 to Sheboygan County government working for you. My name's Adam Payne, Sheboygan County Administrator and co-host of this program with Chairman Bill Gehring. And today we're very pleased to have a special guest with us, Jean Stark, who is currently the administrator at the Sunny Ridge Health and Rehabilitation Center. Correct. How are you, Jean? Good, thank you. It's good to have you with us. Thank you, I'm glad to be here. As our viewers, I'm sure know there's been a tremendous amount of discussion surrounding our healthcare centers for a number of years. And today, Jean's gonna talk a little bit about the challenges associated with the healthcare centers as well as the very good things that are gonna be happening at Sunny Ridge. Jean, please share a little bit about yourself and your role and responsibilities as an administrator. Well, I've been with Sheboygan County for four years, starting there in February 2003 as the administrator. And I've been a nursing home administrator for 15 years. As administrator, you're responsible for monitoring the overall daily operations of the facility, making sure of regulatory compliance, watching admissions, all sorts of things that are associated with the healthcare center. And how long with the county now? Four years. You know, sometimes, time just flies. It does, doesn't it? It doesn't feel like it's been that long. Wow. Obviously, as I said, a lot going on with the healthcare centers, I've been here eight years and it doesn't even feel like four, it's gone by so quickly. But since my tenure here, it's just been constantly a challenge with what's been happening with the healthcare centers. And obviously, you've played a very important role in providing leadership, not only at the healthcare centers in general, but at Sunny Ridge. What is the status of Sunny Ridge? What's happening that led, frankly, to the sale of Sunny Ridge? Well, like all healthcare centers and particularly government, reimbursement really has decreased during the past few years. There was a time when you had millions of dollars that were coming in from the government to help with intergovernment transfer funds for county facilities to operate. That's decreased, where this year we're getting approximately 2 million compared to four or five years ago, it was 8 million. So as a result of that, and then Medicaid reimbursement has decreased, with the county, salaries have increased, wages have increased, benefits are high for a county facility in comparison to private facilities. So your expenses far outweigh your reimbursement. As a result, the amount of tax levy that's been required from the county to keep the facility running has increased throughout the years. So last month, March 20th of this year, the county board took action to sell Sunny Ridge to a private operator. When's that transition going to occur? When's the closing anticipated for? The closing is anticipated for May 1st. We're in the active process right now, preparing for that, contracts being changed over from county to private in preparation, staffing issues being looked at because of course with the two healthcare centers and the union contract staff do have the capability, union staff have the capability of moving from Sunny Ridge to Rocky Null if they desire, if they have seniority. I really believe that since we've been discussing this for years, as you said, the challenges associated with state and federal revenue, declining, IGT or intergovernmental transfer funds declining, Medicaid not keeping up with our costs associated. And as I think most people appreciate government in general pays a wage package, a benefit package, frankly that's far more expensive than the private sector. I think most people in this community know that and frankly I think that's why the county board got to the point they made the decision that they did. But what a lot of people probably don't know is, well, who are we selling this facility to? They've probably heard a little something about senior legacy and health dimensions group and what can you tell us about them that the public would certainly be interested in? Actually, legacy senior services will be the owners and they are a nonprofit organization. But the facility will be managed by health dimensions group out of Minneapolis. They have been in business for approximately 20 years. They have both managed and they also have contractual relationships with companies. With Sunny Ridge they will be managing. So as part of the corporate structure when you look at Sunny Ridge, I will continue as the administrator there and I will report to the regional director of operations. And there will be other corporate people that will be coming in for the various departments to give support in clinical areas, dietary areas, financial. Though we'll have our own people, these regional people will help provide support, make sure that we're running as efficiently as we can. So legacy senior services is a not-for-profit organization. It's gonna be managed by health dimensions group and as you just shared, you're gonna stay on as the administrator there. As some of our viewers may know, currently there's some bumping going on between the two facilities. Employees from Sunny Ridge to Rocky Knoll and from Rocky Knoll back to Sunny Ridge. But how is this gonna impact the residents? I think that's probably the most important issue and maybe on people's minds. What's the status or how will all this impact the residents at Sunny Ridge? Residents that are currently there will be able to remain there. In fact, we