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Lincoln County Board Committee Recommends Broker Bid

The full board will consider an approval of the bid later this month

The Lincoln County Board’s Administrative and Legislative Committee recommended a broker’s proposal to assist in selling Pine Crest Nursing Home during their meeting last week. The full County Board will discuss and potentially accept the proposal at their next meeting scheduled for July 18th.

The recommended proposal is from Marcus & Millichap, a national commercial real estate broker whose Wisconsin office is in Milwaukee. The proposal begins with a short letter from Ray Giannini, the brokerage’s Senior Managing Director.

In comments made to the Foto News in a June 23 article, Lincoln County Board Chairperson Don Friske said a broker’s perspective “is one piece of the information we don’t have.”

However, a review of the County Board’s Ad Hoc Committee minutes and recorded meetings show that a broker’s perspective was already considered in two meetings, one on March 14th and another on May 1st.

According to minutes from both meetings, the broker’s name was Ray Giannini. The March meeting’s minutes state that he was from Best Brokerage Inc. and the video shows him using a Zoom account with that same name. He began his statements by saying he is with Marcus & Millichap but the minutes of the meeting do not reflect that statement.

Activists Rally
Activists held a press conference in the lobby of the Lincoln County Service Center on June 26
Activists held a press conference in the lobby of the Lincoln County Service Center on June 26 | Photo by Erik Pfantz

A group of citizens calling themselves People for Pine Crest is working to gather signatures for a petition opposing the sale of Pine Crest and asking the county board to fund the maintenance of the county home. Their petition states, “Care of the most vulnerable is our collective responsibility.”

As of June 26, the group had gathered over 650 signatures and they will continue gathering them until July’s county board meeting. The group held a press conference early on the 26th prior to the opening of responses from brokers interested in facilitating the county’s sale of Pine Crest.

“Our goal is to find financial solutions that will enable Pine Crest to continue to serve our residents now and into the future,” Renea Frederick said in the press conference.

Todd Frederick also spoke and addressed a common criticism of the nursing home: that only a small portion of the county’s residents benefit from it. He compared it to the fire department by saying that it is an investment that may not directly deliver returns to every citizen but it is there when it is needed.

“How we treat our children and our seniors is extremely critical in how people look at our community and right now selling Pine Crest would not reflect well on our community,” Todd Frederick said.

District 3 County Board Supervisor Elizabeth McCrank also participated in the press conference saying, “selling Pine Crest in any fashion whatsoever is turning our backs on the people who have invested in our community and paid their taxes sometimes for decades to support public schools, the roads, law enforcement and all other public goods.” She continued, “they did it all the while believing that this would be a great place for them to live out their lives.”

“Selling Pine Crest in any fashion whatsoever is turning our backs on the people who have invested in our community”

Elizabeth McCrank, District 3 Supervisor

Al Curtis, a current resident of Pine Crest, spoke about how the services provided by Pine Crest have been essential to him by saying, “those people who are deliberating, contemplating, thinking [what] to do with Pine Crest, it is something that we need. I need it. A lot of people that are worse than I physically and mentally need Pine Crest.” He further said, “our community, our county, and actually our state, if we want to think out wide, can’t get along without something like this.”

Another speaker, Michael Southcombe, pastor at St. Stephens church in Merrill said, “Our quarrel is not with the county board, our quarrel is with the payment structure and the business model we have now for elder care in this country. Most nursing homes are not financially viable if they have more than 10% of their residents on Medicaid. Pine Crest has 70-80% of its residents on Medicaid. It is not financially viable unless it has an outside source of income to make up the losses incurred by having so many residents on Medicaid.”

The value of the facility

Pine Crest has been a recurring political topic in Lincoln County for the last decade or so with previous county boards implementing small initiatives intended to grow revenues or save money instead of a big reworking of the program to address its roughly two decades of budget deficits.

Disruptions caused by the COVID-19 pandemic, particularly a large reduction in the facility’s population and staff, have brought the deficit to roughly $1 million in 2021 and 2022 with another $1 million dollar deficit projected for this year according to North Central Health Care Executive Director Gary Olson. This large deficit prompted the County Board to form its ad hoc committee to consider changes to the county’s relationship with the facility.

An activist wrote some messages in chalk in the parking lot in front of Pine Crest Nursing Home Photo
An activist wrote some messages in chalk in the parking lot in front of Pine Crest Nursing Home | Photo by Erik Pfantz

The county currently owes about $8 million for the 2017 addition of the rehabilitation and memory care wings. The building also needs roughly $8 million in maintenance and replacement costs for things like HVAC, roof repairs, floor and wall work and other fixtures, according to Lincoln County Maintenance Director Patrick Gierl, though some of these costs are not immediate needs.

Administrative Coordinator Renee Krueger drew attention to the facility’s number of bed licenses during the May 1 ad hoc committee meeting. The state increased requirements for obtaining these licenses making it difficult to generate new ones. Pine Crest holds 120 of these licenses and Krueger stated much of the value of the facility comes from these licenses. The condition of the building is somewhat secondary so long as it remains adequate to maintain the licenses. With the recent increase to Medicaid reimbursement rates, the relatively large number of beds may offer greater opportunity to make the facility operate with a balanced budget.

“The value of the building is not what they’re assessing or looking for. Generally speaking it’s in good condition,” Krueger said. “We’re not going to be able to sell the building for what we’re going to be able to sell beds for and nobody wants the beds without the building.”

