Premier improves Gracedale's census
In two years time, Gracedale's census numbers have increased by 60 residents and revenue has increased. Due to the improvements made by Premier Healthcare Resources, there are now 640 residents up from 580 in 2011. Premier's goal is to average a stable 670 census count with a total bed capacity of 688.
While the financial picture is looking rosier for the county's nursing home in upper Nazareth, there are still challenges to meet.
At an Oct. 17 Human Services Committee meeting, county council members received a progress report on Gracedale since Premier took over its management.
Most of the news was positive, but two different accounting methods used to analyze the nursing home's bottom line have left council members asking if changes need to be made to simplify the books.
Using the cash method, Gracedale will need an additional $1.8 million in 2013, which would bring the county contribution to $5.4 million for the year. In 2012, the county's contribution was $5.1 million.
Millard D. Freeman, Gracedale's administrator, said that using an accrual method, which is the healthcare industry standard, Gracedale would be able to account for $5.85 million it expects to collect from private pay residents but this money is not yet on the books.
Most businesses use one or the other accounting method to keep track of income and expenses. Gracedale uses both. There are advantages and disadvantages to each method and in the next few months Councilman Scott Parsons has resolved to research these methods.
Basically the methods differ in the timing of when transactions, including sales and purchases, are credited or debited to accounts. Under the cash method, income is not counted until cash is actually received, and expenses are not counted until they are actually paid.
Under the accrual method, transactions are counted when the order is made, the item is delivered, or the services occur, regardless of when the money for them is actually received or paid.
Additionally, Freeman said the quicker admission process means that Medicaid payers are being provided with services for which the nursing home has not yet received reimbursement.
The higher census count and the new rehabilitation unit have also increased costs because of the need to hire more nursing staff.
Freeman said the improved training and more focus on safety in the workplace has lowered Gracedale's workmen compensation costs. With $2 million reserved in the budget to pay out claims, in 2013 there has been about $500,000 paid out. In 2012, $1 million was used.
Some top goals Premier hopes to accomplish in 2014 are to increase its rating to a 3 star, obtain a VA contract, and to increase private pay residents.
Freeman ended his report by providing some testimonials praising the care people receive at Gracedale. "Gracedale is Heaven's waiting room," was one notable quote from a survey.