Friday January 4, 2013

NEAL P. GOSWAMI

Staff Writer

BENNINGTON -- The Vermont Veterans Home is currently running a deficit in excess of $1 million and is looking to cut costs and increase its census to bring in additional revenue, officials said Thursday.

Little discretionary spending

Home Administrator Melissa Jackson and Board of Trustees President Joseph L. Krawczyk Jr. said they have already begun taking action to cut costs, but there is little discretionary spending that can be cut. They said officials are looking for all ways to cut costs.

"We told staff don't print 20 copies of your email," Krawczyk said.

The state's only nursing home facility for veterans is still recovering from a near-loss of its provider agreement with the Centers for Medicaid and Medicare Services in September, which provides the majority of the home's $19 million annual budget. Several deficiencies identified by state inspectors required corrective action by the home. The home passed a last-chance inspection to preserve the federal funds, but it is now under closer scrutiny until it passes two more inspections without incident.

Staffing issues and expenses related to the home's response to the deficiencies have contributed to the budget gap, according to Krawczyk.

"Part of it is that we had higher than expected overtime, that we had to call people in because of call-outs and other reasons. For two months we had per diem nurses here to make sure we maintained minimum staffing. We had the consultant's fees because of the problems we had here three months ago. That cost us some money. That's where we are, plus, in my opinion, the Medicare and Medicaid funding, as you hear all over, is not adequate to take care of the patients," he said.

Additionally, Krawczyk said some residents are receiving care but the home is receiving no compensation because those residents are unwilling to sign certain paperwork. "We do have residents here that have the ability to pay but they won't sign this paperwork or whatever to be eligible for Medicaid," he said. "How can you throw a veteran out?"

The board of trustees has already voted to raise the cost of care for private insurance by the cost of living, which will help raise some additional revenue.

The home had been limiting the home's census while it worked to correct deficiencies and focus on training employees for future inspections.

"We made a conscious decision after being put back into compliance in September to limit our admissions to focus on those regulator issues and we knew when we made that decision there was going to be some financial impact. I wasn't anticipating the census to go as low as it had," Jackson said.

The lower census resulted in lower revenues, Krawczyk said. However, the home is on more secure footing with regulators, he said. "The risk we were running if we didn't do that was to lose our certification," he said. "So, there was a risk. I don't think it was a gamble, I think we made the right choice but there is a consequence."

Officials hope to boost the current census of 118 residents to at least 140 by February, which will draw down more federal funding. A recent flu outbreak in the home has prevented new admissions for more than a week, but admissions should resume by Monday.

"Our goal is to be in the 140s by February. That being said, that's not just a target number, there's a lot of thought that goes into that. I'm making sure that we're taking patients that are not medically intensive. You don't want to bring in 50 people on IVs," Jackson said. "We would still, most likely, operate at a loss but it wouldn't be at that level."

Krawczyk said the home will request additional funding from the state in the annual budget adjustment act that lawmakers have already begun work on. He said State Commissioner of Finance James Reardon is aware of the financial situation.

"We're not going to be able to close it totally. We're going to have to rely on the budget adjustment to give us some (additional funding)," Krawczyk said. "We know that's going to be tough at the state level."

Krawczyk said it will take involvement from everyone to close the budget gap.

"It's serious to where everybody has to pay attention from the administration, to the staff, to the board of trustees to the governor's office and the Legislature," he said. "We've got six months to try and make some corrections."