Concerned community members called a meeting Wednesday, May 3, in response to the decision to close Wildflower Court, a 13-unit independent living facility at Windemere Nursing and Rehabilitation Center.
The facility has been unable to fill 10 out of the 13 beds, which led to the decision announced in February. Wildflower’s three residents were left with vague housing assurance, and Wednesday’s conversation led to a larger discussion about the future of eldercare on Martha’s Vineyard. Wildflower isn’t scheduled to close until fall.
“Let the wild rumpus begin,” mediator Paddy Moore said to the group gathered in the Windemere common room. Seated around the table were relatives and friends of Wildflower residents, Martha’s Vineyard Hospital and Windemere representatives, and other members of the community who work with the elderly. The two-hour forum moved through discussion of the financial struggles at Windemere, the institution as a whole, the future of elderly housing on Martha’s Vineyard, and, of course, the future of the three individuals affected by Wildflower Court’s closing.
In the end, everyone could agree on one thing — change was in order, and that very meeting was the first step on a long road.
The community wanted answers — how did the hospital reach the conclusion to close Wildflower, and why wasn’t it better communicated? MV Hospital chief executive officer Joe Woodin said the decision was not an easy one, but it rested on the financial problems at Windemere, which are a reflection of nursing homes as an institution.
“Nursing homes are a difficult thing to manage,” Mr. Woodin said. “They typically lose a lot of money.”
That’s why many nursing homes opt to add assisted care and independent living facilities like Wildflower Court. But in order to be successful, these units need enough private paying citizens. This is where Wildflower Court fell short. According to Mr. Woodin, Windemere already loses somewhere between $750,000 and $1 million per year, which the hospital offsets.
The MV Hospital and Windemere are two separate organizations that function as one system on the same campus. Hospital administrator Mathew Muratore, who is also a state representative from Plymouth, believes this is a positive thing, because the profitable hospital can support the less profitable nursing home. Windemere doesn’t have to worry the way standalone nursing homes do.
But members of the community argue the two-for-one system creates problems. “I think it’s a big mistake to have two boards composed of the same individuals running two different organizations,” one community member said. “Is it possible it’s just too much work?”
Mr. Woodin said both organizations are looked at equally, but that Windemere is sometimes unintentionally put off to the side. “It’s always this balancing act,” he said.
The hospital and Windemere are both nonprofit organizations affiliated with Partners HealthCare in Boston. Windemere and the hospital have high reimbursement rates compared to the rest of the state, but even that’s not cutting it.
“A lot of people look at us and think, we’re on the Vineyard so we must have more than enough money, and everyone is private-pay. That’s not true. We’re 85 percent Medicaid, which is higher than the state average,” Mr. Woodin said. Mr. Muratore added that Windemere is underfunded by the state at $37 per patient per day.
Each of Wildflower Court’s 13 beds costs somewhere around $80,000 per year, or $200 per day. According to hospital administration, it is not easy finding individuals that qualify to live independently and pay out of pocket, and that’s why Windemere is having trouble profitably filling the space.
“If there were private paying people knocking at the door looking to pay for those rooms, pinch me,” Mr. Woodin said.
The last time the hospital and nursing home received a rate adjustment was 10 years ago, according to Mr. Muratore. He and Mr. Woodin agreed that organizing a letter-writing campaign that lobbied for higher rate adjustments would open up the conversation.
“With an adjusted rate, would we be able to expand the actual nursing home around a private room model? Is that so crazy?” Len Morris, a brother of one of Wildflower Court’s residents, suggested.
Adding more beds and private rooms to the nursing home are examples of different routes Windemere could take, if the funding is there. Mr. Muratore suggested writing a letter to State Senator Julian Cyr and State Representative Dylan Fernandes, and organizing a community meeting.
“The [Affordable Care Act] repeal means we’ll have more problems in the commonwealth with MassHealth,” Mr. Muratore said. “We are on a federal waiver; we get funds to do this. In the coming months, that conversation is going to change.”
Individuals in the room work closely with the Island’s aging population, and expressed concern for the future of their clients, as well as themselves. This is a problem for everyone on Martha’s Vineyard, whether it be now or later.
“You’re in a unique position here because you’re isolated,” Mr. Muratore said. “It’s not like you can drive 40 minutes away to a different nursing home.”
The discussion was brought back to the future of Wildflower Court’s three residents, which is an ongoing conversation that depends on finances. Going forward, the group agreed to continue these discussions, and next steps would include campaigns and letters that would extend the dialogue to more of the Island community, as well as state representatives.
“There’s a great deal of interest in health and what happens, and I think you can see that from looking around the table,” Mr. Morris said. “I think this was a very positive conversation.”