Change, challenges at Vashon Community Care

Annette Crawford is the interim executive director of VCC. She says her main goal is to be accessible to the residents and their families and to support staff members. (Courtesy Photo)

Annette Crawford is the interim executive director of VCC. She says her main goal is to be accessible to the residents and their families and to support staff members. (Courtesy Photo)

An interim executive director took the helm at Vashon Community Care early this month, a time of transition and some controversy at the center, which has closed its skilled nursing facility and plans to offer memory care in its place as early as next spring.

In a surprise to some, former Executive Director Mike Schwartz’ tenure ended on Aug. 6, and Annette Crawford began the following day. She is expected to serve for a couple of months, as Transforming Age carries out a search for a new executive director with memory care experience. Crawford, who has done consulting work for Transforming Age and previously served as an administrator of long-term care facilities in Gig Harbor and Port Orchard, said her main goal is to be accessible to the residents and their families and to support staff members.

“I plan to be out on the floor with the caregivers, communicating with the families and staff, making sure everybody knows what’s going on and being a visible leader,” she said.

The coming changes to the facility are exciting, she said, but she also acknowledged the stress they have brought, saying she hopes to help staff and families feel consistency through the continuing changes and provide transparency about them. She noted she also plans to be involved with the broader island community.

“I think not only do we have a responsibility for what our reputation is and the quality of care that we provide, but we also have a responsibility to the Vashon community because they are participating in our care, in our mission, in a very different way than most facilities,” she said.

Last week, Kevin McNamara, Transforming Age’s director of operations, talked with The Beachcomber about the leadership change and the path he sees going forward, which includes hiring a new director, tending to staff morale and increasing community outreach and communication. Additionally, several family members of VCC residents shared their varied experiences with the transition away from skilled nursing, with many indicating they believe Transforming Age has not done right by some of its residents, staff and the broader community, which rallied around the nursing home to save it from closure nearly 24 years ago.

Reflecting on the transition to memory care, McNamara said that as challenges arose that changed the financial viability of skilled nursing, such as those related to recruiting staff and lowered Medicaid reimbursement, Transforming Age should have communicated better.

“We certainly could have done a better job of explaining those and including people in that discussion more than we did,” he said. “At the end of the day, we want what we are doing there to be transparent with everybody so that we can have the support to be successful.”

The new director is expected to be instrumental in that process. The person will need to have memory care, philanthropy and community collaboration experience, he said, as well as the skills to “champion, support and lead” the team at VCC. Staff morale has been strained, he said, adding that it is a priority to improve that and to fully involve staff in planning for the new memory care unit and services.

Transforming Age announced its plans to close skilled nursing in April, joining 16 nursing homes in Washington that have closed, converted to assisted living or announced their plans to close since early 2017, according to the Washington Health Care Association. While the change is intended to make VCC sustainable, it meant several residents were displaced, and it has increased criticism of Transforming Age, which took over the facility in 2017.

Longtime island physician Michael Kappelman was among those affected by the closing of the skilled nursing unit. His mother, Anne Kappelman, had lived at VCC for about nine years but had to move in early summer. While Transforming Age officials have said residents’ families were given options of facilities to move to, Kappelman said his list did not include the Vashon adult family home where he settled his mother. She lived there for seven weeks and received excellent care, Kappelman said, until she died on July 21.

He does not blame her death on the move, but he found fault with communication at VCC, saying he and other family members did not believe they received straight answers.

“They were not transparent in their communication,” he said. “That is the biggest thing. There was not as ideal of communication as there could have been in a difficult time.”

Sissel Johannessen’s mother, Phoebe Johannessen, was allowed to remain at VCC, but the experience was difficult, she said. She and her brother had weeks of worry about if Phoebe could remain at VCC, concern over staffing cuts and levels of care that would be offered, and changing information regarding the cost of care. Initially, Schwartz told her that the new cost would be $7,000 a month, but at the next family meeting, he told her the cost would actually be $12,000, nearly the cost of skilled nursing.

Phoebe Johannessen’s health took a turn for the worse early this summer, and she died on Aug. 5 at VCC, with hospice care.

Her mother’s care was good at the center, Sissel said, crediting the aids and the nurses, but she faulted Transforming Age for not being more forthcoming with information since they took over and the challenges of recent months.

“Why were they so secretive? Why could islanders not have any input?” she said. “If they are going to come asking for money, we need to know what is really happening.”

Roberta Brasier’s stepson lived at VCC for 22 years, following a ruptured aneurysm 34 years ago. He was not allowed to stay at VCC and is currently living at a facility on Queen Anne.

The family worked hard to get him to stay at VCC, she said, and offered to pay outside care providers to come in the morning and evening every day, but Transforming Age did not accept that as a solution.

The list she received of places he could possibly move included one with a waiting list so long they would not take her name, she said, and some other facilities without Medicaid availability. Brasier hired a company to help her find a place, but ended up selecting one on the list from VCC. She consulted an attorney and the state’s long-term care ombudsman to try to keep her stepson at VCC — to no avail.

While she is glad she found a facility, she said it is not ideal. The area is too hilly for him to go out in his electric wheelchair, and trips back to Vashon — his home — take a long time with the Access bus, which the family needs to accommodate his wheelchair. Brasier said the family is hoping to buy an accessible van to make the trips back to the island easier. Recent months have left her with strong words about Transforming Age and its treatment of skilled nursing residents.

“They felt these people were dispensable,” she said.

Not all family members, however, share in the strong feelings about the changes at the facility. Jim Hunziker’s dad lives there, and he was among those from skilled nursing allowed to remain. Hunziker, a nurse practitioner, said that while change is hard for elderly people, things have gone fairly smoothly for his family, including communication with Transforming Age.

“We have been told what is going on and what is likely going to happen to the best of their knowledge,” he said.

Noting some long-time nurses had been let go — a move that upset several people — Hunziker noted there are different requirements for memory care compared to skilled nursing.

“If you do not need an RN, then everybody lets them go,” he said. “That is the business of health care.”

His dad’s care has been good, he said, with the same nursing assistants caring for him as before. He added he is not worried about what might come next for his dad and if he might have to leave VCC. He added that the facility has never provided all the services an individual person might need.

“It is not something I lay awake concerned about at night. Not at all,” he said.

McNamara acknowledged that closing the skilled facility was difficult, but said now the task is to look ahead to creating and licensing the memory care facility. Its success will be critical to the viability of VCC, he said.

Financially, a capital campaign will be needed to reimburse Transforming Age for the cost of the renovation, McNamara said, but a previously announced $3 million campaign has been delayed. There are also plans to create a fund that would help offset Medicaid reimbursement shortfalls, and it is possible some funds could come from the public hospital district if the measure passes in November. McNamara said that effort is something he would like to know more about and become involved with.

In the short term, however, Anne Atwell, community relations and development director of the Vashon Community Care Foundation, said she hopes to create an advisory committee comprised of people who have been active with VCC and those who would like to become active with the center. The group’s main goal, she said, will be two-way communication between the community and VCC.

“We really need to up our game in terms of how we’re getting the word out to the community and what we’re getting back from the community,” she said, adding, “At the end of the day, it is all about building trust.”

Community members are welcome are welcome at a farm-to-table lunch at noon Friday, Aug. 30, at VCC. Guests will have the opportunity to see the drawings for the new memory care facility and find out about volunteer opportunities. RSVP to Anne Atwell at 206-567-6164 or Sheri Konvalin at 206-567-6152.

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