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HomeMy WebLinkAboutCorrespondence - BOCCw� �f0GA� z3')f V'k L/Rh/;�. January 25th, 2021 Grant County Commissioners Cindy Carter, Rob Jones and Danny E. Stone 35 C St NW, Ephrata, WA 98823 Re: McKay Healthcare & Rehabilitation Center — request for assistance Dear Grant County Commissioners, The Legislative delegations from Grant County which includes both the 12th and 13th Legislative Districts have been made aware of the very dire situation at McKay Healthcare and Rehabilitation Center since the advent of COVID 19. The attached letter from Erica Gaetner to Governor Inslee explains the situation more fully. Several of us have met with Erica, Bill Moss from DSHS, Legislative Staff and other stakeholders including LeadingAge Washington, a non-profit long-term care advocacy organization to learn about the needs of McKay Healthcare at this present time. We understand the serious need for financial help to continue operations at McKay until the patient census can be rebuilt after the outbreak at the facility. We will continue to work with the full Legislature and the Governor's office to secure longer- term state and federal funding as our budgets are developed. The challenge is that those funds will not be available until at least July 1", 2021 when the 21-22 Biennial Budget is passed. There is also a chance that an emergency supplemental budget could be available earlier under bills being considered outside the Operating Budget discussions, however it is not certain the funds under those bills would be available until April or May 2021. We support the request to increase the Grant County Warrant limitation under which McKay currently operates. The need for continued operation of the facility is paramount. We will do our best to include funding under the federal Cares Act and the state budget to find relief to this important facility. If you have any questions or concerns, please free to contact us. Sincerely, _ r►R Senator Judy Warnick 13th Legislative District Representative Tom Dent 13'' Legislative District Senator Brad Hawkins Representative Mike Steele 12a' Legislative District 12`h Legislative District Y'6�z � Representative Alex Ybarra IP Legislative District Representative Keith Goehner 12'h Legislative District Barbara Vasquez From: Banuelos, Cynthia <Cynthia.Ban uelos@leg.wa.gov> Sent: Tuesday, January 26, 2021 10:15 AM To: Danny E. Stone; Robert Jones; Cindy Carter Cc: Barbara Vasquez Subject: RE: On behalf of WA State Legislators Attachments: 1.25.2021 Grant County state legislative delegation to Grant County Commissioners.pdf Good morning, Attached is a corrected letter. Please disregard the first one. Thank you, 6qffla F""&d Legislative Assistant to Senator Judy Warnick PO Box 40413 Olympia, WA 98504-0413 (360) 786-7624 1 cynthia banuelosWeg.wa.gov Please click here to sign-up for Senator Warnick's e -newsletter! SENATE REPUBLICAN CAUCUS t nrrwa FarAN of Please be aware that any email or documents you provide to this office may be subject to disclosure under RGW 42.56. If you would prefer to communicate by phone, please contact our office at (360) 786-7624. From: Banuelos, Cynthia Sent: Tuesday, January 26, 20219:57 AM To: destone@grantcountywa.gov; rjones@grantcountywa.gov; ccarter@grantcountywa.gov Cc: Barbara Vasquez <bvasquez@grantcountywa.gov> Subject: On behalf of WA State Legislators On behalf of WA State Legislators please see the attachments. Thank you, &a4F""'ad Legislative Assistant to MCKAY j.. Healthcare & Rehab January 12, 2021. Honorable Jay Inslee, Governor Office of the Governor of Washington State PO Box 40002 Olympia, WA 98504-0002 Re: McKay Healthcare and Rehabilitation Center - request for assistance Dear Governor Inslee: We are writing to request financial assistance due to significant loss of income caused by a recent Covid-19 event at McKay Healthcare and Rehabilitation Center (McKay Healthcare) located in Soap Lake, Washington. McKay Healthcare employs approximately 50 people with good paying jobs in the small rural community of Soap Lake, WA. McKay Healthcare is the second largest employer in this community