The chief executive of a struggling skilled care provider is cutting his own position, after 18 years on the job, in a bid to keep the home afloat.

Chris Oswald, CEO of Blue Ridge Village in Martinsville, VA, made the announcement to staff last week. His final day on the job is today, officials at the home said.

In an interview with the local newspaper, Oswald said his facility — which includes a 300-bed long-term care center, and a separate 60-bed assisted living facility — has been strained, as the privatization of Medicare has spelled a drop in admissions and length of stay. Specifically on the rehab center side, they’re averaging about 50 residents below census, which equates to a $3 million dip in yearly revenue.

Seeing that writing on the wall, Oswald said he decided to sacrifice himself to maintain service levels. Come Monday, he’ll be unemployed and looking for work.

“Instead of taking the normal course of action, which would be to cut staff and cut wages, we’re committed to providing quality resident care. We’re unwilling to take that route. So we have to look to other areas that don’t directly affect patient care. I can’t see how you don’t start at the top,” he told the Martinsville Bulletin. “So unfortunately, you could say I fired myself in order to try to meet the challenge.”

Blue Ridge is also trying other maneuvers to balance the ledger, negotiating better terms with vendors, and cutting around a dozen non-care related positions, all of which will save upward of $400,000.

Both facilities have their own administrators, who will continue running the buildings and pick up some of Oswald’s duties. April Patrick will head up Blue Ridge Rehab Center, where she’s been for four years. She told McKnight’s that the staff is sad to see him go.

“Chris is one person who gave his heart and soul to this facility. Very dedicated in every way. I have worked at multiple facilities, and this is the first CEO that I have ever met that was hands-on, that would get down and paint, do floors if he had to or scrub walls. He weeded, he sprayed. This man was all hands-on for everything. He knew every patient’s name.”

Elaborating on the financial difficulties, Patrick said Aetna recently cut the facility out of a Medicare Advantage contract, citing its low star rating. She said Blue Ridge has been stuck in hard place, as it has a memory care unit with difficult-to-treat residents. “Who is going to take these residents who have Alzheimer’s and dementia and take care of them? I can go ahead and get rid of 60 patients and maybe raise my star rating, but I would rather keep them and do without the star rating.”Patrick said the assisted living side has performed well and has not been subject to the same strains, as it is all private pay. In the interview with the Martinsville Bulletin, Oswald said none of these problems are unique to his small Virginia city.

“This is not a Blue Ridge problem. It’s not a Martinsville problem. It’s a nationwide problem. The top two providers of nursing home care in the country in terms of numbers have just gone bankrupt, and many more are going to follow because of the endemic change in the way services are provided by Medicare and Medicaid,” he said, predicting a shift into more privately funded care.