Pine Valley board approves write-offs, reviews finances and staffing as administrator announces departure

The Richland County Pine Valley Nursing Home Board voted to approve write-offs for a set of delinquent resident accounts after staff described delayed reimbursements and exhausted collection efforts.

Board members met in a regularly scheduled session that included the January financial report, a review of accounts receivable changes tied to a software conversion, staffing and admissions updates, and an announcement from the nursing home administrator that she will step down on March 13.

The write-offs were presented as a set of accounts with a range of reasons, including resident death and insurance denials. Finance staff told the board that a software conversion to MatrixCare delayed some December claim submissions and that several Medicaid and Medicare appeals had been lost, leaving balances that Pine Valley could not bill to residents under federal program rules. The board moved to approve the requested write-offs and passed the motion by voice vote.

“Sandy said she will step down as administrator effective March 13 and will remain in an HR role,” the administrator said during the meeting. “I will be available as a mentor under new state guidance while we search for a replacement.”

In the January financial review, staff reported an unusual pattern in cash receipts because claims from December were submitted late during the MatrixCare conversion; staff said $149,904.82 in receipts were delayed into February, itemized as roughly $33,003.44 for family care, $105,259.02 for Medicare A and $11,642.36 for Medicare fee-for-service. The balance-sheet review also noted a new reporting line for hospice Medicaid now tracked separately.

Board members and staff discussed the composition of larger credit-card and vendor payments included in the voucher report, including a $6,602.99 credit-card payment (part of which paid for a sewer cleaning machine), a $8,028.18 quarterly invoice to MatrixCare, and several maintenance and inspection invoices (for example, $4,286.08 for an annual generator inspection). Staff said these larger charges reflected annual insurance premiums, multiple payrolls in the month and other timing effects.

On accounts receivable and write-offs, staff listed individual accounts and reasons: a $2,890.90 patient-liability balance from October–December 2023 where the resident died and estate collection was exhausted; a $99.74 December 2023 co-pay with no collection promise from the resident; a $1,000 Medicare coinsurance balance from January 2023 for which an appeal was lost; a $2,863.22 recovery-audit adjustment citing lack of skilled nursing need; several small balances from 2023 with no intent to pay; and an outpatient-therapy reversal of $9,428.59 tied to a rescinded insurer authorization. Staff asked the board to approve write-offs where billing or legal collection was no longer possible.

Board members asked whether any accounts subject to write-off had real property that could be pursued; staff said they were uncertain in some cases and noted one account with a lien filed that could yield recovery if the property is sold. Directors also pushed staff on whether additional collection attempts or payment plans had been exhausted; staff answered that multiple outreach attempts and appeals had been made in most cases.

On operations, the board heard that January census averages were up: the facility reported a high of 66, a low of 61 and an average near 64 for the month, with assisted living full and nursing-home census increasing toward capacity because of short-term rehabilitation referrals. Staff said referrals were coming from local hospitals including Gundersen and from Madison-area facilities, and that Pine Valley has been using some agency nursing staff while training internal staff—sending employees to CNA classes and medication-aide courses to reduce reliance on agency labor.

Staff announced Pine Valley was accepted to receive a set of 12 robotic companion pets (a grant/selection program described in the packet) and that staff training would follow. Social-work staff Jen and Ryan were identified as the point people for admissions and authorization follow-ups; staff said they will also check whether Pine Valley can pursue a Department of Veterans Affairs contract to keep some veterans’ placements local, noting VA contracts require facility inspection and can pay less than private insurers.

The board concluded routine business with voice votes to approve the agenda and minutes earlier in the meeting and a motion to adjourn. No formal opposed votes were recorded in the meeting minutes on the motions presented.

The board will continue recruitment for a new licensed nursing-home administrator; county staff posted the vacancy and said interviews are expected in the coming weeks.