Long Term Care changes affect residents, staff

Residents notified LTC service will end by July 10

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Long Term Care occupancy stands at 21 Monday, three weeks after the Republic County Hospital board decided to reduce the number of residents to eight intermediate swing bed patients.

The LTC was home to 32 residents at the end of April. Hospital administrator Blaine Miller said residents will have until approximately July 10 to make a decision where they will move.

Miller says to his knowledge, no resident has had difficulty finding another place to live. He said hospital staff will work with the remaining residents and families beginning in June to make sure they have ot

Eight places remain

The hospital board was given an update on the steps taken to close the unit at their May 22 board meeting.

The eight residents who will stay in intermediate swing bed were selected on the basis of who has lived at LTC the longest, continuous time, Miller said. Some residents have lived in the unit five years or more, Miller said.

“We felt that was the fairest way,” he said.

Miller said the hospital will maintain a wait list for the intermediate swing beds. The number available could increase or decrease based on hospital admissions, he said. At the present time the hospital will reserve 15 beds for acute care patients, and two for obstetrics patients. Average acute hospital census is five acute patients and three swing bed patients.

“As long as the total number of beds stays under 25, we’re okay with Medicare,” he said. “The trend over recent years has been for the number of inpatients to continue to decline.”

As a Critical Access Hospital the hospital cannot admit more than 25 patients at a time. CAH hospitals are reimbursed 99 percent of the cost to provide care to Medicare patients, which makes up more than 70 percent of the hospital’s business.

Miller said out of the 42 current Long Term Care nursing staff, the hospital will retain 17. Reducing the LTC will also affect the dietary, maintenance, laundry and housekeeping department staffs, he said.

Of the 47,650 meals served at the hospital last year, 34,000 were provided to LTC residents. About half of the total laundry services were provided to LTC

Financial concerns

Although the Great Plains Health Alliance, which manages the hospital, estimates the hospital would have gained nearly $900,000 more in Medicare reimbursements last year without the LTC, GPHA vice president JH Seitz said “I think we have our work cut out for us” when it comes to stabilizing the hospital’s financial position. “When

“When people have deductibles of $6,000, $7,000, $10,000, it’s too high, and it’s going to affect our bad debt,” he said.

Bad debt so far in FY2017 has nearly doubled from $147,000 this time last year to $309,000.

Cost for employee benefits is nearly $200,000 more than a year ago, and professional fees have increased $100,000, mostly because of contract labor needed to cover vacant laboratory positions, he said.

“Some costs in some areas are just tough to reduce,” he said.

  • The board voted to revisit the issue of HVAC and lighting upgrades to the original hospital building until at least 2018, or when they have a “clearer picture” of the hospital’s finances, board members said.
  • Staff and physicians continue to work to implement the new Cerner electronic medical record system, which has caused frustrations across the board. Hospital CFO Barry Bottger said had the hospital chosen not to implement EMRs, a federal mandate, it would have been penalized some $460,000 in Medicaid and Med
  • The hospital is adding services of a Grand Island radiology group to treat migraines, and Miller said the hospital will become certified to perform sleep studies in house. *The hospital’s property insurance will renew at an increase of $100 from last year, Miller noted. Total premium for the hospital, NCK Medical Arts Center, Prairie Ridge Estates independent living and medical clinic in Courtland is $72,651.

For insurance purposes, the hospital and contents is valued at $28.6 million; the clinic at $2.6 million, and the apartments at approximately $1.5 million. Total insured value of all properties is $33 million