Wednesday, July 3, 2013

Skilled-nursing contract nearly final

Commissioners elect to stick with 10-year term

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By GREG MOORE
Express Staff Writer

    A service contract with Safe Haven Healthcare is on track to being completed by the target date of July 23, County Administrator Derek Voss told the county commissioners during a meeting Tuesday.
    At issue is a draft agreement for the county to convey its Medicare/Medicaid certification to Safe Haven for use at its planned senior-care facility in Bellevue. As part of the plan, Blaine Manor in Hailey, which has been subsidized by the county, would be absorbed into privately operated Safe Haven.
    County leaders are still discussing the agreement. The commissioners objected Tuesday to a provision proposed by Deputy Prosecuting Attorney Tim Graves to reduce the term of the contract from 10 years to five years. Another proposed provision would relieve Safe Haven from having to provide at least 16 Medicaid-funded skilled-nursing beds if circumstances substantially affect Safe Haven’s ability to do so. Those could include changes in Medicare or Medicaid reimbursement rates or competition from another nursing facility.
    “Safe Haven’s fear is, I believe, legitimate,” Graves said. “They don’t want to be locked into providing 16 beds if their future business or regulatory environment requires less.”
    Beginning next year, the federal Affordable Care Act will bring changes that even health-care experts say cannot be completely predicted. In an interview after the meeting, Blaine Manor interim Administrator Stephanie Jaskowski said the state of Idaho will draw up a list of nursing facilities approved for Medicaid payments, and the facilities will need to decide whether they’re willing to accept the new reimbursement rates. In an interview last week, Safe Haven CEO Scott Burpee called the new regulatory environment “very confusing.”
    However, all three commissioners agreed to hold Safe Haven to the 10-year commitment.
    “I’m not in support of allowing a unilateral decision for either party to opt out,” Commissioner Jacob Greenberg said. “[But] we can’t make it so onerous that Safe Haven goes out of business and there’s no skilled nursing.”
    He suggested that the contract include some flexibility as to the definition of skilled nursing.
    Graves said he would take those directions back to his negotiations with Safe Haven.
    One other potential stumbling block is that the two parties must agree to a value of the “operational assets” that Blaine County will be transferring to Safe Haven, most of which Graves said are intangible, such as the ability to immediately obtain an operating license. That value is important because it will constitute the damages that Safe Haven will have to pay if it breaches the contract.
    At the suggestion of Commissioner Angenie McCleary, the current draft agreement will be distributed to Blaine Manor board members for their comments, which were requested to be submitted to the commissioners before their next meeting on July 9.
    Safe Haven’s concerns about competition from another skilled-nursing facility apparently do not extend to The Cottages’ proposed senior-care facility in Hailey, which would include assisted living, but not skilled nursing, facilities.
    “Do we feel threatened by them coming in? Not in the least,” Burpee said last week. “We’re kind of excited that they’re moving to Hailey.”
    Burpee said he expects the two facilities to complement each other, with Safe Haven providing skilled nursing to The Cottages’ residents when they need it. He also said the two facilities will address different market segments in their assisted-living quarters, with Safe Haven accepting Medicaid patients and The Cottages providing services to more affluent residents.
    “They charge a premium but they do a good job,” he said of The Cottages’ nine existing Idaho facilities.

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