HomeMy WebLinkAboutOur Island Home Work Group presentation to Board of Selectmen 07 24 2013_201401281154403955Future 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-
operated senior citizen-related services.
•Review reports, data, documents and
other 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
organizations 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Building is outdated and in need of extensive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
over physical conditions
Demographics are inexorable. Longer life
expectancies; traditional family caregivers a
thing of the past
Our Island Home Work Group
July 2013
0 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
operating 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
2000200120022003200420052006200720082009201020112012Rate 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
of 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