of 1500 people. The median incomes in Soap Lake and neighboring rural communities are among the lowest in the state. About 80% of the residents served by McKay Healthcare qualify for Medicaid. After maintaining a Covid-19 free facility for nine months, Covid-19 finally found its way into our facility in November 2020. It swept through our residents and staff practically overnight. Due to the impact Covid-19 had on our nursing staff, 24 out of 31 residents tested positive and had to be transported to a Covid-19 cohort facility in Pasco, WA. Sadly, several residents passed away at this facility. The few nursing staff who were not sick with Covid-19 stayed to care for the remaining residents who were not Covid-19 positive, some working 24-hour shifts. They are an amazing crew of incredibly dedicated people. While our staff have recovered and our resident population has partially rebounded, no other facility in Washington State has been so severely impacted. Because of this outbreak, McKay Healthcare's census declined by 75% in November. Census is rebuilding but is only at 40% of capacity at the end of December, 2020. As a result of the outbreak, operating losses in November, December and January 2021 are projected to exceed $500,000. We are hoping that access to vaccines will stabilize our resident population and prevent future outbreaks after January, 2021, but access to vaccines has been too slow. To date, they have not been made widely available to staff and residents. Census development is slow because current Covid-19 quarantine rules prevent us from taking on more than 4 residents every 14 days. Also, we are required to maintain 3 rooms for emergency isolation in the event of a second outbreak. These restrictions are more pronounced at our facility than at others because of its small size and uncommon room configuration, dating back to when the facility was built 80 years ago. We only have 2 dedicated single rooms, 12 127 2nd Ave SW I PO Box 819 1 Soap Lake, WA 98851 1 509-246-1111 1 www.mckayhealthcare.org double rooms, and 5 triple rooms. Given our small size, without vaccines widely available for residents and staff, these restrictions make it impossible for McKay to generate a positive cash flow. Based on the operating losses we have incurred and are projecting, McKay Healthcare faces an imminent risk of closure without a significant infusion of capital. Cost cuts are also one of the tools used to extend our ability to operate, but we cannot afford to lose a single nurse. And it is gut wrenching to ask staff to reduce their hours of work who just a month ago worked tirelessly to care for our residents to keep McKay open. But those are the hard decisions facing McKay Healthcare and other skilled nursing homes around the state who provide a vital service so families can be near their elderly family members in need of skilled nursing care. The loss of McKay to our rural farming community would be devastating and compound the unavoidable impact Covid-19 has had in our communities. In addition to the loss of 50 good paying jobs, it would force local loved ones further from their homes, families and deep roots they planted. We have seen first-hand how unfamiliar surroundings can adversely impact our elderly. Because of the loss of other nursing homes in Grant, Lincoln and Adams counties, the loss of McKay would be felt regionally. We understand that there are funds from the federal government that haven't been distributed to places in need. My plea in this letter is for you to recognize the dire straits of McKay Healthcare, and the plight of other skilled nursing homes in the Washington state who have experienced a significant loss in resident census and loss of income because of a Covid-19 outbreak. These losses can't be made up from the federal and state payments systems. Also, nursing facilities are facing rising Covid-19 response costs and rising costs of labor due to statewide nursing staff shortages. While we understand other groups who are in need, no other population has been impacted more than our frail elderly. We are asking for a one-time grant of $500,000 to offset the losses