want them to remain there. This has been their home, whether it's been for a short time or for some of them it's been 10, 12 years because there have been some residents that have been there that long. We really want this to be a seamless transition for them where April 30th, they have the county operating it, May 1st, health dimensions group is managing it. And with that, not to see a change in food that they're gonna receive, activities that they're going to receive, at least in the beginning. There will be changes and we can talk about those a little bit later in the future that are going to have more impact on the physical plan than actually on the care and the services that the residents receive. Excellent, thanks, Jean. Jean, you've mentioned that the county board has been discussing the future of our healthcare centers for a long time. I got on the county board 19 years ago and believe it or not 19 years ago we thought, well, what is the future of our three healthcare centers? I'm really pleased that we finally have a decision regarding Sunny Ridge and it's going to be placed with a very reputable firm. What are some of the plans that they have for changing things at Sunny Ridge? Well, right now they are planning a $1.2 million renovation that will be done within the first year of ownership of the facility by legacy and managed by health dimensions. As part of that $1.2 million, they're gonna do a lot to look at the physical plan because you're going into a building that is approximately 40 years old. With that, there has been upkeep that's been maintained by the county, but you still have long hallways that look very institutional. So they want to get those hallways to look more home-like family, possibly putting in carpeting, different paint colors. There's some aesthetic things that you're talking about with ceilings, looking at that. Also with the dining rooms and lounges on each one of the large floors that we have, looking and putting some cafeteria type services where you actually could have food partially prepared in these areas. Making it more home-like, which really is the trend of nursing facilities today. What are the larger benefits for the community of seeing Sunny Ridge stay in operation? Number one, you're going to have a facility that will continue to admit residents that are here from Sheboygan County. The county was in the process of downsizing Sunny Ridge to go to 125 to try to make it financially feasible for them to keep operational. They weren't able to do that, obviously with the increase in tax levy. Health Dimensions Group has a plan to maintain a census capacity of 189. So you're going to have more room, more residents able to stay in the community. In generally, how is the transition going for employees? I know one day they'll be a county employee the next day, Health Dimensions, but. You know, there's emotions associated with that. With county employees, one of the things is it's unusual to have employees that have 10, 15, 20, 25, 30 years. And we have a number of those, both at Rocky Knoll and at Sunny Ridge. So, you know, they have gained a lot of rapport with the residents and things like that. That thought of separating employment from the county for some is very difficult, but basically they're handling it very well. We are starting to move some staff between the two facilities this coming Monday, April 16th. Staff that are staying at Sunny Ridge, they have gone through a lot. We've read things in the paper and everything, but now you're starting to feel a real excitement starting to grow with people saying, oh, it's going to be fun. It's going to be a good place to work and we're really going to have a great team and a great facility. And that's good to hear because I really feel that Rocky Knoll and Sunny Ridge are going to be good places for people to continue to work. I know that you've accepted a offer to stay at Sunny Ridge with the new owners and I really am sorry to lose you. It's a county employee. I think you've done a great job as a county employee, but can you tell me what went into your decision-making process whether to go with the new owner or not? Well, it was probably about November that I was really struggling with this question because I ironically got approached by a headhunter at the same time. And so then it was the question, what was I really going to do? So at that time I approached Adam and I approached the owners of Health Dimension Group, the principal of Health Dimension Group and discussed it. And I knew I had an option with either one. As we went through the months, I was part of a due diligence team and had the fortune to be able to go and actually visit two of the facilities that were operated by Health Dimension Group. When I went through those facilities, you really could feel the vision, the mission, the things that Health Dimension Group believes in, demonstrate it in the facilities that we went into. They were clean, the residents looked well. You could see improvements that they had put into the facilities and their commitment really to quality care. As an administrator, wherever I've gone, that commitment to quality of care is the most important thing. Because really the residents are the reason that we are in this business. And if we can't give quality care, it isn't part of an organization you really want to be part of. So I'm real pleased that the commitment to quality care that HDG gives is really part of the basic reason that I made the decision to stay with them. I think it's really going to wind up being a win-win