<DIV>BJ,</DIV> <DIV> </DIV> <DIV>Thanks for the response. I want to be clear, I don't blame LHS or the CC for the fail of the LHS--I am angry that others are so quick to shut this place down and make a profit off the great loss of these people without taking the time to find some other sources for it to reopen. Nobody is even trying. It is sad, they have not heart.</DIV> <DIV> </DIV> <DIV>There is no need for an assisted living facility or a skilled nursing facility in the community that only accepts private care like you are proposing. There is only a need for one that takes government funded care. </DIV> <DIV> </DIV> <DIV>The only way a skilled nursing facility can stay open is if it subsidized by the county and state. I see neither Representative Tom Trail or Shirley Ringo, or our Senator Gary doing anything thing for state funding. In fact, the opposite, they are hastening its closing. And I see no local community leaders doing anything to
get a plan and/or get a bond going to help out. No effort at all--not even an interest in saving it. </DIV> <DIV> </DIV> <DIV>But instead, what I do see is the vultures circling around the building looking a piece of profit or gain for their organization from its remains. It really is sad. I thought Moscow had a bigger heart.</DIV> <DIV> </DIV> <DIV>I am all for expanding the medical needs for those in Moscow, but not this way, and not a free profit to medical companies and private practice doctors.</DIV> <DIV> </DIV> <DIV>There is no excuse for our community to stop serving those that are in most need of community support. Many of these people are veterans and spouses of veterans; Tossed to the outshirts in their moments of greatest need. But nobody gives a shit because they don't have money. I am glad I have private insurance, I see how I would be treated otherwise. </DIV> <DIV> </DIV> <DIV>Best,</DIV> <DIV> </DIV>
<DIV>Donovan <BR><BR><B><I>"B. J. Swanson" <bjswan@moscow.com></I></B> wrote:</DIV> <BLOCKQUOTE class=replbq style="PADDING-LEFT: 5px; MARGIN-LEFT: 5px; BORDER-LEFT: #1010ff 2px solid"> <META content="Microsoft Word 11 (filtered medium)" name=Generator> <STYLE> v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </STYLE> <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:SmartTagType name="State" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:SmartTagType><o:SmartTagType name="City" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:SmartTagType><o:SmartTagType name="PlaceType" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:SmartTagType><o:SmartTagType name="PlaceName" namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:SmartTagType><o:SmartTagType name="place"
namespaceuri="urn:schemas-microsoft-com:office:smarttags"></o:SmartTagType> <STYLE> st1\:*{behavior:url(#default#ieooui) } </STYLE> <STYLE> <!-- /* Font Definitions */ @font-face {font-family:"Arial Narrow"; panose-1:2 11 5 6 2 2 2 3 2 4;} @font-face {font-family:Tahoma; panose-1:2 11 6 4 3 5 4 4 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman";} h2 {mso-margin-top-alt:auto; margin-right:0in; mso-margin-bottom-alt:auto; margin-left:0in; font-size:18.0pt; font-family:"Times New Roman"; font-weight:bold;} p.MsoEnvelopeReturn, li.MsoEnvelopeReturn, div.MsoEnvelopeReturn {margin:0in; margin-bottom:.0001pt; font-size:10.0pt; font-family:"Arial Narrow"; color:black;} a:link, span.MsoHyperlink {color:blue; text-decoration:underline;} a:visited, span.MsoHyperlinkFollowed {color:blue;
text-decoration:underline;} p {mso-margin-top-alt:auto; margin-right:0in; mso-margin-bottom-alt:auto; margin-left:0in; font-size:12.0pt; font-family:"Times New Roman";} span.EmailStyle21 {mso-style-type:personal-reply; font-family:Arial; color:navy;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.Section1 {page:Section1;} --> </STYLE> <DIV class=Section1> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Donovan,<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Please notice that the yellow portion on the architect’s rendering is planned for skilled nursing. Gritman will try to find
an organization that will operate skilled nursing or assisted living in the 17,000 square foot upper eastern portion. It would be an ideal place for skilled nursing or assisted living and would work well with Gritman Adult Day Health planned for the green section. A larger version of the architect’s rendering is displayed in the Gritman lobby.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">However, the more Gritman learns about skilled nursing, assisted living, reimbursement rates, county homes, etc., the more apparent that it may be very difficult to find an operator. <o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy;
FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">It’s easy to point fingers at the Latah County Commissioners and Latah Health Services for letting the facility fail. But reality, history and government mandates can clearly explain why this happened.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">At one time, nearly every county in the State of <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:State w:st="on"><st1:place w:st="on">Idaho</st1:place></st1:State> had a ‘County Home.’ Now there are only two remaining, both highly
subsidized by taxpayers. The <st1:place w:st="on"><st1:PlaceName w:st="on">Boundary</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType></st1:place> facility receives about $300,000 annually in county taxpayer subsidies. The <st1:place w:st="on"><st1:PlaceName w:st="on">Blaine</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType></st1:place> facility receives about $750,000 annually in county taxpayer subsidies. A similar taxpayer subsidy would have been needed to keep Latah Health Services open. Would the taxpayers of <st1:place w:st="on"><st1:PlaceName w:st="on">Latah</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType></st1:place> vote to subsidize LHS that much? The Latah County Commissioners didn’t think so. With the reversionary clause in place, <st1:place w:st="on"><st1:PlaceName w:st="on">Latah</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType></st1:place> voters would have had
