By Bill Slocum
Contributing Editor
Larry Simon may have officially retired nearly 20 years ago, but he still puts in a full day.
Last Friday morning he was at Glenville School, instructing fifth-graders about division by fractions. In the afternoon, he had the attention of a more skeptical audience, explaining to the Board of Estimate and Taxation’s Budget Committee why they should continue to support the only municipally-run nursing home in Connecticut, the 202-bed Nathaniel Witherell.
Simon sees a commonality between volunteering at Glenville School four days a week and the post he took just over a month ago, chairman of the Nathaniel Witherell Board of Directors.
“It’s all math,” Simon said, with a shrug.
But hardly easy. Simon acknowledges he came aboard at a challenging time. With Medicaid reimbursement down and staff costs rising, Nathaniel Witherell requires more money from the town to stay operational than ever, between $2-3 million a year by Simon’s own estimate.
Simon calls it a good investment. With Greenwich’s annual schools budget running about $185 million, he argues spending $2-3 million on the town’s aging is the right thing to do.
“I’ve seen enough nursing homes to know this is in a class by itself,” Simon noted. “This is a place where people who live in Greenwich want to bring their loved ones. A lot of people have had loved ones who died there. That’s part of the emotional attachment. Nobody wants to put their parent in a place where they don’t feel they are getting good care.”
Simon’s own attachment to Nathaniel Witherell began back in 1997. He had just taken early retirement after more than 20 years at Health Management Systems, a publically traded company he helped found which has since become a major coordinator of Medicaid and Medicare benefits programs in most of the country. A member of the BET asked Simon if he wouldn’t mind taking some time to look over the nursing home’s accounts receivables.
Simon discovered a cluttered situation where debits were mixed up with credits. He spent weeks sorting things out. “It wasn’t the world’s best-run accounting system,” he noted.
In the process, Simon got to know and like the staff of the Nathaniel Witherell, including its then-chairman, Ed Kovounas. In later years, as Simon’s involvement in Greenwich town affairs increased, in particular during his 12 years on the BET, he found himself checking in on the nursing home to see how it was doing.
Now he is back as chairman, making the case for Nathaniel Witherell to the BET, including Budget Committee chairman Jim Lash, a former BET colleague. Much of Simon’s time before the Budget Committee last Friday had him explaining what should and shouldn’t be counted as losses against the nursing home. The result was a substantial reduction of the overhead charge.
“We got the overhead reduced from $1 million to $288,000,” Simon said.
While some think Nathaniel Witherell costs between $5-6 million to operate, Simon said he was able to use his knowledge of how the town budget works to explain why the true figure is half that.
Asked if Nathaniel Witherell can ever be a profitable enterprise, a statement affirmed as recently as a 2011 report still posted on the town website, Simon said no. The institution is too dependent on Medicaid reimbursement, which is too low at present and getting lower. But he does see positive changes on the horizon.
A costly upgrade of Nathaniel Witherell that significantly enhanced its short-term care programming, Project Renew, has just been completed. Accommodating more short-term rehabilitation patients will allow for more robust payments and less Medicare dependence. Debt taken on to pay for Project Renew will be paid off in 17 years, lowering the overall cost of running the nursing home. Recently, the facility earned a five-star Medicare service rating.
“We are trying to create a facility where people want to come,” Simon said. “We’d like to maintain a place where people can grow old in a sensitive and graceful environment.”
