Federal audit faults Hometown Health management Friday, January 18, 2008 By Michael Lamendola (Contact) Gazette Reporter
SCHENECTADY — A federal audit has faulted Hometown Health’s current management operations as contributing to its near collapse as a viable health care provider in the community. The audit did not call for a management shake-up, but directed Hometown to submit a corrective action plan to the federal Department of Health and Human Services. Hometown officials said they are following recommendations in the audit to put the facility on more solid financial footing, including the integration of its pediatrics department into its family practice department. The integration has resulted in the resignation or firing of three physicians and one nurse practitioner. The audit by the federal Bureau of Primary Health Care, conducted in July, found that Hometown Health “does not appear to be financially viable as currently organized, structured and operated." It also said Hometown “lacks community support, the basic operating presumption for a successful health center.” The audit found Hometown: * Defaulted on a federally guaranteed facility loan; * Accumulated operating losses of $2 million between 2003 and 2007; * Had a $900,000 deficit as of September; * Had a cash-flow “crisis” that has contributed to its inability to meet payroll, keep a building loan current and pay vendors for medical supplies; * Saw its expenses grow 228 percent whiles its revenues grew but 95 percent between 2003 and 2006; * Saw its administrative costs increase by 83 percent between 2002 and 2006, exceeding national and New York state norms by nearly 50 percent.
* Saw its administrative costs increase by 83 percent between 2002 and 2006, exceeding national and New York state norms by nearly 50 percent.
This caught my eye. The administrative costs continue to rise right along with the operating expenses. And even while there are loans in default. And with a $900,000 deficit. Hometown Health sure has had it's share of problems. And yes Mr. Silva is now sitting on the Rotterdam Town Board.
SCHENECTADY COUNTY Audit finds clinic badly run Hometown Health debts, cash flow ‘crisis’ cited BY MICHAEL LAMENDOLA Gazette Reporter
A federal audit has cited Hometown Health’s current management as contributing to its near collapse as a community health care provider. The preliminary audit by the federal Bureau of Primary Health Care found Hometown “does not appear to be financially viable as currently organized, structured and operated.” It also said Hometown “lacks community support, the basic operating presumption for a successful health center,” and that it “masked” its poor financial performance through the use of grants. The audit did not call for a management shake-up, but directed Hometown to submit a corrective action plan to the federal Department of Health and Human Services. Hometown officials said the findings of the audit, conducted in July and sent to the facility in October, were preliminary and that a follow-up audit shows a different picture. Hometown officials said they could not release the follow-up but they are following its recommendations. The recommendations include combining Hometown’s pediatrics department into its family practice department. The merging has resulted in the resignation or firing of three physicians and one nurse practitioner. Hometown is a not-for-profit federally designated community health center that provides primary care services to a large population of people with little or no insurance. Other findings are that Hometown: Nearly defaulted on its federally guaranteed facility loan; Accumulated operating losses of $2 million between 2003 and 2007; Had a $900,000 deficit as of September; Increased its long-term debt by $800,000 since 2004; Suffers a cash-flow “crisis” that makes it unable to meet payroll, keep its building loan current and pay vendors for medical supplies; Saw its expenses grow 228 percent while revenues grew but 95 percent between 2003 and 2006; Saw administrative costs increase by 83 percent between 2002 and 2006, exceeding national and New York state norms by nearly 50 percent. Another finding was that an unidentified former dentist who worked for Hometown is under investigation for Medicaid fraud. The audit found that the dentist was “funneling private insurance patients to his private practice and Medicaid and uninsured patients to the health center.” Hometown spokesman Joe Gambino said the health care center is no longer in danger