The state Department of Public Health (DPH), Division of Health Care Quality, gave high marks to the Martha’s Vineyard Hospital’s Windemere Nursing Home in a performance survey that evaluated five categories of performance over the last three years.
“This nursing facility met 130 out of the 132 key requirements in all five categories in its last three surveys,” DPH said in a report summary. “The number of deficiencies not met as a result of complaint investigations is 0. The facility’s score is 130 after adjustment for scope and severity. Ninety percent of all facilities had a score of 130 or lower. The statewide average facility score is 123.”
DPH evaluated Windemere in 2010, 2011, and 2012. In the most recent year, it found no deficiencies in any of the five categories.
“This year, 2012, was perfect, but the score reflects the three-year average so we ended up being 130 out of 137 nursing homes,” Ken Chisholm, Windemere administrator, said. “Overall, we were better than 90 percent of nursing homes. Being better than 90 percent of anything is pretty good for this little nursing home.”
Mr. Chisholm credited the staff. “The Windemere team worked hard to pay attention to all the quality indicators that determine the score,” he said.
Tim Walsh, Martha’s Vineyard Hospital chief executive officer, said the fact that DPH had no findings is outstanding and attributable to the staff. “It shows all the hard work they do to make that happen,” he said. “It is very unusual to go through a survey with no findings.”
Operating a nursing home anywhere in the state, but especially on the Island, is daunting.
In 1994, its first year of operation, Windemere lost $1.8 million and in 1996 filed for court protection under chapter 7 of the federal bankruptcy code. Windemere emerged from bankruptcy two years later but continued to struggle financially. After a period of huge losses, hospital officials managed to staunch the flow of red ink to an acceptable level and in 2004 Windemere ended the year with its first-ever profit.
Mr. Chisholm said the biggest challenges faced by Windemere is geographical isolation and Medicaid reimbursements that fail to cover the complete cost of caring for residents.
He said Windemere is limited in terms of the ability to fill beds and attract staff by the fact that it is an island.To compensate, Windemere has initiated several nursing programs to train staff and make career opportunities available to Island residents.
At the same time, Medicaid rates do not cover costs. Staying in the black requires a mix of private payers and careful management in an industry that is struggling with increasing health care costs.
For the fiscal year that ended on September 30, 2012, Windemere ended $1,000 in the black. For a nursing home that regularly ended in the red and once lost more than $500,000, even a small amount of profit is a positive.
“From 2004 to 2012 we have ended in the black every year but one,” Mr. Chisholm said. “That’s an amazing accomplishment, given our history.”
The survey information is available to consumers to help evaluate the quality of care provided by the state’s Medicare and Medicaid certified nursing homes, DPH said.
Consumers can evaluate and compare facilities in five categories: administration, nursing, resident rights, kitchen/food services and environment.
“The Division inspects nursing homes at least every 9 to 15 months to assess compliance with federal standards of care such as adequacy of staffing, quality of care and cleanliness of facilities. In addition, as necessary, the Division investigates complaints and serious incidents occurring within a nursing home.
Surveys are unannounced and conducted by health care professionals such as registered nurses and licensed social workers, according to DPH.
A survey report is sent to the nursing home after each survey. If standards are not met, then the nursing home must submit a plan of correction to the Division.