Transparency was a recurring theme at Wednesday’s Grand Traverse County commission meeting, with commissioners unanimously voting to require more reporting and public accountability from the Grand Traverse Pavilions after the county-owned facility received 20 citations in 2022 for issues ranging from food violations to patient care. However, in a narrow split vote, commissioners rejected a proposed policy change some hoped would bring more transparency to the commission itself when it comes to collecting taxpayer-funded per diem payments.

Pavilions
Representatives from the Grand Traverse Pavilions – including CEO/Administrator Rose Coleman and DHHS board members Gordie LaPointe and Cecil McNally – faced extensive questioning from commissioners Wednesday about inspection violations at the facility. The Pavilions received 17 violations from the Centers for Medicare & Medicaid Services in an August inspection, with inspectors citing unsanitary food service and kitchen conditions severe enough to create “a high likelihood of a foodborne illness among any or all (of) the 132 highly susceptible resident population.”

Other cited concerns included residents losing weight, missing meals, complaining of sores, and feeling isolated and bored, without adequate activities or stimulation. The Pavilions also received three violations in a separate report last summer that included a case of non-consensual sexual contact between residents, which was self-reported by the facility. Pavilions administrators were required to quickly submit a plan of correction for each violation. Pavilions representatives emphasized to commissioners Wednesday that many of the violations were connected to food service, and the Pavilions has since switched its dining provider, with new company Forefront Healthcare taking over this month.

“We have taken great efforts to improve in those areas,” said LaPointe, who added that Pavilions staff have the “full support” of the DHHS board. “I am absolutely confident that we are on the right track.” LaPointe acknowledged the Pavilions had a “bad inspection,” and said it was “not acceptable and nobody accepts it.” But he believed the report was an outlier, not an indicator of long-term systemic issues at the facility. Coleman said the Pavilions takes “all of our violations seriously” and continues to monitor flagged issues for months after corrective plans are submitted to the state. Coleman said the Pavilions is working to restore its star rating – which is based on health inspections, staffing, and quality measures – from its current level of two to either three or four next year and five (the highest number) the following year. She noted the rating process does not allow for an immediate reversal, only a gradual one. McNally voiced his confidence in the facility’s plan to get back on track.

“We all want the Pavilions to be a place where people feel like they're at home and treated with dignity,” he said.

County commissioners questioned why it took until February for the August inspection report to be discussed in public at a DHHS board meeting, and why commissioners learned of the violations through the media instead of from Pavilions staff or county representatives. “There are significant issues in here far exceeding a contract with a food services provider,” said Commissioner T.J. Andrews. Chair Rob Hentschel said that while he empathized with staffing challenges faced by the Pavilions, those challenges are experienced industry-wide – with other nursing homes nonetheless avoiding the violations and low rating incurred by the Pavilions.

Andrews made a motion to require the Pavilions to include its state inspection reports in its meeting packets, to keep meeting packets publicly accessible on the Pavilions website on a rolling 12-month basis, and to explore options for recording and posting Pavilions meetings. The motion was unanimously approved by commissioners (Commissioners Darryl Nelson and Brian McAllister were absent). Coleman was asked to report back at her next quarterly update to the commission on the possibility of recording and posting meetings. Hentschel noted that recording could be done simply and at low cost, such as using a smart phone to record and uploading meeting videos for free to YouTube. “It wouldn’t be hard,” he said. “The public is questioning, ‘What's going on in my government?’ So increasing transparency might be one way to increase public trust.”

Per Diem Payments
The topic of transparency came up in another commission agenda item Wednesday, with Commissioner Ashlea Walter proposing updates to the board’s per diem policy. A recent report published by Grand Traverse Democrats showed that some commissioners are collecting thousands of dollars in per diem payments each year – separate from their annual salaries and benefits – including for reasons expressly prohibited by the per diem policy, such as attending ribbon cuttings and meeting with constituents.

Walter said per diem spending is “blowing up the commission budget, causing grief for our staff because they do not have the power to disallow the reimbursements even though they are in violation of the policy, and our constituents are not OK with us using their taxpayer dollars on meetings and time that is inherently part of the job of a county commissioner itself.” She noted some commissioners are also claiming per diem payments – at $65 a pop – for meeting one-on-one with each other, activity that should be covered by a commissioner’s normal salary, she said. Walter suggested revising the policy to prohibit payments for one-on-one meetings, to require that commissioner per diem requests be published in meeting packets, and to remove current language that states commissioners can use their own judgment determining which activities qualify for payments. Andrews and Commissioner Lauren Flynn expressed support for increasing visibility around per diem spending, with Flynn noting that a recent community survey showed that transparency is an issue “the county has been surveying low on.”

Hentschel opposed the changes, saying there have been “no complaints or concerns by the public” about per diem spending and that the issue only came up as a result of Democrat “mud-slinging at the Republicans on this board.” He added: “I don’t see the old policy as a problem.” Vice Chair Brad Jewett also dismissed criticisms about per diem spending as “bull-----,” saying “there’s an issue being made out of a non-issue” for political reasons. Commissioners Scott Sieffert and Penny Morris both said they were open to discussing the policy, but each had issues with aspects of the proposed changes. A motion to approve the proposed changes failed 3-4 along party lines, with Andrews, Walter, and Flynn in support and Hentschel, Jewett, Morris, and Sieffert opposed. At Sieffert’s request, the board agreed to form an ad hoc committee to look at other potential policy revisions and bring those back at a future meeting for commission review. Jewett, Sieffert, and Walter were selected to serve on the committee.