Friday, January 25, 2013

Commissioners: Newly managed Blaine Manor might pose least risk

Croy Canyon Ranch Foundation proposals said to be risky, confusing


By KATHERINE WUTZ
Express Staff Writer

From left, Commissioners Jacob Greenberg, Larry Schoen and Angenie McCleary discussed the future of senior care in Blaine County during a special meeting on Wednesday night. Commissioners said that a proposal from Blaine Manor, as well as one from Pocatello-based Safe Haven Health Care, might pose the least risk of failure. Photo by Roland Lane

A proposal from the Croy Canyon Ranch Foundation to build a tiered-care senior facility west of Hailey might be too risky to encourage the investment of public funding, the Blaine County commissioners said during a special meeting Wednesday.

The commissioners revealed for the first time in a year-long senior-care decision process their individual views on the proposals presented by Pocatello-based TanaBell Health Services, Pocatello-based Safe Haven Health Care and locally based Croy Canyon Ranch Foundation.

While no decisions were made at the meeting, Commissioner Larry Schoen said the presentations given by the commissioners regarding the costs, benefits and risks of each proposal were meant to be viewed as starting points for later deliberations. 

Each commissioner used a matrix developed by County Administrator Derek Voss to evaluate the proposals, but Schoen said the numbers awarded by each commissioner are subject to change.

“The intent is not to lock commissioners into that ranking, because we have not really had a chance to discuss this among ourselves,” he said. “This is a decision-making tool, not the decision itself.”

On the table before the commissioners were roughly six proposals. One was from Safe Haven proposing a modular facility that would start with 30 senior care units and grow to a tiered facility with 48 skilled nursing and 32 assisted living beds.

Another was from Blaine Manor and TanaBell that proposed adding 40 assisted living units to the existing Blaine Manor while TanaBell leases and manages the facility. If all went well, TanaBell would eventually enter into a lease-to-own agreement with the county and take over ownership.

The more complex proposals came from Croy Canyon Ranch Foundation. Two suggested general obligation bonds for new facilities, the first with $29.2 million for construction of a new facility and the second with an $18 million bond that eliminated the construction of independent living units.

Two more proposals combined Croy Canyon Ranch and Blaine Manor. One from Croy Canyon Ranch Foundation proposed adding nine seats to the Blaine Manor board for Croy Canyon Ranch Foundation members and doing some construction of assisted living units. 

During a commissioners meeting Tuesday, Blaine Manor board Vice Chair Linda Haavik objected to having that number of foundation members on its board and said that it needed a renovation not only to add assisted living units, but to improve the quality of the skilled nursing units as well. Both proposals dropped the number of skilled nursing units to 22 rather than the original 40. 

Also on Tuesday, Croy Canyon Ranch Foundation Executive Director Kathleen Eder suggested the facility could be leased to the foundation, which could then sublease it to TanaBell and eventually choose to purchase it.

On Wednesday, Commissioner Jacob Greenberg said his concerns centered on numbers. For example, he said, Safe Haven’s proposal had financial analysis that relied on a large assumption of private pay, rather than Medicaid or Medicare patients. Croy Canyon Ranch Foundation relied too much on public funding and philanthropy, he said.

In addition, he said he didn’t see enough evidence that there would be a demand in this area for the number of skilled nursing beds that the facilities would offer—especially as Blaine Manor has 25 beds and only 16 are filled currently.

“I have not seen any marketing surveys from any of the respondents,” he said. “I am concerned about that, because it tells me there was not enough time spent analyzing that.”

Commissioner Larry Schoen said the county got offers from outside consultants to conduct market analysis studies, but the prices were far too high to justify the expense. However, he said he felt all of the proposals would succeed in the Wood River Valley—his concern lay more in which parts of the market each facility would serve, and whether that service deserved public funding.

“When I think about public financing for this type of facility, I think, what would be the purpose of that financing?” he said. “It’s especially to ensure that the people who have the least number of choices, who have the greatest number of economic challenges, would be able to find care in our community.”   

Schoen said the foundation has shifted from asking for only limited public contributions, such as the proceeds from the sale of Blaine Manor, to requesting a general obligation bond and counting on additional philanthropy.

“People I know in the industry say what are they going to do with all of that money?’” he said. “This has been their vision and they have been adamant in pursuing that mission, and I admire that. But as this process has worn on, Croy Canyon’s mission has clashed increasingly with the goals of the county.”

Schoen said he did not evaluate the proposal that would involve the foundation’s taking places on the Blaine Manor board and leasing the facility, in part because he did not understand the proposal or its benefits.

“I do not support in any way handing the Croy Canyon Ranch Foundation board the keys to Blaine Manor,” he said in an interview Thursday.

Commissioner Angenie McCleary said she thought the original solution proposed by TanaBell and Blaine Manor was not only the most achievable, but also most likely to result in the highest level of senior care for those of all financial means in the county.

“[This proposal] for me is probably the highest right now … if I had to pick one,” she sad. “I was really impressed with the level and quality of care at the TanaBell organization [in Pocatello during her visit in December].”

However, she said she would not take either Croy Canyon Ranch or any publically funded option off the table. She added that she has always been more open to the type of long-term funding that other commissioners have been more opposed to.

“If [a solution] takes public funding and there is public support through a vote for that level of care, that is the level of care we want to achieve,” she said.

McCleary added in a later interview that she does not feel that a long-term county-funded option would be necessary now, as the county has other quality options that require only short-term levies.

The commissioners will continue the senior care deliberations on Tuesday, Jan. 29, at 10:30 a.m. and on Thursday, Jan. 31, during a special meeting at 9 a.m. Both meetings will be held at the old Blaine County Courthouse in Hailey.


Kate Wutz: kwutz@mtexpress.com




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