(Belden Fields is the Chair of Friends of Champaign County Nursing Home)
At its January 9, 2018 meeting, the Champaign County Board decided to put the Champaign County Nursing Home up for sale. All the Republicans voted in favor, and they were joined by three Democrats: Patsi Petrie, Shana Jo Crews and Board Chair Pius Weibel.
Many Republicans have pushed for the sale of the nursing home as far back as 2002, when there were two referenda, one to fund the construction of a new building and an additional tax for its operation. Both of those referenda passed. Unfortunately, during the construction of the building wood was exposed to rain, resulting in a mold problem that cost about $3 million to remedy. Only $1 million was recovered from the contractor. The other $2 million was levied by the Board against the nursing home itself! Of course, the nursing home and its management had nothing at all to do with that loss. So when one reads in the press that the nursing home owes “more than $2.4 million … to various county funds” (Tom Kacich, News-Gazette, 1/9/18), the $2 million is due to the Board’s decision to make the home pay for the construction deficiency that was the fault of the contractor and county officials who were supposed to oversee the construction.
It is true that among the problems the nursing home encountered were an ineffective administrator for several years, and then a less-than-stellar private management firm that was brought in to guide the home. But the big financial hit came when the state of Illinois fell so far behind in accepting and processing Medicaid claims. The county home has a disproportionate number of Medicaid patients who either came in with no financial resources or spent down all their finances as they resided there. That prompted a serious cash-flow problem for the home, putting it in arrears in paying vendors, and necessitating its borrowing from the county to fill in the state payment time gap. It is only recently that the state has hired about 1200 more people and opened a new office in Chicago to accept and process downstate applications. So there has been positive movement on that front, which was probably part of the reason that the home showed a $30,000 profit in November 2017, the last month for which figures are available as of this writing. Another reason is that last summer the county hired a different management firm, SAK, that has brought in more efficient management and financial practices.
Onslaught Against the Home
While some of us in the county have had direct experience with the home and prize it as a public asset with a very long history of caring for the most vulnerable and destitute, there has been an onslaught of negativity from the Republicans, the News-Gazette and County Board Democrat Patsi Petri. In April 2017, there was another referendum on the home. Voters were asked to raise the property tax rate, the proceeds of which were to go to the nursing home, but also to give the County Board the authority to sell the home. This was not a mandate to sell, just giving the Board the ability to sell without going to the public again for permission. Unfortunately, the property tax increase failed. It did so on an urban/rural split. Voters in Champaign/Urbana supported the tax, while rural voters opposed it in sufficient numbers to kill it. There was also an urban/rural split on the authorization to sell. A large majority of the urban voters opposed the authorization to sell (69% in Urbana), while 67% of the rural voters, overwhelmingly Republican, supported it.
There was a more recent attempt by Gordy Hulten, the Republican County Clerk who is now running to become the newly created County Executive, to demonstrate that opinion in the mostly Democratic districts had shifted since last April in favor of selling the home. So he commissioned a telephone poll in which people who answered were told:
“As you know from published reports, the Champaign County Nursing Home is losing hundreds of thousands of dollars every month, and two residents died this year due to alleged negligence. To remedy the situation, the county board must now decide between cutting services—such as laying off police officers and eliminating some early voting locations—or selling the home to a privately funded company prepared to provide better care. We’d like to know whether you support or oppose the sale of the Champaign County Nursing Home in an effort to solve the problems?”
According to Hulton, about 53% responded that they favored sale. Note that this is a push-pull poll, one in which you first feed responders a lot of good or bad information and then ask them to respond in a way that you want them to. Moreover, those cuts might not be the choices that would be made if there were no sale. And why privilege a private company over a nonprofit one? Indeed, the sale of the public Vermillion county home to a private firm has not resulted in better care. That home has a one-star Medicare rating, lower than the two-star rating of the Champaign County Nursing Home. That did not stop Tom Kachich from devoting a full-length article in the News-Gazette (11/12/17) to Hulton’s push-pull poll. Indeed, between Kacich’s reporting and the News-Gazette’s anti-public nursing home editorials, it would be hard for people who rely on this as their news source to avoid feeling that the sky is falling on the nursing home and that privatization is the only savior, despite all the research findings that not-for-profit nursing homes are better than private ones.
Stipulations for the Sale
The County Board has been advised by its broker that it can reasonably expect $11 million for the home. That is the base price in its request for proposals to buy. But money is not the only stipulation. There are others, including that the purchaser must agree to maintain a skilled nursing facility with 220 beds until 2028, a set-aside for 10 years of 50% of the beds for Medicaid residents, and some employee retention provisions. Another provision is that the buyer would assume the existing collective bargaining agreement with AFSCME until the contract terminates at the end of 2018, but with no obligation for union recognition after that.
It would be preferable if the county would also (1) seek out, or give priority to, non-profit buyers because of their better records nation-wide; (2) exclude from consideration corporations engaged in “related property transactions” that do business only with their own separate companies for services (according to Kaiser Health News, quality of care is worst among this kind of private company, New York Times, 1/7/18); and (3) exclude from consideration any buyers, private or public, whose nursing homes average less than a 2-star rating, which is the rating of our nursing home now.
We have to consider the welfare of the residents of our nursing home. Whatever the problems our home is presently confronting, we cannot in good conscience deliver the residents to a worse situation as a result of a sale. Fortunately, an actual sale would require affirmative votes by 15 board members, two more than just approved putting the home up for sale. If we reach a point where we advocates cannot prevent a sale, then at least we can pressure members of the board to act in the best interests of present and future residents.