‘Remarkable turnaround’ of Nathaniel Witherell
Where are we now? Where are we going? And how should we measure our performance?
These questions were raised during my recent interview with Larry Simon, chair of the Nathaniel Witherell board.
“Where do we want to go and what do we want to be,” Simon asked, framing the interview in these terms.
The news was good, and the outlook positive. It was uplifting to hear that after six years of deliberations over Witherell’s future in successive committees appointed by the Board of Estimate and Taxation, and more recently by the first selectman, it’s finally been acknowledged that responsibility for making decisions regarding Witherell’s governance and future direction lies with the Witherell board itself.
Although this might have been obvious, acknowledgment required a written opinion from the town attorney. The backdrop for my interview with Simon was an unpublished committee report that was presented to First Selectman Fred Camillo last fall. The legal opinion accompanied this report.
The previous fall, on Oct. 29, 2020, at Camillo’s request, the Town of Greenwich purchasing department issued a Request For Proposal (RFP) “to invite proposals from qualified firms or organizations to assume the management in conjunction with the possible purchase or lease of the assets of The Nathaniel Witherell.” The submission deadline was 11 a.m. Dec. 15, 2020.
Camillo appointed a committee to review and evaluate the responses to this RFP using the evaluation criteria as outlined in the RFP. After many months of confidential deliberations over the RFPs, not open to the public, the committee presented Camillo with a report and recommendation. According to Simon, the report recommends consideration of one of the firms that responded to the RFP, in addition to the current management.
This recommendation was passed on to the Witherell board in executive session, with the request that the board perform due diligence on the specified
Witherell offers the Greenwich community a high quality of care, as measured in different ways, something that’s never been in dispute.
firm. The board, however, has decided instead to do its own strategic plan and determine its own future direction.
Simon was optimistic as he addressed the questions raised during our interview regarding Witherell’s current situation, its place in the continuum of care, its path to the future, and how best to measure its performance.
Calling it “a remarkable turnaround financially,” Simon said he believes Witherell’s much improved financial situation can be sustained into the future. The Project Renew bonds will be paid off in 10 years. Over time, there will be benefits savings, as fewer people will on the defined benefit plan. There will be reduced costs in changed staffing arrangements. And there have been considerable savings in contracts with outside vendors, including therapy, pharmacy, rehabilitation, medical supplies and food.
Simon also noted that, with the closing of area skilled nursing facilities, Witherell beds will be in even greater demand, and filling beds is the key to a healthy revenue stream. Witherell also benefits from its geographic location in which incomes allow for 25 percent private pay residents. Another demographic that should have long-term benefits for Witherell is an aging Baby Boomer generation.
Among other revenue-enhancing measures will be increased ability to treat people without sending them to the hospital, training staff to take on more complex medical situations, and establishing the ability to provide in-house dialysis.
In addressing performance evaluation, Simon offered data on a variety of measures including occupancy, star rating, staffing per resident per day, and staff turnover. Witherell compares favorably with a sample of other skilled nursing and rehabilitation facilities.
Particularly dramatic is the favorability comparisons regarding overall staff turnover, with Witherell at 18.2 percent when many other facilities have turnover rates in the 50- and 60 percent ranges, and none in the comparison sample below 38 percent. Witherell’s turnover for registered nurses at 26 percent is considerably lower than facilities in the comparison sample with turnover rates in the 50-, 60- and even 70 percent ranges.
Witherell offers the Greenwich community a high quality of care, as measured in different ways, something that’s never been in dispute. Its board members remain committed to maintaining this high quality of care, low staff turnover, and keeping the cost to the town at an acceptable level.
Over the next months this board will be developing a strategic plan. It’s reassuring that, through this board, Witherell remains in town hands.