Chewbacca, Yoda and Princess Leia watched over Joe Mannchen and colleagues as they worked on their Yahara House computers, some designing birthday cards for fellow clubhouse members. 

Taped above each desktop, the “Star Wars” cutouts distinguished the computers from others — a more lively equipment tracking method than four-digit codes, Mannchen explained.   

“We’re not numbers,” the 15-year clubhouse veteran joked. “Why should our computers just be numbers in the system?”

The cutouts accented colorful decor inside Yahara House, which overlooks Lake Mendota on Madison’s isthmus. A pride flag, bulletin boards and photos covered bright blue walls of a mansion built in 1902 and once occupied by Adolph Kayser, a former mayor. Hanging beside century-old stained glass: a “Pets of Yaharans” photo display of cats Pumpkin Boy, B.B. King Cat, Mookie, Spock and Purr. Photos of human Yaharans hung elsewhere.

Yahara House, part of the nonprofit Journey Mental Health Center, is a community mental health program focused on building relationships and job opportunities. The clubhouse model reduces hospitalizations and boosts employment in adults with serious mental illnesses, experts and advocates say. 

Mannchen, who once edited videos professionally, uses those skills to help create updates for members. He and others are considering starting a podcast to promote Yahara House to the community. 

“At the risk of being a little saccharine, it brings me joy,” he said.

Other members work in the Yahara House offices, reception desk or its kitchen, the Catfish Cafe. Still others fill temporary jobs at local shops, restaurants and the State Capitol. A bulletin board celebrates three dozen members with permanent jobs.

Wisconsin has few places like this. Yahara House is one of seven clubhouses in the state and just three with international accreditation, according to Clubhouse International’s latest count. Neighboring Michigan has 37 accredited clubhouses. Advocates want Wisconsin to learn from Michigan to expand clubhouses statewide. 

Medicaid cuts could jeopardize services

Reimbursement from Medicaid, the joint state and federal program to help low-income residents afford care, funds nearly all of the Yahara House budget, said director Brad Schlough.

But budget cuts in Washington may threaten that funding. Seeking to pay for tax cuts and some mandatory spending increases, the Republican-led U.S. House has proposed cutting up to $880 billion in spending over the next decade from the committee that oversees programs including Medicare and Medicaid. For a variety of reasons, including the large size of the program, Medicaid is a likely target for significant cuts. 

“I’m not sleeping well at night worrying about the human costs the proposed funding cuts will inevitably bring,” Schlough said. 

The Trump administration has already made cuts to COVID-era mental health funding and eliminated an office focused on helping older adults and people with disabilities live independently.

More than one in three U.S. adult Medicaid enrollees have a mental illness. Most in Yahara House rely on Medicaid for services within and outside of the clubhouse.

The clubhouse already struggles financially to serve members waiting to enroll or ineligible for Medicaid support services.

“Clubhouses are intended to be open to anyone in the community with a mental illness. The problem is that the funding doesn’t always follow that,” Schlough said.

When members do join the right Medicaid programs, Wisconsin requires hours of recordkeeping for clubhouses to get paid. That contrasts with Michigan, which streamlines payments for clubhouses. 

Yahara House members pride themselves on finding solutions. The community is celebrating 25 years of international accreditation this year and has served adults with mental illness for much longer.

Its longest-tenured member is Michael Larscheid at 47 years. His photo hangs on a bulletin celebrating continuing education. He recently started swimming classes.

While many of his friends have moved or lost touch over the years, Yahara House remains a constant. 

“This is my family here,” he said.

An ‘antidote for loneliness’ 

Larscheid works weekdays in the Catfish Cafe, calling out lunch orders that cost around $1 each.

Mark Benson, a 40-year clubhouse member, joins him, preparing food for about 30 people. Benson researches recipes for twice-weekly desserts that cost 50 cents. In February, he debuted a diabetic-friendly pecan pie. 

Benson is retired from outside work. But when he first joined, Yahara House connected him with a job at an upscale furniture store.

“I was vacuuming around these like three $30,000 consoles and glass tables,” he recalled. “I had to be very careful where I went. It was a good job.”

People with mental illness can often find jobs on their own, but some struggle in workplaces that lack flexibility for mental health days, Schlough said. They might also face transportation barriers. Yahara House keeps a list of more flexible Madison-area employers. The clubhouse trains staff for each job, allowing them to fill in when a club member can’t make a shift. 

Yahara House also provides safe spaces during the day and on holidays and fosters community through weekly events like karaoke. 

Schlough calls clubhouses an “antidote for loneliness.”

Few Wisconsin clubhouses

Despite the advantages, Wisconsin has seen limited clubhouse expansion.

That surprised Sita Diehl, public policy and advocacy director for the National Alliance on Mental Illness Wisconsin chapter. She sees the model as underutilized.

Wisconsin prioritizes other types of services. 

Democratic Gov. Tony Evers’ latest budget proposal does not include specific funding for clubhouses, state Department of Health Services spokesperson Jennifer Miller confirmed in an email to WPR and Wisconsin Watch.

