A Tradition Since 1829 Fades Away
By Thomas J. Prohaska, The Buffalo News, N.Y.
Jan. 6–LOCKPORT — For the first time since 1829, Niagara County is no longer operating a facility to take care of the health needs of the poor.
Mount View Health Facility, the countyowned nursing home that handled primarily Medicaid patients, closed Dec. 28.
The county operated the Upper Mountain Road facility as a nursing home for 34 years. It was the final successor in a long series of facilities that date back to the first county poorhouse 179 years ago.
Although Niagara County won’t be providing health care itself anymore — except for the home care aide programs operated by the Health Department — the cost of health care for the poor remains the largest item in the county budget.
Even though Medicaid patients will no longer be under the county’s direct care, the Mount View refugees and all other eligible county residents will still cost taxpayers plenty.
The $41 million cost of Medicaid is by far the largest item in the county’s 2008 budget. New York counties must pay 25 percent of Medicaid costs.
But Niagara County will no longer be employing more than 200 people to care for those patients.
“There’s an emotional attachment to the service, but we have to look at the fiscal impact on the county,” said Legislator Jason J. Murgia, D-Niagara Falls. “It’s in the best interest of the taxpayers of Niagara County not to be in the nursing home business anymore.”
In recent years, the county has been subsidizing Mount View, which was supposed to be self-supporting, with $1 million a year or more in property tax revenues.
The issue of whether Mount View should be kept open and what services it should offer is a very old one.
The five-story building was constructed in 1939 as the new home for Niagara Sanitarium, a tuberculosis care facility which the county had opened in 1918. Although it’s what most people think of when the name “Mount View” is mentioned, the official name of the five-story structure is the Guillemont Building, named for Dr. Frank Guillemont, who served on the sanitarium’s board of managers from 1932-38.
The other major building on the countyowned Mount View campus, the Shaw Building, had opened in 1931 for care of children with TB. It was named for William Shaw, a member of the board of managers from 1919 to 1937.
Started in 1829
The sanitarium was the successor to a long list of facilities that started in 1829 when the county, complying with an unfunded state mandate from five years before, erected a poorhouse on Niagara Street in Lockport, near where the Niagara County Jail currently stands.
According to the county’s newly issued bicentennial history, the poorhouse included some health care facilities for its residents. The original wooden building was replaced by a three-story limestone structure in 1833, which was expanded in 1845 with a wing for the mentally ill.
The name “poorhouse” was changed early on to “almshouse,” but by the early 20th century conditions were rapidly deteriorating. Its residents were moved in 1915 to the new county infirmary on Davison Road. The infirmary, in effect a hospital for the poor, stayed open until 1979, when its patients were transferred to Mount View.
The infirmary building was reused as the headquarters of the county Social Services Department under the name of the Switzer Building. In 2003, Social Services moved out and the building was closed.
The County Legislature voted in 2006 to sell the building and 16.5 acres of land for $375,000 to Christian Academy of Western New York. That deal, held up by the need to remove an underground fuel tank, is expected to close in March, according to Robin DeVoe, deputy public works commissioner for buildings and grounds.
As new drugs discovered after World War II shrank the demand for tuberculosis care, the county sought new programs for the Mount View buildings.
In 1957, the name of the facility was changed to Mount View Hospital, and the Shaw Building was renovated as the new home of a rehabilitation program for the handicapped. Mental patients were admitted to the top floor of the Guillemont Building in 1965.
Shrinking demand
By 1969, the board of managers, then headed by Matthew J. Murphy Jr., who later became an assemblyman, was recommending in its annual report to what was then the Board of Supervisors, later the Legislature, that extended care could be a good use for the second and third floors of the Guillemont Building. By then they were vacant because of the lack of TB patients.
In 1971, the Legislature passed a resolution ordering the renovation of those floors into an 80-bed extended care facility, which opened two years later. James Kueckle was the first administrator.
In 1974, the 60 beds in the Shaw Building were closed. The facility later became headquarters of the Health and Mental Health departments. A 1973 Legislature resolution that adopted a long-range plan for Mount View commented that closing the Shaw beds and adding extended care services would meet the goal of “bringing the operation of Mount View Hospital out of the red, a long-sought-after objective.”
The name was changed to Mount View Skilled Nursing Facility in 1976 and to Mount View Health Facility in 1978.
The county plowed about $8 million int o a major renovation in 1989, but the level of patient care was what really needed renovation. State inspectors gave Mount View a failing grade in 1990 and Richard A. Majka, administrator since 1976, resigned.
