Most county run nursing homes predate the 1965 introduction of Medicaid when nursing homes were not well regulated, well regarded, or generally available- especially to the poor. That is certainly not true today.
Today there are over 300 nursing homes in New Jersey and over 30 homes in Monmouth County (second highest in the state.) Virtually all of them take Medicaid. They are also highly regulated and publicly rated on quality of care, safety conditions, and other standards. Today the public, poor, patients, and families are well protected and fully informed in a highly competitive and effective marketplace. And most nursing home employees are represented by strong healthcare unions and reasonably compensated.
As a result, less than half of New Jersey counties still run nursing homes. Most counties have closed or sold them to private operators. They have conceded that the private sector (both for-profit and not-for-profit) is better able to manage and provide care in these facilities. Those counties can now focus on public necessities more suited to their abilities. The Monmouth County Freeholders have resisted this trend and actually operate not one but two nursing homes.
The Republicans have controlled the Freeholder Board for 24 of the last 25 years. The Nursing Homes have been managerially and financially problematic during that entire time. These issues have been analyzed, and a sale considered, many times by the Freeholder Board over the last 25 years. The conclusions has always been the same- “the losses by the Center, and funded by the County, will increase in the coming years.” Yet a sale was never consummated.
In the 1990s the deficits were in the range $3 million per year. By the 2000s the deficits had ballooned up to $6 to $7 million per year. This does not necessarily include all of the costs of building, rebuilding, remodeling, and financing the facilities. A reasonable estimate of the total cost to the taxpayers over the last 25 years would be more than $100 million dollars. Put another way, county losses from nursing home operations are the equivalent of 15% of the County’s $640 million debt. And new state and federal programs will remove existing subsidies to county homes and make it still more difficult for them to effectively compete.
Although not one Freeholder has any nursing home industry experience, the so called “small government” Republican Freeholders think they know better. Rather than sell the homes when the issue came up again in 2010, 2011, and 2012 they decided each time to forestall the inevitable. Last time they decided to implement a marketing plan to try to effectively compete in this large, well run industry. Predictably the effort was ineffective and the homes continue to run large deficits.
No responsible fiduciaries would have tolerated this situation for this long, no less intentionally extended it in the face of the known facts! Both Monmouth County nursing homes should be converted to private operation now. Any appropriate patient, family, or employee protections should be a condition of that sale. Thirty years and $100 million is enough.
Democratic Candidate for Freeholder