SIDNEY — A new administrator is at the helm of Fair Haven Shelby County Home.
Jim Melia was selected by Shelby County Commissioners Julie Ehemann and Tony Bornhorst, as well as Mark Klosterman, CEO of Wilson Memorial Hospital, to become the new administrator, succeeding Anita Miller, who retired at the end of 2021.
He brings a wealth of education and experience to the position, hoping to apply the highest quality of long-term care possible to the Sidney area.
Melia, who is originally from Youngstown, started working in nursing home care when he was 16 years old. His aunt was a nurse at a senior community there and she referred him to an open position in a dietary department of a 200-bed facility, where he ended up working for the next six years in various departments.
“It was a wonderful experience that really opened my eyes to what senior care was,” said Melia, because it helped overturn stereotypes. “When you hear about senior care you hear a lot of negative stereotypes, but you really don’t know what’s going on until you’re actually there on a daily basis and you see the wonderful things that are occurring versus all of the negative things that usually get publicized,” he said.
“It also helped me establish relationships with the elderly population. Many teenagers don’t have the opportunity to interact with a large group of seniors, so that was an enlightening and enriching part of my life,” Melia said. “I grew very attached to the community members there and enjoyed interacting with their families.”
Melia received his bachelor’s degree in Business Administration from Youngstown State University and immediately started a career in healthcare. He began by managing a medical billing office and decided that healthcare would be his focus when furthering his education and focusing on the future direction of his career.
Unafraid of the massive challenges ahead, Melia undertook a dual Master of Health Administration/Business Administration degree from Cleveland State University while also holding down a fulltime job. Pursuing the additional education required a daily commute from Youngstown (where he worked in medical billing) to Cleveland (for his night classes) and back again, so he switched healthcare employers to work at a large, Cleveland-based dental practice management company, where he helped to manage multiple dental practices.
“Math was one of my favorite subjects, so the fiscal side of medical operations has always been the easiest part for me,” Melia said. “The most challenging side of the work has been the clinical side.”
After completing the program, in 2008, Melia moved into hospital administration managing the OBGYN physician group for a large county hospital in Ohio. His work there, as part of the hospital administration team, took place alongside physicians and in satellite facilities. It was a front-line, problem-solving position, where he had direct contact and interaction with patients.
“It also taught me to interact with various staff levels within an organization. In one day I could be talking to three different levels of conversation: first I might talk with my medical assistant, then I’d talk to the front office staff, followed by a meeting with the physician,” Melia said.
“After I was done accomplishing all of the goals I wanted to in hospital administration, that’s when my longing to return to senior care began,” said Melia.
The transition, however, required him to complete even more education, like a month in Columbus completing a Core Knowledge, six months spent in an administrator in training (AIT) appointment at a small facility in Akron.
“I wanted to go somewhere I would do some real projects for the facility and gain knowledge versus only observing others doing work,” Melia said.
Once these requirements were met, Melia was hired as assistant administrator at Altercare of Wadsworth, located in Wadsworth, Ohio, where he worked for nearly four years.
Melia then moved into his first position heading administration and was offered the role of administrator at Astoria Health and Rehab in Dayton from 2012 to 2013.
This was followed by Sansbury Care Center in Springfield. Kentucky, beginning in 2013, with the Dominican Sisters of Peace.
Melia explained, “This was my first position managing a continuing care retirement community (CCRC), which is comprised of independent living, assisted living, and skilled care. The Dominican Sisters of Peace were probably the best people you could ever meet in your life. Most were in their early 70s or late 80s and they all had dual Ph.D.s, so they were very intelligent and all about education. But at the end of the day, they were exceptionally down-to-earth people. That was probably one of the greatest experiences I’ve ever had working with people and collaborating on projects. They were so open to everything I wanted to do to make the campus the best it could be for the Sisters who were retiring there as well as for the surrounding community.”
Melia said that he would probably still be there but, with the birth of his daughter, his wife wanted him to move back to Ohio to be closer to family.
From 2016 to 2018, Melia served as the executive director of Otterbein in Cridersville, a continuing care retirement community (CCRC).
Melia left this position to spend about four years in Toledo after a friend, who was the regional director, contacted him about an opportunity at the Franciscan Care Center in Sylvania, a facility that was previously owned by the Franciscan Sisters.
“It’s a small world,” Melia said, because he’d met them once at a retreat he attended with the Dominican Sisters of Peace.
“I instantly thought, I’m going to have to do this because these are probably just as wonderful people,” Melia said.
