ObamaCare puts Monmouth County’s nursing homes in peril

UPDATE: August, 27, Curley pulls nursing home sale resolution

Freeholder John Curley called this morning to say that he has pulled his resolution to sell the Monmouth County owned nursing homes from this week’s agenda. County CFO Craig Marshall is on vacation.  Curley wants Marshall available to address all of the financial concerns regarding the proposed sale. Curley expects to reintroduce the resolution in September.

 

Geraldine L Thompson Care CenterReductions in Medicaid payments for long term care under the Affordable Care Act have led to increasing deficits at Monmouth County’s two government owned nursing homes.

The John L. Montgomery Care Center in Freehold and the Geraldine L. Thompson Care Center in Wall are owned and operated by Monmouth County’s government. Property tax payers have been subsidizing the long term care of the elderly, disabled and infirm residing in these facilities for decades.  From 2007 through 2013 the cumulative deficit funded by Monmouth property tax payers was about $40 million.  Despite cost cutting measures and union givebacks, the combined deficit this year is on track to exceed $13 million plus the cost of repairs and capital improvements required to keep the facilities in compliance with state and federal regulations, due to cutbacks in the amount that Medicaid pays for patient care under ObamaCare.  98% of the patients at Montgomery and Thompson are insured by Medicaid.

Freeholder John Curley has been pushing his colleagues on the all Republican Board of Chosen Freeholders to sell the nursing homes for years.  Every time the issue gets traction or public attention, patients in wheelchairs  and staff members of the nursing facilities show up at Freeholder meetings and plead with the Freeholders not to sell the facilities.  The patients’ stories are heart wrenching. The declarations of love for their patients by the staff members are moving.

At Freeholder meetings, Curley and Freeholder Tom Arnone speak in favor of selling the facilities.  Freeholders Lillian Burry, Gary Rich and Serena DiMaso say they need more information regarding what will happen to the patients, the employees and the value of the properties.

Curley is forcing the issue with a resolution to sell the facilities on the agenda of this Thursday’s Freeholder Meeting.  Arnone is expected to provide the second to the resolution.

Curley and Arnone favor selling the facilities via auction with restrictions on the buyer as to what will happen to the existing patients, employees and with the caveat that the $4 million required for repairs and capital improvements be put into reserve.  Arnone told the Asbury Park Press he realizes that those restrictions could reduce the amount the county gets by selling the facilities.

“I don’t care what we get in the sale or privatizing of it. The things that means the most to me are that the people are taken care of,” Arnone said according to app.

Rich told MMM this afternoon that he favors privatizing the county owned nursing homes, but that Curley’s resolution is premature.  “We’re still gathering information and talking to professionals in order to evaluate all of our options,” said Rich,  “It is important that the patients be taken care, but it is equally important that the taxpayers interests are looked out for.  All we have right now is a realtor’s estimate that we could get between $20 and $25 million for our facilities based upon comparable sales. We’re expecting more information in September and October.  There is no need to rush into a resolution to sell this week.  We still have due diligence to do.”

Curley and Arnone are right.  The bleeding has to stop and the status quo of the nursing homes is not sustainable.  But Burry, Rich and DiMaso are also right.  More information is needed.

The freeholders should expand their thinking to consider options other than selling the nursing homes or continuing to operate them as county owned facilities.  It could be that the best options for the patients, employees and taxpayers is to place the patients in existing privately owned nursing homes and doing something else with the real estate or selling it for another use.

“Making sure the people are taken care of” should not be the freeholders primary concern.  The patients well being should be the primary concern of their families and their caregivers.  The State Department of Human Services is responsible for overseeing nursing homes.  The Monmouth County Board of Freeholders primary concern should be for all the people of Monmouth County, not just the 215 patients at the county nursing homes and the employees who serve them. A $13 million deficit for the benefit of 215 patients is too much.

Curley told MMM that he wants a contract for sale of the facilities to guarantee that all the current patients will be cared for for life and that all of the current employees will be employed for life.  Bad idea on both counts, especially for the employees.  That proposal is tantamount to granting tenure to the employees.

