MONROE - Something needs to be done to help cover the costs of Green County's nursing home, and county officials are discussing a referendum to do so.
The question, which could be decided by voters this fall, is whether the county should raise more taxes or make cuts in other departments or services, Green County Board of Supervisors Vice Chairman Harvey Mandel said.
Pleasant View Nursing Home finished 2008 with a roughly $900,000 shortfall. In 2009, the amount county taxpayers paid for the nursing home was about $632,000 out of the home's total operating budget of about $9.6 million.
After several hours of discussion Tuesday, the Green County Finance and Accounting Committee decided to begin preparations for a referendum. The language for the referendum hasn't been finalized. In fact, it hasn't even been started yet.
Over the next two weeks, Mandel said, the county finance committee and people from Pleasant View will determine how much money is needed and for how long the money is needed. He projected it's likely a referendum would be for between $500,000 to $1 million per year for the next five years.
The Green County Finance and Accounting Committee will meet Aug. 14 to finalize the referendum language. It will present the referendum language to the Green County Board of Supervisors at a special meeting Aug. 25.
If the board votes to have a referendum, the question could be put to voters by Oct. 6.
The county has to have a completed budget by Nov. 15.
Mandel said he understands people might think things are moving quickly, but he said the issue has to be decided soon.
This isn't the first time the county looked at what to do to help with the nursing home's budget.
At the county board's annual budget meeting last year, Mandel told the board the budget for Pleasant View would be an issue by the end of 2009. In January and February, the Pleasant View Nursing Home Committee and the county board learned from Brian Schoeneck, financial services director for the Wisconsin Association of Homes and Services for the Aging, that county operated nursing homes across the state faced financial problems due to the state budget.
Mandel said the county hoped to work with local Legislators to come up with some funding alternatives to help the county pay for the nursing home. Nothing was done at the state level to help the county overcome the deficit in nursing home funding.
Mandel said the nursing home's financial problems aren't due to poor management on the part of the county. The problem with nursing home funding comes from the state level, he said.
Mandel said he also understands people will ask why the county spent more than $12 million for a Justice Center when it needs the money to help cover costs at the nursing home.
He said both were needed and it was a coincidence that the nursing home's financial issues happened at the same time as the Justice Center construction.
Schoeneck told the Pleasant View committee and the county board earlier this year that public nursing homes, such as Pleasant View, generate millions of dollars for the state from the federal government every year. However, the state doesn't reimburse the county homes as much as it should and uses the money for its Medicaid Trust Fund deficits.
He explained that nursing homes don't receive enough money for Medicaid patients. He said that is the reason private nursing homes prefer not to take them. Private nursing homes can make more money by taking Medicare patients or patients that are rehabilitating from surgery. That allows private homes to have higher patient turnover rates, enabling them to make more money, he said.
Medicaid residents are in nursing homes for a longer period of time and require more assistance, he said.
About 70 percent of Pleasant View's residents receive Medicare. About 20 percent of the nursing home's residents are diagnosed with dementia, have complex medical needs and are Medicaid residents other nursing homes won't accept.
Schoeneck said that in 2006-07, the latest statistics available, 96 percent of all public nursing homes in the state suffered Medicaid losses and the average 100-bed nursing home lost about $34.50 per resident every day.
If the county decided to close the nursing home, it still would be required by the state to provide housing for some residents. People who are ordered to a nursing home by the court because they are a danger to themselves or others still would have to be taken care of by the county. Pleasant View has 14 residents who meet that requirement.
To send a resident to live at Mendota, a home near Madison, the county would have to pay Mendota $741 a day for each resident, or about $3.8 million a year. That cost would be transferred to Green County Human Services, and that would have a negative impact on the county if it has to contend with a 3 percent levy limit imposed by the state.
The levy limit wouldn't cover the increased expense at human services.
Mendota might not have room for all the residents. In that case, Green County would have to look for other state homes in other counties for the residents. But as other counties find themselves wrestling with budget issues, residents from other counties often aren't accepted.
