Future Options and Recommendations for Our Island Home and Senior - - PowerPoint PPT Presentation

Future Options and Recommendations for Our Island Home and Senior Citizen Related Services

Our Island Home Work Group July 2013

The Work Group met from October 2012 thru June 2013 to complete its analysis and formulate its recommendations

Our Island Home Work Group July 2013

Work Group Mission

• Future options and recommendations

regarding OIH and associated town-

• perated senior citizen-related services.
• Review reports, data, documents and
• ther information that are on hand.
• Review, discuss and make

recommendations pertaining to Riverwood/Servant’s (to be delivered) status report to the Board of Selectmen as to the Senior Day Care program.

• Discuss pros, cons, costs and revenues of

current delivery systems of the local

• rganizations that provide senior citizen-

related services.

• Review and discuss the Town’s lease with

Sherburne Commons, in terms of long- term planning

Work Group Members

• Joe Agiuar

Jim Kelly

• Rachel Chretien Pam Meriam
• Chuck Gifford

Bruce Miller

• Bruce Glass

Mickey Rowland

• Phil Hubbard

David Worth

The status quo is not a viable long (or even short term) strategy for OIH.

Building is outdated and in need of extensive repair; Dept. Public Health citations in 2013

• ver physical conditions

Demographics are inexorable. Longer life expectancies; traditional family caregivers a thing of the past

Our Island Home Work Group July 2013 10 20 30 40 Our Island Home Northeast Nationwide Years OIH 2X Average Age of Facilities in Northeast

Source: 27th Annual Licensed Nursing Facility Cost Comparison Larson Allen, LLP. 2010

10% 15% 20% 2000 2010 % Nantucket Population 65+

10.5% growth in 65+ island population; trend similar for 75+ population 2000- 2010

Sources: 2000 SF1 P23, P24, P25; 2010 SF1 P26 Analysis by P. Morrison

The nature of skilled nursing care, how it is paid for, and the federal and state reimbursement structure for skilled nursing is changing

68% 25% 6% 1%

Ave 2011-2012

Mass Health Private pay Medicare Other

2000 2012 Growth Rate $

Nursing Facilities

57% of

total $

43% 28%

ICF/MR

15% 11% 1.8%

Home/Com munity Based

18% 33% 210%

Personal care/Home Health

10% 14% 133%

Our Island Home Work Group July 2013

Mass Health – Medicaid is the predominate payer source for OIH putting future revenue at risk as reimbursement trends shift.

Reimbursement trend toward redirecting payments away from institutional settings like OIH and toward Home and Community Based Services which can be provided at a lower cost.

Source: CMS Medicaid Statement of Expenditures (CMS-64) 2000, CMS Medicaid Program Budget report (CMS-37) August 2010 & 2011, Annual Estimate 2012. Figures in $ Billion Source: OIH Operating statements. OIH WG Analysis

Revenue/Reimbursements from all sources not keeping up with

• perating expenses. 80% of OIH operating costs are labor related

$0 $100 $200 $300 OIH Northeast Top Decile Total Labor Cost Salary/Wage Costs Payroll tax & Fringe benefits

Our Island Home Work Group July 2013

$0 $50 $100 $150 $200 $250 $300 $350 $400 $450 $0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Rate per Day

Revenue Expense Rate per Day

27th Annual Licensed Nursing Facility Cost Comparison Larson Allen, LLP. 2010 Source: Town of Nantucket Historical Financials Cost Report

Total labor cost at OIH is 67% higher than the top 10% of all nursing facilities in the Northeast

Our Island Home Work Group July 2013 Facility Reimbursements People Alternatives Community Shared Services The WG’s conclusions have been drawn around six categories . These conclusions have gone into the formulation of our recommendations. At the core of our conclusions is the recognition that the model must change in order for Our Island Home to deliver skilled nursing care to the community in the future

The WG’s recommendations call for a shift to a community based care model with a new, modular OIH to meet the institutional needs

• f the community

Our Island Home Work Group July 2013

Community Based Care Model

New OIH

Entity to coordinate community senior services Monetize existing OIH site Skilled Nursing Home Health Care

Co-locate at Sherburne Commons or hospital; build in modular fashion; share non-medical services Source of financial resources to support recommendations Provided in home and delivered thru OIH

What’s Next? How do we get from here to there?

Our Island Home Work Group July 2013

What Can We Do?

Identify alternatives

What Should We Do?

Alternatives analysis Community Commentary Policy decision(s) TM

How Do We Do It?

Develop implementation plans Begin Implementation October-June 2013 July – April 2014 January + 2014