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by Mark Cheffey
Marion County voters will be asked April 4 to support Proposition A, which proponents contend is vital not only to maintain local control of Maple Lawn Nursing Home, but even provide for its continued existence.
If approved by a simple majority, Proposition A would boost the Marion County Nursing Home District’s property tax from the current 13 cents per $100 assessed valuation, to 25 cents.
The revenue raise by the tax, which has never been raised since the district was established, provides local financial support for Maple Lawn Nursing Home.
This is the second attempt by the district to raise the levy, following a failed try during the August 2022 election, when voters rejected a 22-cent raise.
If the proposition does not pass this time, the district would not be able to try again until next year and not see a boost in revenue until 2025.
“By that time it is most likely that we would not be able to provide our services to the standard that we have been known for,” said Jesse Soodrum, Maple Lawn administrator.
“Maple Lawn has already looked at other ways to cut cost by cutting positions and renegotiating contracts with vendors,” Soodrum said, noting the only hope is to raise revenue.
“In the early days, Maple Lawn was full with more than half its residents as private pays and never saw the need to request an increase in the tax levy,” Soodrum said. “It’s a different world today with increased cost of food, labor and medical supplies. If we did not need the help we would not have brought the situation to the residents of Marion County.”
With other independent nursing homes already closing or facing similar difficulties, Maple Lawn is facing the real possibility of having to sell to a large private company, or even shutting its doors.
“We are lucky to have a good quality nursing home in the community available to its residents who have been past teachers, pharmacists, farmers and neighbors who have supported the nursing home in the workings days,” Soodrum said. “It would be unfortunate to have to uproot them to find comparable care far away from their home.”
According to Soodrum, the cause of the current situation is simple: skyrocketing costs accompanied by flat revenues which included federal and state funding.
While Maple Lawn, and the nursing home industry as a whole, have been strong financially even in the recent past, it all changed drastically when the pandemic hit.
“COVID 19 has brought significant damage to the long- term care industry nationwide,” Soodrum said, noting it resulted in a sudden labor shortage that has effected Maple Lawn and the industry to this day.
“There has been an uncontrollable increase in the cost of labor with the emergence of staffing agency with unnatural wages for CNAs and nurses,” Soodrum said.
And accompanying the higher labor costs are exacerbated by limits on revenues.
Soodrum noted Maple Lawn has had to maintain bed space for COVID patients while also having to cope with the closure of one of the facility’s wings, putting major limits on the number of beds the facility is able to offer.
Soodrum said the closed wing was decertified and initially remodeled for assisted living services but the project was abandoned during the pandemic.
And Soodrum points out unavailability of local workers increases workload, boosting the risk of losing more staff because of burnout.
“That increases the risk of abuse, neglect, accidents, medication errors, complaints, and therefore increase in risk of fines from state and could eventually cost more than the facility can afford,” Soodrum said.
Despite the difficulties, Soodrum said Maple Lawn has been able to maintain a high level of care to this point.
“We are able to provide a higher staff to resident ratio than other nursing homes to make sure that residents are helped in a timely manner,” Soodrum said. “We are the only five-star staffing rated facility in the area according to the Medicare website because we want to make sure that we are able to completely meet the needs of every resident we take in.”
And Soodrum said its status as an independent nursing home results in a stronger commitment to the residents, most of whom are from the local community.
“Maple Lawn does not only invest in the quality of care but also in the quality of life of our residents,” Soodrum said.
But that level of care is under financial strain due to a lack of corresponding support from federal and state funding sources.
Soodrum noted the average nationwide daily cost for a resident is $260 and the base rate for Medicaid residents is only $173/day per residents.
As a result, the district depends on local tax money to compensate for the gap between Medicaid/Medicare private pay reimbursement and actual cost of care and quality of life.
That situation is industry wide.
Soodrum said, since 2019 around 200 to 300 nursing homes have closed yearly nationwide mainly due to financial difficulties and lack of funding.
And the threat of closure is all around as well.
Soodrum said Scotland County’s nursing home was recently closed, while the Tri County nursing home was was bought out by a company, with the Salt River facility on the verge of doing the same, all due to lack of funding.
In addition, Soodrum said, Knox County and Clark County recently asked for and received voter approval of levy increases and are still able to operate.
According to Soodrum, there were, at one time, 100 county- owned nursing homes, but that number has dwindled to 23 today.
“County-owned and standalone facilities are the most vulnerable nationwide and most of them are one bad survey by Department of Health and Senior Services from closing down,” Soodrum said.
Maple Lawn’s origin goes back to 1855 when a “poor farm” was established and later became an infirmary in 1908.
It became a nursing home for the elderly in 1949 before the nursing home district was established in 1980.
“Maple Lawn has received support from the community throughout several generations,” Soodrum said.