The Jackson County medical care facility told the services committee on Dec. 1 that quality ratings remain high while the facility wrestles with persistent operating losses driven largely by payer mix and Medicaid reimbursement timing.

The facility director reported an overall five-star ranking, four stars for quality and survey metrics and five stars for staffing. The director said RN turnover in the facility is about 5.4% — among the lowest in the market — and that nursing turnover has fallen from roughly 46% to 26.5% over recent years.

On finances, the director said October revenue was $2,583,709 (about $65,846 behind budget) and expenses were $2,666,191 (about $21,204 behind), producing a negative net position for the month of $83,482. Year-to-date the facility is operating at a loss, with revenue and expense variances driven in part by health-insurance and overtime costs.

"Medicaid is about 75 to 79% of the residents that we serve," the director said, and explained that Michigan's Medicaid is cost-based — reimbursement is tied to costs reported two years prior. That feature means the facility often must spend now to realize reimbursement increases in later years.

Commissioner Williams and others pressed for ways to reduce recurring deficits. The director warned that cutting patient volume or services to save money can backfire because lower costs can reduce future Medicaid rates; instead the facility must balance near-term cost-control with strategies that maintain or increase allowable cost base to improve future reimbursement.

The director also highlighted a one-time Medicaid billing delay that reduced reported cash-on-hand to about 20 days at the end of October; after receiving the delayed payment, the facility estimated cash on hand nearer 32 days. The director said the facility expects a Medicaid repayment invoice around September 2026 in the approximate amount of $1,170,000 and noted about $4.5 million in additional MOE-related funds are held separately.

Several commissioners asked for a written history of MOE cash flows and recommended the county provide a multi-year report (suggested five to six years) detailing MOE receipts and uses, including bond and interest payments and retiree-health liabilities. The committee asked the administration to prepare that report for a future meeting.

Speakers quoted: Medical Care Facility director (unnamed), Commissioner Williams.

Ending: The committee received the report and asked staff to provide a MOE cash-flow history and additional financial details at the next meeting.