The planned new home would replace the 45-year-old facility on Infirmary Road and would house up to 99 patients.
The new nursing home is the first of five related facilities proposed for a campus-like setting adjacent to Robinson Memorial, including a new county senior center.
Estimated cost for the new nursing home is $5 million to $6 million, County Commissioner Chuck Keiper said.
Commissioners have requested proposals for architectural services and are expected to hire a firm within the next few weeks to design the new nursing home, the senior center and an adult day care center.
Once the nursing home is completed, it would be followed by a new county senior center. Currently, the county center shares space with the cafeteria of the Portage County Administration Building in downtown Ravenna.
"We believe it is an obligation to provide an adequate facility and services," said Keiper who has been working on the new nursing home for more than three years. "It's been one of my top priorities almost from the start."
Other facilities that could be built nearby include an adult day care center, an assisted living facility and an independent living facility, according to a study done for the seniors complex.
But those are lower priorities, Keiper said, and would not be owned or operated by the county.
"When we get done, we'll have the full continuum of care" for county residents, Keiper said.
While the new nursing home is still to be designed, the basic parameters have been laid out. The new nursing home would be 38,000 to 46,000 square feet and retain the current capacity of 99 licensed beds. It would include a secure outdoor area for residents to sit or walk, alleviating a concern at the current nursing home where outside access is limited.
The facility, built in 1952, encompasses 45,325 square feet. The county would borrow to build the new facility and then repay it through nursing home revenues.
"We're fortunate that we have one of the few county nursing homes in Ohio that has never, ever taken from the county general fund" for operating costs, Keiper said. "We have good staff and a good level of care, but the facility is not conducive to the kind of care we provide these days."
Time and changes in health care have made the home outmoded, he said.
The condition of the home provoked discussion on whether the county should be in the nursing home business at all. The county-owned facility evolved from county work homes and poor houses for the indigent, Keiper said.
Through the years, those evolved into county homes and, more recently, into nursing homes.
"The second thing we had to ask was 'Why are we in this business ?'" he said. "There is probably no longer a need for the county to be in it," as private facilities and Medicaid obviate the need for public facility.
In fact, the county stood to make a profit of up to $500,000 if it sold the 99 beds it was licensed for, Keiper said.
But the evolution of the financial side of the health care business created a need for a broader look at the issue.
The increased power of insurance firms to fix fees for hospital stays and other medical treatments is pushing hospitals to make partnerships with other care providers and find ways to maximize their strengths in order to attract the best reimbursement rates.
Robinson Memorial Hospital, a county-owned, nonprofit facility, was looking for ways to succeed in an increasingly competitive arena. If the hospital failed, Portage County residents would lose access to the only in-patient facility in the county.
"When we looked at the question in that environment, the question became broader than 'Should we be in the nursing home business?' It became 'Would our staying in the nursing home business help protect our hospital's strengths?'" Keiper said.
Three years ago, a large committee consisting of Robinson Memorial department heads, nursing home staff, community and other service agency members discussed the future of the county nursing home.
Recommendations from that group included building a new county nursing home, moving it to the hospital campus, and broadening the range of care, Keiper said.
The Portage County Nursing Home was recently certified as an acute care facility, which allows it to care for patients with serious health problems.
Larry Marburger, administrator at the county nursing home, said he expects the new facility to include new or improved facilities such as a dedicated rehabilitation area for residents and a skilled nursing wing, "and private and semi-private rooms rather than the three- and four-bed rooms we have now, and private baths rather than the centralized baths that are located in each wing of the current home."
Marburger said once an architect is selected to draw up plans for the new facility, he hopes the architect will meet with nursing home staff "to find out our specific needs for the new facility."
The proposed adult day care facility is intended to replace the existing Lake Street facility in Kent operated by the Portage Area Senior Services, Inc. The private, non-profit corporation has been operating since the 1970s. It has been providing adult day care since 1984. That service has become the primary focus of the agency, which has clients from all over the county, said Michele Kairis, executive director.
"Our senior adult day care center has pretty much met capacity. We're full. And we know there is a growing number of seniors in Portage County that will need adult day care."
Portage Area Senior Services' existing building has about 45 people enrolled in the program but can serve only about 27 people a day. The center has a waiting list for the program and has clients from all over Portage County, making the hospital campus a preferred location.
"The whole idea is to have senior services that are more centralized and accessible in the county, and what better place than on the hospital campus?" Kairis said.
Plans are to expand to about 75 to 100 daily capacity. Projections are for a 42.2 percent increase in the number of disabled older adults in Portage in the next decade, Kairis said. "So we know there is going to be a need for services for a lot of people to help them remain at home, to help them remain independent."
The senior community center is intended to consolidate and expand services currently provided in the county administration building. The center has about 77 enrolled members and could expand to serve 100 clients.