LAWRENCE COUNTY Future is uncertain for nursing home

County commissioners worry that Hill View will be a drain on taxpayers.
By LAURE CIOFFI
VINDICATOR NEW CASTLE BUREAU
NEW CASTLE, Pa. -- With the population of Hill View Manor dropping, Lawrence County commissioners are mulling over the future of the county-owned nursing home.
Commissioners have contacted Complete Health Care Resource, a Horsham, Pa.,-company that managed Hill View Manor for six years, to discuss a possible management contract. But commissioners say others are also interested in the home, and they are keeping their options open.
Mike Wilt, executive director of the Pennsylvania Association of County Affiliated Homes, said each county operates its nursing home differently.
Some manage them on their own, others hire professional management firms, and others have sold their county homes, he said.
Wilt noted that state law requires counties to care for poor, elderly residents, and selling a county nursing home doesn't mean a county can completely leave the nursing-home business.
"It's one of those gray areas [in state law]. It doesn't say a county has to operate a nursing home, but it does say the county has to take care of its indigent," Wilt said.
Privatized homes
About 10 counties have privatized their nursing homes in the past two decades, and each has taken a different route, he said. All have to make some agreement that will help care for the county's indigent, he said.
"There is no standard model. In a couple of cases there is probably a contractual relationship that a certain number of residents are on Medicaid. In other cases, a county commissioner sits on the board, or it may be situated on county property," Wilt said.
Far more counties still own their own nursing facilities, he added.
There are 43 county-operated homes in 38 counties in Pennsylvania. Large counties, such as Erie and Allegheny, have more than one county home, he said.
"There are a lot of issues to consider with a county nursing home, and finding a way to transfer the workforce [to a private company] may sound attractive. But when you get into the realities of doing it, it's not that easy to sell a facility that treats Medicaid residents," he said.
Not for everyone
Mercer County is among the Pennsylvania counties that privatized its nursing home. In 1997, it became a nonprofit facility called Woodland Place.
It has been a struggle to maintain the home, but Administrator Charles Bish said it was the right decision for Mercer County.
Woodland Place lost about $450,000 in its first year of operation -- about the same amount taxpayers were adding to the budget to fund it each year, he said. But each year that deficit has shrunk and is now down to about $150,000 per year, for which the taxpayers are not liable, he said.
Operating it as a private facility has made decision making easier and taken out the politics that often come with county government, but Bish noted privatization isn't for everyone.
"I think you have to look at each county individually. You have to look at where people will go if the county home isn't there," he said.
Lawrence County Commissioner Roger DeCarbo argues that there are plenty of places Hill View's residents and staff can go if the county home is closed.
He said a recent survey of private nursing homes in New Castle found 157 beds available.
Cost to the county
Commissioners say they are concerned that the recent dip in Hill View's population -- 84 residents -- will eventually become a drain on taxpayers. The facility is licensed to care for 136 people.
The county home has earned enough money over the past five years to cover its own operating expenses, but if the population continues to decline, it could mean the county will have to pay some of Hill View's operating expenses, Commissioner Brian Burick said.
"We're going to look at some proposals. I'm open to any option at this point. We need to make some changes to avoid a situation where the county has to come up with money out of the general fund," he said.
DeCarbo has said he's also open to any options. Commissioner Ed Fosnaught said he is interested in turning the home over to a professional management company but not in selling it.