Can Peoria County still afford to run a nursing home?
"Heddington Oaks is one of the most beautiful and best-equipped facilities in the state. It has one of the best-qualified and dedicated staffs, but where the thing falls down is the the cost," said board member
Harding charged that the board has run through over
That figure is contested by board members like
"We're burning through the reserve money," he said, pointing to the Heddington Oaks reserve fund that's shrunk from
"Selling (Heddington Oaks) is not an option now, but the board's majority won't let us explore all the other options. My fear is that we'll wait too long to make changes," Elsasser said.
Making changes
The
In
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Following the bad publicity, Board Chairman
"We can't spend more than we take in. We've been doing that," he said. To assess the future, the County Health Committee drafted 11 topics to investigate regarding the facility.
Rand conceded that the operational results have been less than stellar, but offering the facility is important to the county, dating back 100 years.
"It's become more of a challenge to run a publicly-owned nursing home with a dedicated mission to help those who can't pay for it," said county administrator
Rand said there are only four alternatives open to the board regarding the facility.
"We could run it until we go broke, hire someone to run it, get out of the business or develop a hybrid partnership," he said.
But the options come with restrictions.
"We used tax-exempt bonds to build the facility, so we can't contract with a for-profit agency. We can't sell the property as long as we hold bonds," Rand said.
Sorrel noted that county's first opportunity to refinance the nursing home will be when the bonds are 10 years old in
"If we don't refinance the bonds, we have 20 years remaining on the original bonds. If we choose to refinance the bonds any time after
With a majority of the county board supporting the safety-net mission of the nursing home, the hybrid partnership appears to loom as the best choice for future administration of the nursing home.
Losing money
County administrator Sorrel says the nursing home needs more residents to stop losing money.
"We projected having 180 residents a day (to build back reserves) but we've had a hard time getting there. We have a hard time getting above 155 residents," said Sorrel, who projected a
"There's no good solution as long as we're stuck at 155 (residents). We've got to get the number higher," he said.
Board member
"One, the Affordable Care Act shifted some nursing homes to in-home spending. Two, Medicaid payments that are only supposed to take 45 days to process can take up to a year or more; that amounts to more than a million-dollar deficit for the nursing home," he said.
"Third, when we built Heddington Oaks, plans were to provide a self-contained dialysis center with a private vendor. Unfortunately, that vendor went bankrupt. That's an opportunity we need to address," Mayer said.
Professional help
In an effort to bring professional expertise to the table,
"Both men have provided tremendous counsel," Rand said.
"Heddington Oaks cares for the most vulnerable populations, and patients who are covered by Medicaid have a reliable place to go when they need care; this is not always the case at other facilities who may have limited number of Medicaid beds available," said Querciagrossa, who cited staffing and leadership among recent changes in the operation of the nursing home.
Heddington's administrator recently left for another job. Replacing him will be a challenge going forward, said Querciagrossa.
"My goal on the committee has always been to provide the most current information from the healthcare space that may have an impact on the county nursing home," he said.
"In any job, there's head-banging, but I'm optimistic," he said. "Take accounts receivable, the amount that's owed to us for services. That balance has gone down for four months in a row."
Assistant County Administrator
While providing for Medicaid patients is part of the county's mission, Musselman said efforts continue to attract more Medicare patients and short-term stays, patients who need to rehabilitate from illness or injury. "We receive a higher reimbursement from Medicare," she said.
Federal, state oversight
One of the issues the county faces is upgrading how Heddington Oaks scores in the rating system used for all nursing homes by the federal government.
Heddington Oaks gets a two-star rating overall from the
The
"We took swift action to remedy this isolated situation as soon as the management team learned about it, including disciplining the employees involved. Those employees are no longer under our employment. We created a corrective action plan that was approved by the state, and have since remained in compliance including the payment of a reduced fine," said Sorrel.
The strict state oversight was another reason for board critics to call for change.
"I've heard that the only thing that government regulates more stringently than nursing homes is the nuclear power industry. If that's the case, we need to put this in the hands of healthcare professionals," said Harding.
Providing service
"Heddington Oaks is the most divisive issue on the board. We need to work together," she said. "All 18 members care about the elderly in
Along with focusing on the business model, Williams said it was also important to understand the people factor. "At the end of the day, (Heddington Oaks residents) are your neighbors. They should be able to spend their last few days with dignity," she said.
Board member
The issues are not new to the board.
"It's been at the top of the
Other counties in the state have struggled to maintain nursing home operations as well, Harding said.
"We've been watching
"We're bucking a trend to hold on to this. County-owned nursing homes are not the way of the future."
In 1848,
In
After 60 beds were added to the facility, the hospital was run by
In 1948, the state of
In
In 2003, over 70 percent of
In 2013, Bel-Wood was replaced by Heddington Oaks nursing home at a cost of
Marketing Heddington Oaks
"We still utilize traditional TV commercials and various print ads, but we've also tried to incorporate some new things like the longer-format interviews on 'Living Well,' a regular feature on
"One of the advantages of a program like 'Living Well' is that it allows us to more fully explain our services and talk more conversationally and less clinically. It can also help us highlight some of the differences between our home and others in the area," said Pearsall. There is a charge for the program.
"Where we're trying to make some headway is with digital marketing. On our new Heddington Oaks website, we provide information on what to look for in a skilled-care facility, what people can expect from their Medicare coverage, why you need to start your Medicaid process (application) sooner rather than later," she said.
Like other health care providers, nursing recruitment is a priority with the area shortage. The county hired an intern for the spring and summer to assist with online recruitment efforts.
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