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For the week of July 12 through July 18, 2000

Planners play hot potato with Blaine Manor

Long-term nursing at stake

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Six of Blaine Manor’s nearly 25 residents eat lunch in the home’s dining room Monday. After December, the existing funding and management arrangement for the long-term nursing facility will cease to exist. So far, no alternate plan exists, either. Express photo by Willy Cook

Express Staff Writer

In December, St. Luke’s new hospital south of Ketchum will be fully operational, and the existing Wood River Medical Center will shut down. That’s good news for just about everybody, perhaps, but it could mean trouble for Blaine Manor, the county’s only long-term nursing facility.

The problem lies in the fact that no plan exists to provide for funding and management of Blaine Manor after the transition.

Blaine Manor is funded by the county and managed by the St. Luke’s Wood River Medical Center.

With only five months left, 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.

During a discussion between county commissioners and St. Luke’s officials on June 16, Commissioner Mary Ann Mix said, "Quite frankly, I don’t think the county wants to be in the business of running a nursing home."

Responding to commissioners’ comments, St. Luke’s chief executive officer, Ed Dahlberg, said, "We’re concerned that we’re four or five months from opening the hospital, and there’s no definitive plan as to how [the management of Blaine Manor is] going to go forward. Part of our trepidation is it’s not expertise we have either."

Then there’s the fact that Blaine Manor consistently loses money, requiring a $66,000 subsidy from the county each year. That figure makes running the facility undesirable to the county, to corporations that specialize in running nursing home facilities and to St. Luke’s, which has repeatedly expressed concern about the financial viability of its medical operations here.

Solutions to the problem are sketchy.

After December, the existing county funding arrangement for Blaine Manor will cease to exist. But during the June 16 meeting, commissioner Len Harlig proposed an interim funding solution that involves revamping the Blaine County Medical Center, which no longer functions but still technically exists as a county entity. Harlig said the BCMC may be able to levy a special tax for the benefit of Blaine Manor.

Dan Adamson, owner of Northwest Bec-Corp., a company that runs seven nursing homes in Idaho, was slated yesterday to make an initial presentation of his services to county commissioners. Adamson said in a telephone interview that he understands St. Luke’s reluctance.

"I know they’re not for profit," he said, "but they don’t do anything they can’t make money at. Not-for-profit doesn’t mean anything in this country—it’s just a way of doing business."

Because the initial meeting had not yet taken place, Adamson was cautious about speculating on whether his company would be interested in running Blaine Manor. However, he said Blaine Manor’s financial problems are due to its small size.

For a long-term nursing facility to break even financially, it needs to have at least 40 beds, almost all of them filled, he said. Blaine Manor has 25, which may be too few to interest Northwest Bec-Corp—or anyone else for that matter.

The 40-bed minimum, he said, is due mostly to labor costs resulting from state and federally imposed staffing requirements. "The standards are extremely high," he said, requiring a federally licensed on-site administrator, a licensed director of nursing services and a minimum data set coordinator (administrative nurse), to name a few.

In all, he said, a long-term nursing home requires approximately eight department heads, not to mention the contracted services of physical therapists, dietitians and more, which a 25-bed facility usually can’t support.

Then there’s changing Medicare and Medicaid rules that are putting the squeeze on companies like Northwest Bec-Corp to provide the same level of service for less and less money.

"It’s a crazy business," Adamson said. His competition in Idaho is Sun Health Care and VenCor, two national corporations, that he said are currently in the throes of bankruptcy.

One apparent success story in all of this is the Shoshone Living Center, a long-term nursing home that, like Blaine Manor, was a county-run facility. Northwest Bec-Corp. took over the 40-bed home in a lease arrangement with Lincoln county. The facility’s administrator, Sharon Galindo, said in a telephone interview last week that the arrangement has "just been marvelous." Among other reasons, that’s because the home’s residents were able to continue living near their families. "I think that’s very, very important," Galinda said.

It’s impossible to foretell what will happen in Blaine County. So far, St. Luke’s has made an initial offer to provide ancillary services such as housekeeping, food and nutrition, maintenance, accounting and social work, to name a few.

A 1996, 34-page agreement among St. Luke’s, the city of Sun Valley and the county lays out in detail the transition from publicly run medical care to medical care provided by St. Luke's. But the agreement says nothing about the future of Blaine Manor.

One paragraph says St. Luke’s must allow the county to purchase land at its medical complex site, if the county wishes to build a nursing home facility there. Today, however, that seems unlikely to happen.

What does seem likely—given the comments of planners so far—is that the county will continue to subsidize Blaine Manor for the indefinite future, with facility management provided by an outside contractor. Adamson said it’s likely that’s the only arrangement under which his company would agree to take on the facility.

"I’m not saying it’s bleak," he said. "It’s just whatever the taxpayers want."


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