Still, Evers’ budget would expand the state’s behavioral health system, fund suicide prevention and improve crisis response, Miller wrote, adding: “Supporting people with mental health concerns is a top priority” and that the administration worries that federal Medicaid cuts would harm Wisconsin residents. 

Substantial funding changes for clubhouses would require legislative and state health department approval. There are no current plans to seek a new clubhouse waiver, Miller said but added that expanding Medicaid like other states would boost resources for many services. 

Yahara House’s Medicaid reimbursements flow through the state’s Comprehensive Community Services waiver for people with mental health or substance use issues that could lead to hospitalization. That program best accommodates easier-to-document treatments like psychotherapy, which unfold in hourlong blocks of time, Schlough said.

Yahara House serves members more sporadically throughout the day, leaving staff to spend as many as six hours daily logging time spent serving members — necessary for reimbursement, Schlough said. The exercise conflicts with a clubhouse spirit that encourages staff to treat members more as peers than patients.  

The clubhouse doesn’t pepper new members with questions about diagnoses and limitations. 

“We say, ‘We’re glad to see you,’” Schlough said. “What do you like to do? What are your interests?’” 

‘We want to be a right door’

As a lifelong Madisonian, Rick Petzke probably drove past Yahara House thousands of times. He didn’t know it could help him until his tour almost five years ago.

He joined and received a temporary job at Hy-Vee.

“They liked me so well, they hired me permanently,” Petzke said.

He regrets not learning earlier about a clubhouse members call “Madison’s best kept secret” — like a fancy restaurant on a hidden street. 

Joining requires little more than having a mental illness and not being a harm to yourself or others. But it can take members up to four months to properly enroll with the county in the right  Medicaid program, and a few don’t qualify, Schlough said. 

When members aren’t enrolled? Yahara House eats the cost.

“There are too many wrong doors in this system, and we want to be a right door,” Schlough said.

The clubhouse has few funds for non-reimbursed services, particularly after Dane County cut part of that budget this year, Schlough said. Proposals for the state to allocate a $50,000 matching grant to each Wisconsin clubhouse failed in consecutive legislative sessions. 

The Wisconsin Mental Health Action Partnership wants state lawmakers to appropriate those funds, streamline Medicaid reporting requirements and adopt a clubhouse-specific Medicaid waiver.

The possibility of federal Medicaid cuts could only harm that cause, leaving Wisconsin with fewer dollars to spread around, Diehl said.

Investing in clubhouses could save governments money over time, experts say. Compared to others living with severe mental illness, clubhouse members are less likely to be incarcerated, more likely to pay taxes and less likely to take costly trips to the emergency room.

‘I need to go back to my house’

Jennifer Wunrow left Yahara House for a decade following more than 10 years as a member. During her years away she felt herself “going down” and slipping toward a crisis. 

“I need to go back to my house,” Wunrow recalled thinking.

Members greeted Wunrow upon her return, asking where she’d been. 

When she secured her own two-bedroom apartment with Yahara House help, members and staff helped her move. 

A year later, Wunrow calls herself “the biggest mouth in the house” and helps situate new members. 

“I take a lot of pride in this house,” she said. “I love it here.”

‘Madison’s best kept secret’: People living with mental illness find work, care and community at a clubhouse built for them is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Yahara House is a community mental health program focused on building relationships and job opportunities. The clubhouse model reduces hospitalizations and boosts employment in adults with serious mental illnesses, experts and advocates say. 

The post ‘Madison’s best kept secret’: People living with mental illness find work, care and community at a clubhouse built for them appeared first on WPR.

The Wisconsin Department of Corrections offers few details about the deaths,
which coincided with a respiratory illness outbreak.

The post Families seek answers after deaths of 2 women incarcerated at Taycheedah prison appeared first on WPR.

Two women incarcerated at Taycheedah Correctional Institution have died following hospital stays that began Feb. 22. The Wisconsin Department of Corrections has shared limited information about their deaths, frustrating family members and those locked up at the maximum- and medium-security women’s prison. 

Shawnee Reed, 36, died Feb. 23, a day after arriving at an area hospital. Brittany Doescher, 33, died Thursday after spending nearly two weeks on life support, according to an online corrections database and family members. 

Both women were mothers, family members said. 

Two prisoners at Taycheedah told Wisconsin Watch and WPR that a third incarcerated woman was hospitalized around the same time as Reed and Doescher. The online corrections  database shows the woman they identified was “out to facility” on Feb. 23. She returned to Taycheedah in the same week.

Reed and Doescher’s official causes of death are pending, said Dr. Adam Covach, Fond du Lac County’s chief medical examiner. Family members of both women say hospital staff linked the deaths to pneumonia. Reed and Doescher’s relatives asked not to be identified to avoid drawing more attention to their families. 

Doescher’s relative said she learned of Doescher’s hospitalization two days after it began. She arrived to find Doescher chained to a bed with blisters around her ankles. 

Following discussions with doctors, Doescher’s family member believes earlier treatment could have prevented the death, particularly because she was so young. 

