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HealthCare

St. Camillus prepares for improvement project. Page 2.

Health-Care People-on-the- Move newsPage 6.

The List: Skilled- Nursing Facilities Page 10, 11.

INSIDE

ERIC REINHARDT/THE CENTRAL NEW YORK BUSINESS JOURNAL

February 6, 2014

St. Joseph’s Primary Care Center – West at 321 Gifford St. in Syracuse opened

to patients on Jan. 20 following a formal opening ceremony on Jan. 15.

See story, page 3.

Business JournalNews Network

Business JournalN e w s N e t w o r k

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Page 2 • HealthCare Provider February 6, 2014

GEDDES — The Centers at St. Camillus, a nonprofit health-care facility in the town of Geddes, is prepar-ing for an improvement project meant to relocate and improve its resident-gathering space.

The project, which the facility hopes to complete before the end of the year, should begin in early March, says Christine M. Kearney, vice president for rehabilita-tion and community-based services at the Centers at St. Camillus.

The Centers’ desire to expand its commu-nity-based services prompted the project, which will cost about $160,000, she says.

“So we opened the social-day program in order to provide another array of services to people who are living at home but are in need of oversight and supervision during the day,” Kearney says.

Community-based services are for peo-ple who may have incurred some type of disability and may need additional support

to continue living at home, she explains.The project’s first phase involves the re-

location of the organization’s resident-gath-ering space. The Centers at St. Camillus will use a $23,000 grant to cover the cost of the first phase.

The organization on Jan. 7 announced that the John M. & Mary L. Gallinger and John F. Marsellus Funds awarded the fund-ing. The Central New York Community Foundation, Inc. recently notified the Centers at St. Camillus about this grant funding.

The first phase involves taking an area that the facility’s pharmacy is vacating, along with a storage area, and creating a new resident-gathering room, Kearney says.

The new location for the facility’s resi-dent-gathering room is in a more central location compared to the some of the long-term care units, according to Kearney. It’s also close to the dining room and located near the elevators that go up to the second and third floors.

The updated room “will be a little bit larg-er space; will be closer to the front door so when family members come in and want to have a family gathering, it’ll be convenient for families as well,” Kearney says.

CBD Construction, LLC of Syracuse is handling the construction work, she adds.

Once the work on the new resident-

gathering space is complete, the project’s second phase involves moving a beauty salon that is located near the facility’s sub-acute rehabilitation unit closer to the end of one of the long-term care units.

“The third phase [will involve] taking the vacated, existing resident-gathering room, the vacated existing beauty salon and merg-ing that space with two smaller therapy gyms that are all within this one block right alongside our sub-acute rehab unit,” Kearney says.

To finance the total cost of more than

$160,000, the Centers contributed more than $66,500 for the architectural design and development, along with environmen-tal services, she says.

Besides the $23,000 in grant funding the Centers will use for the first phase, it also needs to raise more than $70,000 to cover the remaining costs, which total more than $93,000.

The Centers at St. Camillus needs nearly $37,000 to relocate the beau-ty salon, which is part of the second phase.

The organiza-tion is among the 13 groups that will benefit from the char-ity preview event at the Syracuse Auto Dealers Association’s an-nual Auto Expo. The charity pre-view is set for Feb. 12. The Centers at St. Camillus will use that funding toward the second phase, Kearney says.

Beyond that funding, the orga-nization also plans to seek additional grants, contribu-tions, and conduct additional fundraising to meet the goal, she says.

Founded in 1969, the Centers at St. Camillus is located at 813 Fay Road It offers inpatient and outpatient services includ-ing subacute and brain-injury rehabilitation programs; continuing care (nursing home); outpatient rehabilitation, home health care; medical transport, and a variety of other support services.

Aileen Balitz is president and CEO of St. Camillus.

Contact Reinhardt at ereinhardt@cnybj.com

ERIC REINHARDT/THE CENTRAL NEW YORK BUSINESS JOURNAL

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Christine M. Kearney, vice president for rehabilitation and community-based services for St. Camillus, in the current resident-gathering room.

“So we opened the social-day program in

order to provide

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HealthCare Provider • Page 3February 6, 2014

SYRACUSE — St. Joseph’s Hospital Health Center last month formally opened its new and expanded pri-mary care center at 321 Gifford St. on Syracuse’s Near Westside.

The facility, which was previously known as the Westside Family Health Center, is now called St. Joseph’s Primary Care Center – West.

The new 16,000-square-foot building re-places the previous 4,000-square-foot center, according to St. Joseph’s.

“This center will be one of the first of its kind in New York … to integrate in

one place behavioral health, primary care, pediatric care, and ob-stetrical care,” Kathryn Ruscitto, president and CEO of St. Joseph’s

Hospital Health Center, said in her remarks at the Jan. 15 event.

In addition, the facility also provides ac-

cess to onsite lab work, ultrasound and ra-diology services, and an onsite dietician and nutritional program, the hospital said.

The expanded center is located next door to Nojaim Bros. Supermarket.

“It’s a great day for the Near Westside,” Dr. Luis Castro, medical director at Primary Care Center-West, said in his remarks at the formal opening.

Castro started working at the facility 14 years ago and two years before that as a resident, he said.

He displayed some tearful emotion at the opening event, which drew applause from the gathered crowd.

Ruscitto credited Drs. Castro and Maryellen Lewis, along with nurses, nurse practitioners, physician assistants, and proj-ect designers for their early preparation work.

“Together, these teams examined mock-up rooms, drawings, [and] best practices to come up with perfectly designed space,” Ruscitto said.

The opening of the expanded Primary Care Center – West represents the culmina-tion of an initiative to merge primary care and outpatient behavioral health at three

sites, according to St. Joseph’s. The effort seeks to improve access to

care for the low-income, minority, immi-grant, and refugee populations of Syracuse, the hospital said.

In conjunction with the opening, St. Joseph’s will relocate its Maternal/Child Health Center obstetric / gynecology services and pediatric office and move those patients to either the West location or to the main campus of St. Joseph’s Primary Care Center at 101 Union Ave. in Syracuse, the hospital said.

A third site is the St. Joseph’s Behavioral Health Center at 742 James St. in Syracuse, the hospital said.

St. Joseph’s secured state funding for the

West expansion and associated-care con-solidation through a Health Care Efficiency and Affordability Law for New Yorkers (HEAL-NY) phase 11 grant, which included $4.9 million for the facility.

Schopfer Architects served as the project designer, and the Hayner Hoyt Corp. was the contractor on the project.

Crews started construction work in early 2013 and finished the project in December, the hospital said.

