County Nursing Home managers going to great strides to reduce cost while maintaining quality care

Cost-saving measures at the Genesee County Nursing Home could mean that spending at the facility in 2013 will be as much as $896,700 below budget.

Changes include such measures as converting the little cafe at the facility to vending machines, greater use of nurse practitioners and reductions in non-direct care staffing.

"In what really is an increasingly very regulated and scrutinized environment, we're still offering a very good quality of care, but we're also being more circumspect in controlling our expenses," said County Manager Jay Gsell. "That's the only way you survive in the nursing home business, whether you're private, nonprofit, whatever, particularly in the State of New York."

The nursing home is also facing cuts in Medicaid and Medicare. But in moving therapy from independent contractors to a single contractor -- Freedom Therapy -- the county is not only saving money, but also getting a greater rate of reimbursement from the federal government.

The single-vendor system has allowed the home to increase its care rating, which means a greater reimbursement rate from the feds.

The effort to lower expenses has been led by Nursing Home Administrator Chris Schaller and Director of Finance David Lockwood.

Schaller was hired by the contractor that runs the nursing home and Lockwood came down from Orleans County about a year ago, Gsell said, and "has brought a lot of new ideas."

Technological upgrades have also allowed nursing home management to provide monthly reports to department managers about expenses.

That means, Gsell said, managers get real-time information to compare spending against the previous month or previous year on everything from supplies to overtime.

"We now have information that if it tells us (we're spending more) we can say, 'what are we going to do about that,' " Gsell said.

Meanwhile, the county has continued to invest in the nursing home, making sure the facility is in good repair and up to date.

To keep the quality of the facility at "four out of five stars," Gsell said, it's important to maintain the number of patients in the skilled nursing floor at a high level.

"When the occupancy goes down, we lose way more money than we're already losing," Gsell said.

The focus on expense reduction is important not just because state and federal revenue is shrinking, but because there may still come a day when the County Legislature decides to put the nursing home up for sale.

"When the Legislature does want to look and see what an outside group could do, we think we're putting our best foot forward," Gsell said.

UPDATE: A little information I didn't have last night: The nursing home is still projected to run at a gross deficit of $2.5 million for 2013.