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Encyclopedia Dubuque


"Encyclopedia Dubuque is the online authority for all things Dubuque, written by the people who know the city best.”
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Affiliated with the Local History Network of the State Historical Society of Iowa, and the Iowa Museum Association.


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SUNNYCREST MANOR. In 1980, Sunnycrest opened the Sunrise ICF/MR unit becoming one of the first community-based intermediate care facilities for persons with mental retardation. In 2001, Sunnycrest Manor implemented the “Home & Heart” program. The facility became Medicare certified to provide skilled nursing and rehabilitation services in May of 2005. Sunnycrest is also contracted with the Veterans Administration to provide long term care services for eligible veterans. (1)

Care and services provided at Sunnycrest Manor was under the direction of the Dubuque County Board of Supervisors. The Dubuque County Hospital Board of Trustees were elected officials responsible for the maintenance and upkeep of Sunnycrest buildings, grounds and equipment. (2)

In 2001, Sunnycrest Manor implemented the “Home & Heart” program. This innovative resident-centered care program became a model example of nursing home culture change. (3)

On January 27, 2014 the Dubuque County Board of Supervisors unanimously approved a contract worth at least $170,000 with Minneapolis-based Health Dimensions Group which would look for cost-saving changes in the operation of Sunnycrest. At the time of the action, the county-owned, long-term care facility required about $3 million in county tax money annually to cover its financial shortfalls. (4)

Undated postcard. Photo courtesy: Mike Larkin

A new federal medication program at Sunnycrest promised up to $600,000 annual savings on prescription drug costs according to an announcement made in January 2015. The 340B drug pricing program provided discounted medications to qualifying facilities that served uninsured and under-insured patients. Drug companies agreed to provide certain medications at a set price with the difference in cost available to those facilities strictly to spend for life-enrichment purposes. County supervisors were also informed that expenses for the current budget year were expected to fall from $10.7 million to $10.3 million. Revenue was expected to increase about $600 to $8.5 million. (5)

In February 2015 the Dubuque County Hospital Board began exploring whether a new facility would be more cost-efficient and serve the needs of the residents better than the present site. The board voted to hire consultant Health Dimensions Group to assist in planning and future facilities needs. HDG had been working at Sunnycrest for above a year to improve operations and staffing. The board of trustees received about $1 million in taxes annually to oversee maintenance costs for the county-owned long-term care facility with oversight from the Dubuque County Board of Supervisors. (6)

On September 5, 2015 it was announced that Cristine Kirsch, the present administrator of Dubuque's LUTHER MANOR had been chosen to lead Sunnycrest. When she began her work on September 28th, she became the facility's first non-interim leader in nearly twenty months. The former administrator Cathy Hedley resigned in February 2014 during a consultant's review of the facility's operations. Kelly McMahon, an employee of HDG, the county's consulting firm, directed the facility until May. (7)

In July 2016 it was announced that a 32-bed building that would connect to the main facility through a walkway was being planned for Dubuque County’s Sunnycrest Manor care facility. The existing facility in Dubuque currently had 77 skilled-nursing beds and 28 beds for disabled adults. (8)

Based on a future-needs study from consultant Health Dimensions Group, the trustees were interested in adding assisted-living and memory-care services in the new building. While other local care facilities also planned to add memory care services, Sunnycrest would serve indigent county residents. Sunnycrest would need to apply for and receive a certificate of need from the Iowa Department of Public Health for any new services to be offered. The trustees also talked about a “second phase” project that would remodel the second and third floors of the existing facility to make more rooms with a private bathroom. (9)

On April 1, 2016 three managed-care companies took over Iowa's Medicaid program which provided health care for an estimated 560,000 poor and disabled Iowa residents. Delays in Medicaid payments led to cash flow problems in payroll and operating expenses. It was announced in August 2016 that the Dubuque County Board of Supervisors had approved a $1.75 million debt agreement for Sunnycrest to help handle cash flow problems. (10)

With operational expenses projected to be $650,000 over budget during the current fiscal year, the Sunnycrest Manor Advisory Board of Directors in November 2016 considered whether a nonprofit entity would be better suited than to operate the facility. Such an idea had been proposed in a consultant report commissioned by the Dubuque County Hospital Board of Trustees which oversaw the building and grounds of Sunnycrest. (11)

On January 3, 2017 two of three Dubuque County supervisors did not support a suggestion to explore having a private company operate Sunnycrest. The suggestion came after hearing the projected need of approximately $1.7 million additional funding to cover the deficit by the end of the fiscal year in June. This was in addition to the $1.4 million already budgeted as an operating subsidy. (12)

The Dubuque County Board of Supervisors in August, 2017 requested that Sunnycrest Manor return an estimated $950,000 in surplus cash that remained in its fund balance at the close of the 2017 fiscal year. The payment would come through a budget amendment that reduced the county-owned long-term care facilities supplement for the 2018 fiscal year. The 2018 subsidy was budgeted at nearly $2.8 million. Sunnycrest's finance director told the supervisors that in the 2018 fiscal year $14.01 per resident would be paid if a contract with Aramark for dietary and housekeeping services was continued. The same services could be provided for $12.91 if performed in-house. Supervisors delayed on making a decision on the issue. (13)

