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HHS Board studies three nursing home options

A decision about the future of the St. Croix Health Center nursing home may finally be close at hand.

The Health and Human Services Board met Monday to discuss ideas related to the possible closure of the county-run facility or the continuation of its operation.

A standing-room-only crowd attended the morning meeting, with a number of county residents voicing their support for the 100+-year-old nursing home.

Lee Kellaher, New Richmond, urged HHS Board members to not focus solely on tax support for the nursing home when deciding whether to close the facility.

"I don't think closing it is the answer," he said. "Put our own people in front of the dollar."

Scottie Ard, New Richmond, reminded the HHS Board that St. Croix County voters have overwhelmingly backed two separate non-binding referendums that authorized the county to continue to subsidize the operation of the nursing home with general tax dollars.

She challenged the HHS Board members to use their collective business backgrounds to help make the nursing home sustainable.

Gary Kittel, New Richmond, whose wife received care at the county nursing home, said the facility should continue to operate and take care of residents who deserve help.

"To shut down the Health Center would be a very sad day," he said.

For a majority of the meeting, the HHS Board heard a report from consultant Larry Lester, with the Wipfli LLP accounting firm.

Lester boiled the situation down to three potential future paths:

1) Closing the facility or selling the nursing home.

2) Operating the facility with no upgrades, but making budget cuts to reduce the drain on taxpayers.

3) Building a new facility to better compete with other nursing homes in the area.

According to Lester, operating profitable nursing homes continues to be a challenge. The only ones that seem to make it are those that build new facilities, he reported. The new facilities trump those providing a perceived higher level of care, he added.

"It really has nothing to do with how hard the staff works or how they care for the residents," Lester said.

Even with a new facility, Lester told the crowd, the nursing home business is difficult due to varying reimbursement rates and strong competitive forces.

"It's a gamble," he said.

St. Croix County had previously studied the idea of building a new 50-bed nursing home and attached 48-unit assisted living facility. But opposition from some on the St. Croix County Board derailed the suggestion.

HHS Board member Roger Larson said the county shot themselves in the foot when they didn't move ahead with a building plan. Now the county nursing home is suffering the consequences of no decision, he said.

In recent months, the financial stability of the facility has continually declined. The nursing home was dropped from 72 licensed beds to 50 beds a few months back, in hopes that improved reimbursement rates would help buoy the financial statement of the facility.

But as the nursing home's census continues to fall, the financial losses incurred by the facility are mounting. The latest financial projections suggest that the nursing home could be in the red by more than $1 million by the end of the fiscal year. Others suggest the loss could top $1.5 million.

HHS Board member Tom Hawksford said the time has come to make a decision on the matter. The closure, sale or restructuring of the nursing home has been debated for years and nothing seems to change.

"We need to make a decision here," he said. "We have to look at the future, and the future, unfortunately, doesn't look good. Let's stop the bleeding."

HHS member Fred Yoerg agreed, saying the financial picture doesn't seem to be improving despite previous efforts.

"It appears the boat is sinking and it's starting to sink quicker," he said. "It continues to bleed red and is getting worse."

Yoerg said the private sector is building new nursing homes so it's no longer necessary for the county to operate a publically-owned facility.

Larson said he disagreed, noting that he doesn't believe the figures that suggest that the county nursing home's financial pricture will continue to worsen as time wears on.

"I don't feel closing the nursing home is a good option," he said. "I know you're looking at dollars and cents. To lose it (the nursing home) would be a large loss to this community."

Hawksford eventually made a motion to have county employees draft a resolution to close the nursing home over the coming months. The idea died on a 3-4 vote with Hawksford, Chris Kilber and Fred Yoerg voting in favor and Dr. Lisa Ramsey, Leon Berenschot , Roger Larson and Deb Rasmussen voting against. Chairman Fred Horne and member Tim Hood were not in attendance for the meeting.

After the motion failed, Health and Human Services Director Fred Johnson said some operational savings can still be accomplished to help keep the nursing home operating.

One suggestion being discussed is scaling back the salaries of employees to bring them in line with average pay among nursing homes in the region. Other possible cost savings measures could include forcing employees to contribute more money toward their health insurance premiums.

Even with those cuts, Johnson said it would be important for the county's elected officials to determine the level of levy support they feel comfortable providing the nursing home in the future, if any at all. There is also some debate as to whether such financial line items like depreciation should be included in the factoring of the facility's losses.

Another option would be to build a new nursing home that can compete with the private facilities across the region, Johnson said.

The HHS Board set a special meeting for 8:30 a.m. Thursday, Sept. 20, to further consider the three possible options dealing with the future of the nursing home. The board hopes to forward to recommendation to the full St. Croix County Board for consideration during its October meeting.