from our Covid-19 outbreak and to prevent the closure of McKay Healthcare. Thank you for your consideration of our urgent request. Sincerely, . L�►}-� r�2N Erica Gaertner LNHA, RN Cc: Bill Moss, DSHS Peter Graham, DSHS Eric Mandt, Office of Financial Management Deb Murphy, Leading Age, Public Hospital District Commissioners 2 M C K A Y HEALTHCARE &REHABILITATION CENTER FACILITY MASTER PLAN CRITICAL FACILITY NEEDS imi MCKAY EMERGENCY GENERATOR Scope of work: The current back-up generator is a diesel -powered generator, likely installed in the 1960s. Annually, the generator is subjected to'load-testing'and the maintenance manager has informed administration that the testing has been less than stellar but due to the age and finances of the facility, the inspector performing the load tests has been marked in our favor but is not safe or likely to continue. There are 2 types of load testing done on the current generator, a'light-load'and a'heavy-load'- the current generator is passing light -load tests the majority of the time but is unable to pass heavy -load tests all the time. The entire project will include, but not limited, the following broad tasks: • Likely asbestos -testing and removal of the'historical' incinerator • NEW, minimum 100 -watt encased generator with warranty to be installed on concrete pad, formerly occupied by the incinerator • Electrical work to include new control panel, adding the walk-in and freezer units to the new generator, and routing new electrical out to the generator • Decommissioning old generator to include disconnection from gas and electrical, draining of generator fluids, and rendering the unit unusable • Decommissioning the 2 diesel tanks underground which will be likely be by removal vs. filling with sand • Construction review as required by state • Engineering consult for further details and scope of project As of this writing (2/18/2020), the engineer is pending an onsite visit with the maintenance manager for the initial steps and future requirements for this large but critical need of McKay. It would not be a surprise if this entire project is estimated at $350,000-$400,000 for ALL required elements. MCKAY LAUNDRY DEPARTMENT Scope of work: Currently, the laundry department is running off 1 commercial washing machine and 2 electric dryers that are being held together with baling twine and duct tape. The department manager informs the Board that the 2 current dryers must be run for extended periods of time to properly dry resident clothing and linens as many heat coils are no longer functional and no parts are available due to the age of the units. A second washer was installed and functional in years past but a new unit must be'soft-mounted' in order to not wear through the flooring related to daily use. A request to purchase and install 1 washing machine and 2 electric dryers were obtained from 2 sources: Western State Design (2/18/2020): Option A quote -1 Milnor 601b washer and 2 Dexter 801b electric dryers = $29,935 Option B quote -1 Continental 601b washer and 2 Dexter 801b electric dryers = $27,896 Dynamic Sales and Service (2/18/2020): 1 UniMac 551b washer and 2 UniMac 751b electric dryers = $29,048.84 In reviewing the available quotes, each is offering similar 5/3 year warrantees on the unit, installation, and parts. The capacities for each are very similar. There is not a exclusive need to use either companies' chemical products with the quoted units. At this time of writing, Dynamic Sales and Service has offered the quote at a reduced cost of $2,338.00 as they currently have the 2 electric dryers in stock, ready to install. All quotes include freight, install and tax. The department manager expresses a desire to work with Dynamic Sales and Service as the company works out of Spokane, closer than Western State Design from Hayward, California. Past experiences with Dynamic Sales and Service have been favorable and they are prompt in arriving to repair units in the laundry departments. MCKAY TRANSPORTATION VEHICLE Scope of work: McKay no longer has a handicap -accessible bus to transport residents to either doctor appointments, dialysis