In December 2024, TCM was owed over $350,000. During the December Nursing Home Committee meeting, TCM informed the Board they needed payment to continue services. In response, Scott Helms, Chair of the Board, and Tim Whalen, Chair of Finance and co-chair of the Nursing Home Committee, issued an RFP for a new billing company.
For over 2.5 years, TCM has provided extensive services beyond billing for Walnut Acres, including recruiting, clinical oversight, staff training, HR support, therapy services, reimbursement guidance, marketing, billing, and physical plant management. Their contributions have been critical to operations.
At the January 2025 County Board meeting, funding was arranged through an advance on the tax levy, despite earlier claims this was not possible. TCM expressed willingness to renegotiate its contract but claimed Scott Helms failed to relay this to the Board. On January 16, the Board hired MatrixCare for billing only, without addressing how TCM's additional responsibilities would be managed.
The list from TCM of how they have been helping and managing:
TCM full-time recruiter dedicated to keeping open positions filled. Nurses, C.N.A.s and all other positions.
Chief Clinical officer does site visits. Develops policies and procedures to keep up with all changing needs and new regulations.
Is a resource for all things clinical which come up every week.
Trains on clinical topics on all levels. Helps during IDPH surveys.
Audits charts for accuracy.
This resource should not be underestimated.
TCM H.R. Director
Helps with employee issues and keeping current with all new regulations which change often.
Great resource for payroll issues, union issues and grievances.
VP of therapy services.
Does site visits. Oversees the outsourced therapy vendor to keep them honest. Audits charts for accuracy. Trains entire staff in Alzheimer and Dementia care.
Is the Activity department consultant also.
Director of Clinical Reimbursement.
Is involved in weekly meetings regarding correct coding for reimbursement.
Trains on proper documentation which will pass audits.
Is involved with audits of which are always present. The government and insurance companies constantly are auditing our care and documentation.
Is a conduit between nursing and the billing department.
Chief Strategy officer.
Works with admissions and marketing and reviews trends and reports.
Billing and accounting department.
Involved with everything tied to billing and collections.
Documentation needed to get residents bills approved and paid.
Coding correctly.
Appealing denials.
Recording of all income which is received.
Communicating all changes to the department of Medicaid (HFS) for Medicaid covered residents.
Changing resident personal portions due to facility in the Medicaid system.
Sending out all bills to all payers. Mostly electronically.
Medicare quarterly statements. (reconciling)
Medicaid monthly bed taxes. Calculating how much the building owes to HFS
Generating the quarterly PBJ report to the federal and the state government. Failure to do this will cost the facility money due to fines.
TCM Property physical plant manager.
Helps the facility maintenance person with building issues.
President and CFO of TCM. Oversees the Administrator and develops goals and timelines.
Matrix Care will be paid 3.65% of billing net over the next year or a minimum of approx $13,500 and the contract will be reevaluated in one year.
At the same meeting, Marcos Perez was given a permanent position as Administrator. He has been working in that position for about 5 months as a temporary Administrator.
The full county board meeting recording is here. It starts at 1hr19min: https://www.youtube.com/watch?v=8nFrgab9VTQ
Patient census today was reported to be 49.
Essentially, Scott Helms and Tim Whalen are choosing to ignore any of the information below. They will not acknowledge any of it ever happened.
The current strategy is death by a thousand cuts. They are continuing to pay a temporary full-time Administrator $850 per day ($110 per hour). Scott Helms has set up a committee of three to interview for a permanent Administrator position. That committee is Nicole Baker, Ronnie Bush, and a person whose job depends on Scott Helms. It's astounding how hard the members against the nursing home, work to make it fail. Especially when their complaint in the past was we don't know how to run a nursing home.
Next, it seems Board member Tim Whalen wants TCM to train someone at Walnut Acres to do the billing, so they can fire TCM. His comment at the last NH Committee meeting was "If you can do it, anyone can do it". Later in the same meeting, he commented that if we build our census up, we have to hire more people.
Many more things happened at the April Nursing Home Committee meeting. For instance, Helms telling former Chair Bill Hadley he wasn't qualified to sit on the Finance Committee and a whole segment on Tim Whalen wanting to change an employee's bonus package and submit the County to a potential lawsuit.
