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Reinventing Lakeview Manor

Founded in 1902 as the Waupaca County Asylum for the Chronically Insane, Lakeview Manor has undergone constant transformation over the past century.

The facility was built on a 300-acre parcel in Weyauwega and spent much of its history as a farm when 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.

Four years ago, Lakeview Manor faced serious problems and a questionable future.

In 2006, the facility’s reputation had been marred by state and federal fines totaling more than $100,000, after inspectors characterized Lakeview Manor as providing “a substandard quality of care.”

At the same time, the home’s expenses continued to mount each year, while its state and federal revenues plummeted. Between 2005 and 2008, the amount of county tax revenues needed to support the facility rose by 150 percent, from $658,000 in 2005 to $1.67 million in 2008.

“When I became administrator in April 2010, there was a lot of talk about the amount of tax levy the facility was using,” recalled Lakeview Manor Administrator Melissa Drews, who has worked at Lakeview Manor for three years, first as director of nursing, then as the administrator.

County Supervisor Gary Barrington, who also serves as the president of the Lakeview Manor Board of Trustees, said a study done prior to 2010 projected that the facility’s impact on the county’s tax levy could grow by as much as $2 million “if we continued to do business without any changes.”

Drews said a survey among county supervisors found that they would support providing about $850,000 in tax levy for the continued operation of the nursing home.

“That $850,000 gave us a financial goal to strive for,” Drews said.

“The undercurrent was that this was not just a goal but a mandate,” Barrington added. “We either had to improve our financial situation or we might lose the facility.”

In the 2012 county budget, Lakeview Manor’s impact on the tax levy reached the $850,000 goal and is now half of what it was at its 2008 peak. At the same time, total net assets have risen from $200,000 to $1.08 million.

The facility’s revenues from sources other than local property taxes – state, federal and private insurance – have grown from $2.93 million in 2008 to a projected $3.04 million in 2012. Expenditures have dropped from $4.6 million in 2008 to $3.9 million in 2012.

Lakeview Manor’s improving financial situation is the result of what Barrington called “sweeping changes.”

“We had to run this place like a business,” Barrington said. “It meant looking at staff, at programs, at the building. In the end, we changed about everything.”

Drews said, “We looked at how technology could make us more efficient. We updated the building to make it more attractive to short-term rehab patients.”

To reduce expenses, Lakeview Manor cut the number and pay of the staff.

“The employees took a 3.5 percent wage cut in 2009 to help us get back on our feet,” Drews said. “They got that back in 2010.”

In 2009, Lakeview Manor also began combining jobs, cross-training and reducing staff.

“Automation really helped us,” Drews said. “We went from five people in the business office to two people and we do more.”

The facility also changed the way it handles its billings. The county’s Finance Department now handles Lakeview Manor’s accounts payable, while the administrative staff handles billing.

Lakeview Manor also became certified to collect Medicare payments in 2009. Now, Medicare accounts for 9 percent of the facility’s total revenues.

In 2009, the facility’s primary goal was to cut costs. In 2010, its goal was to increase the number of residents through marketing.

In 2006, Lakeview Manor was a 72-bed facility with 61 residents. It is now a 50-bed facility with 43 residents.

Drews said the facility previously had shared rooms for its residents. Now, all the residential rooms are private.

“One of the first things the board approved was to improve the environment. We painted, we did some decorating, we bought new furniture,” Drews said. “It’s the environment that draws people in and it’s the quality of care that keeps them coming back.”

When families come to visit residents at Lakeview Manor, they can meet in any of several rooms. A small room with a couple of tables and chairs overlooks a patio area. Another room has a large bird habitat on one end. There is also a TV room and the cafeteria, in addition to a large space filled with round tables and a smaller adjacent room for residents who feel uncomfortable in crowds.

In 2011, Lakeview Manor replaced a rooftop heating/air conditioning unit, completely refurbished five resident rooms, remodeled the nursing station and medication room, purchased therapeutic and exercise equipment and began landscaping the grounds around the building, among other changes.

“We went from a medical model to a social model,” Drews said. “We used to make people get up early in the morning for breakfast. Now, they can sleep as long as they want. We serve two main meals a day, brunch and dinner. And we serve snacks three times a day.”

Lakeview Manor has also been marketing its facility. Proud of the food they serve, the facility’s staff now provides 200 meals a day for Meals on Wheels in Weyauwega, Fremont and Waupaca. Seniors who take advantage of the Meals on Wheels program may be potential residents in the near future.

“We’re always looking to meet the needs of Waupaca County residents at a reasonable cost to taxpayers,” Drews said, adding that Lakeview Manor has been able to meet that goal thanks to the support of the staff and the community.

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