The Commission has met twice in extended (recessed) meetings since our initial monthly meeting held on Monday, January 27th. FYI - For an additional meeting resulting from a recessed meeting, the Commissioners get no additional pay, as it is considered only a lengthening of the regular meeting. The focus of these extensions was to update the commission on the hospital situation. Several problems had been brought to our attention, including the possibility of Progressive not being able to make payroll.
The revelations that came out of the meetings were shocking from a business perspective. The Commission has not been briefed on any financial issues surrounding the hospital since summer 2019, even after multiple requests from Commissioners.
It now appears that the Mayor has been aware of various problems and has discussed such with Progressive, our attorneys and the Hospital Board. Mayor Creasy has known the depth of the financial problems and has chosen not to share that information with the Commission as a whole.
Last January, Progressive Medical signed a management agreement with Decatur County as a precursor to the purchase agreement for the hospital. To date no purchase agreement has been signed. Dr. Gezim Agolli, who heads Progressive, was present at the meeting on January 30th, but would not commit to signing the purchase agreement.
Dr. Agoli told the Commission that he could not make payroll unless funds were released from BCBS payments which he claimed were due. At this meeting, the Commission voted to fund payroll if Progressive did not meet their financial responsibility on Monday, Jan. 3rd.
As Progressive did not meet this deadline, the county was obligated to fund the payroll for hospital employees as the facility is still a county asset and the county is ultimately responsible for its operation and financing.
Attorney Tracy Powell has sent a letter to Progressive stating that they have breached their agreement and listed 6 specific items of breach. Legally, Progressive has 30 days in which to fix these problems. After 30 days, if the breach has not been “cured” (or fixed), the County can consider the agreement broken and choose to withdraw the agreement.
We learned that the hospital has been under an audit by BCBS and they claim to have identified $1.6 Million in fraudulent billing submissions. BCBS has told CEO Melinda Kirkwood that it is looking to recoup $1.6 Million in payments for billings that they deem to have been fraudulent.
The payments due from BCBS submissions – those expected receivables which Dr. Agoli had referred to - totaled $1.2 Million. Payment for these submissions have been temporarily halted until some resolution is agreed upon with BSBS.
The Commission has repeatedly asked Mayor Creasy for financial reports for the hospital but to date no information has been forthcoming.
We were initially told that the hospital’s had cash-on-hand of $14,000, however this was prior to pending bills due, as well as payroll. Thus, cash-on-hand was considered to be null.
On Monday, Feb. 3, we were told payroll due amounted to $110,000. Later in the discussion we discovered that this figure did NOT account for payments due other payroll entities, such as Federal Tax Withholdings or Retirement Contributions.
When questioned about these additional payroll items, the Commission was told that NO Federal Tax Withholdings, FICA, or Retirement Contributions had been paid since May of 2019.
As Commissioner, I am outraged at the lack of fiscal responsibility of those we have entrusted with the operation of our county-owned hospital. Progressive, as the contracted manager, should have made these payments or should have let the Commission know that there were serious financial problems.
The hospital’s charter dictates that its operational authority is through the Hospital Board of Trustees. They are responsible in overseeing daily operations and are to report to the County Commission as to the financial status or legal issues of the facility.
As mayor of Decatur County, Mike Creasy is a de-facto member of every board and committee, including the Hospital’s Board of Trustees and the County Commission’s Hospital Committee. Additionally, Mayor Creasy is named in the management contract with Progressive as the official legal representative of the county and Hospital Board of Trustees. As such, it is his responsibility to interface with Progressive on the county’s behalf and report back to the Board and the County Commission of all aspects with the hospital until the purchase agreement is complete.
Mayor Creasy has not done this. He has not reported any problems to the Commission, even though he has known the financial issues on a weekly basis, according to testimony of hospital’s CEO, CFO, and Dr. Agoli.
In our meeting of November 2019, Mayor Creasy presented the Commission with a bill of $97,000 from the IRS which, he stated, was due in fines and penalties for late payments in earlier years. The Commission had no option but to authorize payment for these IRS fines/penalties.
We now understand that these penalties occurred during the time when Mayor Creasy was functioning as hospital CEO.
Knowing that this is a costly mistake for the County, Mayor Creasy failed to implement a system that guaranteed this would not happen again. He also failed to follow up with Progressive to ensure these federal payments were being done properly to avoid fines and penalties again.
The CEO and CFO inform the Commission that outstanding IRS payments now stand at approximately $650,000 before penalties and fines.
Due to the apparent incompetence of the management of the hospital’s finances, Commissioner Kevin Cagle proposed that the Commission hire a forensic accountant to investigate the entire financial structure of the hospital. The Commission unanimously agreed and appointed members of the Commission’s hospital committee to engage a professional forensic accountant.
We will reconvene for our regular monthly meeting on Monday, February 24th. I hope that we will have more information on the financial status as well as Progressive’s role going forward.
The Tennessee General Assembly has passed several new laws that are now in effect as of January 1, 2020. The bulk of the laws expand existing statutes with additional language that enhances the scope of the rights and protections of citizens. Knoxville’s NBC affiliate WBIR provides a review of these new laws below:
Starting Jan. 1, 18 new laws will take effect in Tennessee. Legislators passed laws to address opioid abuse, protect elderly people from abuse and much more.
