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County nursing home board agrees to hike rates -- a little

Raising private-pay rates at St. Croix's county-owned nursing home too much could prompt patients to choose other homes or could eat up patients' finances quicker, forcing them to turn to Medicaid.

Taking into account those considerations, the Health and Human Services Board has voted to increase the private-pay charge by $5 a day and to evaluate the rate annually.

The county expected to absorb $58 per day of the cost of each private-pay patient this year. In December Supervisor Buck Malick, town of Hudson, formally asked the HHS Board when the private-pay rate will be raised to the breakeven cost.

The response to Malick's question was presented at Monday's County Board meeting.

There are about 60 open nursing home beds throughout the county at any given time, said HHS Director Fred Johnson. The county's rate for private-pay patients is in the middle of what other nursing homes charge.

If the county were to suddenly raise its rate $55 a day, it would most likely lose 75% to 100% of its private-pay residents to other nursing homes, said Johnson.

Because it was subsidizing care for all patients, the county did raise its rates a few years ago, he said.

Those newer rates mean that in 2007 the county cleared $9.60 a day for each Medicare patient but lost $70.31 per day for each Medicaid patient and $55.72 for each private-pay patient.

The average rate for a shared room at the county-owned nursing home is $183 per day, said Johnson. Other nursing homes charge from $170 to over $200 a day.

A flat $5 a day annual increase won't likely cover higher operating costs and, instead of reducing, might actually increase the gap between costs and the rate private-pay patients are charged, said Supervisor Daryl Standafer, North Hudson. He urged the HHS Board to find a way to increase the rate and reduce the gap.

The county-owned home just completed its third annual state inspection that was citation free, said Johnson. He said that proves the home is providing good service to its residents.

"If we are in fact providing better service (than other facilities), why can't we raise our rates?" asked Supervisor David Peterson, River Falls.

Historically private-pay patients deplete their finances after 60 days in a nursing home, said Supervisor John Borup, who was director of the Health and Human Services Department until his retirement.

"Not many people can afford to pay (private-pay rates) indefinitely," said Borup.

If the rates are raised too high, private-pay patients will go through their savings faster and will move more quickly to Medicaid, agreed Dennis Reiman, the Pathways Health Services consultant who is the nursing home's interim administrator.

Last November county voters adopted a referendum to keep the nursing home open. Now that the issue is settled, the county is planning to hire an administrator to supervise the home.

Johnson suggested that once that is done, a business plan should be developed for the facility.

"What is the shared vision on (the nursing home)?" he asked. "What can this County Board come together on?