voltaren gel chondromalacia minocin stomaco pieno saw palmetto กับ finasteride micardis ace inibitore voltaren tabletten liquid allegra 180 genérico voltaren hydrocodone tegretol effetti collaterali impotenza principio ativo zoloft differin gel scheda tecnica levitra 20 mg costo in farmacia decadron 0 5 mg prezzo triamcinolone acetonide chigger bites risperdal epocrates interruzione allattamento al seno dostinex alimenti con terapia coumadin levitra risposta orlistat de laboratorio chile viagra somministrato a donne albenza alcohol doctissimo viagra internet benzac 5 come si usa generic zyrtec d costco piantina isola di cipro domperidona motilium suspension seroquel bei unipolarer depression spierx viagra cipro sore gums danni da risperdal farmacia cytotec lima augmentin serve la ricetta nizoral rogaine combo il viagra te lo allunga si può prendere il sole con l'antibiotico augmentin naprosyn effetti collaterali prograf iv to po conversion xeloda fa cadere i capelli prednisone grossesse viagra levitra cialis preisvergleich allegra istrati diflucan contraccettivi orali taverna allegra cos e pazz licola effetti collaterali voltaren 50 mg medicament risperdal 4mg testimonianze sul viagra voltaren vs aspirin come prescrivere il cialis voltaren dose per day manfaat voltaren cream trazodone incontinence generico del zovirax cosa sapere su cipro augmentin bambini 3 anni formula chimica del viagra escitalopram 20 mgs voltaren iniezioni bugiardino cipro presidenza ue quinto ciclo clomid medicamento orlistat bula temperatura cipro maggio testimonianze su propecia colchicine division cellulaire posologia del cialis propranolol vademecum unam prevenir varicela con aciclovir voltaren drug abuse proscar diviso in 5 dopo quanti giorni si ovula con clomid triamcinolone acetonide corticosteroid finasteride 1 mg generico betamethasone prednisolone conversion voltaren muscoril igne orapred to prednisone conversion risperdal fatigue-t-il propranolol angststoornis tegretol cr valor voltaren injetável bula pdf neurontin graviditet si puo sospendere il seroquel viagra generico colombia precio aprire una ltd a cipro pfizer depo provera perpetual calendar diovan triplo principio ativo cipro nord villaggio escitalopram cessation levitra orodispersibile prezzi offerte cipro luglio 2012 tomei allegra cipro constitution in quanto tempo agisce lo zoloft lasix soluzione orale cipro 500 posologia voltaren xr ingredients arret brutal risperdal sigarette elettroniche roma cipro finasteride quando i primi risultati zantac è un gastroprotettore spiagge a paphos cipro minocin quanto costa cipro codice stato acquistare cialis online in contrassegno tretinoin gel perrigo arcoxia 120 principio attivo provera ilaç nedir tronchetti provera e calciopoli cipro mappamondo traghetti cipro pireo posologia voltaren 75 mg aborto con cytotec duele dosaggio lasix per dimagrire viagra e cialis prezzo viagra a domicilio capital federal triamcinolone acetonide pregnancy allegra combriccola facebook cialis generico farmacia roma dove acquistare viagra masticabile singulair medicamento generico viagra de vanzare cluj ketoconazole (nizoral) itraconazole (sporanox) fluconazole (diflucan) farmacocinetica e farmacodinamica do propranolol a quoi sert dulcolax farmaci equivalenti viagra chevita ampicillin-t pletal 100 è mutuabile coumadin interazioni propoli cardizem sulfa allergy codeine voltaren posso dare il bactrim al cane cipro temperature invernali cialis daglig motilium sonolencia effetti del viagra sulla pressione arteriosa farmaci equivalenti al coumadin crestor impotenz ristorante giapponese a cipro pantozol voltaren resinat voltaren gel discounts viagra receta farmacia levitra impotenza bula medicamento propranolol 40mg trazodone ativan combination eurovision song contest 2012 cipro risperdal consta ppt indirizzo fermata metro cipro roma levitra 10 mg acquisto on line voltaren 100 czopki porti dell'isola di cipro viagra generico dosagem come acquistare levitra generico temperatura a cipro in marzo augmentin si prende a stomaco pieno farmaco generico del voltaren propranolol unam scintigraphie cardiaque dipyridamole atorvastatina e crestor dimagrire dopo zoloft viagra farmacia 2013 provera stanja racuna banca intesa colonna di san paolo a cipro limassol cipro mare voltaren muscoril bentelan xenical generico brasil laboratorio medicamento nexium orari ufficio postale brescia via cipro clindamycin clotrimazole dosage ora esatta a cipro quanto tempo dura il viagra cataflam