CORRECTED: Nursing home board recommends lease

Bedford County Nursing Home Board of Trustees voted Thursday night to recommend that the county enter a five-year lease of the nursing home to a subsidiary of Johnson City-based Care Centers Management Consulting Inc. (CCMC).

The lease would have to be approved by Bedford County Board of Commissioners in order to take effect.

The lease does not contain any provisions for renewal or for selling the facility outright; both parties will have to negotiate again if anything is to follow the proposed five-year agreement.

Until 2005, Bedford County Medical Center and Bedford County Nursing Home were operated jointly under the county's ownership. In 2005, the hospital, which had a high debt and was in need of a new facility the county could not afford to build, was sold to Brentwood-based Community Health Systems. The hospital moved to a new facility on U.S. 231 and is now known as Heritage Medical Center. But the county retained ownership of the nursing home, believing it to be profitable.

In recent years, however, some county officials have questioned the nursing home's financial health. A patient care incident last year resulted in a 15-day suspension of patient admissions at BCNH, and resulted in additional costs for the facility.

Early in 2009, the nursing home's monthly financial statements showed a profit but the county's finance director and at least one board member said that was misleading, because of past due bills. In March, county commissioners voted to ask for proposals for leasing the nursing home.

Proposed terms

CCMC had expressed an interest in buying or leasing the facility as early as March 2008.

Attorney Wyatt Burke of Bobo, Hunt, White & Nance presented an overview of the lease to the board. The lease would be between the county and a corporation called Christian Care Center of Bedford County LLC which CCMC would create for this purpose.

The company would pay Bedford County $10,000 per month in rent for the nursing home if it uses the existing cafeteria, which is located in the old Bedford County Medical Center, adjoining the cafeteria. If CCMC were to build its own cafeteria, or obtain food service from off-site, it would only have to pay the county $2,000 per month.

Gary Parker, vice president of operations for CCMC, said the company has no plans to build a cafeteria and would like to continue using the existing facility. If the current cafeteria were to become unavailable, for example if the county decided to dispose of the hospital building, Parker said CCMC would still like the county to provide a cafeteria.

Bedford County would remain responsible for major structural maintenance -- for example, replacing a roof or an air conditioning unit -- while the company would be responsible for other routine maintenance, such as painting, plumbing, landscaping and personal property. The lease also sets requirements for CCMC to provide insurance coverage.

Endorsement

Burk reported to the board that Cheatham County Mayor Bill Orange had high praise for CCMC. Cheatham County entered into a 15-year lease of its nursing home to CCMC, after some initial public criticism, but decided to sell the facility to CCMC outright after just two years.

According to a memo given to the board, Orange said he "has not received one negative comment from the Commission nor the County citizens since CCMC has taken over."

Some commissioners have said in the past that they would like to see a lease agreement lead to a sale of the facility, while others have strongly opposed any such sale.

The nursing home's board is chaired by County Mayor Eugene Ray and includes the chairmen of the county commission's four standing committees: John Brown (law enforcement), P.T. "Biff" Farrar (rules), Phillip Vincent (courthouse and property) and Joe Tillett (financial management).

Commissioner Linda Yockey, who was present at Thursday's meeting, has said she'd like to visit one of CCMC's facilities in person before voting on any lease.

Business as usual

Meanwhile, until a lease has been voted upon, the board must continue to operate the facility as normal. Nursing Home Administrator Wayne Schumann presented financial reports and said the facility no longer has any payables more than 60 days old.

The board examined a proposed 2009-2010 operating budget but passed it along to the county's finance committee without a recommendation, because of some questions about some of the figures.

Schumann said the budget includes no salary increases, only the $400 bonus which is being given to other county employees. Some salary line items seemed to reflect an increase; according to discussion, it wasn't clear whether this was an actual increase or whether the figures for the current fiscal year, to which the new budget was being compared, were inaccurate.

The board also voted, as recommended by the staff, to call for compliance with all state and federal laws governing restraints on patients. Restraints can only be used for medical reasons, and the fact that a patient is incapable of making a decision for himself does not give the patient's legal representative the power to ask that the patient be restrained for any non-medical reason.

The board deferred action on purchase of dietary inventory software, with board members saying that is a decision which might be better left to CCMC in the event the lease is approved.