Hospital officials reduce the number of beds to make up for
state Medi-cal cut
Seniors who need long-term care may have to look someplace other
than Hazel Hawkins Hospital, due to a recent decision by the Board
of Directors to reduce expenses at the nursing homes by accepting
fewer patients.
Hospital officials reduce the number of beds to make up for state Medi-cal cut
Seniors who need long-term care may have to look someplace other than Hazel Hawkins Hospital, due to a recent decision by the Board of Directors to reduce expenses at the nursing homes by accepting fewer patients.
Carrol Scott, a Hollister resident since the early ’90s, is a resident at the Mabie Northside facility and has stayed at the nursing home off and on for five years.
“They cut my leg off Nov. 6,” Scott said. “I’ve had nine, 10 operations. All but two I’ve come here for recovery and leave after a month and a half. This time, I’ve stayed longer.”
His last stint started in Oct. 2006. Scott has one roommate.
Other rooms in the Northside facility have three beds each.
“Four rooms down there they closed up,” Scott said. “The rest of [the patients] they bunched up. Three people to a room, that’s too much.”
There are two skilled nursing facilities at Hazel Hawkins, Mabie Northside and Mabie Southside. The facilities offer 24-hour assistance for short and long-term patients. Staff include an occupational therapist, a physical therapist and a speech therapist.
Scott used to work as a truck driver. Without the nursing homes at Hazel Hawkins, he would have nowhere else to go.
“When I have to come back, I’m not sure I’ll be able to,” Scott said. “I’ll just cross that bridge when I come to it.”
It is the option of long-term care that may change due to a $2.2 million reduction in revenue this year because of legislation that reduces Medi-Cal reimbursement rates by 10 percent, said Ken Underwood, chief executive officer for Hazel Hawkins Hospital.
Medi-Cal provides medical benefits for low-income seniors aged 65 and older.
“The current cuts to Medi-Cal are significant,” Underwood said. “The majority of that $2.2 million is in the nursing homes.”
Eighty percent of the long-term patients at the nursing home are on Medi-Cal, Underwood said.
Treating Medi-Cal patients costs $26 more per day than the state reimbursement.
“If I have 80 residents a day times $26, that’s $2,000 per day that we’d lose every day,” Underwood said.
The gap is even higher if indirect costs, such as hours spent by billing or engineering staff, are included, Underwood said.
“In prior years, we’ve averaged 100-107 beds,” Underwood said. “Currently, we have approximately 90 residents at the two nursing homes.”
Hospital officials will maintain a total of between 80 and 90 patients at the two nursing homes.
The hospital’s main purpose is acute care, not the nursing facility, said Gordon Machado, a member of the hospital’s board of directors.
“That area is sucking off the main focus of the hospital,” Machado said. “It’s not a good position. We’re going to keep it open as long as we can.”
A change in the admission policy prioritizes short-term stays of 60 days or less, followed by family hardship, Underwood said. Long-term care is the lowest priority.
“We decided not to accept just anybody,” Machado said. “A case like that where you have a husband/wife with no transportation, we would accept them.”
A senior that can be transported by family would be a lower priority, Machado said.
Current residents will not be affected by the policy change, Underwood said.
“We will not be discharging any patients,” Underwood said. “A lot of hospitals have closed their nursing home. We have no plans to cut either nursing home.”
Nursing home staff will be affected by the change.
There are 54 certified nursing assistants who work at the nursing homes, based on information from Ysidro Gallardo, personnel director at Hazel Hawkins.
Hospital officials may reduce their hours per week or lay off staff, Underwood said.
“Because we have a lower volume we’ve been utilizing a lot less staff at the nursing home,” Underwood said. “It is very possible that those employees will work 30
hours per week.”
A full-time certified nursing assistant at Hazel Hawkins Hospital makes between $26,00 and $35,100 per year, based on information from Gallardo.
For a certified nursing assistant at the lowest end of the pay scale, moving from full-time employment to 30 hours per week means a loss of $544 per month.
It also means paying more for health insurance.
“The people who have dependent coverage far outnumber the people who have single coverage,” Gallardo said.
Part-time employees are eligible for health insurance at an increased rate, Gallardo said. The cost of health insurance increases incrementally, based on the number of hours worked per week. A 30-hour a week employee would pay nearly $40 more a month for health insurance.
Although hospital officials have the right to reduce hours or fire employees without contract negotiations, working conditions must be negotiated, Underwood said.
So far, discussions have been informational, Underwood said.
To reduce expenses, the 2008-2009 hospital budget makes other adjustments, Underwood said.
“We’ve already initiated changes to reduce more than $1 million in expenses for this fiscal year, excluding any staff reductions.”
Among other changes, hospital officials cut a mental health program, Solutions; froze management salaries; and changed the way overtime is calculated on 12 hour nursing shifts, Underwood said.
