URBANA, Ill. (WCIA) — Representatives for the owners of the former Champaign County Nursing Home say they can close the facility in as few as 60 days without permission from the County Board that sold them the home in 2019 under the agreement it remains a nursing home until 2028. Thus, the future of the area’s largest nursing home is left in limbo.

The county unanimously vetoed University Rehab Real Estate LLC’s request on Oct. 11 to amend the agreement and sell it to be made into a substance abuse treatment facility.

Altitude Health Services, Inc. chief investment officer Keith Gibbons, standing in for the company’s principals, said ahead of the vote there were “two options” for the board.

‘Option A’ was the denied amendment and ‘Option B’ would be to close the nursing home since renamed University Rehabilitation Center under the current ownership.

“We do not need approval, respectfully, to close the nursing home,” Gibbons said addressing the board. Approval from the Illinois Department of Public Health would be needed, which is generally a 60-day process.

Healthcare advocates, like Champaign County Health Care Consumers executive director Claudia Lenhoff, and some board members argue the owners knew what they were getting into when they promised they could run the home for nearly a decade.

University Rehab Real Estate LLC is managed by William “Avi” Rothner. He, his father, Eric, and other members of the Rothner family, owned or at least partially owned more than a dozen facilities in Illinois alone under various company names when the board sold them the county nursing home. William Rothner also founded Altitude Health Services, Inc.

“Shame on us in Champaign County that we sold the nursing home to this company, these folks,” Lenhoff said.

Although there was a contentious debate over whether to sell to the Rothners at the time, board members agreed on one thing: ‘We need this nursing home.’

A rare resource: A brief history of the county nursing home

Urbana was once home to an uncommon county-owned nursing home, which came with its advantages, like partnerships with local clinics and hospitals to provide dental and respiratory care.

“It was staffed at a higher ratio of nurses to patients than most nursing homes in the United States,” Lenhoff shared. “Because they’re not in it for the profit.”

The original site still stands off of Main Street. It’s now a law enforcement training center for the Illinois Law Enforcement Alarm System (ILEAS).

A half mile away, in the early 2000s, the county funded the construction of what most know as the Champaign County Nursing Home.

“A public, nonprofit nursing home,” Lenhoff described.

County board member Jim Goss, R, still keeps records of the home’s finances in a pile of folders about the height of a couple of textbooks.

“The size and scope of it was a mess,” Goss said.

“It literally took our county general fund balance down to a dangerous, dangerous level…We were losing, you know, over $100,000 a month when I got on the county board in 2017.”

Years-long financial troubles came to a head in 2017. At the time, the state was also having money problems and decided to temporarily withhold Medicaid payments to healthcare facilities across Illinois, and in nursing homes, the majority of patients’ stays are covered by Medicaid.

The board took the issue to the voters. The question was “Shall the Champaign County Board be authorized to sell or dispose of the Champaign County Nursing Home?”

54% voted to allow the board the option to sell, but doing so still required a 2/3 majority vote from board members and that spurred a contentious debate.

“This is one person’s opinion, the government has no business being in a business that is a nursing home,” Goss said looking back.

Fellow board member (then and now) Steve Summers, D, voted against selling the home. He remembered being in the minority of members who wanted to wait out the state’s financial situation and take the time to explore other funding or buyer options.

“There was also a lot of reason to be optimistic that the financial situation would turn around,” Lenhoff said.

Goss saw the sale as an immediate need. The board hired a broker to seek out interested buyers and make recommendations.

“The broker came back with only three viable choices to buy that nursing home at that time. The Rothners were overwhelmingly the best choice,” Goss argued.

“There are people still lobbying today that we should have never sold it. But that wasn’t an option.”

Goss and Summers stressed the hours spent in late meetings discussing options, some nights until 1 a.m.

Summers, who was wary of selling “particularly to the Rothners,” said “I believe they looked at any viable option in terms of how we could go in terms of selling.”

“Finally a majority of the board voted to sell,” Summers recalled. “The decision of the board at that time was to sell and that’s the outcome.”

Lenhoff called the decision and subsequent sale in 2019 “devastating.”

With the sale, the building was renamed University Rehabilitation Center, along with a signed promise from the Rothners to keep it a nursing home until at least 2028.

‘We’re gonna be in a panic’: Patient families, board members fear future as debate reignites

“The losses that we’ve incurred have been substantial and continued,” Gibbons said three years later to the board, bringing forth the Rothners’ proposal to amend its covenant with the board on Oct. 11.

Gibbons asked the board to let them sell it to a non-nursing home buyer, saying they can’t find an interested nursing home operator.

“In essence, that’s their problem,” Summers said in an interview Tuesday.

“They assured us that they had been in the nursing home business for many years and had the skill set to properly manage the nursing home. And again, they gave us assurances that they were going to remain open.”

The board unanimously denied the request.

“I’ve got four ‘nos’ for you, ‘no,’ ‘heck no,’ ‘hell no,’ and you can figure out the last one,” board member Eric Thorsland, D, said.

Goss was more sympathetic and said he was sorry it didn’t work out, “but for our community, we need this nursing home.”

He said he expected the company to stick to the covenants it signed.

As for the possibility of closing the home, Goss said, “we can revisit this.”

During a follow-up interview with WCIA 3, he said he doesn’t think the county could intervene.

“If the state approves it, I don’t think the county’s got any way to stop that,” Goss said.

“Any nursing home closure must be reviewed by the State,” board member Stephanie Fortado, D, wrote in an email to WCIA 3 in response to a question of whether the Rothners can close the facility without an amendment to their agreement with the county.

“We hope that the operators of the former County Nursing Home will live up to their commitment to our community and keep this vital facility open for our county as a skilled nursing home.”

