Butler County Care Facility develops niche to stay afloat

The Butler County Care Facility is still struggling a bit financially and the outdated building and growing competition have the county commissioners looking for a consultant to devise a master plan for its future.

The 109-bed 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 County Commission since 2013 to fill budget gaps, largely because of the shifting rules and funding levels of Medicaid reimbursement.

Care Facility Administrator Chuck Demidovich had intended to fully repay his debt to the general fund this year, but that isn’t going to happen.

“Bottom line is we plan to pay $250,000 back, we’ve got $937,000 in the bank, we want to pay 250 of it back, it keeps us enough for an operating margin there,” Demidovich said. “Next year our goal is to pay another $250,000 of it back and the third year out pay the last $250,000 back.”

Demidovich said his census, which usually stands around 90 to 92 patients, is now hovering at around 87. They used to have more long-term patients but now the push is on from the state and insurance companies to get people back home — either to their homes or homeless shelters — as quickly as possible.

With shorter stays the administrator says he needs more patients. About 95 percent of his referrals come from Fort Hamilton Hospital but he said he plans to employ a marketing strategy to tap into Bethesda Butler Hospital and the Kettering Health Network. He said there are six nursing homes within three miles of Bethesda Butler and he needs to be able to compete.

“Your statement that you want to remain competitive, I’m just coming into this, but I thought our facility is for people that can’t afford anything else and that’s why they come to the county facility,” Commissioner T.C. Rogers said during Demidovich’s budget hearing. “I wasn’t aware that we are competitive with the other rest homes in the area.”

With the expansion of Medicare in the state and the fact everyone is required to have health insurance of some kind, Demidovich said while his niche is still the most difficult patients — with mental illnesses and other serious issues — that other facilities “don’t want” he still needs to have his facility at the forefront.

“In nursing homes marketing is to the hospitals, letting them know what beds are available, letting them know we will take these kind of people, that’s where we get 95 percent of our referrals,” he said. “Am I going to go on TV and run an ad, no. Am I going to walk to the hospitals with brochures of what services we provide, yes.”

But just getting the name and reputation of the facility out there isn’t going to be enough. Demidovich told the Journal-News it would cost about $47,000 to buy new dining tables and chairs and about $20,000 to replace the 12-year-old carpeting. He also needs about $60,000 to $70,000 to convert the Alzheimers wing so patients who would like private bathrooms can be accommodated.

Commissioner Don Dixon, who is in the nursing home business, said he fully understands Demidovich’s predicament.

“Not only do you have to do it by advertising and marketing but you have to do it with your physical plant,” Dixon said. “Your physical sticks and bricks and that’s somewhere where you guys are running into trouble I’m sure.”

The commissioners agreed they need to find a consultant who can help build the niche for the county home and Demidovich said they will be sending out a request for proposals.

“We have to step in and fill the needs where the private sector won’t go,” Dixon said. “And I know that we’re not going to make any money, you’re not making any money the way you’re going right now, we owe it to the taxpayers to say, if we’re going to spend your money, we’re going to spend it to take care of a need they can’t get anywhere else, that’s really what everybody thinks of the county home anyway and that’s the way it should be.”

Leslee Mast, president of the Ohio County Home Association, said she believes the government-run nursing homes are still viable and needed in the state.

“We all function differently, like our facility is supported through a tax levy,” she said. “So we’re different from Butler County, but with ours, our community votes on it so we know they want us still there.”

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