The Bedford County Nursing Home. Courtesy of Bedford County.

Disagreement with federal COVID-19 mandates for healthcare workers may prompt Bedford County’s Board of Supervisors to sell the Bedford County Nursing Home, one of the few county-owned nursing facilities in Virginia.

The board will hold a special meeting to conduct a public hearing on Monday at 7 p.m. regarding a potential sale of the nursing home, which traces its roots back to days of the old county poor farm, which was founded in 1831 to house indigent people in an age before Social Security, Medicare, Medicaid and other features of America’s social safety net emerged.

Supervisors cited an “ever-increasing regulatory environment,” specifically the COVID-19 vaccine mandates for nursing home employees, as a primary reason for getting the county out of the nursing-home business, according to a statement issued by Bedford County public information officer Shelley Basinger.

In January, the U.S. Supreme Court upheld a Biden administration mandate that vaccinations against COVID-19 be required for all healthcare employees at facilities that receive Medicare and Medicaid funds. Bedford County’s statement cited that the ruling goes against the supervisors’ opposition to mandates and prompted the board to find a buyer for the nursing home.

“With the ever-increasing regulatory environment surrounding nursing homes, the responsibility to make wise decisions in this area is best addressed by industry experts who specialize in healthcare compliance, rather than local government officials who do not have this expertise,” the statement read. “This has always been a challenge, but the COVID-19 pandemic enhanced the [b]oard’s curiosity to explore other options. The healthcare employee COVID-19 vaccine mandate, as reaffirmed by the United States Supreme Court, is contrary to the positions of all [b]oard members and has further complicated uniformity with how employees are treated across all departments of County government.”

Voice and email messages seeking information from other public officials, which included county administrator Robert Hiss and supervisor Tammy Parker, whose district covers the nursing home property, were not returned on Friday afternoon. Basinger wrote in an email: “We will conduct interviews with the media after the Board makes its decision.” 

Bedford County is considering Roanoke-based American HealthCare LLC as a possible buyer of the nursing home, a multi-building complex that is home to about 90 residents and stands in Falling Creek Park at the end of County Farm Road not far from Poorhouse Creek.

American HealthCare operates a string of Heritage Hall Healthcare and Rehabilitation Centers in central and western Virginia, including nursing homes in Blacksburg, Lexington, Brookneal and Tazewell, as well as rural locations in Carroll and Giles counties. American HealthCare also owns South Roanoke Nursing Home.

Bedford County Nursing Home is one of just five long-term care facilities still operated by municipalities in Virginia. The others include Birmingham Green in Manassas, Lucy Corr in Chesterfield, Dogwood Village in Orange County and Lake Taylor Transitional Care Hospital in Norfolk. 

“Governments are getting out of the healthcare business,” said Thomas Orsini, administrator of Lake Taylor. “The same thing happened to general hospitals years ago. It’s been a slow process, but there aren’t many of us left.”

Bedford County Nursing Home receives no county money for operations, relying instead on room rates that cover Medicaid reimbursements. According to an article written by former Bedford County Nursing Home administrator Sue Ellen Clark that was posted on LinkedIn in 2018, the nursing home is self-supporting, with more than 80% of residents relying on Medicaid.

The article also noted that the nursing home evolved from the old county-farm – also known as the “poorhouse” – system Virginia relied upon for more than a century. Poor and enfeebled residents across the commonwealth often ended up living at the county farm, where they would be taken care of or forced to work to pay off debts (The article can be read with a LinkedIn account at https://bit.ly/3EglotA.)

The county-farm system lived well into the 20th century before the United States began adopting ways to address an aging, growing citizenry that needed far more assistance than county poorhouses could provide. With the creation of Social Security, Medicare, Medicaid and other government-backed aid programs, county farms disappeared by the 1950s – although many Virginia counties still have a “County Farm Road” or a “Poor Farm Road” on the maps.

In Bedford County’s case, the poor farm became a nursing home operated by the county – at least for the time being.

According to the county news release, supervisors could approve a sale of the nursing home to American HealthCare as soon as Monday following the public hearing.

“If approved by the [b]oard, there will be a closing period of approximately 60-90 days before American HealthCare would officially take over operations,” according to the county’s statement.

Ralph Berrier Jr.

Ralph Berrier Jr. is a writer who lives in Roanoke.