Update: 7/21/22
The board voted to move ahead with a sale to Illuminated HC and will not to take the issue to a referendum. This is a developing story.
Nursing homes shortages have worsened during the pandemic. At county run nursing homes, the challenge is even greater. It can affect a community’s most vulnerable seniors and strain local budgets.
Mary Roman, 87, has lived at the DeKalb County Rehab and Nursing Center for nearly 8 years. The avid Cubs fan feels it is not what it once was.
“The place was always cheerful looking and acting,” Roman said. “Now the staff is so short that they can't give anybody any extra time or do fun things.”
Recently, some staff members have left with whom she’s had strong bonds. Supply chain issues have also affected some favorites at the home.
“Applesauce is something that you should never run out of for seniors,” Roman said.
It may seem like a small gripe, but it points to some larger issues facing the county.
Tough times
Some of the financial trouble the nursing home faces is tied to COVID-19. But there are also fewer residents. And the former management company failed to properly bill the federal and state governments for Medicaid and Medicare reimbursements.
Scott Campbell is a DeKalb County board member. He says the board faces tough choices as it deals with a $7 million budget shortfall. He estimates it will be an additional $5 million by the end of the fiscal year.
“When an entity that's a public entity like the nursing home runs a deficit, the only option is to cover that financial gap with taxpayer dollars,” Campbell said.
That’s what the board did for several years. The home was once self-sustaining, but now struggles to keep up with its bills. The county board wants either to sell the home or keep it but with major adjustments to its budget, and an increase in property taxes.
Happening elsewhere
These challenges aren’t unique to DeKalb County.
The Winnebago County nursing home, River Bluff, also faces financial problems. Voters favored keeping it and supporting it with a tax levy in an advisory question on the June primary ballot.
Changing views
Back in DeKalb, Mary Roman has spoken up at county board meetings in favor of the county keeping the nursing home. She’s President of the Resident Council at the DeKalb County Rehab Center. But lately, she’s felt differently as the nursing home management and county officials attempt to tighten the budget.
Maggie Niemi is the center’s administrator. She says she understands residents are feeling frustrated.
She’s been on the job since October. She said the role would usually be filled by a finance management company, but they left in December leaving her to fill the position.
“It's been very challenging,” Niemi said. “I have been trying my darndest to do everything that I need to do in order to meet the expectations of the community and the county board, and the County Administrator, and the residents here.”
Niemi says uncertainty about the future of the nursing home has unfortunately meant veteran nurses have left.
For resident Mary Roman, going somewhere else is not realistic. Like many residents, she uses Medicare and Medicaid, the government funded health insurance that covers nursing home stay for low-income elderly people.
“If I could go higher and pay more, but I can't,” she said. “I have to stay within what I make every month with Social Security.”
Ratings vary among facilities
Critics of the plan argue that selling government run homes isn’t always in the best interest of the community. The state has recently been cracking down on inconsistent care among facilities.
In the spring, Illinois lawmakers passed a measure to tackle poor staffing levels at nursing homes. Studies rank Illinois as one of the worst states for nursing staffing levels.
DeKalb County has already received two offers from for-profit nursing home companies, but some county board members are concerned if they do sell, the quality-of-care residents receive will go down.
“We have a lot of members of our community who can't necessarily afford private care,” said board member Scott Campbell. “And if they can't afford private care, it's going to be a stretch for them and their families, which means they're going to have to take the lowest cost provider.”
One of the bidders, Illuminated Incorporated, runs nursing homes where three out of seven facilities in the western Michigan area have been cited by the government for having been cited for abuse.
The other bidder, Saba Health, based out of Skokie owns eight nursing homes with an overall rate well below average.
Moshe Blonder is the owner of Saba Health. He responded to a question regarding the low ratings during a recent board meeting.
“I know that there are some buildings that I have had issues in in the past, and I've moved in there and work to change it,” he said.
DeKalb’s county nursing home in comparison is currently rated overall average with the highest rating possible in staffing.
What's next
Campbell and fellow board member Bill Cummings conducted a financial analysis and found that if the nursing home reduced expenses and had funds coming in through a tax levy, the nursing home could break even.
But Campbell says even with recent attempts to reduce the budget, he hasn’t seen a significant difference in the budget. He said there’s still too much use of nursing staff from outside agencies, driving costs up.
He says if costs can’t be brought down, then selling may be the responsible option to avoid spending money from the county’s general fund to cover the nursing home gap.
“I can tell you that I am unwilling to burden the taxpayers…I can't do it,” he said. “I see where that ends, that ends with the county being insolvent.”
In comparison with other nursing homes in the area, Campbell says the county spends $103,000 per year per resident compared to Bethany Rehabilitation and Health Care Center that spends $82,000, and Pine Acres that spends $74,000.
Board chairman John Frieders says it’s important to remember the financial needs of the county as a whole.
“We need to consider the sheriff's department, we need to consider the highway department, the health department, everything,” he said. “And the nursing home has a huge effect on the county budget.”
The DeKalb County board will vote on Wednesday on whether to bring a referendum to voters to gauge their support a property tax increase to support the facility to keep it in local hands.
According to documents prepared by the County, the levy would raise about $2.44 million per year.
As part of the financial analysis that includes the significant cuts to hiring agency staffing, by 2024 the facility would begin to have income, and by 2031, the nursing home would be able to pay off its debt to the county.
The board will also vote on whether to move forward with a sale.