appointments, scheduled outings, or recreational activities. While the current resident needs are being adequately fulfilled by local resources including People for People, MedStar, GTA and even taxi services, those who are essentially facility -bound have been unable to leave the premises (unless for a scheduled appointment) since the most recent bus was rendered unusable after a 2019 traffic accident. With the upcoming summer months, the Activities department will be looking to get residents out and about in the Columbia Basin and will require transportation geared to their comfort and specialized use. Judy Spencer, current Board member, a long-time advocate for residents and previous employee of McKay Healthcare and Rehab has been working to find a replacement van that includes the minimum following features: • 4 or more wheelchair spots • Seating for 4 or more ambulatory residents • Bariatric capacity lift • Back-up camera • AC and heat Other proposed ideas have been to inquire at Barry Chrysler for financial assistance in obtaining a new or newer bus, utilizing the approx $14,000 dollar insurance pay -out for the value of the previous bus to'match'any donations made towards purchasing a new or newer bus, or applying for a grant to purchase another new or newer bus. Currently, there are no quotes available to attach to this plan (2/18/2020). MCKAY KITCHEN EQUIPMENT Scope of work: Much of the equipment and facilities currently in use in the kitchen are old enough that parts and repair are becoming scarcer and harder to come by. The kitchen has multiple, small items and equipment requiring updating and replacement that, once taken wholly, calculate up to a hefty price tag. Currently, Direct Supply is the main contracted supplier for McKay, we have a many -year working relationship with this supplier with competitive market rates. Direct Supply (numbered in order of need; does not include shipping and tax): 1 Hot and cold carts - Need 1. #M0314- $15,899.00 each $15,899.00 2 Trays for the new carts -We'd need 1 case as our trays for the old carts are not the same size. $924.00 #4131-102, $924.00 case of 24 3 4 -well Portable Aarohot 208v Steam Table -This is ideal as it has the ability to be moved $2,132.00 anywhere and cleaned well. #27357 4 Hobart 5 -qt. mixer -This is a common name brand, easy to repair and find parts for. $3,079.47 5 Hobart 12 -qt. mixer- #77740 $5,056.00 6 T & S pre -rinse unit, wall mount faucet -This is for the vegetable sink. #4708D $520.99 7 Hand washing sink - The pedestal broke on our old one so we got an old one from the $276.99 basement. The porcelain is worn off so it cannot be cleaned properly. It looks unsightly. #10416 8 3 -compartment sink with drain on both sides -Ours is cracking and leaking. #10327 $1,506.00 9 Hydration station - For room to room service with the ability to have multiple items $4,237.00 including condiments up and out of reach of residents with cognitive impairment. Mart Cart #2HH29 (Blue) 10 Beverage Station to remain in the main dining room -Currently we have coffee and water sitting $1,242.00 on a really nice cabinet and it is being ruined due to leakage. This cart would blend well with the other furnishings in the room and is made to withstand spills. #2VD35 (Cherry Mahogany) 11 Robot Coupe 3 -qt. processor with stainless steel bowl - #77761 12 Fiesta Ware 9" plates, case of 12 -We will need 6 cases. #21`408 $198.99 case 13 Slotted top Dunnage Rack - Need 4 for emergency water supply and current use supply storage. It cannot be stored on the floor, which is exactly where it is currently stored. #2J400, $170.99 each Home Depot: $1,308.00 $593.94 $683.96 1- Wall mount faucet center swivel gooseneck, preferably 20" high, as ours has leaked for a long time. Not sure of the cost but around $200.00 Other items on the kitchen list include: 1- Connect the walk-in fridge and freezer to remote temping so if it goes down in the middle of the night, we can be alerted and do something with the food before it is in the'danger zone'temperature too long and we have to throw food items away. This has occurred and hundreds of dollars' worth of food was lost. 