Arnone’s idea of requiring the buyer to put $4 million in escrow to guarantee that repairs are made is also a non-starter.   It is the job of the Department of Human Services to regulate long term care facilities.  The freeholders should sell the facilities for the maximum amount possible, for the tax payers, and move on.

Nicole Brossoie, spokesperson for the Department of Human Services, told MMM via email today that there are 3,911 nursing home beds in the 34 long term care facilities in Monmouth County.  The average occupancy rate is 81.15%, meaning that there are 734 empty nursing home beds located in Monmouth County.  94 of those vacancies are in the county owned facilities, 69 at Montgomery and 25 at Thompson, according to the information Curley provided MMM today.  That leaves 640 empty beds in nursing homes located within the county that could accommodate the 215 residents at the county owned facilities; 110 at Thompson and 105 at Montgomery.

There are actually at least another 47 beds available, bring the total to 687 within the county for our 215 patients.  One privately owned nursing home MMM spoke with today has taken 47 of the rooms they are licensed for out of service.  They converted them to day rooms, but could use them for residents if there was a demand.

The freeholders, as part of their due diligence, should consider the option of closing the county owned facilities and selling the real estate for other uses.  If another use would yield a higher return for the taxpayers, that is the route they should go.  If selling the facilities as nursing homes, without the redundant requirements on the potential buyers for care of the residents and Utopian protections for the employees, yields the highest return for the taxpayers, that is what the freeholders should do.

Supporters of keeping Montgomery and Thompson as county owned facilities argue that rumors that the county is going to close them is what is causing the deficits, at least in part.  But the numbers don’t support that argument.  Thompson, with 135 beds and 105 residents is operating at 78% capacity, slightly lower than the county-wide average of 81%.  Montgomery is operating at only 60% capacity with 105 residents for 174 beds. One would think that if Montgomery is as wonderful as the residents profess at Freeholder Meetings, and that the quality of care is not available anywhere else as they imply, that people would be fighting to fill those 69 empty beds.  One privately owned facility that MMM talked to today said they had a waiting list for long term care beds. Another said they were at capacity.  Those are the places that people are fighting to get into.  Government owned facilities are not likely to get the kind of management that produces those kinds of results.

Curley has done an admirable job keeping this issue front and center in the freeholders’ minds and on the overall agenda.  But his resolution this week is premature.  He should pull it and/or Arnone should decline to second it.

 

Posted: August 26th, 2014 | Author: | Filed under: Freeholder, Gary Rich, John Curley, Lillian Burry, Monmouth County, Monmouth County Board of Freeholders, Monmouth County Health Department, Serena DiMaso, Tom Arnone | Tags: , , , , , , , , | 7 Comments »

7 Comments on “ObamaCare puts Monmouth County’s nursing homes in peril”

  1. bedsore spot said at 9:49 pm on August 26th, 2014:

    i agree with closing the nursing homes but what about the cost of running all of the vocational schools, for a few hundred students?

    high tech, bio, chs, mast are nice and highly ranked, but at what cost. we already pay for schools in every one of those kids home towns. paying for the structures and additional mcvsd teachers and admin is as wasteful as the duplication of nursing homes. if those smart kids cant cut it in their local public schools, theyll never cut it in the real wirld. close the specialty schools and the transportation costs to get kids there, save millions and put some brains back into the local districts to lead and be example role models for the less gifted students.

  2. Jim Granelli said at 10:47 pm on August 26th, 2014:

    @ bedsore spot.

    Those schools turn out the technology leaders of tomorrow, the next stage in creating a viable economy. Well worth the expense.

    It’s not about them “cutting it in their local public schools,” it’s about giving them better opportunities to advance. They are among the brightest of the brightest.

    It is also a selling point for people wanting to move to Monmouth County, that we have opportunities like this.

    And not everyone gets in. Bottom line, if you think education is expensive, wait until you are paying for stupidity. Unless, you would rather have them take jobs in the low pay service industry.

    And if it were YOUR child, I think you would be complaining about the lack of opportunities.

    So, please don’t be so short sited.

