1. Ownership Alternatives Public Meeting Premier Healthcare Resources

2. Ownership Alternatives Nonprofit Corporation Facility Lease Facility Sale

3. Nonprofit Corporation Established as a 501(c)3 Corporation Owned by the County Governed by Board of Directors Board is created by County Commissioners County Commissioners Only County Commissioners and Community representatives County is still liable for any financial outcomes

4. Nonprofit Corporation Benefits for Operations Increases flexibility for staffing No mandatory pension for employees 1000 hours or more a year Reduces Nursing agency costs by increasing Per Diem staff Allows facility to be responsive to market changes Salary Structure Flexibility in structuring employee positions Increases flexibility for operational changes Be more responsive to industry needs/demands Reduces the layers in decision making process Flexibility in purchasing decisions Accountable to Board for financial outcomes

5. Nonprofit Corporation Reduces Personnel Costs Employees are employed by the Facility not County Structure Compensation Package Competitive with Nursing Home Market Salary Paid Time Off Health Benefits

6. Nonprofit Corporation Reduces Personnel Costs Freezes County Pension for current employees No longer contributing to County Pension Pension is still payable based on vesting 5 Years to vest in pension Establish a 403 b retirement package Allows employee to control the amount saved for retirement Allows employee to control their investments Facility can provide match

7. Nonprofit Corporation Eliminates Indirect Costs County no longer allocates indirect costs Services can be contracted – fair market value Need additional staff at Facility Accounting Need to train staff to handle increased responsibility Personnel Purchasing

8. Nonprofit Corporation Increased costs Additional Personnel – Accounting Department Legal Fees – Establish Corporation ( One time cost) Legal Fees – Other issues Increased Administrative time Establish Policies and Procedures Establish Personnel Policies Establish Employee Benefit Program

9. Nonprofit Corporation Financial Outcome – Nonprofit Corporation Projected Net Income $603,239 Financial Outcome – County Identify indirect costs that can be reduced 25% reduction - $346,489

10. Facility Lease County still owns the buildings and furnishings Transfers license and operations Third party operator establishes own operating structure Eliminates County control of Facility mission Unless stipulated in the lease agreement

11. Facility Lease Benefits for Operations Increases flexibility for staffing Operator establishes compensation and benefits package Increases flexibility for operational changes Operator establishes policies and procedures for Facility

12. Facility Lease Eliminates ongoing Personnel costs for County Employees are employed by the Operator Operator structures Compensation Package Competitive with Nursing Home Market Salary Paid Time Off Health Benefits

13. Facility Lease Reduces ongoing Personnel Costs for County Freezes County Pension for current employees No longer contributing to County Pension Pension is still payable based on vesting 5 Years to vest in pension Operator establishes retirement program Competitive with Nursing Home Market

14. Facility Lease Eliminates Indirect Costs County no longer allocates indirect costs County only owns the Buildings and Furnishings

15. Facility Lease Financial Outcome – County Defined negotiated lease payment Based upon Operators return on investment Impacted by Lease agreement stipulations Medicaid occupancy percentage Capital improvement requirements

16. Facility Lease Financial Outcome – County Identify indirect costs that can be reduced 25% reduction - $346,489 Capital improvement requirements Unless stipulated in lease agreement

17. Facility Sale County no longer owns building or license Facility is owned by a private operator Eliminates County control of Facility mission Unless stipulated in the sale agreement

18. Facility Sale Benefits for Operations Increases flexibility for staffing Owner establishes compensation and benefits package Increases flexibility for operational changes Owner establishes policies and procedures for Facility

19. Facility Sale Eliminates ongoing Personnel Costs for County Employees are employed by the Owner Owner structures Compensation Package Competitive with Nursing Home Market Salary Paid Time Off Health Benefits

20. Facility Sale Reduces Personnel Costs Freezes County Pension for current employees No longer contributing to County Pension Pension is still payable based on vesting 5 Years to vest in pension Owner establishes retirement program Competitive with Nursing Home Market

21. Facility Sale Eliminates Indirect Costs County no longer allocates indirect costs

22. Facility Sale Financial Outcome – County Proceeds from Sale Negotiated sale agreement Based upon Owners return on investment Impacted by sale agreement stipulations Medicaid occupancy percentage

23. Facility Sale Financial Outcome – County Identify indirect costs that can be reduced 25% reduction - $346,489