because while you go on to a different job, the community still has you here as an administrator. Well, thank you. Part of the other good news is that all of the management team is staying on. So we've had no turnover in that. So the top group of people that really works well together and is part of a good foundation is going to be staying. Great. Now when the county board deliberated over this, as you know, Gene and certainly Bill knows, we really wanted someone to come in who was going to continue to own and operate the facility, run it as a nursing home. And nursing homes across the state are really struggling, whether they're publicly owned and operated or privately owned and operated. And Fond du Lac County, our neighbor to the west here, recently closed one of their two facilities and it stands empty. They made a tough decision. They made it in relatively short order. But I'm just so pleased that we're able to transition to another reputable operator. And one that as you said, is going to in fact increase the census and the number of beds available for the community. So though certainly a number of our employees are struggling with that decision of, do they bump to Rocky Knoll or do they move on to another privately owned operated facility? The good thing is that if they continue to stay, I think they're staying with a very reputable company and they'll be able to continue to provide the same outstanding quality of care that they've provided in the past. And a lot of our viewers may not be aware, I like to think many do because of the number of years we've been discussing this, but even with this sale, Sheboygan County is going to continue to be one of the predominant leaders in the state with the number of beds that we own and operate. We're going to continue to operate Rocky Knoll. Rocky Knoll has 195 beds. So we're going to be in the top 10 in the state of Wisconsin of how many beds we own and operate. So obviously we're going to continue in this business, but it's going to continue to be a struggle, a challenge, I think, because of the state and federal reimbursement reductions or even hanging onto the status quo was difficult. And some of our viewers may be wondering, all right, Gene, you've decided to stay on with Sunny Ridge. It appears the county's hired a quality organization to come in and take over operation, but how is it? Why is it that the private sector is able to more effectively keep their head above water, if you will, in operating a facility, whereas the public sector tends to have greater losses? What are some of the reasons for that? I think there's two main reasons. Number one, it's the benefit package. The county has a very lucrative benefit package for its employees. Probably about 52% of their salary is also benefits. In comparison, when you look at privates, it's more like 25 to 28%. So you've got almost a 50% decrease in your benefits there. And then the other thing is, there's salaries that are a little bit less, although they're very market competitive. I mean, that's one of the things that HDG has done. They've taken a look at, there has been comparison to other private facilities here in the county, and wages are very competitive. So, in fact, one of the best in the area. But there's still less than county wages. And people have been very complimentary of the county that Rocky Knoll and Sunny Ridge and their staff have really set the bar, raised the bar from a standpoint of the quality of care that's provided. But as you know, there are eight other privately operated nursing homes in Sheboygan County, nursing homes like Pine Haven and Sheboygan Falls or Sheboygan Retirement Facility here in the city of Sheboygan. They just do a fantastic job. And certainly their employees provide outstanding quality care and certainly care about their residents. But I wanted to make sure we really answer this question well. My understanding is, and obviously as the new administrator there is that health dimensions is going to be providing very competitive wage and benefits to the other eight compared to the other eight privately operated facilities. Because if they didn't, frankly, they'd have a difficult time retaining and recruiting employees. What's been your read on that? Absolutely. I mean, when we met with other staff, other facilities, in fact, I've gotten some applications in from staff that have worked at some of the competitors in town. And I look at the wages that are going to be paid by health dimensions compared to them and we are at or above other competitors. So we will maintain that. And certainly one of the things that health dimensions is, the first thing that they're committed to is the residents. The second thing is the staff. I mean, because without one, you can't have the other. And with that, they wanna have the competitive wages. They wanna also have fun in the workplace. And have staff that enjoy coming to work. Because if you don't enjoy coming to work, you don't like the job you do, no matter how much you're doing it. So I think that's really part of their competitiveness and wanting to stay committed to the residents, committed to the staff that are working there at the facility. Well, I wanted to share and agree with Bill that you've just been fantastic during this transition, obviously the last four years, but certainly this transition has been incredibly challenging, not only for you, but all of the employees and the community as a whole. This hasn't been an easy process for anyone. And certainly folks have had different levels of involvement, but