As planned the Butler County commissioners announced Monday they will be closing the Care Facility by the end of the year because of COVID-induced staff shortages, dwindling census numbers and ever changing federal and state rules.
The three commissioners have remained steadfast in their commitment to keeping the skilled nursing facility afloat, loaning substantial general fund sums through the years. The three told the Journal-News last month this would happen.
“It breaks my heart to have to close, the residents and employees have become family and no one wants to cause duress to a family. Though the work during COVID/post-COVID and the toll on staff and residents no longer make sense for a county to operate a skilled nursing home facility and to care, in some instances, for critically ill residents,” Commissioner Don Dixon said. “Government doesn’t have the resources — human, capital or financial — to operate such a specialized service.”
The 109-bed facility, located at 1800 Princeton Road, opened in 1975 and for nearly a half century has provided skilled nursing home care to the infirm and vulnerable populations with little alternative for care. With only 28 residents remaining, the county believes it is time while the market can absorb additional residents. In less than a month, the home has lost nine residents.
“We’re going to do what we can to deploy our necessary resources to compassionately place the remaining residents and of course assist in finding opportunities for employees who we value their service,” Commissioner T.C. Rogers said.
County Administrator Judi Boyko told the Journal-News they have been having general conversations with families, staff, the union that represents some of the workers — that contract is in negotiations — contractors and others that will be impacted by the closure. They needed to make the decision now because there are many statutory requirements, regulations and formal notifications that must be made.
“There’s a statutory process and of course we’ve been identifying critical action items including identifying alternative locations for the residents, obviously working on a staffing plan operationally that would continue to serve whichever residents are there through Dec. 31,” Boyko said. “Notifying any contracts we have with the appropriate termination dates, to name a few things.”
Staffing has been a real problem at the home, forcing the commissioners to use outside staffing agencies to run the facility. The commissioners approved two separate short-term contracts with outside staffing companies totaling $100,000 in the past couple months. Since the outbreak of the pandemic and through the end of last year the county spent $1.3 million on outside agency workers. As of a month ago, they had spent $461,839 on contracted workers.
According to the AARP Nursing Home COVID-19 Dashboard, as of the end of March, 42% of the nursing homes in Ohio are short-staffed; the average nationwide was 32.3%.
Boyko said there are only 15 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 infirm, 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.
Commissioner Cindy Carpenter said “we’ve tried” to keep it open but the time to shut the doors is now.
“We tried to keep the Care Facility afloat and it’s been commitment of this board, but I think we were challenged by the pandemic,” Carpenter said. “It’s pretty obvious the time has come that the facility just can’t be supported by county government. It’s not part of our core duties.”
Boyko said the home’s cashflow currently only covers roughly 70% of the expenses. Through the years the commissioners have had to bail the financially fragile nursing home out with general fund cash infusions, for a variety of reasons. Since 2016 the commissioners have transferred roughly $1.7 million from the general fund to the nursing home in annual loans in the $300,000 to $400,000 range. At one time, the county nursing home owed the general fund $1.1 million, a debt the home partially repaid.
The facility will be repurposed, the prevailing thought has been to use part of the multi-winged building for an emergency mental health crisis stabilization center. Dixon said there could be other medical related uses that also share the facility.
“I think the times have changed to where the building can be repurposed into some other medical and clinical care opportunities for the county,” Dixon said. “The building is not going away our folks are going to be integrated in the rest of the long-term care systems ... I think it’s in the best interest of our taxpayers and the residents and we’ll be able to provide some other services that we desperately need at this time as the healthcare requirements of the county have changed.”