to approve a multi-million dollar bond to renovate the facility and then several hundreds of thousands of dollars for operations. It’s very doubtful the voters of <st1:PlaceName w:st="on">Latah</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType> would have approved, similar to the voters of other <st1:State w:st="on"><st1:place w:st="on">Idaho</st1:place></st1:State> counties where their county homes have gone out of business.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">This is a sad reality but is an indication of the healthcare changes that started in the 1990’s. Medicare and Medicaid do not reimburse enough to pay the costs of indigent care in facilities. Most skilled
care/assisted living operators try to mix Medicaid residents with private pay residents in order to survive. There are at least 50 extra licensed but vacant beds in the other facilities in <st1:place w:st="on"><st1:City w:st="on">Moscow</st1:City></st1:place>. The operators chose not to use them because a higher mix of Medicaid patients would make it difficult to survive.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">The Kaiser Family Foundation has done several studies on Medicare and the uninsured. These papers outline the forced progression away from assisted living and skilled nursing facilities because of costs in favor of Home & Community Based Services (HCBS). Gritman Adult
Day Health and Gritman Home Health are considered HCBS’s. The Medicare Modernization Act of 2003 further emphasizes reduced funding for care facilities. Yesterday, President Bush announced that he wants more Medicare and Medicaid cuts. <o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">I believe there is a clear picture for the government to continue Medicare and Medicaid cuts and more encouragement for Home & Community Based Services, wellness programs, etc. These services are what Gritman is planning for the facility and all without <st1:place w:st="on"><st1:PlaceName w:st="on">Latah</st1:PlaceName> <st1:PlaceType w:st="on">County</st1:PlaceType></st1:place> taxpayer
subsidy.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">Gritman respects the decision of the voters on Tuesday and will hold that decision in highest regard.<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial">B. J. Swanson<o:p></o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV class=MsoNormal><FONT face=Arial color=navy
size=2><SPAN style="FONT-SIZE: 10pt; COLOR: navy; FONT-FAMILY: Arial"><o:p> </o:p></SPAN></FONT></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in; TEXT-ALIGN: center" align=center><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <HR tabIndex=-1 align=center width="100%" SIZE=2> </SPAN></FONT></DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><B><FONT face=Tahoma size=2><SPAN style="FONT-WEIGHT: bold; FONT-SIZE: 10pt; FONT-FAMILY: Tahoma">From:</SPAN></FONT></B><FONT face=Tahoma size=2><SPAN style="FONT-SIZE: 10pt; FONT-FAMILY: Tahoma"> vision2020-bounces@moscow.com [mailto:vision2020-bounces@moscow.com] <B><SPAN style="FONT-WEIGHT: bold">On Behalf Of </SPAN></B>Donovan Arnold<BR><B><SPAN style="FONT-WEIGHT: bold">Sent:</SPAN></B> Sunday, February 04, 2007 3:03 AM<BR><B><SPAN style="FONT-WEIGHT: bold">To:</SPAN></B> Saundra Lund; 'vision2020'; odrawhorn@dnews.com<BR><B><SPAN style="FONT-WEIGHT: bold">Subject:</SPAN></B> Re:
[Vision2020] Daily News, Saturday,3 February 2007: Gritman outlines its plans for LHS</SPAN></FONT><o:p></o:p></DIV></DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"><o:p> </o:p></SPAN></FONT></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">"The 17,000-square-foot upper-eastern portion of the building is vacant, but Swanson hopes it eventually will be leased to an assisted-living facility. We have talked with three different companies,†Swanson said. “The problem is the mix of patients.†<o:p></o:p></SPAN></FONT></DIV> <DIV> <DIV> <DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Housing private patients, as opposed to Medicaid patients, would be more workable, she said."
<o:p></o:p></SPAN></FONT></DIV></DIV></DIV></DIV></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">What about <EM><B><I><FONT face="Times New Roman"><SPAN style="FONT-WEIGHT: bold">skilled nursing</SPAN></FONT></I></B></EM>? It appears that Gritman is not interested in bringing back the skilled nursing facility, the largest and most important part. <STRONG><B><FONT face="Times New Roman">Assisted Living</FONT></B></STRONG> is not the problem, skilled is. Skilled requires licensed nursing staff and skilled is where the super majority of LHS residents
resided, they are in need of level 3-5 care. <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Assisted living is much fewer in number, generally level 1 or 2 care level and don't need licensed nurses or certified nursing staff on the premise to care for them. <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">My belief is that Gritman will not bring skilled nursing back because there is no profit in government funded Skilled Nursing , only Private Pay Assisted, they only thing they want to provide. <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT:
0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Where are Skilled Medicaid Patients to go, they were the ones that LHS serviced? Privately insured assisted living folks don't have the real problems.. Gritman is ignoring the people that are being short changed here, the level 4 and 5 care people that are on government provided care.<o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Gritman can expect to get about 2-3K a month per resident in assisted living, a large profit paying little in wages and medical
costs. With Skilled Nursing, they see about 5K a month but, skilled nursing requires licensed nurses and certified nursing staffing, and higher medical care costs, making it not profitable. <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt"> <o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Donovan J <st1:City w:st="on"><st1:place w:st="on">Arnold</st1:place></st1:City><o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">CNA<o:p></o:p></SPAN></FONT></DIV></DIV> <DIV> <DIV class=MsoNormal style="MARGIN-LEFT: 0.5in"><FONT face="Times New Roman" size=3><SPAN style="FONT-SIZE: 12pt">Former LHS
Employee<BR><BR><o:p></o:p></SPAN></FONT></DIV></DIV></DIV>=======================================================<BR>List services made available by First Step Internet, <BR>serving the communities of the Palouse since 1994. <BR>http://www.fsr.net <BR>mailto:Vision2020@moscow.com<BR>=======================================================</BLOCKQUOTE><BR><p> 
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