Asked about the deaths, department spokesperson Beth Hardtke wrote in an email to WPR and Wisconsin Watch: “The federal Centers for Disease Control is seeing ‘high’ numbers of respiratory illness cases in Wisconsin, and the Department of Corrections (DOC) is taking a number of steps to prevent the spread of respiratory illnesses to staff and persons in our care.”

People incarcerated at Wisconsin prisons, including Taycheedah, were recently tested and treated for Influenza A, Hardtke added.

Relatives said both women started mentioning health issues over the phone around a month ago.

Questions about the illnesses are swirling within the prison. Three incarcerated women told WPR and Wisconsin Watch they learned Reed had died but heard different versions of the cause. 

Corrections officials locked down part of Taycheedah — limiting prisoner movement — on Feb. 28. That was due to an increase in respiratory illnesses, according to an internal memo from Warden Michael Gierach. The department lifted the lockdown Thursday. 

Wisconsin typically charges prisoners a $7.50 copay for each face-to-face medical visit, among the highest in the country. Citing the surge of respiratory visits, the department lifted copays for visits beginning Feb. 28, five days after Reed died.

“DOC health care staff recently reminded employees and those in our care of ways to protect themselves as influenza, COVID-19, pneumonia and RSV continue to circulate,” Hardtke wrote.  

The prisons are providing vaccines, masks and soap for regular hand washing, Hardtke added. Anyone who tests positive for a respiratory illness is quarantined for at least seven days.

While women at Taycheedah did receive information about respiratory illness precautions, the department shared no details about the hospitalizations and deaths, said Kady Mehaffey, who is incarcerated.

“Which is kind of maddening because of the amount of people that are filling in the blanks about what happened,” Mehaffey said.

The department did not publicly announce the women’s deaths, which WPR and Wisconsin Watch learned about from women incarcerated at the facility.  

Online records showed the women had died but little other information. The department has since provided basic information, including the women’s names, ages, death dates, and that they died in an “area hospital.”

States including Minnesota, Iowa and Nebraska publicly announce prisoner deaths, sharing the person’s name, prison, where they died, and in some cases, details related to their cause of death. 

Wisconsin is not the only state to limit the release of such details, but doing so is problematic, said Michele Deitch, director of the Prison and Jail Innovation Lab at the University of Texas at Austin.

“There’s no greater responsibility that prisons have than keeping the people inside safe and alive and when there’s a failure to do that the public has a right to know,” Deitch said.

Hardtke wrote that her department follows best practices to protect the privacy of people who are incarcerated and their families. What’s more, it’s up to county coroners or medical examiners to investigate causes of deaths.

The Department of Corrections does confirm deaths and release names after family is notified, but the department can’t release other details, including cause of death, because of privacy laws, Hardtke said.

Deitch said prison systems often interpret privacy laws broadly and then point to such protections to justify withholding information. 

While the department updates its online database to note prisoner deaths, someone seeking information about a death would first need to know the prisoner’s name. That database was used to confirm the March 4 death of a prisoner at Waupun Correctional Institution — Damien Evans, the seventh Waupun prisoner to die in custody since June 2023. 

Fourteen prisoners residing at Wisconsin’s adult institutions have died this year, Hardtke wrote. The prisons saw 61 deaths in all of 2024 and 54 deaths in 2023.  

Reed and Doescher both participated in a program to help with substance abuse and facilitate an early release, according to relatives and court documents. Doescher expected her release within months, her relative said.

“She was hoping to come home and start her own business,” the relative said. “She wanted to counsel other girls in situations like her.”

Both Reed and Doescher enjoyed jewelry making while at Taycheedah.

“I don’t know how (Reed) did it, but she would get like thread and threaded around like a plastic piece or something like that and she could make these really cool designs,” Mehaffey said. “She was good with the small intricate things.”

Both women have children.

“We’re going to miss her and I certainly hope the prison system can be reformed because there’s no call for this,” Doescher’s family member said. “I feel for any other parent that has to go through this.”

Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.

Families seek answers after deaths of two women incarcerated at Taycheedah prison is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Hundreds of protesters gathered in front of U.S. Sen. Ron Johnson’s Madison office Tuesday to voice their concerns over potential cuts to Medicaid.

The Republican-led Congress is considering significant cuts to Medicaid, the government health insurance program for low-income households. In Wisconsin that includes programs like BadgerCare Plus, which serves children, pregnant people and non-disabled adults, and long-term care programs for people with disabilities and seniors.  

The House budget proposal could cut more than $880 billion in mandatory spending from the committee that oversees Medicaid, according to reporting by KFF Health News. While the Senate’s proposal doesn’t specify exact cuts, they plan to offset over $300 billion in new spending, according to NPR.

Dane County resident Laurine Lusk organized the protest because her daughter Megan is disabled and relies on the government program.

“She’s not safe without this care,” Lusk said.

She wanted to voice her concerns over any cuts to her daughter’s care, but she says she struggled to get in touch with Johnson’s office. 

