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Board seeks answers to planned nursing home changes

A special meeting of the St. Croix County Health and Human Services Board has been scheduled to discuss the county-owned nursing home in New Richmond.

The board will meet at 8 a.m. at the Health and Human Services building in New Richmond. The lone agenda item is "discussion on size of the nursing home."

The meeting was called by Chairperson Esther Wentz, New Richmond, after learning about apparent operational changes being implemented at the nursing home that were not specifically approved by the county Health and Human Services Board.

A meeting was held with nursing home staff people on Monday, where Health and Human Services Director Fred Johnson outlined forthcoming operational changes that would drop the facility from 72 beds down to 50.

A letter was also sent to the families of residents in the nursing home explaining the expected changes, Johnson confirmed.

Johnson said the issue of reducing the number of licensed beds has been part of the HHS Board's discussions for months. At its March 21 meeting, Johnson reported that the nursing home's census was down to 53 and he suggested that the facility would likely fare better financially if it were downsized to 50 beds.

Nursing homes with 50 beds or less get a higher level of Medicaid reimbursement, and if the bed total was reduced the facility would pay less bed tax on spots that remain empty. With a 50-bed facility, the nursing home could also reduce expenses by hiring a part-time administrator. The hope is that the nursing home would require less than $300,000 in levy support in future years if it were downsized.

Even though the HHS Board took no official action on the matter, Johnson said he made an "administrative decision" to begin the process of downsizing the nursing home to 50 beds.

He said it's clear that the financial situation at the nursing home will not allow for continued operation as a 72-bed facility. He noted that auditors have confirmed that the facility was more than $400,000 over budget last year, and that number doesn't include tax levy support that was already budgeted for its operation.

After talking with other county officials, Johnson said he made the call to move ahead.

"I didn't do this in a vacuum by myself," he said.

None of the operational changes have been implemented yet, Johnson noted.

"It's a plan to make changes," he said. "We're moving forward with how to get there. At this point no decision has been made to drop the 72 licensed beds down to 50. We are working on adjusting operations to 50 beds."

Johnson said he expects Wednesday's meeting will include plenty of discussion about whether the downsizing plan is a HHS Board decision or an operational decision that is the administration team's hands.

Wentz said she, and several other board members, feels as if county officials have attempted an "end run around us" by pushing ahead with the changes.

"I was extremely surprised," she said. "We (the board) wanted to be able to make that decision."

Wentz said she called a special meeting to "clear the air" and get some clarification about what happened between the board's March 21 meeting and Monday that precipitated the administrative action.

"While we may be a partially lame-duck board, they will not back us into a corner," Wentz said. Wentz and a couple others on the HHS Board are not seeking re-election to the St. Croix County Board and will be replaced on the committee by new members. They remain on the board, however, until their replacements are sworn into office.

Wentz said she was disappointed with the timing of the administrative decisions, just days until Tuesday's (April 3) county-wide referendum vote that asks St. Croix County voters if they support the use of tax dollars to "partially" subsidize the operation of the nursing home.

"Why did we have to hurry up and do this now, before the vote on Tuesday?" she asked.

Wentz said she's convinced St. Croix County voters will again overwhelmingly approve the referendum, just as they did in 2008. By Wednesday morning's meeting, Wentz said, the HHS Board will know the will of the voters and will be better able to discuss the future of the county-owned nursing home.