RAVENNA — The future of the Ravenna Medical Clinic became clearer Monday night.
Owner and physician’s assistant Ryan Lieske said his clinic lost $20,000 last year. Lieske said he plans to apply for a $12,000 a year grant for five years through the city of Ravenna to help keep the clinic open.
If the Ravenna Economic Development board and City Council don’t approve the application, Lieske told the Kearney Hub he won’t sign a lease renewal on his clinic’s building with the city of Ravenna.
The loss of the clinic would be a another blow to a community that has lost a manufacturing plant, Burlington Northern Santa Fe railroad stop and grocery store within the past six years. The nearest medical clinics are in Loup City, Grand Island and Kearney.
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Lieske said he thinks the loss of the clinic would be devastating to the community.
“I don’t think you’re going to get a grocery store to come to town. I don’t think the pharmacy’s going to survive. When you lose a grocery store, a clinic and a pharmacy, I don’t know how the community survives because it will eventually hurt the nursing home and assisted living,” said Lieske, who currently serves Seneca Sunrise Assisted Living residents.
Additionally, Ravenna community member Sharon Gruhn said she would follow Lieske to another clinic if he leaves Ravenna.
“And my prescriptions are going with me,” she added.
Gruhn said she likes Lieske, and though he’s a PA, she would rank him as high as any doctor.
The potential loss of the clinic has been a topic of discussion in Ravenna for some time.
On Monday night at the Ravenna City Council meeting, about 100 people packed a small conference room to hear about Lieske’s lease negotiations with the city.
Since Lieske took ownership of the clinic from First Care Medical Clinic in 2017, Lieske has used the building rent and utility free, but these cost savings haven’t been enough, according to Lieske. He said it’s tough to keep the business in the black because Medicare and Medicaid reimbursements are less each year.
“We’re still as busy as we ever were and we’re still supported. It’s just reimbursement is worse,” Lieske told the Hub after the meeting. “With private insurance you get $110 for a 15-minute office visit. Medicare pays you $58. Medicaid pays you $48.”
Lieske said many of the Ravenna Medical Clinic patients are on Medicaid.
In August, Lieske asked the City Council for $12,000 to continue operations.
“When I told them I lost $20,000 last year, I asked for $1,000 a month. I told them it would not go to anybody’s salary. It would just go to pay the expenses and I was willing to show them receipts and everything,” he said after the meeting. “I was willing to lose the other $8,000 and I was willing to be able to assume any other further losses.”
But at Monday night’s meeting Ravenna City Attorney Mark Eurek said it would be illegal for the city to provide the funds to Lieske.
“The city cannot give taxpayer money to individuals,” Eurek said.
However, as discussed at the August meeting, Lieske could apply for a grant. That grant money was made available through LB840, a half- cent sales tax, which was approved by Ravenna voters in 2011, Eurek said.
Ravenna City Clerk Kellie Crowell told the Hub that there is $387,648 in that fund.
Lieske said before he decided whether to apply for grant funding, he wanted to reach an agreement on the building lease with the city. The lease provided to Lieske on Monday outlined that he must provide his tax returns before each lease renewal. Lieske didn’t agree with the term.
“I freely gave you my financial information in April and May. And the first contract you offered back to me was $5,000 of rent even after I showed you my loss,” he said to the council. “In my opinion I feel my tax returns have no bearing on this contract.”
The City Council agreed to strike the income tax return requirement from the lease, but Lieske will need to provide that information on his grant application.
Buffalo County Economic Development Council President Darren Robinson asked that the city “limit how many eyes are on Lieske’s personal finances.” City Council members said they would comply with that request. Robinson is assisting the Ravenna Economic Development board and Lieske through the process because Friday is the last day for Ravenna Economic Executive Director Dana Dennison.
Lieske also asked that the lease agreement not make him responsible for maintenance and repairs to the walls, ceiling, windows and interior door surfaces and all fixtures. The council agreed to strike those requirements from the contract and to cover those expenses.
The council then unanimously approved the lease, which outlines that the city will pay for utilities each month for five years and the tenant will pay $1 a month rent.
With a lease agreeement, Lieske said he will apply for the grant from Ravenna Economic Development, which will review the application on Sept. 26. The City Council will set a special meeting that evening or the following day to make a final decision.
City Council member Fred Matejka said if the economic development board approves the application, “We would have no problem approving those funds.”