The McLean County Nursing Home is at a “tipping point,” according to a blue-ribbon panel of health care leaders that studied the facility.
A.J. Querciagrossa, president of OSF Home Care Services and a panel member, said prospects for the home are bright despite a $1.2 million loss last year. Querciagrossa said even a few quick changes can stop financial hemorrhaging at the facility.
“If the county decides to put resources toward this and move forward, we believe it’s very sustainable in the long term,” said Querciagrossa.
The panel released its report Monday. The panel recommended a long list of items including forming cooperative referral agreements with area hospitals called Accountable Care Organizations (ACOs), increasing marketing efforts with hospital liaisons to work with families on nursing home placements, begin planning for more Medicare rehab and Medicare patient segregation from the Medicaid population, and commit to longer-term work on facility improvement.
Querciagrossa said the county might need to increase pay to attract more permanent staff and reduce the cost of temporary workers.
“Over the last two years, McLean County has used significant funds to bring staff in from agencies. In 2017 we had over $500,000 in costs for agencies. We call them guns for hire in our industry,” said Querciagrossa.
He said agency hires come with a 30 percent premium for RNs and 15 percent for LPNs over existing salary expenses.
The panel concluded even an average of ten more Medicare patients per month would stop the budgetary bleeding and perhaps allow the home to break even in a year to a year and a half.
County Board member George Wendt said closing the home would allow the private sector to fill in the gap.
Panelists said private care facilities would not choose to do that because Medicaid patients are not profitable enough to serve.
On paper, Barb Nathan of Westminster Village acknowledged there might be Medicaid beds vacant in the community, but private nursing homes often refuse placement for financial reasons or because they do not have staff to handle particular patients with acute care needs.
The panel also noted that the McLean County Nursing Home’s four-star federal rating should give it a competitive advantage in referrals. There is also one five-star facility in the county, according to the report, but no other home even has three stars, the minimum needed to gain a waiver of the federal three-day hospital stay before a patient can be placed in a nursing home for ongoing or rehab care.
Nursing home census counts started falling for the facility in 2013, as did many nursing homes. The federal government is moving more toward managed care options, which give incentives for home, rehab, and hospice care instead of longer term nursing home placements.
The report indicated the number of nursing homes in the industry and the number of licensed beds are both on a multi-declining trend.
But panelists said the McLean County Nursing Home remains the only viable place for large numbers of Medicaid patients and that communities which have shut down their homes place significant pressure on low-income families once their elderly relatives have exhausted their assets paying for care. They said it leaves those most in need in the lurch.
The full McLean County Board will take up the report and the policy debate in a couple weeks.
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