Northwest Bec-Corp suggests deregulating Blaine Manor
"Every major nursing home business in the country is in
bankruptcy."
Dan Adamson, Northwest Bec-Corp CEO.
By TRAVIS PURSER
Express Staff Writer
With no long-term management and funding plan in hand for Blaine
Manorthe countys only skilled-care nursing homeBlaine County
Commissioners last Tuesday considered a proposal to deregulate the facility.
Northwest Bec-Corp, a Pocatello-based healthcare and pharmaceutical
conglomerate, proposed three collaborative arrangements with Blaine Manor.
Two these plans would allow the home to remain a skilled care facility
under private management. Little comment was made on these proposals which almost
certainly would prove expensive.
The third idea, which took up most of the meeting, is a plan to convert
the home to a residential care facility under Northwest Bec-Corp management. That would
remove state and federal rules, slashing costs and making the home financially viable for
the first time, the company says.
The deregulated system would qualify to care for 80 percent of Blaine
Manors 25 current residents, the company says. Those 80 percent would include
extremely frail, sick or debilitated residents. No plan exists for the Manors other
20 percentthose needing temporary skilled nursing while recovering from illness or
surgery.
Currently, the county helps fund Blaine Manor while St. Lukes
manages the home. In December, when St. Lukes new hospital south of Ketchum becomes
fully operational, the arrangement will end. With only five months left before that
happens, planners are scrambling for a solution to the dilemma.
But negotiations are complicated because both St. Lukes and the
county say they lack the necessary experience to run the operation.
New Medicare and Medicaid rules have exacerbated the homes financial
problems. Just how much the home loses each year, however, is not clear. Last week,
Commissioner Len Harlig said the county pays a $66,000 subsidy to the home each year to
cover losses.
At least one hospital administrator denies any loss at all, however.
When asked during a telephone interview if the home operates at a deficit,
St. Lukes director of clinical services, Debbie McCoy, who oversees Blaine Manor,
said, "I wouldnt say thats the case."
The homes temporary, on-site administrator, Paula DeAnda, said
during last weeks meeting that she feels St. Lukes keeps her "in the
dark" about the homes finances.
"Im told that Im $350,000 over," she said. But she
doesnt know the details of that figure because St. Lukes does not provide her
with an itemized financial statement, she said.
Both DeAnda and McCoy declined further comment on those discrepancies,
deferring instead to St. Lukes Wood River Medical Center CEO Jon Moses. He was out
of town and unreachable through this week, a hospital official said.
Whatever the case, Northwest Bec-Corps 32-page, spiral-bound
proposal predicts the home would lose $230,000 each year under a straight Northwest
Bec-Corp management contract if the home remains a skilled-care nursing facility.
If Northwest Bec-Corp leases Blaine Manor and manages it as a skilled-care
nursing home the facility would lose $314,000 each year, the proposal says.
But as a deregulated residential care facility, Blaine Manor, the proposal
predicts, would net a small profit of nearly $13,000 per year.
However, with that profitability comes a change in the level of care.
In its current status as a skilled-care nursing home, Blaine Manor
provides the services of a registered or licensed nurse, who administers and monitors
medications, injections, catheterizations and similar procedures ordered by an attending
physician. Post-hospital stroke, heart or orthopedic care is available, with related
services such as physical, occupational and speech therapy, dietary consultation and
laboratory services.
A residential care facility provides services for people not needing
skilled-care level nursing, but who require medication assistance, help with dressing and
special diets, according to the Idaho Health Care Association.
During the Tuesday meeting, Northwest Bec-Corp CEO Dan Adamson said costs
plummet when converting a skilled-care nursing facility to residential care. Thats
because state and federal rules require a reduced level of administration and staffing and
fewer services for residential care.
"Its unbelievable, some of the differences," he said.
"The numbers turn themselves around and theres a small profit at the end of the
tunnel." Adamson also said that deregulating Blaine Manor might be a "terrible
idea" for people needing a high level of skilled-care nursing that will no longer be
provided. But recent changes in state rules could allow skilled-care qualified people to
reside in a residential facility, he said. And, planners could decide to have the home
continue offering the same level of care thats offered today, he said.
"Its just that the regulation is gone." Adamson admitted deregulation is a
novel idea that is not yet widely accepted. The Idaho Health Care Association, he said,
calls it the "death knell for skilled nursing homes."
"We didnt come up here thinking you would slap a contract in
our hands," he told the commissioners. But with Medicare rule changes in January 1999
that reduced payments to nursing homes by 60 percent, and changes to Medicaid rules this
month that reduced payments by 80 percent, he said, "every major nursing home
business in the country is in bankruptcy."
It might simply be impossible to continue operating Blaine Manor as a
skilled-care nursing home, he said.