2- Would also like a new center work station as the drawers are worn out and are very heavy to open or close. MCKAY RESIDENT ROOM WINDOW SHADES Scope of work: While resident rooms at McKay generally have large windows and good views, they are a source of either intense sun/heat during summer or a great loss of heat in winter even with large heat registers under most windows. Simple vinyl mini -blinds are not effective in managing heating and cooling costs for the facility and a quote for blackout shades for every resident room was obtained from Phoenix Textile. Phoenix Textile (2/18/2020): Translucent cell shades in'Sunbeam'- $8,500.00 Does not include freight Does not include tax (7.9%) Does not include installation and hardware Pending a quote for blackout shades in'Sunbeam' MCKAY UNIT CONVERSION & MEMORY WING ADDITION PROJECT Scope of work: Project includes re -configuring existing triple and double room units into single and double units and expanding the healthcare center to replace removed beds into 17 rooms in a memory care wing. The existing rooms shall only be reconfigured as far as allowed to maintain grandfathered regulations, while new units will meet all current codes and standards. HVAC, electrical, plumbing, and sprinkler systems will need to be carefully coordinated between existing and new equipment to provide required services for new and existing rooms. Expansion shall take into consideration future plans of McKay Healthcare and Grant County Public Hospital District #4. Current Cost Estimate: Approx. 5.5 million (Kovach Architects, Aug. 28, 2019) Existing Building includes: 42 beds in 19 rooms 2 single rooms 11 double rooms 6 triple rooms Proposed conversion includes: 25 beds in 19 rooms 13 single rooms 6 double rooms 0 triple rooms Additional items needed: • Blueprints for required construction review for state approval • Promissory notes in hand, may be necessary for grant approval • Grant writing assistance This has been identified as a critical need but is not to a refined stage to request any funding for at this current time (2/18/2020). FACILITY UPGRADES CONSIDER MCKAY BARBEQUE / RESIDENT OUTDOOR AREA Scope of work: While currently serviceable, the resident BBQ area requires expanding and updating to offer more space for multiple wheelchairs, shade/sun protection, and an updated walking path to allow residents more time to enjoy and refresh in the outdoors.The current age and condition of trees provides relieving shade and landscaping beauty and are adequately spaced to allow for some minor improvements in beautification and improving resident access. The following are some major points to improving the outdoor area: • Replacing current asphalted'walkway'with concrete • Extending wide walkway around inside perimeter of fencing with concrete • Resurfacing current concrete stop and ramp to smooth out surface • Extending concrete around current BBQ area and around one tree • Adding an adequate, temporary, unwired/unplumbed storage shed to house patio furniture, BBQ and other outdoor entertaining supplies during the winter months • Adding on to existing, permanent canopy/pergola to replicate current structure providing aesthetic continuity • Removing rotten planters/beds • Adding landscaping bark to areas not serviced by current UGS to decrease weeds • Removing shrubs/bushes not adequately serviced by current UGS • Adding a timed, drip irrigation system to new planters/beds and provision of adequate number of appropriate hoses to keep current landscaping looking well-nourished • Possible construction review for walkway Currently, there is no available quote for this work. Administration has tasked the Activities Manager in contacting Job Corps for the bulk of the concrete work which may include schematics, quotes for supplies and possibly labor and could be done as early as spring. MCKAY ACOUSTIC CEILING TILES Scope of work: The last full ceiling the replacement project was completed in 1967 according to records. The current tiles are old, stained, and although the sizes are standard, the material and pattern are not able to be matched with current styles available. Only