    As to the nursing home situation, I gotta look at that. But, thanks to Mr. Obama, old people are getting short changed.

  3. no way said at 11:55 am on August 27th, 2014:

    Jim, I respectfully disagree.

    Those students are not the leaders of anything, that’s just another liberal lie that parents and teachers have repeated to the point of believing. The students are the same goofy teenagers as all of the other goofy teenagers just as we all were. They are not unique, they are not special, but they are coddled and hidden away from the “diversity” of the real world and often the uncomfortable interactions with people who aren’t the brightest. Those students don’t have to learn to deal with those who aren’t as bright or who aren’t interested in learning from a book in a classroom. Those career academy schools are a liberal’s dream environment having none of the “diversity” they claim to desire and then they use standardized tests to exclude those who they deem undesirable so they can hide behind a system that puts their kids in a class above the others. Some of those same “bright” students would do just as well in a local public school, others will have a hard time dealing with the other students – the real world is full of those other students and the true bright students will learn to deal with them or won’t succeed.

    You yourself have noted in the past all of the improvements to Neptune schools, yet the MCVSD then takes the students who are most likely to get the most out of the improvements out of the local school and puts them into a redundant school system. What’s worse is that the best teachers and best administrators are also taken out of the local schools and put into the MCVSD schools and rather than a class of 30 having access to the best teacher, a class of 10 has access to that teacher and the taxpayers are left funding an inferior teacher in the public school with an over populated class that they are incapable of controlling or educating the students who are left behind.

    The bottom line is that it doesn’t help “the county” to run a multi-million dollar education program that is entirely redundant for a few hundred students just as it doesn’t help “the county” to run a multi-million dollar nursing home program for a few hundred seniors. Any specialized schools, like the nursing home, intended for a small and specific populations should be run by private investors who believe that they can offer some product or service in a market where the public will choose to pay for those services.

    Just as
    “Making sure the people are taken care of” should not be the freeholders primary concern. — Art Gallagher
    I loosely quote Art:
    The Monmouth County Board of Freeholders primary concern should be for all the people students of Monmouth County, not just the 215 patients 1200 students at the county nursing homes “career academies” and the employees who serve them.

    The right thing for the Freeholders to do for taxpayers is to reduce our tax-burden, eliminate the redundancy of those career academies, eliminate the expense of the nursing homes and then when people want to move to Monmouth County, it will be because the taxes are lower and because every town has a local school district who sends students off to college with a good education.

  4. Victims said at 12:00 pm on August 27th, 2014:

    Democrats & Unions always like to use us as props.

  5. Jim Granelli said at 1:00 pm on August 27th, 2014:

    @ no way.

    NO WAY could the High Schools efficiently & cost effectively handle specialized classes for in a career, let’s say in health as the Allied High School does.

    https://www.mcvsd.org/sharedTime/allied-health.html

    READ THEIR BIO

    Nationally recognized

    https://www.mcvsd.org/academy-of-allied-health-and-science.html

    High Technology High School does host “the best of the best”

    https://www.mcvsd.org/high-tech-hs.html

    MAST

    https://www.mcvsd.org/mast.html

    The high schools can’t handle the above courses efficiently one by one.

    These schools are specialized into various fields. They fast track the students into those fields.

    And that is what it is all about. As the husband of a Neptune Board Of Education member, I can easily see the benefit of these efforts. Neptune might not have enough students for the kinds of specialized classes and fields such as the above.

    Anything that you can do to get a student better prepared for the next level of their education is worth it.

    Let’s face it, not everyone should be going to college and that is what High School generally does, prep people for college. These schools prep them for trade schools or specialized colleges. And in many circumstances, they can earn dual enrollment college credits, CUTTING OFF anywhere from a half to a full year of college expenses. So, in a way; the money spent on these schools comes back to taxpayers via cheaper college costs.

    Penny wise, pound foolish closing these schools IMHO. So, on my behalf…

    SERIOUSLY Respectfully Disagreeing…

    Based on a little more insider information.