of defaulting on its loan. “We brought that up to date immediately when the auditor was here,” he said Friday. The auditor has been visiting Hometown regularly since December. The Rev. Michael Hogan, chairman of the Hometown board of trustees, said the board has confidence in Hometown’s administration and that “there is nothing that has been told to us that indicates the management ought to be replaced at this time.” TOO MANY ROLES The preliminary audit, which Hogan and Gambino said they haven’t seen, faulted Hometown for “pursuing other lines of business that distracted it from ensuring full use of its new facility on State Street. Those businesses were its contract with Schenectady County to provide medical services to jail inmates and its takeover of the Ellis clinic. Specifi - cally, the audit called “ineffective” Hometown’s strategy of “improving its financial position through growth” and that Hometown pursued these ventures without considering its federal government loan and loan approval guarantee on its State Street facility, which opened in 2005. The federal government guaranteed 80 percent of the $5.7 million loan on the project. The Community Preservation Corp. offered a $2.8 million loan; Metroplex a $1.5 million loan; and Primary Care Development Corp. $1.4 million in loans and grants. Hometown took over the Ellis health clinic in 2004 for $1 but plans to close it in February, citing financial losses. Hogan said the two ventures were “originally seen as money makers. They should have brought in some good finances and it was a way for us to be a real part of the community.” He said Hometown “ran into a lot of problems with Ellis and the jail, but as soon as we realized they would not help us, we terminated those contracts. It seems to us you have to try and if it doesn’t work out you have to be able to cut it.” The audit faulted Hometown’s board for lack of oversight over fi - nancial operations at the center: “The health center has not been financially viable for a very long time, indicating a lack of understanding and sufficient oversight of the management team.” In response to this finding, Hogan said the board put in place “a pretty good finance committee that has been working steadily.” CUTTING BACK Hogan said measures Hometown’s management is taking, with board approval, give him confidence the facility will survive as a primary care provider in the community. “We are quite furiously right-sizing. We have too many positions for the number of patients we are seeing. We are letting physicians go or accepting resignations to realign the business to the number of patients we have.” The decision to “right-size” has been controversial, especially to Dr. Kevin Karpowicz, a noted pediatrician in the community. Karpowicz joined Hometown in 2005 when it bought out his practice, becoming its vice president of medical services. In November, he resigned as vice president but remained as a pediatrician on staff. In December, he submitted his resignation, effective in April, stating that Hometown’s financial problems were overshadowing patient care. The board accepted his resignation Jan. 9, the day an article appeared in The Daily Gazette in which he stated his concerns. He said the federal audit “lays out the picture pretty clearly, and the response to it has not been consistent with what the report says.” The audit did not say Hometown should eliminate pediatrics, “at least it was not discussed with me,” Karpowicz said. “They are eliminating it basically because all the pediatric providers are leaving anyway.” He said Hometown management is blaming the providers for the facility’s problems and that they “should bear the brunt of the changes.” With Karpowicz’s departure, the remaining Hometown medical staff is bracing to handle thousands of patients with a limited staff. Hometown said its staffing levels are adequate for the current patient load. Karpowicz said he doesn’t believe this and is working with St. Clare’s Hospital to open a new pediatric service in Schenectady County by Feb. 1. However, it was announced Thursday that St. Clare’s will be taken over by Ellis Hospital under state directive; no timetable for this has been cited. “It is my feeling and St. Clare’s feeling that the children of Schenectady, especially the poor and high-needs children, require pediatric services and that is why we have taken this step,” Karpowicz said. “It isn’t to steal or take away from Hometown’s services, but to provide a service they are voluntarily relinquishing.”
