Nursing home spots a limited commodity

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Press Photo by Beth Wischmeyer Residents of St. Benedict’s Nursing Home in Dickinson Francis Mayer, foreground, Jean Doerr, left, and Vaughn Doerr play bingo at St. Benedict’s, Friday, Dec. 11.

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Though North Dakota law only allows skilled nursing facilities to care for 6,500 residents statewide, there isn’t a demand to increase the number, a state official said.

Dickinson has the second highest number of nursing home “beds” in the state with 72 per thousand of elderly. Jamestown is number one with about 77 beds per thousand.

While homes cannot add beds, agencies can buy and sell bed licenses from other facilities, said Shelly Peterson, North Dakota Long Term Care Association president.

Some have sold for as much as $22,000 but demand is low now and they have been selling for about half that price or less, she said.

The limits came about because the state believed there was an overabundance of nursing home beds compared to the state’s elderly population. A law was put in place in 1995 restricting the number, Peterson said.

“At that time, we were probably 89 beds per thousand elderly in North Dakota,” she said, adding lawmakers set a goal of having 60 per thousand by 1996.

The average is 65.3 beds per thousand elderly now and the state got rid of about 800, she said.

She said too many beds can be “really expensive for our budget as a state.”

“About 55 percent of people in nursing facilities are on Medicaid and Medicaid is a government program,” Peterson said, adding that in the last legislative session $54 million more was needed over the 2007-09 biennium.

The steady influx of older adults has created more and more needs for senior services in Dickinson, said Jon Frantsvog, administrator and chief executive officer for St. Benedict’s Health Center in Dickinson.

“In my 11 years here at St. Benedict’s, our total bed count has gone down just a little bit...,” Frantsvog said.

St. Benedict’s has about 164 skilled nursing beds, he added. Residents’ average stay is about two to three months.

Frantsvog believes there will always be a demand for skilled nursing beds, and said the agency sold about eight beds around 2000.

Since it was implemented in 1995, the moratorium has been renewed each legislative session, with the most recent renewal extending it until 2011, when it will be studied again, Peterson said.

Rep. Duane DeKrey of Pettibone was the only one to oppose the most recent extension.

DeKrey said the state is seeing hometown nursing homes with financial problems.

“What’s happening is that all these beds are heading to the major cities in North Dakota,” DeKrey said. “I just don’t see where that is a good thing for the state or certainly for the rural people, when they get placed in a nursing home that they have to move so far away from home.”

North Dakota has an aging population, he added.

“I just don’t see where the number of beds right now — even though some places may have trouble filling them — I don’t see where it’s a good thing to be taking the elderly out of their home community and moving them into the major cities,” he said. “I saw that as just a further effort to speed up the exodus from rural areas into the cities of North Dakota.”

Frantsvog said older adults from surrounding communities move to Dickinson to be closer to health care.

Lately, beds have been purchased for Bismarck, Fargo and Grand Forks.

“Literally, those are the only three areas of the state where there has been a substantial increase in demand,” Peterson said. “Right now, I know there have been a few facilities that are interested in selling beds but there has been very, very little demand.”

The moratorium hasn’t been a problem for the Hill Top Home of Comfort in Killdeer, said administrator Greg Armitage.

“Hill Top was originally built with 40 skilled (nursing beds), and 24 basic-care back in 1988,” he said. “In 1998, we decertified beds because the market dried up.”

In 2000, it dropped to a 50-bed facility and Hill Top did not sell the beds, Armitage said.

“Unfortunately, at the time there was no market for them and no one wanted them,” he said. “The state wasn’t banking them, so we just decertified.”

Most demand right now is for basic-care beds.

“That’s not a skilled-nursing facility,” Peterson said. “There’s a moratorium on those, too.”

If an area feels it requires more basic-care beds and can prove that there is a need and other basic-care providers are at least 90 percent occupied, then an application can be filed with the state for more beds.

Trends are leaning toward older people staying at home longer, Peterson said.

“They are coming in sicker, but they are staying there for shorter lengths of time,” Peterson said.

A certain amount of beds can be “in limbo” or not used and licensed. Peterson said a facility can hold these beds for four years, but after that time, if they are not in use and licensed, they are lost by the facility forever.

“It happens rarely,” Peterson said.

There are about 83 nursing homes in the state, which represents 6,248 beds. Peterson estimates there are about 200 additional beds sitting “in limbo.”

— Jennifer McBride contributed to this story.

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