Branch County Commission to consider Maple Lawn millage for Nov. 8 ballot

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

The commission would also need a short-term cash infusion of $1 million to fix financial issues after the state demanded repayment of $874,976 of Medicaid payments from 2019 to 20121.

Nursing home administrator Jane Sabaitis made the emergency request to commissioners at the board's work session Aug. 4.

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

Commissioners want answers from the nursing home administrator and its board on how the finances became so dire quickly without some warning.

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

The immediate problem comes after state officials demanded Medicaid overpayments following a COVID-19 delayed reconciliation. The state did agree to withhold reimbursement in three payments of $291,659 in July, August and September.

The problem occurred when occupancy fell to 75% during the COVID-19, and lack of staffing prevented bringing in more patients.

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

County administrator Bud Norman said the $1 million could be an additional allocation to the nursing home from county reserves or an advance to come back to the county from later funding.   

Sabaitis told commissioners there is no deadline for the money.

"My concern right now is just making our payrolls and being able to pay our bills. So I would say sooner rather than later. We still have money, cash coming in from our (state) payments, and other insurances. We're billing Medicare. We have built up our Medicare census at this point. We do have more rehab, which is a more lucrative business for us."

"We still have to do some investigation with the advance to make sure that we can do that and what is required to do that," Norman said.

If there was an advance, repayment could come from two sources. One would be the millage if it passed. The second is federal funding. Rules were changed to allow government-owned nursing homes to receive COVID-19-related employee retention credit from the federal government.

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

The county would need to dip into its fund balance reserves for the cash for Maple Lawn.   

As it prepares its 2023 budget, Norman told commissioners on July 17 that spending is down for this year, but so are revenues. Approximately a $900,000 loss from the prior year is because commissioners did not renew the half mill jail operational and maintenance millage. The decision was after voters passed the new construction jail millage.

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

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

The county has the American Rescue Plan funds of $8.2 million. Norman noted, "ARPA has a clause for lost revenue. If you do that, then there is something else that you're not going to be able to do with that money." The county received requests above its ARP fund allocation.

Branch County received a Michigan marijuana excise tax of $451,627. It used that money to bring the sheriff's road patrol back to 11 deputies. Norman is concerned that revenue will drop in future years.

"Ultimately, there are options as far as closing the facility or selling the facility. Both have significant impacts, obviously on the employees and the residents of the facility," Sabaitis said.

The reason Branch County is one of 83 counties in Michigan with nursing homes is "The goal and mission of a county medical care facilities to take care of the Medicaid population."

Over past years, some residents and hospital staff criticized Maple Lawn for taking private insurance patients over Medicaid.

The county is also on the hook for $9.96 million in revenue bonds that added 31 more private rooms and completely renovated the facility in 2017 if Maple Lawn does not have revenues to pay back the debt.

Some have suggested selling the home to a private company. This sale would be similar to that of Community Health Center to ProMedica in 2018.

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

This article originally appeared on The Daily Reporter: Branch County Commission to meet today on Maple Lawn millage