In a response to questions from WPR and Wisconsin Watch about the protest and complaints that constituents were having trouble reaching him, Sen. Johnson provided a statement. He wrote: “It is difficult to respond to complaints and protests that have no basis in truth or fact. It is unfortunate that Democrat elected officials are lying to their supporters regarding the Senate Budget Resolution and encouraging them to take to the “streets.” I sincerely hope their actions do not result in violence. My primary goal is to keep my Wisconsin staff safe while enabling them to continue dedicating their efforts to help constituents.” 

The Republican senator’s office was closed to visitors Tuesday due to “previously scheduled outside commitments,” according to a sign taped to the office door. 

Protesters chanted, “Hey, hey, ho, ho Ron Johnson has got to go.” One protester held up a sign that said, “Answer your phone, Ron.”

U.S. Rep. Glenn Grothman faced a hostile crowd last week at a town hall in Oshkosh. When asked about Medicaid, he said cutting the program “would be a mistake,” according to previous WPR reporting. Other Republican lawmakers have come out against cuts to Medicaid.

Dorothy Witzeling drove from Appleton to join the protest. “I am terrified of what I am seeing happening with our government,” she said.

Witzeling carried a sign with a photo of her brother who had Down syndrome and relied on Medicaid for care.

Former Madison alder and former Dane County Board member Barbara Vedder said she attended the protest because she has a disability and couldn’t live without Medicaid.

“This is what democracy looks like,” Vedder said. “It brings my spirits up to see so many people speaking up because this needs to change.”

‘Not safe without this care’: Wisconsin Medicaid recipients fear budget cuts is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Addie Costello here, Wisconsin Watch reporter and WPR investigative reporting fellow. Most of my reporting focuses on issues related to health care, and my editor asked me to write a bit about how tips have shaped my stories.

First, you have to know that I have an unbreakable phone pacing habit. My family mocks the little circles I make — in and out of the kitchen and up and down the living room — when I get a call. Sometimes I spend hours a week pacing across our newsroom. 

While walking back and forth in our office hallway as many as 20 times a day can get tiring, the reason I’m doing it always gets me excited, particularly when I’m calling people who filled out our tip form.

Almost all of my stories are from tips, including my latest look at how residents in several counties are organizing to resist efforts to privatize public nursing homes. Tips introduce me to people facing challenges across the state. They virtually guarantee my stories will resonate since the public inspired them.

Still, many of the people I talk to don’t end up in my stories, at least not immediately.  

That’s not because their stories aren’t interesting or important. Usually it’s just a timing issue. Sometimes my plate is already full with other stories, or another newsroom may have covered something similar. We strive to focus on stories other newsrooms haven’t told. But the conversations always prove helpful. Hearing about the same issue again and again helps us better understand it and realize how many people it affects. 

Since reporting on instances in which assisted living homes rejected Medicaid and therefore oust lower-income residents who have few other options, I’ve heard from more than a dozen people about long-term care challenges in Wisconsin. Some of those tips resulted in stories, like one that examined a trend of privatizing county nursing homes. Most helped me recognize that our state’s long-term care system needed broader, more sustained coverage. They led me to stories about people who lost Medicaid access, assisted living closures and state budget battles affecting long-term care. 

So, if you’ve ever talked to me as I paced around the Wisconsin Watch office, thank you. And if you think you might have a story, send us a tip. It will do more than help me reach my step goals for the day.

Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.

How tips shape our health care reporting is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Nancy Roppe, 64, has advice for anyone speaking at a Portage County Board meeting: Write your statement down, rehearse it ahead of time and keep it under three minutes.

As she leaves home for each board meeting, her husband Joe offers his own advice to his wife: “Don’t get tased.”

Roppe, a self-described “five foot nothing, crippled little old lady,” fiercely opposes selling Portage County’s public nursing home to a private bidder. She’s spent years causing “good trouble” in voicing that opinion to elected board members. Deputies have escorted her out of meetings “more than once,” she said.

Board members say the county can no longer afford to operate the nursing home. They see Roppe differently, describing her as caustic, extremely loud and unproductive. But it’s hard to deny the impact she and other organizers have achieved. The nursing home remains in county hands — for now.  

During years of debate over the Portage County Health Care Center’s fate, organizers successfully landed two referendums on the ballot to increase its funding, both of which voters approved. And after Roppe and her colleagues in 2024 highlighted the poor reputation of one  potential buyer, the board chose not to accept its offer.

Several grassroots campaigns across Wisconsin aim to halt the privatization of county-owned nursing homes, which tend to be better staffed, have higher quality of care and draw fewer complaints than facilities owned by for-profits and nonprofits, as WPR and Wisconsin Watch previously reported.

Portage County, whose nursing home holds a perfect 5-star federal rating, was one of at least five Wisconsin counties last year that considered selling, started the sales process or sold their county-owned nursing homes citing budgetary concerns. 

Proponents of keeping nursing homes in county hands have created social media pages, yard signs, T-shirts, and petitions and led protests — all dedicated to slowing and stopping sales. 

A for-profit company decided against buying Lincoln County’s nursing home after an organizer and board member sued the county over the sale. Organizing in Sauk County has drawn federal regulators’ attention. Public nursing home supporters in St. Croix County packed a meeting where board members ultimately voted against selling.

