Martha T. Berry director briefs commissioners: census, finances and $13–14M in needed building work

Kevin, a representative of the county medical care facility Martha T. Berry, told the Health and Human Services Committee that the facility’s census is 202 (about 93% of operational capacity) and that the facility faces substantial capital and maintenance needs.

The presentation — given to the joint committee after the Internal Services portion of the meeting — laid out occupancy, finances, building ownership and project lists. Kevin said the facility keeps two beds offline for maintenance, that its licensed capacity could reach 217 if those rooms were brought back online, and that the nationwide state average referenced by staff is roughly 74% occupancy under the state’s certificate-of-need measurements. “For now our census is staying strong at 202, we're at 93%,” Kevin said.

Kevin told commissioners the facility’s year-to-date expenses were roughly $7.7 million on a $39 million budget at the time of the report. He said the county owns the building 100% and that, since his tenure began nine years ago, the facility has invested “just under $12,000,000” into the physical plant. He listed 25 open maintenance projects, including emergency-power work tied to a county jail project, a cracked heat exchanger that has been replaced, and a therapy-area roof that needs replacement.

Committee members pressed for governance and contract documents. Several commissioners asked whether Martha T. Berry has a lease; Kevin said there is no formal lease but a “building use agreement” and a joint operating agreement (JOA). He told the committee the building-use agreement is “convoluted” and that he would provide the documents to commissioners. Kevin said maintenance responsibility for the current projects is being covered by the facility at present. “Right now we are, 100%,” he said when asked who is paying for the open projects.

Staff explained the facility’s classification under state rules: Martha T. Berry operates as a class 3 facility, which staff said provides higher Medicaid reimbursement for care of the most medically complex patients than the class 1 reimbursement model used by many for-profit and nonprofit nursing homes. Kevin said the facility’s mission — reflected in state law — is to serve as a safety net for patients that other facilities cannot accept because of acuity or payer mix. He described how nationwide changes and workforce shortages have reduced the number of skilled nursing facilities and noted that Macomb County has about 35 nursing homes overall.

Admission priorities and operational details: Kevin explained the facility’s admission hierarchy: hospital referrals are prioritized first, then county residents, with a preference for Medicaid where applicable. He said the facility cannot accept residents who do not meet skilled-nursing criteria. On available capacity he said, “We have 15, we have 2 off lines with a total of 13 that we could fill.” He also said roughly 98% of residents are age 65 or older.

Commissioners asked about staffing and workforce trends. Kevin said the facility’s staffing mix has shifted over time toward more part-time workers (approximately a 60/40 split of full-time to part-time employees) and that the facility ranks in the top 6% in the state on FTEs providing direct care even if it is not meeting the threshold for a higher star rating because of RN counts.

Financial planning and capital needs: Kevin said the facility maintains a five-year plan and estimated $13–14 million in necessary repairs plus roughly $1.5 million in desired but not required projects. He said the facility had used a 0.1-mill millage in the past for capital assistance and that operations are intended to be self-supporting under the joint operating agreement.

Commissioners and staff requested the JOA and building-use agreement be circulated; Commissioner Hall suggested including both agreements if the commission circulates documents. Kevin also said the facility will return with a more detailed financial presentation at a future meeting (noted for July in his remarks).

What this means: Committee members received a detailed operational briefing and asked for documents that clarify responsibility for capital and maintenance work. No formal committee action was taken on the presentation; commissioners directed staff to provide the JOA and building-use agreement and to bring more detailed financial materials at a subsequent meeting.