Re Jan. 9 article, “Doctor says system’s financial strain affecting care”: I was saddened to read of Dr. Kevin Karpowicz’ plan to resign his position as pediatrician at Hometown Health Center. I was sickened, however, to learn that he has since been relieved of his duties immediately, under the guise of three months’ paid leave to be granted in lieu of seeing his patients and ensuring some level of continuity of care before he leaves. It is the equivalent of being dropped out of a plane without a parachute, both for Dr. Karpowicz and his patients. For over 25 years, Dr. Karpowicz and those he has worked with, fought to establish a system of health care based on a relationship between the provider and the patient. The fact that the administration of Hometown Health Center has taken this action is further proof that they aren’t interested in the well-being of the patients they receive federal dollars to serve. There have been no provisions made for the hundreds of children Dr. Karpowicz would have seen during his last months, and his exit will leave the center with inadequate staffing for the volume of patients in need of care. This is a devastating loss to our community, needlessly hastened by the actions of the CEO John Silva. To have any hope of saving the organization, Silva is the one who should be replaced, as evidenced by the many caring and talented providers who have either left to practice elsewhere or been fired due to his approach to management and his numbers-based approach to providing medical care. If you think this isn’t your problem, remember whose tax dollars are funding this rapidly crumbling organization. Remember that for people without options, our emergency rooms become primary care facilities, and long waits will become even longer when your loved one is in need of care. Remember that a community that does not take care of its children denies its own future. Take note, Hometown Health Center board members, and take action. MARY PINN Schenectady
Thank you Mary for the article. We could have waited forever for the Gazette to connect Silva's name with Hometown Health. He is the CEO after all!! Oh sure Silva's name was connected to Hometown in the past, but as of late his name seems to vanish. Perhaps this is just another dem who is in 'favor' with the metroplex.
Quoted Text
Metroplex a $1.5 million loan
Perhaps?
Rotterdam residents need to listen and watch him closely.
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
Hometown’s fi scal health not as dire as story indicated
There has been much concern recently about the financial health of Hometown Health Centers. It’s no secret: Hometown Health does struggle at times to meet its financial obligations. We make no excuses. Offering primary health care and dental services to the uninsured and underserved is not a lucrative profession, but it is a noble one, and we must do everything possible to make sure the health center survives. Regarding the Jan. 19 article, “Audit faults health center management,” an unnamed source provided Daily Gazette reporter Michael Lamendola with an early summary of fiscal findings from Hometown Health, that painted the health center in an unfavorable light. Some of the information originally reported was not accurate. For example, the person who wrote the summary has assured me it was not an audit, but more of a snapshot that needed much more analysis. After further review of Hometown Health’s books, it was determined that our financial position was much better than expected, a finding never reported in The Daily Gazette. To place Hometown Health Centers on a strong and stable financial footing, a federal consultant has been working with [our] leaders for two months. Following a review of clinical data, staffi ng, number of patient visits, productivity and, of course, revenue and expenses, the consultant found some inefficiencies and excess. Clinical productivity was low and revenues didn’t cover expenses. Right-sizing and restructuring the organization were the next necessary steps. Hometown Health, with the support of its board, is continuing to implement changes as recommended by the consultant — [they] are already improving efficiency, cash flow and the bottom line. We have always done what was needed to make sure Hometown Health remains open so we can serve the poor in Schenectady. At times we need fi nancial assistance, and we’ve always been blessed with support from compassionate and caring lawmakers. Our new plan is a blueprint for longterm stability. This is not the time to challenge change; it’s the time to embrace it. Providing the best quality medical and dental care to the children and adults in this community has always been the No. 1 priority of Hometown Health, and it always will be. THE REV. MICHAEL HOGAN Schenectady The writer is chairman of Hometown’s board of directors.
They can apply for those 'rebate' checks from the feds......there is sure footing for ya---according to Ms.Pelosi(who probably has an accountant deal with all her finances)...... ...she never had dinner at my house.....get out of my business....sorry, I went further than I thought, but, point being the Dems still think handing out $$ will make folks 'responsible'........they should look at Hometown health and that population....some folks are on hard times and others just dont make an effort(we can and have fallen into that category at one time or another),,,,but the Dems like folks fat and stupid......