Here's the April 2024 Nursing Home Committee meeting recording. I highly recommend everyone listen to it themselves and draw their own conclusions. Pretty crazy stuff that ultimately costs you and me money. https://www.youtube.com/watch?v=xrJYDtEpgQk
The September 2023 video clip of Chairman Helms stating progress on the potential sale AND
the October 2023 video clip of Chairman Helms again stating the progress on the potential sale
the January 2024 video clip of Chairman Helms being questioned by Jim Hart.
This section of our website is for ALL the citizens who support the long history of having a publicly-owned nursing home in our County. Walnut Acres, a.k.a. Stephenson County Nursing Center is an asset to our community, and shows that we care about our citizens, no matter what their financial abilities are.
Please review the documents posted here to help our community understand the facts about Walnut Acres and the controversy around selling it. If you continue to have questions, please email Jim Hart (County Board, District D) hartjt@comcast.net or Casey Anthony (County Board, District C) caseymjanthony@gmail.com
Take a look at this video, made by citizens in a Wisconsin County in the same battle with their County Board. Link to video on YouTube: "Why Do Nursing Homes Keep Shutting Down?".
Walnut Acres was formerly known as Stephenson County Nursing Center. It has been an important part of our county for over 169 years. It's owned by us, the citizens of Stephenson County, and currently it shows up on our real estate tax bills at approx $25 per household/per year, plus or minus depending on your real estate. $25 is the average when you divide the $500K tax levy/per year by the number of households in the County.
It's our view, that private is not always better and in the case of caring for our County's elderly and sick, it's certainly better to have direct oversight for both the patients and the employees that live and work there. After all, it's been our tradition since 1842. Here's a link to an article about its history.
The Stephenson County Board and their Nursing Home Committee oversee the facility along with a Management Company called Transitional Care Management (TCM). There is also an Administrator in the building daily overseeing operations.
On February 16, 2023, Mike Filippo, Chief Financial Officer of Transitional Care Management (TCM) gave a presentation to the Stephenson County Board. Click below in the white box for the video.
This second link is to a video presentation done by Casey Anthony on October 27, 2022, while she was Chair of the Nursing Home Committee. https://www.youtube.com/watch?v=bz1Yt_5wWb8&t=776s
Walnut Acres has been in the black every month in 2023
"As I have said dozens of times before, the business is structured to not lose money. The state has safeguards in place to make sure county-owned non-profit nursing homes won’t fail. Why isn’t anybody talking about this and how to leverage this concept to help improve the nursing home financially, operationally, and physically?" Mike Philippo, August, 2023
Why the Nursing Home Can’t Lose Money
“On the topic of “If you collect the money that you bill, and you are a County Owned Not-for-Profit Nursing Home you can’t lose. There’s a report that goes out every year, called a cost report that goes to Medicaid (State). It’s all your expenses and all your income for the nursing home. The way that the State determines the Medicaid rate for your County owned Nursing Home is they take that report and they take your expenses and they divide by the number of patient days you have and that’s your new rate. So they are basically saying you are going to break even, you can’t lose money. We are giving you credit for every dime you spent. But, they won’t give you credit for money you haven’t collected. That’s on us, on you, and everyone here. That’s on the County and the Nursing Home.
As long as a good percentage of dollars that are billed, are collected, and over the last year, our statistics tell us that we’re at 98.2% collected, which is one of our strengths of TCM, among many, there’s no reason why this building should ever fall backward and start losing money by chunks and chunks. The past was an anomaly that happened but it shouldn’t happen again.
It also offers opportunities. There’s a $500,000 tax levy (approx $25 per household), on this building and so every year the County allocates $500K to the nursing home. So, if you are doing everything we just talked about, there’s a $500K profit because you didn’t need to dip into the tax levy. You can use that money for other things. You can fix the building, you can pay higher wages, buy nursing equipment, or pave the parking lot, EVERY year. You can do whatever you want with it, there should be extra tax money.