The new building opened to patients on Jan. 20. q

Contact Reinhardt at ereinhardt@cnybj.com

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St. Joseph’s opens primary care center on Syracuse’s Near Westside

ERiC REiNHARdt/tHE CENtRAl NEW YoRk BUSiNESS JoURNAl

St. Joseph’s Primary Care Center – West at 321 Gifford St. in Syracuse opened to patients

on Jan. 20 following a formal opening ceremony on Jan. 15.

eric reiNhardtJoURNAl StAFF

Page 4 • HealthCare Provider February 6, 2014

BY ERIC REINHARDTJOURNAL STAFF

WATERTOWN — Samaritan Medical Center (SMC) and the North Country Family Health Center (NCFHC) last month announced details of a plan the organiza-tions had devised to help “stabilize” the operations at NCFHC.

The New York State Department of Health back in October appointed SMC as the temporary operator of NCFHC as the clinic had announced plans to close.

The temporary-operator agreement is a six-month agreement, extending through the end of April, says Krista Kittle, director of marketing and community relations at Samaritan Medical Center.

“But we do expect it to go a month or so past that at this point,” says Kittle.

Based on a work plan that SMC and the health center submitted to the department, the organizations have outlined the “prior-ity” focus areas and changes in processes and structure to help meet the objectives.

Their plan to increase revenue involves outsourcing its billing function and reduc-ing no-show rates at the clinic.

The coding on a bill helps determine the amount of the organization’s reimbursement for a given patient’s treatment, Kittle says.

“So we want to make sure that we opti-mize and code correctly, so that we get the

reimbursement for the correct level of care that was provided,” she adds.

NCFHC is outsourcing its billing to Visualutions, Inc., a Spring, Texas–based health-care-technology company that pro-vides clinical, financial, and information-tech-nology solutions to enterprise organizations such as federally qualified health centers (FQHCs), according to its website.

A patient no show means no reimburse-ment for the health center, Kittle says.

NCFHC is changing the way it schedules by building time into the schedule for addi-tional visits, depending on what the centers determine as a percentage of no shows.

“It’s almost like overbooking, but if you use that historical number based on the people who don’t show, you’ll have plenty of room in your schedule to make up for those no shows by those extra patients who are scheduled,” Kittle says.

In addition, they hope to certify the health center as a Level III patient-centered medical home, up from the current Level II status, and increase provider capacity for seeing patients, Kittle says.

Job cuts, fundingBesides the focus on increased revenue,

NCFHC also intends to restructure and consolidate operations to reduce expenses.

It won’t fill seven currently vacant posi-tions and one expected retirement this spring. The plan also includes laying off five employees, three of which occurred in December as part of the billing transition.

The organization also cut two manage-ment positions as of Jan. 13, including the adult-clinic manager and the dental clinic manager, according to Kittle.

“Those positions were consolidated into one person who will oversee all of the clini-cal services, and the title is clinical-services officer,” Kittle says.

The center hired a new person to handle those duties, she added.

The organizations will also pursue loan and grant opportunities to support the plan. The Northern New York Community Foundation awarded $100,000, and the New York State Health Foundation awarded more than $32,000.

Another request for $100,000 is also pending.

When asked to provide details about what organization is considering the re-

Page 10 • HealthCare Provider February 8, 2013

With Wellness: You Don’t Have to be a Big Business to Achieve Big ResultsWellness is a state of mind and body. It’s an individual thing. So, when it comes to employee participation, let’s not get lured into the misconception that well-ness only works in large numbers, and therefore is more fitting for a sprawl-ing Fortune 500 company than it is for a small busi-ness with 25 to 100 em-ployees.

Wellness today is for all employers and all of their employees. Even back in the 1980s

when I was consulting with small businesses, some of them had a well-ness program in place, and didn’t even realize it. When break time came, the employees of one

particular small business would take a walk around the block. Walking together during business hours was built into this com-pany’s culture. The only difference between then and now is today we would count the steps with a pedometer clipped to our belt

and walk with iPod buds stuck in our ears as opposed to a Sony Walkman. But the results remain the same.

But when it comes to getting companies to implement a wellness program into their corporate culture, it all comes down to get-ting them to practice what you preach. And what I found to be effective is utilizing the old KISS system with a slight modification — Keep It Simple Sells.

This is not to suggest that a good insur-ance agent doesn’t know that having a solid health and wellness plan in place will benefit his/her client. But sometimes the litany of objections from the employers — “There’s nothing I can do about health-care costs going up,” “It’s too expensive,” “We don’t have the facilities for exercise,” “My employees won’t want to do it” — can be overwhelming.

John Basten of The Mid-State Group in Lynchburg, Va. says employers are frustrat-ed with the ever-increasing cost of health premiums, and thus turn to brokers for solutions, which often include delivering “wellness” by implementing disincentives and benefit-design changes in an effort to change behavior. It’s a concept that Basten says doesn’t work.

“It’s only through education that you can guide employers to better understand the risks and obstacles they are facing,” he ex-plains. “Essentially, step one is to help them

identify the specific health factors within their company, because when real data drives the decision, one can plan for the expected re-sults.”

York International, a large regional bro-ker in Harrison, N.Y. derives about 25 per-cent of its $10 million in revenue from benefits serving the middle-market employ-er of 50-2,500 employees. For the past five years, York has been focusing on drawing employee benefits and wellness resources and capabilities from much larger busi-nesses to bring to smaller firms.

“The Fortune 1000 or 5000 have been practicing engaging employees in health beyond the financing of sickness for many years and we think that there is a tremen-dous opportunity to continue to do that with these middle-market companies,” ex-plains Mike Bodack of York International. “When our point of entry is who we call the ‘user buyer’ of insurance for their company, we try to engage the ‘economic buyer’ as well. It is not often the same person, but it does happen on occasion.”“When we deal with that economic buyer, we find that it is easy to focus the conversa-tion,” he adds. “Certainly, some folks will have their head in the sand. But the ones who are intelligent, rational human beings understand very quickly. Because in the end, it’s just a math problem.”

When employers perceive wellness as an added cost instead of an added benefit, bad things happen. Or nothing happens at all. Basten of the Mid-State Group has fought that battle for years.

“Employers are frustrated with the ever-increasing cost of health care and are look-ing for viable strategies to reverse the trend,” he says. “Many are looking for quick fixes which end in employers spending excessive funds in areas that don’t have long-lasting effects. Our specific focus is to educate the employer on how wellness should be defined as an employee benefit. We educate our clients that identifying the specific risk factors affecting their employee group is an essential and foundational step in creating an effective wellness program, starting with getting a minimum of 90 percent of their employees to complete a health-risk assess-ment without providing incentives.”

Getting the employees behind a well-ness program can often be the fuel that jump-starts an employer’s decision-making process, as now he/she sees what was per-ceived as a potential expense reaping poten-tial dividends in increased employee morale and decreased employee sick days.

As York International’s Bodack sees it, it’s all about the employee kick-off. “We’ve received tremendous response from our kickoff meetings,” he says. “The delivery of the health-risk assessment to an employee is a measure of control all by itself. When an employee takes the 10 minutes to read it, it may be more information than they get about their health from their own doctor. And, an annual health-risk assessment of-fers the employee a grand picture of his or

her health, year after year.”He adds, “When employees have some-

thing personalized, such as their HRA, and see directives they can look at year after year, it provides a tremendous level of control and a heightened awareness. We routinely reach 85 percent or 90 percent involvement from employees who review their Health Risk Assessments.”