“In a way, I kind of take it as a threat,” Urbana resident Bill Hand said of Gibbons’s presentation of ‘Option B.’

Hand’s wife, Cindy, moved into the nursing home six years ago after a massive stroke.

“I see my wife twice a week right now,” he said.

He lives three miles from University Rehabilitation Center and those visits are crucial to Cindy’s well-being. They are also important to him and their daughter.

“We’d be lucky to see her once a month or once every other month if they moved her out,” he fears. “And that’s not just my work. That’s everybody over there.”

The Rothners’ representatives claimed a Savoy nursing home, Champaign Urbana Nursing and Rehab, could immediately take in all of the former county home residents.

“There’s not that many openings. There are far few Medicaid beds,” Hand reacted, remembering trying to find a bed for his wife years ago.

“We’re gonna be in a panic.”

“It’s more than financial, it’s people.”

Bill Hand, whose wife lives at University Rehabilitation Center

An attorney who handles media response for Champaign Urbana Nursing and Rehab did not respond to calls and an email asking whether that claim is true.

‘They know exactly how all of this works’: Family of industry veterans has history of buying, selling nursing homes

“They told us they were very adept at running nursing homes, they’d been doing it for years,” Summers repeated in the Tuesday interview.

Unlike the county when it encountered financial trouble, the Rothners are in the nursing home business, and they had a lengthy history in the industry when they bid to buy the building.

The county home is one of three they purchased in Champaign-Urbana and now the third they’re looking to close.

“What it looks like to me is that their business model is not really about delivering nursing home care. Their business model is about acquiring properties and flipping them.”

Claudia Lenhoff, Champaign County Health Care Consumers executive director

The Rothners also bought the former Helia Nursing Nome on S Mattis Ave in Champaign around the same time as the county facility. They permanently closed it by late 2020 and sold it to Fairlawn Real Estate Property Management in 2021, a company that manages more than 200 rental housing properties in Champaign-Urbana alone.

It sits idol, fenced up today.

They also bought Heartland of Champaign on Springfield Ave in early 2019, before deciding to close it just a few months later. The closure announcement happened within a month of finalizing the purchase of the former county nursing home.

It’s now student housing.

“What it looks like to me is that their business model is not really about delivering nursing home care,” Lenhoff said. “Their business model is about acquiring properties and flipping them.”

Lenhoff was among those who fought against the board selling the county home. She said she personally visited several facilities run by the Rothners back then “to get a good sense of the type of quality of care that they were providing.”

“And it was not good, it was abysmal.”

Champaign County Health Care Consumers documented findings about the existing facilities on its website in 2018.

“So we tried to warn the community and tried to tell the county board if you’re going to sell, go back to the drawing board and try to find a different buyer,” Lenhoff remembered.

Quality of care concerns in previous facilities have since spilled over into University Rehabilitation Center.

A yellow triangle with an exclamation point shows up next to University Rehab’s Medicare.gov rating. The facility is actually ‘unrated,’ meaning it has a “history of serious quality issues” and is at risk of “termination from Medicare and Medicaid.”

“If you look at why nursing homes generally have low ratings, it’s generally because of staffing,” Goss said. “Staffing isn’t easy.”

“That’s just obvious. There don’t seem to be enough people there to help out. That’s the biggest issue,” Hand said of his and his wife’s experience with the facility. “They just are overwhelmed.”

Illinois has grant money available to bolster staffing through the CNA Tenure and Promotion Payments Program.

The Rothners have not applied, Fortado revealed at the Oct. 11 meeting.

“I don’t understand why they’re not willing to use a program that would help them enhance the pay for their CNAs,” Summers said in the Tuesday interview with WCIA 3. “That’s kind of mind-boggling for me.”

Generally speaking, higher staffing levels improve quality of care, which in turn, leads to more filled beds, and theoretically, that should result in a higher cash flow for the managing company.

Families, like the Hands, counting on the home expect a little more from the owners who they say committed to continued community care for years to come.

“Do everything you do can to keep it open,” Hand pleaded. “I feel like they really don’t care.”

“All they are looking at is, you know, taking care of what they could pad in their pocket. And that’s it.”

“I think that for the home to remain open, the Rothners are going to have to invest a little bit more money,” Summers said. “I think they need to put a little bit more money into the home.”

“I hope that they don’t close it. But, you know, I have fear that it will,” Goss concluded.

“As the county, we’ve done what we can do to stop that. I just don’t know that it’s going to be enough.”

If University Rehabilitation were to close its doors, there would be three facilities that take Medicaid left in Champaign County.

Champaign Urbana Nursing and Rehab in Savoy, Illini Heritage Rehab and Health in Champaign, and Country Health Care and Rehab in Gifford combined have 362 beds for Medicaid patients across Champaign County and those coming from smaller surrounding counties.

Clark-Lindsey Retirement & Assisted Living Facility in Urbana does not accept Medicaid patients.

Lenhoff fears that wouldn’t be enough, which goes against the argument posed in the proposed agreement amendment signed by William Rothner. He claimed there is an overabundance of nursing homes “in the vicinity.”

The conservative end of national statistics concerning the percentage of Americans over 65 living in nursing homes revealed Champaign County would need more than 700 beds.

The current low census in the county’s homes is, in part, a result of pandemic restrictions and deaths in nursing homes, Summers raised.

NIC MAP Data Service presented by Fortado on Oct. 11 showed national nursing home occupancy reached a low in 2020, and while it has not reached pre-pandemic levels, it has risen over the course of 2022.

County board members are scheduled to meet with the Rothners Friday. The meeting is closed to the public.

Multiple calls and emails to William Rothner and representatives at Evanston-based Altitude Health Services, Inc. have not been returned in the last week.