Monday’s RTM meeting agenda features four nominations to the board of the town-owned nursing home, The Nathaniel Witherell: Peter Kelly, Pamela Packard, Dr. Michael Goldstein and Brad Radulovacki.
Two of them may be controversial.
Both Dr. Michael Goldstein’s and Brad Radulovacki’s nominations were discussed at RTM district and committee meetings last week, including Appointments and Health and Human Services.
During the Appointments Committee meeting, Elizabeth Quigley from the Family Council at the Witherell, said her group opposed Mr. Radulovacki and Dr. Goldstein on the grounds they believe both are hostile to operating the Witherell as a town department.
They said they had 493 signatures on a petition opposing those two nominations.
“Their sole objective for a seat on the board is to move forward with the transfer of management to a third party operator,” Ms Quigley said to the Appointments Committee. “We feel they do not have the well being of the residents as their top priority.”
“We are deeply concerned that First Selectman’s nominees have a partisan bias to privatize the operation of the Witherell at the expense of the safety and well-being of the residents” Quigley added.
Mr. Radulovacki denied having previously made any statements supporting privatization and said he had not made his mind up at all.
Further, he read from the remarks he made at a previous Finance Committee meeting, referring to the $11 million in uncollected revenue at the facility. “‘Fair minded folks may rightly asked whether this would happen with a private sector manager in charge,'” he said.
“That is not a demand for privatization. That is a wake up call to the board members that they need to understand what is wrong with this business and maybe have a private sector approach that runs it efficiently for everyone’s benefit.”
Mr. Goldstein who has been characterized as “anti-vax” and favoring privatization of the Witherell, also pushed back.
He said he had never advocated privatization and was offended that anyone would think he had an agenda.
“The problem with the Witherell is, obviously, it’s a mess,” he told the Appointments Committee. “Financially it’s a disaster. The amount of managerial incompetence is unbelievable. There’s $12 million that weren’t billed because the person in charge of billing quit and there was no one competent to take his place. That is unbelievable. Of the $12 million, approximately half was recovered and we’ll be spending approximately $3 million in fees.”
As for accusations that he was “anti-vax,” Dr. Goldstein said he had a medical exemption for himself because he had a Hematologic condition and had a letter from a Hematologist saying he should not be vaccinated.
“I have not been vaccinated. I had Covid, and I have natural immunity,” he said. “If you had the measles, you don’t need the Measles vaccine. If you had Chicken Pox, you don’t need the Chicken Pox vaccine. I think the same science should apply to Covid.”
“I’m not an anti-vaxxer per se. I’m an anti-mandatory vaxxer, and certainly in the area of Covid, I think we need to follow the science. People who have natural immunity – and that has been proven though all kinds of medical research – will have no benefit from vaccination, and sometimes because your immune system is already sensitized, some people have had adverse reactions.”
“I think people should have the options,” he added. “I don’t think we have all the information on all the pros and cons of vaccination.”
After appearing before the Appointments Committee the candidates joined the Health and Human Services Committee.
Appointments Committee Vote, Tuesday, Sept 12:
Radulovacki: 7 yes, 4 no, 0 abstention
Goldstein: 8 yes, 2 no, 1 abstention
Health and Human Services Committee Vote, Tuesday, Sept 12:
Radulovacki: 5 yes, 3 no, 1 abstention
Goldstein: 1 yes, 6 no, 2 abstentions
On his Ask the First Selectman show on Friday, Fred Camillo said the Nathaniel Witherell needed to be run in a different, more efficient way.
“Almost everybody who has looked at this knows there has to be change, and even if it stays as a department, it has to be run differently,” Camillo said. “But it’s going to have to change, because that is real money – money that could be put back in for our seniors, towards our schools, towards our parks, our infrastructure. That’s a lot of money.”
He said in the past 9 years the town had subsidized the facility by $43 million, not including expenses like lawsuits.
“The way we’ve done it in the past is obviously a reason no one does it like this,” Camillo said. “It has to change, and how that change is going to come about – that’s why these people we put on the board because we think they can help, they are very good. They bring their skill sets. They have knowledge of the facility.”
Witherell in the Headlines
Controversy over the future of the Witherell is not new, but it has been heating up. In 2021 the nursing home’s 5-star rating dropped to 3. Then in 2022 it dropped to 1-star. And, sadly, pandemic took a toll on enrollment and there were deaths among residents who also suffered greatly from isolation.
At a December 2022 public hearing on the future of the facility, dozens testified with the majority urging the board not to privatize, though those who favored privatization were equally passionate. About 20 people testified against privatization an about 10 people in favor of privatization.