One point that Bodack and Basten agree on as wellness experts is that employers should not rely on incentives for employee involvement in the program. And, converse-ly, neither should they be penalized for not participating.

“Employees are already struggling with family pressures and an uncertainty about the future,” says Basten. “The last thing em-ployees need is a work environment where they are told what not to do and being penalized for doing so. This doesn’t create a thriving corporate culture. Wellness should be offered solely as a benefit and not as a ‘reward,’ and delivered to the employees as such. Only then will the employer get the proper participation they need for the program to be successful.”

Mark Nantz of Knapp Miller Brown Insurance Services in Salem, Ind. says a key component of a successful wellness program, which he has used many times, is the shared clinic model, a benefit which also includes wellness coaches. “The shared clinic model allows smaller employers to use the clinic model, as long as there is a larger employer to act as the anchor,” says Nantz. “Think of a shopping center with the large big box store as the anchor tenant. A large employer can have its own clinic and it can act as an anchor for surrounding com-panies to share its on-site clinic. On-site clin-ics can also pull out employees with chronic illnesses and focus on wellness initiatives for those folks.”

It has become increasingly clear that workers’ compensation, employee benefits, and wellness are the three faces of employ-ee health, and the cost of that health means insurance producers must be equipped to bring a unified approach to employers. With the new health-care reform legislation, em-ployers will have an enormous need for expert advice on benefits and wellness. The insurance agents of the future are quickly arming themselves with new ways to at-tack the true root causes that are driving up health-care costs. And if employers can make their employees healthier without cutting benefits or shifting more premium costs to their employees, where is the down-side? q

Preston Diamond is managing director and co-founder of the Institute of WorkComp Professionals (IWCP), based in Asheville, N.C. In 2010, IWCP created a sister orga-nization, the Institute of Benefits & Wellness Advisors, that trains, tests, and certifies ben-efit and property & casualty insurance agents in wellness and employee benefits. Contact him at preston@workcompprofessionals.com

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Class A Medical Space SMC, North Country Family Health Center outline plan to ‘stabilize’ agency

PHOTO COURTESY OF SAMARITAN MEDICAL CENTER

Samaritan Medical Center and the North Country Family

Health Center (NCFHC) last month announced details of a plan the organizations had

devised to help “stabilize” the operations at NCFHC.

See SMC, page 11

HealthCare Provider • Page 5February 6, 2014

ONEIDA — Oneida Healthcare announced it has appointed Mary Parry to the position of vice pres-ident for operations. She replaces Paul Scopac, who retired on Jan. 3.

Parry earned her bachelor’s degree in health-services management and MBA in technology management from SUNYIT in

Marcy. She also holds an associate degree in respiratory ther-apy from Onondaga Community College and has 22 years ex-perience in cardiopulmonary leadership. Parry served as clinical coordinator of re-spiratory care at Rome Memorial Hospital before joining Oneida Healthcare in 1998.

In addition to her clinical and manage-ment responsibilities at Oneida Healthcare, Parry has also been responsible for the de-velopment of several new services, accord-ing to an Oneida Healthcare news release.

That includes the Sleep Center, Oneida Health Support (Durable Medical Equipment), Advanced Pulmonary Function, Digital EEG, Fit Testing, and elec-tronic integration of cardiology studies.

A resident of the city of Oneida, Parry

currently serves as a commissioner on the city’s Water Board and as a direc-tor of the Greater Oneida Chamber of Commerce. She also served as vice chair of the Mohawk Valley Community College Advisory Committee for Respiratory Therapy during that program’s reaccredita-tion process in 2010.

Oneida Healthcare says it employs 950 people and generated a projected $86.1 mil-lion in revenue in 2013.

Oneida Healthcare names Parry new VP for operationsBY JOURNAL

STAFF

Parry

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MedTech Association signs up 10 new member companiesSYRACUSE — MedTech Association, a bioscience and medical technology (bio/med) trade associa-tion, recently announced that 10 new companies have joined as members.

The companies are DePuy Synthes, Fisher Scientific, FTT Manufacturing,

Guideline Medical, HS Design, MPR Associates, Raland Technologies, Saratoga

Economic Development Corp., UK Trade & Investment, and Varian Medical, whose local subsidiary is Salina–based InfiMed.

The new additions bring the total num-ber of MedTech members to 95.

“We are excited to welcome such a wide range of bio/med companies and service providers to our membership,” MedTech Association President Jessica Crawford said in a news release. “Their commitment speaks not only to the strength of the indus-try in New York State, but to the ability for MedTech to provide resources from which to grow.”

MedTech says it supports the bio/med industry in New York through edu-cational opportunities, connections with other members, advocacy, and public outreach.

Its members include pharmaceutical, biotech, and medical technology compa-nies, their suppliers and service providers, and research universities.

DeWITT — Dr. Tansy Schoonmaker and Dr. Cosmina Nolan formally opened Little Jaws Big Smiles Pediatric Dentistry at 4605 East Genesee St. in DeWitt on Jan. 6.

The practice specializes in providing dental care to infants, children, teens, and children with special needs.

The office offers complimentary dental exams to all children under the age of two.

Little Jaws Big Smiles provides many treat-ment services, includ-ing white restorations

and oral conscious sedations. To help make the best experience possible for children, the office has overhead televisions and nitrous

oxide available in all treatment rooms. The reception area has an indoor grotto

where children are immersed in an interac-tive underwater adventure.

Schoonmaker studied at the University of Buffalo Dental School. She completed her pediatric dental specialty training at the University of Pittsburgh, Children’s Hospital. Nolan also studied at the University of Buffalo Dental School and then completed her pediatric training at St. Joseph’s Hospital/Lutheran Medical Center program in Providence, R.I.

Pediatric dental practice opens in DeWitt

BY JOURNAL STAFF

BY JOURNAL STAFF

Page 6 • HealthCare Provider February 6, 2014

FAXTON ST. LUKE’S HEALTHCARE FSLH

Michael F. Trevisani, M.D., has been named senior vice president/chief medical officer at Faxton St. Luke’s Healthcare (FSLH). He received his bachelor’s degree from Hamilton College and earned his doctorate in medicine from SUNY Upstate Medical University in Syracuse. Trevisani completed a residency at Robert Packer Hospital in Sayre, Pa. and a fellowship in colon and rectal surgery at UMDNJ-Robert Wood Johnson Affiliated Hospitals in New Brunswick, N.J. He also received his MBA from the University of South Florida in Tampa. Trevisani most recent-ly held the position of vice president of Medical Affairs/CMO at UHS Chenango Memorial Hospital in Norwich and UHS Delaware Valley Hospital in Walton.

