HomeMy WebLinkAboutResolutions 2003 (13) r � -
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RESOLUTION AUTHORIZING THE ST. CROIX COUNTY NURSING HOME
TO DOWNSIZE TO 7 2 BEDS
RESOLUTION 13 (2003)
WHEREAS, the St. Croix County Nursing Home is responsible for caring for those needing
nursing home care; and has experienced a declining census; and
WHEREAS, the State of Wisconsin has recognized the declining census statewide and imposed a
penalty on the Medicaid rate if occupancy drops below 90.5 %; and
WHEREAS, declining Intergovernmental Transfer Dollars (LG.T.) will significantly increase
costs for County Nursing Homes; and
WHEREAS, St. Croix County can reduce county expenditures by downsizing the Nursing
Home's capacity, as of July 1, 2003.
NOW, THEREFORE, be it resolved by the St. Croix County Board that the St. Croix County
Nursing Home will proceed with downsizing the Nursing Home's licensed bed capacity from 124
beds to 7 2, beds, effective July 1, 2003, with a letter to the State of Wisconsin dated by June 30,
2003.
Dated this 11 day of April, 2003.
Offered by: St. Croix County Health and Human Services Board.
AFFIRMATIVE: NEGATIVE:
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Amended by the St. Croix County Board of Supervisors by changing
84 beds to 72 beds and adopted on April 15, 2003.
(04ndyk 6i
Cindy Campbell, County Clerk
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1. Resolution to downsize Nursing Home licensed bed capacity:
a. The issue to downsize is being pushed by the state's penalty
to tax licensed beds beginning 7- 01 -03. The estimate net
effect of that bed tax will be- $38,000 per Brian Schoeneck.
David Lund from the state's financial department has offered
an incentive to guarantee our Medicaid rate through the
downsizing period. If a decision is made as to the facility
number before June 30, 2003, the board will not need to bank
or unbank beds since we will be in the process of downsizing.
Additionally, the option to switch beds from one wing to
another after they are delicensed can be done so the facility
is not stuck with a delicensed bedroom that may later be
needed during remodeling.
b. The size of the facility does affect staffing and revenues.
For example, every M dicaid day generates a revenue of $122-
$145 per day. So taking the average per diem of $133.50 would
generate an annual revenue of $48,727.50 per resident. If that
same resident were Medicare, the average per diem is $377.40
or $137,751. So if the # of beds available decreased from the
estimated census, such as from 84 to 76 or 8 beds, it would
mean a decrease of revenues of $386,180(MA) or $1,102,008(MC)
or any combination in between depending upon the pay source.
The estimate of staff cost reduction is as follows:
Staff reduction in 2003 when census dropped to 80 $126,237
Staff reduction in 2003 if bed size is 76 $76,286
Total $202,523
Additional efficiencies could be attained if a remodeling
project included space for a dining area on each floor so
staff would not need to use the ramp three times a day for
meals.
Delicensing beds should enable the facility to collect
bedhold, which would help the revenues, and could amount to
$5,000 to $8,000 per year.
After much discussion with staff regarding the size of the
facility, it seems reasonable to downsize to 84 beds. The
rationale is as follows:
1. The average census for 2002 was 88.50
2. The average census for the first quarter of 2003 is 86
3. Bedhold could be collected at 95% of occupancy.
4. Staff reduction has already taken place during this year.
Other efficiencies will continue to be looked at, but a bed
size of 84 would be less disruptive to the total operation
since our census has been slightly above and slightly below
that number. Please see the chart below of average census by
month for 2002 and 2003.
5. Revenues for 8 residents would be maintained.
6. If census would continue to decline, further downsizing could
be done, but if beds were reduced to 76, the 8 beds could not
be requested back.
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c. Census is 85 today (4- 03 -03) with two residents on LOA, and 1
pending admissions. Admissions have been slow the past two
weeks.
d. Corporation Counsel has been consulted with regard to Chairman
Malick's suggestion to operate two small nursing homes to
maximize the state's incentive for 50 beds for small homes.
Corporation Counsel said the idea should be carefully
considered and outside expert, legal counsel as well as
financial and tax consultants should be obtained to determine
if it is possible. Corporation Counsel does not feel this is
an area within their expertise. Corporation Counsel also
suggested that if the Health and Human Services Board wants to
pursue it, that it should be referred to the Finance Committee
for approval.
NURSING HOME CENSUS FOR 2002 AND 2003:
2002 2003
90 91
88 84
84
86
89
91
90
90
86
88
89
91
Average 88.50