Total resident census was lower than budgeted due to increased competition and options for senior citizens, and residents staying for shorter periods of time than they once did. Due to State and Federal cut backs Lasata did not reach budgeted Medicaid revenue amounts. Private Pay census was lower than budgeted and these revenues were down as well. All these factors resulted in Room and Board Revenues being $236,000 below budget.

Lasata’s daily Medicaid rate is now $60 per day below estimated costs resulting in $2 million of losses incurred by caring for Medicaid residents. The federal Intergovernmental Transfer Program (IGT) did provide nearly $1.4 million in funding to cover these losses but this was $266,000 lower than budgeted. There are plans at the federal level to possibly phase out this program over the next few years. If this happens Lasata would have even larger revenue shortages.

Lasata’s year-end Operating Deficit of $872,308 included $476,000 of depreciation expense and $874,000 in expenses for Lasata’s portion of the County’s un-funded pension liability payment. This deficit did not include payments for principal on debt or any outlay costs for capital construction or capital equipment purchased. After all these audit adjustments were made the year-end adjusted Cash Deficit was $821,795.

State and federal codes require all nursing homes to staff at specific levels to ensure adequate care is provided to residents. In order to meet these staffing levels wages and fringes offered to staff have to be competitive in order to retain qualified staff and to recruit new staff to fill vacated positions. This creates competition with other facilities in the industry and did result in increased costs for wages and fringes.

Additionally, several of Lasata’s nurses retired, spent significant time with the armed forces, or were out on extended medical leaves. This created a dilemma in finding enough nurses to meet staffing requirements so usage of staff overtime and ‘pool’ nurses did increase. Unfortunately there is a nationwide shortage of licensed nurses and Lasata, as well as other facilities, will have to continue to find creative ways to replace an aging work force and recruit new nurses to long-term care.

There was a 35% increase in new admissions to Lasata during 2003 but conversely there were 24% more discharges and deaths because residents are now older and more debilitated, or are coming for short-term rehabilitation stays usually after some type of fracture or surgery. These short-term admissions created an increased burden for staff in that they spent more time on paperwork, medical follow-up and intervention for considerably less total billable days.

A total of 162 residents were admitted during the year, 116 were new admissions and another 46 were re-admitted after a short-term hospital stay. A total of 167 residents were discharged during the year, 69 due to death, 35 returned to their home, apartment or another living facility and 63 were sent to a hospital for a short-term stay.

There were several positive events at Lasata during 2003. In June the State of Wisconsin Bureau of Quality Compliance performed an annual licensure and certification survey. Lasata achieved a perfect survey with no deficiencies for resident care. This was the first perfect survey at Lasata in over 15 years.

Staffing levels for certified nursing assistants was very stable as there was less turnover and reliance on ‘pool’ nursing assistants than in the past several years. By having Lasata nursing assistants instead of ‘pool’ nursing assistants there was a decrease in cost of $86,000 from 2002, and a decrease of $240,000 from 2001. However the costs of the non-benefit nursing assistant program, and even the cost of our regular fringe benefits and wages, is now becoming nearly as costly as ‘pool’ nursing assistants.

The dayrooms expansion and fire system upgrade project was completed at $166,000 under budget. The remaining money was used for modernization of the four passenger elevators. This project should be completed by April of 2004.

In cooperation with the Cedarburg Light and Water Utility Lasata received a State Public Benefits Program grant of $13,500 that paid for 70% of the costs to retrofit several areas of the building with energy efficient lighting. This grant also allowed the Utility to provide a $21,950 credit to Lasata’s electric bill. Over the past three years Lasata has received $52,300 in credit to electric bills through this program.

Several changes were made to internal operations in 2003 in an effort to be more efficient and reduce cost. These changes resulted in savings of $50,00 by laying-off staff and eliminating several positions during the year. A reduction in laundry usage of nearly 10% saved $25,000 in contract and utility costs. With the help of the County Purchasing Agent several contracts were modified saving an estimated $12,000 in medications, $15,000 in capital outlay, and $10,000 in service contracts and utility costs.

Occupancy levels in Wisconsin nursing homes averaged about 89% but Lasata’s average occupancy was 97% (195 beds filled out of 201). Twenty three percent of the residents were Private Pay, 71% were Medicaid(T-19), and 6% were Medicare(T-18). These numbers have been fairly consistent at Lasata the past 3 years.

Sixteen percent (19 total), of new admissions were from the Lasata Heights apartments, nearly triple from 5 years ago. It is obvious that many Lasata Heights tenants are aging-in-place and then moving to Lasata when they can no longer live independently.

Over 49% of Lasata residents had Alzheimer’s disease, dementia or some other brain disorder as their primary diagnosis. This was by far the largest category of primary diagnosis. Another 17% were diagnosed with heart attack or stroke and 18% were diagnosed with paralysis, fractures or a skeleto-muscular disease such as Muscular Dystrophy or Multiple Sclerosis.

The average age of all residents was 84.3 years, the youngest was 40 and the oldest was 102 years old. There were 4 residents under the age of 55 and 4 residents over 100 years old, this required staff to meet the physical, medical and social needs of a very diverse population.

Goals for 2004 include completing the elevator modernization project, retention and recruitment of qualified licensed nurses, negotiating a fair and equitable labor contract, and completion and presentation of a plan of future operational options. In an effort to keep the public and elected officials informed of progress on this feasibility study there is a link on the Ozaukee County Web-site where people can follow the progress of the study as well as respond with their suggestions and/or opinions.