Long goodbye: County set to shut long-term care center

San Mateo County may close its antiquated long-term care facility in Burlingame, shifting residents to other care homes and potentially laying off hundreds of workers, rather than lose more than $9 million annually by renewing its lease.

Health System Director Jean Fraser is asking the Board of Supervisors to forgo another agreement for Burlingame Long-Term Care and instead open 32 more skilled nursing beds at the San Mateo Medical Center. The board will consider the request at its Feb. 14 meeting and board President Carole Groom is already leaning toward the proposal.

"I’m thinking it is the right thing to do because of the high cost of the lease and the extremely poor condition of the building. But it’s a painful thing to do because we have 200 residents there and we need to find new places for them,” Groom said.

The center at 1100 Trousdale Drive currently uses about 230 of its 281 beds and the average stay is a year although several clients remain indefinitely. Patients at Burlingame Long-Term Care are a mix of ages, no longer needing the acute care of the hospital but still requiring medical help. Dementia is common and the care home houses patients who have no alternative because of their mental and behavioral problems.

The medical center already has 32 skilled nursing beds in its previously used Unit 1B before the planned addition of 32 more. Rather than move Burlingame Long-Term Care residents to those slots, Fraser said those will be held for short-term patients coming out of the inpatient unit.

"The plan, to the extent possible, is to put all residents in other placements,” Fraser said.

The county is working with the Department of Aging and Adult Services and an outside firm to locate those placements.

Regardless of where they land, Groom said residents will likely be in a better spot than their current conditions. In fact, the outdated building’s condition led the San Mateo County Civil Grand Jury to recommend closure in a 2011 report.

Faced with the pending lease renewal, Fraser hired an outside consultant who concluded that although the staff was doing the best job possible within their limitations, the facility should close. Among the building’s challenges are its lack of seismic safety, limited access to outdoors and small crowded rooms with inadequate privacy.

San Mateo County is one of only a few counties operating a large skilled nursing facility. The county assumed responsibility 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.

"There was a gun to the county’s head. There was no place else for [the patients] to go quickly and, as the provider of last resort, the county had no other choice,” Groom said. "It was the right thing to do.”

Since then, the nearly 50-year-old building continued to age and not support modern car standards.

County officials originally projected generating $1 million annually after bailing out the facility with millions in loans but the glowing financial picture never happened.

The county cut funding and staffing in fiscal year 2010-11, in part because Medi-Cal lowered reimbursement fees. The smaller reimbursements led to the closure of multiple private care facilities, placing a greater burden back on the Burlingame facility.

The state also cut its reimbursement rate for nursing care by 23 percent in November, leaving the county to struggle further in operating the center.

The decision to close the center was not easy, knowing the impact to patients, family and staff, said Fraser.

"But it is the right decision given the age and condition of the building,” she said.

If the board votes not to renew the lease, the transition of patients and staff is anticipated to take 16 months. Although the lease runs through 2013, Dr. Susan Ehrlich, San Mateo Medical Center CEO, said the Health System wanted ample time to move residents.

"We will not leave Burlingame Long-Term Care until everyone has a new home,” Ehrlich said.

Whether the staff will have a new home is another question.

The facility has 200 filled staff positions and while Fraser said the Health System has held vacant as many spots as possible, she doubts there will be room for everybody.

"Honestly, under such budget pressure and not a lot of open positions, it is inevitable there will be layoffs,” Fraser said.

Residents and families can find more information about the recommendation and transition plan at http://www.sanmateomedicalcenter.org/content/LTCResources.htm

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