County mulls nonprofit model for Centre Crest

Centre Crest was again a topic of discussion for the county Board of Commissioners on Tuesday, but this time rough timetables for decisions were drawn out.

The board, which would like to get input from experts and county residents before making a decision on the future of the nursing home, is planning a series of public town hall meetings across the county that Commissioner Chris Exarchos would like to see completed before the end of March.

Exarchos also wants county staff to identify a potential expert who could make a recommendation in the next two weeks.

“I think one thing is for certain,” he said. “We can not sit by and do nothing.”

Centre Crest was locked into a low-reimbursement rate after state legislation in 2006, and the county has had to make up the difference. The law was designed to give counties a fixed and expected reimbursement rate based on its Case Mix Index. This year, the county will have to spend about $1.5 million to balance the nursing home’s budget.

The CMI is determined by the number of patients who need critical extensive care. At the time, Centre Crest accepted a variety of patients and was locked in at a very low CMI and therefore low reimbursement rate through Medicaid. Medicaid patients make up about 70 percent of the residents at Centre Crest, Commissioner Chairman Steve Dershem said.

“The reimbursement structure is stacked against county-owned homes,” Exarchos said. “It’s foolish to stay in a structure if it’s not beneficial.”

The main solution that the board will be looking at is changing the model to a 501(c)3 nonprofit, similar to the model of Mount Nittany Medical Center. The county will not sell the home, but it will become a public entity with a board of directors rather than the elected Board of Commissioners making the final decisions.

Dershem said this also will increase the reimbursements to the home because Centre Crest’s CMI is not “light years ahead” of where it was, and it would be the difference between the home “being in the red” and “being in the black.”

He also wanted to ensure employees and residents that the process will be transparent. He said they are dedicated to the continued care of the patients and want to ensure that the employees won’t lose their jobs in the transition if they decided to do it.

This model has been looked at in the past and never moved forward, but Dershem said the current board is more unified on the issue and it could be the answer going forward.

The board will meet with Centre Crest employees Wednesday to field questions and allay any concerns before the investigations continue or any actions or decisions are made. The county is encouraging anyone with thoughts, opinions or questions to bring them before the board or county administrators.

Commissioner Michael Pipe said he would like to see action taken on the issue one way or another by midyear, adding that he views it as very important to have an end-date in mind.

“Most importantly, I think this is a smart move for Centre Crest to move forward,” Dershem said.