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1854 The Rock County Board purchased property at Johnstown Center for the Rock County Poor Farm and Alms House. The site contained a hotel and barn. It was in our State that the classic development of the county care system was developed for the care of the chronic insane.
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1881 The Rock County Asylum opened. Through the efforts of the State Board of Charities and Reform, a statute was enacted that finally crystallized the county care system. The operation of the Rock County Asylum became official in 1881. Residents were referred to as inmates. The number of inmates continued to grow. It became evident that additional farmland was needed to keep the inmates profitably busy.
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1893 The Rock County Board purchased the Baker Farm (present site) and built the County Hospital and Poor House. Johnstown was so far from railroad service that it was thought best to move the poor farm where it would be more accessible to the railways. This three hundred and fifty acre farm was located at Routes 14 and 51 north of Janesville. Two hundred adjoining acres of land were purchased over the following years.
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1894 The new County Hospital opened as the Asylum for the Chronic Insane. The County’s insane and poor inmates were moved to the new quarters on March 30, 1894.
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1894 The Poor House opened as the Alms House.
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1911 The Poor Farm and Asylum continued to be managed with the inmates doing the bulk of the work. Very little was publicly said regarding the management of the Poor Farm and County Asylum. The facility was known as the County Farm, Poor House, Insane Asylum and County Hospital. Over the next 50 years, long-term care consisted of food, clothing, lodging and social supervision but did not include treatment by professional staff. “Deviants” of the community, were confined to the county farm. These included epileptics, unwed mothers, drug abusers, and prostitutes.
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1925 The Alpha Building opened as the “Women’s Residence”. Women living in the Alpha building worked in the kitchen and the laundry.
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1929 The Pinehurst Tuberculosis Sanitarium opened.
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1939 The Beta Building opened as the “Men’s Residence”. Men living in the Beta Building worked in the laundry and on the farm.
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1942 The County Hospital had a bed capacity of 247, the Poor House had a capacity of 80. The numbers of people cared for continually exceeded capacity levels. Most of the welfare babies were born at the Poor House. Staff members worked twelve hour days, had one day off a week, and one weekend off a month.
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1944 The chief cook, matron, and wife of the superintendent, went to Pember Clinic for a two-week training course in nursing. These women were responsible for most of the care given to ill patients. They often walked the tunnels from the nursing home at two and three in the morning to check on a sick patient.
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1957 The first nurse, a LPN was hired for the County Hospital. Physicians came from town once a week.
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1961 There were between 42 and 50 employees at the County Hospital caring for 302 patients.
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1964 After fifteen years of planning and numerous set backs, Rock Haven was built and admitted its first resident in December. Rock Haven, a skilled nursing home, had a capacity of two hundred and forty-eight beds. All chronic patients in Rock County, however, were excluded from psychiatric services and continued to be “warehoused”.
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1964 The Beta Building was converted to the active treatment (or “DATO unit”). In later years, it housed the Public Health Department.
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1970 The Pinehurst Tuberculosis Sanitorium closed. The building name was changed to the Pinehurst Building. The outpatient TB clinic operated until August 15, 1981. Later, the building housed the Public Health Department. Finally, the Pinehurst building became part of the new Rock County Jail.
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1971 Services expanded rapidly and by 1971, an alcoholism treatment program was established. The Janesville Guidance Clinic officially unified with the county hospital.
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1972 The Rock County Health Care Center opened on July 3rd. The center had a capacity of 282 beds. Acute psychiatric services, alcohol/drug treatment, and care of chronic patients were provided in this building. Over the next 25 years, Rock Haven served the frail elderly and the Health Care Center was recognized as a regional center for residents with chronic mental illness or dementia with behavioral concerns.
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1978 A Disturbed Developmentally Disabled Unit was introduced on the HCC’s second floor. That unit closed in 1982. Human Services Department had offices on the second floor, the Developmental Disabilities Board on first floor and the Information Technologies Department on the fifth floor of the HCC.
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1985 31 beds at Rock Haven became Medicare certified.
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1988 Rock County contracted with Keefe and Associates to complete a needs assessment for the Rock Haven and Health Care Center. The 1989 report summarized their findings. They assessed present and future nursing home bed needs, the impact of OBRA 87 on nursing homes reimbursement, changes in preadmission screening for residents with developmental disabilities and chronic mental illness, the need for active treatment and specialized services for these groups and the effect that an 80% Medicaid population was having on the tax levy. They reviewed the nursing home bed need in Rock County and projected that by 1995, we would have 445 more beds than needed due to COP funding and other community initiatives. Their study also looked at closing, selling or leasing the facility. They did not recommend any of those options.
