Ottawa County officials and staff at Riverview Healthcare Campus responded with shock when the facility's levy failed in November.
Wednesday they were prepared to face reality.
The center will shed nearly 40 positions from its 200-member staff in a massive restructuring that administrators hope will get the center through 2009.
The 29 full-time and 10 part-time jobs will be cut from across facility departments.
"We had to balance the budget, obviously, and we started taking a good hard look at our structure," said Kendra German, the center's administrator. "The (question) was: How can we survive 2009 without this money?"
She said that while the decision to lay off workers was difficult, it had to be done. Two of the positions will be eliminated through retirement, and two have already been vacated. The remaining 35 workers will be laid off in mid-February.
"It's been very difficult for me because Riverview is not the building. It's ourresidents, and it's the people who keep the residents happy in their homes," German said. "It's losing part of our family, and it's a very difficult reality to face."
County commissioner Steve Arndt said the center is facing a $1 million to$1.5 million deficit this year.
The levy on the November ballot included a 0.5-mill renewal as well as a 0.25-mill increase. When it failed, the center lost money it had counted on for five years, as well asadditional funds it needed to help care for residents on Medicaid.
German said the staffing cuts would help keep the facility out of the red, but she said it was hard to crunch numbers with so many unknowns. The budget will be affected throughout the year by unemployment costs, the number of residents at the facility and reimbursement from the state and federal governments.
"We really don't know how we are going to end up at the end of the year," German said. "We're hoping that these cuts will help us in the long run, but we're not sure."
The number of residents at the home has decreased in recent months, which contributed to the need to reduce staff. About 95 people call Riverview home and countless others seek rehabilitation and senior day care services at the facility.
German said the restructuring was designed to make sure residents will continue to receive quality care. The Centers for Medicare and Medicaid Service recently awarded the center three out of five stars for overall care of patients, making it the highest rated nursing home in the county.
While the facility has found a short-term fix to the financial problem, the future remains uncertain. Arndt said Riverview's board of directors is determining when and if they will put another levy on the ballot. The decision depends on trends in the number of residents at the facility and state and federal reimbursement.
"When talking to my staff I keep saying, 'This isn't easy, it isn't going to be easy, but we need to depend on each other to make it work,'" German said.