[Vision2020] Selling Latah Health Services

[Jerry Weitz]

B.J. ,  The two Nursing homes in Spokane became interested because I called 
them and I have/had family members in both.   Both are privates and are 
very committed to their communities.  Both would commit to our community if 
they came and this certainly is not a profit move on their parts. The 
industry is simply not profitable for a variety of reasons.  I am for 
Gritman assuming ownership if nothing comes of the inquiry.  Gritman is a 
great asset, yet Gritman is not in/ nor should be in the long care 
business.  It is my understanding that when they talked to you, that 
Gritman wanted to be in control over the structure of what would 
happen.  Is this correct or did they misunderstand what you were 
saying?   It seems and hopefully that I am wrong that an unwelcoming 
picture was painted from the call I took from one of the CEO's after their 
converations. I have been out of town and have not followed up with the 
CEO's.  I know that they contacted the commissioners. I will contact the 
homes and report back.

I have little problem with an out of area entity that committs to running a 
nursing home and keeping the therapy pool open.  Again, what I am very 
concerned about is the loss of local skilled nursing. As for profits being 
siphoned off to Spokane by these nursing homes, I find this argument as a 
slightly bad faith argument since Gritman will not be filling nursing home 
community need. Most likely, any entity would incorporate in Idaho and 
would operate similar to Good Sam. Both homes were sensitive to community 
reactions if they tore down and replaced the old section (which I found to 
be of good faith).  Both facilities would not be exclusively dedicated to 
indigent care.  LHS certainly was not and I could not run my practice on 
medicaid rates.     Whether Gritman or some other entity takes possession, 
a substantial amount of effort and capital will need to be invested.  I am 
truly thankful that Gritman stepped up to the plate by keeping the pool 
operating and willing to make something of the facility for the community's 
benefit.

The basic questions: If there are entities that can be found that will 
fulfill the nursing home end and keep the pool open should the public have 
the opportunity to choose?   Do you think more options should be pursued 
such as dual ownership?   What is the solution for skilled nursing for our 
county? Do you think the existing vote time line is in the best interest of 
our community?  Best, Jerry


At 11:08 PM 1/10/07, B. J. Swanson wrote:
>Jerry & Roger,
>
>There are some inaccuracies in your Vision 2020 posts that I feel must be
>clarified.  I am writing this as a Latah County citizen and not as Chair of
>the Board of Gritman Medical Center.
>
>Murf Raquet's editorial in the Weekend Daily News presented an interesting
>but unfeasible concept.  This was reviewed by the Latah County Commissioners
>and County Attorney Bill Thompson at the Board of County Commissioners
>meeting on Monday, January 8.  Mr. Thompson said that the Idaho Statutes are
>clear that simply asking voters to remove the reversionary clause from a
>county owned health care related property is not allowed.  I believe the
>Statutes are 31-3515 and 31-3515A.
>
>It is very unfortunate that Latah Health Services closed and many skilled
>care and assisted living residents were forced to move elsewhere.  LHS had
>been in serious financial trouble for at least the last five years.  It was
>unable to adequately maintain the facility and found it very difficult to
>borrow money to fix it partially because of the reversionary clause.  County
>officials were concerned that a tax supported bond to fix the facility would
>not pass.
>
>Jerry is correct in stating that the nursing home industry is highly
>regulated.  It is also very poorly reimbursed by Medicare and Medicaid.
>Quite often the reimbursements do not even pay the costs of care, not
>including maintaining a facility.
>
>LHS tried for years to recruit nursing home operators to manage the skilled
>nursing and assisted living areas.  Where were the Spokane companies then?
>No one was beating down the LHS door to take over this facility.  They
>finally contracted with (begged) Valley Vista in hopes that a more
>experienced operator could make it work.  With poor reimbursement and a
>facility in disrepair, Valley Vista could not make it work either.  This
>trend is very common in the nursing home industry. Bankruptcy and failures
>are common and include previous owners of Aspen Park, Clark House and Aging
>with Grace.  Now add LHS to the failure list.  If this is such a lucrative
>industry that two Spokane care companies are all of a sudden interested,
>then why didn't they show up several years ago?  In my opinion, neither
>seemed very interested now, either.  It is common that nursing facilities
>must have a majority of private pay residents to basically subsidize the
>Medicaid residents.  Thinking that Rockwood Manor or Sunshine Gardens from
>Spokane could make this work with mostly Medicaid residents with Idaho
>reimbursement rates is a fallacy.  Jerry said they were interested "...under
>the right conditions."  It would be interesting to know what conditions.
>For Latah County taxpayers to subsidize Spokane companies, one for-profit
>and one non-profit, would probably not be popular either.
>
>Gritman is a 501(c)(3) non-profit corporation.  It is owned by the community
>and governed by a 10 member community board. Gritman's mission is to meet
>the healthcare needs of the community and has been doing this for over 100
>years.  Any profits that Gritman makes are reinvested in healthcare for this
>community, not Spokane, not dividends for shareholders and all board members
>are unpaid volunteers.
>
>If the voters approve transfer of the property to Gritman, it is Gritman's
>intent to remodel the facility into a community wellness center for the
>benefit of the whole community.  This will include the therapy pool, Gritman
>Adult Day Health and many other wellness services that are currently being
>studied, including the possibility of assisted living if a viable operator
>can be found.  Gritman is also willing to lease back space for County
>offices. It is estimated that just bringing the facility up to safety
>standards will cost well over $1 million, which Gritman is willing to
>invest.  Removing the reversionary clause will enable Gritman to negotiate
>more favorable financing to fund the necessary renovations and repairs.
>Leaving the reversionary clause in place would make it financially
>unfeasible for Gritman to operate the facility as a non-profit wellness
>center.
>
>Gritman has never developed property for anything but healthcare related
>purposes and has never wavered from that position.  I am confident the
>expert planners, managers, grant writers, etc., available to Gritman can
>make LHS a valuable community asset now and far into the future.
>
>B. J. Swanson
>Latah County Citizen
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