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Nursing homes push back against proposal

Weatherford Democrat - 7/10/2018

July 09--Parker County commissioners Monday held off sending a letter saying they would not oppose the construction of a nursing home in Weatherford with more Medicaid beds after getting pushback from area nursing homes.

A spokesman for Lloyd Douglas of Aledo last month asked commissioners for a letter of support for a proposal to build a new nursing home in Weatherford with additional Medicaid beds, citing a shortage of available Medicaid beds in Parker County.

Joe Matlock, who spoke on behalf of a group of existing area nursing homes, told commissioners that more Medicaid beds were not needed in Weatherford and another nursing home could make the current staffing shortage worse.

A draft of a letter written by County Judge Mark Riley, who was not present Monday, acknowledged the application and said that if all legally required conditions were met and the project was approved, commissioners would not oppose the construction of another nursing home.

"Just sending this in affects y'all?" Precinct 1 County Commissioner George Conley asked.

"It does," Matlock said, noting that commissioners don't know who will be operating the building once it is constructed.

"We were not made aware through the proper channels -- and there are proper channels to go through with [Health and Human Services Commission] with the state in order to initiate building of a new facility," Matlock said. "We weren't notified. I guess the state is kind of behind. And we didn't get notification until just recently through the publications from the last meeting at the commissioners court."

Matlock asked that commissioners table the issue until they can research how the proposal will impact the county.

Matlock called Rhodes' characterization of about how many Medicaid beds are occupied inaccurate and said occupancy in area nursing homes averages lower than 80 percent.

"The state requires, to grant a certificate of need to actually build a building, 90 percent occupancy," Matlock said. "So there was an attempt made to kind of go around the process and get basically green lit through the commissioners court stamping a certificate of need."

Matlock called the census of need greatly exaggerated.

The biggest single problem with the proposal is that it will impact staffing at existing facilities, he said.

Matlock said area nursing homes have one- or two-star ratings on the Medicare.gov website when it comes to staffing because of the availability of the labor pool.

"Mr. Douglas said they are going to bring X (number of) jobs to Parker County," Matlock said. "That's just not going to happen. What they are going to do is take positions away from the facilities that are here."

"And so the end result is having nine facilities in the county that are very, very understaffed," Matlock said. "That is good recipe for good care."

His company currently uses an outside firm for labor because of the staffing shortage, Matlock said.

"These employees come from Fort Worth, they come from wherever," he said. "And they aren't static. You get different employees every time. It's just a bad situation."

Another facility will compound the problem, Matlock said, adding that another facility is expected to soon be constructed in Springtown that will add 120 Medicaid beds.

"At least force Lloyd to go through the proper channels and allow the state to determine whether there is truly a need," Matlock said.

Precinct 2 County Commissioner Craig Peacock said he's noted a problem with staffing while visiting his mother, suggesting that they table the issue, and Precinct 3 County Commissioner Larry Walden agreed, making the motion, approved unanimously.

"We are going through the exact process that the state requires to get a waiver for Medicaid beds," Jeff Rhodes, of the Rhoman Group on behalf of Douglas, told commissioners. "Part of the application process is to show community support. There's not a rubber stamp. Obviously, I didn't try to get a rubber stamp. I didn't ask you guys to support the need of a new nursing home but to let the state know you weren't opposed to it."

"The state will determine whether or not there's a need for this," Rhodes said. "We've had a third party demographic assessment done. Every entity in the county that's representing our industry will have an opportunity to make these comments to the state and the state will decide. But we cannot move forward. We can't complete our application without the community support component."

Once the application is submitted to the state, it will be public record and area nursing facilities will be notified by the state, Rhodes said.

"We're not trying to hide anything, do anything under the table, anything funny," he said. "We're not trying to pull the wool over anybody's eyes.

"We used a third party demographic assessment that was done on our behalf."

Rhodes noted that nursing home occupancy is not the same as Medicaid bed occupancy. He said they are asking for a community needs waiver because they believe that the community has need and the state will ultimately determine whether there is a need.

Keith Fuchs, administrator at College Park Rehab and Care Center, which rates much below average in staffing, echoed the staffing concerns.

"You write a letter to build a new nursing home and the staffing isn't there, people's lives are on the line," Fuchs said, asking commissioners not to take away from the nursing pool.


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