Long-Term Care Board presents answers to City's questions and provides update on financials

Editor's Note: The following is a follow-up article to Tuesday evening's Nevada City Council meeting.

Amid a tense meeting with the Nevada City Council Tuesday evening, the Long-Term Care (LTC) Board presented answers to questions the City had presented the board in a letter dated Sept. 20.

The City Council passed Resolution 1711 on May 2, 2023. This resolution states, "The Council of the City of Nevada, Mo., finds and declares after prolonged analysis, study, and review, that the City of Nevada can no longer financially support the municipal long-term care (nursing home) operations." The ordinance goes on to direct the City Manager to develop the best options and coordinate with LTC Board to transfer the City's long-term care operations to private enterprise or any other interested and qualified entities. The resolution notes that the process should be done in a manner, and under terms and conditions, exposing patients and nursing home staff to the least possible adverse impact.

The letter sent from the City of Nevada to the LTC Board on Sept. 20 was a request for information in regards to the progress and steps taken in the process outlined in Resolution 1711.

The following are the City's questions (in bold) from the aforementioned letter, accompanied by the LTC Board's responses that were presented at Tuesday evening's city council meeting:

Provide a summary of your negotiations with any buyer including Medicalodge. If at a standstill, advise what would be required to resume negotiations.

A summary of negotiations with any prospective buyers includes only Medicalodges at this time. Bill Kohler (LTC board member) spoke with Scott Hines, President and C.E.O., Medicalodges, centered on the Barone building only. Kohler shared information on Barone's history, operations and financial performance. At a later date, Hines approached the LTC Board that they might have an interest in the Barone facility, to be used as either a dementia care unit or a behavioral health care unit, but only if the LTC Board agreed to shut down Moore-Few Care Center. Negotiations ceased at that time. To explore the possibility of selling the entire operation, including Barone and Moore-Few, to a company who might have an interest in keeping the nursing home intact, Kohler has made contact with a brokerage firm in Springfield, Mo. They have requested documentation that is being assembled at present time.

Provide the board's thoughts, as well as any preferences of potential buyers, as to timing of the transfer of patients and property of the nursing home, and any commitment as to utilization of staff devoted to patient care and utilization of staff devoted to administration.

As stated in the prior response, the LTC Board has made contact with a brokerage firm in Springfield to help locate a potential buyer. It is the opinion of the LTC Board that both properties would need to be sold together. Missouri Department of Health and Senior Services (DHSS) state regulations prohibit the sale of a property that has accepted a two-year emergency closure until that property has been inspected and reopened. If the City Council has the right to and wants to close Moore-Few, a 30 day written notice written in a language understandable to the resident and/or responsible party will need to be given to that person. Staff are owed $120,289.86 PTO (paid time off) time as of Friday, Oct. 13, 2023, and severance pay totaling $290,505.20, for a grand total of $410,795.06.

Obtain from your administrative staff and provide for submission to the City Council complete and reliable current financials including all indebtedness, both committed and contingent, that should be addressed on conclusion of business operations.

The LTC Board presented financial information for the months of June, July, and August to the city council. For the month of June, long-term care showed a net income loss of $316,460. As of June 2023, the year-to-date net income was a loss of $2,443,292. For the month of July, long-term care showed a net income loss of $135,929 — an improvement from the prior month. And for the month of August, long-term care showed a net income loss of $80,556 — also an improvement from the previous month.

Provide the thoughts of your board with respect to transfer methodology. Should the City sell the business and licenses alone? Should it include the building and the personal property? Should it require a period of occupation of the building? Should it consider an accomodation as to rentals? Should the City demolish the structure? If not included in a sale, how should the furnishings and other personal property be disposed of? How should patient care records be preserved? If there is controversy as to these issues, outline the differing thoughts of the board members.

The LTC Board asked that they be given more time to explore the sale of the businesses to a single entity who would want to keep the nursing home located at 901 S. Adams St. open or the possibility of becoming a not-for-profit or LLC. Barone is licensed for 40 beds and Moore-Few is licensed for 108 beds. The value is in the license, not the buildings. The LTC board has no opinion for the disposal of the land, furnishings nor equipment. Federal and state guidelines must be followed concerning patient and employee records and must be stored in a secure, locked storage location until the appropriate time has expired and records can be destroyed appropriately and correctly.

The Not-For-Profit option would create a new business in a competitive atmosphere and would likely encounter reluctance of federal authorities absent assurance of financial stability. Funding availability is also an issue. As a minimum, USDA financing of this nature requires a minimum of two years. This option, while a good idea, may not be practical. At the moment, the Council directive anticipates avoidance of inordinate delay.

The LTC Board plans to explore with specialized legal counsel, as time allows, the possibility of local ownership.

The LTC Board went on to note that it has been supplied (by FORVIS accounting firm) with businesses to assist with the transfer of City of Nevada ownership of the City Convalescent Center, and visits are scheduled with two of those provided.