Why do I support the thoughtful handing off of Otsego Manor to a provider that has a record of good care?
• There is a significant shift in policy around long-term care in our state that will change the complexion of skilled nursing facilities.
This shift is starting this year with the move to regional pricing and will continue with all New York state Long-Term Care Medicaid residents being enrolled in Managed Long-Term Care (MLTC) by 2014 in Otsego County. To survive in this world of Managed Long-Term Care, an organization must be able to be flexible, efficient and agile (able to reconfigure quickly).
• County nursing homes are particularly vulnerable to this shift because of the enormous constraints of the Civil Service structure and the outdated labor contracts and past-practice issues that hamstring the organizations’ ability to make the changes needed to survive in this new MLTC environment. By state law, county nursing homes are required to provide millions of dollars of New York state retirement benefits that other organizations are exempt from. Otsego County also provides a generous health insurance benefit to retirees and offers wages for some titles that are outside the averages that the pricing system will allow. Our current contract, which expired Dec. 31, 2011, provides a level of paid time off (PTO) that is over the allowable level of the current and future reimbursement methodology. The quality-of-life design of the building requires more staff. As a result, Otsego Manor today is saddled with more than $3 million of non-reimbursable expenses that must be paid for through contributions from the general fund.
• A nonprofit or for-profit provider would immediately be relieved of these expenses. I am not laying the problems we are facing at the feet of our staff. Even if we would have been successful this year in creating some form of MOU to relieve the Manor financially of some of these un-reimbursable expenses, they would not be enough to keep the gap from growing in future years.