my compliments to you and your management team and all the employees at Sunny Ridge, challenging on easy time. It's a lot of uncertainty for a number of months and years now, but it's good to see it come to closure. And as you said, in a few weeks, closing on the contract and moving on the health dimensions group will be nice to see and good to put behind us. Thank you. And it's been a pleasure to work for the county and to be part of this. It has been a challenge, but it's also been a learning experience for all of us. And I think we've gained from it. Now, Sunny Ridge, as you said, beautiful facility, outstanding reputation in the community. And at one point we had, I think, almost 300 residents there. And over the years that's changed as market conditions have changed, demands have changed. The county board was looking at reducing that to 125. We got down to about 150. And then after a national search, three private operators come forward. We select one. And they're now looking at going back up to 189. So as you mentioned earlier, Jean, it's gonna offer more beds, more opportunities for people in the community. From your standpoint, is that gonna be difficult to maintain in the future? Do you think that Sunny Ridge is gonna be able to level off at that 189 and maintain that? Or do you think that's gonna be a challenge in the future? I don't think we'll be at 189. The budget that we're looking at for this coming year is an average daily census of 174. And so today we're at 170. And we've just started re-admitting in January. And whenever a facility stops admitting residents, it's going to take a period of time for you to get back up and for people to know we're taking admissions. The other thing I think is the community is waiting to see what is really going to happen at Sunny Ridge. Is the care really going to continue? Because there's still that question out there. HDG isn't in here. But from everything I've seen in this transition period, the commitment that they've had, they've had marketing people in already. They've worked with our new marketing person that has accepted a position. She's out into the community working with hospitals. You can see the change. You can start to see referrals starting to increase. Because during the month of February before the decision really got made, is the county going to sell? What is it going to do? The county board was discussing it. There were still too many what-ifs. What's going to happen? But now with the decision made, we're starting to see a change in that. And I think once the community sees HDG gets in, their name becomes more known. There's other things that are happening. They really want a community awareness and for the facility to be part of the community. Part of blood drives, part of other things. I mean, we're doing a job fair at the facility next week. That's something that's never been done before because as county we've used other means, there's been more resources to do that kind of thing. But a job fair is not a typical thing for a private organization to have. So I'm excited to be doing those things. And it's been encouraging to see the admissions, the census actually increase, even with the uncertainty associated with the agreement the last few months and the transition and that's encouraging. It is. And I think it's a tribute to the reputation that Sunny Ridge has as a county facility and that we anticipate will continue as a privately owned organization. So again, to review, we've obviously sold the South Building and Health Dimensions Group is going to come in and take over operations. And this obviously is going to address a real financial challenge the county's had for some time. But we have that North Building attached to it. And some of our viewers might be wondering, well, what's going to happen to that? The Health Dimensions or senior legacy services is going to own the South Building. The county will continue to own the North Building. What are the plans there? Well, for the North Building for the first year after HDG assumes management, they will use the first two floors, one and two north. After that, they will be vacant as part of the sales agreement. Health Dimensions Group is going to be used as a consultant with the county to look at additional options that may be used for the North Building. There's been discussion, you know, is it going to be offices? Is it going to become assisted living? What could happen there? And I think that answer is still unknown. But when Health Dimensions looked at it, to operate a building that was this large with both the South and the North Building, it was not financially feasible for them to continue to do that. So that's why the decision just to use the South Building. And there will be some changes with that. Some of the rooms that we currently are just using as private rooms in the South End will become semi-privates again. But we still are going to maintain at least 60 private rooms within the facility. So there will be plenty of options for people that are looking to come in to have a private room available. And as part of this discussion over the last few months, if not few years, there's been some misnomers out there that, well, if they go private, they're not going to take certain residents. They won't take Medicaid residents, for example, people who need that additional financial support. What are the facts there? Facts are that we will review any admission that is referred to us. And if we can meet their needs, they will be admitted. And that should be typical of any