But some of those victories may prove short-lived. Sauk County’s board approved a buyer last year, Lincoln County is looking for new buyers, and the Portage County Board voted in December to again consider a sale.

“If I can throw a monkey wrench in what they’re trying to do, I’m going to exhaust every possible avenue to do that,” Roppe said in an interview.

But after years of fighting the sale, she might be running out of options. 

Sister’s memory fuels advocacy

Roppe’s older sister Carol could make friends with complete strangers.

“That was one of her best things,” Roppe recalled. “She just knew everybody.”

Carol, a longtime nurse, was 57 years old when she began needing care following a kidney cancer diagnosis. She lived at home between treatments — until the day she fell. The cancer had deteriorated her spine, which the small slip fractured. With no way for her family to give her proper care at home, she moved into the Portage County Health Care Center. 

Roppe visited her every day until Carol died in 2015.

When the Portage County Board started discussing selling the nursing home, Roppe started to speak up at its meetings, tapping her comfort with public speaking.

“I got a big mouth and I use it,” she said.

In 2018 Roppe and other organizers campaigned for people to vote in favor of a ballot referendum to raise taxes to keep the nursing home in county hands.  

Voters approved it with 61% of the vote. 

But Portage County board members worry about more than just operating costs. The center was built in 1931 and hasn’t been significantly updated in 30 years. The building needs major renovations, board members and advocates acknowledge.

A 2022 referendum asked voters whether they would take on higher taxes to build a new facility. That passed, too, earning 59% of the vote. 

But county leaders haven’t moved forward with construction. They say the county can’t afford it, even with the voter-approved levy, due to rising construction costs. The board rejected advocates’ calls for yet another referendum. 

“Is this a business that Portage County should be in?” That’s what Portage County Board Chair Ray Reser asks. He says the county board is focused on keeping the nursing home beds in Portage County, even if the county no longer owns them. The groundswell of support for the nursing home doesn’t surprise him.

“It’s a really beloved institution in the county,” Reser said, while adding that it’s not the facility it once was. 

When Carol moved into the nursing home, Roppe knew it didn’t have the newest amenities or the nicest building. But it had the best care, which the federal government still rates “much above average.” 

Portage County’s only other nursing home is for-profit and rated “below average.”

Roppe now spends some entire days organizing to protect the nursing home, even though a decade has passed since her sister lived there.

Before major board votes, the Roppes post the meeting agenda and other details to their “Save the Portage County Health Care Center” Facebook group.” Nancy prints and delivers agendas to advocates without social media and crafts her own public statement. Joe sets up a livestream of the meetings for those wanting to watch at home, and Nancy arrives in-person at least 15 minutes early. 

Nancy follows each meeting by typing up a colorful summary to share with those who couldn’t watch. “The Grinch is alive and well in Portage County,” she wrote in December after the board voted to solicit buyers. 

“I enjoy the fight,” she said. “I wish I didn’t have to fight, but I’ll take the fight on.”

St. Croix County organizers see victory

Nearly 200 miles west of Portage County, the St. Croix Health Care Campus is no longer the subject of a privatization debate.

A discussion about selling prompted opponents to flood a St. Croix County board meeting last August. 

“There were more than 100 rather annoyed old people there,” said 70-year-old Celeste Koeberl, who attended.

The board ultimately voted to keep the highly rated nursing home public, determining its revenue would likely grow, aided by higher state reimbursements and a federal grant to open a dementia wing.

Board Chair Bob Long said his colleagues never seriously considered a sale. But Koeberl credits local organizers with a victory. 

“I think that that’s an encouraging thing, that when we show up, when we speak up, we can make a positive difference, and we should remember that,” Koeberl said.

She doesn’t know anyone at the nursing home but joined neighbors in opposing the sale after learning about the possibility last summer — seeing the center as providing quality care that the county can’t afford to lose.

“Everybody has experience with an older person in their family who needs help, and everybody who faces that learns the dearth of resources,” Koeberl said.

In Portage County, nursing home advocates face challenges in maintaining the energy that propelled them early in their fight. They regularly filled county board meetings years ago, Nancy Roppe said, but now just six to eight attend each meeting, with additional folks at particularly important ones. Some core group members have died in recent years.

“People are going to get older and sicker and are just not going to be able to physically do it anymore,” Roppe said. 

At a December board meeting, nine people testified against selling, with two speaking in favor. Still, the board voted 17-8 to move a step closer by approving a potential sale.

Roppe likes to remind her colleagues that they have a winning record so far, despite the challenges.

“You cannot now get all depressed,” she said. “The fight continues.”

Advocates take case to state officials

Portage County’s nursing home debate has swirled for the majority of Grace Skibicki’s 14 years living there. She can’t recall any board members seeking her opinion.

“What’s their beef with us?” Skibicki asked. “Is it because we’re old and we don’t count?”

She moved into the nursing home following a stroke in 2011. Without an easy way to join meetings from the nursing home, she relies on friends for updates.

Skibicki worries public pressure won’t be enough to persuade the board to tap the brakes on a sale. Board members won’t be up for reelection until 2026.

