So many questions, so few facts
The river towns are in something of a tizzy because the River Hospital’s board of directors has thrown in the towel on the hospital’s skilled nursing unity, quietly filing a plan for closure with the state Department of Health and receiving, the day before a public meeting held to discuss the issue, a go-ahead from the state to close.
The directors and the hospital administrator have painted a woeful picture of the facility, saying there is an $82-dollar-a-day gap between Medicaid reimbursements and the hospital’s cost per resident. With 25 residents on Medicaid (93 percent of the unit), that would give the hospital a funding gap of $748,250 — clearly, a large sum of money.
But wait. The rate paid the hospital, retroactive to April 2009, has been increased by $48 a day. That means the gap has been reduced to $34 a day, which would yield a much more palatable $310,250 deficit. While this higher rate may not hold past 2010, it would give the hospital some breathing room — especially since it will reimburse for eight months of last year.
According to CNNMoney.com, the average cost of nursing home care in Central New York, the nearest region surveyed, is $207 a day. Presumably, that figure provides a profit for these facilities. River Hospital’s cost is almost 15 percent higher than that average rate. Yet, the board of directors has not indicated whether they have attempted to reduce their operating costs — which would reduce the cost per day — for their operation.
With 40 employees serving 27 residents, one immediately must wonder "Is that an efficient way to run a skilled-nursing facility?" Whispering Pines, the county-operated nursing home, has 50 residents who are served by 25 employees. To my knowledge, quality of care has never been an issue at the facility, which is plagued by a deteriorating physical plant but otherwise lauded by many families of the residents.
The ratio of employees to clients at River Hospital's skilled-nursing facility is 1½ to 1. The ratio at Whispering Pines is ½ to 1. It doesn't take a John Nash to figure out something is out of balance here. If this is symptomatic of the way the facility is run over-all, perhaps the need for its closure is more due to mismanagement than to inevitable insolvency.
If it is, or if it isn't, residents of the river towns that support River Hospital have a right to ask these questions, and have them answered. A little transparency would go a long way to answering the main question residents have: is this really necessary? If the hospital put ALL the numbers out there (not just the ones it wants to present) and gave people a chance to ask questions and make suggestions, the final decision, whatever it is, would likely gain the approval of most of the community. Without that, no one will every really know if the unit could have been saved. And the bad feelings that will engender will damage River Hospital for a long time to come.
