Last year, a group of investors wanted to buy a friendship nursing home, a community about 90 minutes north of Madison.
That wasn't uncommon. Since 2016, the same group has purchased six nursing homes in Wisconsin. All of these are rated as one or two-star facilities by the Federal Centers for Medicare and Medicaid Services. -Star scale.
But the Wisconsin Department of Health Services did something unusual in friendship. It prevented the sale. Then, a month later, the state intervened again when another buyer tried to buy three South Central Wisconsin nursing homes, including the SSM Health St. Mary's Care Center in Madison.
In doing so, experts say the health department, including Wisconsin – is rarely used to ensure that nursing home owners are financially sound and proven track record of quality. He used the power that he said.
Nationally, state approval for the sale of nursing homes is usually rubber stamps, said Charlene Harrington, professor emeritus at the University of California, San Francisco, who studies the Department of Nursing Facilities.
“If you can go to the bank and borrow money, you can own a nursing home. You don't need to have experience, expertise or track record,” she said.
The Wisconsin Department of Health temporarily blocks sales at SSM Health St. Mary's Care Center on the southwest side of Madison, taking the unusual step of buyingers intervening to maintain financially sound and quality care. Ta.
In a letter blocking friendship and sales in southern Wisconsin, the state cited both the history of future owners of serious quotes from the Centers for Medicare and Medicaid Services (CMS). Both have suspended federal funds for a certain period of time.
For groups looking to buy a home of friendship, the state agency pointed to financial errors in the application that questioned whether the future owner had enough funds to run the home. .
When considering whether to transfer nursing home licenses to new buyers, the health department should consider the performance of other homes owned by the group.
Still, the state has not blocked nursing home sales since 2019, department spokesman Elizabeth Goodion said in an email. That's despite the same group looking to buy a house of friendship in 2021, buying another facility in Fondulac.
The Department of Health ultimately allowed the purchase of three South Central Wisconsin nursing homes, including one in Madison, after reaching a settlement agreement with the buyer.
The sale was allowed to proceed only after the new owner was issued a probation license requiring him to investigate past issues at Madison Nursing Home.
Rick Abrams, CEO of the Wisconsin Healthcare Association, which represents commercial nursing homes, believes the state has chosen to take a closer look at sales in light of some issues at other facilities across the state. He said that.
For example, in 2022, New York-based buyers purchased homes in Algoma, Brown Deer and Wausau, with all three facilities being placed at recipients last year. It was a sign of financial distress, and the court's order came after an apparent dispute between the owner and his financial aid, as well as allegations of financial mismanagement.
The city of Algoma sold its nursing home in 2022, and within two years the facility lost a high level of quality rating from the federal government, causing financial difficulties.
The recipient, a custodian appointed to manage a struggling organization, declared the owner “insolvable” in August, and unpaid bills of more than $1 million between the three nursing homes I declared the book.
The Florida-based group purchased two homes in South Range and Minocca near Superior in 2020, and two years later, both facilities were on unpaid bills, low personnel and poor quality of care I've started to run into problems.
They were also eventually placed on the receiving vessel and sold at the end of last year.
Those sales should have “pull up the antennae” of state regulators, Abrams said.
But if the state continues to block future sales, he said nursing homes may simply close rather than find better buyers.
“I think they (the state health officials) would agree… Just say no to sales and shutting down facilities is the worst result,” he said. “So we have to overcome these issues and address the reasons why the department chose to deny first.”
Harrington, professor emeritus at the University of California, San Francisco, demands that regulators do more to check potential owners and that all entities owning nursing homes are more transparent in their finances. He said that it should be done.
And she said the state could build Medicaid payments to benefit housing with lower income residents.
As Wisconsin nursing home sales accelerate, the quality of care is declining.
Since 2016, more than a third of all licensed Wisconsin nursing homes have been sold, many of which have been converted from public ownership to individuals. Almost half of all sales, federal quality ratings have since declined.
“There is no government effort to strengthen public sector nursing homes and nonprofits,” Harrington said. “And I really think the COVID crisis has shown us that ownership makes a big difference. I'm not saying that every nonprofit and every county nursing home is good. But in general, they are far better than for-profit organizations.”
Many believe that the federal government can also play a bigger role. Consumer advocates point out that it is difficult for people to communicate who own nursing homes, and experts say that financial documents submitted to CMS are not necessarily accurate. They say it's not going to be audited.
Barb Bowers, an Emelita professor at the University of Wisconsin-Madison University Nursing, can do more work to properly pay, train and maintain staff. She also advocates that increased funding for nursing homes ensures that they actually do it on the facility floor, rather than just pure profits.
“There's more transparency at the ownership level and where money is actually on the way,” Bowers said. “And we need some pretty strict guidelines on how we can spend that money.”
