North Dakota Veterans Home Board Minutes

October 15, 2004

PRESENT: Daryl Beard - Chairman, Larry Dakken, Orletta Kilen, Darrol Schroeder, Robert Volk, Neal Asper, Administrator-NDVH

ABSENT: Norris Braaten

GUESTS: Rudy Jenson, Chairman, Administrative Committee; Jake Reuter, NDVH Social Service Director; Kristin Lunneborg, NDVH Accounting Manager; Margie Ourenhagen, NDVH Executive Secretary

Meeting called to order by Chairman, Daryl Beard. The Pledge of Allegiance was recited, followed by a moment of silence for the POW/MIA's.

MINUTES: Darrol Schroeder made a motion, seconded by Larry Dakken to accept the August 6, 2004 minutes as mailed. Motion carried.

ADMINISTRATOR'S REPORT: Neal Asper, Administrator

V.S.O. Vacancy: The Ransom County Commissions have voted not to fill the Ransom County Veteran Service Officer vacancy, even though there were some qualified candidates interested in the position. Their reason being this V.S.O. Officer has to dedicate most of the time at the Veterans Home. Administrator, Neal Asper, plans to meet with the County Commissioners at a scheduled meeting October 19th. Due to the V.S.O. vacancy Ross A. DeSautel, of the Department of Veterans Affairs, will be visiting the veteran's home once a week to assist the residents with paper work.

Pharmacy & Primary Care Contract: We are awaiting the approval of the construction plans from the Board of Pharmacy. Discussion also has been transpiring between the Attorney of Dr. Sheets Olson and Mary Kay Kelsch from the Attorney Generals Office concerning the Medical Directors contract and fees.

Addiction Counselor: A Licensed Addiction Counselor has been hired. Connie Longie will start Mid November. She has eight years of experienced in both individual and group counseling. She is moving here from Nebraska and is originally from Rolla, North Dakota. We are awaiting the approval of her North Dakota License from the North Dakota Social Service Board.

Priority Communication: (See Handout) Due to the recent fall of a skilled resident, the NDVH Safety Committee reviewed the incident and made some recommendations. The following are from the October Safety Meeting minutes.

  1. Skilled residents leaving the Skilled Unit who shouldn't leave the unit were discussed. Items completed:
    • The magnet has been disconnected on the hallway door.
    • Vulnerability assessments will be completed by Care Team.
    • The 80's elevator will be locked out so that it does not stop on 1st floor.
    Other suggestions made:
    • Install wander guards.
    • Install door alarms.
    • Use colored bracelets with a corresponding dot on the spine of the residents chart.
  2. Skilled Residents that manage to leave the Skilled Unit:
    • All staff members are responsible to escort residents that are not allowed off of the skilled unit, back to the skilled unit.
    • If staff sees a skilled resident off of the skilled unit, call the nurses' station to see if it is OK or not.
    • Nursing needs to chart if residents are leaving the unit unsupervised.
    • Nursing staff will be responsible/more accountable for wandering residents.
  3. Having adequate staffing at the feeding hours was also discussed.

Pat Rotenberger of the ND State Health Department was contacted and agreed that this situation will require the ND Veterans Home to evaluate what happened and make the necessary safety changes.

Nursing Home Watch List: (See handout) Discussion was held on the Consumer Report watch list which listed the North Dakota Veterans Home.

VA Survey: This survey was conducted Sept. 28 & 29th. We do not have the results back as of date. At the exit meeting there were some policy and procedure items discussed which need to be updated, however there were no patient care issues discussed. The State Fire Marshall also completed an inspection on Sept 27th. There was no fire safety deficiencies observed.

Flu Vaccines: Our vaccines were ordered from the company that had the contaminated batch so we are not sure when or how many vaccines we will be receiving.

Asbestos Removal: Discussion was held on the media attention given in the Fargo Forum concerning the asbestos removal. The 8 feet of asbestos that was to be removed was located on some pipes in an old garage on the NDVH grounds. The board questioned why this incident was not reported to the Administrator or the Safety Committee, prior to being reported to the North Dakota Public Employees Association.

The L & M Contractors of Jamestown completed the asbestos removal. They will send a receipt for the disposal of this asbestos to the Veterans Home, as the veteran's home is the owner of this asbestos and is responsible to see that it is disposed of properly.

NDPEA Meeting: Kelly Noack, Representative of the North Dakota Public Employees Association will be meeting with any interested employees October 21st from 11:30 to 1:30 at the veterans' home in the Staff Dining Room.