Melanie Pogoda, R.N., has been named nurse manager of 2 West at FSLH. Her previous position with FSLH was as nurse manager of urgent care. Prior to joining FSLH, Pogoda was a nurse man-ager of the Orthopedic Neurosurgical

Unit at Southern Hills Hospital in Las Vegas. She has also held staff and charge nurse positions at Sentara Potomac Hospital in Woodbridge, Va., as well as St. Elizabeth Medical Center in Utica. Pogoda earned an associate degree in nursing from St. Elizabeth College of Nursing and a bachelor’s degree in nurs-ing from Utica College. She is currently enrolled at the University of Phoenix in the master’s of health care administration/informatics program.

Paul Abbass has been named chief of medical physics for The Regional Cancer Center of Faxton St. Luke’s Healthcare, as well as radiation safety officer for the Faxton Campus. He received a bachelor’s degree in fitness and cardiac re-habilitation from Ithaca College and a sec-ond bachelor’s degree in radiation therapy from SUNY Upstate Medical University in Syracuse. Abbass earned his master’s

degree in medical physics from Illinois Institute of Technology in Chicago, and earned board certification as a therapeutic medical physicist through the American Board of Radiology. He is also a board-certified radiation therapist and medical dosimetrist. Prior to his promotion, Abbass worked for six years as a staff physicist at The Regional Cancer Center. Abbass is also an adjunct professor at SUNY Upstate Medical University, teaching junior and se-nior level radiation-physics courses.

UPSTATE MEDICAL UNIVERSITY

Upstate Medical University announced the following new faculty appointments. Aart Geurtsen, M.D. has been named assis-tant professor of medicine and a hospital-ist, specializing in general medicine. He received his medical degree at Upstate Medical University and completed his sur-gical residency at Kern Medical Center in Bakersfield Calif. Prior to Upstate, Geurtsen worked in a private practice in Marcellus, served as a school physician for the Baldwinsville School District, and has been employed at Upstate Community General campus as a part-time hospitalist.

Andrea Intartaglia Berg, M.D. has been appointed assistant professor of med-icine, specializing in geriatric medicine. She is a graduate of Cornell University, received her medical degree from George Washington University School of Medicine, and completed her medical internship and residency at Yale New Haven Hospital’s Primary Care program. Berg then com-pleted the Harvard Fellowship in Geriatric Medicine and served as an attending pri-mary care provider at the Newton Wellesley Hospital in Massachusetts.

Emily Lazzari Albert, M.D., has been named assistant professor of medicine and a hospitalist. She received her medical degree from Upstate Medical University, where she also served as chief medical resi-dent. Albert also holds a master’s degree in public health from Ohio State University.

J. Kurt Concilla, M.D., has been ap-pointed assistant professor of medicine and a podiatrist for Upstate’s Joslin Center for Diabetes. He received his medical degree from the California College of Podiatric Medicine and completed his surgical resi-dency in Portland, Ore. Prior to Upstate, Concilla worked as a board-certified foot surgeon and podiatrist at Crouse Medical Practice.

Manju Paul, M.D., has been named as-sistant professor of medicine, specializing in interventional pulmonology and pulmo-nary and critical care medicine. She re-ceived her medical degree from St. John’s Medical College in Bangalore, India and completed her residency and fellowship training at Upstate in internal medicine and pulmonary and critical care medicine. Paul completed an additional subspecialty fellowship at the combined Beth Israel Deaconess Medical Center-Massachusetts General Hospital interventional pulmonol-ogy program of Harvard Medical School.

Matthew Hess, M.D., has been named assistant professor of medicine and a hospi-talist. He received his medical degree and completed his residency in internal medi-cine at Upstate. In addition, Hess worked at Upstate as a research laboratory techni-cian, where he studied olfaction develop-ment in neonatal animal models and how this may be related to the predisposition of alcoholism later in life.

Patrick Kohlitz, M.D. has been appoint-ed assistant professor of medicine and a hos-pitalist. He received his medical degree from St. Georges University School of Medicine in Grenada, West Indies, and completed his residency in internal medicine at Upstate.

Ruban Dhaliwal, M.D. has been named an assistant professor in medicine, special-izing in endocrinology, diabetes, and me-tabolism. She received her medical degree from Vinnica National Medical University in Vinnica, Ukraine and completed her resi-dency in internal medicine at North Shore - LIJ Hospital at Forest Hills, where she also served as chief resident. Dhaliwal also completed a bone and mineral research fel-lowship at Winthrop University Hospital.

VALLEY HEALTH SERVICES

Valley Health Services (VHS) in Herkimer recently hired Ashley Lundquist as its cardiac-rehabilitation nurse. She received a bachelor’s degree from SUNYIT in psy-chology in 2008 and a bachelor’s degree in nursing in 2012. Prior to joining VHS, Lundquist worked on a cardiothoracic progressive-care unit.

WOMEN’S HEALTH ASSOCIATES OF ONEIDA

Hazem Qalla, M.D. has joined Women’s Health Associates of Oneida in the practice of obstetrics & gyne-cology. He received his medical training at Ross University School of Medicine, Dominica W.I. and completed his OB/GYN surgical training at New York Methodist Hospital and Drexel University School of Medicine. Qalla also served as clinical assistant professor and full-time faculty member at SUNY Downstate Medical Center / Hospital University of Brooklyn. He will be joining Oneida Healthcare’s da Vinci robotic surgery team.

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HealthCare Provider • Page 7February 6, 2014

Developing your individual strategic positioning plan“No one’s ever achieved financial fitness with a January resolution that’s abandoned by February.”

— Suze Orman

I believe that almost all studies regarding individuals making New Year’s resolutions arrive at the same

conclusion. That is, most of them are bro-ken during the month of January or may die a slow death over the remainder of the year. The celebration, pomp, and circum-

stance of each New Year brings boundless enthusiasm to individ-uals around the globe. As Americans, I hap-pen to think we do it best.

However, 2014 pres-ents tax-exempt orga-nizations across many, if not all, service sec-tors with significant challenges that must be turned into oppor-tunities.

Therefore, I have personally resolved that, no later than June 1, 2014, I will do the following.

I will engage our tax-exempt clients and you, my readers, with the specific objec-tive of developing a strategic action plan to best position your organization for success, outstanding outcomes, and fiscal viability for 2014-16.

In January, Congress passed the Omnibus Budget Reconciliation Bill and Gov. Andrew Cuomo released the NYS

2014/15 fiscal year budget. These two docu-ments provide most tax-exempt o r g a n i z a t i o n s with the rules, re-quirements, and revenues that es-tablish how the business “game” for tax-exempts will be played for the near future.

I offer you the following 10 infor-mation items for

you and your organization to consider in developing your individual strategic posi-tioning plan.

1. Doing more for your constituents with less government funding.

As of Jan. 1, 2014, New York state had about 6 million Medicaid-eligible citizens. Demand for services will continue to

increase. Fundamental transformation of tax-exempt service delivery will continue.

