Sitting next to me was Birdman Paul, who brought his camera to capture politicians in their natural habitat. Before the night was over, he had banded Angle, State Rep. Rich Grucela and Dauphin County Commssioner Jeff Haste, who migrated from the land of midnight payraises for an evening in the slate belt. Council members Bruce Gilbert, Barb Thierry and Tom Dietrich were there, as well as County administrators John Conklin and Ross Marcus. But the star of the show was Eckert Seamans legal heavyweight Mike Miller, whose powerful presentation seemed to sway a dubious audience. I'll try to summarize the points made.
Deficits. - Three out of every four publicly owned nursing home is running at a deficit. In 2009, Gracedale's shortfall was $4.6 million, and this year's deficit is ecpected to run at about $5 million. Next year, if you include needed capital expenditures, Gracedale will run $11.7 million in the red. Over the next ten years, $70-80 million in taxpayer dollars will be needed to finance operations and capital expenditures. Since we only bring in around $80 million in real estate tax revenue, this is a money pit.
Reimbursement. - For reasons known only in the land of midnight payraises and the bowels of our nation's capitol, County-owned nursing homes get the shaft when it comes to reimbursement for Medicaid. In 2006, for example, Gracedale received $2.6 million less than it would have received as a private facility. In 2010, our nursing home is reimbursed $4.3 million less than it would receive if it were private.
Competing pressures. - The government has to decide between a new boiler at Gracedale or fixing a bridge. A private company can concentrate on the nursing home.
Trend against nursing homes. - Thirty-eight of Pennsylvania's sixty-seven Counties no longer provide a public nursing home, and an additional seven Counties are considering a sale.
Reducing the size will fail. - The smaller you get, the less money you get, and that begins to affect the quality of care offered to residents.
Benefits. - The benefits made available to the workforce in a County-owned facility are a whopping seventy per cent of their actual salary.
Quality of care. - That may actually increase under private management. Unless they provide a high quality of care, they will lose residents to other nursing homes that provide it. "Quality of care drives success in the long-term care industry," according to Miller. He added that quality of care can be provided for by "contractual commitment" with a new buyer. It could even be associated with the star-rating system at Gracedale. Dauphin County Comm'r Haste stated that the man reason for selling Dauphin's public nursing home was to improve that quality of care. Angle added, "We are very concerned about the patients in there." Council member Bruce Gilbert added, "That is our very deepest concern."
Access to the Indigent. - Miller explained that, when he negotiated with the private buyer at Dauphin County, the buyer contractually committed to "always keep the front door open" for the poor. This commitment, somewhere around 80%, was actually included in the deed and will bind successors. There are also quarterly reports to assure the County of compliance.
Employee retention. - "You just can't bring in 800 employees," remarked Attorney Miller. "The new owner wants them to stay because of their institutional knowledge." Comm'r Haste added that many employees left the nursing home, only to return a few months later. Angle noted that many of the Gracedale workers (300 plus) could retire from the County and start working on a second pension at a private facility. "It can be very lucrative, quite frankly, for the employees," reasoned Angle. Everyone agreed with Bonnie Labar's statement that "it takes a special kind of person" to want to work in a nursing home. Gilbert added that "the employees are the true jewel."
Will Sale Enable Tax reduction? - Angle noted that, thanks to a poorly considered $111 million bond, the County was shackled with a quarter-billion dollars in debt. In addition, the swaption price tag is somewhere around $18 million. Angle voted against it, but has to figure out a way to pay the piper. Gracedale itself has about $4 million in debt. "So if you think selling Gracedale is somehow a windfall, it's not a windfall at all." He presented a sale as something that would help both the patients and the taxpayers.
He acknowledged not everyone is gong to be happy. "My wife said this just yesterday, 'I'm not sure there's anybody happy with you anymore.' I said, 'Well, I'll go up in the field, fire up a cigar, and talk to the cows. As long as I keep feeding them, they'll still be my friends.'"
"Nobody is going to vote to sell Gracedale and deteriorate the level of care or eliminate the opportunity for people who need to go there because of their finances."
A fourth informational meeting about Gracedale is scheduled for tonight, 7 PM, at Chrin Community Center, 4100 Green Pond Road, Palmer, PA 18045.