By Cindi Andrews
The Cincinnati Enquirer

Drake Center officials agreed Thursday to consider withdrawing their request for a March tax levy vote because of questions about why their costs for nursing-home care are at least twice that of other nursing homes.

And if they don't agree to wait until November, Hamilton County commissioners are poised to make the decision for them.

Drake, a long-term care hospital, wants almost $20 million a year from Hamilton County taxpayers beginning in 2005. That would be a 39 percent increase over the current levy.

Instead, the commissioners' tax levy review committee unanimously recommended Thursday that Drake wait for the November 2004 ballot.

An outside review resulted in more questions than answers, the committee said, and it wants to get a second opinion from an expert in hospital finance.

"I think there is almost unanimous discomfort with our lack of understanding about what they do and how they spend their money," committee Chairman George Vincent said.

Drake said it needs more money mostly to compensate for losses in its skilled-nursing facility, which takes Hamilton County residents regardless of their ability to pay. The hospital's more intensive long-term acute-care and rehabilitation services are on solid financial footing.

President and CEO Roberta Bradford said Thursday that she would poll the Drake board - made up of two-thirds University Hospital appointees and one-third county appointees - about delaying the hospital's levy request. A November levy, if successful, would still take effect in 2005.

The hospital could ask commissioners for a March levy despite the committee's recommendation, but the request would fall on deaf ears.

Commissioner Phil Heimlich wants a delay to give the county time to see whether another operator can more efficiently run Drake's skilled-nursing facility, he said Thursday.

"At this point I wouldn't agree to put it on until we get other facilities to put in proposals," Heimlich said.

Commissioner John Dowlin was out of town and unavailable for comment, but even if he supported the levy, that wouldn't be enough for passage. The third commissioner, Todd Portune, said he would abstain from voting on Drake because he's getting physical therapy there after spinal surgery this year.

Drake leaders say the costs for their skilled-nursing facility are twice as high as regular nursing homes because Drake takes the most difficult cases - usually people who've had an accident or other catastrophic problem rather than the elderly people that populate most nursing homes.

Even though skilled nursing is the money-loser, Bradford said, it can't just be lopped off. Patients often move among the levels of care, and resources are shared.

"The doctors float back and forth; the lab services are for both," Bradford said.

Drake has provided long-term hospital care in Hamilton County for more than a century and a half. It was run by the county until University Hospital was brought in as a partner in 1989 after the Donald Harvey murders. The former nurse's aide admitted killing 24 patients.

The committee commended Drake for its turnaround since then, which included expanding its outpatient rehab services.

"Drake has done a spectacular job with changing that image and becoming a world-class facility," Vincent said.

Still, committee member Chris Finney, an antitax activist, questioned whether taxpayers should pick up the tab for that care, noting taxpayers elsewhere don't.

"Of the 88 counties in the state of Ohio, there is not one that subsidizes a facility like Drake," Finney said.

Long-term hospitals elsewhere rely on Medicaid to pay the bills.

E-mail candrews@enquirer.com