State officials allow the purchase of publicly owned nursing homes in southern Wisconsin, despite previously blocking the same owner from taking over different homes due to a history of quality concern at the facility.
The approval fears that after residents lobbyed the state health department and refused to sell the Salk County Health Care Center, it could lead to a decline in the quality of care at a facility about 61 miles northwest of Madison, Leesburg.
Regulators approved an application from Salk County Aria to purchase the home earlier this month, telling group leader Akiba Brandman, “DHS has determined that the applicant meets the regulatory requirements.”
At least half a dozen Wisconsin counties have either explored the sale of public nursing homes or have taken concrete steps to do so in recent years.
A vote by Salk County officials in September to sell the facility angered locals. County Commission members said the facility lost money, but residents argued that the claim was misleading.
Judy Bray, who said she was happy to have the home as an option for her mother before her death in 2021, said activists from Salk County and other parts of the state met with health services officials in January to express fears about the sale.
Bray and others have founded a group of citizens at the Sauk County Health Care Center, which has attracted over 1,300 signatures against the sale.
“It was a big slap in the face,” Bray said of the state's decision to allow the sale to proceed.
SAUK County facilities have historically been rated above-average facilities by the Federal Centers for Medicare and Medicaid Services, which regulate nursing homes.
As in May 2024, the SAUK County facility received a 5-star rating. This implies the highest mark given by the CMS and above average care. However, in the second half of 2024, the rating plunged to the lowest possible star.
That drop appears to be largely due to two serious violations in 2024. There, patients were not receiving care according to specialized practice standards. Brie said that staff sales have high sales, but the house is still highly valued for staffing and clinical data collected by CMS.
Aria operates 14 homes in Wisconsin, with an average rating of 2 stars. Three more Illinois homes run by the same owner have an average rating of 2.7 stars, while Aria's owners operate a one-star facility in Webster City, Iowa.
Representatives from the ARIA group did not reply to an email from Captime seeking comment on approval of the sale.
In October, the state pointed to fines and discipline from regulators that Aria bought the house in friendship and “shows a history of violation.” It was the first time the Ministry of Health has taken such action since 2019.
The state also questioned whether buyers had “sufficient resources to allow the facility to operate for six months (in friendship)” and noted “significant” financial errors in the group's applications.
Wisconsin law requires the state health department to consider the performance of other nursing homes run by the ownership group when deciding whether a facility should be permitted to purchase.
A health ministry spokesperson did not answer questions about what has changed about Aria's ownership since October.
To complicate the matter even further, the state ultimately allowed the sale of the house of friendship to proceed. The Friendship House will operate under a provisional license for next year, and the owner will need to submit a financial report and hire a consultant to improve the quality of care in one of the other homes.
It is not the first time that Salk County has sold a county-operated facility in Wisconsin. Washington County voted to sell the nursing home in 2023. Seven years ago, a Racine County official did the same.
Counties near Wisconsin own more nursing homes than most other states. However, approval for the sale of SAUK County could indicate that state regulators would allow other counties to abandon publicly owned homes.
Officials have tried to sell county-operated nursing homes in Lincoln County, but efforts to do so have declined last year. Like Portage County officials, the county is trying again.
In Salk County, critics filed a lawsuit seeking to reverse the sale of the home, claiming that the county failed to follow the proper procedures to approve the transaction and violated Wisconsin's public meeting laws. Salk County attempted to dismiss the lawsuit.
Bray said maintaining nursing homes at the hands of the county is the best option despite the state's recent actions.
“They (DHS) said, 'Yeah, but we're worried that we might lose those bed licenses. They can just shut down,” Bray said. “I said, 'Well, if you're worried about it, you need to worry about selling it to a company with a disastrous track record.
Editor's Notes: This story was updated to provide additional details regarding the purchase of a friendship home provided by the Wisconsin Department of Health after publication.