diclofenaco dietilamonio euro commemorativi cipro durata effetto cialis 5 mg rocaltrol medicine nizoral scalp fluid quanto costa bactrim stafilococco epidermidis allegra lucci thuoc chloramphenicol sodium succinate sardegna cipro seroquel costi istruzioni augmentin bambini capo di stato di cipro psicofarmaco zoloft voveran price in india ristoranti zona cipro viagra per disfunzione erettile prescrizione del viagra 50 mg interazione clopidogrel e pantoprazole cipro vita in uk ciprofloxacin otologico voltaren y coca cola cialis dosi consigliate risperdal annostus derive du cialis augmentin tempo di azione prednisone alopecia barbae bactrim clostridium difficile colitis quando non funziona cialis voltaren iniezioni posologia uti cipro emedicine mcneil motilium domperidone lamictal effetti collaterali gravidanza can voltaren cause tinnitus il cialis generico si vende in farmacia passare da cipro sud a cipro nord vermox 500 bambini trazodone in pediatrics cibo con effetto viagra diovan 160 mg price in india viagra generico cipla topamax e pillola anticoncezionale avapro approval clomid nello sport clomid ovulazione tardiva il methotrexate e un chemioterapico motilium loperamide brevetto viagra quando scade effet secondaire prednisone campionato basket cipro levitra spedizione rapida voltaren diclofenaco sodico medicament apo clonidine vasco canzone allegra augmentin bambini per otite risperdal crise d'angoisse medicamento generico del nexium singulair infantil posologia voli da palermo a cipro abilify nei bambini controindicazioni dello xenical a cosa serve clomid remeron pastiglie propranolol cyp450 cosa succede se mi prendo il viagra cosa contiene il clomid diflucan soluzione iniettabile lariam profilassi antimalarica natural alternative dilantin effetti collaterali del farmaco levitra interazioni farmacologiche del coumadin ristorante cinese cipro augmentin ghiandola di bartolini blutergüsse voltaren conversion rosuvastatin atorvastatin aciclovir compresse opinioni equivalente viagra in farmacia spotting depo provera pregnancy come finisce questa allegra gioventù risperdal consta lp 37.5 mg voltaren and sotalol dulcolax medicine constipation cipro temperature annuali viagra costo mexico efficacy voltaren gel ovuli di cleocin in gravidanza mezza pasticca di lasix augmentin compresse foglietto illustrativo voltaren riesgos viagra farmacie cluj generico do atrovent danazol sigma aldrich bactrim esposizione al sole ventolin hfa sulfites cipro 0.2 controindicazioni augmentin in gravidanza procardia and zocor viagra naturale controindicazioni olanzapine cims seroquel rilascio prolungato 200 mg viagra in blumen viagra generico pagamento paypal geografia fisica di cipro ciclo scarso con clomid musica country molto allegra cialis 5 mg dove comprarlo strattera macht aggressiv costo del viagra colombia elavil cortisol temperature meteo cipro voltaren e prostatite augmentin ed allattamento voltaren diclofenaco potássico augmentin sospensione orale adulti escitalopram agomelatine combination voltaren gel ammar levitra tempi di reazione aleve vs voltaren ventolin ciclistas rita allegra messina seroquel farmaco indicazioni augmentin per ascesso perianale chloramphenicol palmitate polymorphs voltaren gel patient assistance program strattera opiumwet voltaren gel iontophoresis cialis al femminile voltaren sr 75 10 tablet albiera allegra alessia propranolol hcl ta 10mg cipro colirio preco escitalopram nootropic prednisone medicare part d ventolin vendita online bactrim durante allattamento provera tem generico metoclopramide diverticulitis colonoscopy prep dulcolax magnesium citrate terapia con il voltaren mopral motilium parche viagra femenino voltaren gel indicazioni terapeutiche cos'è il female viagra depo provera severe depression triamcinolone acetonide 0.05 levitra originale 5 mg prezzo spiaggia grecian cipro detrol anticholinergic adalat gonfiore caviglie allegra passugger mineralquellen ag carlsberg allegra pelissero provera racuna na 063 voltaren cream prescription trazodone no prescription tempo di azione cialis dose augmentin bambino 7 kg dove posso acquistare il levitra finasteride serve la ricetta voltaren intramuscular infarmed voltaren gel vid graviditet cimone a cipro clomid altera la temperatura basale assunzione diflucan 150 procardia gel voltaren tabletti ilman reseptiä plavix rimborsabilità cipro meteo annuale escitalopram fda pregnancy category eruzioni cutanee da cialis avapro to diovan conversion dermatite causata da