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Uncertain future for Cos nursing homes, $4 million subsidy looms


July 21, 2010
BERLIN — County taxpayer subsidies will likely rise to $4 million — $2 million for each of the two county-owned and operated nursing homes — when the federal stimulus program ends because of continued Medicaid rate cuts.

This year $1.3 million in direct federal dollars are being pumped into the county coffers for nursing home operations.

The board of Cos County commissioners concluded at Wednesday morning's meeting that talking soon with the county delegation about whether or not it can afford to operate its two nursing homes is a top priority.

A review of the impacts of the July 1 Medicaid rate decreases will result in substantial shortfalls in the 2010 revenue projections, explained county administrator Sue Collins. The rate was cut to $134.71 a day in Berlin, down from $136.85 in the first six months, and to $139.23, down from $141.37 at West Stewartstown. This followed on the heels of an earlier cut on Jan. 1. The 2009 rate was $146.91 a day in December 2009 in Berlin, and $150.26 in West Stewartstown. "That results in a state downshift to the county of $604,700 to the county taxpayer," Ms. Collins said.

Commissioner Paul Grenier of Berlin noted that nursing homes are not required by statute.

"We can't afford to continue with this kind of downshift," said chairman Burnham "Bing" Judd of Pittsburg. He pointed out that with the job losses the county has sustained, the county was turning into a place where only retired people are able to live.

It could take two to three years to get out of operating nursing homes in which 100 residents live in Berlin and about 75 in West Stewartstown. The commissioners discussed the fact that "privatizing" the homes would be a virtual impossibility, since the vast majority of residents are on Medicaid.

"It's difficult situation," Commissioner Grenier said.

"We cannot keep on this path," Commissioner Tom Brady said.

The counties that can least afford to pay with the least population are the most adversely affected, he said.

Both Ms. Collins and chairman Judd questioned whether there was any reasonable alternative for the frail elderly men and women who need care other than county nursing homes.

The commissioners agreed that it would be better for the state representatives to focus on the red ink produced by the county's nursing homes than on the far smaller subsidy needed by the county farm.

In other action, the commissioners agreed that county representatives will not travel to Concord to discuss proposed Incentive Fund Grants. The program was to have been locally driven, chairman Judd stated and having agency personnel whose programs are potential recipients as well as county panel members — Rep. Eric Stohl and victim-witness advocate Jessica Riendeau, plus the three commissioners travel to former state hospital grounds is unwarranted. He said,

"I'm not going to Concord; we'll only agree to a meeting held in Cos County."

No resolution has been reached as to where the county attorney's office should be located, Ms. Collins said.

Chairman Judd explained that as far as he is concerned the county attorney should be in the courthouse and not in a former bank building. Time is of the essence, Ms. Collins said, pointing out the current lease between the Court and the state court system expires on Aug. 31.

The lease covers the offices of the Register of Deeds, Sheriff, and County Attorney.

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