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Nursing home bed cuts may be regulated

A nursing home company's decision to pull nearly two dozen beds out of its Inverness facility has prompted the regional health planning council to draft changes that would prevent a similar situation from reoccurring.

In late February, the state Agency for Health Care Administration approved the Avante Group's request to transfer 87 beds from three of its nursing facilities to a proposed 120-bed facility in Sumter County.

The Hollywood, Fla., corporation contends its $9.9-million facility, planned for the Villages retirement community, would furnish the only community nursing home beds in an area facing significant growth in its elderly population.

But due to a state moratorium on additional nursing home beds, the company must dip into spots at existing facilities to develop its new site. As a result, 21 beds will be removed from the Avante at Inverness facility. Another 33 beds each will be taken from similar nursing homes in Leesburg and Mount Dora, as well as the Oakwood Nursing Center in Ocala.

The switch would leave Citrus County with 1,060 beds, down from 1,081, at a time when the county's nine nursing homes are at 89 percent capacity.

"Does it hurt Citrus County to lose 21 beds?" asked Edith Orsini, executive director of the North Central Florida Health Planning Council. "Well, probably it's not the end of the world.

"However, if it happens to be your mother or your aunt that needs a bed, Citrus County now has 21 less beds," she said. "And now that means you might have to leave Citrus County to find a bed."

According to the state's report, Marion County meets the criteria for high occupancy and high need: The most recent data pegs its total occupancy rate at 93 percent. Citrus County has a moderate average occupancy and low need.

At 75 percent of its capacity, the Oakwood Nursing Center had the lowest occupancy rate among Marion County's nine nursing homes between last January through June. But occupancy at the three Avante homes ranged from 92 to 95 percent.

"It is my belief that the occupancy rates at the facility in Citrus County and the facility in Marion County did not warrant the reduction in beds," Orsini said.

This concern for the soon-to-be depleted beds in Citrus, Lake and Marion counties has planning council officials looking to refigure the way skilled nursing care is disbursed in their 16-county district.

Currently, this is the only district in the state where companies have the flexibility to shift beds from one county to another. The council's newly devised plan would create subdistricts to limit such movement. Under the plan, which Orsini will present to council board members March 24, Citrus would become its own subdistrict.

With the rule changes, Orsini said, "there will not be the opportunity for another group of that nature to say, "Well, we're going to take beds out of here, here and here.'

"Our belief is that the district has rounded out its nursing homes' needs as much as possible, and now it istime to start considering the closure and movement of beds and how it affects residents," she said.

State agency and Avante officials backed their case by noting that Lake and Sumter counties are expected to experience the largest boom of the 65 and older population in the district in the next couple of years.

The new facility, planned for the northeast corner of Sumter County near Villages Regional Hospital, would offer both nursing care and rehabilitation services like its sister homes. Construction could begin sometime next year on what would be the first nursing home built within the retirement community.

Avante officials said the new facility also would increase the privacy of residents at the four nursing homes losing beds by eliminating all four-bed wards. Those rooms will become private and semiprivate rooms, officials said in their application.

Avante at Inverness currently has only four vacant beds, running at 98 or 99 percent capacity, but officials said that doesn't mean Citrus residents will be displaced by the removal of beds. Typically, the home has about 35 Medicare patients who stay no longer than 100 days, said Darren Caruso, president of Avante at Inverness and the Avante Group.

Other patients move back home after rehabilitation. The high turnover will allow the company to slowly remove beds as they empty, he said.

He acknowledges that the 96 percent of Avante at Inverness residents who hail from Citrus County eventually will have fewer beds to choose from but said the state determined that the county had enough other empty beds to fill the need.

"We have no plan of some mass exodus," Caruso said. "Never, ever."

_ Colleen Jenkins can be reached at 860-7303 or