"Nobody should profit off our nursing homes."
Wanting to preserve the quality of care seniors receive, local Wisconsinites are fighting back against the sale of their community-owned nursing homes to for-profit entities.
When a closed-door meeting showed up on the Portage County Board of Supervisors’ agenda last February, Nancy Roppe got suspicious. She’s an open book, and she expects her local government to be, too.
“Oh, here they go!” she thought to herself. She had a suspicion about what they were up to.
Nancy and her neighbors in Stevens Point, Wisconsin, have been engaged in a seven-year battle to prevent their beloved county-owned nursing home from being sold. Her sister, like so many others, had received top-notch care at the Portage County Health Care Center, and for the last hundred years, it's been a community institution people can count on, no matter their income, as they age. Twice, Portage County residents have managed to get a referendum on their ballot to invest in the home, and twice they have won that vote.
The Portage County Board of Supervisors, however, has continued to try to sell the five-star nursing home despite community objections. Nancy suspected that that closed-door meeting was with a for-profit buyer. And, as she and other community organizers soon found out, that buyer did not have Portage County’s best interests in mind.
“These guys weren’t going to let us know about this sale until it was a done deal!”
That really hit her hot button.
Save the Portage County Health Care Center
Years earlier, Nancy and her husband, Joe, started a Facebook page called “Save the Portage County Health Care Center.” The page is big for a small county and has a few hundred followers; it has developed into the go-to source for the latest information on the efforts to privatize PCHCC. On the page, Joe regularly livestreams and recaps county board meetings, and members of the group often post colorful commentary about their local government and why they care so deeply about the nursing home.
When the Roppes saw the closed-door meeting, they decided to post about it to the Facebook group. Quickly, they realized there was a series of meetings scheduled– February 27, March 5th, March 11th– and they sensed the Board was closing in on a sale. But to whom?
Soon, they found what they were looking for. One meeting's description contained the phrase “review letter of intent from Sam Follman.”
“When the name appeared, we posted it in the Facebook group, and everyone started to dig in,” explains Nancy. “We said: Anyone know this guy? And, oh boy, it didn’t take long.”
Nobody knew Sam Follman—not actually. He wasn’t from Portage County or even Wisconsin. He was an out-of-state businessman whose LinkedIn profile says he specializes “in acquiring and transforming distressed healthcare facilities.” Not only was PCHCC not distressed, but Follman’s “transformation” track record was abysmal.
A quick Google search showed that Follman had already done business in Wisconsin, buying facilities in Algoma, Brown Deer, and Wausau in recent years. Soon after these purchases, these facilities were financially failing and in receivership, with over $1 million in unpaid bills.
Even worse, the Algoma nursing home, like Portage County’s, was a five-star facility when Follman purchased it and was now rated with just two stars.
Follman’s apparent business model is to create LLCs and pay himself management fees between the companies. A lawsuit suggests that Sam Follman may have used profits from these now-failing homes to pay off personal vehicles and credit cards.1
“What we uncovered was unbelievable and shocking, the litany of violations, citations and fines,” says Nancy, who isn’t the type to mince words. “Who would ever knowingly do business with a guy who has this terrible track record?”
There was so much information that the group dug up that she and Joe made folders for each of Follman’s business ventures and put it out in batches on the Facebook page for followers to research and review. “We just kept finding more and more damning stuff; a big ol’ pile of stuff on this guy.”
What miffed Nancy most was that the information was so easy to find. “They must think we are a bunch of dumb hicks,” she said. “Well, if we are, at least we know how to Google!” She and Joe point out to me that the county has paid attorneys and paralegals involved in this sale process, and they find it unbelievable that no one seemed to have done any research into Follman. “We aren’t the ones with access to paid subscriptions and legal databases!” Nancy says. “I mean, come on, man.”
Even over the phone, I can hear her roll her eyes.
Dead in the Water
Even though Nancy and Joe knew that local Supervisors would read what they were posting on the Save Portage County Health Care Center Facebook page, they also knew that just putting the findings about Sam Follman out to air wasn’t going to be enough. They issued a call to action to the group, asking local residents to come out to the next Board of Supervisors meeting, which was less than a week away. At this meeting, they fully expected the Board to vote on the sale.
