Columbia County Health System (CCHS) board report for May

DAYTON—CEO Shane McGuire told the Hospital District Board of Commissioners he is now cautiously optimistic about Columbia County Health System finances.

“2020 won’t put us out of business and we are ready for fall,” he told them, at their regular board meeting in May.

The CARES Act set aside one billion in aid from the U.S. Dept. of Health and Human Services for hospitals and health systems to weather the COVID-19 challenge, and the CCHS has been allocated around 4.4 million dollars, he said.

McGuire said an initial award in the amount of $654,993 offsets the $600,000 deficit from April’s low volumes of revenue-generating services provided in the hospital and in the clinics.

There were various targeted funds from the distributions, which included money for the skilled nursing bed program, but the bulk of the money was to provide general help getting through the crisis, he said.

McGuire said at its worst the health system was losing $130,000 per week because of the reduced services.

He is asking the finance team to look into various financial scenarios to prepare for an anticipated surge of COVID-19, in the fall.

Further discussion needed for the board to move forward with building an assisted living facility

For the past three and one-half years the CCHS administrators have been looking into providing an assisted living facility in Dayton.

CEO Shane McGuire said patients who meet the criteria for skilled level of care are routinely turned away from admission into the Booker Rest Home causing many to move from their homes into other communities to receive care.

He said a larger number of patients can be cared for, and other types of care settings would be made available to residents with an assisted living facility on site.

McGuire said the Booker Rest Home runs a large operational deficit because the State does not reimburse CCHS for the actual cost of care for Medicaid residents. Only 50 percent of the actual cost of care is covered by the Centers for Medicare and Medicaid (CMS) which has led to an operational loss of $1.6 million, last year, alone. While there is a State fund to cover some of those losses, it is not secure and is not guaranteed from year to year.

It is possible negotiations with CMS for Medicaid care could allow for a better rate of reimbursement McGuire told the commissioners.

Limiting Medicaid admissions is not an option in light of the District’s mission and expected service to the community, he said.

McGuire said custodial skilled nursing services would still be provided in one wing of the Booker Rest Home facility, freeing the other wing up for use as needed.

“We would maintain up to 12 beds for this purpose so that no services are lost. This will not impact staffing and there will be no staff reductions. . . There will be no reduction in care services and no residents will be displaced,” he said.

The assisted living project will not be a bond or taxpayer funded project, said McGuire. Rather it is intended to be a builder funded project, with the hospital leasing the cottages and administering them.

Cory Burnett a business consultant with Community Link Consulting provided the commissioners with several financial scenarios.

He said three one level cottages, with eight or ten beds each, would make the most financial sense. They would need to be occupied 93% of the time to be cost sufficient. There will be associated costs in the way of personnel, supplies, building maintenance, dietary services and for administration, he said.

Burnett said given a room rate for self-payers of $250 per day, for a private room, $217 per day for a semi-private room, with a better negotiated rate for Medicaid patients, and figuring in ancillary costs, each cottage stands to turn a $152,000 profit every year.

McGuire reminded the commissioners private payers are currently charged $263 per day at the Booker Rest Home.

Commissioner Bob Hutchens said he wanted to know more about costs before signing off on the plan. The board of commissioners agreed they would need further discussion and CCHS Controller Tom Meyers is expected to provide his professional expertise when they talk again on June 10.

McGuire said Stephanie Carpenter, Katie Roughton, Finance Manager Matt Minor, Michele Page, RN, and Architect John McLean are to be commended for their thoughtful and pragmatic approach to developing this vision into an operational design.

John McLean with Blue Room Architecture has been assisting with the initial draft design.

If built, the cottages would be located on the north side of the hospital. Each of the three cottages would have private or semi-private rooms with wide halls, nurse call buttons, a kitchenette, showers and other communal areas.

They would be designed around the needs of people living in them. They would be for people needing a higher level of care, like those with dementia or Alzheimer’s disease. Additional homes could be built later for people requiring a lower level of care, and with lower costs, McGuire said.

McGuire told the commissioners the first round of bids for the proposed dental facility to treat Medicaid patients at Columbia Family Clinic was disappointing. The architect on the job said it might be better to wait until the COVID-19 shutdown is over, and the crush of projects needing completion gets done, before sending the project out for rebid. McGuire said he is working with an outside contractor to determine a better pricing strategy.