Henry M. Sloma, operator of Fairchild Manor Nursing Home in Lewiston, was hired to clean up the mess while the Legislature decided whether to kill the nursing home or keep it. Legislator Lee Simonson of Lewiston, who was chairman at the time, credited Legislator Margaret F. Truax, RLockport, with convincing her colleagues not to unload the nursing home.
After Sloma he righted the ship as interim director for a few months, Robert F. Harrington was hired as administrator in 1991 and presided over the facility’s 1990s heyday.
In the late 1990s, thanks to federal aid which was later phased out, Mount View was flush with money. Its surpluses were so healthy that workers received what in the private sector would have been called profit- sharing checks, while the Legislature was able to use the Mount View surpluses to avoid raising property taxes.
“For a while there, we were making money hand over fist,” Simonson recalled in a recent interview.
In a November 1998 interview with The Buffalo News, as the Legislature was about to drain the nursing home’s $2.5 million surplus to avoid a tax increase, Harrington acknowledged that its actual operations were never profitable and the reason for the surplus was state and federal aid, which averaged more than $1 million a year, starting in 1996.
“We’re always in the red to one degree or another,” Harrington said at the time.
Bonus checks
In 1999, 67 Mount View workers who were members of the Civil Service Employees Association received bonus checks averaging $2,496, shares of Mount View budget money that didn’t have to be spent because of employee-generated savings ideas and state and federal aid. When the other Mount View union, the American Federation of State, County and Municipal Employees, joined the program in 2000, there were 214 bonus checks averaging $829.
The salad days didn’t last long. By the early part of this decade, the bonus program ended and property taxes had to be assigned to Mount View again as the extra federal aid dwindled and disappeared. Meanwhile, Medicaid reimbursements from Albany didn’t keep pace with the rising cost of health care supplies.
“The benefit levels of the county employees were much higher than in the private sector. Every study showed that,” Simonson said.
Harrington, who had proposed to enhance Mount View including its own cogeneration power plant, retired in 2001. His successor, Edmond C. Marchi, inherited Harrington’s proposals and expanded on them.
But by the time Gregory D. Lewis was hired as county manager in May 2003, the sale or closure of Mount View had already been on the Legislature’s mind for some time. In November 2002, the Legislature voted to advertise Mount View for sale, but it also hired a consulting firm to prepare paperwork to submit to Albany for a possible expansion. At the time, Marchi said the nursing home was losing $200,000 a month.
Marchi’s expansion and modernization plan, at first called the “greenhouse plan” and later the “cottage concept,” occupied a lot of time in committee meetings for a couple of years, but the full Legislature never voted on it. It would have cost $13 million to $15 million, although up to 85 percent of that could have been reimbursed by the state. However, other counties in the area that carried out nursing home projects counted on Albany reimbursements that were later denied on technicalities.
Tiring of the Legislature’s hesitation, Marchi quit in October 2003 and was replaced by Patricia Weeks O’Connor. But after the Democrats lost control of the County Legislature in the 2003 election, the new Republican-controlled body showed more philosophical interest in selling or closing the nursing home than expanding it.
Lewis argued frequently that the county shouldn’t be involved in providing services that are offered widely in the private sector. The Legislature disagreed with his proposal to unload the county golf course, but when it came to Mount View, it was ready to sell.
In 2004, the Legislature voted to seek bids. Senior Associates, an Amherst company, was the only bidder, at $2 million. The Legislature and Lewis decided to try again, but again Senior Associates was the only bidder, bumping up its offer to $2.1 million.
The county was able to negotiate Senior Associates up to $2.4 million, but that was as good as it got. On June 20, 2006, the Legislature voted 14-5 to approve the sale.
However, by that time, the Berger Commission, a state panel empowered to order closures of hospitals and nursing homes, was at work. In November 2006, its report called for Mount View to be converted to an assisted living facility. The order had the effect of canceling the sale.
The state Health Department, slapped with a lawsuit by the county for torpedoing the deal, agreed to the county’s desire not to get involved in assisted living. On June 26, 2007, the Legislature voted 13-6 to approve the closure plan which was carried out with the departure of the last two patients Dec. 28. There had been about 130 residents when the closure plan was approved.
O’Connor resigned in February 2007 and Robert E. Sobon was hired in July to preside over the shutdown as the last Mount View administrator.
tprohaska@buffnews.com
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