By way of a preface... When I was a reporter in Canandaigua and an editor would assign me a story about any sort of agency (pseudo, government or otherwise) and its finances, procedures or reportings, I cringed. Visibly, I'm sure. Scowling, grumpy and none too sure what was going on, I tried my best to crack the bureaucratic nut and spill out a tidy, readable article. I'm not talking the routine meeting stuff. I mean the hundred-page report in small type with definitions of the definitions of the indecipherable financial jargon. It took me half my shift once to figure out what one word meant on a company's earnings report. All I remember was that the term not only had nothing to do with its meaning but was very much an obstacle to understanding it — maybe like using the word liquid to describe something solid and unmoving.
So I sympathize with reporter Paul Mrozek wholeheartedly in his attempt to write a comprehensible article about an auditor's report on the Genesee County Nursing Home that showed the facility lost $1.7 million last year.
That being said, there is so much information involved in these sorts of articles, that too much is always said and too much is always left out.
Mrozek tells us that this was the second year in a row that the nursing home lost more than a million dollars and had to be bailed out by the county with subsidies — but that right there raises the first question that is never really answered. If the nursing home is a county-run facility, wouldn't the county already be responsible for its funding?
Further, how is the loss measured?
Mrozek tackles that fairly well by breaking down in simple language the facility's costs per resident versus its revenues: $229 to $204, respectively, for a shortfall of $25 (per resident per day). That sounds pretty significant when you consider the nursing home has 160 beds: 160 x $25 x 365 = $1.46 million lost per year if all beds are filled. They aren't. But at 96 percent occupancy, they're close.
So why are costs higher than revenue?
A few reasons are given in a few different places in the article. One, since the nursing home is a public facility it has to accept patients on "public assistance and people who have no health insurance," while a for-profit facility can fill its beds with people who have fully-funded private health insurance. Another reason is overtime for employees, an expense that seems problematic in both the public and private sectors, but not easily remedied.
Mrozek writes that the county legislature is looking at "a possible increase in Medicaid payments" to help offset the imbalance. One of the auditors is cited as saying that the increase would "reverse the trend of increased county subsidies." (That is one of a few instances in the article that Mrozek paraphrases the auditor using language such as reverse the trend or confluence of changes.)
That's really the best as I can do for a summary of this article, though it seems like an issue worth revisiting, or at least further explications. Check out the paper for more details.
A sincere kudos to Mrozek for tackling this tricky topic. Hopefully, we can get an article in the future explaining in simple language how the nursing home is funded — touched on some in this article. Is it all through Medicaid and insurance? What about the folks with no insurance?
I'm a financial dunce and could really use the detailed explanations. And I'm sure I'm not alone.
Also, if the county is putting up the big bucks to bail out the nursing home, what does that mean for us? Does the county just have that money lying around? Where does it come from? How is it managed?