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1991 Keefe and Associates revised their phase 1 report. At that point overtime and agency costs were soaring and health care costs rising. They recognized that Rock County paid employees a benefit package that was 70% higher than the industry standard. They also noted that the introduction of DRGs in hospitals was resulting in admission of more short-term, acutely ill residents with costly care needs and insufficient reimbursement.
Once again, they made recommendations: maintain status quo, sell Rock Haven, sell Rock Haven but maintain the Special Nursing Home Program and the ICF/MR in the Health Care Center, minimize losses by limiting high cost services such as serving out of county residents with CMI or DD diagnoses, close the Special Nursing Home Program and the ICF/MR, or eliminate services for short-term stay residents with medically intensive needs.
They reviewed the mission of the Rock County Health Care Center and said that the traditional mission remained:
1. Care for residents who are “hard to care for”.
2. Care for residents with behavioral problems.
3. Care of the poor.
4. Avoid competition with private nursing homes.
They noted that with the closure of the 328-bed Caravilla nursing home, any downsize at RCHCC could impact the care of Rock County citizens in the future. They suggested that discontinuing admissions for out of county would eliminate that worry. They also suggested that the mission be revised to recruit a private pay base of 20-30% of the resident population and a Medicare base of 6-8%.
An April 27, 1992 Keefe report review the financial implications of these options.
At the same time, the County recognized that the Rock Haven building needed updating. A September 1, 1995 report, “Rock Haven Renovation Project” reviewed the HVAC, plumbing and fire protection systems. An architectural study of August 9, 1996 detailed a “Preliminary Master Plan” for the renovation of the Rock Haven building with an addition off the south east end of the building. That design supported a 248-bed facility with pod type neighborhoods, two 36 bed sub-acute units, 71 beds devoted to general care 105 beds devoted to dementia care. They also looked at air conditioning and sprinkler options.
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2000 The cost of both facilities became a burden for Rock County taxpayers and on September 28, 2000 the County Board adopted resolutions to downsize Rock County Health Care Center to 180 residents and limit admissions to Rock County residents.
That goal was accomplished by early 2003. RH 2 and RH 4 were closed, and all other units had been downsized.
In 2000, the County contracted with IHA. Ken Friedman was the lead consultant on that project. Early recommendations resulted in three County Board resolutions.
1. March 3, 2000, a Board resolution established a Blue Ribbon Task Force to plan for the future of the nursing home.
2. September 15, 2000 a Board resolution discontinued the practice of admitting out-of-county residents.
3. On September 28, 2002 the Board resolved to downsize the facility from 380 to 180 beds.
At that time there were 9 nursing homes in Rock County with a total of 1,257 licensed beds. Their projected nursing home bed needs for Rock County were: 1996 - 1,099, 2000 - 1,021, 2010 - 997.
We implemented almost all of the recommendations from 2004 to 2007. We did not follow the suggestions to move the ICF/MR unit to RH 4 or to outsource the dietary department and chose to stay at 130 beds on three floors in order to have more private rooms and to capture the additional revenue provided by those 10 beds.
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2005 Plans were made to consolidate all nursing home beds in the Rock Haven building and to work with the DD Board to transition the ICF/MR clients into the community, closing the ICR/MR unit.
January – February: RH 4 was renovated and the administrative and business offices were moved from the HCC building to that floor.
March - April: RH 2 was renovated and HCC 3 residents were moved to that floor on April 26. Cable TV was replaced in Rock Haven. The original central nurses’ stations on each floor of Rock Haven were removed and relocated to unused patient rooms.
September: The lighting upgrade was completed. New boilers were added to RH ground floor.
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2006 January 25, 2006: The ICF/MR unit closed.
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2007 The Rock County Board resolved to reduce Rock Haven to 130 beds. On June 1, 2007 the Rock Haven downsize was complete.
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2008 Money was budgeted for the proposed study. The decision was made to wait one year in order to better understand the effect of Family Care on Wisconsin nursing homes and to determine the date by which a sprinkler system would be required
in our current building.
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2009 Study intended to evaluate the following options:
1. Renovate the existing building without an addition.
2. Build a new facility on the County grounds.
3. Renovate the existing building and expand to meet the program.
4. Incremental difference application.