facility. Sometimes you get a number of referrals that if you have behavior issues or let's say they have special care needs issues, a wound vac, special equipment that you don't have, you don't have available, then you may have to make the decision that you are not able to admit them. But that's typical of any nursing home today, that they would be making the same decision. But we will admit any person as long as we can meet their care needs. Outstanding, outstanding. Well, in the few minutes we have remaining genius, is there anything else that you wanted to talk about a little bit or discuss? Well, I just think that people need to believe that Sunny Ridge is going to continue to be a facility that provides quality care, that's committed to the residents, committed to the staff that are there and that we're excited about this opportunity. It's real hard for me because you hear me talk, we right now, and it's this transition period. You know, we're at one second, I'm kind of wearing a county hat, and the next second I'm wearing a health dimensions group hat. So, but I'm looking forward to it. Like I said, the support from both the county and HDG during this process has really been appreciated as we transition. You will see more of the corporate people in during the next few weeks as we're setting up systems, we're getting set with payroll, billing, all of those types of things, but it's an exciting opportunity for everybody. Sheboygan County has about 23 departments, $155 million budget, and about 45 million of that is property tax levy. And we have state caps in place, and every year it's a challenge balancing our budget and trying to maintain, if not limit, levy increases. And as everyone knows, or at least I think, as most people are aware, if they've been tracking this, our tax levy associated with the healthcare centers went from as little as zero or one million to six million in a very short period of time. Sunny Ridge is about half of that. And after the sale is complete, the finance director of the county estimates that we're gonna save about $14 million over the first six years, $35 million over 10 years. So it's a tremendous property tax savings or at least less pressure on the property tax payer to continue to be in this line of work at this broad scope. We'll continue to have rocky note, we're gonna continue to have expenses and challenges, but it won't be to the degree that it is today. And I think we're in good hands with Gene Stark at the reins and we're in good hands with the health dimensions group coming in and hopefully providing a very seamless transition. It'll be nice to look back at this perhaps a year from now and see how well we did, but we know we wanna make that as a seamless transition as possible for the residents. Absolutely, because it is their home, that's why we're there for their families, for them, we do want it seamless. And everything is being done to make that a reality. Now, one of the other things that I forgot to mention is that as part of the renovations, the changes that they're doing, they're also looking to make a dedicated subacute rehab unit in the facility. Looking at this being an area particularly where residents come that are short stay, that are just only going to want to stay for the period where they may need some therapy or if they need some special medical needs met, they'll be able to do that and then be discharged. So we also will be developing that dedicated wing. Excellent, excellent. Well, Chairman Gehring, who is obviously the leader of the PAC of the Coney Board and Mike Van Der Steen, Health Care Centers Committee Chair and the members of the Health Care Centers Committee provided some outstanding leadership to move us forward. The Coney Board ultimately voted, I think it was 27 to seven. So it was a very strong vote for we need to move on and address this uncertainty. And not only are we seeing a changing of the guard at Sunny Ridge, but at Rocky Knoll, as you know, the Health Care Centers Director for some time, Dale Pauls, retired recently and we missed Dale, but we're gonna also have new leadership at Rocky Knoll. And as I said, the county will continue to own and operate Rocky Knoll. We take a lot of pride, not only in the quality of service at Sunny Ridge, but Rocky Knoll as well. And we're in the midst now of selecting from a list of candidates and will soon have new leadership at Rocky Knoll. And we just hope that this is gonna go well and I think most of us are confident that it's going to. I anticipate it will. And I also would like to think that we will continue to have a collaborative working relationship. You know, you're still gonna be in competition, but there's still no reason why we can't continue to work together to provide the best for the community. Well, Jean, thank you so much for joining us today and enlightening us on the status of the transition and where things are at. And next month, we're gonna have another new face before you. Jim Hulbert is our new planning director. Jim just started about four weeks ago. Replace Shannon Hayden who was with us for about five years in the planning office. She did a great job for us, but moved on to Denver and as I said, Mr. Jim Hulbert will be here to talk a little bit about the roles and responsibilities of the planning and resources department and some of the very new and creative initiatives that are happening then. So please join us next month and until then on behalf of Chairman Bill Gehring, the Sheboygan County Board and myself, Adam Payne, thank you for joining us.