  6. parent of CHS graduate said at 2:45 pm on August 27th, 2014:

    Jim, I’m not sure what “inside” information you get as the husband of a BOE member when just about all of the information is public record anyhow but I’m the parent of a CHS grad and in-law to a MCVSD teacher so I’ll claim to have a bit of “inside” info myself.

    You are correct, the local public high schools don’t and can’t offer the specialized classes; because they shouldn’t offer specialized classes, neither should the “career academies”. The county funded programs to prepare your kid to be a hairdresser and the like are equally wasteful as they are not solely focused on the basics of education and are not equally and fairly available to all of the students. High school is not supposed to be “college-prep school”, it’s supposed to be “high school”, to ensure that students can do some basic reading, writing and mathematics; then apply to college or join the workforce. If the public education system works, and I assume you’ll defend it as the husband of a BOE member, then every student who graduates a Monmouth County public high school should be equally well prepared for college or life as a trade worker at least to the minimum requirements of the education system which should be the minimum requirements of the college system. The specialized schools are a redundant tax burden on all of the taxpayers of Monmouth County for the benefit of a very, very small percentage of the population.

    Your position on the schools mirrored to the position on the nursing homes would be the equivalent of suggesting that the private nursing homes can’t provide the same high level of care that the county homes provides, even though both have to meet the same minimum federal and state healthcare standards, just as the MCVSD and local schools have to educate students to the same minimums. When you suggest that the MCVSD exceeds those minimums and therefor should be kept open at all expenses, would be equivalent to the workers at the county nursing homes suggesting that they provide better care than their counterparts and should be kept open at all expenses because their care is better. Both may be true, the county schools and the county nursing homes may provide a service far exceeding the minimum required of them, but the taxpayers in the county shouldn’t be on the hook for going above and beyond, that should be a choice that families make, and pay for.

    And before you jump on me for sending my own kid to one of these schools and then complaining about them, I’ll note that I also complain about tax breaks “for the rich” and tax rebates for solar and hybrid cars, etc but I’ll certainly take advantage of those tax breaks while I’m already paying taxes into the programs that fund the “breaks”. You’d be foolish to be eligible for a tax credit and not take it because you oppose taxes, you should still oppose the taxes. I’ll also note to other readers, if you have a child due to enter high school next year, have your kid apply for a career academy program, the quality of education is much better than the local high school; but the career academy program is still unfair to taxpayers and a redundant tax burden and once the freeholders do what is best for taxpayers and close the MCVSD career academies you can choose to invest your tax savings in your kid’s private tutor.

  7. Jim Granelli said at 4:08 pm on August 27th, 2014:

    @ Parent

    What I am say is that as a husband of a board member, I more closely see the benefits of such a system because we are both intimately involved in education issues.

    I did not say that high schools are supposed to be college prep, I said that’s what happens. That said, the basics need to be taught much younger and are indeed being taught much younger.

    The way the high school system is evolving (as it should) is to get students better prepared for their careers.

    Are you against that? I sincerely doubt it.

    My daughter was able to shave off at least a half a year because she chose Dual Enrollment courses. YAY for parents.

    Remember, the education money follows the student. And, for better preparation in specialized areas, I am for any reasonable extra expense a County High School brings because the money comes back in the form of higher earnings.

    You said this “You are correct, the local public high schools don’t and can’t offer the specialized classes; because they shouldn’t offer specialized classes,”

    WHY NOT I ASK? One of America’s problems is that we are WAY behind other countries on education, especially dealing with technology. Japan ring a bell?

    We are no longer a manufacturing country for the most part and we need to invest in bright minds and good preparation for people to earn good livings.

    AS TO THIS COMMENT ” If the public education system works, and I assume you’ll defend it as the husband of a BOE member, then every student who graduates a Monmouth County public high school should be equally well prepared for college or life as a trade worker at least to the minimum requirements of the education system which should be the minimum requirements of the college system”

    You do know that school teachers are not the parents, right? It is up to the parents to see that little Johnny gets his homework done, and gets on the right path.

    How many times have you seen that NOT happening, especially among minority students? You can not demand that a High School (or any other school) guarantee a student is ready. Too many variables, too few parents accepting responsibility.