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St. Croix County * Wisconsin
AGENDA - NURSING HOME PROPOSAL REVIEW COMMITTEE
ST CROIX COUNTY
NOTICE OF COMMITTEE MEETING
October 10, 2007 at 3:00 P.M.
County Map
(Board Room, St. Croix County DHHS Building, New Richmond, WI)
CALL TO ORDER
REVIEW OF AGENDA
CONSENT AGENDA
DATE OF NEXT MEETING -
OLD AND NEW BUSINESS
1. Election of Officers.
2. Review of Health Dimensions Group proposal for future operation of the Nursing Home.
3. Review of Presbyterian Homes proposal for future operation of the Nursing Home.
4. Review of other proposals /alternatives for future operation of the Nursing Home.
ADJOURN
(Items may be taken in different order)
* *Additions /Changes /Corrections
MINUTES
NURSING IIOME PROPOSAL REVIEW COMMITTEE
OCTOBER 10, 2007
The St. Croix County Nursing Home Review Committee met on October 10, 2007 at the St. Croix County Government
Center.
MEMBERS PRESENT: Esther Wentz, Chair
John Borup
Dr. Glenn Hoberg
Stan Krueger
MEMBERS ABSENT: Gordon Awsumb
Tom Caflisch
Don Jordan
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Chuck Whiting, Administrative Coordinator
OTHERS PRESENT: Bill Cranmer
Brian Purtell, DeWitt, Ross and Stevens Law Firm via phone
Chuck Mehls
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Nursing Home Proposal Review Committee - October 10, 2007 Page 2 of 3
Dave Schnitzler
Buck Malick
Lona Thompson
Anne Fagnan
Craig Zelinski
Theresa Branstad
Loyla Waskul
Kathy Olson
Lisa Leahy
Sheri Wagner
Connie Sarauer
Sheila Liebfried
Dean Winquist
Sarah Ketchum
Jeff Peterson
Gail Winship
Wentz called the meeting to order at 3:00 PM noting the meeting was properly and legally publicized.
Consent Agenda: Motion by Borup, seconded by Krueger to adopt the agenda. Carried unanimously.
ELECTION OF OFFICERS Wentz announced the election of officers would take place. Wentz was appointed the
Chair position by the County Board.
Wentz asked for nominations for the position of Vice Chair. Krueger nominated Borup for the position of Vice Chair.
Wentz called for additional nominations for Vice Chair three times. Wentz closed nominations and a unanimous vote
was cast for Borup to be Vice Chair.
Wentz asked for nominations for the position of Secretary. Krueger nominated Caflisch for the position of Secretary.
Wentz called for additional nominations for Secretary three times. Wentz closed nominations and a unanimous vote
was cast for Caflisch to be Secretary.
REVIEW OF HEALTH DIMENSIONS GROUP PROPOSAL FOR FUTURE OPERATION OF THE NURSING HOME
Purtell reported Health Dimensions (HD) took over the Sheboygan County nursing home and was in transition at the
time of St. Croix County's RFP process so chose not to participate in St. Croix County's process at that time. After
Christian Community Homes (CCH) withdrew their offer, Health Dimensions was approached to submit their
interest in St. Croix County in writing and offer their vision for the future. What they submitted is a framework and is
not a concrete offer. The offer is modeled similar to the offer negotiated with CCH would be a management and
development agreement. HD would take over operation management of the current facility and would then build a
new facility and be the owner and operator of the new facility. HD is looking for a subsidy comparable to the current
county allocation and continued support for the current operations and additional subsidy during the first year when
in the new facility, with subsidy ending in the middle of 2010. It is anticipated employees would continue to be
employed by the County until the new facility is opened and then employees would be employed by HD. HD would
likely negotiate a new union contract with staff when in the new facility. HD has identified an alternate piece of
property to build the new facility that is closer to the hospital and is not St. Croix County property.
Wentz expressed concern regarding the union contract HD has in Sheboygan County has a significantly lower wage
scale and employee numbers are less. HD is a for -profit group and is a management arm for Senior Legacy.