augmentin voltaren 100 rp clomid e fecondazione abilify und risperdal picosulfato sodico dulcolax viagra venduto in italia finasteride generico 5mg compare metformin gliclazide cipro antibiotic salmonella voltaren for ibs casodex 150 mg effetti collaterali glucophage 1000 mg effetti indesiderati viagra po terminie escitalopram hypotension elavil phentermine come usare al meglio benzac tagliare il cialis eparina coumadin differenze risperdal 1 mg schmelztabletten cipro e russia per comprare il ventolin ci vuole la ricetta la storia del cipro astrazeneca shionogi crestor minocin quando prenderlo pinworm albendazole dosage topamax dosaggio bambini dopo quanti mesi di clomid siete rimaste incinta viagra senza ricetta pagamento contrassegno mappa dettagliata cipro ta två voltaren flessioni viagra antidepresivi escitalopram allegra d preco droga raia effetti collaterali con viagra secondo figlio con clomid sandoz rosuvastatin vs crestor triamcinolone acetonide lotion 0.025 finanza allegra doxazosin foglietto illustrativo voltaren retard 25 mg plavix somministrazione situazione economica di cipro impotent trotz viagra effetti collaterali di prometrium succinato de metoprolol 100mg plavix 75 dosaggio voltaren gel coupon card cause crisi bancaria cipro adalat farmacocinetica y farmacodinamia posologie diflucan 200 differenza tra cialis 5 mg e 10 mg meclizine in rabbits frigideira inox allegra clomid e anticipo ovulazione metolazone to lasix conversion farmacia cipro viale degli ammiragli passaggio da coumadin a cardioaspirina entocort prednisolone conversion viagra levitra sau cialis prometrium 200 e ritardo ciclo bari cipro traghetti cipralex escitalopram nedir seroquel tavor meglio parlodel o dostinex il cialis ha una scadenza triamcinolone scalp lotion risperdal meccanismo d'azione temperature medie cipro maggio glucophage mercola co diovan preis dicloreum fiale o voltaren contre indication viagra ditropan dizziness nizoral crema principio attivo augmentin antibiotico vie urinarie allegra donadio calendario generika von risperdal viagra naturel aliment cialis generico da inghilterra allegra d é antibiotico viagra naturale per le donne bactrim sciroppo bambini combivent mdi price differenza tra voltaren e artrosilene allegra da tramontina diflucan 150 compresse prezzo cipro xr generico cosa non si può mangiare se si assume il coumadin organizzare un viaggio a cipro allegra villa verucchio voli firenze cipro voltaren masc cena minoxidil contre propecia a che cosa serve il viagra po ile viagra w egipcie lisinopril tiene diuretico flovent ventolin effet secondaire sertidel diltiazem uso continuo de viagra differin gel 0.3 anti aging cialis generico 5mg costo équivalent solian risperdal allegra d generico nome cipro isola dove si trova triamcinolone acetonide cream on scabies canzone allegra led zeppelin norvasc compresse 10 mg prezzo xenical posologie voltaren dolo capsulas il viagra quanto dura naltrexone dermatomyositis dostinex fa male in gravidanza registro ms tegretol cr 400 procardia pill identification pillola yasminelle e antimicotico sporanox antibiotico augmentin duo allegra suspensao posologia viagra cialis levitra italia dostinex dopo quanto fa effetto depo provera coding 2013 strattera pt assistance uczulenie na voltaren levonorgestrel e acetato de ciproterona si puo dividere il cialis c difficile doxycycline compazine infusion il diflucan funziona cipro alternative for prostatitis prezzo viagra originale pfizer augmentin influenteaza menstruatia prometrium dopo iui come sospendere anafranil acquistare viagra torino allegra 180 comprimidos zantac bebe efficace tenormin e pressione bassa diclofenac si misoprostol dolobene gel vs voltaren meclizine hcl 25 mg/ antivert can escitalopram cause missed period viagra naturale dove trovarlo voltaren luminari viagra vitamin e propecia per ricrescita capelli cardizem unotard 180 mg triamcinolone 2mg propranolol sinusitis scandalo viagra olimpiadi medicamento orlistat 60mg prezzo benzac gel 10 clomid follicoli piccoli que es strattera 18 mg capote au viagra cipro in settembre porphyrie voltaren allegra d prednisone voltaren e stomaco concerta ritalin strattera effetti indesiderati dello zyprexa cipro piatto tipico zoloft 50 mg e allattamento oral diflucan for tinea versicolor propranolol doccheck voltaren retard 50 mg
Share this page on facebook
Nursing home’s future hinges on $10 million plan PDF Print E-mail
Feature
Written by BILL SCHANEN IV   
Wednesday, 28 May 2014 18:53

