Hillcrest ends fiscal year in the black

McCOOK, Neb. — Hillcrest Nursing Home will garner $105,000 in revenue over expenses for the fiscal year.

While not an astounding number, it’s still better than losing money, said Hillcrest Board of Trustee president Randy Dean at the board meeting Wednesday morning.

The year-end profit is “not by very much, but it’s the first time in many years that we’ve been in the black for the entire year,” Dean said. “There’s no extra money there, but the bills are being paid.”

The fiscal year for the facility ended June 30. Being able to show a profit, albeit a small one, is good news, especially in rural states. Because state Medicaid payment rates have not kept up with actual costs and more home-based services are being used, nursing homes across the country are struggling to keep up or closing.

More than 440 have closed or merged nationwide last year, according to one study, with six closing in Nebraska in 2018.

After struggling financially for five to six years, Hillcrest’s low point came in 2012, when Red Willow County Commissioners borrowed $1.1 million from McCook National Bank to pay construction and bond payments and meet payroll expenses at the facility. The nursing home is owned by the county but operates on its own revenue.

Shortly after, based on the recommendation by the bank, commissioners approved paying $6,000 to an Omaha-based healthcare management firm for in-depth study of the entire operations of the 54-year-old nursing home.

Conclusions from the study included that new software programs be implemented concerning financial records, private pay rates be studied and that appropriate evaluations be done on services needed by residents.

Since then, the $1.1 million loan has been paid off by Hillcrest, the board of trustees hired a healthcare management firm, Rural Health Development (RHD), and a new administrator has come on board, hired by RHD.

At Wednesday’s meeting, Hillcrest business manager, Renee Wright, weighed in on the year-end profit and said it gives the facility a cushion for next year. Every department but the childcare center came in under budget this past month, she said, adding that the childcare center was never intended to be money-maker but rather as an employee benefit. She said Brad Cheek, Hillcrest administrator, is in discussions with with the childcare director to see how expenses can be curtailed.

She and Cheek both commended staff and department heads for holding down costs in overtime and other expenses.

Three fourths of the residents at Hillcrest rely on governmental entities for their stay at Hillcrest, Wright said, whether it’s Medicaid, Medicare or the Veteran’s Administration.

The push from the Nebraska Legislature this year on Medicaid reimbursements to nursing homes was mildly successful, with a 6.1% increase, although the increase still doesn’t cover the entire costs of services, confirmed board member, Randy Dean. In a letter distributed Wednesday to board members from Ron Ross, director of RHD, the healthcare management firm at Hillcrest, Ross said he and other health care associations have been working with the Nebraska Department of Health and Human Services, the state agency that allocates Medicaid reimbursements, on changes in Medicaid reimbursement methodology.

Ross said HHS has been pushing hard to take the methodology out of regulations and that wouldn’t be a good idea, as the public and nursing homes would have very little say about changes into the rate structure.

Statewide, 53% of nursing home residents rely on Medicaid to pay for their care, Ross said in previous interviews. In rural homes such as in Southwest Nebraska, Medicaid pays for as many as 65% of the residents.