2. Continuation of the dramatic shift in favor of paying nonprofits for ser-vice outcomes and quality versus the “previous model” of fees for services rendered. The concept of Pay for Performance

(P4P) will continue to spread throughout the health- and human-services sector. Physicians and hospitals have been

dealing with P4P for a number of years. P4P is likely to become a standard

reimbursement methodology.3. Gov. Cuomo’s budget makes it

quite clear that 2 percent is the maxi-mum magic number for purposes of additional government funding. We all know that 2 percent does not

adequately cover cost increases occurring in many areas (example: health insurance). Therefore, further cost reductions and ef-ficiencies must be identified. An effective and flexible Salary

Administration Program will be a funda-mental requirement for success.

4. If your organization provides ser-vices to Medicaid-eligible individuals, pay particular close attention to the re-quirements of Executive Order No. 38 covering both executive compensation and caps on administrative costs. In 2015, administrative costs for

Medicaid providers must be below 15 per-cent. Be sure to calculate this percentage in

accordance with published regulations. For executive compensation, deter-

mine whether or not you need to file a waiver application.

5. The federal government and the Cuomo Administration believe there is more than enough capacity in New York state to provide health and human services. There is an assumption, in some ways

flawed, that fewer and bigger tax-exempts will inevitably lead to more efficiency. Read David Lapiana’s column on

“Merging Wisely” — http://www.ssire-view.org/articles/entry/merging_wisely Expect that the “Walmarting of the

tax-exempt sector” will proceed at an in-creased pace.

6. If you are considering a merg-er, acquisition, or strategic affiliation, make sure that you speak with your audit firm.

Accounting rules for nonprofit mergers and acquisitions were changed recently. Ask your audit firm to describe the

challenges associated with the require-ments of FASB No. 164.

7. New dollars for purposes of fund-ing new-service initiatives or trans-formation of current delivery models will be largely determined based on the success of grant applications from collaborations and joint ventures of multiple service providers. Become familiar with the Vital Access

Provider program and the Balancing Incentives program, among others. Private and community foundations

may offer an expanded opportunity for grants on the strength of the stock market’s performance.

8. Pay attention to the demographic changes that are affecting service de-mands. On average, 10,000 Americans are

retiring each day for the next 15 years. The Baby Boom generation and its

shift to retirement with inadequate retire-ment funds will have a dramatic effect on service demands and payment sources. Consider the number of New Yorkers

who, after retirement, move to the South for a lower or no-tax state of residence.

9. By 2020, less than six years away, those nonprofit organizations that will remain autonomous with local decision-making authority will have to continue to develop a signifi-cant private-sector fundraising effort. These development efforts will require annual success from both special events and planned gifts. Given the industry environment de-

scribed herein, make a basic assumption of less money from government. Replacing declining government rev-

enue with private-sector funding and/or cost efficiencies will be key. Identifying new opportunities for

revenue sources in this changing environ-ment should always be a primary focus area. Don’t wait until it’s too late to consider

partnerships, collaborations, or mergers for purposes of continuing your mission.

10. As a “bean-counter,” I would be remiss if I did not give recognition to the ongoing “efforts” of the account-ing profession in making your lives more difficult and complicated.

The New York State Society of CPAs recently conducted its Nonprofit Annual Update training. The topics were as fol-

lows: Developing a measure of operations Corporate affiliations What you need to know about IT-

cloud computing, the payment card indus-try, identity theft, and mobile options. Accounting for contributions versus

exchange transactions Demystifying Executive Order 38 Addressing and implementing an

effective enterprise risk management (ERM) process Attachments to Federal Form 990

that cause the most headachesI am hopeful that you will be suc-

cessful in accomplishing both your in-dividual and organizational resolutions for 2014.

Gerald J. Archibald, CPA, is a partner in charge of the management advisory ser-vices at The Bonadio Group. Contact him at garchibald@bonadio.com

GERALD J.ARCHIBALD

NONPROFIT MANAGEMENT

In 2015, administrative costs for Medicaid

providers must be below 15 percent.

As of Jan. 1, 2014, New York state

had about 6 million

Medicaid-eligible citizens.

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HealthCare Provider • Page 9February 6, 2014

New York state recovers a record $851M in improper Medicaid paymentsPreliminary calculations indicate New York state inspectors recovered more than $851 million in taxpayer money that was improperly spent in the Medicaid program in 2013, the “largest sin-gle year of recoveries” in state history.

That’s according to a statement New York Governor Andrew Cuomo released on Feb. 3.

New York’s Office of the Medicaid Inspector General (OMIG) recovered

the funding from Medicaid providers who inappropriately billed Medicaid and individuals who re-ceived services to

which they were not entitled, Cuomo’s office said.

It brings the three-year total under Cuomo to more than $1.73 billion recov-ered, representing a 34 percent increase over the previous three years.

OMIG’s recoveries are the “highest on record” for any state Medicaid program integrity unit, Cuomo’s office said.

The $851 million recovered from Medicaid abuses in 2013 is the highest total in the state’s history, Cuomo said in the news release.

“Our focus on cleaning up the Medicaid program is showing record-breaking results, and OMIG’s efforts serve as a role model for other states to follow. Eliminating this kind of waste is vital to transforming New York’s healthcare system, and this year’s tremen-dous amount of recoveries shows that we are well on our way to building a healthier and fairer New York,” Cuomo said.

OMIG has worked to eliminate fraud through aggressive responses to allega-tions of fraud in social adult-day care, excluding unscrupulous providers, and

focusing on ineligible individuals.Among the improvements in fraud and

abuse prevention established under the Cuomo administration are the creation of pre-claim reviews, which are specialized reviews of home health claims and inven-tory reports; improved practices for re-viewing pharmacy operations; and strong data sharing and coordination with federal, state, and local partners, according to the governor’s office. q

Contact Reinhardt at ereinhardt@cnybj.com

DiNapoli: N.Y. state agency overtime rose 16 percent last yearA pair of health-servic-es agencies posted among the most over-time hours

Overtime earnings at state agencies rose to a “record” $611 million in 2013, a nearly 16 percent increase over 2012.

That’s according to a new report that New York State Comptroller Thomas DiNapoli re-leased today.

Overtime-pay outlays in 2013 rose for the third straight year, DiNapoli’s office said in a news re-lease.

State employees logged 14.8 million overtime hours last year, costing taxpayers a record $611 million.

“New York’s overtime bill is increasing and needs to be reined in,” DiNapoli said. “State agencies should take a hard look at how they are using overtime and for what. To hold the line on state spending, state agencies should double their efforts to reduce this expensive habit.”

DiNapoli’s report found overtime earnings were up by more than 27 percent for the seven-year period ending in 2013. Overtime repre-sented nearly 4 percent of total payroll in 2013, the highest share in the years analyzed for the report, according to DiNapoli’s office.

