By Tim Bonfield
The Cincinnati Enquirer

HARTWELL - The Drake Center needs to redesign itself to significantly cut costs or it will be asking Hamilton County taxpayers for even more money five years from now - even if voters approve a tax levy in November.

ABOUT DRAKE

Services: At Hartwell: 166 beds for hospital-level long-term care, 148 beds for nursing home-level care, and the Bridgeway Pointe assisted living home. At Christ Hospital in Mount Auburn: 30 beds for long-term care. Overall revenue (as of June 30, 2003): $70.2 million. Overall employment: 793 Biggest funding sources: Medicaid, 27 percent; Medicare, 25 percent; county tax levy, 21 percent; private health plans, 21 percent Projected losses without tax levy: $19.3 million in 2003, $18.1 million in 2005, $23.8 million in 2009. Nursing care costs: Drake $430 per day.

So says a 70-page study made public Thursday that could change the fate of an institution that has provided health services to needy county residents for more than 150 years.

In recent years, Drake has rebuilt its campus in Hartwell, added services, has expanded the numbers of patients it treats, and has been hailed for providing above-average quality of care.

But the long-term nursing and rehabilitation center remains unable to operate without heavy tax subsidies.

A study conducted for the Hamilton County Tax Levy Review Committee recommends rethinking how Drake does business.

"We believe the level of care ... cannot be sustained without ongoing increases in taxpayer subsidies," says the report from the Cleveland-based consulting firm Howard, Wershbale & Co.

"We believe that, over the course of the next tax levy period, the management of the Drake Center Inc. should make a substantial commitment to reduce cost, analyze and appropriately adjust staffing levels and evaluate the various business sectors in which they operate."

The report concludes that the "vast majority" of services provided at Drake could be provided by organizations that do not get county tax support.

The report, compiled after consultants spent 12 weeks at Drake, recommends several changes, including selling unused nursing care beds, hiring companies to provide kidney dialysis and therapy services, reworking a money-losing contract with staff doctors, and possibly cutting staff.

Drake officials aren't saying how much money they will seek in November. The center has until May 6 to formally respond to the report and make its levy request.

Drake has been a good steward of taxpayer money and constantly looks for ways to reduce costs as long as they don't threaten the quality of care, said Roberta Bradford, Drake's chief executive.

"I think we're something that Hamilton County should be very, very proud of," Bradford said.

Bradford said Drake gets less county support now than it did five years ago and treats more patients. Since the late 1980s, the portion of Drake's $70 million annual budget covered by county tax money has fallen from about 60 percent to about 20 percent.

Chris Finney, chairman of the tax levy review committee, said: "I think everything is on the table with respect to Drake.

"We either have to agree to continue with things largely the way they are, or we revamp the whole approach," he said. "Both sides here need to think of alternatives to a steadily escalating tax burden."

The tax levy review committee will make its recommendation in early June. County commissioners would need to act by Aug. 6 to put a levy on the November ballot.

E-mail tbonfield@enquirer.com