The Schuylkill County commissioners are facing a decision that many other counties throughout Pennsylvania have had to make in recent years: whether or not it should get out of the nursing home business. “The counties are always torn in making the decision,” Douglas Hill, executive director of the County Commissioners Association of Pennsylvania, said Thursday. “It is something they have been doing for about 150 years.” The County Code once required all counties to operate their own nursing homes. Since that is no longer the case, most counties have decided to cut ties with their nursing homes. “I have been doing this for about 30 years,” Hill said. “When I started, there were probably 46 or 50 counties that still had nursing homes. Now, it is down to 22.” Schuylkill County’s Rest Haven nursing home, Schuylkill Haven, had a net operating deficit of about $3 million at the end of 2013. So far this year, the county commissioners had loaned the facility $1,307,927.73 and allocated $758,891.59 to help pay the bills. The commissioners allocated $255,415.62 in 2012 and $300,000 in 2011. Before that, the commissioners did not have to allocate funds since giving Rest Haven $975,000 in 2004. “The easy answer is the cost,” Hill said about county homes not turning profits. “The reimbursement rate per bed is not adequate to cover the cost and counties generally have to make up the difference.” Hill said about 90 to 95 percent of payments at county-run nursing homes come from Medicaid and Medicare, while it only makes up about 40 to 60 percent at private facilities. The rest comes from private payments. The reason for the discrepancy is that county homes are required to take in patients that are first-day eligible, Hill said. Since the cost of care usually exceeds medical reimbursement, private facilities tend to lose less money on their patients. “The cost balance is easier for a private home to maintain,” Hill said. Built in 1912, Rest Haven is a 142-bed facility. The daily cost per bed at the facility is $221.47 while Medicaid only reimburses $172.09. About 84 percent of the patients at Rest Haven pay with Medicaid while 5.5 percent use Medicare. The remaining 10.5 percent use private payments. That is a difference of $29.38 in daily medical reimbursements per bed and adds up to a loss of $2,144,820.30 over the year. Hill also said reimbursements from medical assistance have not increased accordingly. “The reimbursement rate is in no way keeping up with rising costs,” he said. In Carbon County, similar problems led the commissioners to sell Weatherwood Nursing and Rehabilitation Center, Weatherly, in 2010. “At the time we made the decision to sell the home, we were projected to have a $3 million deficit each year,” Carbon County Commissioner William O’Gurek said Thursday. O’Gurek, now is in his 11th year on the board, said the facility started losing money in 2008 and through 2009. He also cited low medical assistance reimbursements along with union contracts for nursing home employees making things difficult for county-operated homes. “With what the costs have increased to, it makes it very hard to keep your head above water,” he said. A 200-bed facility, Weatherwood only had about 150 beds filled prior to being sold. Rest Haven, on the other had, was operating at full occupancy at the end of July. The population at Rest Haven has steadily increased since Service Access and Management, Pottsville, took over management responsibilities at the facility in 2012. It is the first time Rest Haven operated at full occupancy in at least six years. “We found ourselves in a competitive market in Carbon County in that we are surrounded by nursing homes all over the place,” O’Gurek said. According to the government Medicare website, there are at least 14 nursing homes in Schuylkill County. “It also dropped because as a Medicare provider, we had faced some violations,” O’Gurek said. O’Gurek said the facility was not permitted to accept Medicare patients until plans to resolve those issues were submitted to the state Department of Health. The hospitals in the area were also recommending patients to wings at their facilities. “We were also competing against ourselves in that our Area Agency on Aging administers a waiver program encouraging seniors to stay in their homes longer by providing them with programs and funding for things like nursing and housekeeping,” O’Gurek said. “In one department, we are encouraging people to stay in their homes and in another, we are trying to run a nursing home.” Carbon County then acquired the services of Marcus & Millichap, Real Estate Investment Services of Philadelphia, to review all the finances at the nursing home, including union contracts, operational expenses and medical assistance reimbursements. O’Gurek said the company provided them with three options.
Posted on: Sun, 24 Aug 2014 01:59:01 +0000
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