WATERLOO — Black Hawk County is considering a plan to downsize its financially struggling Country View care center.
Country View Administrator Dennis Coleman presented a proposal to the Board of Supervisors on Tuesday to cut the number of nursing beds at the county-owned facility to help limit annual operating losses.
The plan would reduce the 134 nursing beds spread across two floors to just 75 or 80 beds on a single floor. A separate, profitable 34-bed intermediate care facility for the intellectually disabled would remain intact.
“We can better care for our residents and better care for our staff if we have them on one floor,” Coleman said.
The plan would reduce clients over time, result in 12 to 15 fewer employees and cut down on maintenance and utilities needed for the third floor. Coleman projected it would take two or three years to fully implement the changes.
County officials have been searching for ways to sustain Country View, which is projected to lose $1 million this year and deplete its reserve funds early next fiscal year.
The supervisors so far have chosen not to raise property taxes to subsidize the facility but are planning to rely on the county’s strong cash reserves to cover the losses while administrators and others look for a long-term solution.
While the county and Iowa Department of Human Services are obligated to provide care for individuals with mental health issues, Black Hawk is one of just two counties that operate their own nursing homes.
Country View, as a government employer, faces employee benefit costs well above the industry average. Unlike other nursing homes, Country View is almost entirely funded through Medicaid reimbursements.
Coleman said it costs Country View $230 per day for a nursing client while Medicaid reimburses less than $172 per day.
Assistant Country View Administrator Genevieve Shafer said many Country View residents also have mental health needs.
“We care for very vulnerable individuals, and I don’t think people understand the complexities of not only their physical care but also their unique social situations,” she said.
Supervisors Frank Magsamen and Chris Schwartz said action is necessary at the state and federal level to boost reimbursement rates to meet the cost of the care.
“My issue is not with the care that’s provided at Country View,” Magsamen said. “My frustration is that state and federal government does not reimburse at a rate that allows us to at least have a break-even point.”
Coleman said Country View is working on the licensing issues and other matters necessary to implement a reduction in nursing beds.
“There’s so many pieces of this pie that need to be safely navigated,” he said.
County Social Services director Bob Lincoln pitched a similar plan last month to cut the number of residents in the nursing unit and focus on providing care to a smaller number of persons with complex mental health care needs.