And then when you spend that money, and you put it on the next cost report, you get reimbursed again and it’s an endless cycle every year. You can improve the building every year. Or perhaps someday the $500K or half of that levy, could be decided to be returned to the County so they can use it for something else. It’s possible.
On Jan 1st TCM started doing these profit and loss statements. Walnut Acres has been in the black every month this year. There are two ways to do accounting. One is cash basis and one is accrual. What the state requires on these reports and what we do is on an accrual basis."
Mike Philippo, CFO, Transitional Care Management (TCM)
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Referendums were held in our County in 1970 to erect the current building and also a $500K Tax Levy was voted on by the Stephenson County residents (approx $25 per household), 25 years ago, in 1998.
IL State Statute - 55ILCS 5/Div. 5-21 heading
(55 UKCS 5/5-21001) (from Ch. 34, par. 5-21001)
It takes 2/3rds majority of all members of the board, to sell, dispose of or lease for any term, any part of the home properties in such manner and upon such terms as it deems best for the interest of the county, and to make and execute all necessary conveyances thereof in the same manner as other conveyances of real estate may be made by a county.
However, if the home was erected after referendum approval by the voters of the county, it shall not be sold or disposed of except after referendum approval thereof by a majority of the voters of the county voting thereon.
Stephenson County Nursing Home, AKA Walnut Acres, uses the industry standard of accrual accounting. You cannot mix cash and accrual to "make your case" that Walnut Acres is losing money.
The fact is that TCM has written off (with board approval) a little over $1,000,000 of receivables that were easily collectible at one point and time. If that money was in the bank today wouldn’t that change the conversation? The decisions of the board were directly responsible for these dollars not being collected. Why does the board get to wash that away and simply say, sell the building, when they were responsible for the building being in the financial shape it currently is in?
Hiring TCM, during Casey Anthony's tenure as Chair of the Nursing Home Committee, resulted in the finances turning around. Casey Anthony was removed from this position when Scott Helm became the Chair of the County Board, in Jan 2023, directly because of her success in chairing that committee and the partisan wrangling to not allow any Democrats in leadership positions.
IL State Statute - 55ILCS 5/Div. 5-21 heading
(55 UKCS 5/5-21001) (from Ch. 34, par. 5-21001)
It takes 2/3rds majority of all members of the board, to sell, dispose of or lease for any term, any part of the home properties in such manner and upon such terms as it deems best for the interest of the county, and to make and execute all necessary conveyances thereof in the same manner as other conveyances of real estate may be made by a county.
However, if the home was erected after referendum approval by the voters of the county, it shall not be sold or disposed of except after referendum approval thereof by a majority of the voters of the county voting thereon.
After the State Statute was discovered and brought to the attention of the Board, in January 2023, two things happened. First, our Stephenson County States Attorney, Carl Larson gave his opinion to the State Statute. This was recorded during a County Board meeting on April 20, 2023.
After Carl Larson's opinion, the Stephenson County Board asked for the United Counties Council of Illinois' (UCCI) opinion about the State Statute. It's one page stating that Carl Larson's opinion could be right and 3 pages stating that his opinion is not the right one. That when laws are written, they typically are written in plain language. When the law says erect, it means to build, especially when there are references to real estate elsewhere in the law.
Perspective is necessary when discussing star ratings.
"The overall star rating for nursing homes lets you compare nursing homes on topics you consider most important and gives you a “snapshot” of the quality of each nursing home. The rating, between 1 to 5 stars, combines results and data from 3 important sources, including:
A star rating is calculated for each of these 3 sources, along with an overall rating.
How should I use the nursing home star ratings?
Star ratings can give you important information and help you compare nursing homes, but aren't a substitute for visiting the nursing home. Use the star ratings together with other sources of information, and review the Guide to Choosing a Nursing Home and the Nursing Home Checklist to help you think of questions to ask when you visit the nursing home and determine whether a nursing home fits you or your family members' needs."
Copied from: https://www.medicare.gov/care-compare/resources/nursing-home/overall-star-rating
The Stephenson Cursing Center Foundation no longer makes donations to the nursing home. They decided not to because the Board continued to push for a sale. As you can see from this listing of past donations, that was a very large loss to our community.
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