As counties across Wisconsin sell off publicly-owned nursing homes to private companies, communities worry that privatization will bring understaffing, declining quality of care, and more regulatory violations, driving many residents to fight back.
After Karlene Ferrante broke her femur, she underwent major surgery and was transferred to a skilled nursing facility to recover. She spent a little over two months at the county-owned Portage County Health Care Center in Stevens Point, Wisconsin.
“I lucked out and got sent to the Portage County Healthcare Center. They took wonderful care of me for that whole summer and until I was able to go home,” Ferrante said. “Because of that great care that I got, I am able to walk. I have my leg. I didn’t get an infection and I didn’t fall. They were adequately staffed and they provided really good care.”
There are only two skilled nursing facilities in Stevens Point. The publicly-owned Portage County Health Care Center, which has served the community for nearly a century and has a five-star rating from the Center for Medicare and Medicaid Services (CMS), and the privately-owned Stevens Points Health Services, which has a one-star rating from CMS. Ferrante was relieved to get into the county-owned facility, but the relief faded when she returned home and learned that the county was considering selling Portage County Health Care Center to a private company.
“When I found out that they were trying to privatize it, I decided then that I’m going to work on this,” Ferrante said. “I’m not going to let that happen, because other people should be able to get the same kind of care that I got.”
Across Wisconsin, County Boards have been voting to sell their skilled nursing facilities as local communities fight the sales, especially in rural counties. In Portage County, retired professor Ferrante, a two-time patient at the Portage County Health Care Center, has joined the Save the Portage County Health Care Center group, which opposes the privatization of the county facility.
“We are the only five-star skilled nursing facility in Portage County,” said Nancy Roppe, a lifelong resident of Portage County and one of the group’s organizers. “The quality of care is stellar… people clamor to get their care here, because they know when they press the call button, somebody will respond.”
In 2018, Portage County residents approved a four-year, $5.6 million referendum to support the facility’s operations. Then, in 2022, they passed another measure authorizing tax increases to fund the construction of a new facility.
A billboard in Portage County. (Photo courtesy of Nancy Roppe.)
Roppe said the referendums signaled public strong support for Portage County Health Care Center, but Portage County is trying to sell the health care center to The Ensign Group, a private company which has purchased other nursing facilities in the state.
In Lincoln County, Wisconsin, the County Board voted over the summer to sell the county-owned Pine Crest Nursing Home, which had been serving the county for over 70 years, to Ensign. Just a few months after the transition from county to corporate ownership, members of the Lincoln County community have seen noticeable changes in the quality of care.
“We are already seeing the changes,” said Pastor Mike Southcombe, the senior pastor at St. Stephen’s United Church of Christ in Merrill, the county seat of Lincoln County. “The staffing is less than it was when the county ran it.”
Research consistently shows that publicly-owned facilities not only maintain higher staffing and care standards but also serve as essential safety nets for vulnerable populations, ensuring access to long-term care for residents who might otherwise be turned away by for-profit operators.
A 2022 report by the Center for Medicare Advocacy warned that privatizing county-owned nursing homes often led to lower staffing levels and diminished quality of care, as for-profit operators prioritized revenue over residents’ needs. The report found that promised cost savings rarely materialized, while accountability and public oversight were significantly reduced.
An academic study also found that privatizing county-owned nursing homes increased regulatory violations and reduced residents’ quality of care and quality of life, while failing to improve access for Medicaid recipients.
Working Class Storytelling reported that during a February town hall in Lincoln County, data presented by LeadingAge Wisconsin indicated that publicly-owned nursing homes in the state provide higher-quality care than private or nonprofit facilities.
While some Lincoln County officials said that the county did not have adequate funding to continue the operation of Pine Crest, Eileen Guthrie, a retired accountant who lives in Lincoln County and regularly volunteered at Pine Crest, crunched the numbers and found that Pine Crest was bringing in a profit.
“I started looking at all of the public records, whether they were from the finance committee or the county board, or online… I kept digging and digging,” said Guthrie, who was an active member with People for Pine Crest. When she looked through all the 2023 and 2024 financial statements, she found that Pine Crest had a positive balance upwards of $400,000 in 2023 and a positive balance above $550,000 in 2024. Guthrie said part of this positive balance was due to the state’s Medicaid reimbursement policies.
People for Pine Crest hosted community town halls. (Photo courtesy of Eileen Guthrie.)
Lincoln County officials said the sale of Pine Crest would help relieve the county’s deficit, though they did not clarify what expenses were driving that deficit.
“I know not everybody’s happy about it. I understand that all of us, most of us, have people in Pine Crest, and I understand that, but I’m comfortable with Ensign, that they’ll be here and they’re going to serve the community properly,” said County Supervisor Greg Hartwig at a July County Board meeting, according to WXPR.
As the county pushed forward with the sale, many residents felt their voices were ignored. Among them was Scott Doerr, a Lincoln County resident who had worked in local factories for more than 30 years before retiring. Frustrated by the way local officials handled the Pine Crest sale, he filed paperwork to run for County Board Supervisor.
“I just felt that the county board wasn’t listening to the citizens,” Doerr said. “I’m probably going to be campaigning on giving the voice back to the people.”
The sale has raised deeper concerns about the future of the facility.
“Being county-owned was a comfort and now we have to wonder, year to year, if they’re going to sell it for profit and make things worse instead of better.” Doerr said.
That concern about the future of nursing care is shared by others who see the facility as more than just a business, but as a vital community resource.
“People have been paying taxes on [Pine Crest], volunteering at it, supporting it, all those years, with the expectation that it would be around for them when they needed it, or be around for family members when they needed it,” Southcombe said. “The population up here, as it is everywhere, is aging. The elementary schools are shrinking. The need for nursing homes in home care and just general health services is just going to increase. And we’re also going to need people to work at those places.”
People for Pine Crest at the Christmas Parade in Lincoln County. (Photo courtesy of Eileen Guthrie.)
For Guthrie, the sale of Pine Crest is not necessarily the end of the fight for better community services.
“The loss was significant, but there is a win in there,” Guthrie said. “All of these people worked together for the good of the community, for the good of the employees and the residents. And maybe that’ll be enough to say, okay, yeah, we lost, but there are other things that we can do, so I’m hoping that there will be more to come.”
As the Save the Portage County Health Care Center group has watched other sales, like those in Lincoln County, happen, they are working to get creative about spreading the word across the county ahead of deciding votes. They have started sharing information in newspaper ads, billboards, and online videos.
“We’ve had to go and reinvent the wheel. We’ve come up with new ways to reach the public. And how does the public react when they know? They are angry,” Ferrante said. “They’re surprised. After voting twice to support the referendums and paying the taxes to have the nursing home continue and be rebuilt, people have been shocked to learn that the current administration in the county is just selling it.”
With the county’s vote looming this week, local community advocates said the stakes feel like a matter of life and death, and they aren’t slowing down.
“Where do we find the energy to fight [for Portage County Health Care Center]? For me, I feel like I owe them,” Ferrante said. “They kind of saved my life.”
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