Nursing home inspection fees will increase 275 percent under a plan approved by Cincinnati City Council on Wednesday.

        The increase — from $10 to $37.53 per bed — would make the city's program self-sustaining and save it from budget cuts passed in December.

        The 6-3 vote didn't come without a measure of political intrigue.

        Supporters of the plan stalled the meeting so that Councilman Paul Booth — who arrived 53 minutes late — could vote in favor of the proposal.

        With Mr. Booth's vote, the margin became veto-proof. Though he has yet to veto an action of City Council, Mayor Charlie Luken made it clear that he sees the inspection program as redundant.

        “If the issue is improving the standards of nursing care in the state, our energies would be better directed toward Columbus,” he said. “I don't understand why the city of Cincinnati is the only city in Ohio to support its own program.”

        Voting against the plan were Pat DeWine, who has always opposed the program, and Chris Monzel and Jim Tarbell.

        Mr. Tarbell and Mr. Monzel reversed their earlier votes in support of the program — Mr. Tarbell because he wasn't convinced the program made a difference in the quality of care, and Mr. Monzel because many large nursing homes were against it.

        But a survey of nursing homes by Councilwoman Minette Cooper showed that 17 of the 25 responding nursing homes wanted the fee increase if it meant saving the program. There are 43 nursing homes in the city.

        “If we deal with it as we do in other situations, the majority vote rules,” Ms. Cooper said.

        She said nursing homes like the city inspections because they are more likely than state inspections to focus on quality of care issues. Many nursing homes also use the city inspections as a marketing tool to tell families they meet a higher standard than facilities outside the city.

        The city requires higher staffing levels and for an administrator to be on site 40 hours a week, versus a state requirement of 16 hours.

        City inspections are also more frequent (every 12 months versus 15 months) and often unannounced, city officials said.

        The inspections program costs about $190,000 a year.

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