Decline in census has MCF suspending construction plans
A proactive approach to a statewide issue has management suspending work on construction upgrades to the Schoolcraft Medical Care Facility.
With a loss of 19 patient beds in recent months, MCF management has put a halt on the construction phase of their current Quality of Life Improvement Project.
According to facility Administrator Jerry Hubbard, they are suspending work on the renovation phase of the project, which is being developed to improve space for special needs patients who have Alzheimer’s disease and other forms of dementia.
The construction project, estimated to cost $971,000, was being funded internally from cash reserves.
“There has been a slow decline in our census since 2009, but in the last two months it has dropped precipitously,” Hubbard says.
The MCF had 59 admissions and 78 discharges from Oct. 1 through March 31. Currently, there are only 63 residents at the facility, which is licensed for 100 beds.
Hubbard says it is hard to pinpoint the reason for the decline, but notes that there are two key factors that have had an impact on admissions here in Schoolcraft County and across the state. They include the fact that the aging population is seeking other community services available to them, and that more family members are providing care for their loved ones at home.
“What we are seeing is, today there are more support services out in the community that they are taking advantage of, and more care is being provided at home by family,” Hubbard says. “That means when they do come here, they are sicker or near the end-of-life stage. As an example, three of our admissions in February did not make it until the end of the month.”
Sue Ray, director of nurses at the MFC, adds that it is a trend across the state.
“We are all experiencing the same pinch,” she says. “Any more, it is not uncommon for people to use their personal resources to pay for care, either at home or to live in an assisted living facility. When it comes to the point when they can’t pay any more or they have used all their resources, they apply to Medicare and come here.”
Ray went on to say the situation is not unique to Schoolcraft County.
“We hear it everywhere we go,” she says. “Facilities are decertifying beds and looking for other ways to adjust to the lower census.”
Because the patient population today affects revenue in the future, Hubbard says they are addressing the issue now, with the intent of staying out in front of it.
“Our current census will have a major effect on us starting in October of 2013,” Hubbard says. “I am afraid to do anymore with our cash reserves that were set aside for construction. It just does not make sense to finish the project and not have enough money to meet our day-to-day operational needs. We are at the point now where we need to figure out when we are going to stabilized and develop a plan accordingly.”
Hubbard says they have until August to decide on an action plan, which could include “banking” beds or de-licensing them to bring their census in line.
“I believe we will have to de-license beds,” he says. “The question is, how many. We are watching the census really close. We don’t want to cut too many and all of the sudden have demand out there that we can’t meet, so it is a delicate process. Our target is to cut enough beds to maintain 85 percent occupancy, which will allow us to reach an adequate reimbursement level through Medicare.”
Licensed for 100 beds, the facility census has leveled out between 63 and 68 beds the last several months.
By banking beds, Hubbard says, they would have to keep that space empty, wait a period of one year, and then determine if there is demand for that space, or if they should continue banking the beds for an additional year.
By de-licensing beds, they would have to reach an occupancy level of 97 percent and maintain that level for three years before putting those beds back online.
Under consideration are the facility’s older, smaller double rooms, which could be converted to private rooms by de-licensing one bed in each room.
“There are always issues with the small rooms at the facility,” Hubbard says. “We would like to make some of them private. By doing so, they would be way more desirable for our patients.”
The lower census has had an effect on the state-mandated staffing levels at the MCF, but there have not been any layoffs, only a reduction in hours for some part-time employees.
Hubbard believes they have reached the point where census has leveled out and they now can size the facility and staff accordingly. He notes that while certain “positions” have been eliminated, he does not expect layoffs as a result of the change.