Second-generation owners cultivate elder care center

“This is our mission from God,” said Dan Serven. “We take care of people here. We don’t go to Africa or overseas to minister. Our work is done right here.”

Although the Servens have run Ozark Riverview Manor for 25 years, its history dates back to 1917. Originally Christian County Nursing Home, it was the first facility of its kind in the county. At the time, it operated in an old building west of the present location, 1200 W. Hall. When Donna Serven’s father, Joe Waggoner, visited his mother and grandmother in the facility in the late 1960s, he learned that the owner, Omar Bilyeu, had died and that the nursing home was for sale.

Waggoner purchased the nursing home from Jewell Bilyeu, Omar Bilyeu’s widow, in 1970. He moved from Detroit, obtained his administrator’s license and ran the facility for 10 years before selling to his daughter and son-in-law.

“When we bought the building in August of 1980 there were three stories, no elevator and no air conditioning,” Donna Serven said. “It was the only nursing home in the whole county and people were beating down the door to get in.”

The Servens changed the name of the 56-bed intermediate care facility to Ozark Riverview Manor. Donna Serven, who also was working as a school nurse, was initially the director of nursing, and Dan Serven was the administrator.

In the fall of 1986, Dan Serven bought a 7.5-acre former pig farm alongside the Finley River to construct a new building. Expansion followed.

A 90-bed skilled nursing facility opened in July 1991. In 1995, Riverview Residential Place, a 40-bed residential care facility, was connected to the skilled-care building. “The addition allowed us to meet the needs of a section of the senior population that we had not been able to reach before. It allowed residents who require less professional care than those in the skilled nursing facility to receive the TLC that Ozark Riverview Manor gives,” said Dan Serven.

In 1998, the Servens added classrooms, storage and a maintenance building.

Now, Ozark Riverview Manor employs 100, making it the third largest employer in Ozark.

Even more important to the Servens is the quality of care scores the facility has earned. In 2003, CareScout, an independent organization that rates nursing homes, named Ozark Riverview Manor as one of two AAA-rated nursing homes in Missouri. Nationwide, only 151 of the 16,400 certified nursing homes were rated AAA. To achieve AAA ratings, nursing homes must meet exceptional quality of life and care requirements, maintain full compliance with all elder care laws and regulations, and be free of any health deficiencies as noted by state and local officials during the most recent inspection.

“We’ve gone 11 straight years with no deficiencies,” Dan Serven said of the state’s annual inspections.

The facility has been at least 98 percent occupied since 1991. “The (industry) average is in the high 70s,” he added.

Bob Smith is a victim of multiple strokes who stays at Ozark Riverview Manor. His wife of 51 years, Mary B. Smith, admitted him there because she was familiar with Donna Serven as a school nurse.

“We’re very pleased with the care,” Smith said. “The girls that take care of Bob are wonderful and see to his every need. Dan and Donna are supportive and do anything they can to handle any problem the way I want it handled.”

While admitting it isn’t easy to achieve high ratings and high occupancy, the Servens attribute their success to the fact that as owners, they are on-site every day. “We’re also highly overstaffed,” said Dan Serven. “The state requires a ratio of one staff for every 10 residents. Ours is one for every 4.5 residents. We can give better care that way. You’ve got to have enough people to do the job. The payroll is our biggest expense, but it’s worth it.”

Serven said payroll expense topped $2.4 million last fiscal year, but he would not disclose revenues.

Like the rise and fall of the river that runs behind their facility, the Servens have weathered the ups and downs of the industry over the years.

One of the biggest challenges is Medicaid funding. With 50 percent to 70 percent of residents on Medicaid, the Servens are dealing with decreasing Medicaid reimbursements. Another challenge is keeping up with the ever-changing regulations.

Other changes through the years include the types of residents cared for by the Servens. In the beginning, most residents were in their 60s, mostly women with early dementia. Now there are patients with heart problems, arthritis, fractures and other medical problems. Lengths of stay that were commonly two to 10 years are now less than a year. “Now they’re very old, sick and in their 80s or 90s,” said Dan Servens. “It’s more complicated now with more problems to treat.”

Room rates are $110 per day for a semiprivate room and $130 per day for a private room. That includes 24-hour nursing care, activities, cable TV, chaplain, housekeeping, laundry, social services, palliative care and incontinent care products. For an additional charge, IV therapy, dietary supplements, speech, physical and occupational therapy and a beauty shop are available, in addition to other services such as the WanderGuard system so patients don’t wander away. Other services such as dentistry, optometry and physician visits can be billed or the patient can pay directly.

Most residents are from Ozark, but some have come from surrounding counties and as far away as California.

Third-generation ownership may be in Ozark Riverview Manor’s future. Son-in-law Dean Tlustos has his administrator’s license and is working toward running the facility.