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Orchard Manor looks at options with open wings
Biggest issue for nursing home is finding staff
Orchard Manor

“You have got to have staff.”

Orchard Manor Committee Member Diane Nelson came back to the heart of the matter after a portion of her committee had heard a report from Patrick Carroll from Wipfli consultants about options for the county nursing home, which is about half-occupied due to a shortage of staff.

The report compared the fiscal impact on whether the nursing home remained focused on being what it has been, or if it added assisted living to its empty space. The report presented gave few options on how to solve the greater dilemma of finding adequate staff to fill the needed roles.

Currently, Orchard manor is sitting at less than half capacity.

Orchard Manor has seen the impact of a lack of qualified workers strike the institution in two ways - it limits the number of people who can be residents, and it has increased the cost of their outside services they are paying for, as they are contracting out to fill roles like CNAs.

In the past, Orchard Manor had been spending an average of $275,000 in outside services, according to Carroll. Because of the dearth of CNAs, Orchard Manor has seen that cost increase to $874,000 last year, and it is projected to nearly double to $1.435 million by 2027.

Likely seeing the issues that nursing homes are dealing with on staffing, as well as increased costs due to inflation, the state has put in two straight years of increases into Medicaid reimbursements for nursing homes, including a massive increase of 27 percent this year.

“We have never seen it,” Carroll said of  the increases.

While the state is reducing its supplemental payment program, which is meant to help publicly-run nursing homes with losses, Carroll said the result is the nursing home will have more funding overall, there will be more money, and the projections are the budget for Orchard Manor will be in the positive in future years.

Because of this, and the projections in the future, Carroll said it made more sense to stay as a nursing home, than create a nursing home/assisted living center hybrid.

“If you had staff available, you would pick the skilled nursing facility,” Carroll said of whether to choose between being a nursing home or to add assisted living.

However, staffing demands were exactly why the county was looking at options. 

The idea behind looking at assisted living was that such programs are not as labor-intensive as  a skilled nursing home. 

Another thought about adding assisted living space is to get people in the door, and familiar with the facility. Erdenberger noted other reports show that demand for skilled nursing care will remain the same for the next decade, and that switching some of that unused space into assisted living will mean people who are looking for that type of facility with get to feel familiar with Orchard Manor for if or when they would need to shift into a skilled nursing home.

Carroll felt the impact would be minimal as assisted living facilities are beginning to offer more specific support for needs of residents.

As far as what was presented Tuesday, there were few options given on ways to increase staffing at the facility, and what was presented was thought to be nominal at best.

Carroll talked about the possibility of creating two different wage schedules for CNA staff, one for those using the county insurance plan, and for those who do not.  Carroll noted that when it comes to CNAs, they tend to be younger, and therefore they would still be covered by their parents’ insurance plans. Carroll stated that to incentivize them to do so, the county could create another wage schedule for those employees, paying them more.

Personnel Director Joyce Roling thought the impact would be very minimal. She noted that in the case of high school-age CNAs, they are not taking insurance right now anyway, and they often do not work the minimum of 30 hours to qualify for county health insurance.

“I’m not so sure how much that would save us,” Roling stated.

Another item Carroll discussed was making it easier for people to apply to the facility, stating it took him 15 minutes to find the place to apply.

“If it takes that long, they will apply somewhere else,” Carroll stated.

Carroll also pointed out that there are a lot of residents in the state who are looking for longterm care for their loved ones who suffer from cognitive issues like Alzheimers and dementia, as well as other psychotic issues.

“That population is underserved across the state,” Carroll stated. “I think you could increase residency present day if you could find staff.”

Erdenberger agreed, and noted that based on the referrals she receives from doctors and specialists, the demand for support programs is there.

The meeting was held on a Tuesday, varying from the committee’s normal Wednesday meeting day. Because there were only two members of the committee there - Nelson was joined by Donald Splinter as well as County Board Chairperson Robert Keeney - the meeting did not have a quorum. The only item on the agenda was to review the Wipfli report, and since no action was being taken (any action would require a quorum), they continued on to get the information  to move forward.

Wind turbines hot topic at listening session
Listening session

Area wind turbines were a popular topic, mostly for their unpopularity at the listening session of state Sen. Howard Marklein (R–Spring Green) at the Legion Hall on Monday Feb. 3.

More than 40 people packed the Legion Hall on a windy, cold day to make their voices heard to the 17th Senate District senator, who was joined by 49th Assembly District Rep. Travis Tranel (R–Town of Hazel Green).

Concerns of those who spoke on already existing wind turbines, and the possibility of more coming into the area, included communication, health of those living near turbines , and the farm land the turbines are being built on.

A common cry of attendees was “We need to get our voices back.” Marklein and Tranel introduced a bill to require the approval of all cities, towns and villages within 90 days of a request for approval by a developer of a wind or solar farm. A board that chose to take no action would be considered a vote for approval under the bill.

One speaker stated that “we know how slow our government works; we would like that to become even 180 days, as many manipulates only meet once a month.”

Those sentiments were echoed by a woman who recently inherited her father’s farm near Montfort and stated the notifications he was receiving were few and not very timely. “We need to find out everything we can before it’s too late,” she said.

Possible health concerns of living near wind turbines were also a hot button issue.

Statistics were cited that up to 1 in 10 people living near wind turbines will suffer migraine headaches, nausea, vertigo, and anxiety, among other symptoms.

One woman said she lives in the Mount Hope are near the River Ridge School, which she estimated had 400 students, meaning 40 students who are put at “potential risk” if wind farms continue to expand.

Another said her family recently moved away from Montfort last June because her daughter was starting to experience vision issues and headaches. She said those have subsided since they moved to the Mount Ida/Fennimore area.

She also stated her concern of the land in general: “The Driftless is gone. I’ll put my body down in front of loader before another turbine goes up,” a statement met with applause.

Another expressed concern over maintenance and cleanup of the turbines, questioning what would happen during a strong wind storm or if one catches on fire. “We cleanup be guaranteed?” she asked. “What will the land look like in 30 years? We’re supposed to be leaving the land better than we found it.”

Another stated that as of now 317,000 acres of farmland could become areas for more turbines, which brought up the topic of out-of-state or foreign land owners in the area selling off their land without worrying about the ramifications for their neighbors.

“We don’t know who are neighbors are and they aren’t here see what these are doing to us,” one attendee said.

Other topics

Although the main focus, wind turbines weren’t the only issues/concerns brought to the attention of Marklein and Tranel during the more than hour-long listening session.

A few mentioned the state’s budget surplus, which many would rather see used for programs for young people such as affordable health care and child care.

Schools and school referendums also came up as many questioned why so many schools have had referendums in recent elections and our school systems and funding formula for school districts needed to be addressed.

One speaker even suggested tax credits for families instead of vouchers for home schooled or private school families.

The same speaker stressed school choice should be parents’ choice and not the government’s, which was again met with applause.

A nurse from the area also said there needs to be an increase in the “bridge” between responsible gun ownership and protecting ourselves from those who may do harm to themselves or others should they be in position of a firearm.

Marklein  thanked all those who attended the session, which went 15 minutes into “overtime,” saying it was a bigger turnout than that morning’s in Prairie du Chien.

Tranel said “many of the ideas that come from these listening sessions do become state laws.”