Scramble is on to claim Ottawa nursing home beds

January 28, 2011
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A Southfield company that was prevented by a technicality from applying to build a nursing home in Ottawa County two years ago has filed notice that it intends to try again.

Nursing home operator Ciena Healthcare Management filed one of four letters of intent to claim 70 additional beds allocated to Ottawa County in a process that has local health care planning agency Alliance for Health crying foul.

Alliance for Health President Lody Zwarensteyn said that the bed reallocation plan was less obvious to the public and local providers than it could have been at a December Certificate of Need Commission meeting and the CON website.

“Without public awareness, it is difficult for parties to participate in the CON process,” Zwarensteyn stated in an e-mail to CON commissioners and staff. “This is highly unfair. As the regional review agency in West Michigan, we want to express our concern over the unfairness to our constituents who might wish to be considered if added beds are available.”

Letters of intent filed by Ciena and Trilogy Health Services of Louisville, Ky., prompted Spectrum Health and North Ottawa Community Health Services to scramble to pull together their own applications by Feb. 1.

Under the proposed bed allocations that the Michigan Department of Community Health’s CON staff has sent to the legislature, Ottawa is the only local county that falls short based on the current number of beds that already have been approved. Ottawa is 70 beds short of the new standard.

Kent County’s allocation went up by 3 percent to 2,451. But the county already has 2,517 regular nursing home beds, which still leaves it with 66 too many.

Also in West Michigan, Barry, Ionia, Lake, Manistee, Mecosta, Montcalm, Oceana, Osceola and Wexford counties were presented with additional bed allotments.

In Southeast Michigan, Oakland, Washtenaw and Livingston counties were allotted more than 500 new nursing home beds between them. But more than 700 were taken away from the allocations for Wayne County and Detroit, leaving the state’s largest county and city with about 10 percent too many beds.

Statewide, the MDCH is planning a 2 percent increase in bed need to 46,995. However, 49,165 nursing home, specialized nursing home and hospital long-term care unit beds are either already in use or have received CON approval. Some 40 Michigan counties have too many beds, under the new calculations.

Larry Horvath, manager in the MDCH’s Certificate of Need section, said that if legislators allow them to stand, the new standards and bed allocations will go into effect in March.

Horvath said that when nursing home bed standards were reviewed in 2008, a change was made that requires the department to look at nursing home standards every two years rather than every 10 years as had been the previous regulation. That provision prompted the staff review in 2010.

The topic was presented to the CON Commission and open for public comment, he said.

“I think people just didn’t catch it,” Horvath said.

“We and others were caught flat-footed by that,” said Alliance for Health Board of Directors Chair VanSkiver, who also is chief communications officer for North Ottawa Community Health System. “We feel that there was a lack of public notice afforded to everyone enabling us to determine what was at hand to be discussed, participate in, and, third, based on that information, to make a strategic decision on whether we wanted to engage.”

The public hearing generated comment in October from trade group Health Care Association of Michigan and from HCR Manor Care, a private equity-owned firm with 28 facilities across Michigan, including three in the Grand Rapids area.

Ciena’s proposal was blocked two years ago because the company delivered its application to the MDCH, but not to the Alliance for Health. The Alliance for Health is the only regional CON review agency in the state and reviews requests from 13 West Michigan counties. 

Why is Ottawa County targeted for additional nursing home beds?

Horvath said the department uses a methodology based on census and utilization figures to determine bed need.

“We use a methodology that looks at population projections,” Horvath said, noting that the shrinking population of Detroit goes hand-in-glove with the reduction in nursing home bed allocations in Southeast Michigan.

“A place … might also be shrinking because younger people are leaving. The methodology is sensitive enough to pick that up,” he added. “You could have a shrinking population, but more people using skilled care. We look by age specifically, then utilization rates by those age groups.”

2010 Census redistricting results are expected to be released starting in February. Preliminary results from five years of data collected by the bureau’s American Community Survey show that the number of people age 65 and older is growing in Ottawa County.

The Ottawa County population age 85 and older has exploded by 25.9 percent over the past decade, the figures reveal. In Census 2000, some 3,337 residents were at least 85 years old. In the 2009 ACS, that population increased to 4,201.

The number of people age 65 and older went from 24,112, or 10.1 percent of the population, to 28,602, or 11.1 percent of the population. That is an 18.6 percent increase in the number of people age 65 and over in Ottawa County.

Total population growth from Census 2000 to the 2009 ACS was about 24,000 county-wide, from 238,314 to 261,957, an increase of nearly 10 percent.

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