Worried over its future, some Cumberland Co. residents call for ‘pause’ on sale of county-owned nursing home

In south-central Pennsylvania’s Cumberland County, Claremont Nursing and Rehabilitation Center in Carlisle has been serving residents for 192 years. But plans to sell the facility, introduced by county commissioners last year, have some residents worried. 

Claremont has a three out of five star rating, according to February 2021 data from the Centers for Medicare and Medicaid Services. It also is home to more than 200 residents, according to census data, many of whom rely on medical assistance programs to afford their stay. 

“Where are low income people in Cumberland County going to be able to get this kind of care if Claremont isn’t there?” Morgan Plant, a Harrisburg lobbyist and Cumberland County resident who works with human services causes, asked. Plant does not not represent the nursing home, but does describe herself as a concerned citizen. 

Plant’s concern over the loss of quality care led her to join Citizens Saving Claremont, a group of approximately 100 apprehensive residents who say they fear that selling the facility would cause job losses among the home’s current staff and affect the quality of resident care. 

The October 2020 announcement from county officials calling for bidders is on par with statewide trends that have seen an increase in the sale of county-run nursing homes over the past decade. 

There are 20 nursing homes across 17 counties still operating under county ownership across the state, according to 2021 Centers for Medicare and Medicaid Services data. 

If Claremont were sold by its tentative transaction date of this June 30, 19 county-run homes would remain. Four are in Allegheny County.

Plant and other members of the citizens’ group said that the call for bidders was sudden, a claim disputed by two of the county’s three elected commissioners. 

County Commission Chairman Gary Eichelberger, disputes the group’s claims that the Claremont issue is new or that the vetting process is being rushed. 

“It’s been on our radar for 20-plus years,” Eichelberger, a five-term commissioner, told the Capital-Star, noting that the facility’s financial outlook has “been trending downward for some time.”

Commissioner Jean Foschi, a Democrat who was elected to the board in 2019, agreed with Eichelberger that Claremont has been the subject of much research and deliberation over the years. 

Citing examples such as staffing issues, Foschi noted that “a number of things led to the decision” to send out requests for proposals. 

Foschi said she “most certainly agreed” with the need to explore other options for the home’s future. 

“Go look let’s see what’s out there,” Foschi said. “Let’s do the investigation and see what’s out there.”

However, Foschi said it became clear to her soon after she started in her role as commissioner that her colleagues, Eichelberger and fellow Republican Commissioner Vincent DiFilippo, had plans in mind for Claremont. 

That was a concern shared by Tim Potts, another concerned county resident and volunteer with the group, said he believes the Republican commissioners entered the process “with their minds made up.”

Foschi said a Feb. 22 public board meeting was “alarming” because “both of my colleagues said statements that led the public to believe that we had already made a decision.”

Foschi said she recalls Eichelberger saying at the meeting, “We are not going to be the owner of this facility much longer.” She also recalled comments made by DiFilippo: “The new owner will also see this and address it.”  

At that point, Foschi said she reversed her position on the matter because “the due diligence wasn’t being done anymore.”

While the board has narrowed down the search to two bidders – Transitions Healthcare LLC and Allaire Health Services – Eichelberger told the Capital-Star that “this is by no means a done deal.”

Following the October 2020 public announcement by county officials calling for bidders, the group began researching the home’s lengthy history and more recent struggles. 

The group assembled the research they could conduct themselves into an 11-page report outlining their findings, which included a comparison of the quality of care of area for-profit and public nursing facilities and background on six bidders being considered. 

The report was then shared with the county’s three commissioners – who will ultimately decide the fate of the home – as supporting reasons why Claremont should remain in county hands. 

In a Jan. 11 email obtained by the Capital-Star Eichelberger responded to the group’s submission. 

“I am certain that those who actually understand the financial situation will be intrigued by an analysis conducted from afar with no apparent consideration of the long financial history of Claremont, or any understanding of the ongoing efforts the county government has undertaken over many years to address those conditions through the concerted (and informed) effort of many,” Eichelberger wrote.

After rebuking several of the claims made in the group’s email, Eichelberger said the final decision rested with the board. 

“The commissioners bear the responsibility for making decisions regarding the management and stewardship of property and assets of the county government – of which Claremont is one component.  While we are always considerate of public feelings as part of any decision, an assumption that any decision regarding Claremont is somehow now a ‘shared decision’ or a ‘community decision’  is not accurate,” he wrote.  “The commissioners will exercise their legitimate responsibility for this choice utilizing the input and participation of others in the manner we determine to be the most responsible, and in keeping with our role in managing public assets, as bestowed by the voting public.”

Plant and Potts said they felt “dismissed” by the response. 

Eichelberger told the Capital-Star that he was “terse” in the Jan. 11 email exchange because he and the other commissioners have “entertained a high degree of public input.”

Noting that he’s taken several calls regarding Claremont, Eichelberger said answering concerned callers’ questions “usually helps” resolve any trepidation. “I don’t believe the general public is nearly [as] concerned about this.”

Addressing worries that the quality of care would change at Claremont should it be sold, Eichelberger said clinical innovations from private companies that have multiple nursing facilities “have options available that we simply don’t as a county government.” Eichelberger said he believes Claremont has a “much better chance of being a better facility” in private ownership than if it were to stay in county hands. 

But those assurances haven’t assured some residents. 

“The county has options,” Plant said, noting the county’s AAA bond rating and healthy reserve fund. “What we’re saying is, slow this down so we can really have a transparent, thoughtful consideration.”

Potts echoed her comments. “I’m not content with rushing through the process,” he said, adding that he’d like it to be a “process in which people can have confidence.” 

Potts told the Capital-Star that after a “due diligence” analysis of the facility was done and the public has had time to consider the issue over the course of a year’s postponement, that he would be “content” to accept whatever conclusions were reached regarding the home’s future. 

“There is a way to do this,” Potts said, “or to figure out that the landscape has changed so much that there isn’t really hope.”

Citing neighboring counties such as York, which sold its county-operated facility in 2018, Eichelberger disagreed with the group on the options available.

“We can’t stay on the path that we are on and our choices are extremely limited,” Eichelberger said, noting that while the RFP was open to nonprofit bidders, “none were interested.”

Calling county-control of the home a “legacy function,” Eichelberger believes that the home’s best chance for survival is in the hands of a private entity. 

“You can’t freeze time and hold on to a past that no longer applies,” he said. “You can only swim against the tide so long.”