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'All I am Asking For is a Fighting Chance'

County Approves $500k for Valley View Home

During their regular meeting Jan. 26, the Valley County Commissioners threw a much needed lifeline to Valley View Home of Glasgow, a licensed 96-bed nursing home facility.

Both Board President John Fahlgren and Commissioner Paul Tweten voted in favor of providing $500,000 to the nonprofit facility from American Rescue Plan Act Funding (ARPA) acquired by the county. Mary Armstrong abstained from the vote due to a conflict of interest.

Valley View has been facing potential insolvency due to financial issues directly stemming from the COVID-19 Pandemic, said Wes Thompson, Valley View Administrator.

"What are the main reasons we require this?" Thompson asked during the commissioner meeting, attended by about 15 members of the public. "Well, census is low and it is going to stay low a little longer. We were all the way up to 76, and I believe we had an average of 67.9 for the entire year. We will get back there, but it will take time."

The pandemic "created lack of trust in longterm care nationwide," Thompson continued.

Lisa Wiltfong, President of the Valley View Home Board of Directors, on Jan. 17 sent a letter to the three commissioners requesting them to consider funding.

"Valley view home is requesting immediate financial support in order to sustain day to day operations and continue to provide quality care to our local and county residents whom we cherish so much," she said. "We at Valley View Home have been fighting strategically for the past tow plus years against the effects from the Coronavirus pandemic and are sadly losing this battle. This battle is specifically due to the enormous increase in federal regulations without any matching reimbursement funding and the highly unpredictable wage inflations for employee retainment due to agency competition."

In 2018, the board of directors put together a long term plan for financial viability that initially succeeded, Thompson said. But, no one at that time could foresee the COVID-19 pandemic.

"This was built with an analysis from health services, stating this is probably the only way Valley View will sustain because of 16-years of tremendous loss," he said. "In 2019, we did it. We hit every single goal. We actually proved Valley View Home can be run for a long time. At the beginning of 2020, we were extremely optimistic [having] a high census and some serious full time retained staff. And then something horrible hit. Although it is fizzing out in the community and at the schools ... it is still stronger than ever within long term care facilities. This pandemic is just crushing us left and right."

In 2020, Valley View home was able to remain viable "due to a payroll protection program loan and forgiveness along with three grants we were approved for," Thompson said. "By March of 2021, the state and federal levels said we are cleaning our hands of all of you. You are on your own."

Instead of giving up right away, the staff at Valley View Home has taken a proactive approach, Wiltfong said.

"We at Valley View have been spear heading these issues for Montana and have spoken to the Government Accountability OFfice, the Federal Trade Commission and of course our state representatives, and we will be continuing to fight so that State and Federal representatives are more informed and may soon act on these concerns. The problem is that there simply isn't enough time and immediate funding is the only means to continue to exist. This is not a local issue and is affecting nursing homes nationwide. But, much more impacted are the rural nonprofit facilities like Valley View Home."

"We at Valley View were ahead of this," Thompson added. "We have been trying frantically to get a hold of every single person we can, not just locally but at the state and federal levels. We have been, at the most, more successful than anybody else in Montana and that is evident by 22 other administrators and CEOs following my lead along with the entire Montana healthcare association participating behind my back."

Changes in state Medicaid reimbursement for nursing homes also is a problem for Valley View, Thompson said.

"Right now it is called a flat based rate prospective reimbursement methodology model. It means they pay me up front at a really low rate for every resident at the same price. That is wrong. The state implemented a Medicaid add-on fee. They never published it nor did they advertise it until the March or April time frame. Then they never showed us how to submit for it until June. There are 76 facilities in Montana. They all attempted to get this reimbursement back in June. Since June, all of them quit trying to get this Medicaid add on fee because it is a complete failure. Only four of us have still been trying."

Smaller Census

Thompson said the declining census at Valley View, or the number of residents at any given time, was partly because families kept their loved ones at home for care instead of placing them in a facility.

"It was good because it meant people could provide care for their own loved ones. Although it is against our business model, we love hearing about more home-based and community care. We believe that is the first step for anybody who has to come to a nursing home for 24-hour care. We want that and are glad about that. We are also fully aware that if you look at analysis from the department of labor statistics, along with the U.S. Census bureau, that within two to six years our ratio at valley view home will not be a lack of occupancy. It will be too much occupancy due to the lack of staffing. That is a fact."

The goal is to remain viable until then, Thompson said.

"What is going to happen in the future? We are asking the county for $500,000, along with the possibility of another $500,000 in six to eight months."

To date, Valley View staffers have been ahead of the eight ball on securing financial sources, Thompson said.

" We have submitted analysis to the Federal Trade Commission due to the staffing crisis. We have provided real data and analysis to the government and accountability office proving that CMS guidelines and regulations that change on a monthly basis in longterm care have not increased reimbursement by one penny since 2019. The federal office is very aware of this. Last week, we were physically in Helena in the governor's office along with the participation of the director of long term care services, Barb Smith. Rose Hughes with Montana Healthcare Association, and Senator Mike Lang also physically participating."

The staffers went to the capitol with two goals in mind, Thompson continued.

"We were prepared not to meet either of those goals, but we here at Valley View Home were able to make the state say, 'OK. We are doing it wrong. We are going to look at and change Medicaid reimbursement for the entire state.' Valley View Home is already ahead of this further than anyone else throughout the state, and we are proud of that. My second goal was to attempt to retain some ARPA funding that the federal level provided the state, but the state denied us. To date, they will not attempt to help nursing homes any further. That is the reason why you are seeing a lot of negative publicity in the [media]. We cannot rely solely on community and county funding for support. All I am asking for is a fighting chance."

 

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