Three agencies that operate institutional fa-cilities — including the New York State Office of Mental Health (OMH), the New York State Department of Corrections and Community Supervision (DOCCS), and the New York State Office for People with Developmental Disabilities — accounted for 63.5 percent of the overtime hours in 2013, the comptroller’s office said.

Total overtime hours dropped slightly at all three, compared with 2012. Other agencies paid high hourly rates for overtime, such as the New York State Police, which spent an average of $74.35 per hour of overtime at a cost of $35 mil-lion, according to the state comptroller’s office.

DOCCS paid the next highest average of $51.18 per hour of overtime for a total of $160 million.

At the same time, DiNapoli’s report found that New York’s agency workforce has declined nearly 11 percent, from 180,564 in 2007 to 160,829 last year, excluding the State University of New York and City University of New York.

DiNapoli “regularly” reports on state-agency reliance on overtime, according to his office.

Contact Reinhardt at ereinhardt@cnybj.com

Photo courtesY oF the oFFice oF goverNor ANdrew cuoMo

Governor Andrew Cuomo released a statement on Feb. 3 reporting preliminary calculations indicate New York state inspectors recovered more than $851 million in taxpayer money that was improperly spent in the Medicaid program in 2013.

Health Foundation for Western and Central New York to share information on CNY safety net on Feb. 28sYrAcuse — the health Foundation for western and central New York and John snow, inc. will present the central New York primary care safety-net assessment report and recommenda-tions at a Feb. 28 event, at the doubletree by hilton hotel syracuse, near carrier circle in dewitt. the event runs from 9:30 to 11 a.m.

This safety-net assessment, being done for the first time, is designed to provide information to the Health Foundation and

primary care stake-holders throughout the region on the ca-pacity and strength of the existing primary-care system. It will also provide recommendations on how the Health Foundation and the region’s health-care providers should move forward in order to take advantage of the dramatic changes that are occurring in the health-care system.

Following the formal presentation, at-tendees will be able to give feedback and ask questions about the findings before the final report is posted on the Health Foundation website (www.hfwcny.org) in March.

After the presentation and discussion, there will be a half-hour demonstration of

a new easy-to-use website that will allow anyone to search and select safety-net data by location and topic area, according to the Health Foundation.

To register, visit www.hfwcny.org. Organizers are asking attendees to regis-ter by Feb. 21. For more information, email safetynet@hfwcny.org.

The Health Foundation for Western and Central New York says it is an independent, private foundation whose mission is to improve the health and health care of resi-dents of Western and Central New York. It says it invests in, and partners with, organi-zations and communities to improve health and health care for vulnerable and under-served populations, including frail elders and children, from birth to age five, living in poverty. q

eriC reiNHarDtJourNAl stAFF

bY JourNAl stAFF

eriC reiNHarDtJourNAl stAFF

Page 10 • HealthCare Provider February 6, 2014

SKILLED-NURSING FACILITIESRanked by No. of Certified Beds

Rank

NameAddressPhone/Website

CertifiedBeds

FTEmployees

OccupancyRate

Medicare 5-StarQuality Rating1 Key Administrative Officers

YearEstab.

1.Loretto Health and Rehabilitation Center700 E. Brighton Ave.Syracuse, NY 13205(315) 413-3400/loretto-cny.org

583 750 97% 2 Derek Pierce, CFOJack Pease, Administrator

Sandra Russell, Director of NursingCheryl Coolican, Director of Admissions

1926

2.James Square Health & Rehabilitation Centre918 James St.Syracuse, NY 13203(315) 474-1561 /jamessquare.com

455 597 95% 2 Helen Norine, AdministratorScott Murphy, Assistant Administrator

1970

3.The Masonic Care Community of New York2150 Bleecker St.Utica, NY 13501(315) 798-4800/mccny.com

340 800 98%2 2 Robert Raffle, Executive DirectorJill Wynne, Comptroller

1893

4.Willow Point Nursing Home3700 Old Vestal RoadVestal, NY 13850(607) 763-4400/gobroomecounty.com/wpnf

300 265 95% 2 1969

5.The Centers at St. Camillus813 Fay RoadSyracuse, NY 13219(315) 488-2951/st-camillus.org

284 670 97% 1 Aileen Balitz, CEOMichael Zingaro, VP Finance

1969

6.LutheranCare108-110 Utica RoadClinton, NY 13323(315) 853-5515/lutherancare.org

280 298 92% 1 Andrew Peterson, President/CEO 1919

7.Presbyterian Homes & Services4290 Middle Settlement RoadNew Hartford, NY 13413(315) 797-7500/presbyterianhome.com

236 390 93% 2 Michael Sweeney, CEORussell A. Clark, CFO

Alexandra Maliwacki, AdministratorLucy Viti, Director of Nursing

1967

8.St. Luke's Home1650 Champlin Ave.Utica, NY 13503(315) 624-8600/faxtonstlukes.com

202 366 99% 2 Kathy Perra, Acting Executive DirectorLisa Volk

1996

9.ElderWood at Waverly37 N. Chemung St.Waverly, NY 14892(607) 565-2861/elderwood.com

200 205 98% 4 Maria K. Landy, Executive Director 1971

.St. Luke Health Services299 E. River RoadOswego, NY 13126(315) 342-3166/stlukehs.com

200 470 95% 2 Terrence Gorman, CEO & AdministratorShelly Youngs, Controller

1975

11.St. Regis Nursing Home, Inc.89 Grove St.Massena, NY 13662(315) 769-2494/stregisnh.com

162 200 96% 4 John M. Bogosian, CEOWheeler Maynard, Jr., Administrator

1971

12.Oneida Healthcare Center ECF and RehabilitationCenter323 Genesee St.Oneida, NY 13421(315) 363-6000/oneidahealthcare.org

160 167 98% 4 Gene F. Morreale, CEOBryan G. Ehlinger, ECF Administrator

Candace Schucht, DON

1974

.Valley Health Services, Inc.690 W. German St.Herkimer, NY 13350(315) 866-3330/valleyhealthservices.org

160 187 96% 5 Lisa M. Betrus, CEO & AdministratorJudith M. Way, CFOCindy Reese, CNO

1984

.Elderwood at Liverpool4800 Bear RoadLiverpool, NY 13088(315) 457-9946/elderwood.com

160 158 95% 4 Kristin Russell, Administrator 1984

.Susquehanna Nursing and Rehabiltiation Center282 Riverside DriveJohnson City, NY 13790(607) 729-9206/susnursing.com

160 215 92% 3 Shannon Cayea, Administrator 1973

.Lewis County General Hospital7785 N. State St.Lowville, NY 13367(315) 376-5200/lcgh.net

160 157 98% 4 Eric R. Burch , CEOJoseph S. Todora, Nursing Home Administrator

1931

17.Sitrin Health Care Center2050 Tilden Ave.New Hartford, NY 13413(315) 797-3114/sitrin.com

155 372 98% 2 Michael Silverman, ChairmanChrista L. Serafin, CEOJulianne Cardone, CFO