“We filled the gallery at the next meeting,” says Nancy. “People got up and spoke against the sale. We were careful not to repeat ourselves, but there was enough dirt on Follman that it was easy to have each person present use their allotted three minutes to share different findings and still have some left over. We could have gone on for hours.”
The Board of Supervisors didn’t answer if they had known about Sam Follman’s past or not– their lawyers made sure of that. But they did decide to send the decision around Follman’s purchase offer back to committee for further discussion.
“What a surprise! The sale was dead in the water, and we never heard about it again.”
A Growing Movement
The group organizing in Portage County that Nancy and Joe belong to is part of a larger movement in Wisconsin to prevent the sale of county-owned nursing homes. Similar fights are happening in counties throughout the state, especially in rural communities. Earlier this month, nearly 150 people turned out for a Lincoln County town hall where People for Pine Crest presented their findings and alternatives to selling. In January, residents from Portage, Lincoln Sauk, Marathon, and Walworth Counties headed to Madison to meet each other face to face for the first time. They then went to meet with state officials, asking questions that any county board member who is responsible for a nursing home should have been asking: How does the quality of care in public nursing homes compare to private nursing homes? What's the revenue stream for our nursing homes? What are some potential sources of funding to pay for nursing home maintenance and capital improvements?
“Selling isn’t the answer. People love these nursing homes being community-owned and don’t want to see them taken over by some businessman for his own profit,” says Nancy about the overwhelming community response across Wisconsin.2
It’s not the first time that Roppes have seen for-profit interests try to out-compete the will of local residents. In the 1990s, Nancy says, “big developers came to Stevens Point wanting to build a mall. We told them that we didn’t need it and that it would hurt our main street, but the town went along with it. Fast forward to now, and most of that mall has been bulldozed.”
She saw it again in Stevens Point in the early 2000s when the Tavern League worked to defeat an anti-smoking ordinance wanted by the majority of residents. Nancy argues that residents usually have their finger on the pulse of the local community in ways that business interests can’t, don’t, and won’t. “Once we finally managed to negotiate the smoking ordinance, they found out they should have always gone along with the people the whole time because more people turned out to drink in the bars now that we didn’t have to go through clouds of smoke.”
For-profit models, the Roppes know, don’t necessarily mean better service. In fact, data shows they can be worse. At the February town hall, Rene Eastman of LeadingAge Wisconsin showed data that publicly owned nursing homes provided the highest-rated care compared to private or even non-profit entities. It’s not just a sense that the Roppes have; there really is a benefit to the community being in charge.
Who is this Town For?
“Private sector for profit entities DO NOT do a better job!” Joe wrote on the Facebook page last month, sharing a news article about failing for-profit assisted living homes that had recently come under fire for poor care. “Another reason why the PCHCC should remain county-owned!”
For-profit businesses, as Algoma’s experience with Follman shows, don’t necessarily have the interests of the community at heart but instead are often coming to town to extract wealth for themselves. Follman isn’t an anomaly: A different Wisconsin nursing home CEO was indicted on federal fraud charges in 2023. “At its heart, it’s a conflict of interest,” says Nancy about the push to convert publicly owned entities into private hands. When a community runs something, she argues, they are thinking about people, not profits, and act accordingly.
Nancy and Joe worry that the Board of Supervisors is more likely to listen to the pitches from for-profit businesses than their constituents who have voted them in. “Who is this town for?” asks Nancy. “They show that through who they listen to.”
The grassroots organizers in Portage County are determined to make sure the county doesn’t repeat old mistakes and that this time, their elected officials listen to them. The Board of Supervisors continues to look for a buyer for the Health Center, but Nancy, Joe, and the others continue to organize and turn out.
When I ask Nancy how she remains optimistic after all these years, she laughs. “Well, watching over their shoulders and being a pain in their side has worked so far– we just have to keep that up until elections come and vote out the ones who won’t listen.”
Andrew Bahl at Cap Times has recently conducted excellent reporting on Follman and the nursing home industry.
Addie Costello has done extensive reporting on the Wisconsin county-owned nursing homes and the move to sell to private interests such as this article here.