Council’s nursing decision

Bangor City Council last week had to make a decision about the direction of the City Nursing Facility — to do nothing would have been to doom it to fiscal failure. Deliberately and without foot-dragging, councilors chose a course that will help the facility remain in business for years to come.

The choices for councilors were two: Change the services at the facility or sell its license. Councilors voted 8-0 to change services. They approved a $400,000 project that will renovate the building, removing five of 61 nursing-home beds and add 17 residential beds for boarding care.

The nursing facility, like many similar institutions statewide, was filled near capacity until a state policy, called Med ’94, raised the level of illness necessary for nursing-home care and encouraged less expensive avenues of care, such as boarding or home care. The policy is creating in Maine care options that many states have used for years, but it dropped occupancy percentages at some nursing homes from the high 90s to the mid 80s. That creates financial problems that could grow worse as the care options continue to expand.

The city responded earlier by allowing nonresidents into its facility but that helped only a little and put the city in the position of competing with private businesses. By expanding into boarding care, Bangor can serve more people while costing taxpayers less.

The most important part of the plan, however, will be less visible than the renovations at the facility. Part of the council’s reccomendations, based on a study by Baker, Newman and Noyes, would have the nursing home made into a nonprofit corporation, with a board of health-care experts, rather than the council, making many of the decisions. This board would allow the facility to respond faster and more effectively to the rapid changes in health care. City councilors are not and should not be expected to be experts on the health-care industry, yet they were being asked to make crucial decisions in this area. That had made for a slower, more difficult process than is necessary.

A key issue for councilors was whether the city should be in the business of nursing care at all. It is a fair question. The city could have sought a buyer for its license and let the market dictate how this facility, which has been a part of the city in one form or another since before Bangor was incorporated, is to be operated.

Nursing facility administrator Kathi Murray, however, raised a point that people in the health-care field and patients at the facility knew to be true: the City Nursing Facility is widely known for providing an unusually high level of care. Clearly, Bangor facility residents and their families benefit from this quality of care; one question for the City Council was, how much is this added increment of care worth?

The council decided, appropriately, that the estimated deficit, five years from now, of $82,000 was a worthy investment. It ensures that high-quality care will be there for residents this year and well into the future. It was a smart, compassionate move by the council.