“I started there pre-COVID,” Melia said. “But once COVID hit, it really wore me out with the long commute and extremely long hours, and that’s when I knew I had to make a change and work closer to home.”
Melia, who resides in Shawnee Township in Lima, Ohio, with his wife and daughter, said he decided at that time to take the position, once offered, at Fair Haven in Sidney.
In a previous article, Miller stated that dealing with COVID-19 while at Fair Haven was the greatest challenge of her career.
Melia found that to be true too.
“COVID is a big challenge,” Melia said. “The beginning of it while I was in Sylvania was just a nightmare because senior communities were the first ones mandated to basically shut the doors. People didn’t understand. I had never received so much negative criticism in my 25 years in healthcare. That is, until the rest of the country got onboard, and when they started shutting down factories and stores. Then families understood why we had to do that because COVID was so serious and did a 360. They started thanking us and asking us to please protect our loved ones from COVID. Still, it was stressful because we were put under a lot of pressure due to the constant changes required by the CDC and CMS, and it was never ending. I probably haven’t fully recovered from the stress an anguish that we as administrators were put through in the early days of COVID,” Melia said.
Taking over at Fair Haven, in terms of feedback due to COVID, the hard part has passed, Melia said. “We’re two years into this now, so people are much more understanding.”
Now that visitors are allowed, there are still requirements for people to enter the facility — like temperature checks, required masks, and basic COVID health screening questions to answer — but a small minority still question the seriousness of COVID. “Due to the masks, it’s not quite face-to-face visitation yet,” Melia said.
One of Fair Haven’s apparent challenges is its lower ratings by third party reviewers of long-term care facilities. When asked how he intended to tackle this issue, Melia said he did not put much faith in the accuracy of those reviews or statistics, citing the fact the statistics, like staffing ratios, can be too easy to manipulate by unethical individuals.
“At Fair Haven, we have a great staffing ratio. These numbers in the third-party reviews aren’t always factual. People outside the industry don’t understand,” Melia said.
Melia emphasized three critical components when it comes to assessing the measurement of quality of care (QoC) at senior care facilities.
“One, you have the staffing component, which is created by numbers that are put on a spreadsheet and submitted. If an organization has a large regional staff, they could say a regional nurse, regional director of operations, and so on, visited that day, and you can make it look like you had 10 extra people that day. But were those 10 people touching or helping any resident? Probably not.”
“Then you have another factor, the quality measures (QM), and that data is gathered by the MDS coordinator. But if I’m the MDS coordinator at a building and don’t mark anything down, that facility is going to look like they have the best quality in the world. I’ve seen this happen in markets that I’ve been in from competitors that are so-called 5-star rating facilities where I would not put my loved one. For example, I walked into a facility to see someone, and I spotted 10 deficiencies right off the bat, just knowing how facilities are supposed to operate. That’s why star ratings can be misleading. And there’s simply not enough resources in this country to evaluate and investigate potential data manipulation if a QM looks too good for the number of people they’re sending back to the hospital, or something of that nature.”
The third factor is the ratings don’t compare apples to apples, because they don’t consider the level of care required by special groups within that care community.
“For example, some behavioral facilities are penalized just for the nature of their residents, because all they take are those difficult behaviors that other organizations and facilities can’t take. When they do accurate charting, there’s a lot of different things that people with behaviors do that can trigger negative things on the MDSs, and of course, their quality measures look terrible. But at the end of the day, they’re treating an under-served population. They should be applauded, not scrutinized,” Melia said.
Only by comparing similar behavioral locations with one another can a fair, realistic, and accurate assessment be achieved.
“That would be a fair initiative, and I’ve been at many seminars where administrators at these facilities have screamed for some fairness and some satisfaction to not make them look so negative in the public eye. But no one does anything.”
In addition to looking at these three factors behind the numbers, Melia advises families to rely on word-of-mouth recommendations about a facility’s reputation when deciding where their loved one should go instead of relying on star-ratings.
In terms of Fair Haven, Melia said, “I run facilities that I’ve always felt provided the best quality of care, but at the same time we’ve provided the most ethical data as possible. So maybe I’m only three or four stars, but it’s a real three or a real four and I can sleep at night. If I were unethical, which I’m not, I could go into any facility and make it a five-star by manipulating the data.”
Fair Haven is located at 2901 Fair Road in Sidney. For details about room availability or questions about Fair Haven’s long-term care services, contact Melia by calling 937-492-6900, or emailing email@example.com.