A recent Overton County News poll asked “Do you think the Director of Schools should be an appointed or elected position?” Of 260 total responses, 241 (93 percent) preferred the position to be elected and 19 (7 percent) preferred to keep it appointed.

State Senator Charlotte Burks and State Representative John Mark Windle each sponsored bills to provide a means for giving the vote back to the people in the just finished session of the General Assembly. Burks’ bill stalled in committee, and Windle’s bill was deferred to the summer session.

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A reduction in certified beds could be a timely cost savings for Overton County Nursing Home.

Bed decertification was discussed in the Thursday, April 25 Overton County Nursing Home Board meeting while looking at ways to offset a possible $130,000 per year in additional operating expenses when the Affordable Care Act, commonly called Obamacare, kicks in next January.

“We all know the Affordable Healthcare Act is coming January 2014,” Administrator Jennifer Bouldin said, “and it is going to affect us somewhat.”

Of the current 139 employees, OCNH has 73 employees taking the offered insurance, and 37 more are eligible to take the insurance.

“It looks like, worst case scenario for us, that the total cost for the health insurance coverage would be around $130,000 annually,” Bouldin said.

Bouldin first presented the possibility of cutting employees’ paid holidays down from 14 to six, as it was a few years back, to cut costs, but Bouldin also had another alternative.

“Since I’ve been here, the census, when I came, it was 98,” she said. We got up to 135; we’re back down to 100. Okay, how many years prior to that were we 160? I mean, I can’t even find information where we were 160.”

OCNH Board member Donna Savage said there once was a waiting list, and other members said likewise.

“But for at least nine years that we know about, we have paid bed taxes on beds that we have not used,” Bouldin said.

She said that concerns over not being able to get beds back once they are decertified is unfounded.

“You can get beds back,” Bouldin said. “You have to show a need. But right now, with our census a hundred, we’re paying bed taxes on 160. And it doesn’t matter, you’re always going to pay bed taxes on 160, don’t matter how many patients you have.”

OCNH Board member Billie G. Phipps asked, “And how much is that?”

“Bed taxes, for each bed, every year, is $2,250,” Bouldin answered. “If we decertified 25 beds, that’s $56,250 money we’re not paying back to the state.”

Phipps asked how hard it would be to get the beds back if needed.

“It is not hard,” Bouldin answered. “There is a pool of 125 and you just have to submit your certificate of need, just like we did for the building. You have to show you need them.”

OCNH Board member Darwin Clark asked how long it would take if additional beds were needed. He was told that the process for the Certificate of Need would be about 120 days.

On the monetary benefits of decertifying the beds, Bouldin said further, “Not only do we not pay those bed tax revenue, but for TennCare patients, there’s 10 bed-hold days every year that if they go out to the hospital, the nursing home still gets paid for that if you are 85 percent occupied. We haven’t been 85 percent occupied in nine years that I know of.”

“But you could be if you took these off?” Phipps asked.

“Yes,” Bouldin answered. “Not only that, there is an average of $3 per resident day that TennCare would add back to our daily rate because we would show that 85 percent occupancy. We lose money based on our occupancy.”

She then told the board how much would be saved.

“So, the total savings of all of that, if we decertified 25 beds–$211,000,” Bouldin said.

Phipps asked, “What’s the process of doing that? What do you have to do?”

“We just submit a letter to the state and say we need to decertify these beds,” Bouldin answered.

Controller Charla Zalewski added, “And that would bring us down to 135.”

Bouldin said, “That is a very doable goal.”

The nursing home would need a census of 115 to reach the needed 85 percent. OCNH had a census of 99, with three pending admissions, as of last Thursday.

Clark said, “I’m going to put it in the form of a motion that we get all the information together, get everything prepared and get ready for the next meeting’s vote.”

The motion was seconded and all voted yes.

Where all members were in accord on that vote, another vote was not unanimous and a bit confounding. The subject was making a statement against selling the nursing home, which was presented by Clark.

“With all the talk going on about selling the nursing home, stuff like that, I think the Nursing Home Board needs to go on record and vote one way or the other whether they want to sell it or not,” Clark said.

Not wanting to delve into the controversial subject at the time, OCNH Board member Frank Martin said, “Well, I’d like to get the information before we do anything.”

“Well, it’s done went through two committees,” Clark said.

“I know that, but all we voted to do was to take it to the full (County) Court,” Martin said.

Clark put forth that the Nursing Home Board had not been asked about selling the nursing home.

“I think it should have been brought before this board first, but it hadn’t,” Clark said. “So, I think our board needs to take a position on it, one way or the other.”

Clark made a motion to suspend the rules, and Martin said, “Well, it’s not going anywhere until we get some information, and if the information is not there, it won’t go nowhere then.”

Savage seconded suspending the rules and all voted for it except Martin, who voted no.

After stating that he wanted to be on record as opposing a sale of the nursing home, Clark said, “I make a motion that we don’t sell the nursing home.”

Phipps seconded the motion.

A voice vote was taken in which all said aye except Martin, who passed on the vote.

Then Chairman Randall Boswell said that vote was to put the motion on the agenda, and then called for a roll call for voting on the motion.

Though the intent was to vote against selling the nursing home, the motion having been worked in the negative sense apparently caused confusion as to what a no vote meant because when a roll call was taken and Commissioners Phipps, Clark, Savage, and Boswell voted no, and Martin abstained. Thus, the motion failed with four no votes and one abstention, though no one acknowledged it and the board moved to other business.