REVIEW OF PRESBYTERIAN HOMES PROPOSAL FOR FUTURE OPERATION OF THE NURSING HOME
Preliminary correspondence with Presbyterian Homes (PH) indicated they would like to develop a 5o -bed nursing
home as part of their master plan for a campus and are seeking beds to do so. There is currently a cap on beds and a
moratorium on getting more beds. PH is interested in the acquisition of beds only and is not interested in the land or
the current operation. PH would be amenable to discussion on the value of the beds. They only want 5o but may turn
the additional 22 beds in to receive enhanced reimbursement. The beds would stay in New Richmond. Wentz
expressed she is not in favor of selling the beds only and questioned what PH's rules would be for admission. Purtell
explained the County could put conditions on the sale of the beds, but at this time the discussion with PH has been
limited.
REVIEW OF OTHER PROPOSALS /ALTERNATIVES FOR FUTURE OPERATION OF THE NURSING HOME CCH
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withdrew their offer for the nursing home but indicated they may be interested again if other alternatives do not work
out. Purtell reported there are brokers in the area who work in marketing and brokering nursing home transactions.
Johnson, Wentz and Whiting have met with Dennis Horner and Dave Schnitzler from the City of New Richmond. No
formal statement has been issued or exchanged regarding what the City and County may do as partners. Wentz
indicated the City of New Richmond is anxious to keep the nursing home in New Richmond and to keep the residents
safe. Malick pointed out there is very little the City could do via subsidy due to levy limits; however, the City may
have land that would work for a new facility or be able to obtain low -cost financing with municipal bonds. Schnitzler
did not have an offer as to what the City could do but the City is willing to talk with the County.
It was suggested investigating the nursing home facility in North Branch, Minnesota, which was built as a municipal
partnership. Another suggestion was investigating Brewster Village in the Appleton area.
Purtell said St. Croix County is not alone in the nursing home issue. Bargaining advantage for St. Croix County will be
reduced as more and more county homes go up for sale. A market study was done for the New Richmond area. The
study results showed currently 90 beds are need for New Richmond and there are 72 for St. Croix County and 61 for
New Richmond Meadows. It was not clear if HD has the results of the market study but it can only be assumed they
have done their own analysis. Purtell recommended against considering leasing the current facility.
Discussion was held regarding this committee obtaining authorization from either the County Board or Health and
Human Services Board to hold a closed session for negotiation purposes. From the negotiation standpoint, there is a
need to keep negotiations confidential until the final terms are ready to be disclosed. The committee will rely on
Purtell to give advice when it is time to hold a closed session to protect negotiations. Johnson will ask Corp. Counsel
to review the agenda when closed session is needed.
Malick questioned if there are only three entities to have discussions with before going forward or if there is a need to
go to brokers to see if there is anything else out there. Malick said long term protections could be put in a contract
that a new operator provide services to financially needy individuals in the nursing home. Definitions should be
identified regarding the subsidy the county is willing to make, the average number of Medicaid patient days over the
past three years, acuity of care, etc. Purtell reminded the committee costs are associated with the more additional
terms or conditions added. Malick indicated if the taxpayers are expected to subsidize the facility, the taxpayer
should be getting something for it.
Borup emphasized the facility does not have a feeder system and whatever happens with the facility, if there is no
feeder system, the facility is in trouble. Leahy reported referrals have continued despite everything that is going on
with the nursing home.
Motion A motion was introduced by Krueger, seconded by Borup, and unanimously adopted: That Wentz and
Johnson develop correspondence to send to the City of New Richmond to request a proposal for the future operation
of the nursing home.
i
It was the consensus of the committee that Purtell continue discussions with HD and PH. Malick said it is key to keep
at least two vendors at the table.
NEXT MEETING The next committee meeting was scheduled for October 24, 2007 at 9:oo AM at the St. Croix
County Department of Health and Human Services building -Board room. Agenda items suggested are as follows:
1. Review of other proposals /alternatives /vendors for future operation of the Nursing Home
2. Follow up with City of New Richmond correspondence regarding future operation of the Nursing Home.
3. Committee's definition of serving Medicaid consumers, including level of acuity.
4. Recommendation to County Board on closed session
Malick reminded the committee it is possible only one item may need to be discussed in closed session so the entire
meeting would not need to be in closed session.
Wentz adjourned the meeting.
not CARMICHAEL ROAD - HUDSON WI 54M6
7t.9.g86.4600
LAST CI'DATE: Oct 1, 2010
DISCLAINIE
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