Another development in the past two years is that the board of directors learned from an opinion of town counsel that the fate of the nursing home was not for the Board of Selectmen, but rather theirs to make.
Family Council Petition
Members of the Witherell’s Family Council circulated a petition among Witherell residents, their family members, and town employees, as well as friends and neighbors opposing the nominations of Dr. Goldstein and Mr. Radulovacki to the Witherell board of directors.
(The votes on the Board of Selectmen for Dr. Goldstein and Mr. Radulovacki were 2-1 with Republicans Mr. Camillo and Selectwoman Lauren Rabin voting yes and Democratic Selectperson Janet Stone McGuigan voting no.)
Specifically the petition says the signers supported maintaining the Witherell as a Town of Greenwich service.
“The selection of the Witherell’s Board members has become more critical since it was determined earlier this year that the Board has the authority to vote on outsourcing its operation. The First Selectman has clearly stated that privatizing Witherell is one of his top priorities. We feel he now seeks to seed the Board with members who support this position.”
The petition said both candidates had made their positions clear.
“They are hostile to a Witherell as a department of the Town, and their sole objective for a sat on the board is to move forward with the transfer of management to a third party operator. They do not have the well-being of the residents as their top priority.”
The petition goes on to say that Dr. Goldstein has “publicly stated his opposition to Covid vaccinations, which should automatically exclude him from consideration given the Witherell’s vulnerable populations.”
As for Mr. Radulovacki, the petition states he had expressed a belief the Witherell should be privatized.
“Any board member should serve in the best interest of the residents with the determination and skills to provide them with a dignified end-of-life experience in a well-run nursing home.”
“We are deeply concerned that the First Selectman’s nominees have a partisan bias to privatize the operations of the Witherell at the expense of the safety and well being of the residence,” the petition goes on to say.
Lastly the petition states that in future, the Board of Selectmen’s interview process should be “democratic and collaborative,” and include the Family Council, Friends of the Witherell and other stakeholders and groups with expertise to do what is best for the residents and rehab patients.
On Wednesday, Dr. Goldstein circulated the following via the all-230 member RTM email:
“I am interested in joining the Board of Directors of the Nathaniel Witherell Nursing Home for the specific purpose of ensuring that it will continue to serve the residents of Greenwich. There has been a recent chain of events that has damaged the institution and it must be fixed.
I am a senior citizen myself and I have direct experience with the services of Nathaniel Witherell as I outline below. I recognize the importance of Nathaniel Witherell to our seniors and our community.
I find letter by Ms. Badini offensive and unsupported, and I trust the RTM won’t let such misconduct rule the day. It is troubling that someone who knows nothing about me and has never spoken to me would claim to speak on my behalf.
Response to False Allegations by Amy Badini
Ms. Amy Badini falsely claims that I am in favor of privatizing Nathaniel Witherell. That is absolutely false. My concern is first and foremost to improve medical services.
The second offensive remark is that I ”do not have the well-being of the residents as [my] top priority.” This statement is both untrue and based in ignorance. As a physician who has spent 43 years serving and advocating for my patients to the best of my ability and serving my profession and community, it is really outrageous that Ms. Badini would make such a false accusation.
The third statement regarding Covid vaccination misrepresents my position. I am not vaccinated because I had Covid, and on the advice of my physician I did not vaccinate due a medical condition where the risks of vaccination outweigh the benefits. I believe that in high-risk groups Covid vaccines have been effective in preventing death and serious illness. However, in those that are not in high-risk groups the decision to be vaccinated should not be a mandate any more than flu shots, but instead be based on an informed consent discussion between a patient and their physician regarding the risks benefits of vaccination.
I am a Board-Certified Ophthalmic Surgeon and a long time Greenwich Resident. I became a lawyer while being a full-time physician. I have lived a life of service on numerous medical and not-medical Boards.
Among numerous other positions, I have served on the New York County Medical Society with several roles including, President and Chairman of the Board of Trustees.
I am the current Chairman of the SUNY Downstate Medical Center Alumni Association Endowment Fund that provides scholarships, grants and other support to medical students.
As for Hospital Service, which has similarities to nursing homes, I served on the Networking and Contracting Committee for New York Eye and Ear Hospital and their Board of Managers during the formation of Mount Sinai Health Partners, a clinically integrated IPA with over 6,000 physicians. I served on the Operating Room Committee who’s role was to ensure the efficient management of patient flow from admission, surgery and discharge from the hospital.
