The Canyonlands Care Center and its governing body are in a very different financial place than they were just two years ago.
As visitation to Moab continues to soar, revenues from a year-old, voter-approved health care sales tax are exceeding projections, easing concerns about the reliability of future mineral lease revenues from oil and gas development that also help support care center operations.
“I think that we can be fairly optimistic that the sales tax will continue to come in, in increasing levels, with the amount of visitation that’s happening in our community,” Canyonlands Health Care Special Service District (CHCSSD) board chair Kirstin Peterson said during the board’s May 24 meeting. “So that’s a positive compared to the complete unknown about mineral lease money.”
Altogether, the district’s share of revenues from the sales tax totaled $1,166,620 from April to December 2017; another one-third of revenues from the tax are now going to Grand County Emergency Medical Services (EMS). In comparison, year-to-date revenues from mineral leases in Grand County totaled $88,897, according to CHCSSD board treasurer Ken Ballantyne.
The district’s annual share of mineral lease revenues once topped $1 million, helping the care center stay afloat as administrators worked to improve its long-term financial viability. But after global oil prices tanked in late 2014, those revenues plunged sharply, leading district officials to push for the new revenue source.
The one-half of 1 percent health care sales tax, which county voters approved in November 2016 and then took effect in April 2017, brings in an additional penny for every $2 — or 50 cents for every $100 — that residents and visitors spend on goods and services, excluding gasoline and groceries used in food preparation.
AFTER SLOW START TO 2018, PACE PICKS UP
According to Canyonlands Care Center Business Manager Tom Lacy, the care center reported $826,882 in revenue from January to April 2018, below the previously budgeted amount of $900,822.
It ended the first four months of the year with an operating loss of more than $411,000, when administrators had budgeted for a loss of $368,665. The main reason for that loss, Lacy said, is that the number of residents at the 36-bed facility was down at the start of the year; the center also had to catch up on its Medicaid collections.
As of late May, however, the current census was up to 34 residents — down one resident from the previous week — and inquiries for prospective residents continue to come in, according to Canyonlands Care CenterAdministrator Kim Macfarlane.
“Now (the census of residents) is back up, and our collections are catching up from the problems that we were having with Medicaid, so we’re expecting that (within) another two or three months, we should be back up to the budgeted amount (contingent upon the census numbers),” Lacy said.
In April, the care center’s revenues were still behind budget, by about $15,505, but at the same time, its expenses were below budget by an even larger number. While administrators had expected a more significant loss of $73,801, the actual operating loss in April was $56,939 — the first month this year that actual results have been better than budgeted expectations, Lacy said.
Operating losses aside, 2018 marked the first year in its history that the care Center has earned a five-star rating from Medicare’s Nursing Home Compare website, and Macfarlane anticipates that it will hold on to that rating for “quite a long time.”
Weekly audits continue to show that residents are happy with the level of care they receive at the care center, Macfarlane said, and she’s also heard positive feedback about the facility in the community.
“I think word of mouth is good out there, which is very important,” she said.
Administrators are getting ready to welcome two new certified nursing assistants (CNAs) to the facility, although the care center is currently down by three employees, and Peterson said the center is still dealing with a number of staffing-related challenges.
“Particularly in regards to wages and keeping people with how difficult it is in this town — there’s just not enough people to fill all of the jobs, and so there’s better options with less responsibility out there,” she said.
At some point in the near future, Peterson said she hopes the district’s board will consider a proposal to address the issue of employee retention and recruitment.
“This is something that to some extent, seems to be seasonal,” Peterson said. “There (are) times of the year where this is a more pressing matter, but the way that things are going here, it’s only — I think, each year, it’s going to get worse.”
Macfarlane noted that Moab Regional Hospital recently raised its rates for its CNAs, but the care center has yet to follow suit.
“So we’re not keeping pace with them,” she said.
The care center has also worked to recruit nurses, Macfarlane said, but the online advertising it paid for was expensive — and didn’t yield any results, she said.
“We did get two nurses that came and applied, but none of them from that source,” she said.
EMS MAY LOOK ELSEWHERE FOR NEW FACILITY
CHCSSD board member Elizabeth Tubbs hailed the recent formation of an EMS special service district, although she noted that it will take much more work to build a new EMS facility.
“It’s great to have that established,” she said. “I was very much in favor of it, but it doesn’t in the least bit address the need for a home for EMS — a building.”
EMS officials estimated earlier this year that it could cost more than $7 million to replace the current facility off 100 North — up from initial estimates of $4 million to $5 million. However, that number didn’t include additional costs for roads and infrastructure.
“The building cost is really, really a lot,” Tubbs said.
The new facility would consolidate EMS operations that are currently scattered across three aging structures. In addition to an ambulance bay and housing for personnel, it would provide space for community CPR classes, EMS training and administrative facilities for the next 50 to 70 years.
Peterson said that district and EMS officials might have to look beyond the previously considered option to build a new facility on the east side of the CHCSSD-owned property near the hospital, given the high costs to develop that land.
“That’s probably looking way outside of their cost range because of the improvements that would be needed at that intersection and just what the city would need to happen,” she said. “So if they decide (they) still want to work with us, we’re looking probably back toward the original piece, which the hospital had expressed interest (in) … they would rather have that piece because it’s closer to the hospital, but it’s probably a lot cheaper to develop.”
Another option could be the former senior center site at the eastern end of 100 North.
EMS officials are planning to submit a funding application to Utah’s Permanent Community Impact Fund Board (CIB), and they still need to work out wrinkles in their search for other funding sources, she said.
“I think it’s like, all options are on the table,” Peterson said. “The funding — and how to secure that funding — is really the big question.”
Census numbers are up, but staffing challenges remain
I think that we can be fairly optimistic that the sales tax will continue to come in, in increasing levels, with the amount of visitation that’s happening in our community.