The least risky way to ensure that a senior-care facility remains in the county indefinitely would be to establish a county-owned hospital, with a board appointed by the county commissioners, Blaine County counsel said Tuesday.
Blaine County Deputy Prosecuting Attorney Tim Graves presented a memo outlining the legal risks involved with the county’s accepting one of three proposals by private companies to manage senior-care facilities. The board had requested the memo in December.
Graves said the legal issues involved in proposals by Croy Canyon Ranch Foundation and Pocatello-based Tanabell Health Services were such that he would recommend the county form a hospital board to govern the facility, rather than simply entering into an agreement for services with either organization.
The Croy Canyon Ranch Foundation has proposed building a senior care facility west of Hailey that would provide skilled nursing, assisted living and independent living. TanaBell has proposed taking over operations of the existing skilled nursing facility in the valley, Blaine Manor, and expanding it to include assisted living.
Both proposals have asked for public funding. TanaBell has asked for a $6 million levy to fund Blaine Manor’s shortfall until efficiencies can be made and assisted living facilities can be constructed. Croy Canyon Ranch Foundation requested an $18 million general obligation bond to fund construction of a new facility and to cover Blaine Manor’s operating shortfalls until the new facility is completed.
But Graves said if either proposed facility were to fail, the county would have no way to save it. The county is prohibited by Idaho code from lending to a private corporation or guaranteeing its debt, and Graves said that would prevent the county from stepping in and saving a failing senior care facility.
“The board should consider owning [a facility], owning it and being the guarantor to make sure that money goes toward a public use and to make sure that public use is protected,” he said. “It eliminates a lot of the risk involved.”
A county-owned hospital governed by a hospital board would be subject to county authority regarding budgets and operations. Graves said the county would also be able to provide voter-approved bonds and levies to fund construction of either facility, including the independent-living and assisted-living portions.
Graves said a county hospital board would be the best way to protect the taxpayers’ investment in either facility. Without a board, he said, the county has no way to ensure the facility’s long-term existence.
“The only thing tethering us to the private nonprofit [would be] this service agreement,” he said. “That tethering scares me. I don’t know how much protection the county can get through a service agreement.”
Graves said the proposal by Pocatello-based Safe Haven Health Care had far fewer legal issues because the company was not asking for public funding. He said the company’s request for a transfer of Blaine Manor’s Medicare and Medicaid certification would give the county a certain amount of leverage in future negotiations.
Commissioners Jacob Greenberg and Angenie McCleary did not comment during the meeting about whether they would support a county-owned facility, and McCleary said she would not comment without digesting the information first.
However, Commissioner Larry Schoen said he would not support the formation of a county hospital board. The goal of the process, he said, was to get the county out of the senior-care business.
“I have put pressure on this board to come up with a solution and follow through with our original mission,” he said. “I want to state categorically that I do not support that option.”
Kate Wutz: firstname.lastname@example.org