Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, March 19, 1995                   TAG: 9503180044
SECTION: EDITORIAL                    PAGE: G-2   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

NURSING CARE ISN'T CITY'S BUSINESS

The answer often is yes. Many programs and services may need to be made more effective and cost-efficient, but remain the proper purview of government.

Some may be obsolete.

Many others are still necessary, but would be best taken over by the private sector. Roanoke city's nursing home falls into this category.

The home, on city-owned property at Coyner Springs in Botetourt County, was built in 1939. Though an outgrowth of the city's ``poor house'' for indigent elderly residents who had no place else to go, the facility has been operated like most private nursing homes in this area since 1958 - with this notable exception: The city subsidizes its operation at a cost to taxpayers of more than $440,000 a year.

This subsidy is almost sure to increase as state and federal governments consider reducing Medicaid and Medicare. Most of the home's patients are on Medicaid, and state cuts in those payments already have meant the home has been a losing proposition for the city since about 1982.

What's more, the facility is seriously outdated by modern nursing-home standards set by the government. Some of the 58 patient rooms don't have sinks or commodes. If the city stays in the nursing-home business, it eventually will have to build a new building - at an estimated cost of at least $3 million.

The question is whether there's any reason to do so - and the answer would seem to be a resounding no.

The city home provides no service that is not provided at other nursing homes in the area. Where it once was the only option for many poorer Roanoke residents, the region now boasts more than 2,000 nursing-home beds, most available without regard to patients' ability to pay. The city home, incidentally, is no longer for Roanoke residents only. Some patients come from as far away as Pennsylvania.

It is, of course, a compliment to the city and the 50-member nursing-home staff that many patients prefer the small and aging Coyner Springs facility over larger, more modern private facilities. It is also understandable that some patients are upset that they may be uprooted from a familiar, family-like setting if the city turns over the operation to a private firm that would build a new facility.

But it makes sense for the city. The needs of the patients can, indeed, be met by the private sector - and as the city explores a private-sector takeover, one of the conditions it is setting is that all current patients be guaranteed a place in the new facility if they want it. (Similarly, the city will insist that all members of its nursing staff be offered jobs with no loss of salary or benefits.)

There is no longer any justification for the city to be competing with private business to fill nursing-home beds - basically using taxpayers' funds to give itself a competitive edge. That's not fair to private nursing homes or to taxpayers.

A change such as this can be emotional for the home's patients and staff. But city leaders must be guided by their responsibility to taxpayers. Roanoke has many needs that only the government can provide. The money that would be freed up by getting out of the nursing-home business can and should be put to better use.