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Nursing home not profitable, committee told

Wednesday, February 25, 2009

(Photo)
Joe Tillett
Bedford County Nursing Home's January financial report shows a profit of $31,123 for the month, and a profit of $52,888 for the fiscal year so far -- but county Finance Director Robert Daniel told members of Bedford County Financial Management Committee those figures are misleading.

"I don't think we have a profit," said Daniel, saying the nursing home is behind on some of its debts. He noted that the balance sheet shows $296,335 in current assets and $594,665 in current liabilities.

County commission member Joe Tillett, who chairs the financial management committee, said some of the nursing home's bills are more than 90 days past due.

Tillett met with nursing home administrator Wayne Schumann Tuesday afternoon to discuss the nursing home's financial situation. He said some staffing changes may need to be made, and said some jobs now being done by registered nurses could be done by licensed practical nurses instead.

Meanwhile, the committee continues to look at the county's financial picture. Daniel discussed the county's January tax revenue figures, but said the February figures, which won't be available until next month, will tell more of a tale.

The lion's share of property tax bills will be paid this month, and the sales tax revenue the county receives this month will reflect sales in the month of December, during the busy Christmas season. So this will be a critical month in determining the county's tax revenue, said Daniel.

Target spending areas

Daniel gave the committee the monthly breakdown of spending in several target areas. At the end of January, 58 percent of the budget year was past, so that figure was used as a comparison to determine whether spending is over or under budget.

Spending areas that were over budget:

Electric utilities, 69.19 percent

Food supplies, 68.81 percent -- Daniel said this reflected increasing food costs, which are the result of increasing fuel costs.

Vehicle maintenance, 65.60 percent

Spending areas that were under budget:

Natural gas, 47.57 percent

Travel, 38.77 percent -- County departments have cut back on travel expenses as a whole, but some individual line items are over the 58 percent mark, including several within the school system. Commissioner J.D. "Bo" Wilson questioned School Superintendent Ed Gray about a school board trip to a Tennessee School Boards Association meeting at the Gaylord Opryland Resort and Convention Center in Nashville.

Gray said school board members are required to attend some of the inservice training that took place at the TSBA meeting. Wilson asked whether board members might have commuted to the meeting on an unused school bus rather than staying at the hotel overnight.

Gasoline, 36.59 percent

Diesel, 32.34 percent

Legal services, 26.68 percent

"The days of wine and roses are over, folks," said Wilson.

Wilson said the county needs to carefully scrutinize end-of-year budget amendments. In the past, some departments would take money that was underspent in some operational line item and ask for permission to spend it on some special project or capital expenditure. But Wilson said such requests don't need to be rubber-stamped given how tight the county's fiscal situation is at present.

Looking 'grim'

Gray said that prospects for the school budget are troublesome as well.

"Next year's budget looks more grim than this year's," he said. Gray said the school system has been conservative in its spending, which has enabled the school system to furnish the new Learning Way Elementary School and the new building for Community High School.

Gray cautioned that the economic stimulus money announced for Bedford County by U.S. Rep. Bart Gordon's office may not turn out exactly as expected. He recalled a previous situation where the state announced in a news release that it would fund $400 pay raises for teachers. By the time the money trickled down to local school systems, it was less than that, and by the time taxes were taken out the actual impact on a teacher's take-home pay was even smaller.

Gray said some of the grant money also comes with staff development requirements that create additional costs for the school system.

Other discussion

  • The committee voted to recommend a budget amendment of $67,500 for reroofing the Medical Arts Building. Last month, committee members thought that money could come from a fund of loan money repaid by the nursing home, but there's not enough in that fund to do the project.
  • Daniel reported that the sheriff's department and Bedford County Emergency Medical Services have turned in new compensatory time policies. All county departments have until mid-March to turn in new policies to Daniel.
  • Daniel presented a summary of worker's compensation losses for the county.
  • The county highway department will take over waste disposal at the nursing home. Even with the cost of purchasing waste bins and compensating the highway department for an additional employee, this is expected to save money compared to the current contract with BFI.


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Sell it. The County has no need to be in the nursing home business.

-- Posted by sameoldstory on Wed, Feb 25, 2009, at 10:28 AM

I disagree with sameoldstory. I don't think we should sell the nursing home. I do believe we should clean house starting at the top and working down the ladder. Tell me why the administrator didn't comment on why/how the nursing home is behind on its debts? Sounds like mis-management. I have had family in both nursing homes and I would have to say the staff at BCNH was better to me family. With the exception of Schumann who put one family member in direct harm physically and finacially.

-- Posted by what??? on Wed, Feb 25, 2009, at 10:40 AM

Why does the county keep beating a sick horse to death? Bedford County Nursing home is definitely a necessary entity, but I'm not convinced the County should be the owner. The Nursing home is in dire need of upgrading. It is a dark, dismal place cosmetically and esthetically. If it is not depressing enough to walk in and see the sick and the elderly, then the dank, outdated facility should be enough to finish you in. I'm sure every worker and health care professional there is doing the best they can with what they have to work with, but the county just cannot afford to upgrade the facility in any way and if the county is looking for a money-making proposition, I cannot see how they expect to find one in the health care industry with its high cost of medicine and healthcare. The government is cutting back on benefits and there seems to be more and more demand for services. It almost seems selfish to keep holding on to something we cannot afford, instead of selling it if for no other reason but to break even and get out of debt, and give someone who is more experienced and more able to furnish perhaps a higher quality service than what the County can provide.