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
CEO resigns from Hometown Health Centers in Schenectady Wednesday, July 16, 2008 By Michael Lamendola (Contact) Gazette Reporter
SCHENECTADY — Hometown Health Centers CEO John Silva has resigned from the financially struggling health care facility on State Street, officials said. He left the facility Wednesday. The facility’s Board of Directors appointed Angella Timothy Wednesday as interim CEO. Timothy, who is a registered nurse, has served as the health center’s chief operating officer for nearly four years. A search committee is in place and is actively recruiting candidates to fill the positions, said Hometown Health spokesman Joseph Gambino. Board President Rev. Michael Hogan said Silva made the decision to leave after discussing the proposal with the board for “some time.” Silva was not available for comment. He came to Hometown Health, then called Schenectady Family Health Services, in 2000 as a federal consultant to help salvage operations at the center. The center at the time was losing money and was about three weeks from closing. Silva became executive director within a year of his arrival in 2001. Hogan said the board retained confidence in Silva’s leadership even after a preliminary audit last year by the federal Bureau of Primary Health Care found Hometown close to financial collapse. A federal consultant has been working with Hometown since then to improve its financial health, Gambino said. “The federal representatives have made it very clear that the health center is in no danger of closing and that its federal grant funding is secure,” he said. The government provides $1 million annual toward Hometown’s annual budget of approximately $5 million. Hogan said the board regrets Silva’s departure. “He has been a rather dynamic leader,” he said.
The PLOT THICKENS!! Maddone! what the heck is going on over there. Will he skip out on town board now? What about what this means to the conservative party clout in the town board since this here means there was only one guy on that board beholden to any extent to that party leadership. This is big stuff in politics in Rotterdam now
Sal you make it sound like the dems are running the conservs. Now that just can't be...can it? And furthermore...perhaps Silva will go back to where he came from. I don't remember exactly if it was Boston or Buffalo..one of them. Or even better yet...the dems will create a position for him for, oh let's say for about $80K/year! Perhaps he could get a job with Kosiur. Ya know, taking care of the kids if they get hurt on the playground.
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
SCHENECTADY Struggling neighborhood health clinic’s leader resigns BY MICHAEL LAMENDOLA Gazette Reporter
Hometown Health Centers CEO John Silva resigned from the financially struggling health care facility on State Street, officials said. He left Wednesday, although his resignation does not take effect until October. Hometown’s Board of Directors Wednesday appointed Angella Timothy as interim chief executive officer. Timothy, a registered nurse, served as the health center’s chief operating officer for nearly four years. A search committee is recruiting candidates for the position, said facility spokesman Joseph Gambino. Board President the Rev. Michael Hogan said Silva made the decision to leave after discussing the proposal with the board for “some time.” Silva was not available for comment. He became CEO in 2002. The federally qualified health center serves the community’s poor, uninsured and under-insured and is considered a vital part of the county safety net. Hogan said Silva’s departure was not related to critical review last year of Hometown’s operations by the federal Bureau of Primary Health Care. “It is related to his desire to pursue other goals,” Hogan said. The bureau review from last July said Hometown did not appear to be financially viable as “currently organized, structured and operated.” It also said Hometown “lacks community support, the basic operating presumption for a successful health center,” and that it “masked” its poor financial performance through the use of grants. Gambino said a federal consultant has worked with the Hometown since then to improve its financial health. “The federal representatives have made it very clear that the health center is in no danger of closing” and that its federal grant funding is secure, he said. The government provides $1 million a year toward Hometown’s budget of approximately $5 million. Hogan said the board regrets Silva’s departure. “He has been a rather dynamic leader,” he said. Gambino said Silva handed in his resignation Wednesday. “Opportunities presented themselves to John and he decided now was the appropriate time to do it.” Silva, a Democrat, remains a member of Rotterdam Town Board. Town Clerk Eunice Esposito said Silva had not resigned from the board as of Wednesday. CRITICAL TURNAROUND The federal government sent Silva as a consultant to Schenectady in 2001 to help the health center, then called Schenectady Family Health Services, get out of financial troubles. The center at the time was about two weeks from closing. Within a year, Silva was leading the organization as executive director, later president and CEO. Under his tenure, Hometown improved its financial situation, even building a $5.7 million community health center at 1044 State St. in 2005. The new center replaced a dilapidated facility at 602-608 Craig St. But it never escaped financial problems, caused in part by having to deal with a significant population of uninsured and not receiving adequate reimbursement. Silva tried to expand Hometown’s market into other areas. Hometown took over Ellis Hospital’s clinic and had a contract with Schenectady County to provide medical services to jail inmates. However, it abandoned the clinic and the jail contract in short time, after losing money on both ventures.
