Windemere ends year in the black


The Windemere Nursing and Rehabilitation Center ended 2008 with a profit. The good news is tempered by uncertainty over the extent to which expected state cutbacks will affect Martha’s Vineyard’s only nursing home.

Windemere’s 2008 budget projected a net gain of $5,910. But when its fiscal year ended on Dec. 31, 2008, the operating gain was $41,805.

Tim Walsh, Martha’s Vineyard Hospital chief executive, attributed Windemere’s performance to several factors. These include increased state reimbursements, a refurbished assisted living unit now near total occupancy, and a decreased reliance on contract labor, thanks to a unique nurse training program.

Windemere ended the year with total revenues of $6,474,771 and expenses of $6,432,966. When combined with gifts of $45,065, the total gain for 2008 was $86,870.

Mr. Walsh presented the unaudited year-end financial statements at a meeting of the hospital finance committee on Tuesday. Windemere is owned by the hospital but operates as a separate entity.

“Remember, this facility lost $600,000 a few years ago,” Mr. Walsh told The Martha’s Vineyard Times in a telephone conversation to discuss Windemere’s year-end numbers. He was referring to the numbers that followed the hospital’s purchase in 2000 of Windemere after the nursing home emerged from bankruptcy.

Faced with huge losses some hospital board members talked about closing the facility. Under new leadership the hospital began to post profits, and Windemere losses decreased to manageable levels until red ink turned to black.

The fact that Windemere posted a profit as the hospital braces for a loss when it ends its fiscal year on March 31, 2009, highlights the increasing challenges healthcare leaders face in a worsening economy.

Last year, the state adjusted its reimbursement rates to reflect the high costs associated with running an Island nursing home, said Mr. Walsh. Those payments were made retroactive and account for some of the 2008 gain.

Mr. Walsh said that it is unlikely that healthcare, including nursing home payments, will escape state budget cuts. “That is the big worry for Windemere going forward,” said Mr. Walsh. “What is going to happen with the rate, and in general what happens with state cutbacks.”

One bright spot on the horizon is a decreased reliance on contract labor. In 2008 Windemere spent $330,948 to bring nurses from off-Island to fill its labor gaps. In the 2009 budget that number is projected to drop to $6,000, a 98-percent reduction.

Mr. Walsh said that Windemere director Ken Chisholm took advantage of a state program designed to finance worker training in order to create a tuition-free training program by which certified nursing assistants can become licensed practical nurses. The goal was to reduce the nursing home’s reliance on outside labor and lead to a permanent program that can provide a nursing career path for Island high school graduates who want to remain on Martha’s Vineyard. The 2009 budget reflects the results of that program, according to Mr. Walsh.

The need for an Island nursing home remains evident. Mr. Walsh said average census in December for the 21-bed Alzheimer’s unit was 20.74. The number for the 40-bed skilled unit was 38.55. The assisted living unit has 16 beds and that number stood at 12.26, a figure he said would change based on current interest stemming from the unit’s recent makeover.

Asked if there is a waiting list for the nursing home, Mr. Walsh said the reality is that when people need a nursing home it is often an immediate need. He said some people may go to a mainland facility, but there is no way to say how many.

Mr. Walsh said that at this point Windemere appears to be able to accommodate demand. “Week to week it can change,” he said.

Without Windemere Martha’s Vineyard would need to rely on mainland facilities for nursing home care, Mr. Walsh pointed out. Across the state, however, nursing homes continue to struggle to stay afloat and that is particularly true on Nantucket.

The Island Home on Nantucket is one of a small number of municipally owned nursing homes. According to a published report in the weekly newspaper the Nantucket Independent, the 45-bed nursing home runs an annual deficit of between $2.5 and $3 million that is picked up by island taxpayers.