Representative David Dill
Representative David Dill is excited about helping Cook County. On Friday, March 11, 2011, he flew in to the Cook County Airport with Spectrum Health Companies owner/CEO Merle Sampson and his chief financial officer and three representatives from Ryan Companies US to take a look at how new amenities and facilities could aid the struggling Cook County North Shore Hospital and Care Center.
The visitors met with Hospital Administrator Kimber Wraalstad, board member Howard Abrahamson, County Commissioner Jim Johnson, and Cook County/Grand Marais Economic Development Authority (EDA) board member Hal Greenwood.
Dill enthusiastic
Reached by phone after his visit, Representative Dill said he has been concerned about the financial problems associated with inadequate reimbursement to the Care Center ever since the Cook County Hospital District’s levy cap was lifted several years ago. “How much more can you tax?” he asked. “How much more can people pay?”
Dill pointed out that the Care Center loses more money the more residents they have because of the way services are reimbursed, explaining that when a critical access hospital has a nursing home attached to it, the government figures that the nursing home is a steady source of income for the hospital and as such can be carried financially by the hospital to a certain extent. Across rural Minnesota, he said, reimbursements are not keeping pace with costs.
Nursing homes have become a source of care for people who really don’t need that level of care, Dill said. Some people without physical limitations need memory care but not nursing home care; others can live independently but would benefit from assisted living services. That’s where Spectrum Health Companies comes in. They provide a wide variety of services based on individual and community needs. They have numerous facilities throughout the eastern third of the state.
Over the last three years, Spectrum has opened three new facilities in the Arrowhead region. “We worked with Ely and Cook to essentially right-size their nursing homes,” Dill said. At the same time, they determined what the communities’ other needs were. The outcome was a 30-unit assisted living/memory care facility and homecare services in Cook and a 40-unit assisted living/memory care facility, homecare services, and senior apartments on the grounds of the hospital in Ely, which is now moving toward becoming a nonprofit.
The newest project is an assisted living facility that just opened in Silver Bay in December, and it is available even for those on financial assistance. “In the case of Silver Bay,” Dill said, “this was about bringing people home.” A difficult transition for many elderly is having to move not only out of their homes but out of their communities as well.
“They’re filling up rapidly,” Dill said of the three new assisted living/memory care facilities. He said that Spectrum approached him about the possibility of assessing the needs in Cook County.
“Right-sizing” the nursing home would have ramifications for some Care Center employees, Dill admitted. Some lowering of staffing levels can be done through attrition as employees retire, move away, or seek employment elsewhere, however.
Losing a lot of money every year is not going to keep jobs, either. “Ultimately you reach a point that can no longer be sustainable,” Dill said. Cook County needs its hospital, he said, and the array of services offered is unparalleled in a community of this size. One thing he heard in Cook County that he hadn’t heard in Silver Bay and Ely is that Cook County has a dearth of housing.
Dill said he is responding to pleas from leaders of this community for help to address these issues. We have a real demographic problem here, he said, with a large percentage of elderly who need “the best service for the least cost.” The hospital board is going through a process of strategic planning this year, and he considers this very forward thinking.
“I just thought it was really important that I came up there,” Dill said. “I thought we just need to do something to help.”
Impressions from a commissioner
Jim Johnson reported to the Cook County News-Herald that the specific statutory requirements for assisted living facilities might preclude converting a wing or wings of the Care Center to assisted living, something that has been considered. At the meeting with Dill, they discussed the possibility of building a new facility on hospital grounds or buying and converting the Masonic Lodge next door.
Spectrum owner interested
“We had a good discussion with the hospital,” Spectrum owner Merle Sampson told the News-Herald. “We had a very cordial meeting up there. … We’re available if they’re interested.”
Sampson pointed out that Ely, Cook, and Silver Bay all sought out his company to fill in the service gaps in their communities. The three new facilities created 100 new jobs that don’t depend on the mining industry, he said. They are not the highest-paying jobs, he said, but people who had moved away for jobs in places such as the Twin Cities are now coming back.
Representative Dill and State Senator Tom Bakk have been very helpful with these projects, Sampson said. While pressure to make funding cuts continues, Spectrum has been creative in holding off on drastic cuts in wages and benefits, he said.
Spectrum Health Companies employees 500 people in Minnesota and serves thousands of citizens. As the proportion of older citizens grows in the U.S., more services will be needed to care for them, but fewer workers will be available to do that. And will the funding be there? Sampson wondered Right now, the U.S. has five workers for every retired person, he said. In ten years, that number will be down to three.
A word from Administrator Wraalstad
“We will continue to analyze all opportunities to allow services to be available for our elderly in Cook County,” Wraalstad told the News- Herald. “How that will look and the role of Cook County North Shore Hospital and Care Center remains to be seen.
“During the next several months, we will be analyzing and creating models of various options involving our entire organization. As legislation is proposed in St. Paul, we will also continue to share the possible impact of that legislation with Representative Dill.”
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