Report: Close health facility

"I don't think it's that far off base," said Carole Groom, president of the Board of Supervisors. "The rent is too high and the building is too old."

The civil grand jury appears to have a sophisticated understanding of the complicated issue, said Louise Rogers, deputy director of the San Mateo County Health System.

The Burlingame site at 1100 Trousdale Drive is one of two skilled nursing facilities under the umbrella of the San Mateo Medical Center. The other is a 64-bed facility providing short-term care on the main hospital campus in San Mateo.

The Burlingame care home currently uses about 230 of its 281 beds and the average stay is a year although several clients remain indefinitely.

The county took over Burlingame Long-Term Care in August 2003 rather than risk the state Department of Health Services placing its Medi-Cal patients in facilities as far away as Oregon. DHS had assumed operation the previous year when the facility faced bankruptcy but couldn't find a new owner until San Mateo County stepped in.

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 county lease ends in 2013 although there is an option to extend.

According to the civil grand jury, the county should be looking elsewhere.

County officials originally projected generating $1 million annually after bailing out the facility with millions in loans.

The county cut funding and staffing in fiscal year 2010-2011, 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 nursing home is also saddled with design deficiencies, like a limited number of exits, and doesn't meet seismic safety codes mandated for new hospitals.

The San Mateo Medical Center has unused space that could be used for up to 96 long-term patients with minimal renovations, the jury concluded.

Groom said there is "nothing wrong" with that idea but moving clients is a delicate situation that requires working with them and their families, if they have any.

"It's our responsibility to care for these folks and we have to do what is best," Groom said.

Over the next few months, health officials will work on options they can bring to the Board of Supervisors, Rogers said.

"I want to stress that if it's decided that closing Burlingame Long-Term Care is necessary, we would take the time needed to make a very extensive, deliberate and careful plan to ensure our patients and staff are protected and cared for," Rogers said.

Another solution is the state giving San Mateo County a Medi-Cal waiver which relaxes the rules of where the money can be used. The concept, known as long-term care integration, gives a county flexibility to pick the most appropriate placement at the lowest cost.

Currently, though, Medi-Cal recipients often have to stay in nursing homes like Burlingame Long-Term Care even though it is expensive and they may be better served elsewhere such as a small board-and-care home or even their own house with in-home support.

If the state Legislature passes Senate Bill 21 to approve Medi-Cal waivers, San Mateo County would potentially be the pilot site for integration.

Grand jury reports carry no legal weight but recipients must respond in writing within 90 days. The full report is available at www.sanmateocourt.org/grandjury

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