Resident Petition: Discussion was held on the NDVH Resident Council letter received by Chairman, Daryl Beard, concerning the petition for the charges for the refrigerators & vehicles. The following ideas were discussed:

  • Would it be fair to raise the rent and charge a resident who does not drive a vehicle, the extra rent to help cover the cost for the resident parking lot?
  • Should a resident only be allowed to park one vehicle at the veteran's home?
  • Should the vehicles parked at the veteran's home be in running condition?
  • Should residents be allowed to park other vehicles in the trees for a charge?
  • Administrator, Neal Asper, will draft a policy pertaining to parking of vehicles at the veteran's home. Any action will be tabled until the next Governing Board meeting.
  • The implementation of the $3.00 charge for refrigerators in the rooms will be tabled until the next Governing Board meeting.
  • Also discussed was the North Dakota American Legion Auxiliary donation of the three, three wheel bikes to the veterans home which are used by some of the residents.

Non Payment Issues: NDLTC survey focused on the issues all homes have on outstanding collections. Penalties can not be added to these bills and the only recourse is to give a 30 day discharge notice. You also must find a placement for the resident before discharging them.

Jake Reuter discussed redesigning the performance appraisal to reflect staff/resident relationships.

The HIPAA Security Compliance is well underway. A contingency plan is being developed in case of a disaster.

Discussion was held on purchasing a new computer server. At the present time when a staff member logs onto the Computer System the information goes to Bismarck and back to our computer. If the line is cut between Bismarck and Lisbon we are unable to even print out information. If a long term interruption with Bismarck arises, a new server would give us the capability to switch over to internal operations.


NDLTC Sept. 21-23, Bismarck; Administrator, Neal Asper, attended this fall convention. He also met Governor Hoeven on this trip.

Strategic Plan Legislative Update, Oct. 5th, Bismarck: (Handout) Jake Reuter discussed the Strategic Plan for the North Dakota Veterans Home that he presented at the Legislative Council Meeting in Bismarck October 5th which Administrator Neal Asper and Jake attended. Chairman, Daryl Beard, acknowledged to the Governing Board the wonderful representation of the North Dakota Veterans Home to the Legislative Council by Jake.

DAV Convention: Administrator, Neal Asper, attended the DAV convention in Valley City, October 9th.

ND Legislative Council Budget Review Committee: This committee met at the North Dakota Veterans Home August 25th. Neal Asper commended the Veterans Home Department Supervisors who gave a presentation concerning their department. (See attached meeting minutes).

In this meeting it was moved by Senator Mathern, seconded by Representative Kreidt, and carried on a roll call vote that the committee ask the chairman of the Legislative Council to encourage the Veterans Home to present information to the Appropriations Committees during the 2005 Legislative Assembly on the cost and feasibility of developing a dementia skilled care unit at the Veterans Home and on the budget adjustments necessary to restore funding reductions made in anticipation that eight skilled care beds would be added to the Veterans Home during the 2003-05 biennium. Senators Lee, Erbele, Fischer, Kilzer, Mathern and Thane and Representative Droval, Kingsbury, Kreidt, Metcalf, Pietsch, Rodenbiker, Sandvig, Uglem, and Vigesaa voted "aye". No negative votes were cast.

The NDVH Foundation has $106,000 cash on hand. It was recommended that a request be made to the Chairman of the Foundation for the use of some of these funds for a study on the possible expansion of beds, enlarging the dining room, and moving the restorative care unit to the main floor. The Board questioned if we should consider building a dementia unit in Lisbon or in another area of North Dakota. A new facility would have to be two hours away from any other Veterans Home. Discussion concerning whether there is Federal project money available.

Also discussed was the previous project submitted to build a veterans home in western North Dakota, which was opposed by the North Dakota Long Term Care Association. However, if the North Dakota Veterans Home would not increase the number of beds in North Dakota the NDLTCA probably would not oppose this project.

Neal Asper will write up a recommendation for presentation to the Governing Board at the next meeting.

Resident Communications: DSL was installed and there are computers located in two different locations at the Veterans Home for Resident use.

Also recently Fiber Optic Cable was installed at the Veterans Home to service the TV's. There are more channels available and we have a clearer picture.

The cell phones are available for resident use from 8:00 p.m. to 11:00 p.m. weekdays and 24 hours per day on the weekends.

MDI CLINICAL SOFTWARE: North Dakota Veterans Home staff will be trained to use the MDI clinical software next week.

NDVH Foundation is sponsoring a gulf tournament the 2nd weekend of June 2005 in Lisbon. Hopefully this golf tournament will be continued and circled around the state.

CHAIRMAN: Daryl Beard

Performance Evaluation: Neal Asper, Administrator, received his performance evaluation from the Governing Board. Chairman, Daryl Beard, thanked Neal for his job performance and stated the Board is looking forward to working more with him.

Governing Board vice Chair: Darrell Schroeder made a motion to nominate Orletta Kilen as Vice Chairman. Larry Dakken moved nominations cease. Motion carried unanimously.

