After reinventing itself in 2010, Lakeview Manor continues to evolve to meet the changing needs of the elderly.
Last week, the Waupaca County Board gave Lakeview Manor the go-ahead to remodel the facility.
The remodeling project will shift the facility’s focus to assisted living care for dementia patients. It represents a new phase in the facility’s ongoing transformation that began when it opened its doors in 1902.
History of transition
Known as the Waupaca County Asylum for the Chronically Insane a century ago, Lakeview Manor was built on a 300-acre parcel in Weyauwega.
For much of its early history, the facility was as a farm where the mentally ill could experience a quiet, rural setting. In 1947, as the county began to see the facility’s residents as patients rather than inmates, the name was changed to Waupaca County Hospital.
In 1974, when Wisconsin abolished the county hospital system, Waupaca County rebuilt the facility as a certified nursing home.
Over time, the traditional nursing home model began to fail. Due to dwindling state and federal revenues, combined with escalating costs, the facility was no longer able to sustain itself financially.
Between 2005 and 2008, Lakeview Manor’s impact on the county tax levy grew from $658,000 to $1.67 million.
After a study in 2008 and subsequent changes in management, costs were brought under control and new sources of funding were found.
“We have been below $850,000 for the last three years,” County Supervisor Gary Barrington said regarding the amount of tax levy dollars that now support the facility.
Barrington, who also serves as the president of the Lakeview Manor Board of Trustees, said the remodeling project will give the facility a chance for survival.
“We knew we couldn’t continue the way we were because we were becoming an ever-increasing burden on the taxpayers,” Barrington said.
Lakeview Manor plans to remodel the facility to allow for two 10-bed units. Each unit is projected to cost $645,000 to build.
Barrington said the sale of some of the land that the county owns adjacent to the facility could cover part of the project’s construction costs.
“We have 165 acres of farmland here and we’d love to get that back on the tax roles,” Barrington said.
Barrington noted that several county supervisors do not favor selling the land for farming.
At the November county board meeting, Supervisor Don Morgan, of Weyauwega, said the land could be used to develop an industrial park.
In addition to jobs, Morgan said the land would have a higher value and generate more tax revenues if used for industry rather than farming.
Barrington disagreed, saying, “If we sell the land, we should be able to pay off the loan much quicker.”
The Lakeview Manor board estimates that the county would need to borrow about $1 million to finance the remodeling work.
The nursing home will account for just under $3.85 million of Waupaca County’s $70 million operating budget in 2014.
State and federal sources provided $2.78 million in revenues to Lakeview Manor, while the county levy provided $880,000, a $30,000 increase over 2013.
The facility plans to use nearly $183,000 from its reserve funds to cover expenses in 2014.
New design
Carrie Baxter-Crist, Lakeview Manor’s resident services coordinator, said the new units will be specifically designed for residents with dementia.
“Currently, the facility is designed with corridors coming off a central desk,” Baxter-Crist said. “It was not designed for patients who wander.”
Baxter-Crist described how dementia patients need to walk around, without finding themselves at the closed end of a hallway or in a busy, noisy room.
“They want to pace, they want to rummage, they’re looking for home,” Baxter-Crist said. “With dead-end corridors, you create more anxiety, more restlessness. With a circular route, there won’t be any dead ends.”
Barrington said dementia patients will have their own single-occupancy living space. They will be encouraged to bring some of their own furniture so the space seems more like home.
“They will have their own lounge area and their own cafeteria,” Baxter-Crist said. “They will also be able to do their own laundry because as dementia patients age, their minds still want to work.”
Lakeview Manor staff will also offer special programs for residents with dementia.
Changing needs
Baxter-Crist said the changes planned at Lakeview Manor are in response to shifting demographics.
In October, the Johnson Foundation and the Wisconsin Department of Health Services sponsored a statewide summit in Racine for those involved in providing care for the elderly with dementia.
According to the summit’s report, “Wisconsin had almost 120,000 residents with Alzheimer’s disease or related dementias in 2010, a number that is expected to increase dramatically over the next 25 years, due largely to the aging of the Baby Boomer generation.”
The report noted that up to 90 percent of people with Alzheimer’s will exhibit agitated behavior.
“While relatively few of these people will become violent or dangerous, a small but not insignificant proportion will exhibit behaviors that are challenging enough for their caregivers such that an emergency response is warranted,” the report said.
Baxter-Crist said many private nursing homes are not designed to handle those residents with more challenging behaviors, such as violence or repeated attempts to wander away from the facility.
She noted that residents with dementia are more costly, due to a need for greater patient-staffing ratios.
By shifting part of the facility from a standard nursing home to assisted living, however, Lakeview Manor will be able to cut some of its operating costs.
“Nursing homes are more regulated than nuclear plants,” Barrington said. “Assisted living facilities are less restrictive.”
Melissa Goke, business office manager for Lakeview Manor, pointed to the state’s bed tax.
“Nursing homes are taxed at $170 per month per bed, regardless of whether they’re occupied,” Goke said.
Over the past four years, Lakeview Manor’s bed tax has more than doubled. It now costs the county $102,000 annually for its 50 nursing home beds.
By designating 20 beds as assisted living, the facility will cut its bed tax expenditures by at least 40 percent.
Once the remodeling project is completed, Lakeview Manor estimates its impact on the county tax levy will drop to $765,000 annually, which includes both operating expenses and a $1 million loan at 3.25 percent interest for 10 years.