Independent living unit at Windemere suspends admissions, may close

After declining census, immense financial losses, hospital takes steps to close Wildflower Court.

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Martha's Vineyard Hospital announced last week that they are taking steps to close the independent living facility at Windemere. — MV Times file photo

Windemere Nursing and Rehabilitation Center (WNRC) has suspended admissions to its independent living facility as it moves to close the 13-bed unit, where three people now live.

In a conversation with The Times on Tuesday, Joe Woodin, president and chief executive officer of Martha’s Vineyard Hospital (MVH), was vague about the closure of the independent living facility, owned by the hospital and on the MVH campus in Oak Bluffs. Though Mr. Woodin didn’t say conclusively that the unit will close, he said MVH is exploring the option of closing.

“We’re going through the process of strongly analyzing this and looking at the options for closing the unit,” Mr. Woodin said, referring to the independent facility known as Wildflower Court.

According to Mr. Woodin, MVH would not have started the discussion had it not been seriously considering its closure.

“I think there’s some intent there,” Mr. Woodin said.

Rachel Vanderhoop, director of development and public relations at MVH, told The Times Friday that MVH is “looking at our options, and closing that unit is something we’re looking at.”

The hospital, in a press release last week, explained WNRC will suspend admissions, and that the move came as a way to reduce losses after a decade of a declining resident census and financial deficits. Shortfalls in revenue are currently covered by MVH, a unit of Partners Healthcare, which also owns Mass General. Typical annual deficits ranged between $750,000 and $1 million.

“If we close the unit, we will rent the space to the hospital, which will help Windemere’s budget,” Mr. Woodin told The Times. “And the hospital could use the space.”

Despite suggestions that it’s a matter of if and not when Wildflower Court will close, the Vineyard Gazette reported last Wednesday that the independent living unit will close, and the newspaper’s article was posted on the MVH website.

“Citing low occupancy and ongoing financial losses, trustees at the Windemere Nursing and Rehabilitation Center announced Wednesday that the independent living facility at the Island’s only nursing home will be closed,” The Gazette reported (Feb. 15, “Windemere Will Close Its Independent Living Facility”).

Carol Lashnits, former director of Island Elderly Housing (IEH), told The Times on Monday that she hopes MVH will use the space for an assisted living facility. She said she believes opening the independent living facility at Windemere was an unwise decision in the first place.

“I never thought that that would work, because who wants to live at a hospital?” Ms. Lashnits said.

IEH has 165 apartments between four campuses in Oak Bluffs and Vineyard Haven, and extensive waitlists. It operates under a rental-assistance program that’s subsidized by the government. Rent is based on a person’s monthly Social Security income — residents are responsible for 30 percent of the rent, and the government subsidizes the other 70 percent.

The cost of a unit at Wildflower Court, according to Mr. Woodin, ranges from $210 to $270 per day. A resident at an independent facility is expected to function without assistance.

Last week’s press release said that the process of closing the unit may take up to six months, and in the meantime, the staff is working with residents and their families to find ways to move them to other units or locations.

“My understanding was that people were notified the week before and had discussions with the previous administrator,” Mr. Woodin said.

Georgia Morris, a resident of Vineyard Haven, has a brother who lives at Wildflower Court. In a conversation with The Times on Monday, Ms. Morris said she found out that MVH will close the independent living facility in The Vineyard Gazette last week.

“I was taken aback by the announcement in the paper,” Ms. Morris said. The day before the article appeared, she said, the director of nursing notified her of the “possibility” the facility would close. “She wasn’t saying they were going to close,” Ms. Morris said. “They said if they decide to close.”

Ken Chisholm, the previous administrator and director of human resources, had worked at Windemere since 2002. The hospital did not announce his departure from WNRC, but Mr. Woodin confirmed that Mr. Chisholm left at the end of January. Mr. Woodin declined to comment on the circumstances surrounding Mr. Chisholm’s departure, and Mr. Chisholm could not be reached for comment.

Mr. Woodin said that Marie Zadeh, the director of nursing at Windemere, is working toward obtaining her nursing home administrator’s license in order to replace Mr. Chisolm.

The costs associated with operating a nursing home are daunting. In 1994, its first year of operation, Windemere lost $1.8 million, and in 1996 itm filed for court protection under Chapter 7 of the federal bankruptcy code (April 27, 2011, “Martha’s Vineyard’s Windemere nursing home wins state approval for facelift”). Windemere emerged from bankruptcy two years later, but continued to struggle financially. Under new leadership, the nursing home ended 2004 with its first-ever profit.

Yet even with the cost pressures and labor shortages nursing homes face across Massachusetts and the country, Windemere has continually scored high marks for quality of resident care.

A Department of Public Health Quality of Care Survey completed in October 2010 ranked the Island nursing home better than 83 percent of nursing homes in the state.

State and federal reimbursements are the largest factors that affect the bottom line for hospitals and nursing homes (Feb.19, 2014, “Budget news mixed for Martha’s Vineyard Hospital”). Because MVH is designated a critical-access hospital, it receives cost-based federal reimbursements. Cost-based reimbursement is provided to the hospital for patients who qualify for state Medicaid, also known as MassHealth. But there has been no change in reimbursements paid to the only Island nursing home that accepts residents on Medicaid.

According to the MVH press release, about 85 percent of Windemere residents are on Medicaid, and the current rate formula has not been updated in 10 years, still using costs from 2007.

“The independent living unit has proven to be an inefficient and unsustainable approach to care on the Vineyard,” the hospital press release said.

Despite multiple meetings with elected and administrative officials at the state level, the state has been unwilling to improve the rate formula for Windemere. The organization has received cost-of-living increases from the state averaging 0.5 percent for the past 10 years to pay for the rise in labor, benefits, and supply costs.

A recent financial analysis showed that an increase of 2 percent annually over the past 10 years would have provided enough financial relief to stabilize the organization’s finances.

Windemere as a whole began to suffer from systemic financial shortfalls two years ago. As a result, MVH trustees authorized the transfer of funds from MVH to WNRC and directed the administration to develop a sustainability plan.

The plan had three goals: to increase the number of residents in all units; improve the staffing model and reduce the need for off-Island workers to fill vacant positions, which can cost anywhere from 75 to 100 percent more in labor expenses; and to petition the state to update the costs used in the rate-formula calculations for Medicaid payments.

Mr. Woodin told The Times that closing Wildflower Court is a “sensitive subject,” and the topic of elderly housing on the Vineyard is an “important issue.”

“Based upon the comments and feedback,” Mr. Woodin said, “we should look at how elderly housing is being addressed on the Island.”