Saturday, September 26, 2020

Fifty-four years later, Metro is closing the Bordeaux nursing home.

by Rod Williams - After serving in the council and also just observing government for a long time,  I have learned a few things. One is that government is slow to change. Part of that is structural.  Because  new budgets are build upon last years budgets, it is easier to look at new needs and ask for more money than it is to reorganize or eliminate a division. Growing departments can provide more opportunity for promotions and employees are happy and the bigger a budget one commands, the more respect.  So, positions or agencies that have outlived their usefulness continue to exist. Bloated departments get more bloated. 

Another factor is that elected officials do not want to reduce the number of government employees.  They do not want anyone to lose their government job, ever.  Thankfully the State of Tennessee is not afflicted by this but it seems Metro and most governments are. Maybe it is because government employees are also voters.  Employees and their families make up a big part of the electorate. However, I think it has more to do with a mind set that government should set an example and that public service is somehow more noble than just working for money and that public servants should be immune to the laws of economics. Let me give you a couple examples:

When I first got elected to the Council in the 80's we still had elevator operators in the courthouse. There was a basement were there were a couple public offices and a snack bar, the ground floor where the mayors office is located, the second floor or mezzanine level where the Council meets, a third floor operated by the Sheriff's department.  There may have been a fourth floor but it was not open to the public and I don't recall what was there or even if there was a fourth floor.  Only rarely did someone go to the third floor. So basically the elevator served the basement, the first floor and the second floor.

Now, at that time, Metro courthouse was the only building in Nashville that still had elevator operators. I remember as a young boy growing up near Knoxville, I would go to town with my parents and there were department stores that had elevator operators but not many.  By the 1980's elevators were self-service. In the Metro Courthouse, the city had already modernized the elevators.  They no longer required manually closing the elevator gate and door and driving the elevator to the requested floor and properly aligning the elevator and building floors. By the time I was elected to the Council, elevators look much like they do now, yet there was an operator who sit a stool inside the elevator door and asked you which floor and pushed "B," "1," or "2," and rarely "3." Soon after I was elected in one of the first budgets, those positions of elevator operator were eliminated, but not without some regret and grumbling. 

Also, when I was elected, the city still had an ordinance that required all movie theaters to have a licensed projectionist.  At one time, so I understand, operation a movie projector was a skilled job and movie projectors were a potential fire hazard if not operated properly.  By the 80's technology had changed and any high school kid could load a cassette into the projector, yet Metro still required the job to be performed by a licensed projectionist. The law was essentially ignored but on occasion enforced. A bill was introduced in the Council to repeal the law.  It was resisted by the labor unions and many councilmembers voted against changing the law. It was changed but not without resistance. 

When I was first elected, Metro still provided twice-a-week, back-door garbage collection with everyone providing their own garbage cans.  This was costly as an operating budget item but also, disability claims and disability retirement by garbage men was an enormous cost. It seems as if it was almost expected that garbage men retired early with disability.  I don't doubt that the disabilities were real. Emptying garbage cans all day is bound to eventually cause a back injury. 

We did go to once-a-week, street or alley,  automated lift, collection as we see today but not without a fight.  Many wanted to keep the collection the way it was. People liked collection from their back door and did not want to haul their garbage cans to the street or the alley.  Secondly, many on the council saw the position of garbage man as a valuable employment opportunity we were providing to the least employable citizens.  High school drop outs who were not too bright could collect garbage and they didn't feel we should eliminate those jobs.  This change in the way we collect garbage took months to achieve and was hard fought. 

Medicaid was passed into law in 1965. By that act, the poor were no longer dependent on charity.  The poor were given choices.  At that time, Metro operated a charity hospital and charity nursing homes. We still do.  It was just recently announced that we are finally closing the Bordeaux nursing home. 

Signature HealthCARE has been the operator of the Bordeaux nursing home for the last six years and their contract is expiring in January. Prior to 2014, Metro actually operated the facility and the staff were metro employees. In 2014 we privatized the operation of the facility and it is now operated by Signature. Metro sent out an RFP for an operator and neither Signature nor anyone else submitted a proposal. Bordeaux has been unable to fill its beds and is operating at only one-third of its licensed capacity. Bordeaux is rated 1-out-of-5-stars by CMS. So, finally Metro is closing the Boudreaux nursing home and the site will be redeveloped. It is not anticipated there will be difficulty in finding beds for the patients in Bordeaux as there is adequate capacity at nearby facilities. 

Finally, we are getting out of a business we should have gotten out of over fifty years ago. It is now time to  also close General Hospital. We need to change the mindset that because government once did something, it should do it forever. We need to recognize that change happens. We need to embrace technology and innovation. Transportation is a good example. We still move people along fixed routes in big conveyance vehicles while in the private sector, on-demand and flexibility and options are the norm.  We need to stop thinking that it is governments job to give people a government job with a guarantee they will never lose that job. 

For more on the closing of Boudreaux, follow this link and this link

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