County says nursing center lacks cash to cover payroll, will advance $75,000 as stopgap

County officials told the board on July 14 that the county-operated nursing center has not received expected Medicare and Medicaid reimbursements and currently lacks enough cash to cover payroll and the facility’s health-insurance obligations. County staff said the county will provide a $75,000 advance immediately and place repayment lower in the priority order for tax-advance recapture. The matter arose during the board’s administrative financial update when the county administrator explained the center’s cash flow problem and the interim fix. “With the Medicare and Medicaid payments not coming through…we do currently do not have enough revenue to cover payroll and health insurance,” County Administrator (unnamed) said. He added: “So they will be getting the 75,000 upfront, and then the repayment will be second priority.” Why it matters: county officials said the center lacks sufficient cash to make payroll and pay health insurance, and vendors at the facility have not been paid since July 3, creating an immediate operational risk until federal/state reimbursements arrive. The administrator told the board that the county will reverse the usual priority on an anticipated tax advance so the nursing center receives cash now; the recapture and repayment of that advance will occur later. Details and discussion: County staff described the $75,000 as an interim “plan Z” to bridge payroll until Medicaid/Medicare funds arrive. The administrator said roughly $25,000 remained in the nursing center’s account after recapture of an earlier advance and that health-insurance payments next would total approximately $51,000. “Vendors…have been paid since July 3,” the administrator said, adding that some vendor payments have been postponed. When a commissioner asked, “Do we know when we expect to get some Medicaid catch up?” the administrator replied, “I don’t know when,” and said an estimated $83,000 might be coming but that the timing and source were not certain. Board direction versus formal action: staff presented the advance and said it would be provided; the transcript records that as an administrative decision/direction rather than a recorded formal vote by the full board. The board discussion included questions about timing of Medicaid receipts and whether additional options existed to accelerate payments. Context and next steps: staff said the nursing center’s cost report has been filed and accepted and that the center’s shortfall stems from delayed federal/state payments rather than a new billing issue. County staff told the board the recapture and final accounting of the tax advance will be handled later in the year when revenues are reconciled. No ordinance, statute, or formal board resolution was cited during the discussion. Less critical detail: speakers noted that the issue may create budget requests in the next cycle as department heads prepare their budgets and that some reimbursement flow is expected but not yet confirmed.