What’s old will be made new again.

The Greenwich Representative Town Meeting on Monday approved $20.5 million in bonding for the renovation of the town-owned nursing home on Parsonage Road.

“Project Renew,” as it is being called, will increase the number of single, private bedroom units in the facility from 26 to 62, and the number of double bedroom units from 136 to 142, through the elimination of 40 less-popular four-bedroom units and reconfiguration of interior space.

The project also includes installation of a sprinkler system in the nursing home's 80-year-old administration building, as well as installation of new boilers for heat and hot water; new backup power generators; new bathrooms and nursing stations; and expansion of the existing rehabilitation space. The building’s square footage and existing footprint will remain the same.

The RTM voted 153 to 28, with 10 abstentions, to finance the project. As per the town charter the request for authorization for bonding required a majority vote of the 230-member legislative body — less vacancies — thus it required a minimum of 116 "yes" votes to pass.

The total project price tag is $22.5 million. Some smaller parts of the project have reportedly already been completed. Construction will begin in 2013 and the project should be completed by 2014, according to David Ormsby, chairman of the Nathaniel Witherell board of directors, who spoke at last night’s meeting.

"Nathaniel Witherell has waited patiently, politely and without complaint,” Ormsby said, making reference to the other capital projects the Town has undertaken in the past year, including the construction of a new auditorium for Greenwich High School and the renovation of the Central Fire Station. “Now, I would suggest it is our turn.”

As Ormsby explained, Project Renew has "seen a long journey" since the initial, $45 million plan to build anew was first proposed in 2002. In 2006, that plan was withdrawn after support for it eroded due to its high cost, he said. A subsequent plan calling for a scaled-back, $38 million (but still all-new) facility, based on the original plan, also failed to pass in 2010. With each new plan and each set of public meetings the project stirred debate all along the way — finally reaching its milestone approval from the RTM on Monday.

“Nathaniel Witherell is a central component in the continuum of care offered by the Town of Greenwich to its residents,” Ormsby said. “For many Nathaniel Witherell represents a final support system for our weakest and most vulnerable citizens.”

This time around the project has been scrutinized in the context of other Town capital projects and its impact on future town budgets. Uncomfortable with the Town’s rising level of debt service, the Board of Estimate and Taxation recently implemented a cap on spending for all municipal capital projects, making prioritization of such projects more challenging.

Opponents of the project contended that it could preclude the town from pursuing upcoming and perhaps unexpected capital projects. Some opponents said it was too risky for the town to be in the healthcare business at this time, due to pending federal legislation and the many unknowns of how the industry will operate in the future. They suggested the town mitigate this risk by tuning the facility over to a private operator. Other opponents sais the Town had not done its due diligence in planning the future of the facility.

“The BOC supports Nathaniel Witherell — it has an important role in or community and it has passionate support for its important function,” said Bill Drake, chair of RTM Budget Overview Committee, in his committee report. “We think that a ‘no’ vote is a vote for a permanent and sustainable solution. We think it’s a responsible and positive step and we invite you to join us. A ‘no’ vote is not a vote to close Nathaniel Witherell.”

“The easier thing to do is pass the cost to taxpayers now, and ask for their financial support annually for the next 20 or 30 years,” Drake added. “The right thing to do is to involve all the parties – the board of Nathaniel Witherell, the private friends of Nathaniel Witherell, the town, the state, the unions and management to cooperate to design a solution that can last. One that can finally put the Witherell on sound financial footing and change it private ownership. The time is now to get it right.”

Supporters of the project said it would result in operational effieciencies that would help the nursing home stay out of the red (it reportedly just turned a small profit in the past couple years due to improved management) — in particular that the increase in the number of single bed units would help it attarct more patients and more cost effectively support them.

Helping to defray the cost of the project for taxpayers is a certificate of need that the nursing home obtained from the state and a subsequent commitment from Gov. Dannel P. Malloy's administration to increase Medicaid reimbursement rates for the project.

Doug Wells, chairman of the RTM Legislative Rules Committee, in his committee report explained that the state will fund $12 million, or about half the cost of the project, through an enhanced Medicaid payment through the state over a period of about the next 30 years. Wells said the current $252.63 per day the nursing home gets from the state per Medicaid patient will increase by $13.70 per patient per day.

The nursing home gives priority to Greenwich residents. Currently about 90 percent of Nathaniel Witherell’s residents are from Greenwich “or have a Greenwich connection,” Wells said.

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