The Clatsop Care Health District may hire a management company to replace its departing CEO, a move the district hopes will improve the bottom line of the oldest care facility in Astoria.

Though the district itself is financially secure, Clatsop Care Health and Rehabilitation Center on 16th Street — also known as Clatsop Care Center — has long operated with a deficit.

The center is expected to end this fiscal year with an operational deficit of $606,000. Property taxes and timber revenues will make up the difference.

The district is looking to bring in outside management, in part, to prevent the center from closing, District Chairwoman Karen Burke said.

“As a public health care district, we need to stay in the black,” she said.

While the center is onerous to manage and staff, the chronic budget shortfall is due to a decline in census, as well as cuts to Medicare and Medicaid reimbursements.

The center is licensed to serve more than 70 residents, both long-term residents and short-term care rehabilitation patients, including people recovering from surgery.

But, in recent years, the number of residents has gradually dropped. Then, last year, the district relocated about a dozen long-term residents because of a shortage of certified nursing assistants. All residents now occupy the fourth floor. The center currently keeps 24 beds.

Although the care center is still not making money, the downsizing stabilized losses: It shrank the deficit but didn’t fix the problem.

“We’re still a bit in the red as far as the care center goes,” Burke said, adding, “We’re not losing more money than we were, whereas before we were kind of having increasing losses on a regular basis, and that is not happening.”

Meanwhile, the district is no closer to selling the aging building — a maintenance headache driving up operational costs — than it was last year. Though brokers have shown the building to interested developers, no offers have been made.

If the building is sold, the new owner would continue to lease it to the district while residents transfer to other locations.

The idea to recruit a management company to run the district’s day-to-day operations came from outgoing District CEO Nicole Williams, who has worked for the district since 2013 and was recently hired by Columbia Memorial Hospital. She said she plans to leave the district in early March.

“I think the job has grown to be too much for one person to do,” Williams said.

Encompassing all of Clatsop County except the cities of Gearhart, Seaside and Cannon Beach, the health district oversees the health and rehabilitation center, Clatsop Retirement Village in Astoria and — the latest addition — Clatsop Memory Care Center in Warrenton. It also provides in-home care throughout the community.

In addition, complex new Medicare and Medicaid regulations take up more time and staff members to implement.

“We’re really stretched thin,” Williams said, “and I think, in order to be successful in the future, you have to affiliate somehow with a larger company.”

The district’s basic structure will remain the same, she said. All employees would remain district employees. The district board would remain an elected board, whose job would be to oversee the management company and ensure it is held accountable, she said.

The board has not yet chosen a company, but is looking at Oregon-based firms that specialize in managing nonprofit agencies, particularly in small, rural communities.