Nearly one year after Ecumen staff, managers of the Heritage Living Center, last pitched rebuilding a portion of the campus, the plans have been revived.
Ecumen real estate development director Dana Wollschlager presented the proposed plan to Hubbard County commissioners and the Heritage Living Center advisory board at a joint work session Wednesday.
Heritage Living Center administrator Kurt Hansen said the county board looked at the project last November, but decided not to go further until after the election.
If the advisory board approves the project in October, the project will once again come to the county board in November.
"We haven't looked at this in a while... but by and large, the project does pencil (cash flow) and would not require further assistance on a monthly basis," said Wollschlager.
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The proposed plan would demolish the mostly vacant A wing of Heritage Living Center to build a memory care center for residents with dementia.
The A wing currently houses the senior day program and meeting rooms, but is condemned for 24-hour resident care.
Ecumen would tear down the wing in phase I of the project and fix code violations in the rest of the building.
According to Wollschlager, the initial wave of construction would also expand therapy, laundry and kitchen facilities. The kitchen is currently split by the entrance hallway to A wing, she said.
Phase II would create the memory care unit for residents, explained Wollschlager.
Heritage could house two units of eight residents in the secured memory care wing. The wing also includes an enclosed courtyard garden and separate entrance for visitors.
Ecumen would seek licensing the wing with the less stringently regulated residential care standard and would save staffing costs on residents who would otherwise be housed in the skilled worker portion of the center.
As part of the renovation, the plan would reconfigure existing nursing rooms to create three decentralized "neighborhoods" for residents. Each neighborhood would possess its own dining area, lounge and regular staff.
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Many of the rooms in the skilled worker area would be converted for single occupancy use. Each remaining double occupancy room would utilize its own bathroom instead of four residents sharing a restroom.
"It will create a home-like environment we don't have now. It's very institutional (now)," said Wollschlager.
A complete renovation carries an approximate price tag of $6.8 million. The cost reflects an approximate 9 percent escalation from last November to June, when Ecumen completed its most recent estimate.
Wollschlager said equity contributions from the Friends of Heritage, Heritage Manor Fund and the building fund can pay for about $640,000 of the project.
Hansen added the state allowed facilities a one-time rate adjustment to create funds for code renovations, which will add another $60,000 for the project.
The remainder of the loan can be paid off from revenues of the memory care wing, Wollschlager said. After stabilization, Heritage would have debt coverage of up to $1.30 for every dollar taken out on the loan.
Commissioner Don Carlson asked how much it would cost to only bring the building to code.
Cost for installing a sprinkler system, updating the nurse call system and putting in new doors runs close to $2 million, said Wollschlager.
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"We were told that, and we said, look: let's create an option that will reposition this facility for the next 20 years," she said.
Wollschlager said the demand for alternatives to traditional nursing home methods is increasing as more people reach retirement. People entering nursing care prefer less intrusive care.
"It isn't a product our customers want. They communicated that loud and clear," said Wollschlager.
Commissioner Dick Devine echoed Wollschlager's sentiment.
Devine said, "I think it's a kind of fundamental question we've wrestled with for the last eight or 10 years I've been on the board. The problem is the nursing industry is just really changing.
"Any time we build a business there is a certain amount of risk. The question is whether the citizens of Hubbard County want us to do this... the people I've really discussed this with feel that we really have to go forward with this," he continued.
Commissioners also discussed the possibility of selling the nursing home.
Commissioner Greg Larson inquired how much Heritage Living Center would be worth if it was sold.
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Hansen said he figured the entire facility, including Heritage Manor and Park Villa, would be valued at around $3 million "if we could find a buyer," but the skilled workers area make up a small portion of the net worth.
"Probably the best thing on that would be to shut down the skilled building and keep the other two facilities," said advisory board member and former commissioner Floyd Frank.
Frank said the skilled portion of the nursing home does not receive enough reimbursement to both properly pay the staff and care for patients, and single occupancy rooms are more attractive to residents.
"I think, eventually, it will all be single rooms for single occupants," Frank continued.
Carlson asked what the options would be for skilled care if the county sold Heritage.
"The difficult thing would be finding a facility that has room for them," Frank said.
According to Hansen, roughly 60 residents on Medical Assistance would need to find care outside the county.
"That's the challenge. Today, those beds would not be available in any neighboring county. We'd have to go as far as necessary to find a bed. Maybe as far as Fargo-Moorhead," Hansen said.
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Wollschlager asked the county board if Ecumen "should do due diligence" and update the numbers for a final presentation.
Commissioners agreed by consensus to hear the proposal with finalized numbers in November.
"I'm behind it, at least until November," Devine said.
