Portage County health care center staff review finances, press for decisions on referendum and capital needs

Portage County health care center leaders told the county’s health care committee on a June meeting that the facility’s finances and capital needs require clearer direction from the county and that indecision is hampering long-term planning.

The presentation, led by the center’s administrator Marsha, summarized a finance packet prepared by the finance director, which included operating income and occupancy trends, payer-source breakdowns, comparisons with other Wisconsin skilled nursing facilities and a historical timeline of county planning and past referendum activity. Marsha said the materials were intended as an “educational tool” for committee members and asked supervisors to review the packet to support future decisions.

The packet, the committee heard, documents a county levy limit under Wisconsin statute and includes guidance from the Wisconsin Department of Revenue (DOR) on levy calculations and reporting. Finance staff also provided a fund-balance snapshot: the packet listed a current fund balance for the health care center fund of $9,569,496 and a projected December 31 figure of $9,969,496; committee members requested a fuller explanation of what composes that fund balance for a future meeting.

Why it matters: committee members said they need to move from persistent review to concrete decisions — on whether to invest in capital improvements, pursue a sale or lease, or continue operating the facility as a county entity. The choices will affect staffing, licensing, capital spending and potential buyers or operators the ad hoc committee might vet.

Most important details

- Census and utilization: staff reported a steady average daily census of about 31 residents while noting turnover — 43 different residents were served during June. The center’s leadership emphasized that stays vary month to month (short rehabilitative stays versus long-term residents), which affects revenue and planning.

- Revenue levers discussed: committee discussion included the possibility that adding 5–6 Medicaid-eligible residents could materially improve monthly revenue; during the meeting one participant estimated that scale could add roughly $3,000 per day in revenue (about $90,000 per month), though the committee noted that staffing patterns, case mix and state reimbursement rules could affect realizable revenue.

- Capital and facility needs: administrators reviewed a 10-year list of capital requests (HVAC, boiler, windows, front entrance safety concerns and other building systems). The administrator said major projects carry additional infrastructure costs (for example, electrical upgrades for larger HVAC units) and that some emergency repairs — including a $138,000 water hydrant replacement required by the state surveyor — have already been completed this year. She said contingency and emergency plans are in place to preserve resident safety if equipment fails.

- Referendum and levy context: the finance packet included a history of the county’s past referendum planning, the board’s prior resolutions and DOR guidance; the administrator stressed that the referendum materials make clear what is mandatory or optional under Wisconsin law and how reported levy funds are subject to audit.

- Sale process and vetting: a public commenter warned about a recent Sauk County transaction in which bed licenses were transferred to a company identified as Arria (spelled in the comment A-R-I-A), and urged caution about vetting potential buyers. The commenter, who said he represented Sauk County interests, stated that the company had outstanding fines and was seeking a lease rather than a purchase; the committee discussed the need for careful review of any prospective operator or buyer.

- Outside expertise and next steps: the group agreed to invite Renee Eastman, CEO of LeadingAge, to a July 8 meeting to brief the committee on Medicaid reimbursement trends, workforce issues and other topics the committee identifies. Finance staff and Lisa (health care center finance staff) were asked to provide an updated financial package through May and to clarify the components of the fund balance at the next meeting.

Quotations

Marsha, the center’s administrator, told supervisors: “My number 1 goal ... is to not have indecision be a part of our daily operations.” She also described the finance packet as a stable, factual educational tool: “...this is truly ... sums up all of the questions that we’ve been having over the past several sessions.”

In public comment, a Sauk County representative said a recent buyer, “the company’s name is Arria … one of the worst possible buyers you could ever see. They have hundreds of thousands of dollars in fines and violations,” and urged caution when evaluating offers.

Committee actions and directions

- The committee approved the May 25 health care center committee minutes (approved as distributed).

- Direction: staff to place a LeadingAge briefing on the July 8 meeting agenda and to solicit topic priorities from supervisors; Lisa will present updated financials through May; finance staff will prepare a clearer breakdown of the health care center fund balance for the next meeting.

- Scheduling: the committee set its next regular meeting for July 8, 2025, at 4:00 p.m., when LeadingAge’s representative is expected to speak.

Background and context

Committee members reviewed a decade of planning documents going back to early strategic plans and partnership explorations (including past work with the Sisters of St. Joseph and surveys from Saint Norbert’s). Staff noted the county previously considered regional compensation alignment and other shared-service initiatives. Administrators emphasized ongoing operational challenges: labor shortages, changing payer mixes since the COVID-19 pandemic, and the complexity of balancing daily resident care with capital upkeep.

The committee repeatedly distinguished discussion items from next steps: many topics are under review and require follow-up from finance, facilities and the ad hoc committee that would vet potential buyers or operators. The meeting included public comment and staff reports but no sale or transfer action was taken.