Saving the nursing homes? HCIA recommends company to handle facilities

After an extensive closed session on Feb. 21, the Hudson County Improvement Authority (HCIA) has approved Omni Asset Management Company’s contract offer to take over operations and purchase the properties at Pollak Hospital in Jersey City and the Meadowview Nursing facility in Secaucus.

Now, the county’s board of freeholders has to approve the HCIA’s recommendation.

“We moved forward with Omni’s proposal as our recommendation to the Hudson County Freeholders,” said HCIA Chairman John Shinnick. “The Freeholders will have to ratify the contract.”

The firm, Shinnick noted, has extensive experience in operating nursing facilities throughout the state, including three in Hudson County: Union City, Guttenberg and Jersey City. Each facility has 180 beds.

“It was a tough issue – especially with it going on at the same time as problems with the former county executive,” Shinnick said. “But we felt we had to move forward, and that’s what we did.”

Omni agreed to purchase both facilities for $15 million. The Meadowview facility will remain open; Pollak has been closed for a month and its future is uncertain. But the contract calls for Omni to take over operations and make renovations to Meadowview, and eventually purchase the building.

A second, possibly better deal was expected to be considered at the Thursday, Feb. 28 freeholder meeting from 140 Park Associates, a different company. It would pay the county $18 million, paying $2 million deposit, $6 million within 60 days, and the rest over a 42-month period.

Why it happened

In 1995, at the recommendation of former County Administrator Abe Antun, the county hired Progressive Health Care, then of East Brunswick, to take over operations and eventually purchase the two buildings for $10 million.

Late in 2000, Progressive could not make the first payments on the buildings. When pressed for payment last May, Progressive declared bankruptcy. Early in February, Gary Marks, the trustee assigned by the court to keep operations running during the transition to a new operating company, closed Pollack Hospital, over the protest of county officials who claimed they had not had enough time to work out a deal for a new operator.

The closing of Pollak has meant the loss of as many as 200 jobs and the scattering of residents to other facilities in and around Hudson County.

Carol Ann Wilson, director of the County’s Department of Social Services, told the freeholders in January that the county could provide beds in other facilities for about 93 people at various locations. Antun said Meadowview could account for about 30 of those 93 if all the people qualified. But as of January, Pollak still had about 183 patients.

Now, Pollak is closed, and 26 of those patients are in Meadowview.

While Pollak was closing, they ceased to take any new patients, but the number of employees remained the same, Antun said. This left a poor financial ratio between patients and personnel, and made the purchase less attractive to operating companies.

A valuable commodity

These facilities are operated by license. The license controls how many beds the operator can control. The license is valuable because the operator who buys it can open new facilites with new beds anywhere in the state and be licensed for 1,100 beds. They don’t have to hold onto the Meadowview and Pollak buildings.

Thus, operators could be seeking a contract with the idea of using the license to develop a more profitable operation.

The county is trying to include an agreement keeping the buildings as nursing facilities.

Freeholder Al Cifelli said this license could be resold for as much as $4 million. The county’s requirement that the aging facilities be renovated as part of the contract has discouraged some bidders.

Although the county received three other proposals in January, none came in time to prevent the closing of Pollak, and it is still uncertain as to whether or not Pollak will be reopened even if the freeholders select from one of the two current proposals.

As of January, Liberty House of Jersey City was among bidders for the project, offering to lease the two facilities for 20 years and pay an annual payment to the county. A company called Hamilton Park, which sued to stop the county from giving the contract to Progressive in 1995, also submitted a bid, but refused to give the $1.5 million deposit until certain conditions were met. The court claimed this violated the court order. There was a third proposal from New Era, the details of which were not available.

Should the county operate the homes instead?

Although the county officials claimed to be shocked by the closing of Pollak, most of the freeholders knew in early January that it would likely occur unless they got a deal.

Freeholder William O’Dea said once Pollak closed that it would difficult to reopen the facility and to give back the jobs and beds lost at that location.

“The state Department of Health is not going to force whoever buys that license to keep that building open,” he said, noting that someone who purchases the license could very well use it to build a facility outside of Hudson County, and charge prices beyond the means of Medicaid residents to pay.

O’Dea has advocated having the county take over the facilities again, and becoming the nursing home provider, rather than selling the contract to someone else.

“We have never really looked at it,” he said. “Everybody is deathly afraid of going back into the nursing home business. The reason that that didn’t work is only because of an antiquated facility that can’t operate as a nursing home anymore.”

O’Dea said the county has the ability to step in now, find the money to renovate Meadowview for additional beds then relocate there the patients previously living at Pollak. The county could recoup some of the costs by selling the unused portion of the licensed beds off to a private provider.

Antun, however, argued against the move, claiming he had been instrumental in the county’s getting out of the nursing home business in 1995.

“These are Medicaid nursing home beds. We cannot support that operation,” he said. “Within a week of my coming to this county [in 1990], the first things I said to the administrator and to the county executive are that we had to get out of the nursing home business. After five years, they finally asked me to consider that again, and I did. We got out of it.”