In March, 2018 supervisors in Black Hawk County voted to potentially sell its care facility. If that occurred, Dubuque County would be the only county in Iowa operating such a facility. County Supervisor Daryl Klein was unsuccessful in convincing Jay Wickham or David Baker to seek proposals from local nonprofits to take over operations. Neither the Dubuque County Hospital Board of Trustees nor the Sunnycrest citizen advisory board recommended looking for a new operator, although cost-saving efforts would be continued. Dubuque County subsidies (in millions) to Sunnycrest Manor were: (14)


In January, 2019 Sunnycrest officials expected they would need an additional $300,000 from Dubuque County to cover wage and insurance costs. Total expenses were projected to be $12.8 million, an increase of about $558,000. Revenue was expected to be $9.32 million which was an increase over the $9.27 for the current year. The facility had 192 employees. (15)

An across-the-board wage increase and tuition reimbursement program were among proposals Sunnycrest administration hoped to begin as a means of ending a persistent nursing shortage. The pay increase would hinge on the employees remaining with Sunnycrest for a specified time. (16)

In December, 2019 the Dubuque County Hospital Board of Trustees which owned and maintained the 77-bed facility while Dubuque County oversees its operations, announced it was finalizing a plan to renovate the interior of the facility. The $4 million project included remodeling 44 rooms. Sunnycrest was last remodeled in 1969. The board in 2016 had proposed to add a new 32-room building. When the board of supervisors stopped the idea, the board moved on with the remodeling project. The board had an estimated $3 million in reserves to apply to the work and collected about $1.2 million annually through taxes. Half of this was saved and half was spent. (17)

Three factors accounted for an anticipated decrease of about $650,000 in taxpayer support for Sunnycrest in the 2020 fiscal year--staffing shortages, high Medicaid reimbursement rates, and improved financial management. Sunnycrest was not fully staffed in 2019 in the areas of licensed nursing, dietary aide, and housekeeping positions due to competition from local hospitals, restaurants, and private nursing facilities. Officials expected Sunnycrest would receive about $9.5 million in billed revenue. With higher Medicaid reimbursements for skilled nursing that would equal an additional $5.00 per day per resident. Rates for care given to those with intellectual disabilities were expected to increase by $18 per resident per day. Revenue for 2020 was expected to exceed $9.6 million with $11.9 million in expenses. That would result in a $2.26 million subsidy compared to the 2019 operating subsidy of $2.9. Historically, Sunnycrest was subsidized $3.1 million annually. (18)

The 1977 through 2020 Dubuque City Directory listed 2375 Roosevelt St.




1. "Sunnycrest Manor,"

2. Yager, Alicia. "Board OKs Deal with Sunnycrest Consultant," Telegraph Herald, January 28, 2014, p. 1

3. "Sunnycrest Manor Celebrates 100th Anniversary," KWWL.com Online: http://www.kwwl.com/story/35623998/2017/6/8/sunnycrest-manor-celebrates-100th-anniversary

4. "January," Chronology 2014, Telegraph Herald, January 1, 2015, p. 4

5. Yager, Alicia. "Sunnycrest Could See More Savings," Telegraph Herald, January 27, 2015, p. 3A

6. Yager, Alicia. "New Facility for Sunnycrest?" Telegraph Herald, March 4, 2015, p. 3A

7. Jacobsen, Ben. "Sunnycrest Board Hires Administrator," Telegraph Herald, September 5, 2015, p. 3A

8. Yager, Alicia. "Board Explores New, 32-Bed Facility at Sunnycrest Manor in Dubuque," Telegraph Herald, July 23, 2016. Online: http://www.thonline.com/news/dubuque/article_2edef4a1-1c1d-5a19-94da-6c1f8688f8bc.html

9. Ibid.

10. Yager, Alicia. "County OKs Debt Agreement with Sunnycrest," Telegraph Herald, August 23, 2016, p. 3A

11. Yager, Alicia. "Panel Weighs Sunnycrest Options," Telegraph Herald, November 15, 2016, p. 2

12. Yager, Alicia. "Sunnycrest Solution Splits Supervisors," Telegraph Herald, January 5, 2017, p. 3A

13. Goldstein, Bennet. "Aramark Contract Under Review," Telegraph Herald, August 16, 2017, p. 3A

14. Barton, Thomas A., "Partners in Care: Sunnycrest, Dubuque County," Telegraph Herald, March 25, 2018, p. 1A

15. Yager, Alicia, "Sunnycrest to Ask County for Larger Subsidy," Telegraph Herald, January 12, 2019, p. 3A

16. Goldstein, Bennet, "Sunnycrest Proposal Seeks to Bolster Nursing Workforce," Telegraph Herald, February 1, 2019, p. 3A

17. Fisher, Benjamin, "$4 Million Sunnycrest Revamp in the Works," Telegraph Herald, December 10, 2019, p. 1A

18. Barton, Thomas J., "Sunnycrest Subsidy Projected to Fall," Telegraph Herald, January 21, 2020, p. 3A