-- Posted by writeattitude on Wed, Feb 25, 2009, at 10:45 AM

I have been yelling sell for years. The cost of running a nursing home is far beyond what Bedford County can afford. We are one good lawsuit away from getting us into real trouble. I have someone who is currently in Bedford County Nursing Home and she gets good care, but it will never be profitable to Bedford County. The cost of this type of care is on the rise and the regulations may be too much for Bedford County to handle and still manage it's money well.

-- Posted by sameoldstory on Wed, Feb 25, 2009, at 3:55 PM

WHERE DO YOU EXPECT THESE RESIDENTS WILL GO IF THE NURSING HOME IS CLOSED?? I feel sure that there is all sorts of ways to cut costs, but I don't see that cutting out some of the registered nurses and using more LPN'S is the answer!! Cutting your staff could create liabily problems.

-- Posted by barbara.a on Wed, Feb 25, 2009, at 4:22 PM

WHERE DO YOU EXPECT THESE RESIDENTS WILL GO IF THE NURSING HOME IS CLOSED?? I feel sure that there is all sorts of ways to cut costs, but I don't see that cutting out some of the registered nurses and using more LPN'S is the answer!! Cutting your staff could create liabily problems.

-- Posted by barbara.a on Wed, Feb 25, 2009, at 4:22 PM

I may open up a big can of worms but the bean counters need to quit looking at the cost of an RN's pay versus an LPN's pay when it comes to cutting costs. In the medical field both are needed entities, but there are skills that RN's are taught and needed that LPN's are not allowed to do according to state regulations. I would way cutting RN's out of the mix would do some harm to the family members that are being cared for at BCNH.

-- Posted by Sharon22 on Wed, Feb 25, 2009, at 5:04 PM

Sharon22,

I have to agree. There is no way in the world I would stand for an LPN to do much more than take my blood pressure.

I do feel that in many areas of healthcare there has been a 'downward shift' in professional level.

From MD's to Pa's or NP's, from physical therapists to athletic trainers or PTA's, from RN's to LPN's, the trend is clearly to make do with a less educated and less trained professional.

Sickening.

-- Posted by gottago on Wed, Feb 25, 2009, at 10:15 PM

gottago,

LPN's are very much capable of doing more than BP's. What highly concerns me is a "bean counter" that has no connection with healthcare stating that an RN can be replaced by an LPN. I know a great many experience LPN's that I would trust caring for me over some brand new RN's. The big difference is experience versus what your state licence allows you to do, for example all patients admitted to hospitals are to be assessed (i.e. listen to heart, lungs, etc.) and I would guess that would be the same in the nursing home. One of the best tidbits I was given in school was to find an experience LPN and listen to them. The key with LPN's is the word PRACTICAL. The are trained in bedside care and know how to care for a person and most are very good at what they do. I would have to disagree that we are dumbing down healthcare with the use of PA's, NP's and other ancillary persons, each has an appropiate spot in the system. I work with and know several NP's that have excellent assessment skills and are very capable of treating patients correctly and professionally. I'm sorry to get on my high horse with the subject, but it's a subject near and dear to me.

-- Posted by Sharon22 on Wed, Feb 25, 2009, at 11:25 PM

I have this to say to Mr. Gray about the budget of our school system. At my daughters school they have nothing but whiteboards which is very costly for the cleaner and markers. The teachers also copy daily assignments instead of writing them on the board like in the old day. If the schools would go back to blackboards and the students writing down thier assignments this would save the school board some money. I know it would not fix everything in the budget but it is a start.

-- Posted by stephsmom on Thu, Feb 26, 2009, at 8:29 AM

stephsmom,

Get in the 21st century. You want teachers to go to chalkboards? Dry Erase is not that expensive and it is user friendly. Due to allergies most kids cannot be around chalk. What are you going to suggest next, horse and buggies.

-- Posted by what??? on Thu, Feb 26, 2009, at 9:44 AM

stephsmom, did you mean to post that on this blog? they are talking about the Nursing Home expenses, not the Schools expenses. I do agree with gottago though, chalk is a health issue.

-- Posted by Momof3&3step&1gran on Thu, Feb 26, 2009, at 10:17 AM

I wonder if the two death incidents that happened, and the cost of penalties may play a part in the loss of income of BCNH.

-- Posted by Momof3&3step&1gran on Thu, Feb 26, 2009, at 10:19 AM

I guess when it comes time for me to go into the nursing home and bedford county does't have one,i can not aford prive pay there's only one thing to do commit a crime and go to jail

Then i would have a place to go for meals and medical care

thats what a person can do and survive

-- Posted by lonewolf2110 on Thu, Feb 26, 2009, at 1:36 PM

I have to agree with you lonewolf2110 It is a shame we treat criminals better than we do our elderly.

The only thing I see as a positive in that is one day they too will be old and What goes around comes around!

-- Posted by Dianatn on Thu, Feb 26, 2009, at 10:41 PM


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