When the city of Bangor voted in September 1997 to stay in the nursing-home business by appropriating $400,000 to renovate the City Nursing Facility and add residential care beds to meet changing state policies, it did so out of compassion for city residents needing care and based on the facility’s long history of high quality. These still take precedence, but the city’s cautious discussion of alternatives to its current operating method makes sense for at least three reasons.
Councilors were surprised after the vote to learn from a consulting engineering firm that the facility’s building would need nearly $2.5 million in improvement work over the next 10 years. That was followed by the announcement that the facility had fewer long-term residents than was predicted in 1997. And changes in Medicaid rules suggest there will be even fewer in the future. These are not fatal problems, but they raise questions about how much the facility will cost taxpayers in the years to come.
Certainly, the city could decide that, like many other services it provides, the nursing home is an integral part of the Bangor community and worth subsidizing at any cost. But it should not reach that conclusion without first looking at alternatives. The council has been properly careful in its approach to seeking statements of interest from the private sector to lease, purchase or manage the facility. It has continually emphasized the need to maintain quality at the facility and recognized that approximately 90 jobs are at stake.
The text of the council order reflects that. It instructs City Manager Ed Barrett to determine “the ability of any third party to undertake such an enterprise in a manner which insures continued quality of care to current residents.” In no sense does this obligate the city to accept an offer.
The council has likewise observed that looking around for interested parties should not be an open-ended process — that would create too much uncertainty among residents and potential residents, further reducing the population at the facility. By mid-January Bangor should know whether private firms are interested and qualified.
The primary purpose of the state’s nursing-home reforms during the last five years has been to reduce the number of long-term beds while increasing the amount of less-expensive care. The City Nursing Facility, like other nursing homes, is feeling the effect of these policies, and councilors would not be doing their jobs if they ignored these changes.
The City Nursing Facility has undergone changes in name and mission during its 140-year existence; more changes are inevitable. The council will best serve patients there if it, first, ensures the continued operastion of a safety-net for nursing-home patients, and, second, occasionally asks if there is a better way for it to be run.
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