But selling the facility would also require state approval.

That’s why the Roppes and more than a dozen public nursing home advocates from Sauk, Portage, Lincoln, Marathon and Walworth counties met with state officials in January in Madison — a two-hour trip from Stevens Point in Portage County. 

It was the organizers’ first meeting after years of advocating in individual counties.

“We were working more in our own little backyard, where now we’re branching out to say, ‘Hey, we need help from the state,’” Nancy Roppe said.

The organizers rehearsed questions in a hotel conference room before meeting with officials at the Department of Health Services and the Office of the Secretary of State.

The state can block individual sales based on a buyer’s financial instability or poor past performance. But the state can’t force a county to keep its facilities.

No matter what happens in Portage County, Roppe considers all of her effort worth it. Delaying the sale this long matters for residents who have relied on the nursing home in recent years.

Last year she received a reminder of that impact in the mail: a card from a former neighbor whose late husband Paul spent his final years at the Portage County Health Care Center. If not for the facility, she could not imagine where he would have ended up, the neighbor wrote.

“If we did nothing else, there was a place where Paul got the best possible care in his last days,” Roppe said.  

Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.

Wisconsin residents organize in fight to keep county nursing homes public is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Arlene Meyer is a busy woman. 

The 86-year-old starts each morning by watching the news in her room at Pine Crest Nursing Home in Merrill, Wisconsin. Then it’s off to the dining hall for breakfast so she can “BS with everybody out there.” She never skips her daily walk and devours books delivered by the public library each week — anything except romance or science fiction. 

The event calendar in Meyer’s room lists a smorgasbord of other options: manicures and mimosas, chair Zumba, trivia, Packers watch parties and beer pong. Meyer spent a recent Friday at an exercise class in an area of Pine Crest that later hosted a happy hour with live music. 

“The concept of old people, it’s out,” Meyer said, adding that “the days go by so fast” — an observation that surprises outsiders with duller expectations for nursing home life.

Meyer moved to Pine Crest in 2023 to recover from pneumonia. She liked it so much she stayed permanently. The nursing home’s social media posts show her holding a lizard, relaxing during a spa treatment and singing a Willie Nelson song at karaoke — photos that brought joy to those who know her.

“Sassy Arlene! Love it!” one person commented on a photo. “Happy you haven’t changed Arlene,” wrote another. 

Lincoln County owns Pine Crest, one of 36 county-owned nursing homes in Wisconsin. They tend to be better staffed, have higher quality of care and draw fewer complaints than facilities owned by for-profits and nonprofits, a WPR/Wisconsin Watch analysis of U.S. Centers for Medicare and Medicaid Services data shows. 

Wisconsin has more county-owned nursing homes than any state but Indiana. But perhaps not for long. 

Over more than three decades, residents in 22 Wisconsin counties lost public nursing homes to sales or closures. This year alone at least five counties — including Lincoln — considered selling, started the sales process or sold.

County leaders say they have only two options while facing financial pressures and staffing shortages: sell or close the homes. Local organizers disagree, arguing counties should continue providing high-quality care for low-income older people and disabled adults. 

Lincoln County’s board voted to sell Pine Crest to a for-profit at the start of this year. After that buyer backed out, the board is planning to find a new one.

Meyer worries about potential disruptions at Pine Crest.

“I love it here,” she said. “I sincerely do.”

A flurry of nursing home sales and closures

Meyer, a former Lincoln County Board supervisor, doesn’t own a phone, but she stays up to date on local happenings. It didn’t take long before she heard rumblings about selling Pine Crest. 

“I was teed off about it because of some of these SOBs,” Meyer said. “They said, ‘well, the cost factor.’ Now I think about what jerks were running this.”

Running a nursing home is expensive, and counties aren’t required to do so — something officials often realize during recessions and inflationary periods.

The financial crisis of 2007 and 2008 was Wisconsin’s busiest stretch for nursing home sales, with four counties selling.

Since inflation started surging in 2021, at least five counties outside of Lincoln have sold or considered selling: 

• Iowa County closed its nursing home in 2022 after failing to find a buyer.
• A private nursing home chain took over Washington County’s nursing home in July. 
• The St. Croix County Board considered selling before voting against it.
• Sauk County’s board this year approved a sale to a for-profit that still requires state health department approval. 
• Portage County heard interest from one prospective buyer but chose not to sell following public pushback. It will decide later this month whether to look for a different buyer.

Meanwhile, dozens of for-profit nursing homes have closed in recent years. 

Lincoln County started debating Pine Crest’s future in 2022 while the board sought budget cuts. Then-board chair Don Friske noticed Pine Crest had for years run substantial annual deficits.

That’s been the case since the 1980s for county-run nursing homes nationwide, said Anne Zahradnik, an associate professor of health administration at Marist College.

Those remaining “are a holdover from an orientation toward government solving problems,” she added. 

From ‘poor farms’ to nursing homes

Wisconsin’s county governments have a long history of housing vulnerable populations. 