changing part of them with a different style would not match with the upgrades we are attempting to make within the facility. A full replacement would be time intensive but, in the end, the overall aesthetic would be well -worth the effort. Currently, there are no active quotes to provide on ceiling tile replacement (2/18/2020). MCKAY FLOORING Scope of work: Asbestos tiles were used heavily from 1920-1960 and faded from use in the 1970-1980 era. Today, no flooring utilizes asbestos as it is now known the damage asbestos does to the lungs. Currently, McKay has 9x9 tiles and based on the most recent records indicating any kind of flooring remodeling was done in 1967, it is strongly likely that the current flooring contains asbestos. Mitigating asbestos removal can be a long, expensive process compounded by the presence of a vulnerable population residing in the facility. In June of 2016, it was recommended by the then LNHA that the best way to mitigate this was to cover the floor entirely with new flooring. A few excellent brands that manufacture flooring specifically for heavy use industries such as nursing homes and long-term care facilities are Armstrong, Karndean, and Patcraft. They have multiple designs and colors, all designed to withstand years of heavy rolling loads (beds, Hoyer lifts, wheelchairs, gurneys, etc.) and gouge/scuff/scratch resistant. With a total square footage of 22,350, the estimate to purchase and install new flooring throughout the facility would be approximately $ 2.50-3.00/sq. foot ($55,875-$67,050). Currently, there are no active quotes to provide on flooring (2/18/2020). McKay Healthcare [Past - Present - Future] November December January February March April May lune July August Sept Oct Nov Dec Days in Month 30 31 31 28 31 30 31 30 31 31 30 31 30 31 Mcd Days - PPD 7.33 9.77 12.00 14.00 16.00 16.00 16.00 16.00 16.00 16.00 16.00 16.00 16.00 16.00 Mcd Rate $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 $ 225.77 Private Days - PPD 1.60 2.03 2.00 2.00 3.00 3.00 3.00 3.00 4.00 4.00 4.00 4.00 4.00 4.00 Private Rate $ 262.50 $ 259.84 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 $ 258.00 Medicare Days - PPD 0.13 1.52 2.00 2.00 2.00 2.00 3.00 4.00 4.00 4.00 4.00 4.00 4.00 4.00 Medicare Rate $ 663.17 $ 679.36 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 $ 550.00 Total Days - PPD 10.00 14.35 17.00 19.00 22.00 24.00 27.00 30.00 33.00 35.00 37.00 37.00 37.00 37.00 Avg Routine Revenue $ 237.48 $ 300.50 $ 240.00 $ 240.00 $ 240.00 5 240.00 $ 240.00 $ 240.00 $ 240.00 $ 240.00 $ 240.00 $ 240.00 $ 240.00 $ 240.00 Total Revenue $ 256.48 $ 319.50 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 $ 259.00 Total Routine Rev (MO] $ 76,944 5 133,721 $ 136,493 $ 137,788 $ 176,638 $ 186,480 $ 216,783 $ 233,100 $ 264,957 $ 281,015 $ 287,490 $ 297,073 $ 287,490 $ 297,073 Special Revenue $ 278,528 Net Inc - MO (Loss] $ (214,649) $ 117,878 $ (32,268) $ (25,109) $ (25,915) S (16,616) $ 12,444 $ 26,819 $ 4,947 $ 12,606 $ 9,892 $ 14,419 $ 9,892 $ 214,419 Net Inc [i.oss)-YTD $ (156,522) $ (38,644) $ (70,912) $ (96,022) $ (121,937) $ (138,552) $ (126,109) $ (99,289) $ (94,342) $ (81,736) $ (71,843) $ (57,424) $ (47,531) $ 166,888 Analysis of County Debt November December January February March April May June July August Sept Oct Nov Dec County Debt $ (449.134) $ (460.499) County Cash $ 103,962 $ 136,719 Adj for Voided Checks County Debt Protection Resident Cash Collected From Budgel $ 175,547 $ 123,260 $ 133,721 $ 137,606 $ 136,753 $ 174,064 $ 181,803 $ 216,758 $ 237,730 $ 268,314 $ 282,112 $ 286,365 $ 295,910 $ 286,365 Other Corrections NSF Correction Payroll al $ (85,855) $ (81,323) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) Payroll a2 $ (81,646) $ (78,403) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) $ (85,000) Payroll a3 $ (86,325) $ (85,000) $ (85,000) Extra Payroll Accts Payable [Net of Cancelled Warr $ (126,929) $ (137,463) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) $ (120,000) County Interest $ (1,007) $ (1,047) $ (1,522) $ (2,013) $ (2,511) $ (2,900) $ (2,701) $ (3,267) $ (3,389) $ (3,640) $ (3,747) $ (3,737) $ (3,432) $ (3,731) Proshare Money $ 278,528 $ 46,000 $ 46,000 $ 46,000 $ 46,000 5 46,000 $ 46,000 $ 250,000 Property Tax Collections $ 18,902 $ 4,166 $ 7,289 $ 2,414 $ 26,986 $ 115,237 $ 29,472 $ 4,530 $ 2,197 $ 2,636 $ 13,793 $ 72,317 $ 18,902 Net Debt [EOM] 5 (345,173) $ (323,781) $ (428,292) $ (534,285) $ (617,057) $ (574,656) $ (695,082) $ (721,061) $ (774,523) $ (797,214) $ (795,056) S (730,110) $ (793,730) $ (551,095) Resident AR [Goa1250k $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 $ 175,000 Accounts Pa able $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216,000 $ 216000 $ 216,000 Expense $ (170,000) $ (170,000) $ (170,000) $ (170,000) $ (255,000) $ (170,000) $ (170,000) $ (170,000) $ (170,000) $ (170,000) $ (255,000) $ (170,000) Notes* McKay ended 2019 with a net loss of $484,879 Medicare census still under budget; Medicare census is the special sauce to your success. McKay received federal grant money in May in the amount of $155,000 McKay Received federal grant money in August of $70,900 and DSHS funds of $2,678 Projected Proshare recepts In December of 250k Census tanked in November due to positive COVID cases Planning on rebuilding total census by 3 per month McKay Healthcare [Past - Present - Future] Notes: McKay ended 2019 with a net loss of $484,879 Medicare census still under budget; Medicare census is the special sauce to your success. McKay received federal grant money in May in the amount of $155,000 McKay Received federal grant money in August of $70,900 and DSHS funds of $2,678 Projected Proshare recepts in December of 250k Census tanked in November due to positive COVID cases YTD 2018 YTD 2019 July August September October November December January Days in Month 31 31 30 31 30 31 31 Mod Days - PPD 30.15 27.61 25.94 25.94 25.43 25.52 6.83 10.00 15.00 Mod Rate $ 175.35 $ 175.56 $ 231.27 $ 223.27 $ 223.27 $ 225.77 $ 225.77 $ 225.77 $ 225.77 Private Days - PPD 3.97 4.41 5.61 4.03 4.46 5.06 1.60 2.00 3.00 Private Rate $ 249.38 $ 257.10 $ 254.34 $ 257.23 $ 258.46 $ 254.70 $ 262.50 $ 258.00 $ 258.00 Medicare Days - PPD 2.04 2.13 1.39 1.84 0.53 1.13 0.10 1.00 2.00 Medicare Rate $ 522.03 $ 581.58 $ 599.83 $ 624.92 $ 653.22 $ 655.19 $ 640.79 $ 550.00 $ 550.00 Total Days - PPD 38.10 34.06 33.94 33.23 31.83 31.71 9.70 14.00 21.00 Avg Routine Revenue $ 249.38 $ 209.03 $ 250.02 $ 267.94 $ 238.82 $ 245.56 $ 236.11 $ 240.00 $ 240.00 Total Revenue $ 268.81 $ 228.03 $ 269.02 $ 286.94 $ 257.82 $ 264.56 $ 255.11 $ 259.00 $ 259.00 Total Routine Rev [MO] $ 297,788 $ 240,799 $ 283,011 $ 295,547 $ 246,219 $ 260,063 $ 74,236 $ 112,406 $ 168,609 Special Revenue $ 250,000 NetInc -MO [Loss] $ 90,799 $ (26,735) $ 11,414 $ (61,973) $ (28,363) $ (245,764) $ 42,406 $ (151,391) Net Inc [Loss] -YTD $ 135,468 $ (517,651) $ 137,049 $ 148,463 $ 86,490 $ 58,127 $ (187,637) $ (145,231) $ (296,622) Analysis of County Debt 12-2018 December July August September October November December Jamuary County Debt $ (232,824) $ (401,121) $ (248,711) $ (393,105) $ (320,316) $ (324,867) County Cash $ 10,575 $ 9,904 $ 87,382 $ 152,522 $ 29,579 $ 80,683 Adj for Voided Checks County Debt Protection Resident Cash Collected $ 299,021 $ 243,473 $ 270,342 $ 217,106 $ 301,802 $ 241,386 $ 68,707 $ 104,160 Other Receipts $ 73,578 NSF Correction $ 9,159 Payroll #1 $ (80.178) $ (91,320) $ (86,230) $ (81,956) $ (77,177) $ (65,000) $ (75,000) $ (80,000) Payroll a2 $ (78,006) $ (93,447) $ (81,700) $ (91,583) $ (85,714) $ (80,000) $ (80,000) $ (80,000) Payroll b3 $ (93,186) Extra Payroll $ (3,905) Accts Payable [Net of Cancelled Warrants] $ (83,371) $ (116,031) $ (266,671) $ (106,723) $ (163,909) $ (140,000) $ (140,000) $ (140,000) County Interest $ (1,669) $ (149) $ (370) $ (791) $ (766) $ (1,148) $ (1,217) $ (1,111) Proshare Money $ 158,501 $ 250,000 Notes: McKay ended 2019 with a net loss of $484,879 Medicare census still under budget; Medicare census is the special sauce to your success. McKay received federal grant money in May in the amount of $155,000 McKay Received federal grant money in August of $70,900 and DSHS funds of $2,678 Projected Proshare recepts in December of 250k Census tanked in November due to positive COVID cases