Long-term care money transfer a short-term solution

A brief overview was provided in Wednesday’s edition of the Nevada Daily Mail on the Nevada city council discussion that took place during Tuesday evening’s regular meeting regarding the request that monies be transferred from long-term care to NRMC.

The original request of $1,000,000 was reduced to $650,000 in an amended ordinance to authorize the transfer of funds to be dispersed as follows: $350,000 in March, and $100,000 each for the months of April, May and June, which is the end of NRMC’s fiscal year.

City Manager JD Kehrman explained the reduction in amount as a result of negotiations with the bond insurer (ACA) that wouldn’t harm the hospital and wouldn’t hit long-term care as aggressively in one month. After speaking with hospital leadership, ACA determined that more money would be needed in the first month to help them catch up on some accounts payable issues and the initial dispersal of $350,000 was agreed upon.

Discussion was lengthy, sobering and ranged from concerns with the amounts being transferred to the hospital, possible liquidation and on a more positive note, the formation of a grass-roots organization and an effort to find a long-term remedy.

City Attorney William McCaffree took the floor to answer concerns regarding transferring funds from long-term care. “We need to recognize that this is being done because it’s an emergency. This is not because you want to do it, but we have a situation where the bonding company can require an independent agency to come in and inspect the hospital and make recommendations as to liquidating it.”

He described the first confrontation with ACA. “They actually brought in an investigative team, essentially to make recommendations about liquidation.” He said he thought the investigation cost the hospital around $400,000, but that he wasn’t absolutely sure. That is when the city was able to “turn them around by deciding to change management and to make an alliance with a hospital elsewhere – in this case it was Freeman – for support and management and expertise – and advice as to finances.”

According to McCaffree, the city was able to save the hospital by changing management and at that time infusing a million dollars from the nursing home into the hospital operation. “It was a difficult issue and so in order to protect the nursing home – they can’t do this forever at this level and stay alive - and hard decisions have to be made.” He reminded that both the nursing home and the hospital are owned by the city, are interconnected and are both essential to the welfare of the community.

“ACA originally wanted another million and the city manager negotiated to $650,000 and that saved the hospital $400,000 in what would be charged by the team that would come in and find a way to liquidate the hospital – because they would pull the plug,” he continued. “The bond company came down and they were very definite with the mayor, city manager and me that they meant business and that they weren’t going to horse around with us.”

McCaffree explained that the current efforts were to save both the nursing home and the hospital and they are very tough decisions to be made. “If you don’t have a turnaround in income down there, if you don’t have a way to infuse other capital in there, you are going to have look at some awful things with respect to services and programs, but I think that your hospital is going to be one of the things you are going to consider as absolutely necessary for the community. Whatever it takes to save it. I think you need to steal yourself for the fact that you are probably at the point where the public is going to want you to do it.”

Kehrman discussed Dr. Lovinger’s grass-roots leadership committee, Citizens United to Strengthen Our Hospital, and their efforts to find ways to help sustain the hospital. The group is researching the possibility of a ballot issue and exploring ballot language in order to help meet that need. “We have provided them with some information about what it would like and what would be required. My understanding is that the purpose of the group Dr. Lovinger is forming is to find ways to help sustain the hospital - and sustainable means a revenue source that’s not what we can bleed of the city’s general fund or what we can take from the reserves of the LTC.’”

“It’s going to require some kind of a long-term, predictable infusion of cash,” Kehrman continued. “I’ve been here 10 years and have never had a group of citizens ask for something to be on the ballot, but this could be a real, long-term sustainable funding source. It hasn’t come to fruition yet, but ultimately, that is what is going to fix this. The good news is that we have the beginnings of a grass-roots effort of a group of people who are willing to take this thing on. We are going to help them in any way in which they request.”