Many questions in Rock Haven’s future
At the turn of the 19th century, county-run health care was new to Rock County. Care was provided to the “insane” and “deviant.”
The number of patients far outstripped the number of caregivers, and the county didn’t hire a nurse until 1957.
That’s a far cry from Rock County’s health care system today.
At Rock Haven Nursing Home, 3418 County F, 260 nurses and support staff care for 130 frail, elderly and severely disabled patients.
The national push is to get people out of nursing homes, and programs and money now are available to keep many more elderly or developmentally disabled adults living with their families or in small group homes.
While it’s easy to see how things have changed, nobody knows what the future of county-run health care will be—or if Rock County will stay in the game.
Although the Rock County Board approved $80,000 in its 2008 budget to study Rock Haven and the needs of county residents who would use it, the study has been called off while health care officials look at regulation and funding questions, including:
-- When will the federal government require fire sprinklers in nursing homes?
-- When will Rock County get into Family Care, a state-mandated program that’s pegged to streamline funding sources to care for the elderly, disabled and developmentally disabled?
Answers to those questions and others will determine whether it would be more cost effective to renovate Rock Haven or to build a new facility if the county decides to keep providing care.
Those answers also could change the demographic of people who are cared for at Rock Haven now and in the future.
Director Sherry Gunderson said Rock Haven is “comfortable” with 130 patients. The skilled care nursing home was built in 1964 to hold 248 beds, so today, the building has space for offices and day rooms. Most patients have private rooms.
Rock Haven is home to people with traumatic brain injuries and those who are too chronically mentally ill to live in the community, Gunderson said. The home also cares for the frail elderly and an increasing number of patients with dementia and Alzheimer’s disease.
The home had its first major downsize to 180 beds in 2000 and another to 130 beds in 2007. The county has added lighting, boilers and generators to “buy five or 10 years” while it debates Rock Haven’s future, Gunderson said.
“We’ve done a whole lot of things to be able to stay here,” Gunderson said.
That doesn’t mean she wouldn’t like to see Rock Haven move into a new building. Continuing to upgrade Rock Haven could get expensive, she said.
The building is at its maximum electrical capacity, she said, and it will be a chore to add fire sprinklers if they become a requirement.
Legislation requiring all nursing homes to have a sprinkling system is pending at the federal level. While Gunderson doesn’t know when the bill will become law, it would cost about $1.3 million to install sprinklers at Rock Haven, she said.
It would cost another $2 million to air condition the building, Gunderson said.
Many of the patients’ bathrooms are not approved for accessibility by the Americans with Disabilities Act, she said.
Despite the questions, Gunderson hopes the county stays committed to providing care.
“It would be a shame if the county decided to get out of the nursing home business,” Gunderson said. “We have provided such a service to the community for so long.”
HEALTH CARE HISTORY
The history of health care in Rock County:
-- 1854—The Rock County Board buys property at Johnstown Center for the Rock County Poor Farm and Alms House. The site contains a hotel and barn. It was in Wisconsin that the classic system of the county care system was developed.
-- 1881—The Rock County Asylum opens. Residents are referred to as “inmates.”
-- 1893—The Rock County Board buys the current location of the county complex and builds a hospital and poorhouse. The facilities open the next year as the Asylum for the Chronic Insane and the Alm House.
-- 1911—The poor farm and asylum operate for many years with the inmates doing the bulk of the work. Long-term care consists of food, clothing, lodging and social supervision but not treatment by professional staff. The facility houses “deviants” including epileptics, unwed mothers, drug abusers and prostitutes.
-- 1925—The Alpha building opens as the women’s residence. The women work in the kitchen and laundry.
-- 1929—The Pinehurst Tuberculosis Sanitarium opens.
-- 1939—The Beta building opens as the men’s residence. The men work in the laundry and on the farm.
-- 1942—The county hospital has a capacity of 247 and the poor house 80. Patients continually exceed capacity. Staff work 12 hours days, have one day off per week and one weekend off per month.
-- 1957—The county hires the hospital’s first nurse.
-- 1961—About 50 staff members care for 302 patients. (Today, 260 staff care for 130 residents at Rock Haven.)
-- 1964—After 15 years of planning and many setbacks, Rock Haven opens as a skilled nursing home with 248 beds.
-- 1970—The Pinehurst sanatorium closes. (Today, the building is part of the Rock County Jail).
-- 1972—The Rock County Health Care Center opens with a capacity of 282 beds. Over the next 25 years, Rock Haven served the frail and elderly while the health care center served as a regional center for those with chronic mental illness or dementia with behavioral concerns.
-- 1988—Rock County contracts with Keefe and Associates on a needs assessment for Rock Haven and the health care center. Keefe’s report suggests six options, including staying at 388 beds or cutting beds for a variety of services.
Keefe projects that by 1995, the county would have 445 more beds than needed because of initiatives to provide at-home and community care.
-- 1991—Keefe makes six more recommendations, including maintaining status quo, selling Rock Haven or minimizing some services. Keefe notes that the closure of the 328-bed Caravilla Nursing Home and potential downsizing of the Rock County Health Care Center could impact the needs of county patients.
-- 2000—The burden of both Rock Haven and the health care center become too much for Rock County taxpayers. The health care center is cut to 180 beds and limited to Rock County residents.
Rock County is home to nine nursing homes with a total of 1,257 beds. In 2000, the bed need is 1,021 and projected to drop to 997 by 2010.
-- 2005—Residents and offices are moved from the health care center to Rock Haven. Emergency management, information technology and the intoxicated driver program move into the health care center.
-- 2006—Rock Haven closes its Intermediate Care Facility for the Mentally Retarded. Volunteers build a fenced entry garden, fire emergency doors are installed and smoking is banned.
-- 2007—Rock Haven is cut to 130 beds.
Source: Rock Haven Director Sherry Gunderson