Study to determine viability of county nursing home

Feb. 08--BUTLER COUNTY -- Butler County commissioners plan to spend $9,500 on a study to determine whether the county should be in the nursing home business.

The 109-bed Butler County Care Facility is one of 33 county-run nursing homes left in Ohio. The nursing homes were mandated in all 88 counties when the first facility was built in 1830 to serve the sick, poor and homeless. Many of the facilities closed after the state legislature lifted the mandate, and counties opted to let the private sector handle nursing care as government budgets shrank.

But Butler County has maintained its county-run nursing home despite its financial challenges in recent years. The care facility has had to borrow $1.1 million from the commissioners since 2013 to fill gaps in the $7.4 million budget, largely because of the shifting rules and funding levels of Medicaid reimbursement.

Care Facility Administrator Chuck Demidovich said he has $500,000 remaining on his bill with the county. He intends on erasing the debt over the next two years.

The commissioners approved a $9,500 contract with Plante and Moran on Monday to do a "comprehensive assessment of the role of Butler County Care Facility in the community and strategic planning analysis."

A letter by Christopher Joos, a partner with the firm, outlined the scope of the project that potentially has two phases. The first phase, which the commissioners agreed to fund, involves determining if the facility has value in the community. If it is determined it does and will in the future, then the commissioners will be asked to authorize $13,000 to $15,000 for the second phase.

The first phase includes examining market demographics, admissions, patient mix and profiles and other data. This phase is expected to take about a month. If authorized, the second phase involves recommendations for how the facility can stay viable into the future.

"Phase 2 includes meetings with the management team and or key stakeholders to prepare data, complete analyses and discuss strategic initiatives and potential priorities for the future," Joos wrote.

County Administrator Charlie Young said the thrust of the study is not necessarily to advocate for or argue against closing the facility.

"It's really to look at the needs within the community," he said. "We're trying not to make any assumptions ahead of time about what those needs are and how they are best met."

With the expansion of Medicare in the state and the fact everyone is required to have health insurance of some kind, Demidovich said his niche is still the most difficult patients -- with mental illnesses and other serious issues -- that other facilities "don't want." His census has remained pretty steady at 90 percent or 99 patients. He said he is seeing younger patients with chronic illnesses who now have Medicaid coverage, so he believes his financial woes may be over.

"We've been able to keep our census up, and we've done a pretty good job of getting people that are pending on Medicaid, into the Medicaid system," he said. "I can pretty much break even and make one or two percent, but it's not a huge profit margin by any means."

Commissioner Don Dixon said another part of the equation is the building is in bad shape and if the county decides to stay in the nursing home business they would seriously need to consider building a new facility. Demidovich said with today's regulations that would cost $12 to $14 million.

The commissioners have been wrestling with whether they should remain in the health care field for some time. The answer has always been there are poor people out there that have no other options so the Care Facility should stay. Now they are just going to quantify their decision with hard facts.

"At this point it is not specifically about the money," Dixon said. "It is how does it fit into our overall social services plan for the county. At the end of the day, if there is a need and we need to subsidize it, then that's something we need to talk about."

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