Melanie Marraffa, Administrator

1951

18.UHS Senior Living at Ideal600 High Ave.Endicott, NY 13760(607) 786-7300/uhs.net

150 110 96% 2 Mary Lou Faust, President, CEO, Administrator 1990

19.Menorah ParkHodes WaySyracuse, NY 13214(315) 446-9111/menorahparkcny.com

132 300 99% 4 Mary Ellen Bloodgood, CEOJeff Scheer, President, Menorah Park Board of Directors

1912

20.Cortland Park Rehabilitation & Nursing Center193 Clinton Ave.Cortland, NY 13045(607) 756-9921/cortlandparkrehab.com

120 110 95% 1 John Alvarez, Administrator NA

.St. Joseph Nursing Home2535 Genesee St.Utica, NY 13501(315) 797-1230/stjosephnh.org

120 145 95% 2 David Hartnett, CFOFrederick P. Deck, Administrator

1971

.Bethany Village-The Manor3005 Watkins RoadHorseheads, NY 14845(607) 739-8711/bethany-village.org

120 367 97% 3 1975

.Manor at Seneca Hill20 Manor DriveOswego, NY 13126(315) 349-5300/oswegohealth.org

120 142 96% 2 Maureen Annal, VP & COOHolly Magdziuk, Comptroller

Esther Field, Director of NursingKathy Cocciole, Director of Adult Day Health Services

1999

24.Country Manor Nursing & Rehabilitation Centre1045 West St.Carthage, NY 13619(315) 493-3220/clrchealth.com

90 106 94% 4 Patrick Martone, CEOAnthony Durante, CFOBonni Shippee, COO

Linda Queior, Administrator

1968

25.The Crossings Nursing & Rehabilitation Centre217 East Ave.Minoa, NY 13116315-656-7277/crossingscaring.com

82 71 96% 2 Patrick R. Martone, CEOAnthony Durante, CFOBonni Shippee, COO

Ramona Gonzales, Administrator

1970

THE LISTResearch by Nicole Collins

ncollins@cnybj.com (315) 579-3911

Twitter: @cnybjresearch

NOTES

1. Medicare.gov Five-Star Overall Ratings combines three sources of data: health in-spections, staffing, and quality measures. The more stars the better.

2. The Masonic Care Community of New York has an occupancy rate between 95 percent and 98 percent.

ABOUT THE LISTInformation was provided by representatives of listed orga-nizations and their websites. Other groups may have been eligible but did not respond to our requests for informa-tion. While The Business Journal strives to print accurate information, it is not possible to independently verify all data submitted. We reserve the right to edit entries or delete categories for space considerations.

WHAT cONSTITUTES THE cNY REgION?Central New York includes Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga, and Tompkins counties.

NEEd A cOpY Of A LIST?Electronic versions of all our lists, with additional fields of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx

WANT TO BE ON THE LIST?If your company would like to be considered for next year’s list, or another list, please email ncollins@cnybj.com

An Alternate View—facilities with a 5 or 4 star rating

H H H H H

Valley Health Services, Inc.

H H H H

Elderwood at Waverly

St. Regis Nursing Home, Inc.

Oneida Healthcare Center ECF and Rehabilitation Center

Elderwood at Liverpool

Lewis County General Hospital

Menorah Park

Country Manor Nursing & Rehabilitation Centre

Rome Memorial Hospital RHCF

Good Shepherd Communities

HealthCare Provider • Page 11February 6, 2014

SKILLED-NURSING FACILITIESRanked by No. of Certified Beds

Rank

NameAddressPhone/Website

CertifiedBeds

FTEmployees

OccupancyRate

Medicare 5-Star

Quality Rating1 Key Administrative OfficersYear

Estab.

26.Cortland Regional Nursing & Rehab Center134 Homer Ave.Cortland, NY 13045(607) 756-3900/cortlandregional.org

80 875 100% 3 Mary Wright, VP Long-Term Care Services 1993

.UHS Senior Living Chenango179 N. Broad St.Norwich, NY 13815(607) 337-4111/uhs.net

80 66 90% 3 Drake Lamen, MD, President & CEO, UHS ChenangoMemorial Hospital

1912

.Alpine Rehabilitation & Nursing Center755 E. Monroe St.Little Falls, NY 13365(315) 823-1001/alpinerehab.com

80 123 97% 3 Teresa Creedon, AdministratorJulie Jensen, CFO

Sheila Salls, Director of Nursing/CNODr. Deepak Buch, Medical Director

1973

.Sunnyside Care Center7000 Collamer RoadEast Syracuse, NY 13057(315) 656-7218/Sunnysidecare.com

80 75 94% 1 Michael Edward Svendsen, Administrator 1972

.Chase Memorial Nursing HomeOne Terrace HeightsNew Berlin, NY 13411(607) 847-7000/ChaseNursingHome.com

80 82 98% 3 Jeffrey W Emhof, Administrator/CEOSusan Holbert, Director of Nursing

Karen Elliott, Controller

1969

.Rome Memorial Hospital RHCF1500 N. James St.Rome, NY 13440(315) 338-7318/romehospital.org

80 82 93% 4 Keith Heinrich, Administrator 1977

.Finger Lakes Center for Living20 Park Ave.Auburn, NY 13021(315) 255-7188/auburnhospital.org

80 80 96% 2 Diane Harrington, Director of NursingAdeline Gunger, Director of Nurses

1995

33.Good Shepherd Communities80 Fairview Ave.Binghamton, NY 13904(607) 724-2477/goodshepherdcommunities.org

54 237 100% 4 Michael Keenan, CEOAnne Dooley, Executive DirectorKathy Swezey, Executive Director

Richard Hall, CFO

1968

34.The Nottingham RHCF1305 Nottingham RoadJamesville, NY 13078(315) 446-0123/thenottingham.org

40 37 97% 3 Derek Pierce, CFOJennifer Ingerson, Executive Director, The Nottingham

Tracy Engle, Director of Nursing

1995

THE LISTResearch by Nicole Collins

ncollins@cnybj.com(315) 579-3911

Twitter: @cnybjresearch

NOTES

1. Medicare.gov Five-Star Overall Ratings combines three sources of data: health in-spections, staffi ng, and quality measures. The more stars the better.

2. The Masonic Care Community of New York has an occupancy rate between 95 percent and 98 percent.

NEED A COPY OF A LIST?Electronic versions of all our lists, with additional fi elds of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx

WANT TO BE ON THE LIST?If your company would like to be considered for next year’s list, or another list, please email ncollins@cnybj.com

quest, Kittle had to decline. “Because it’s pending, I’m not at liberty

to say,” she says.That request, along with the funding

from the Northern New York Community Foundation and the New York Health Foundation are grants that the NCFHC will use to pay for services such as outsourcing billing with Visualutions.

“It’s being able to fund those without taking funds from the clinic operations,” Kittle says.

