The Horace Nye Nursing Home won't be privatized any time soon.
Essex County supervisors voted Monday not to hire an outside broker to help sell the county-owned home in Elizabethtown. The broker, Marcus and Millichap, said it could sell the home for about $4.5 million and would charge a $157,000 fee, or 3.25 percent.
Supervisors Randy Douglas of Jay, Roby Politi of North Elba, George Canon of Newcomb and Randy Preston of Wilmington voted in favor of hiring the broker. Nine supervisors voted against.
Essex County is facing a projected 2011 property tax levy increase of more than $4 million, or almost 30 percent, of which about $2.5 million is the cost of the nursing home. Several supervisors, including Politi, who chaired the Horace Nye task force, have been open to privatization all year, while others have argued that the home is a service the county should provide its residents.
"The issue is not eliminating a nursing home," Politi said Monday afternoon. "That was never my feeling. The nursing home would remain, but remain and be operated by people who are in the business, and know the business a hell of a lot better than county management does."
Two members of the public spoke at the meeting, concerned the quality of care at the home would decline if it were privatized.
"My personal opinion (is) government doesn't usually get it right," Politi said. "The private sector does. There are others who felt otherwise."
Moriah Supervisor Tom Scozzafava, who has opposed selling the nursing home, said constituent services like the nursing home don't always operate in the black, and that its cost is "money well spent.
"There are 100 county residents in that nursing home right now that lived here all their lives, worked and paid taxes," Scozzafava said. "For the families and those residents, the nursing home is a Godsend."
Douglas, who chairs the Board of Supervisors, said selling the home is now a "dead issue ... until there's either a change of positions on the board, or new data comes forward that we just can't afford it anymore."
Supervisors Cathy Moses of Schroon, Sue Montgomery Corey of Minerva, Noel Merrihew of Elizabethtown and Joyce Morency of St. Armand were absent, and Willsboro's seat is vacant. The absences count as "no" votes; a two-thirds majority of the weighted vote would have been needed to hire the broker.
The county board would have to vote again to sell the home; however, if it rejected the sale, it would still owe Marcus and Millichap the brokerage fee for their efforts.
Douglas said the sale is an "emotional issue" but said the county can't afford the home any longer. Counties throughout the country are privatizing their nursing homes due to the cost. Every $200,000 of the home's cost means a 1 percent tax increase that could have been avoided if it were sold, Douglas said.
"The county taxpayers can't sustain it any longer," Douglas said.
Douglas said he has had relatives in Horace Nye and in private nursing homes, and that the quality of care had been about the same.
But Scozzafava, who has also been researching the issue, said he is worried about what would happen to residents who can't afford private pay rates if the home were privatized. More than 90 percent of the home's residents are paid for by Medicaid. Although a private home couldn't reject them, they could be knocked to the bottom of the list in favor of paying patients.
"Looking at Essex County's demographics, the size of the county, the median income and so on and so forth, in my opinion it makes more sense to have a publicly run nursing home versus a private nursing home," Scozzafava said.
The county is looking at other ways to save money at the home, such as management changes, and is bringing in an outside company to handle billing services.
"They better make some changes quickly," said Politi, adding that a 2004 study recommended numerous cost-saving changes that were never implemented. He said this is "one of the reasons, in my opinion, government doesn't do a good job. But I'm in the minority."
Scozzafava said he "absolutely" supports making changes and commended Politi, saying he "really brought the issue to the forefront."
As well as cost-saving changes, the county could increase its Medicaid reimbursements by expanding the services offered, such as creating an Alzheimer's unit. Another possibility, Scozzafava said, would be to look into building a new nursing home. The building is in poor shape, and county Manager Dan Palmer recommended earlier this year that the county should build a new home if it is going to keep running one at all.
It has been estimated that building a new home would cost $17 million. Politi didn't support the idea.
"To me, that's like going from the pot into the fire," Politi said. "We can't run it the way it is. How the hell are we going to run it and make it bigger and better, supposedly? I know the county manager (Palmer) doesn't want to run it."
Politi, who voted against borrowing money to fund the proposed $65 million renovation of North Country Community College's Saranac Lake campus - which is in his town - said Monday he had hoped, if the county sold the nursing home, it would be able to afford the NCCC project.
---
Contact Nathan Brown at 891-2600 ext. 26 or nbrown@adirondackdailyenterprise.com.