In Greenwich I served on the Board of Trustees of Temple Sholom for six years and I was the Chairman of the Committee of Trustees. This is all relevant experience that would assist me carry out my duties at Witherell.
Why Nathaniel Witherell
Following a stroke, my mother-in-law spent time in multiple facilities, including Nathaniel Witherell. I am a technically active senior citizen who is very familiar with and understands the important role that Nathaniel Witherell plays in serving our community. I believe that my role on the Board of NW would first and foremost be focused on improving the level of care. In my specialty of Ophthalmology I serve a lot of elderly patients and I have a strong feelings that they should not be neglected or abused as has occurred. For 43 years I have honored the oath I have sworn to serve my patients which also means advocating for them. I strongly believe that the residents of Nathaniel Witherell are entitled to the best quality of care possible. Unfortunately, that has not been the case and the rating of the nursing home is extremely poor. This must be fixed.
Nathaniel Witherell must provide top quality care to its residents, it needs to improve its ratings and attract self-paying patients, it needs to attract more in-patient rehabilitation patients and to increase its occupancy rate while expanding into outpatient rehab and examine the feasibility of adult daycare.
Billing is the lifeblood and must be done by people who are experienced in medical billing with follow up action for denied claims. This has been a weakness of Witherell for far too long and the system needs to be evaluated to see how the facility can increase the reimbursement for services due to better records and proper billing.
I believe all of this must be done BEFORE any thought is given to whether to privatize NW and I am glad to devote my time energy and effort to achieve these goals.
Should the Town, including the RTM, want to consider privatization in the future, I understand from my personal experience the connection the Town has with Nathaniel Witherell and we will work to retain those ties even if a privatization occurs.
I thank the members of the RTM for their time and consideration, and I hope to get your confirmation.
Brad Radulovacki also circulated a statement via the RTM all 230-member email
I am Brad Radulovacki and I serve with you on the RTM. I am now also a candidate for the Nathaniel Witherell Board. I have over a decade of experience in managing and operating urgent care centers and am very interested in helping the Nathaniel Witherell provide the best care for its residents in a responsive and efficient manner.
Some members of the Witherell Family Council have written in opposition to my candidacy for the Board because they fear I may be set on privatizing the facility, but I can assure you that I have not made my mind up on any potential restructuring alternatives. However, I recognize that privatization is likely one of the alternatives the Town may consider if this can provide better care for the residents and lead to more efficient and effective operations.
If we can achieve those goals through self-management, I would be prepared to support that path as well.
Opponents of my candidacy have argued that I have publicly advocated for privatization, which is untrue. At Appointments last night, when this question was raised, I read my public comments and showed that I never advocated for any particular solution. The only public record of my comments regarding Witherell is to (1) urge board members to better educate themselves about the key operational issues causing the on-going instability in levels of service and financial performance at the nursing home and (2) highlight the need for better financial controls regarding billing patients. Both of these issues were illustrated in consultant reports available to the board and are presently the subject of a review by the Town finance department.
The Witherell is in urgent need of the best management, board oversight and staffing. The past 2 years have been the most difficult time for the Witherell in decades. We’ve witnessed a decline to a one-star rating (now 2 stars), instability in key management positions, an unprecedented bad debt write-off ($5-6 million and counting) and faltering enrollment.
My experience can help ensure that either as a standalone entity or with the help of a professional manager we will improve the level of service and avoid many of the current financial pitfalls. I have strong relevant experience, motivation and a patient-centered vision of how health care should be delivered. I have spent 2 years educating myself about the Witherell as part of the Finance Committee Working Group on the Witherell.
I volunteered for this position because my experience as a manager and operator of urgent care centers, where patient satisfaction and efficiency in providing services is the key to success.
This is what we need to make the Witherell the best it can be. I am excited to give back to the Town, and assure you my desire to help is sincere and open-minded. I hope you will support me in my goal to improve the Witherell. If you have any questions, please feel free to reach out as I would be happy to talk to you more about this. Thank you.
Family Council member Amy Badini
On Thursday, Ms Badini addressed RTM district 6, where she said First Selectman Camillo had made it clear that he wanted to “unload” the Witherell for a long time.
“Last year, when he realized that the board has the vote to privatize or remain a town service, he has been steadily marching toward the goal of placing folks on the board who are favorable to privatization.”
To share an opinion on the Witherell or the nominees, it is possible to email all 230 members of the RTM.
Dissecting the Loss of the Nathaniel Witherell’s 5-Star Rating November 30, 2022