Cifelli said at least one firm had backed down from the purchase because of the 100-percent Medicaid nature of the county facilities. The firm, he said, had envisioned a different mix that included private patients.

“Today’s nursing home as a for-profit institution can never sustain itself on Medicaid rates,” Cifelli said, quoting arguments brought by one potential provider. “Obviously Medicaid is a fact of nursing home life, but that in order to sustain itself and to run a first-class operation that patients deserve, you need to get a different mix in there.”

Antun also said there is an important difference between payments from Medicare and Medicaid programs. While payments from the government may change from year to year on each, Medicaid has archaic rules that are not designed to pay the actual cost for a patient’s care. Antun called Medicaid reimbursements unreliable and unpredictable.

Antun said a proposal from New Era agreed to keep 80 percent of the beds reserved for Medicaid patients, but did the company did not say whether it would keep Pollak or build a new facility. Hamilton Park agreed to keep 55 percent of the beds Medicaid and 45 percent from private parties or insurance.

The contract with Omni agreed to keep all the beds in Hudson County and to maintain 70 percent as Medicaid, Shinnick said. “This is the best deal we could get,” he said, “and it keeps things going and us moving forward.” A good life in Meadowview

Nearly every morning after their breakfast, residents of Meadowview Nursing Care Center wander down to the community room to gather around the TV. The generation of residents, most of whom exceed the age of 70, have their own version of MTV as they tune into repeats of the 1950s and 1960s’ Lawrence Welk Show.

“You should see some of his moves,” joked Joe Valese, a volunteer advocate and the state’s Ombudsman for the Institutionalized Elderly.

Valese has been monitoring the nursing home for about two and half years, checking on the health and welfare of the residents here.

“I come here two or three times a week to look around and see what needs to be done,” he said.

Valese said about 26 people had been transported from Pollak Hospital as of Feb. 23. Pollak was closed on order from a bankruptcy court, leaving Meadowview as the sole county facility for the aged.

Meadowview is a long-term senior citizen care facility. The building was constructed in 1962 to accommodate senior citizens and the mentally ill. The facility still has a psychiatric unit, although officials at the facility say that population is kept separate from the senior citizens.

The Secaucus building was constructed to provide many of the services that had once been conducted at the county’s Laurel Hill location in Secaucus, and was operated by the county until 1995, when Meadowview and Pollak operations were taken over by Progressive Health Care of East Brunswick.

This year, Progressive declared bankruptcy, sending county officials into hurried negotiations with other healthcare providers, and leaving some fearful about the fate and condition of patients at the two facilities.

Although this firestorm roared through decision-making bodies such as the Hudson County Freeholders and the Hudson County Improvement Authority, life here as gone on pretty much as normal. People are living their lives via routines: sewing, reading, watching TV, or taking advantage of one of the occasional pieces of live entertainment that come into the facility.

Despite all its legal woes, Meadowview’s rooms and halls are remarkably clean and well-lighted. Unlike many more successful private healthcare facilities, people and wheelchairs are not cluttering the halls. Senior citizens here do not seem abandoned to their own resource.

Yolanda Dobbins, president of the Residents Counsel, has been a patient since 1986. She is 73 going on 74 and grew up in Jersey City near Central Avenue. She does not mince words and has taken on the job of handling residents’ concerns and welcoming new patients.

“We hold meetings with residents and talk about their concerns,” she said. “Are the nurses doing a good job? Are people being well-treated? How is housekeeping? We talk about everything.”

Life in Meadowview has been good, despite the political turmoil, she said.

Valese agreed saying patients have been treated well and that the facility, despite its age, has been kept clean.

“In some ways, the age of the hospital works to the advantage of the patients,” he said. “The long halls give people a place to walk and get their exercise.”

Part of the agreement with a new health provider would have Meadowview upgraded. In 1992, the county upgraded the hospital to meet modern privacy requirements instituted by the state. In October of 1992, patients here were moved temporarily to Pollak Hospital as the county brought in a mix of union workers and low-risk prisoners to do the project. The facility was designed then to handle up to 118 residents, a figure that would be expanded with a new upgrade program.

Valese said the facility, complete with corridors connecting its six buildings, is already handicapped accessible, wide enough to easily accommodate wheelchairs.

Elaina Teresa, 70, of Hoboken, said she has lived in Meadowview for several years after being transferred there from St. Mary in Hoboken. She had no complaints.

“I love the food they serve here,” she said. “I’ve never been treated so well.”

Helen Scalia, of Secaucus, is one of the temporary patients here. She lived in Secaucus for 14 years, before which she and her husband lived in Jersey City where they ran a tavern. Her husband died last year, and then she discovered that she had cancer.

“I’m fully recovered now, and I’m looking to move back into town [Secaucus],” she said. She said the people in Meadowview have been good to her. – Al Sullivan

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