DeKalb County nursing home faces ongoing budget challenges

SYCAMORE – Budget shortfalls continue to plague the DeKalb County Nursing and Rehab Center, county officials said recently, worsened by what they said was declining resident numbers and cost increases.

As a result, the DeKalb County Board recently voted by a 23-0 vote to cover expenses in the event that the nursing home’s expenditures exceed revenues, with the measure also requiring any nursing-home-related purchase of more than $5,000 to have pre-authorization from the county comptroller or administrator. Officials said the measure was needed after noting budget shortfalls in March.

As other long-term care facilities in the country are facing similar resident-retention issues, DeKalb County Administrator Brian Gregory said the average daily census for the DeKalb County Nursing and Rehab Center went from 181 in 2018, to 168 in 2019, to 141 in 2020, to 117 this year.

“You can see what’s happening with the census – it continues to slide,” Gregory said during the County Board meeting Oct. 20. County Board member Kiara Jones was absent from the meeting. There was no discussion before or following the vote during the meeting.

According to county documents, the nursing home raked in about $2.1 million less than expected in revenue during fiscal year 2019. In August 2020, the county sold $13 million in bonds for the nursing home’s expansion project to be paid from operating revenues over the next three decades.

The nursing home’s debt service averages about $661,500 per year, or about $55,000 per month, according to county documents. That totals about $19.8 million, documents show.

The expansion included additional rooms, an activity center, an upgraded fire alarm system, a nursing call system, a larger chiller and a new boiler system. A 15,400-square-foot transitional care unit added 18 rooms to the 83,000-square-foot facility.

The nursing home then collected $2.8 million less than expected in revenues during fiscal year 2020, according to county documents. The county treasurer’s office began to note cash flow issues with the nursing home fund in March 2021, which resulted in the County Board approving a $2 million loan for cash flow purposes.

By Sept. 1, the loan proceeds were exhausted, the documents state. Gregory said that’s what led to the County Board approving the measure for the nursing home.

“The challenges were in place prior to COVID-19,” Gregory said. “So this wasn’t just a COVID-19 thing. Obviously, COVID-19 has probably exacerbated things.”

There was no previous spending approval threshold set for the nursing home before the Wednesday vote, Gregory said.

On top of the county paying nursing home staff directly, the county also pays hiring agencies to bring in staff to work at the county nursing home.

Gregory said the next steps for county and nursing home officials will be to provide regular updates to the County Board’s committee of the whole, and finding ways to increase facility residents and reduce expenses.

“That’s the combination of the census sliding and reliance on agency staffing, because one thing we’re not going to let slide, of course, is the quality of care,” Gregory said. “The county is committed to the residents and the care that’s expected.”

This story was edited to include additional clarification related to the $5,000 nursing home spending protocols from DeKalb County Administrator Brian Gregory on Oct. 25, 2021.