Weatherwood

The fate of Weatherwood, the county-owned nursing home, will soon be discussed, officials said.

During the Carbon County Commissioners' meeting on Thursday, the board listened to a presentation by Jay Wenger, managing director of the Susquehanna Group Advisors, Inc. of Harrisburg, that illustrated the county's options when it comes to the financially bleeding nursing home, located in Weatherly.

Wenger, a representative of the company hired by the county earlier this year to complete the assessment of the 200-bed facility, said some of the reasons for the nearly $3 million deficit in 2009 was deficiencies that were reported that nearly forced the nursing home to shut down; the challenge of competing in the skilled-living market; and the current case mix index is too low.

This means that some residents who are in Weatherwood do not need to be in a skilled nursing home so their CMI number is low. The number determines how much Medicaid reimburses the county for its services. The lower the number, the lower the reimbursement. Therefore, the Medicaid reimbursements coming in for some of the residents are not enough to break even in the expenses.

Wenger also provided three options for the nursing home: continue to operate the facility as a county-owned asset; outsource the management function; or exit the health care business.

Under the first option, he said it would take the county 18 to 24 months to implement changes and begin to see a turnaround.

This means that Carbon County would continue to subsidize Weatherwood for 2010 and 2011, and hopefully break even in 2012.

During this period, the county would also have to look at finances, manage staffing hours, implement care tracking software, hire a consultant for care tracking, develop a marketing strategy to improve the population, eliminate Weatherwood residents with a CMI of less than 1.0, evaluate downsizing to a 160-bed facility, develop a five-year capital budget and a two-year operating budget, and look at any other ways to cut costs and save money.

Option two calls for the county hiring an outside management company to operate the facility.

This means either a not-for-profit or a for-profit company that specializes in managing skilled nursing facilities would take over the operations of the nursing home, including managing expenses and charge a fee for its services, but the county would retain ownership.

A 12- to 18-month turnaround is estimated with this option, but no guarantees of whether or not an outside company could make the nursing home operate in the black.

The third option is to sell Weatherwood and get out of the nursing home business completely.

Under this option, Wenger said there are many companies looking to purchase nursing homes and many counties have already utilized this option.

The advantage, he explained, would be that the county would possibly see a sale by the second half of the second quarter in 2010, if they decided to sell.

"Based on the state, we believe there would be interest," Wenger said. "The county would walk away with a substantial gain and there would be no tax increase to fund it."

The commissioners then held a brief discussion on the presentation.

Commissioner Charles Getz, who has been adamant that he will not vote to sell the nursing home, said that the county is going to review all the options and try to get the number of residents higher.

"My last option is option three," he said. "I think all three commissioners want to see that the county controls it but we have to get it where we're not losing what we're losing because we just can't afford it. Can we get it down that maybe it won't cost the county a half of a million dollars a year? I don't know, but we certainly are going to try."

Commissioner William O'Gurek, chairman, pointed out that in the 2010 proposed budget, which the county revealed yesterday, there was a line item for $2.5 million for Weatherwood.

He said that if Weatherwood still requires another nearly $3 million for 2011, he won't vote next year to increase taxes to fund it.

"I'm going to hang in there as long as I can and see what happens at Weatherwood, but a year from now, I'm not going to vote for a tax increase of 30 percent to the people of this county to keep this place (under the county's management)," O'Gurek said. "I'm willing to move forward with the contribution that we budgeted for 2010 but, the results will have to be seen pretty quickly although the people in the business are saying it's unlikely to happen.

"When we make that decision, one thing is clear, if we continue to keep the home open under county management, it will require a 2 mill increase for 2011 and I'm saying right now I'm not voting for that next year so it remains to be seen how it unfolds, but I'm not going to vote next year to raise taxes on the backs of the people who cannot afford to pay taxes now. It's unfair to ask the taxpayers of this county to pay the freight to keep that place open under county management."

The commissioners will now review the assessment and determine which option would be the best for the county. No action, officials said, would be made until probably the middle of 2010.