“[If] we go from public to private that will, just by definition, cut out some people who would be able to stay there”

Dave Johnson, former City of Merrill City Administrator

Dave Johnson, former City of Merrill City Administrator, spoke to me about the Merrill area’s population trends and what impacts those trends are having on things like housing stock, the school district, or public services like Pine Crest. He said the areas’ aging population will increase the need for facilities like Pine Crest.

Activist's chalk message on the River Bend Trail
Activist’s chalk message on the River Bend Trail | Photo by Erik Pfantz

Publicly funded facilities like Pine Crest will take patients whose payments are subsidized by Medicaid or Medicare while private facilities can choose not to take such patients.

“That’s done economically. They don’t make the money on them therefore they’re not going to take them,” Johnson said. “[If] we go from public to private that will, just by definition, cut out some people who would be able to stay there and that is not in the best interest of our aging community.”

“That is very shortsighted on the part of the County Board,” Johnson said. “They’re on a mission to save money in the short term, not looking at the long-term impact of those present day savings.”

The historical justification of a county-owned care facility

Johnson also talked about the historical value of this kind of facility. “There was a need. There’s always been a need,” he said.

“There was something before Pine Crest, there was the county farm and that goes back in the state into the 1800s,” Johnson said. “They actually had a dairy farm with other farm products that they sold to help fund the place and some of the older people that lived there actually helped out on the farm.”

“There’s a long tradition of county owned facilities. That’s been a tradition for well over a hundred years and it’s a system that worked,” Johnson said.

According to George O. Jones’ “History of Lincoln County,” written in 1924, the county originally purchased a farm to be designated as a county home in 1875 but that property never was used for that purpose. Instead, “an establishment located near the Prairie River in Merrill was run by a paid agent of the county” and identified Mr. and Mrs. A. S. Chilsen as the operators for “many years.” Lincoln County was established in 1847 and Merrill’s first school was built in 1855, to give some context for what “many years” may have been. Little is said about what duties the “agent of the county” performed but they were likely being paid by tax dollars.

“There was a need. There’s always been a need”

Dave Johnson, former City of Merrill City Administrator

Jones then shares that the County Home “was started about 1900.” It began with 80 acres and, in 1920, 74 adjoining acres were bought and added to the property. The building cost $8000 and had space for 50 people and only housed 40 at the time Jones was writing. The farm had a herd of cattle and sold 60 of them in the two years prior. It’s likely that selling this amount was not enough to deplete the herd but was how many surplus cattle were available as the farm also produced meat, milk, eggs and vegetables. Jones also writes, “there is a fine barn, thoroughly modern in equipment, and a concrete silo.”

A county hospital was added on to the County Home and opened on July 14, 1920. Jones wrote, “[it] is not strictly a charitable institution, although those unable to pay for hospital facilities are cared for there without charge, in addition to the regular paying patients.” He goes on to describe the building as having two floors, sun porches on both floors on the west side, three wards, seven private rooms, sterilizing rooms, baths and other features.

Current site of the former Lincoln County Home on Highway G just northwest of the Merrill High School
Current site of the former Lincoln County Home on County Road G just northwest of the Merrill High School | Photo by Erik Pfantz

“Everything is thoroughly modern; and the operating room is particularly well equipped, having among other features an electric illuminator six feet in diameter,” Jones wrote. This is likely referring to a chandelier as electric lights in buildings were beginning to be more common at this time.

By 1920, the Lincoln County Home was a quality facility offering care and housing for the elderly, sick, disabled, orphaned, poor and unfortunate, continuing a program of providing care for “paupers” that began at least 45 years or so earlier. The facility was sustained both through county funds and revenues generated by typical farm production. Sometimes facilities like the Lincoln County Home were called “Poor Farms.”

Different historians paint different pictures of the conditions on these farms. A video on YouTube filmed around 1994 and shows an old man giving a tour of the former poor farm in Lincoln County, Tennessee. He seemed to have positive memories attached to the place and emphasized how everyone worked to make it mostly self-sustaining. Other sources paint them more negatively.

Elder care and other social care programs changed with the Social Security Act of 1935 and other New Deal era programs to address poverty. These initiatives infused federal funding and medical care standards into the existing county care facilities and shifted them away from the farm labor model. A couple decades later, the Lincoln County Board decided to build the original Pine Crest building; the building that stands above the current single-story Pine Crest Nursing Home and currently houses the county’s health services departments.

A local resident’s voice

I spoke with Tony Dantas, a local resident, on the River Bend Trail. He attended one of the town hall meetings the county board held to hear the public’s opinions on the issue.

“I went to one meeting and by that conversation I felt they had already made a decision,” Dantas said. “My feeling is that they bought a cow that didn’t produce milk and they don’t want to feed the cow.”

“My feeling is that they bought a cow that didn’t produce milk and they don’t want to feed the cow.”

Tony Dantas, local resident
People for Pine Crest's petition on a bench on the River Bend Trail
People for Pine Crest’s petition on a bench on the River Bend Trail | Photo by Erik Pfantz

“Pine Crest was made into a problem to solve other problems,” Dantas said. “You get rid of it, then you have less expenses, then you can do what you want to do. And this is not a problem of Merrill, it’s not a judgment on them, it’s everywhere you find people doing that in government.”

“Pine Crest is something that serves a need, also it’s very important for the county to have a place where people can go. So there is a sorry side to this story,” Dantas said. “From an economic point of view, maybe sell it, I don’t know. But when I look for the other facts, you gotta see the whole thing.”

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