County considering Maple Lawn mileage for November vote this afternoon

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At 4:30 p.m. today, the Branch County Commission will consider a resolution to place a mile on the Nov. 8 ballot to bail out Maple Lawn, the county-owned retirement home.

The commission also reportedly needs a short-term cash injection of $1 million to address financial issues after the state demanded reimbursement of $874,976 in Medicaid payments from 2019 to 20121.

Care home administrator Jane Sabaitis made the emergency request to commissioners during the council’s business session on August 4.

The proposed 0.99 mill assessment imposed on taxable property in Branch County would yield approximately $1,656,932 collected beginning in 2023. It would yield a similar amount for the next 10 years.

The commissioners want answers from the care home administrator and its board about how finances got so dire quickly without warning.

Branch County’s recently received audit for last year showed Maple Lawn suffered a loss of $1.67 million on revenue of $13,985,710 in 2021.

The immediate issue comes after state officials demanded Medicaid overpayments following a delayed COVID-19 reconciliation. The state agreed to withhold repayment in three installments of $291,659 in July, August and September.

The problem arose when occupancy dropped to 75% during COVID-19, and understaffing prevented more patients from being brought in.

When the September payment is withheld, Maple Lawn would have minimum reserves to cover expenses, including payroll.

County Administrator Bud Norman said the $1 million could be an additional retirement home stipend from county reserves or an advance to flow back to the county from later funding.

Sabaitis told the commissioners there was no deadline for the money.

“My concern at the moment is just to do our payroll and to be able to pay our bills. So I would say as soon as possible. We still have money, money from our (state) payments and from “other insurance. We bill Medicare. We’ve built our Medicare census at this point. We have more rehabilitation, which is a more lucrative business for us.

“We still have to do some investigation ahead of time to make sure we can do it and what is needed to do it,” Norman said.

If there was an advance, the reimbursement could come from two sources. One would be the mileage if it passed. The second is federal funding. The rules have been changed to allow government-owned nursing homes to receive a federal employee retention credit related to COVID-19.

Sabaitis said its accountant, Plant-Moran, applied ERC funds for the first three quarters of 2021. The ERC would bring in about $3.2 million. Receipt of ERC funding is not assured.

The county would have to dip into its fund balance reserves for the Maple Lawn money.

As he prepares his 2023 budget, Norman told commissioners on July 17 that spending was down for this year, but so was revenue. A loss of about $900,000 from the previous year was due to the commissioners not renewing the operation and maintenance mileage of the half-mill prison. The decision was made after voters adopted the new construction prison mileage.

The county also increased expenses by $500,000 due to inflationary costs and eliminated the two-tier salary scale. That gives the county $1.4 million less to spend on other items in 2023.

The county had a deficit of $506,765 last year to reduce its fund balance.

The county has US bailout funds of $8.2 million. Norman noted, “ARPA has a clause for loss of revenue. If you do that, then there’s something else you can’t do with that money.” The county has received requests in excess of its ARP fund allocation.

Branch County received a Michigan marijuana excise tax of $451,627. He used that money to reduce the Sheriff’s Highway Patrol to 11 deputies. Norman fears that income will drop in the years to come.

“At the end of the day, there are options with respect to closing the facility or selling the facility. Both have significant impacts, obviously on the employees and residents of the facility,” said Sabaitis.

The reason Branch County is one of Michigan’s 83 counties with nursing homes is “the purpose and mission of a county medical care facility to care for the Medicaid population.”

In recent years, some residents and hospital staff have criticized Maple Lawn for taking private insurance patients rather than Medicaid.

The county must also pay $9.96 million in revenue bonds that added 31 additional private rooms and completely renovated the facility in 2017 if Maple Lawn doesn’t have revenue to pay off the debt.

Some have offered to sell the house to a private company. This sale would be similar to that of the Community Health Center at ProMedica in 2018.

The sale would give the county money for other projects or to fully fund pension shortages.

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