By Jeff Poole
More than 50 years ago, Orange County Supervisor Monroe Waugh went to the home of fellow supervisor and board chair Lindsay Gordon and told him, “Lindsay—we got to build us a nursing home.”
Waugh, a six-term supervisor at the time, had been looking all over for a place to move his sick mother, but couldn’t find any place he liked. Fed up and frustrated, he decided the best option was to stop looking and start building.
So, one evening, he rode down to Gordon’s house on Monrovia Road and offered his own solution to the problem.
In a 2005 interview from his home, Gordon recalled, “He parked right there in the yard. He was very upset. He said he’d looked and looked for a nursing home for his mother, but couldn’t find one. He wanted a nice place.”
When the supervisors met the following Tuesday, Gordon appointed a committee to look into the idea. The committee, consisting of Waugh, health department director Dr. R.S. LeGarde, Robert Downer and Robert Grady, would travel to Kentucky to learn about a county-owned nursing home there.
The local delegation was gone two days and came back with a report to the board.
“Monroe said, ‘It’s going to cost us a little money,’” Gordon remembered, “But I told him to make a motion.”
Waugh made his motion for the county to construct a nursing home using state revenue sharing funds and the board passed it unanimously.
Gordon said he was surprised it passed so easily.
Prior to the vote, the county had circulated a survey among citizens asking whether or not they felt enough need existed for a local nursing home. Gordon said the response was overwhelmingly positive.
Current District 2 Supervisor and Orange County Health Center Commission member Jim White described the development in how communities care for their older citizens.
Through the 1960s, nursing homes generally were considered “poor houses,” where the aged and infirmed were sent away. They were not nice places to visit.
“They were dumping grounds for older people,” he said, particularly those without means or resources. “Think of that model and that time. In comparison, what we do now is very different from that. We keep our residents as part of the community. That was a revolutionary change in the way we treated our older generation.”
In 1967, the county paid $90,000 annually to house their aging citizens elsewhere. Those with greater means generally were cared for privately in their own homes or lived with family members. But few options existed for those whose circumstances prevented or exceeded the bounds of in-home care.
It was a somewhat risky venture for the county to construct a nursing home at that time. Several counties operated collective homes with costs shared jointly. Orange was forging a new path.
The headline in the Oct. 19, 1967, Orange County Review points out that Orange is the first county in the state to undertake its own nursing home.
“It’s a monumental job, but I don’t hesitate going into it,” Waugh said at the time.
Estimated construction costs for the 51-bed facility were $225,000, with an additional $60,000 needed to equip the facility. The board purchased the nursing home’s 4.84-acre site from Miss Kean for $19,000.
Plans called for 17 beds on the lower level and 34 beds on the upper (ground floor) level, with business and administrative offices upstairs as well.
“Our aged have been paying taxes all their lives,” Waugh noted at the time. “It is the duty of the county to provide this care for its senior citizens at a reasonable rate.”
Rather than reserve the home solely for the indigent, the nursing home was designed to serve all older citizens, with local residents having first priority.
The county would oversee operations, but the nursing home would be operated as its own entity. The board’s goal was to have the nursing home pay for itself and operate as a break-even venture.
The county turned the operation and oversight of the nursing home to the board-appointed Orange County Nursing Home Commission.
“The nursing home caught on quickly,” Gordon said. “I told Monroe it was working well and doing fine. It was paying for itself.”
Gordon said one of the board’s goals in the planning stages of the nursing home was to maintain affordability for residents and their families. Early minutes of the nursing home commission indicate it cost $14.27 per bed, per day.
It wasn’t long after it opened, though, that the board realized it had a slight problem of supply and demand.
“It was working out so well, I told Monroe we’ve got to add onto it,” Gordon recalled.
“The original nursing home was founded on meeting a need for long-term care in the community,” White noted. But that’s a moving target as health care and aging needs change.
In 1975, the nursing home commission recommended adding 69 nursing facility beds to the original 51.
Three years later, the board was talking about expansion again.
By 1982, the nursing home again was expanded to 134 nursing facility beds and 34 adult care residence beds.
After a busy building period in its first dozen years, the nursing home held off expanding again until 17 skilled care services slots were added to provide rehabilitation in 2002.
Two years after that, nursing home officials announced plans for the construction of a new, 66-bed assisted living annex adjacent to the original facility.
Vernon Baker, the administrator at that time, said, “By going to a 66-bed stand-alone assisted living facility, we can covert our 34 assisted living beds to 30 nursing home beds. As we move folks from this unit into the new building, we can renovated and upgrade the original building.”
Two years before the senior living facility opened in 2009, the Orange County Nursing Home and Home for Adults changed its name to reflect its current range of health care services to the community. It became Dogwood Village of Orange County.
In 2017, Dogwood Village and the health center commission took the next step toward planning for the changing aging landscape and purchased an adjacent property (the Lerner house, across from the Orange Village Shopping Center), for future expansion.
“As people tend to stay home longer, they live longer, but by the time they come to Dogwood, they may be less healthy and need more care,” White said. “The initial approval to build was to meet long-term care needs, but that’s evolved as the community’s needs have changed.”
White said the commission continues to discuss its next challenges which most likely will be to meet the growing memory care population.
When the county first conceived of operating its own nursing home, it was a novel idea. According to White, it still is.
“It’s an unusual set-up. There are only five facilities in Virginia where the local government is involved in the ownership and operation,” White said. “Only one—Dogwood Village—doesn’t get any tax money from the county.”
Dogwood continues to operate as a business without relying on local government assistance.
“Care for the residents is the only source of revenue,” he said. “Every dollar that comes through the door at Dogwood Village is directed to resident care.”
Initially, that may have been a challenge, but it’s clearly a success story, White noted.
Over the last 50 years, Dogwood hasn’t just been a place in the community, but a fundamental part of it.
With an annual budget of approximately $18 million and more than 300 employees, Dogwood Village is one of the top two or three employers in the county (not counting the school division).
Many of its residents were active, contributing members of the community who are able to remain engaged by living there.
“Dogwood is sort of a social setting for our community,” White said. With so many friends and family also volunteering at Dogwood, “that party just gets bigger.”
The fact so many of Dogwood’s employees are local illustrates its relationship with the community, he added.
In pre- (and hopefully, post-) Covid times, those interconnecting relationships can be seen through Arts Center Outreach programs, Halloween trick-or-treating, Grymes Memorial School’s adopt-a-grandparent program, Master Gardener visits, church choir concerts and more.
White suggested one of the things that’s made Dogwood such a successful operation is the community’s embrace of it.
“I think the community feels that this is a place they know and trust. If mom or dad, or your husband or wife need more care than you can provide in a home environment, they know there’s a place with an answer to that problem locally,” White said.
He attributes that level of comfort and trust to the dedicated staff, past and present, who care for Dogwood’s residents.
“It takes a really special person to work in that environment,” he said. “The administration is important, but the real difference-makers are the ones who are taking care of the residents.”
That Dogwood Village remains Covid-19 free amid the current public health crisis is a testament to the staff, he said. “That’s a major metric on how dedicated they have been to the residents of the facility. The fact we’ve gotten this far only adds to the comfort and trust the community has in Dogwood Village.”
Fifteen years ago, Gordon shared similar sentiments. “The nursing home has been a real asset to our community,” Gordon said as the facility neared its 35th anniversary. “In 28 years on the board of supervisors, I never had people fuss about the nursing home. It’s worked out very well.”
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