Gallatin Rest Home

In this Chronicle file photo, Marla Davis, a physical therapist at the county-run Gallatin Rest Home, helps Virgil Carl recover from a knee replacement surgery on Thursday, July 12, 2018, in the home’s rehabilitation gym.

The Gallatin County Commission plans to increase its financial commitment to the Gallatin Rest Home for next year and ask voters for a mill levy next spring to address the long-term care center’s ongoing deficit.

“We are just limping along, funding this one year at a time,” said Commissioner Joe Skinner. “I think by next year, we’ll have a longer-term picture. And we realize that to keep the Rest Home going, which we want to do, we need taxpayer support.”

For many years, the Rest Home met its financial needs and built up reserves with the payments it received from residents and insurers, but recent changes to the health care industry have been a challenge, said administrator Vickie West.

The Rest Home has ended each fiscal year since 2013 with a deficit and depleted its reserves. In 2018, the commissioners pledged one mill annually — about $295,000 at the time — to the Rest Home to help address its ongoing deficit.

For next fiscal year, the commissioners anticipate committing an additional 1.56 mills to the Rest Home, bringing their total contribution up to 2.56 mills, which will be about $755,000, said county finance coordinator Justine Swanson.

“We’ve known for a number of years now that this was going to happen,” said Commissioner Don Seifert. “I think in order to deal with the deficit that we’ve got, this is the responsible thing to do.”

Included in the additional money is a pay increase for Rest Home kitchen aides, laundry aides and housekeepers, totaling about $47,000 annually. The increase could improve recruitment and retention and reduce the Rest Home’s reliance on expensive staffing agencies, West said.

The additional money also will be used to hire a consultant next fiscal year for $25,000. The consultant will explore ways to keep the Rest Home open and financially sustainable.

“It’s not good management for us to put off some of the county’s other dire needs for ongoing situations at the Rest Home, so we need to look at other options,” Skinner said.

The other options include asking voters to support the Rest Home through a mill levy.

“We’re putting the public on notice that we’ll be asking for their taxpayer support,” said Commissioner Scott MacFarlane.

In the hopes of reducing its deficit next year, the Rest Home will cut some services and finding less expensive supplies, West said. The Rest Home also may receive additional revenue next year because looming changes to Medicare reimbursement could provide better reimbursement rates. The changes go into effect in October.

It is not yet clear what savings the cuts to operations and the improved reimbursement rates will provide, but they won’t fully remedy the Rest Home’s financial situation, Swanson said.

The Rest Home’s fiscal challenges partially stem from an increase in long-term care options in the county, which has caused the number of residents to decline over the years. The newer long-term care options are more accessible to those paying for their own care or using private insurance providers, West said. This has left the Rest Home with a growing proportion of its residents on Medicaid and Medicare, which doesn’t reimburse for the full cost of care.

“I want to make it clear that we don’t blame anyone, staff or management at the Rest Home, because it couldn’t have been managed differently,” Skinner said. “It’s a situation where reimbursement isn’t adequate.”

Perrin Stein can be reached at 406-582-2648 or at Follow her on Twitter @PerrinStein.

Perrin Stein is the county, state and federal government reporter for the Chronicle.

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