Changes on the way at HLRC

In a last ditch effort to keep the Hi-Line Retirement Center (HLRC) from shutting its doors, the center’s board voted last week to decertify the nursing home and become exclusively an assisted living home.

“We are in the process of retiring our nursing home license and applying for an Assisted Living license,” HLRC Board President Rick Mikkelson said in a letter. “This will be a most difficult transaction for some and will go unnoticed by others in our facility. We ultimately in the next 60 days will need to help find a new home for probably 10 to 20 of our more acute care residents and will need to qualify many others for assisted living.”

Mikkelson said the HLRC Board is saddened by the failure to make the retirement center financially stable but because of the expense of locums (rent-a-nurse), servicing a large debt and low Medicaid reimbursement we have not been able to do so. (Mikkelson’s entire letter can be read on the Phillips County News website under “Hi Line Retirement Center to become an Assisted Living Center.”)

Karl Rude, VP of Operations of Health Management Services out of Billings, Mont., the firm brought to Malta last August to manage the HLRC, said the travel nurses brought to town to assist in the nursing home had become too much of a financial burden for the retirement center, costing $944,000 last year. He said that three weeks ago, when looking at the financial solvency of the HRLC, it was decided the center was no longer able to pay for the expensive travel staff.

Rude said that when he arrived last August, the HLRC Board told him that their mission was to find local nurses to staff the center. He said “every effort we possibly could make” was extended to local nurses, but none came back to work at the Malta center.

“When you look back at what has happened over the last two years, let’s look back to January of 2015, this institution has had a rise from the ashes, Phoenix moment, every four months,” Rude said. “So if they didn’t like leadership number one, and they were going to come back, they would have come back the first time. If they didn’t like leadership number two, when he went away, they would have come back that time . . . at every single time that you had this reincarnation of management, whether it’s new administration or new directors of nursing or new whatever, there was always this hope that we would open the doors one morning and nurses would come rushing in as though it was Black Friday and it just never happened.”

Rude said after he arrived in Malta, his marching orders to the staff at the HLRC was to find local nurses. He said a list of names with the title of “nurse” next to their name was made to find and hire local nurses.

“And we contacted, I can’t even tell you how many people,” he said. “I was satisfied at the end of that little venture to say there are not nurses, they just aren’t there.”

A letter from both Rude and Donna Handley, HLRC Assistant Administrator, explained how the HLRC will proceed to decertify and become only an assisted living facility under Categories A, B and C.

“This licensure, when received, will allow us to evaluate our current residents to see if they are appropriate to receive care in the newly licensed facility,” the letter states. “During this evaluation we will ensure that residents have the appropriate level of care for their needs.”

(The entire letter penned by Rude and Handley can be read on the Phillips County News website under “Assistant Administrator at HLRC Letter”.)

Rude said that with the change to an assisted living center will come with a reduction in staff. Currently there are about 43 employees – in one capacity or another at the center – and that number will be down in the neighborhood of 30 employees.

“The majority of that shift of going down is getting rid of LPN and RN staffing that will no longer be required,” he said.

One complaint that Rude said he often hears is getting rid of nurses is bad for resident care.

“The truth of the matter is of my 43 residents on the skilled nursing side, it is not every one of them and it is not the vast majority of them that need complex medical care,” Rude said. “Most of them simply need help with activities in daily living. And once we have those new expanded licensures, B and C, we should be able to meet those needs.”

Last year, the community of Phillips County helped raise nearly $500,000 to assist HLRC during it’s time of financial straits. Rude said last August that the money donated to the HLRC was spent on operations, to pay employees and “stop the bleeding.”

As Mikkelson stated in his letter, somewhere between 10 and 20 residents will be forced out of the HLRC in the next 60 days, dropping the residents from 62 down to 40. Rude said with the change, HLRC will no longer be able to keep residents with a great complexity of care.

“The ability to offshoot the expensive nurses that I can’t afford verses the number of people we think we won’t be able to service their needs for, should have a net-positive effect on the outcome of the institution,” he said, “provided people still want to stay with us and they don’t leave for whatever their opinions or reasons are, we should be able to be very stable.”

Rude said the full-care retirement homes close to Phillips County are in Chinook, Glasgow, Havre and Lewistown. He said he doesn’t expect that those facilities will be able to take all of the residents who will have to leave the HLRC and he will have to look across the state to find them new places to live.

Rude added that though he is not happy with the changes to be made at the HLRC, he said he’d rather look forward to what can be gained with change rather than what will be lost.

“What we were going to lose three weeks ago was everything,” he said, adding that the HLRC’s problems have been ongoing for the past five years and to not make a change would be to continue to “kick the can down the road.”

“The community rallying together and our appreciation of their rallying together last year to raise nearly a half million dollars is outstanding,” he said. “There have been many people that have sat in the position to make whatever the difficult decision would be to make and it is this week that the board has decided, together, to make that difficult decision. . . It has been coming for a long time.”