The Other Side of the Coin
Joseph Berman and Cindy Powell
In a recent column on TheTentacle.com, Board of County Commissioners’ President Blaine Young tried to spin a believable story about his ill-conceived plan to sell Citizens Nursing Home and close Montevue Assisted Living. Fifteen months after announcing this bad business deal, his story still fails the test for truth and good judgment. Here’s why.
Where’s Montevue? Mr. Young won’t admit the sale of Citizens means Montevue, the county’s assisted living center for low income and poor seniors, closes forever. We’re ahead of every other Maryland county, keeping seniors who cannot live alone but need medical support out of more expensive nursing homes and hospitals while providing a high quality of life. Why is this fact treated with derision by Mr. Young instead of pride? By ignoring Montevue, he denigrates its residents and the 400 or more Frederick countians who need the services of Montevue right now.
Let’s Talk Money. Mr. Young continues to falsely assert that over the last decade, Citizens has “lost $52 million.” The fact is that over the last 13 years, the county has spent $23.65 million to care for the residents of Montevue, a budgeted expense over those years, and spent $29.9 million in subsidy to Citizens – subsidies that were expected to be needed from the day the facility opened in 1975.
Long before Mr. Young’s tenure, growing inefficiencies in the old Citizens building led Citizens’ trustees and preceding county commissioners to recognize the need for a self-sustaining facility that could help pay for Montevue. With that in mind, the Jan Gardner Board of County Commissioners encouraged the inclusion of profit-making centers in the new building that opened just 18 months ago, such as a Ventilator Support Unit and plans for outpatient physical therapy services. Under the Young Administration and its managers, these features have either not been implemented properly or not implemented at all, resulting in lost revenue.
Four months after cutting the ribbon on the new building, the Young Board announced it would sell the facility, refusing to work with the Board of Trustees to secure a stable and successful management team. The Young Board has failed to properly vet and hire any individual or company competent to oversee Citizens’ business operations, particularly in managing accounts receivable, despite calls to do so by the very Board of Trustees the Young Administration terminated last June. Nursing home experts have gone on record that a failure in management has led to the fiscal problems at Citizens and that with proper management, there is no reason why Citizens cannot be fiscally sound and help pay the costs of operating Montevue.
Which bring us to Aurora Health Care. Why did Aurora offer a bid to purchase Citizens? Because they knew it could be profitable.
· Can we trust Aurora’s “patient quality ratings” as Mr. Young asserts?
Looking at the quality data about Aurora’s other facilities and not just the superficial rankings, the quality or lack of quality becomes clear. It has had actual harm citations in each of its Connecticut centers and one immediate jeopardy under their ownership/management. One center had 61 deficiencies – the highest number among all facilities in Connecticut. Several actual harm citations reveal a pattern of systemic management problems and these are not isolated issues. Is this the company to maintain high quality care at Citizens/Montevue?
· Did the county put “protections in place for nursing home patients” in the bid process as Mr. Young states?
The county cannot take credit for protecting Citizens patients from forced transfers from the nursing home. Federal and state rules tell all nursing homes who, how and when they might move a nursing home resident.
The county prepared nothing to protect Montevue residents until outraged citizens raised the issue. Under pressure, Mr. Young and Aurora created an agreement that theoretically protects current residents for four years – although the money must be budgeted annually and can be removed at any time.
· Who did the background check on Aurora?
Apparently not the broker hired to do so. Research shows that individuals listed on Aurora’s bid submission as references for the company’s quality of care and business operations were never contacted by either the broker or county staff and were never even asked by Aurora if they could be used as references. This is a company Mr. Young trusts? Taxpayers will pay Marcus & Millichap, the broker chosen without a competitive bid, $750,000 for what?
More about money: Aurora’s sweetheart deal:
· Purchasing a $37.7 million state-of-the-art medical facility for $30M.
· Receiving 7.5 acres of road-front property at no cost.
· Receiving $10.7 million over four years to allow current residents of Montevue to remain there. Montevue beds are no longer being filled despite the needs of county seniors.
· Buying the accounts receivable at a 50% discount. Nursing home business experts say a majority of accounts receivable is typically collectable. Aurora will certainly do that after the sale and make millions.
What Savings? Mr. Young states that “the existing debt of the nursing home will be paid off, so taxpayers did not lose out…” Not so fast.
· The bonds that financed the facility are not callable. The county will have to pay approximately $4.2 million over six to seven years in debt service until the bonds can begin to be redeemed. That’s debt service on a building and land taxpayers will no longer own.
Mr. Young states that “more money (will be) available for….programs to support aging in place with dignity…”
· Proceeds from the “sale” must be placed in treasury bills, earning about 1% interest, until the bonds are paid off. Mr. Young has no “savings” to put anywhere.
· Montevue is a key to “aging in place with dignity” for poor seniors in Frederick County, and he will close it.
Mr. Young’s Administration went into this proposed sale with no developed, community reviewed plan, no dollars earmarked for improved services and, most importantly, no acknowledgement of the existence of the elderly poor it is throwing under the bus. They didn’t even wait to read their own needs assessment of the aging population. It has eliminated all grants-in-aid funding to non-profits in the FY2015 budget and failed to increase any funding critical to poor seniors, including Meals-on-Wheels.
The sale of Citizens/Montevue will be a disaster for poor elderly in Frederick County and a huge loss for all taxpayers.
Cindy Powell is a local business owner and Joseph Berman is a retired physician who served on the disbanded Citizens/Montevue Board.