Rock County Board of Supervisors members heard a detailed update and wide-ranging discussion on consultant recommendations for Rock Haven, the county’s 128-bed skilled nursing facility, during the board’s regular meeting.

The presentation, led by county staff and followed by questions from multiple supervisors, summarized a series of consultant reports and an ad hoc committee review, clarified current operating costs and staffing challenges, and outlined possible next steps including reopening a 32-bed wing that has been empty since January 2022.

The consultants’ operational analysis and the ad hoc committee recommended a mix of short- and medium-term actions to improve staffing and finances at Rock Haven. County staff told the board the facility’s total operating budget is about $19 million and that the 2025 budget includes roughly $2.5 million in tax levy support — about 12% of the facility’s budget. County staff also said debt on the facility is expected to be paid off in 2026.

“ We have 32 beds that have been empty since January 2022,” said Randy Terrones, a county staff presenter. He and other staff summarized previous consultant work, including a 2021 workplace culture review by Nolan Law LLP and a later operational and financial analysis by Health Dimensions Group, which produced more than 80 recommendations.

Natalie, Rock Haven’s nursing home administrator, explained hiring and onboarding processes and described the facility’s current census and staffing composition. “Rock Haven has about 177.2 FTE total,” Natalie said, noting many nurse positions are part time and that part‑time staff above a budgeted threshold are eligible for benefits under county policy.

Supervisors pressed staff on three recurring themes: how quickly additional staff could be hired, whether the closed wing could be opened in phases, and the financial trade-offs between using agency (contract) staff versus recruiting permanent employees. Several supervisors urged stronger HR and marketing efforts to recruit residents and staff, and some suggested changing wages or bonuses to be more competitive with private agencies.

“ If you give us the go ahead right now to say, okay, get as many agency staff in, yes, we will open that wing. All 32 beds,” Natalie said, adding that staffing the wing with agency labor would increase costs and risk quality or citation issues.

County staff said the facility currently spends approximately $1.0 million a year on agency staffing and warned that continued reliance on contract staff could raise costs further; staff estimated a potential budget shortfall of roughly $500,000 for agency staffing in 2025 if hiring of permanent staff does not increase. Staff also told the board the county previously used federal ARPA funds and sales tax one-time money to reduce levy support in 2023.

Board members and staff discussed options the board will need to decide over time, including whether Rock Haven should continue serving only Rock County residents or be opened to out‑of‑county residents under defined conditions, whether some administrative authorities should be delegated to the Health Services Committee, and the specifics of targeted incentive pay and scheduling changes to reduce agency reliance. Don, a county staff speaker, reminded the board that debt service on the building runs through 2026 and that any long-term decision about the facility will take time.

Staff told the board they would organize the consultant recommendations into a sequence for committee review and provide a consolidated follow-up document answering questions raised at the meeting; supervisors requested questions and clarifications be submitted to county staff by July 7 so staff could provide ETAs and written answers to the board.

Votes at a glance

- Consent agenda (adoption of agenda; approval of minutes from 06/12/2025 and 06/14/2025; appointments to ADRC advisory committee and park advisory committee; recognition of Rebecca Lucas): Motion by Bostwick, second by Tillman. Voice vote; approved (no roll-call tally specified).

- Recognition of Diane Kowal (item 8A): Motion by Knutson, second by Tillman. Voice vote; approved (no roll-call tally specified).

- Motion to adjourn: Motion by Woodman, second by Sutter. Voice vote; approved.

Why this matters

Rock Haven is a county‑operated skilled nursing facility with a mix of Medicaid, Medicare/Medicare Advantage, private-pay and hospice residents. The facility’s operating shortfalls have required varying levels of tax levy support and one‑time federal funds in recent years; any board decision to increase wages, change operations, open beds, or alter the patient mix would affect county finances, residents’ care, and workforce recruitment. Supervisors emphasized the need for careful, well‑timed committee review rather than a rushed decision.

What’s next

County staff will compile answers to the questions raised at the meeting, post an updated status dashboard of consultant recommendations, and circulate the information to supervisors electronically. Supervisors asked that follow‑up questions be submitted by July 7; staff said they will provide ETAs for responses and distribute the answers to the entire board.

No formal board action (ordinance, resolution or motion specific to Rock Haven operations) was taken at the meeting; the presentation and discussion were informational and preparatory for future committee consideration.