Renovations seen as key to improving care, keeping Lasata Care Center financially viable head to County Board

    That which once divided the Ozaukee County Board — a plan to invest $10 million in the Lasata Senior Living Campus — now has significant support heading into a series of votes that could determine the fate of the county’s 28-year-old nursing home.

    The board is scheduled to vote next week on a proposal to borrow $10.3 million to renovate Lasata Care Center in Cedarburg to create a smaller, efficient nursing home that provides more comfortable and dignified care for the county’s oldest residents.

    But what makes the plan politically viable is its financial ramifications.

    Without the renovations, the nursing home will bleed cash at the rate of $717,000 a year, sapping revenues generated by the other components of the campus — the Lasata Heights apartments and Lasata Crossings assisted-living facility — and saddling the county with an annual deficit, according to an analysis by Horty Elving, a Minneapolis-based architectural and engineering firm hired by the county.

    With the renovations, however, the nursing home’s losses will be held to about $286,000 a year. That deficit will be negated by the $657,000 in annual revenue generated by the Heights and Crossings, leaving the senior-living campus with an annual average profit of $371,000, according to Horty Elving.



    “Going ahead with the renovations just makes good financial sense,” said Supr. Rob Brooks of Saukville, chairman of the Health and Human Services Committee, which oversees the Lasata campus.

    Doing nothing to improve the nursing home, he said, isn’t a viable option.

    “We’re not going to build a new facility and there’s no public support or political will to sell the facility, but if the renovations aren’t approved, we’ll get to a point where the nursing home will be hemorrhaging money and we’ll be forced to sell it. There’s no ifs, ands or buts about it,” Brooks said.

    “I suppose that could be a good or bad thing depending on your view, but I think it would be great to improve the quality of life for nursing home residents with the renovations and be able to continue this service at no cost to county taxpayers.”

    Lasata Campus Administrator Ralph Luedtke noted that even if the county does not approve borrowing $10 million for the renovations, basic infrastructure improvements included in the borrowing plan will need to be made at a cost of more than $1 million a year for several years.

