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For the week of July 19 through July 25, 2000

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 Manor—the county’s only skilled-care nursing home—Blaine 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 Manor’s 25 current residents, the company says. Those 80 percent would include extremely frail, sick or debilitated residents. No plan exists for the Manor’s other 20 percent—those needing temporary skilled nursing while recovering from illness or surgery.

Currently, the county helps fund Blaine Manor while St. Luke’s manages the home. In December, when St. Luke’s 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. Luke’s and the county say they lack the necessary experience to run the operation.

New Medicare and Medicaid rules have exacerbated the home’s 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. Luke’s director of clinical services, Debbie McCoy, who oversees Blaine Manor, said, "I wouldn’t say that’s the case."

The home’s temporary, on-site administrator, Paula DeAnda, said during last week’s meeting that she feels St. Luke’s keeps her "in the dark" about the home’s finances.

"I’m told that I’m $350,000 over," she said. But she doesn’t know the details of that figure because St. Luke’s 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. Luke’s 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-Corp’s 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 it’s 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. That’s because state and federal rules require a reduced level of administration and staffing and fewer services for residential care.

"It’s unbelievable, some of the differences," he said. "The numbers turn themselves around and there’s 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 that’s offered today, he said. "It’s 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 didn’t 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.

 

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