Many ran “poor farms” or “poor houses” for residents experiencing poverty starting in the 1800s. Most states eventually created centralized nursing homes to serve older people and those with disabilities from across the state, while Wisconsin prioritized keeping people close to home. A Wisconsin network of local nursing homes and converted poor farms started receiving federal Medicaid funding in 1974, according to a Legislative Audit Bureau report.

Nursing homes for decades were the only long-term care option for populations they served, and people who relied on government assistance had few choices outside of county homes. 

That is changing as people increasingly age at home or in assisted living facilities that offer more independence at a lower cost. Wisconsin’s assisted living options hold more than double the beds of its nursing homes. 

But assisted living, unlike nursing homes, can’t care for people who need regular medical attention. Nor do they offer the same protections against evictions for residents who rely on Medicaid, the joint state and federal aid program to help low-income residents afford care. 

More than a quarter of nursing home beds, on average, at for-profit and county-owned nursing homes sit empty, according to federal Medicaid data.

Almost 40 of Pine Crest’s 120 beds are vacant, but Wisconsin can’t afford to lose them. 

Without nursing homes, hospitals struggle to find housing for their sickest patients, Zahradnik said. The Wisconsin Counties Association projects a need for roughly 10,000 new skilled nursing beds by 2035 as state demographics trend older. 

To keep Pine Crest running, Lincoln County’s board debated converting part of it into assisted living or even knocking it down to build a smaller nursing home with lower operation costs. Both options would require up-front money the county lacks, Friske said. 

The only remaining option the board sees: selling.

Counties struggle to keep up

Medicaid policy is complicated and frequently changes. The program is also how most nursing home residents pay for care. 

Lincoln County’s board lacks expertise on nursing home management, making it hard to keep up, Friske said, echoing officials in other counties.

“We’re horrible at it,” he said.

As the board discussed exiting the nursing home business, it learned the county was short more than $1 million in expected revenue to cover one year’s costs.  

The state has traditionally subsidized county-owned nursing homes, and it started increasing Medicaid reimbursements in 2022. The change shrunk ongoing county deficits to provide care, wrote Elizabeth Goodsitt, a spokesperson for the Wisconsin Department of Health Services, which distributes the nursing home supplements. 

That was positive. But shrinking those deficits meant counties would get smaller lump sum subsidies for operating nursing homes – something officials in multiple county governments didn’t anticipate, leading to budget shortfalls.

“Just when you think you’re one step ahead, you’re two steps back,” Washington County Executive Josh Schoemann said.

He described the unexpected loss of the subsidies as “just another brick in the wall” for a nursing home the county ultimately sold to a for-profit this year.

Lincoln County used federal pandemic funds to cover the unexpected subsidy loss — a short-lived option.

Despite supporting county-owned nursing homes, state officials don’t always effectively communicate with counties, said Rene Eastman, vice president of financial and regulatory services at LeadingAge Wisconsin, an advocacy group for older adults. 

Still, Eastman said, the recent Medicaid rate reimbursement hikes could ease financial pressures over time.

“If counties hung on for a little bit longer, they would really see the effects of that funding infusion, and they would see the increased need in their communities,” she said.

St. Croix County commits to nursing home

St. Croix County Board Vice Chair Bob Feidler said his colleagues didn’t seriously consider selling its nursing home. But a discussion about that possibility prompted opponents to flood an August board meeting. 

The board voted against selling, deciding that nursing home revenue would likely grow, aided by higher Medicaid rates and a federal grant to open a dementia wing. 

“All of a sudden, we went from what had been a negative revenue to barely a positive revenue, to a more solid projection,” Feidler said.

Many Lincoln County residents hope their board will reach the same conclusion. But increased Medicaid rates alone won’t cover needed costs outside of care, like renovating Pine Crest’s  building, Friske said. That would likely require a property tax increase.

“You can’t just go on a whim, ‘Hey, yeah, we’re going to throw this extra money on the property tax,’ ” Friske said. “People are struggling.”

County leaders have historically asked voters to support nursing homes through ballot measures.

Voters in Green County, for instance, approved an April ballot measure to continue funding their nursing home. 

Portage County voters approved one referendum in 2018 and a $20 million referendum four years later for the construction of a new nursing home — renovations that still haven’t started. Rising construction costs since the delay mean millions more are needed to fund the project, according to county board members who have blocked calls for a fresh referendum.

In Lincoln County, more than 80% of respondents to a 2023 Merrill Foto News and Tomahawk Leader online survey opposed selling Pine Crest.

But the board blocked two efforts to put Pine Crest’s future on the ballot.  

How private homes profit: Cutting staff, benefits 

Friske had gotten unsolicited calls from brokers even before putting Pine Crest on the market, as have officials in other counties. 

Why buy a money-losing nursing home?

For-profits can’t simply build new facilities. The state determines the need for nursing home beds in different communities — requiring newcomers to typically buy a license from an entity already operating a facility. 

Deficits under government ownership don’t mean private companies can’t turn a profit.  

They might find savings by rejecting applicants with behavioral issues who require costlier care. Counties that own a nursing home typically send higher-needs residents there. Counties that don’t own a nursing home still pay to send such residents to another facility that will accept them. 