Here’s a closer look at the laws that may impact you and your family the most:
Tennessee gun owners will have a second option when applying for handgun permits. A "concealed only" gun permit is now available. It allows permit holders to carry a weapon if it is concealed. This new permit is in addition to what was previously the only handgun permit in Tennessee, which lets people either open-carry or concealed-carry. That permit is now called, "an enhanced gun permit." The enhanced gun permit costs $100, an 8-hour hands on class and some other background check requirements. The concealed only permit costs $35 less and only requires a 90-minute training course with no hands-on component.
A new law to stop opioid abuse begins in 2020. Now, any prescription for an opioid must be issued as an electronic prescription from the doctor. The deadline for pharmacists to update software to comply with the new law is Jan. 1, 2021.
People now have the "Right to Shop" around when it comes to health care. This new law requires health insurance companies to show the prices of services before treatment, so patients know what their out-of-pocket costs are upfront. Companies must now list prices for services ranging from x-rays and MRI's to physical therapy.
Prosecutors are now able to do more to protect the elderly in Tennessee. Starting today, prosecutors will soon be able to charge someone with felony murder if a person dies as the result of aggravated neglect of an elderly person. Lawmakers say it is a small but significant change that could bring more abusers to justice.
STATE EMPLOYEES CAN NOW GET EXPANDED TREATMENT
A new law allows state employees' proton therapy to be covered by state insurance. Proton therapy is a form of cancer treatment that claims to be more accurate and efficient, with less risk. It is used for cancers of the brain, lung, breast and neck.
As enacted, reduces the age required for a person to receive an initial school bus endorsement from 25 to 23 if the person is an honorably discharged veteran of the United States armed forces, a member of the national guard or reserves, or a licensed teacher employed by an LEA. - Amends TCA Title 49 and Title 55.
As enacted, changes the date from Oct. 1 of each year to April 15 of each year, by which assessors in counties, other than counties with a metropolitan form of government, must file that year's property maps with the register of deeds. - Amends TCA Section 67-5-806.
As enacted, beginning January 1, 2020, requires electrical inspectors employed by a municipality, a county, or Tennessee to be certified by the state fire marshal; establishes a recertification process for such electrical inspectors every three years; requires certain electrical inspectors under contract with the commissioner of commerce and insurance to be certified on and after January 1, 2020. - Amends TCA Title 68.
As enacted, establishes continuing education requirements for residential contractors. - Amends TCA Title 4, Chapter 5 and Title 62, Chapter 6.
As enacted, extends continued health coverage to the surviving spouses and children of park rangers who are killed in the line of duty to the same extent as survivors of other first responders who are killed in the line of duty. - Amends TCA Title 7; Title 8; Title 11 and Title 58.
As enacted, enacts the "Proton Therapy Access Act." - Amends TCA Title 8; Title 56 and Title 71.
As enacted, revises provisions governing identifying the person who makes service of process. - Amends TCA Section 16-15-901.
As enacted, requires travel promoters to use trust accounts to avoid commingling their funds with customer funds that are held for disbursement for payment of travel services. - Amends TCA Title 47 and Title 62.
As enacted, revises provisions governing the determination of whether an employer-employee relationship exists in certain employment arrangements. - Amends TCA Title 50.
As enacted, enacts the "Healthcare Billing Clarity Act." - Amends TCA Title 33; Title 47, Chapter 18; Title 56; Title 63; Title 68 and Title 71.
As enacted, makes police officers and firefighters who are members of the state retirement system eligible for service retirement upon completion of 25 years of creditable service. - Amends TCA Title 8, Chapter 34; Title 8, Chapter 35; Title 8, Chapter 36 and Title 8, Chapter 37.
As enacted, enacts the "Tennessee Right to Shop Act." - Amends TCA Title 8; Title 33; Title 56; Title 63 and Title 68.
As enacted, expands the definition of agricultural land for purposes of greenbelt property tax program to include two non-contiguous tracts of land within the same county totaling at least 15 acres and split only by a road, body of water, or public or private easement. - Amends TCA Title 67, Chapter 5, Part 10.
As enacted, enacts the "Elderly and Vulnerable Adult Protection Act of 2019." - Amends TCA Title 39; Title 40 and Title 71.
As enacted, changes the requirements for the operation of horse-drawn vehicles on state highways. - Amends TCA Title 55, Chapter 9, Part 4.
As enacted, creates a concealed handgun carry permit, which allows a person to carry a concealed handgun; redesignates the existing handgun carry permit as an enhanced handgun carry permit. - Amends TCA Title 10; Title 33; Title 38 and Title 39.
As enacted, allows certain persons who receive certified occupational training as a prisoner or a student in a high school technical training class to receive an equivalent credit toward an occupational license relating to the training received. - Amends TCA Title 4, Chapter 6, Part 1; Title 37; Title 38; Title 41; Title 49; Title 62 and Title 63.
As enacted, creates a program managed by the commissioner of commerce and insurance to annually award grants to volunteer fire departments for the purchase of firefighting equipment or to meet local match requirements for federal grants for the purchase of firefighting equipment and training. - Amends TCA Title 68, Chapter 102.