    “Our nursing home will be 50 years old,” Luedtke said. “If the board decides not to make the renovations, we still have boilers and plumbing fixtures and ventilation and electrical systems that will be 50 years old and need to be upgraded.”

    Supervisors, who were briefed on the proposed renovations and toured the nursing home last week, will be asked next week to support the plan, which has the unanimous backing of the Health and Human Services Committee.

    But the true test is expected in July or August. That is when the board will vote on whether to borrow $10.4 million for the renovations. Support from three-quarters of the supervisors on the board — 20 of its 26 members — is needed to pass bonding resolutions.

    If the board authorizes bonding for $10 million, the county plans to borrow about $3.5 million this year and the remaining $6.9 million next year.

    If the proposal clears those hurdles without delays, the project would likely begin early next year and be completed in April 2016, Luedtke said.

    “I think we’ve addressed the concerns that supervisors had and now have very strong support for moving ahead with this,” Brooks said.

    That wasn’t always the case. After more than a year of planning, the Health and Human Services Committee proposed last year building a $3 million, 24-room community-based residential facility (CBRF) adjacent to the nursing home that would specialize in care for the frail elderly and people with dementia, as well as spending $7 million on nursing home renovations.

    That plan was headed toward a County Board vote when several supervisors led by Brooks, who was not a member of the committee at the time, put the brakes on it. Brooks advocated for a more thorough vetting of the plan, arguing that if the CBRF cost more than $3 million to build, it would hamper efforts to renovate the nursing home, putting the future of the facility at risk.

    Earlier this year, a report from Horty Elving revealed that the $3 million CBRF envisioned by the Health and Human Services Committee would cost at least $5.7 million to build. The committee immediately dropped its plans for the new facility and backed a proposal to spend $7.2 million on nursing home renovations.

    Most recently, the cost of the project was increased to $10.4 million so more resident rooms could be renovated.

    About $1.2 million would be spent on infrastructure improvements needed to keep the building operational. This work, which would include replacing vital systems such as heating units, can be done much more efficiently during a major renovation rather than piecemeal over the next several years, Luedtke said.

    The rest of the project would focus on interior renovations that would provide safer, more dignified living conditions for residents and better working conditions for employees in what officials refer to as a “right-sized” nursing home.

    “Lasata Care Center residents deserve a better facility,” Luedtke said. “They deserve a more dignified facility. They deserve a safer facility.”

    The number of beds would be reduced from 162 to 134 to accommodate larger private rooms with more spacious bathrooms, updated bathing rooms, new service kitchenettes and renovated nursing stations and resident day rooms.

    The number of residents would be reduced through attrition, Luedtke said.

    “We’re not going to kick anyone out of our nursing home,” he said.

    Other improvements would include the creation of specialized rooms for larger residents, front lobby renovations and improvements to the therapy facilities.

    The 134-bed facility would maximize efficiencies, Luedtke said, requiring the equivalent of 35 fewer full-time employees to operate and resulting in lower energy costs.

    The financial projections associated with the renovations are based on essentially maintaining a mix of residents in keeping with the Lasata’s mission of providing affordable care. Currently, about 70% of Lasata Care Center residents rely on Medicaid or Family Care to pay for their care. Because the renovations will result in more single-occupancy rooms, however, officials expect that percentage to decrease to about 64%.

    That percentage is critical to the bottom line of the nursing home because Medicaid and Family Care do not cover the full cost of care. For instance, the nursing home realizes $45,000 more in annual revenue for every resident who can afford to pay for care — so-called private-pay residents — and $100,000 more a year for every resident who uses Medicare to pay for short-term, rehabilitative stays at the nursing home, according to Horty Elving.

    “Our projections are very, very conservative,” Brooks said. “If we get just a couple more private-pay residents and one or two more rehab patients, the nursing home could actually operate in the black.

    “We’re in a unique situation. I think we’re probably the envy of other counties with nursing homes because we’re going to be able to operate our campus at a significant profit. That gives us a very strong case to present to the board.”


Comments (0)Add Comment

Write comment
You must be logged in to post a comment. Please register if you do not have an account yet.

busy