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Alma Rutgers Witherell’s rich legacy collides with a changing market

May 20, 2019

It’s like déjà vu all over again.

Yogi Berra’s “Yogi-ism” came to mind as I prepared to write about Nathaniel Witherell, the town-owned Skilled Nursing and Short-term Rehabilitation Center that so many Greenwich residents cherish as a community treasure.

Originally a municipal hospital for infectious diseases, Witherell has been part of the Greenwich landscape for more than a century. Its function, however, has varied over time, adapting to the health care environment and changing community needs.

Wednesday afternoon, three Witherell representatives — board chair Larry Simon, board member Dr. Nirmal Patel, and executive director Allen Brown — appeared before a special committee of the Greenwich Board of Estimate and Taxation (BET) to review the recommendations in consultant reports prepared for the BET by Health Dimensions Group (HDG), a health care consulting and management firm, and the accounting firm of PKF O’Connor Davies.

This BET committee — the Nathaniel Witherell Strategic Planning Committee — chaired by Arthur Norton, is now in its second incarnation. Created in March 2016, and recreated in January 2018, it has been at work for more than three years.

Simon, assisted by Brown, gave the committee detailed responses to each of the accounting, financial, and operations recommendations in the two reports. And Patel addressed the potential impact of the change in Medicare’s reimbursement system that is to take effect Oct. 1. This shift away from a therapy-based system to one based on medical diagnosis may actually present Witherell with exciting new revenue opportunities, she said.

Not discussed Wednesday were the strategic options that HDG considered: continue as a town-owned facility and seek greater operational efficiencies; sale/lease to a 501 (c)3 not-for-profit corporation; sale/lease to a for-profit corporation. HDG recommended further examination of the not-for-profit option.

But Simon was emphatic that Witherell is not considering any option other than being a town-owned facility that continues to seek operational efficiencies.

The BET special committee will take up those strategic options at its next meeting May 19, when members will discuss what the committee hopes to ultimately accomplish. They should give serious consideration to opting for Witherell to remain a town facility. In so doing they will reaffirm what the Greenwich community has already affirmed.

In 2007, the Greenwich Representative Town Meeting (RTM), after extensive study and community discussion affirmed that Nathaniel Witherell should remain a town facility. This decision was reinforced in 2011 when the BET and RTM approved bonding for the $27 million renovation known as Project Renew. This town commitment to Witherell was further reinforced in 2012 with approval of an additional appropriation and bonding authorization of $2,426,000 for Project Renew.

The Project Renew public hearings made clear that the Greenwich community wants Witherell to survive and thrive as a town-owned institution, with taxpayers making a considerable investment in Witherell’s future.

So why are we experiencing this déjà vu all over again?

There’s concern that a changing market and reimbursement environment will adversely impact Witherell’s revenues and require increasing town subsidies. But these changes affect all nursing and rehabilitation facilities, regardless of ownership structure.

Witherell, as a municipal facility with a town subsidy, may be in a stronger position to compete in this environment than its for-profit competitors. All nursing facilities in our market area, with the exception of Witherell, are for-profits. Most have lower occupancy rates than Witherell.

Witherell, a known “brand” in this market area, has a very high occupancy rate, provides an excellent quality of care, and is Greenwich Hospital’s nursing home and rehabilitation facility of choice. Witherell is well positioned to build upon its fine reputation.

“We will become, we hope, everybody’s favorite nursing home,” Patel said during the presentation.

But why is the town in this business, some ask?

It’s part of what makes Witherell special. We can all feel at home there. Witherell belongs to all of us, touching countless Greenwich lives over the years.

When BET committee members discuss strategic options this week, they should consider the costs to the community of removing Witherell from town hands, and the huge risks involved. They should ask what it’s worth to Greenwich taxpayers to safeguard this valuable town asset that’s served the community so well for more than a hundred years.

Alma Rutgers served in Greenwich town government for 25 years. Her blog is atblog.ctnews.com/rutgers

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