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Staff cuts, renovations at Butler County-run nursing home

Hamilton Journal News - 4/26/2017

April 26--BUTLER COUNTY -- The Butler County Care Facility has struggled financially for years, but the dark, unwelcoming atmosphere has been eradicated and a consultant hired by the county is working on revenue enhancements, process improvements and realigning staff for more efficiency.

FIRST REPORT:Taxpayers bail out county home with nearly $1M

Butler County hired Jennifer Strickland, a consultant with LeaderStat LLC, about a month ago to work with and eventually take over for the current Care Facility administrator, who plans to retire in September.

County Administrator Charlie Young said one of her first recommendations was to realign staff to industry standards.

"We are now streamlining operations, as part of that effort we are more closely aligning our work force to industry standards," Young said. "That has resulted in reductions in some areas. We will be working with those impacted as some have transfer and or retraining opportunities."

Young said 16 reduction-in-force notices went out about a week-and-a-half ago but the net result will only be about six people. Several employees have left the county's employ and others are taking advantage of retraining. Strickland said the RIF process is still a work in progress and there were about 120 employees before the layoff.

"What we are wanting to do is be more efficient with taxpayer dollars," she said. "The goal overall is to be self-sustaining and progressive in our directions so we can continue to be a viable resource for the community moving forward."

Jennifer Hensley, a nursing manager at the facility, said the staffing reduction upset some people at first.

"As far as staffing, we're rolling with it, we'll see," she said. "There have been a few people upset, some of the staff, but I think it all ended up working out. I don't think it's as bad as anticipated."

The county is paying LeaderStat up to $48,000 for Strickland's services until September. The company specializes in interim health care staffing and recruitment for post-acute and senior care providers, according to its website.

In December, commissioners had to loan another $225,000 to the facility so payroll could be met through the end of the year. That brings the Care Facility's outstanding bill up to $750,000, just below a previous loan amount of $1.1 million.

Commissioners have all said previously they have a duty to keep the nursing home because it is the "last resort" for medical care for some poor and elderly residents.

Young said even though the facility has been failing financially the commissioners knew they had to spend some money to get it to a viable condition both physically and fiscally -- hence they have co-administrators in Strickland and Chuck Demidovich for about six months.

"The reality is the policies and procedures that we had in place, we needed to change them. So we needed to bring expertise in to bear to make sure the changes we were making were good changes, that they were going to lead to better care and they were also going to lead to more efficient care, so we could get the facility back on stronger financial ground," Young said. "The reality is sometimes you have to pay for expertise."

Commissioner Don Dixon said keeping Demidovich on the payroll -- he earns $86,323 or $107,153 with benefits -- until he retires was a good move because he has institutional knowledge Strickland needs.

"It was a good business move to be able to transfer some of his knowledge to the new person and help with the transition," Dixon said. "He's got a 20 year history and he's got a lot to contribute."

The commissioners hired another consultant Plante Moran a year ago to study the different options for pulling the failing facility out of the red. Chris Joos, a partner at the business consulting firm, gave the county several "scenarios" that included a "do nothing" option.

He said the county could raise taxes, lease the facility to a third party to run, continue to outsource billing and accounting functions, downsize to 99 beds and spend $500,000 making renovations to the facility so it is more competitive with private providers. Under this plan, the Butler County Care Facility "would be able to reach a healthy cash balance of $1 million by 2019," Joos wrote.

The commissioners have said that a tax levy is not an option.

Demidovich had already begun some of the suggestions before the report came out, like changing some billing practices and sprucing the place up so it isn't so dark and uninviting. Before, windows were covered up, it was dark and shabby looking. Today the concrete block walls in the main area are painted white, there is new, bright, energy-efficient lighting and a spectacular view of downtown Hamilton can be seen out of windows now cleared of obstructions.

They have spent maybe $10,000 on the transformation -- out of the maintenance budget -- and Strickland said it is a "blank canvass" at this point because new furniture, flooring and other improvements are in the offing.

Dixon said the nursing home has always been top-notch in terms of patient care but other priorities countywide have put it on the back burner facilities-wise.

"No one has ever neglected it as far as patient care and cleanliness goes, we didn't have the resources to put behind it, update it and bring it up where it needs to be," Dixon said. "We're not going to be up there as a 'Five Star' structure, that's not our goal, that's not our mission, our mission is to take care of the people who need us."

Michael Faulkner, a former patient at the nursing home, was back for a visit this week and couldn't believe the transformation. He has been able to get back on his feet after a year at the facility and now has an apartment in Hamilton.

"It's wonderful, it really is," he said about the improvements, adding the care he received there saved his life. "It did me wonders, I don't know where I'd be without it. It's the best thing that ever happened to me."

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