The plan calls for dealing with finan-cial obligations and debt, including the refinancing of the NCFHC mortgage. The health center also repaid two short-term loans to Community Bank and Watertown Trust in November, along with a short-term loan from SMC, Kittle says.

In addition, it intends to address delin-quent vendor-payable balances.

The organization also wants to use elec-tronic-medical records and improve data collection to monitor and improve effi-

ciency and productivity.Additionally, the plan calls for reapplying

for designation as a federally qualified health center, and the funding that comes with it, as well as opening the Lowville dental / medical site and continuing to serve the homeless.

The organization intends to collaborate with community leaders to expand the NCFHC board of directors.

Under the plan, SMC expects the NCFHC to end 2014 with a “near break-even budget and positive cash flow” in order to continue operations without interruption in services to patients.

BackgroundThe North Country Family Health

Center, formerly known as the North Country Children’s Clinic, had announced its intention to close in early October.

NCFHC had cited financial difficulties as the reason.

“It was really a surprise … to everyone including ourselves and the [New York State] Department of Health,” Kittle says.

At that point, executive director Daniel

Wasneechak reached out to Samaritan CEO Thomas Carman to see if SMC could provide help.

The temporary operator agreement re-sulted following talks between the clinic, SMC, and the state Department of Health.

“We actually stepped in on the 10th of October,” Kittle says, noting the agreement was formalized on Oct. 31.

In that time, Wasneechak resigned, and SMC appointed Joey Marie Horton as in-terim executive director, who had previous experience with the clinic as part of its school-based clinic program.

“From the beginning, our role was …

to find a long-term solution for the clinic’s stability,” Kittle says, noting the clinic’s business model wasn’t sufficient to sustain its operations.

SMC brought in its officials with exper-tise in finance, communication, and other areas of need.

“Our CEO [Carman] was very active in assisting them as well to try to do what we could to keep the doors open temporarily until we could work together to come up with a long-term solution,” she says.

Contact Reinhardt at ereinhardt@cnybj.com

SMC: The plan also calls for dealing with financial obligations and debt

Continued from page 4

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Page 10 • HealthCare Provider October 26, 2012

A New York City–based not-for-profit home health-care organization has received state approval to expand its Medicaid managed long-term care plan to 24 counties out-side of the city — includ-ing several in the Syracuse and Utica areas.

The Visiting Nurse Service of New York (VNSNY) is moving on plans to spread its VNSNY Choice Medicaid Managed Long Term Care plan to Herkimer, Madison, Oneida, and Onondaga counties. That’s after the state approved the market expan-sion in September.

The managed long-term care plan is tar-geted at seniors and individuals with chron-ic illnesses and disabil-ities who cannot live

independently at home, but do not want to move into a nursing home. It’s a voluntary option for Medicaid-eligible beneficiaries that provides nurse-care managers who visit members’ homes and coordinate the health-care services they receive.

News of VNSNY Choice’s expansion follows New York Gov. Andrew Cuomo ac-cepting recommendations from a Medicaid Redesign Team in February. The redesign lifted a moratorium on the extension of existing Medicaid managed-care plans, ac-cording to Christopher Palmieri, president of VNSNY Choice Health Plans, who also acted as an adviser to the state during its Medicaid redesign. VNSNY has been open

to the option of growing its service area since before that moratorium was lifted, he adds.

“We’ve been interested in expanding our service area since about 2003,” he says. “It was something that we’ve been working on for the entire year. We started our process to apply for market expansion in the early part of 2012.”

VNSNY Choice isn’t the only Medicaid managed long-term care plan that will be growing into Central New York and its sur-rounding areas. Fidelis Care, a Catholic health plan based in Rego Park in the New York City borough of Queens, announced in August it was expanding its Fidelis Care at Home managed long-term care program into 11 counties in and around Central New York.

Numerous plans have applied to the state for expansion, Palmieri says. VNSNY Choice wants to offer its plan to all eligible New York residents eventually, he contin-ues.

“Our organization felt that we should be offering our coordinated care through managed long-term care across the state,” Palmieri says. “[This] expansion was one step toward becoming a statewide health plan and serving all 62 counties in the state.”

MV/CNY expansionVNSNY Choice has opened a Utica–area

office at 2 Ellinwood Drive in New Hartford and hired three employees to start building relationships with senior centers, nursing organizations, and hospitals that could be-come part of its network. Palmieri expects to hire more employees in Central New York and the Mohawk Valley in the future, although exact timelines and staffing levels are not set.

“It is safe to say that we’ll have a major

presence in Oneida County, Herkimer County, and Onondaga County, and we’ll look at whether we need an office in Madison County,” he says. “A lot of our work force is field based.”

VNSNY Choice has hired its own nurse care managers in New York City. It could follow that model in upstate New York, or it could turn to subcontractors if they seem like a good fit, Palmieri says.

“Those care managers have a direct relationship with the patients today,” he says. “When there aren’t those opportuni-ties, we’re happy to build the infrastructure ourselves.”

The Medicaid managed long-term care plan does not have any members in Central New York or the Mohawk Valley at the mo-ment. It could sign up interested members today but will likely make a push at the end of 2012 or beginning of 2013, according to Palmieri.

VNSNY Choice doesn’t know how many members it will sign up, and it’s not clear how many competitors it will face in the up-state market. It has nearly 14,000 managed long-term care beneficiaries in New York City, Palmieri says.

Rough estimates show the plan will re-ceive about $18,500 per member per year in Medicaid revenue. Those payments will vary by hundreds of dollars in different state rating regions, however.

“Around the first of the year is when we’ll have a formalized business plan based upon what we’ve projected and budgeted,” Palmieri says. “The challenge we have right now is, because there has not been a man-aged long-term care delivery system for this type of long-term care in the past, it’s going to be tricky to get the rates right.”

VNSNY Choice has 1,470 total employ-ees. It offers Medicare Advantage plans, Medicaid long-term care plans, and a health plan for individuals with HIV/AIDS and their children. It forecasts premium revenue of about $1 billion in 2012 — about $550 million of which will come from man-aged long-term care plans. Palmieri didn’t

have estimates of premium revenue for 2013, but says top-line revenue is estimated to be about $1.8 billion in 2013.

The managed long-term care plan has existing operations in New York City’s five boroughs and previously received state approval to grow into Nassau, Suffolk, and Westchester counties.

More recent state decisions have given it approval to expand into Herkimer, Madison, Oneida, and Onondaga counties, as well as other counties. They include Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Albany, Columbia, Delaware, Fulton, Greene, Montgomery, Otsego, Rensselaer, Schenectady, Saratoga, Schoharie, Warren, Washington, and Monroe counties.

VNSNY Choice has hired seven people in Fishkill in Dutchess County to spearhead its efforts in the Hudson Valley counties. It leased a 3,000-square-foot office there.

Palmieri is no stranger to the Mohawk Valley. He’s a Utica–area native who helped build Faxton St. Luke’s Healthcare’s Senior Network Health managed long-term health-care plan in the late 1990s, he says. q

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