Governing Board Appointments: Darrell Schroeder agreed to find a replacement for himself for June 2005. Four of the members are to be Veterans and three can be non-veterans.

The names of Diana Herner, a licensed professional clinic counselor, and Shelly Graening, a RN, were submitted to Chairman, Daryl Beard, to be considered to fill the term of Alex Schweitzer, which expires June 2005. These names will be submitted to the Administrative Committee on Veterans Affairs for approval.

Pharmacy & Medical Expenses: Discussion was held on the future unknown cost of the pharmaceutical and primary care of the residents which will be the responsibility of the Veterans Home. Some other state veteran's homes, who have the same responsibilities, charge the veteran $1500 to $2000 per month to live in the facility. Other homes charge the resident 50% of the resident's income with no cap. At the present time we have a cap of $550.00 per month and our mission is to have our charges as fair and as equitable as possible.

FINANCIAL UPDATE: Kristin Lunneborg reported on the following issues:

  • Financial Report: (See handout)
  • Deficiency Appropriation: A deficiency appropriation of $200,000 for the remainder of this biennium was submitted. $150,000 of that is to be used for regular operating expenses. The remaining $50,000 is to be used for the resident's primary care to help cover the lab and x-ray cost.
  • Outstanding Accounts & Write off: (See handout) Discussion was held on the accounts that have been discussed with the attorney generals office. Small claims court proceedings will be filed on some of the basic care past due accounts. If the current residents do not pay the rent bill by the due date they receive a discharge notice.
  • Resident # 1 on the Basic Care Rent Past Due has passed away and the Attorney General's office gave the opinion all his funds need to be submitted to the funeral home. Motion was made by Darrol Schroeder, seconded by Orletta Kilen to write off the $236.90 owed to the Veteran's Home for rent. Motion carried.
  • Census: (See Handout) Discussion was held on the empty beds at the NDVH Basic Care & Skilled Care Units. The need for some new marketing ideas was discussed
  • 2005-2007 Budget Change: (See handout) Discussion was held on the items that have not been purchased due to the upcoming changes of resident primary care. Also discussed was the pharmacy portion of the budget for $156,932.00 which was placed in the optional budget, but the FTE's were placed in the original budget. Motion was made by Robert Volk, seconded by Darrol Schroeder to approve the increase to the NDVH original budget of $156,932.00. Motion carried.
  • Late charges on overdue bills: (enclosed) Senate Bill 2003 allows only a 1% per month rate on unpaid rent bills. Currently the NDVH rent policy is written to charge 1.5% interest with no cap and a $20.00 penalty fee. This rent policy needs to be updated as per this Senate Bill we can only charge a 1% interest fee per month with a cap of $25.00. Also discussion was held on the accounts that we are receiving a monthly payment on. Motion was made by Darrol Schroeder, seconded by Larry Dakken that as long as a reasonable good faith effort payment is made each month no interest will be charged. Motion carried. This rent policy will be submitted to the Administrative Committee on Veterans Affairs for approval.
  • Holiday Pay Policy: (Handout) Discussion was held on the four holidays, January 1, July 4, November 11 or December 25 that could fall on a week-end. For office employees this holiday will be paid on the preceding Friday for a Saturday Holiday or the following Monday for a Sunday Holiday. Employees working on the holidays will be paid for the hours worked plus the equivalent holiday hours they are eligible for or they may be provided an alternate day off. The payroll records will be adjusted for the employees holiday pay if their week schedule is not for the 8-hour day, 5 days per week. A prorated amount will be paid (See policy) Adjustments have been made to all employees who worked the holidays in the 2003-2005 biennium. Motion was made by Larry Dakken, seconded by Orletta Kilen to approve the Human Resource Policies and Procedures for Employee Benefits for Holidays. Motion carried.
  • Annual Leave Policy: Discussion was held on the annual leave that may be taken in increments of 15 minutes (i.e.25, .50, .75). Motion was made by Darrol Schroeder, seconded by Larry Dakken to approve the submitted Human Resource Policies and Procedures for Employee Benefits for Annual Leave. Motion carried.

Resident Burial Account: Discussion was held on the NDVH Social Services Department encouraging residents to set up a reasonable amount in a burial account. It also was stated that by State Law when a resident moves into the Veterans Home they do not give up their county of residents. (See handout) If the resident wishes to change it they can. It also was discusses that an absentee ballot can not be obtained from that county for this resident. This absentee ballot issue can be challenged as long as the resident does not vote in Ransom County.


  • NDVH Governing Board will meet Friday, February 18, 2005 at 1:00 p.m. at the Veterans Home, Lisbon, ND.

Motion was made by Larry Dakken, seconded by Darrol Schroeder to adjourn this meeting.

Meeting adjourned.

Neal Asper