Less than nine months after Frederick County voted to privatize its two resident care facilities, more than 17 percent of the beds at Montevue Assisted Living are empty.
Fifty-four of Montevue's 75 beds were occupied by subsidy patients as of Wednesday, and another eight by those paying privately, said Diane Grove, a county administrator for the facility.
The number of subsidy patients has fallen through attrition as they leave or die, officials said. Montevue no longer accepts patients who cannot afford to pay the $150 per day on their own, according to Grove and Michael Roles, an administrator for Aurora Health Management, which took over managing the facility in June.
Medicare and Medicaid do not cover the cost of assisted living at Montevue.
The 13 vacancies are a result of the ebb and flow of the assisted living business as patients come and go, Roles said. Montevue had about 70 patients when he started working there, he said.
“You want to be as full as you can,” he said. “Seventy-two (patients) is where you want to be. ... We can certainly come back.”
Montevue has gotten one to three new paying patients each month since June, Roles said.
Aurora has reached out to Frederick Memorial Hospital, senior centers, home health agencies and other adult care facilities to recruit patients, Roles said. Aurora is also looking at added amenities, including allowing residents to choose paint colors for personal rooms and bring personal furniture, to help attract residents.
“We have plans to do that in the very near future,” Roles said.
The Board of County Commissioners voted in June to sell Montevue and the neighboring Citizens Care and Rehabilitation Center to Aurora, a for-profit company based in Millersville. The $30 million sale has not been finalized and is wrapped up in legal proceedings.
Plaintiffs suing to prevent the sale have argued that it violates the property's deed because the prospective buyers are under no obligation to care for new indigent residents.
Commissioners President Blaine Young said filling beds with subsidy patients would only cost taxpayers more. Montevue has continued to operate at a loss. As of December, the facility had lost a little more than $1 million in fiscal 2014, according to a report made available to the commissioners this month.
“Unfortunately, it is more cost effective to leave them empty than to fill them,” Young said of the vacant Montevue beds.
Young doesn't fault Aurora for unfilled private payer spots, he said; if the county had planned to keep Montevue, it would have had to seek a different balance of subsidy and private pay patients to reach cost effectiveness.
People may have questions about Montevue that are deterring them from choosing it, including "who's in charge, who's running it?" Young said. "What's going to happen once it gets sold?
"I have heard a broad spectrum of concerns when it comes to the nursing center," he said.
Speculation that current subsidy residents will be kicked out or moved to another Aurora-run facility is incorrect, Young said. Maryland code prohibits a subsidy patient from being removed from care, and the board's agreement with Aurora includes a caveat that it can't move a patient to another facility, he said.
Commissioner Kirby Delauter said filling the beds is Aurora's responsibility and will not affect the sale of the property.
“No more than I worry about empty seats at McDonald's. I'm not going to worry about it because it's not going to be taxpayer money,” Delauter said.
Commissioner Billy Shreve is not familiar with a vacancy baseline by which to judge Aurora's rate, he said, but he has been satisfied with how the company has run Montevue so far.
“We hired them and we have to look for improvement, and they've shown improvement so far,” Shreve said.
Roles does not know how many subsidy patients had been turned away in recent months, he said, but current patients can stay as long as necessary. Under an agreement with the county, Aurora will receive $10.7 million over four years to continue to care for subsidy patients at Montevue. After four years, those patients can stay on until their needs are no longer met and they transfer out.
“The bed will stay subsidy for as long as the patient is able to stay in the bed,” Roles said.
Commissioner Paul Smith said a senior needs analysis showed that as many as 400 people in the county would be eligible for subsidy status at Montevue. By freeing the county from covering Montevue's losses, "there's that much money that can be freed up for these people," Smith said.
Commissioner David Gray is the board's lone opponent of the sale. He doesn't think he's getting the straight story about the deal with Aurora, he said, calling the company's management of Montevue while it also tries to buy it and CCRC a conflict of interest.
Montevue reported one unexpected death in December, which Gray believed was handled by the county with indifference, he said.
Gray wants to consider opening beds to subsidy patients, he said.
“I would like to see this back in the county's hands for the citizens and not in the hands of Aurora.”
Follow Courtney Mabeus on Twitter: @courtmabeus.