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Nursing home’s fate in balance

Original source:

The San Mateo Daily Journal
Michelle Durand Daily Journal Staff
February 14, 2012

Conclusions about the structural and financial soundness of Burlingame Long Term Care, the county-run nursing facility recommended for closure in July 2013, might well be wrong — according to one of the two brothers who own the building.

Mario Muzzi said he and brother Vincent aren’t trying to sway the Board of Supervisors one way or the other about the proposal. Their dog in this fight isn’t that one. Instead, Mario Muzzi said he simply wants the board to be fully informed rather than rely solely on a report that makes the facility seem bound for physical and financial ruin if the county renews its contract.

“There is a lot of incorrect information and we’ve clarified as much as we can. Even if the county decides not to stay for financial reasons, which is their prerogative, we did not want it to be based on wrong information,” Mario Muzzi said.

In a 12-page letter to the board delivered last week, the Muzzis pick apart the Dec. 20, 2011 report by consultant Lawrence Funk who the county hired to assess the center’s future. The Muzzis say Funk never interviewed nor consulted them for his evaluation. Mario Muzzi also plans to attend the Board of Supervisors meeting this morning to deliver the same message and answer any questions.

For 11 years, the Muzzis have owned the Trousdale Drive building as part of 1100 Trousdale, LLC, and California Trousdale, LLC.

San Mateo County took over the 281-bed nursing facility in 2003 at the request of the Department of Health Services which put the facility into receivership because the operator faced bankruptcy. The county stepped in rather than risk patients being shipped as far away as Oregon. At the time, officials originally projected generating $1 million annually after bailing out the facility with millions in loans. That never happened and now they say the county will lose $9 million by renewing the lease. The Health System also points to a July 2011 civil grand jury recommendation the county cut ties with the facility which sparked Funk’s hiring.

Muzzi said he isn’t worried about his and his brother’s own livelihood if the board follows through on the closure recommendation although finding a new tenant is far from a cakewalk. Instead, he’s concerned about a decision made on poor information, long-term residents being uprooted and the county-run facility being replaced with a private provider that may not house the number of needy Medi-Cal patients that current live in Burlingame Long Term Care.

For instance, Muzzi said that the building was completed in 1970 rather than 1963, as Funk wrote, and that it is in full compliance with the Americans with Disabilities Act provisions for existing facilities.

Muzzi may very well be right but the bottom line in choosing whether to renew is the “very expensive” lease price, said Supervisor Carole Groom.

Funk estimated the lease will increase by 34 percent from now to 2017-18 but Muzzi said this is wrong because rents are based on Medi-Cal reimbursements which are expected to be flat.

Groom called estimates of reimbursement rates “probably premature” because some changes are based on the success of the governor’s November tax initiative.

Muzzi also dissects a laundry list of $1.63 million in potential capital improvement, maintenance and repair costs, concluding that many are unnecessary or don’t fall under the county’s responsibility.

Adrienne Tissier, president of the Board of Supervisors, said it’s hard to know whose assessment is right or wrong but just knowing the facility’s age makes her believe upkeep will get more expensive over time.

“It doesn’t mean it’s not a good building but if the opportunity arises to use something more modern we might as well take it,” she said.

Groom also said the only two knowns right now are that the building is old and that the county has the ground floor of its hospital available for use.

At the last board meeting in which the supervisors took aim at the overall budget, throngs of residents, staff and family members asked for reconsideration of the closure plan. Through frequent tears and choked voices, they told the board of close relationships and having nowhere else to go.

California Advocates for Nursing Home Reform and local ombudspeople urged the county to increase occupancy to the full 281 from its current 230 residents to add more funding. Some said the facility was acceptable and pleaded not be moved. Some were resigned to a new facility but asked that it be a unit at the San Mateo Medical Center rather than nursing homes out of the area or even out of the state.

The current proposal calls for reopening hospital wing Unit 1B with an extra 32 beds but Health System Director Jean Frasier has said she wants to keep those available for short-term patients coming from the hospital rather than the long-term residents of Burlingame Long Term Care.

Many of the speakers at the last meeting asked the board to approve opening the entire 96-bed wing and Groom said some of her questions today will be specifically about that possibility and also the number of other facilities available countywide.

“How many are long-term care? How many are assisted living? How many are places purely for dementia?” she asked. “I”d like an inventory then have more time to make that decision.”

Groom prefers not to place anyone outside of San Mateo County although she concedes it may be an unrealistic goal.

The long lead time between the vote and lease expiration next year makes it more likely residents won’t need moving very far and the Health System will try placing them as close as possible to where they want to live, said Health System spokeswoman Robyn Thaw.

Although she wants information on the hospital wing’s capacity, Groom does not believe a vote will be taken Tuesday on just how many beds will be made available. Tissier also said the two discussions will be separate.

“I understand how traumatic this is for residents and for family members. I really want to be sensitive to that and make sure I understand the plan clearly before making a decision,” Groom said.

Aside from patients, the closure will likely also lead to staff layoffs. The facility has 200 filled staff positions and there are current vacancies in the Health System for some but not all.

The Health System can’t make any moves toward placing the residents or staff until after the board’s vote but Thaw said a transition team is in place and ready to go as soon as a decision is made. If the board favors letting the lease expire, the next step is state approval of a transition plan and assessing each resident to identity the best placement, Thaw said.

The county is also looking at approximately $9 million in one-time transition costs, including severance and moving expenses, if the board does not extend the lease. The hospital’s cost per adjusted patient day cost will also increase from $900 to $920.

Note: The Board of Supervisors is not meeting in its usual location to accommodate the large crowd expected for this agenda item. The Board of Supervisors meets 9 a.m. Tuesday, Feb. 14 at the Westin San Francisco Airport Hotel, 1 Old Bayshore Highway, Millbrae. Parking for attendees is free. Take a ticket at the kiosk and exchange it for a validated ticket from staff inside the meeting.

Michelle Durand can be reached by email: or by phone: (650) 344-5200 ext. 102.