(Published March 14, 2007, 12:52 p.m.)
Walworth County could save $1 million a year at Lakeland Health Care Center by cutting 12 staff positions and adding more private-pay and Medicare residents, according to a financial consultant.
Cutting six nurse aide positions could save $254,000, and cutting six staff from the dietary department could save $274,000, said consultant Brian R. Schoeneck, who is also financial services director for the Wisconsin Association of Homes and Services for the Aging.
Schoeneck's study indicates that cutting the number of Medicaid-funded residents and bringing in more residents who pay privately or with Medicare could add about $721,000 to annual revenues.
"Over time, even if you make a small change in the percentages, it's worth a substantial increase in revenues," Schoeneck told the Lakeland Board of Trustees and county human resources committee Thursday. "I think this is something, as part of a business plan, that you need to work toward."
Medicaid's reimbursement doesn't cover costs, leaving tax dollars to pay the rest. Private-pay residents and Medicare pay more.
About 85 percent of the center's 120 residents use Medicaid. Schoeneck recommended reducing that to about 75 percent.
Such a proposal was discussed during the downsizing debate four years ago. Moving toward a more privatized model drew criticism from private nursing homes but not "an overwhelming groundswell," County Administrator David Bretl said.
Since the county started caring for residents in the late 1800s at the county "poor farm" and "insane asylum," county facilities have primarily been for people who can't afford private care.
Schoeneck said it's now common for county nursing homes to seek residents who can pay.
"You'll always be left with more Medicaid patients, but if you improve the mix, you'll have a (positive) effect on the bottom line," Schoeneck said.
Improving the mix of Medicaid to Medicare and private-pay residents will happen over several years, Schoeneck said.
Staff reductions could be carried out over one year, Schoeneck said.
The county has not made a list of positions that could be eliminated consistent with Schoeneck's recommendations, nor has it approved any cuts.
Schoeneck said the cuts he recommends would not affect patient care. The facility still would have more than the minimum staffing required by law.
The county is looking to operate its nursing home on no more than $3.5 million of taxpayer money per year. The 2007 budget called for about a $4.5 million tax levy for the nursing home.
"I think our goal is very attainable in a way that is not going to compromise the quality of care," Bretl said. "I have a feeling we will be on track with this financially."
Lakeland under new department
Walworth County committees on Thursday put Lakeland Health Care Center under the health and human services department.
With Lakeland Administrator Phyllis Williams out because of a medical emergency, the health care center is left without a licensed facility manager, opening the county to liability.
"I am not comfortable with a situation where we do not have the responsible person on site," Bretl said.
The Lakeland Board of Trustees and county human resources committee Thursday unanimously approved merging the departments, making newly hired Health and Human Services Director Linda Seemeyer the administrative leader of the health care center.
Seemeyer expects to create a study group to find a nursing home employee who can act as interim director for the facility until Williams returns. At least two staffers are licensed to be nursing a home director, Bretl said.