The federal review faulted Hometown for “pursuing other lines of business that distracted it from ensuring full use of its new facility on State Street.” Specifically, the review called “ineffective” Hometown’s strategy of “improving its financial position through growth” and that Hometown pursued these ventures without considering its federal government loan and loan approval guarantee on its State Street facility. The federal government guaranteed 80 percent of the $5.7 million loan on the project. Hometown also acquired the pediatric practice of Dr. Kevin Karpowicz, a noted pediatrician in the community, in 2005. Karpowicz remained with Hometown, becoming its vice president of medical services. In November, he resigned as vice president but remained as a pediatrician on staff. A month later, he submitted his resignation have no impact to the environment stating that Hometown’s financial problems were overshadowing patient care. The board accepted his resignation Jan. 9, the day an article appeared in The Daily Gazette in which he stated his concerns. Karpowicz said the federal review laid out the picture pretty clearly, “and the response to it has not been consistent with what the report says.” Gambino said Hometown had to eliminate staff, such as pediatricians, to bring its operations in line with federal recommendations. Hometown is still following the recommendations and currently has a full complement of medical providers, including pediatricians, he said.
Everything is being pulled down and will be built back up again to the 'high standards' of government........I'm sorry but healthcare is not a toy and it is a misnomer......it is medicine.....healthcare is from personal responsibility, medicine is from doctors and nursing is from nurses........we need the days back when the doctor can confidently state"You smoke there is nothing I can do for you. You are overweight there is nothing I can do for you. You have poor hygeine there is nothing I can do for you."..........albeit there are those that are out in the world that used live in institutions before the deregulation(and there are alot), not to mention those with the 'addiction disease' and other psychosis........most of the time medicine doesn't 'cure' things it just makes things look/act like the 'normal' perception we already have of 'life as usual'......
what to do what to do........dont worry once national health care is accepted the snake oil salesman will have a field day.....no one likes to wait in line
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
Former Sunnyview head takes over Hometown Health Monday, August 18, 2008 By James Schlett (Contact) Gazette Reporter
SCHENECTADY — The former head of Sunnyview Rehabilitation Hospital is taking the helm of the financially troubled health center for Schenectady County’s poor and insured patients. Hometown Health Centers announced today that Robert Bylancik will serve as interim CEO of the federally-qualified health center on State Street. Bylancik will head the clinic until a permanent replacement can be found for John Silva, who abruptly announced his resignation last month after six years. Hometown Health is pulling Bylancik out of retirement to head the facility, which treats more than 22,000 federally-registered patients annually. Bylancik retired as Sunnyview’s president and CEO in 2007 after arranging a merger between what used to be upstate’s only freestanding rehabilitation hospital and Northeast Health, the Troy health facilities network that includes Albany Memorial and Samaritan hospitals. Bylancik already has deep ties with the county’s community and health officials. He started working at Sunnyview in 1969 as a staff social worker and became its CEO in 2000. He also sits on the Schenectady Museum’s board of directors. Silva left Hometown Health in mid-July, though his resignation does not take effect until October.
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And furthermore...perhaps Silva will go back to where he came from. I don't remember exactly if it was Boston or Buffalo..one of them. Or even better yet...the dems will create a position for him for, oh let's say for about $80K/year! Perhaps he could get a job with Kosiur. Ya know, taking care of the kids if they get hurt on the playground.
