In private hands, can health center have quality care?
The writing is on the wall: Washington County Health Center is almost certainly going to be sold to private owners.
One of the few remaining counties in Pennsylvania that still operates a nursing home, Washington County has been considering pulling itself out of the nursing home business because the facility is immersed in red ink. In the last four years, the county has lost more than $9 million on the health center, with the possibility of an additional $3 million being lost this year. In order to pay the health center’s bills, the county has been subsidizing it with revenue it has received from oil and gas drilling on county land.
County commission Chairman Larry Maggi pointed out that federal and state governments have reduced their payment formulas, which is helping to nudge counties toward putting their nursing homes on the market.
Given this predicament, the county is fulfilling its fiduciary responsibility by looking for another operator. All options should absolutely be explored. But families and friends of patients at Washington County Health Center – and people who might be patients there one day – have ample reason to be concerned that the quality of care will decline once it’s in private hands.
The costs of operating the 288-bed facility in Arden are substantial, and the costliest item in its budget is personnel. There are 319 employees there, with nurse’s aides and food service workers starting at salaries in the neighborhood of $33,000. That’s significantly better than what they would find in the private sector. According to the U.S. Bureau of Labor Statistics, in 2015 nurse’s aides earned a median salary of $25,000, with the lowest earners making about $19,000. Food service workers usually make $16,000 to $29,000 per year.
A private operator will presumably want to reduce personnel costs. This would probably include positions being eliminated and salaries being frozen or cut, and that would probably lead skilled, veteran employees to start looking for jobs elsewhere. Having fewer employees and higher turnover would likely diminish the quality of care at the health center.
A 1998 study by the Keystone Research Center found when nursing homes in Pennsylvania were privatized, staffing levels and wages dipped, employee turnover went up and there were complaints about shortages of supplies.
More recently, a study released last year by the Center for Medicare Advocacy compared privately owned nursing homes in California and publicly operated homes in Norway, and found the Norwegian facilities devoted more money to direct care and spent less on administrative costs.
“Privatization of long-term care is correlated with reduced reimbursement for care and increased reimbursement for administrative overhead and profits,” the report concluded.
This might be akin to wanting to have a cake and also eating it, but we can only hope that a private buyer will uphold the level of care at Washington County Health Center that has helped it earn a first-rate reputation. Dollars and cents matter. But so does the well-being of employees and patients.