By LeAnn R. Ralph
COLFAX — To accommodate changing trends in nursing home care, the Colfax Health and Rehabilitation Center plans to convert 12 skilled nursing beds and the short-term care units in Birch Lane to assisted living.
“Our (skilled nursing) census has been low. It’s something the whole industry has been facing. It’s not just happening here. It’s a trend,” said Jill Gengler, CHRC administrator.
When Colfax Health and Rehab moved to the new facility on the south side of Colfax five years ago, the number of skilled nursing beds went from 50 down to 40.
At the time the facility moved, Gengler said she had expected to have a waiting list with 40 skilled nursing beds, because at the old facility on High Street, CHRC had always been full with 50 skilled nursing beds.
As it turned out, the skilled nursing unit has rarely been full at the new facility.
The census in skilled nursing has usually hovered around 32 or 34 residents, Gengler said.
Lately, the skilled nursing census has been decreasing, and on the day the Colfax Messenger spoke with Gengler, CHRC’s skilled nursing unit had a census of 26 residents.
By contrast, Ridge Crest Manor, CHRC’s community based residential facility (CBRF), which is the facility’s assisted living unit, is often full, and in fact, has a waiting list.
“There seems to be more of a demand for assisted living … for a lot of reasons, it’s making sense to put more beds where the demand is,” Gengler said.
Even though CHRC plans to convert Birch Lane to assisted living, short-term care for rehabilitation after surgery will still be available.
Maple Lane will be used for rehabilitation, and it is just a short walk to therapy, Gengler said.
Since the current rehab unit has its own dining room, CHRC plans to create a small dining room in The Square for rehab patients.
“Not only for those patients in rehab, but anyone who is able to come on their own could come to the cafe (in The Square). Anyone who doesn’t feel like eating in the dining room could come for restaurant-style service in The Square,” Gengler said.
CHRC averages between three and five rehab patients on any given day and plans to continue offering rehab services.
“The therapy providers are all the same. Nothing will change there,” Gengler said.
Adding to the CBRF/assisted living unit will give Colfax Health and Rehab more flexibility in staffing, Gengler said.
Instead of registered nurses or certified nursing assistants, the CBRF can operate with personal care workers, she said.
CHRC is not planning to eliminate any positions at the facility.
“Our goal is not to cut anyone’s hours, but there are going to be some reallocations. Someone might not get the shift or day they want. We have shortages in nursing, and some positions are open but others will get downsized. Our goal is to offer them hours in a different department or on a different shift,” Gengler said.
“They will not be out. It might not be convenient for them, but they will not be cut,” she said.
CHRC employees “will go home with the same paycheck, even if it’s a night shift and they typically work a p.m.,” Gengler said.
“We are so fortunate here in Colfax. There is an element of the people who live here, work here. They get to know the residents, or they grew up with the residents. They were their neighbors. Or their teachers. Or they are a relative. Their grandmother,” she said.
“It just adds so much to the mix. They care just so much more. It is a palpable element here. You can feel it when you walk in. They treat you like family, even if you didn’t live in Colfax (before moving to CHRC),” Gengler said.
“It is different here than other places. And I will credit that to the home-town level of caring,” she said.
“It’s a strategic move to stay ahead of the trends. A lot of nursing homes are closing. A lot of them have wings closed. Many of them are operating at a deficit. If we don’t keep changing and keeping abreast, we’re going to end up there, too. And we just don’t want to do that,” Gengler said.
Colfax Health and Rehab borrowed money from the United States Department of Agriculture (USDA) to remodel the old nursing home on High Street to operate as a memory care unit.
Unfortunately, the cost for remodeling and installing a sprinkler system “got out of control,” Gengler said.
CHRC scrapped the memory care unit idea, and USDA has authorized Colfax Health and Rehab to use the money to do the changes needed to expand the CBRF.
The changes are minor and require items such as smoke detectors and heat detectors to convert for use as a CBRF, Gengler said.
Colfax Health and Rehab also is working on obtaining bids to demolish the old facility on High Street.
USDA has authorized the use of some of the borrowed money for demolition, Gengler said.
“And that will help us out as well. It’s very expensive to carry. We are spending $60,000 to $70,000 per year just to keep the building. There’s no rental income to offset that cost,” she said.
The old nursing home facility on High Street must be heated during the winter, and there are other maintenance costs as well.
Up until two years ago, Mayo Clinic was renting the clinic facility at the old nursing home, but then Mayo decided to close the Colfax clinic.
The Village of Colfax has been looking for another health care provider for clinic services but has not found another provider to fill the space.
At one point, it appeared as if Marshfield Clinic was going to open a clinic in Colfax, but Marshfield backed away because of financial commitments to other projects.
CHRC also had offered to give the old nursing home building to the village. After considering the options that were available for use of the building and the cost to remodel, the Colfax Village Board decided to turn down the offer.
Gengler says after the old nursing home is demolished, CHRC plans to keep the lot for the time being.
If another clinic were to want a facility in Colfax, a new clinic could be built at Colfax Health and Rehab. The original plan for the new building was to build a new clinic and move Mayo Clinic from the location on High Street.
Unfortunately, federal regulations related to the original funding prevented the clinic from being moved.
Gengler has told the Community Cares food pantry the building will most likely be demolished.
“But we will give them plenty of notice. We don’t want that program to go away,” she said.
Gengler said she is not sure about a timeline for the expansion of the CBRF/assisted living.
Colfax Health and Rehab has to apply to the state to receive approval to change the short-term care beds to assisted living, and the amount of time needed to receive approval is unknown at this point, she said.
After CHRC receives approval to convert the beds, then the work to complete the expansion must be done, and then state inspectors will need to inspect the facility before CHRC can start accepting residents in the expanded portion of the CBRF, Gengler explained.
Colfax Health and Rehab looked into selling the skilled nursing beds, but the process is complicated, and there are many nursing home beds available. The facility’s financial advisor said it probably would not work very well to try to sell them, and there is also a geographical limit as to how far away they can be sold.
With the sale of the beds restricted to this area, CHRC would be selling them to a competitor, Gengler said.
(For clarification, when nursing home administrators talk about “selling beds,” they are not talking about selling the physical beds, but rather, are talking about selling the licenses for the beds. )
For two years after the skilled nursing beds have been eliminated at Colfax Health and Rehab, they can be put into a “restricted use” category, Gengler said.
CHRC would not be paying taxes on the nursing home beds, but they could be re-implemented if the facility suddenly experienced a higher demand for skilled nursing. After that, CHRC would have to rely on the state to determine if there is shortage of long-term care beds and to reissue the licenses, she said.