Nursing home calls stretch area city’s EMS capacity

Concerns lead to denial of zoning request for nursing home.

About 1 in 5 ambulance calls in Xenia are now for assisted living and nursing home residents, which city officials say is straining their fire department’s capacity.

These concerns came up again at a recent meeting when the council voted down a proposal for a new nursing home, with several city leaders saying it could further burden the EMS squad.

Other communities in the region have wrestled with similar issues with growing EMS demand, from the struggle to recruit enough EMS workers to meet increased call volume, to a Dayton paramedicine program that can help frequent 911 callers get other services.

“The city of Xenia is not the only community in the region trying to find creative ways to deal with increasing EMS call volume,” Xenia City Manager Brent Merriman said.

Merriman said senior living facilities in the Greene County city have been increasingly calling for an ambulance to transport residents when it is not an emergency, such as taking a nursing home resident to a scheduled test or an x-ray.

MORE: Xenia nursing home avoids getting cut from Medicaid, Medicare

“They are picking up the phone and calling EMS because they can’t find private transport agencies,” Merriman said.

He said many of the facilities have also changed policies to routinely call EMS whenever there’s a fall.

The city of Xenia’s call volume has been growing each year by about 5% since 1988, which Merriman said is unsustainable and much faster than the city’s population has grown. The volume has grown significantly in recent years, with 4,764 EMS calls in 2019 compared to 3,788 in 2012.

City staff and council members have been working on the EMS issue for more than a year, saying that non-emergency calls for their EMS squad place a cost to the tax payer and take away personnel who could be standing by for actual emergencies. Merriman said city staff are analyzing call volume and have started meeting with the larger local nursing centers and assisted living facilities to work to correct the trend.

“Where they are having problems, we want to work with them to correct that,” Merriman said.

The city also recently switched to a new EMS billing agent.

MORE: Critical EMT jobs in demand across region

“Right now we’re not having to increase taxes, but at the rate of growth, if we can’t curb that growth we’ll have to,” Merriman said.

In Lebanon, a little more than 1 in 10 EMS calls last year were to the three nursing homes in the city, according to data provided by the fire department. For Washington Twp. Fire Department, which also covers Centerville, about 26% of 2019 calls were to 10 nursing homes or assisted living centers in the Montgomery County portion of those communities.

On Dec. 30, Xenia city council voted against changing the zoning to allow a 99-bed nursing home to be built on 13 acres along North Detroit Street, near the Timber Ridge subdivision.

At 6 p.m. Jan. 23 meeting, the city council is planning to hold a public presentation on the second floor of the Administration Building at 107 E. Main St., Xenia, on the growing demands on their EMS services, where they will also answer common questions about what types of vehicles and personnel need to go out on different types of calls. For those unable to attend, the meetings are streamed live on the city’s Youtube page.

Greg Miller, with Health Care Management Group, the developer and operator proposing the nursing home, said at the meeting that he expected to create over 125 jobs with $4.5 million in payroll that would generate over $100,000 in income tax revenue.

Miller told the council the proposed nursing home would be primarily used for short-term stays for rehabilitation with a low re-hospitalization rate. He also told the that he feels current facilities in Xenia are inappropriately using EMS services.

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Several residents in the Timber Ridge neighborhood also objected at the meeting to a nursing home being built in their neighborhood, saying the land should be for single family homes or green space. Miller had said he would build a buffer for the lots and the streets would not be connected.

Besides the increase in calls by nursing homes and assisted living communities, Merriman said the city is also working to redirect people who misuse 911 calls. Last year, he said about 10 people in the city were behind almost 250 EMS runs. The city is researching ways the city staff and other community organizations can help, such as by helping people frequently calling 911 get help with preventive care or social services.

“It’s clear that there are other social work or mental health care services that these individuals are needing, but it’s masking as an emergency medical service,” Merriman said.

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