Private owners frequently reduce staffing and benefits upon purchasing county-owned facilities, Eastman said. Lower staffing correlates with poorer care. 

The Centers for Medicare and Medicaid Services rates nursing home staff on a 1 to 5 scale, considering time they spent with residents and turnover. 

The median staff rating at Wisconsin’s county-owned nursing homes is 5, the highest possible, according to WPR and Wisconsin Watch’s analysis. That’s compared with a median rating of 3 at for-profit facilities in the state.

A sign outside of the Portage County Health Care Center touts its 5-star rating. Grace Skibicki, a resident of 13 years and a former care center nurse, recognizes that as impressive. 

She expects care to decline if a chain with a lower rating purchases it. She wouldn’t plan to stick around. 

“It’s really scary because you don’t know what’s going to happen to you,” Skibicki said.

Staff are also waiting to see what their future holds.

Nursing home work can be grueling with modest pay, accounting for significant staff turnover across the industry. But county-owned nursing homes employ public workers who earn county benefits and access to one of the country’s best-funded retirement systems. That may explain why median turnover trends at Wisconsin’s county-owned homes (41%) are lower than they are at for-profits (51%), WPR and Wisconsin Watch found. 

Wisconsin’s for-profit nursing homes drew a median of three substantiated complaints over the last three years, compared to a median of zero at county-owned facilities, which also fared better than for-profits and nonprofits in health inspection and overall quality ratings.

Nursing homes owned by Lincoln, Portage and Sauk counties all rate above average, but county officials believe private owners could run them better.  

Counties struggle to make quick decisions the fast-changing industry requires, Friske said.

Potential buyers named in Lincoln, Portage and Sauk counties all own multiple facilities across the state. Two own facilities in other states. That setup makes it easier for them to fund repairs or convert rooms to assisted living quickly without repeatedly asking taxpayers. 

Care & Rehab Company, which initially sought to buy Pine Crest, owns six facilities in Wisconsin and Minnesota. Two share Pine Crest’s “much above average” federal rating, but two others received “below average” ratings.  

People for Pine Crest

Dora Gorski kept her husband Ken at home for as long as possible. 

Ken, a father, veteran, martial arts instructor and first responder, was often too proud to admit to falling — even when Dora woke up to find him on the ground.

She initially got help from neighbors and home health aides who warned her about his worsening dementia. Ken eventually ended up hospitalized and in need of a wheelchair. 

When Dora realized she’d have no way to get him into their house upon their return, Pine Crest was her first call.

The woman in admissions knew Ken, who had taught her children aikido. Once he moved in, a maintenance worker recognized Ken as his former martial arts teacher. A caretaker told Dora she knew Ken, too — having worked with him as a phlebotomist. 

It turned out that Arlene Meyer, a fellow first responder who had long known Ken, lived down the hall.

“It was people who not just knew him as a doddering old man who is barely able to talk,” Dora said. “They knew him as a respected instructor.”

Two weeks before Ken’s death in December 2023, Pine Crest hosted his 90th birthday party. His children, former students and friends, including Meyer, packed a community room. 

“That meant a lot to Ken,” said Dora, who still participates in a group called “People For Pine Crest,” which opposes a sale.

“We own it. It’s our place. We all take pride in it being here,” she said.

The group spent 2023 urging the Lincoln County Board to keep the nursing home. Their flurry of petitions, yard signs, T-shirts, public testimonies, phone calls and emails didn’t work. The board voted to sell to Care & Rehab.

But an attorney and ally on the county board noticed a language problem in the sale agreement and sued the county to halt the sale.

Care & Rehab backed out before the case could move forward, offering People For Pine Crest a reprieve. 

But Friske, who lost reelection this spring, sees a ticking clock. He expects Pine Crest will face a fiscal crisis that will force a closure unless it sells. 

He resents any suggestion that his board colleagues don’t care about those who depend on Pine Crest.

“The county board is not a congressman from Missouri, Arkansas and Texas, telling Wisconsin how to live,” Friske said. “What’s happening here is friends and neighbors who are elected to the county board. They live here, their families are here, we’re all here.”

Lincoln County has just two other nursing homes, both in Tomahawk and with lower federal ratings.

Dora Gorski, who lives 20 minutes from Pine Crest, said the short distance allowed her to eat breakfast with Ken most mornings. That routine would have been tough to maintain — doubling the length of her drive — had he lived in one of Lincoln County’s two private facilities or the state veterans home in King, Wisconsin.

The county hopes to keep some nursing home beds in Merrill, said current Lincoln County chair Jesse Boyd, but they won’t be county-owned. He agrees with Friske’s financial outlook. 

“Right now, we’re drowning,” he said. 

The county now has lined up a couple of potential buyers for Pine Crest.

If a sale proceeds? Pine Crest won’t be the same, Gorski expects. For now it’s “full of neighbors and friends and people from our community, people who love us and know us,” she said.  

“You don’t find that in some big city, and you don’t find that in a private, for-profit nursing home.”

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‘We own it. It’s our place.’ Worsened care feared as counties privatize their nursing homes is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.