The question, which could be decided by voters this fall, is whether the county should raise more taxes or make cuts in other departments or services, Green County Board of Supervisors Vice Chairman Harvey Mandel said.
Pleasant View Nursing Home finished 2008 with a roughly $900,000 shortfall. In 2009, the amount county taxpayers paid for the nursing home was about $632,000 out of the home's total operating budget of about $9.6 million.
After several hours of discussion Tuesday, the Green County Finance and Accounting Committee decided to begin preparations for a referendum. The language for the referendum hasn't been finalized. In fact, it hasn't even been started yet.
Over the next two weeks, Mandel said, the county finance committee and people from Pleasant View will determine how much money is needed and for how long the money is needed. He projected it's likely a referendum would be for between $500,000 to $1 million per year for the next five years.
The Green County Finance and Accounting Committee will meet Aug. 14 to finalize the referendum language. It will present the referendum language to the Green County Board of Supervisors at a special meeting Aug. 25.
If the board votes to have a referendum, the question could be put to voters by Oct. 6.
The county has to have a completed budget by Nov. 15.
Mandel said he understands people might think things are moving quickly, but he said the issue has to be decided soon.
This isn't the first time the county looked at what to do to help with the nursing home's budget.
At the county board's annual budget meeting last year, Mandel told the board the budget for Pleasant View would be an issue by the end of 2009. In January and February, the Pleasant View Nursing Home Committee and the county board learned from Brian Schoeneck, financial services director for the Wisconsin Association of Homes and Services for the Aging, that county operated nursing homes across the state faced financial problems due to the state budget.
Mandel said the county hoped to work with local Legislators to come up with some funding alternatives to help the county pay for the nursing home. Nothing was done at the state level to help the county overcome the deficit in nursing home funding.
Mandel said the nursing home's financial problems aren't due to poor management on the part of the county. The problem with nursing home funding comes from the state level, he said.
Mandel said he also understands people will ask why the county spent more than $12 million for a Justice Center when it needs the money to help cover costs at the nursing home.
He said both were needed and it was a coincidence that the nursing home's financial issues happened at the same time as the Justice Center construction.
Schoeneck told the Pleasant View committee and the county board earlier this year that public nursing homes, such as Pleasant View, generate millions of dollars for the state from the federal government every year. However, the state doesn't reimburse the county homes as much as it should and uses the money for its Medicaid Trust Fund deficits.
He explained that nursing homes don't receive enough money for Medicaid patients. He said that is the reason private nursing homes prefer not to take them. Private nursing homes can make more money by taking Medicare patients or patients that are rehabilitating from surgery. That allows private homes to have higher patient turnover rates, enabling them to make more money, he said.
Medicaid residents are in nursing homes for a longer period of time and require more assistance, he said.
About 70 percent of Pleasant View's residents receive Medicare. About 20 percent of the nursing home's residents are diagnosed with dementia, have complex medical needs and are Medicaid residents other nursing homes won't accept.
Schoeneck said that in 2006-07, the latest statistics available, 96 percent of all public nursing homes in the state suffered Medicaid losses and the average 100-bed nursing home lost about $34.50 per resident every day.
If the county decided to close the nursing home, it still would be required by the state to provide housing for some residents. People who are ordered to a nursing home by the court because they are a danger to themselves or others still would have to be taken care of by the county. Pleasant View has 14 residents who meet that requirement.
To send a resident to live at Mendota, a home near Madison, the county would have to pay Mendota $741 a day for each resident, or about $3.8 million a year. That cost would be transferred to Green County Human Services, and that would have a negative impact on the county if it has to contend with a 3 percent levy limit imposed by the state.
The levy limit wouldn't cover the increased expense at human services.
Mendota might not have room for all the residents. In that case, Green County would have to look for other state homes in other counties for the residents. But as other counties find themselves wrestling with budget issues, residents from other counties often aren't accepted.