Stephenson County panel advances two bidders for nursing center billing; approves advance to cover TCM invoices

The Stephenson County Finance Committee on Monday advanced two finalists for billing, collection and consulting services for the Stephenson County Nursing Center and approved a resolution to advance nursing-facility levy funds to pay outstanding invoices to Transitional Care Management (TCM).

Committee members reviewed four proposals in response to an RFP for billing, collection, accounting and consulting: Hayward Financial Group, CC and M, AGT (identified in the packet as a nonnursing billing firm), and Matrix (MatrixCare/affiliated vendors). After presentations and discussion about experience, integration with the nursing center’s electronic health record and fees for handling outstanding accounts receivable, the committee directed staff to seek more information and move Hayward Financial Group and Matrix forward for further review ahead of full-board action.

The vote to advance the two finalists was recorded as committee consensus rather than a roll-call decision; no final contract was awarded Monday. County staff and several committee members emphasized the need for clearer performance metrics from proposers, including clean-claim rate, days in accounts receivable, net collection rate and reconciliation procedures.

“Hayward Financial Group is dedicated to supporting Stephenson County as a community asset,” Malasia Hayward, CEO of Hayward Financial Group, told the committee during her presentation. “We will implement a streamlined process… and provide monthly and annual reporting that offers full transparency and insight into financial performance.”

Committee members discussed three cost models among the proposals: billing-on-going-net-billings percentages for future billings, and higher contingency percentages for pursuing older outstanding receivables. Matrix’s proposal included a blended approach: a higher contingency fee (quoted in the proposal for older receivables) for collections on aged accounts and a smaller ongoing percentage for billings going forward; committee members asked staff to clarify exactly which receivables would be subject to the higher contingency fee.

County staff also reported longstanding reconciliation problems with the current TCM contract and an aging accounts-receivable backlog. The committee approved a resolution authorizing an advance on Fund 113 (the nursing-facility real-estate tax levy) to cover approved, outstanding payable amounts to TCM. County staff said they negotiated a $24,000 reduction in the amount owed to the vendor and that “payment would be issued to TCM on Friday,” as described in the meeting; the committee approved the advance and the item will go to the full county board for final action later this week.

Public comment at the meeting included multiple speakers urging the county to keep the nursing center in public ownership and to continue TCM’s management roles. Ed Klein, a resident, told the committee the nursing center moved back to a stable financial footing after TCM became the full-time management team and asked the board to publicly commit that “the nursing center is not for sale.” Other speakers, including Lynette Williams and Allison Bridal Khan, said they preferred retaining TCM’s services while the county resolves billing and accounting issues.

Committee members and staff asked vendors for more detail on transition plans and on how proposed systems would reconcile billed amounts with cash actually deposited to the county account. Several members said they want any future vendor contract to enable reconciliation on a collections (cash) basis rather than purely on billed accruals.

The committee did not award a contract Monday. Staff will return with follow-up information on the two recommended bidders and with clarifications about fees for aged receivables before the full board considers a vendor contract.

Votes at a glance: The committee recorded voice approvals on several routine and specific items during the meeting. Where roll-call tallies were not taken, outcomes are reported as committee voice votes.

- Resolution: Advance of Fund 113 (nursing-facility real-estate tax levy) to pay approved outstanding invoices to Transitional Care Management (TCM). Outcome: approved by committee; staff said payment to TCM will be issued on Friday. Notes: staff reported a negotiated $24,000 reduction in the outstanding amount; full board will consider the resolution Thursday.

- Approval to accept RFP respondents and advance Hayward Financial Group and Matrix for additional review and negotiation. Outcome: committee consensus to move both firms forward for more due diligence; no contract awarded.

- Other routine approvals taken earlier in the meeting (agenda, minutes, committee claims and department claims) were approved by voice vote; those routine claims were not the subject of extended debate.

Why this matters: The county nursing center’s billing performance and accounts-receivable backlog affect cash flow for facility operations. The choice of a billing and revenue partner, contract terms for collecting aged receivables, and whether the county continues TCM’s management role all bear directly on the center’s short-term liquidity and long-term viability.

What’s next: Staff will collect additional performance data from the two finalists and return to the full county board with recommendations and contract language. The levy-advance resolution approved by the committee will go before the full board later this week.