Clear Heads and Detailed Data

At today's Board meeting, there was a discussion about Manor finances and the impact of the swiftly-changing regulatory and reimbursement landscape affecting nursing homes in New York State.

Finances first – the tax kind of finances. County Treasurer Dan Crowell laid out the cost to the taxpayer of retaining the Manor as a County facility: a 30% increase in the property tax for every Otsego County property-owner, over two years. And certainly increasing after that. If we wanted to raise the sales tax to give property-owners a little relief, each increase of 1/4 % in the sales tax would reduce the property tax increase by 10%. So, if we raised the sales tax by 1/2%, property taxes would only have to go up 10%. Dan cautioned us about the long regulatory road trip facing a county petitioning the State to raise its sales tax.

So, regardless of how you do the math, everyone in Otsego County will have to share the substantial cost of keeping the Manor in County hands.

Ed Marchi, Manor administrator, was at the meeting as well, and a number of Board members asked him to explain why it costs so much more for the County to run the Manor than it would for a private company. Some of the major points:

• Manor employees are represented by the CSEA, the public employees union, and they have negotiated a very strong salary and benefit package. Compared to private nursing home employees, their salaries are higher, and the opportunity for overtime is greater; they get time and a half for each of the nine County holidays, plus another day off sometime else.
• The County must contribute to the NYS public employee's retirement system; right now, that contribution is 20% of salary. A private company would not, of course, have this expense at all.
• Medicaid rates are set based on costs in our region; most nursing homes in this region are privately owned, with lower costs, so our reimbursement is lower than the actual costs, while for the private facilities, the reimbusement is much closer to, or at, their cost.

Beth Rosenthal, Represesentative for the northeast corner of the county, asked Ed what the nursing home environment would look like in five years. In a lengthy, eloquent, passionate but grim accounting, Ed laid out a picture that, as it turns out, will be the same whether the Manor is sold or not.

Briefly, the State is moving nursing homes toward a home-care model, a decentralized system which moves healthier residents to much smaller community-based residences. The nursing home facilities themselves will be used for only the most fragile residents. “When you walk into the Manor, you'll see IV drips everywhere.” The neighborhood system will not survive this evolution.

“We love the Manor. We've built something that is beautiful. But that beautiful thing will not last.”

Ed was clearly unhappy about this future, and so are we – all of us on the Board. But we need to meet this future with clear heads and detailed data. We'll continue to pursue this as we move forward.