From yesterday's News-Gazette:
The Champaign County Nursing Home, which will have to borrow money from the county to stay afloat, could save money by altering its mix of clients to reduce Medicaid patients – which would go against its tradition of serving the poor.
About 60 percent of its residents are on Medicaid, up from 48 percent in 2000, the first year for which Administrator Andrew Buffenbarger has census records.
About 28 percent are private paid and 10 percent Medicare, which has a higher level of reimbursement.
Taking care of the less-well-off has been part of the county's mission since it ran a poor farm on the same site as county offices.
But the rising proportion of Medicaid residents is hard on the nursing home's finances, Buffenbarger said, because "Medicaid reimbursement is considerably lower than the cost of services."
In other words, if Buffenbarger filled every bed in the new $24 million facility with Medicaid patients, the nursing home would lose even more than the up to $100,000 a month it has lost in the last two years. Instead, the home has run with about 80 of 243 beds empty recently.
Additionally, Medicaid reimbursement has not only been cut by $600,000, it's months behind.
Discuss.
UPDATE: Big E has more thoughts here.
Some apparently expect the home to run on at least a break-even basis. But if that is the case, why is government involved at all? Is there a lack of private nursing home companies out there? Not likely. Why in the world would an impotent county government imagine that it is in a better position than a professional private company to run this operation? If the goal is to minimize expense to taxpayers, sell the damn thing to a professional operator and cut your losses.
It is not a little ironic that the idea of booting impoverished Medicaid recipients is being floated. If the goal of the facility is to provide refuge to those who would otherwise be out in the cold, this step would be absolutely contraindicated.
So what's it going to be, you dummies? A decision to provide heavily-subsidized care, or to make the facility a self-sufficient enterprise? The choices could not be more stark, but resolution will require courage and clear-thinking. I, for one, am not holding my breath.
I never thought the County Nursing Home should be expected to make money or break even. The private homes all have restrictions on the number of medicaid residents they allow, and many of them are struggling financially. We've lost a couple here in the past 10 years, others have been sold several times, and rumor has it that Carle is trying to unload the Arbours. And not all of the elderly who cannot live on their own require the highest levels of skilled nursing care, resulting in lower reimbursements from the State. But these people are still in need of a place to live. Most nursing homes have various levels of care, with corresponding fees. Someone needs to take care of those who cannot care for themselves. If not the County, then who?
And I don't want to hear the "If they had planned for their retirement" argument. These are mainly people who have never been in a position to save for the future. Many are females who grew up when women were encouraged to get married and stay home to raise the family rather than get an education or a job. Many have outlived spouses and/or children. Lots of families exist from paycheck to paycheck, often even with more than one job. Those of us with good retirements benefits and health insurance would still have a hard time payment for long-term nursing home care.
Our county home has been making inquiries thru out the region as to the number of beds available,,,,that is just in case they need to relocate residents. Even a person with a decent retirement income needs help from Medicaid, example,,,,if a person has a combined Social Security income with a pension or an annuity,,,and that comes to $2500.00 a month, at current rates medicaid could kick 1000 or 1500 or more to help. There is no shame in my eyes to needing help from Medicaid. There has been, and will always be a delicate mix between private pay %100, and a mix of private and medicaid help. For most homes,,,,a full house is not the answer. My mom ran a home very well for 25 years,,,we were certified for 120 beds,,,,,,,,but in reality 97 full beds was the optimum. I have no way of knowing what the CCNH's break even point is...there is nothing wrong with a small yearly subsidy from the county,,,,but something is really amiss when millions have to poured in there,,,something seriously amiss.
The question is not whether the nursing home will be subsidized or whether it should "break even". it currently receives a subsidy of 2.5 million a year through our property taxes so it is far from breaking even. Further, if it was a private for profit facility it would pay about half a million in property taxes. So the question is whether it should be subsidized even more.
I hope and pray that if the worst case doe's come to pass,,the transfer of residents is done with dignity and repsect. Our home was on the receiving end several times of receiving new residnets in mass,,,I even drove over in a bus and picked them all up on occassion. It needs to be done in the open,,,I dont think the County Nursing home wanted it to be public knowledge that they have been looking around for empty beds,,,,I know it might create panic and dispare to families and residents. But, the county board needs to make sure it is open and above board,,there have been too many secrets over that place already,,,,,,,which one reason they are in the boat they are in now.
This burden on the taxpayers will be endless. If you think one tax increase is going to be enough, then you're crazy. If this nursing home cannot break even, they why tax the be-jesus out of the citizenry to pay for it. It's a painful and expensive lesson....private providers must break even, public nursing homes have absolutely no emphasis to be even remotely break even...why should they? The taxpayers just handle a bigger burden and down the road we go to financial ruin. If the union employees contract come up today...I'l bet the county would give a sizeable raise regardless of this poor financial picture. Sadly, that's how government operates.