Heritage weighs options for future uses
The Heritage community campus board is looking far into the future, envisioning how it can meet the rapidly changing needs of nursing home patients and the reimbursement rates those services bring in.
Among the suggestions are a traumatic brain injury facility or a rehabilitation wing.
"We've been ahead of the game," Hubbard County commissioner Dick Devine said at Wednesday's meeting. "No one's sure where long-term care is going. The nursing home is old and needs remodeling."
A state program called the threshold project will fund up to $1.4 million in improvements that can be built into nursing home rates in a one-time adjustment.
Devine said the Heritage board has been thinking outside the box as to whether it could acquire property to the south of the current campus and build a second facility.
"There's a very long waiting list for the Manor," he said of the Heritage assisted living facility.
But it's the 1960s era nursing home that is the primary focus of the campus board.
"For example, the demand for rehab is taking off and our facilities need to be upgraded," said director Kurt Hansen. "We're looking at 14 days to 60. Some go as many as 120 but these are the shorter stay people that otherwise wouldn't be able to receive the services without staying elsewhere."
Hansen said doctors are typically reluctant to release, for instance, a hip replacement patient until it's safe for that patient to return home.
"Our knowledge and the feedback we're getting from customers and staff is that obviously our buildings are from the '60s and expectations are different now and our programmatic needs are different," Hansen said.
Last year 80 percent of the nursing home's patients were transitional, returning to another level of care or home, Hansen said.
But a key factor in catering to short-stay patients is that the reimbursement offsets losses in other areas.
"What's interesting is that reimbursements for these shorter stay patients that are covered by Medicare or third-party insurance is significantly higher," Hansen said. "Of course these types of patients are more expensive given the need for acute nursing care and rehabilitation care therapies. But it's a manageable program that we can work with."
The daily rates set by the state for private pay patients and those covered by Medical Assistance fall well short of actual expenditures, Hansen notes.
"That's where the funding challenge comes," he said. "If there's a margin for a Medicare patient it's often times lost on the people who are here, not covered by Medicare or third party insurance."
And because there is a state moratorium on building new nursing homes - Heritage has steadily decreased its beds - tapping into the short stay market makes fiscal sense. Last fiscal year's 1,231 patients actually turned the facility over twice, Hansen noted.
That's why the Heritage board put on its thinking caps Tuesday.
"The intent was to let the commissioners know we're engaging in a strategic planning process, that we're committing to some preliminary design development in anticipation of a future project," Hansen said of his appearance before the county board.
"We're seeing needs at the nursing home based on its age and that could be something as minimal as remodeling to razing part of a building," he said. "There's dollars available through the Department of Human Services to finance up to a certain amount."
Hansen said much discussion will ensue over the scope of the project, but it will be based on need and public input. Heritage has a "rich history" of exemplary service in the county, he acknowledged.
"Several nursing homes have used the (DHS theshhold project) dollars for replacing a roof, changing out old equipment, capital improvements, and we want to look further," Hansen said.
"What that's going to look like right now I don't know because we haven't gone through the exercise. I think it's very exciting. I feel our priority is our nursing home and it's time to step up and make these improvements and meet those customer expectations."