Left, nurses and other staff members help wheel residents outside during a summer city band concert at the Portage Co. Health Care Center. (City-Times photo)

Study shows wages, benefits of health care center employees above average

By Brandi Makuski

The future direction of the Portage County Health Care Center can resume serious discussion thanks to a facilities study which shows current deficiencies and clear options.

County leaders have considered the possibility of relocating the assisted living facility to a more central location within the city limits- an idea County Executive Patty Dreier outlined in her “campus concept” report which would reduce long-term costs by bringing all county- level services into the one area of the city. County leaders did earlier this year approve outsourcing housekeeping duties to save costs but decided a facilities study was needed before deciding to proceed with additional cost-saving plans.

Steve Witt, business manager for the Portage Co. Health Care Center (PCHCC) said the report was essential to helping county leaders determine the future of the health care center.

“The board approved making it a goal in 2013, analyzing and finding sustainable solutions for the health care center,” Witt said. “The board approved that goal to build, sell or improve operationally the center, but what that goal doesn’t say is maintaining the status quo as one of the options. The report also gives us a chance to address some problems.”

In a report compiled by Schenck Health Service Solutions, an Appleton- based CPA and business consulting firm hired by the Portage County Board, detailed costs were compiled for three options being considered by the county: remodeling the current building, building a new 80- bed facility and constructing a new 100- bed facility.

If a new building was approved by the county, Witt said its location would be decided by the County Board and likely situated on land already county- owned.

Mark Knuth, a CPA with the firm, said the report also included data- driven information showing staffing models haven’t adequately fluctuated with the needs and revenue of the center. The health care center, he said, has more fulltime employees and offers higher salary and benefits than the industry standards.

“In 1990, there were 49,021 licensed beds in the State of Wisconsin,” Knuth said. “In 2012, that decreased to 35,161. What’s happening there is the State of Wisconsin is basically forcing that upon us.  In their mind they see less Medicaid dollars being paid out.”

Knuth said private assisted- living competitors have also helped in reducing the number of residents seen at PCHCC, which helps raise costs associated with county- run facilities, which in turn need to make some hard choices- and changes- to stay afloat.

“There’s more competition now, and there’s a whole new dynamic happening there.” He said.

PCHCC is licensed for 100 residents, or “beds”, and must pay annual state fees for each bed even if it’s not occupied. Currently 81 residents live at the center, higher than the Stevens Point Care Center, which has 48 of 68 licensed beds filled. But how county leaders prepare the future of the building is essential, Knuth said, because it needs to be able to handle a spike in residency as Baby Boomers, who are estimated to number over 600k statewide by 2020, need care within the next 10-15 years.

Community Living Solutions (CLS), an Appleton- based company which specializes in “creating, transforming and sustaining senior living communities” has partnered with Schenck to offer solutions to the county based on the facilities report. Terry McLaughlin, chairman and architect for CLS said the current building would be difficult to remodel because of the strength of its concrete frame, something he said was “designed to take a direct hit.”

Among the top deficiencies of the center, according to McLaughlin, were lack of private bathrooms and spacing between resident rooms and central meeting spaces.

“We’re trying to address the resident need of privacy- it’s of upmost need and importance. I’ve been doing this the better part of 35 years; I haven’t done a resident room without a private bathroom in the past 25. That creates a very large gap between one facility and others in the market,” he said.

Reducing the distance between a resident’s room and congregational areas like dining or social spaces, he added, would in turn reduce staffing or at least focus staff attention to more essential areas. McLaughlin said the building’s current layout forces residents who may have a tough time walking on their own to travel a greater distance than necessary.

“That increases your number of staff when you have residents who simply can’t get from their room to that centralized congregating area on their own,” he said. “Bathing, dining and social activities should be right outside the door or no more than 30-40 feet away. Residents have better health outcomes because they’re a little more active and it’s less work for the staff, it’s more of a familial type of setting. That’s the neighborhood concept we’re proposing.”

McLaughlin said blueprints would be provided to county leaders and the public once the county decided whether to remodel or build new.

The Schenck report indicated with any of the proposed changes, the county will continue to annually see a one percent increase in government reimbursements and a three percent increase in private payor costs, a three percent increase in expenses and decrease in wages and benefits costs with new staffing models.

The costs for each of the proposed changes are:

•Remodeling current facility cost of $13,949,000 included in projection with inclusion of depreciation over 40 years and 100% financing interest at 2%.

•New 80- bed facility cost of $13,857,500 with a depreciation life of 40 years and 100% financed at 2% annual interest rate.

•New 100 bed facility cost at $19,030,000 with depreciation over 40 years, and 100% financed at 2%.

The Portage County Health Care Center Committee could discuss the report in further detail at its January meeting. Any recommendations will then come before the Portage County Board for action.