Vashon Community Care ends skilled nursing service

Vashon Community Care ends skilled nursing service

The center will offer memory care and will soon launch a $3 million capital campaign

Vashon Community Care is closing its skilled nursing facility and will offer enhanced assisted living and memory care in its place, care center officials announced last week.

This news comes less than a year and a half after the care center affiliated with Transforming Age with the goal of making VCC financially sustainable. Along with the news about the change of course, Transforming Age officials said the Bellevue-based nonprofit had provided more than $2 million in “cash contributions” since it affiliated with VCC. They also stated that the cost to provide skilled nursing services “significantly exceeds” the reimbursement for that care. Additionally, reimbursement from Medicaid, which provides health coverage to low income people, including elderly adults — is slated to be reduced by $38 per day per resident, reducing revenue by approximately $166,000 annually. Staffing challenges have also contributed to the operating deficit, Transforming Age officials said, causing Vashon Community Care to rely heavily on agency staffing, at a cost 50% higher than regular wages.

“Our commitment in the beginning was to have Vashon be sustainable in the long run, and we could not make that be true for skilled nursing,” Transforming Age’s Regional Director of Operations Kevin McNamara said in an interview last week.

Soon, Vashon Community Care will renovate the skilled nursing wing, turning the 16 residents’ rooms into studio apartments for those who need enhanced assisted living services and memory care, which is currently not available on the island. Additionally, Transforming Age executives announced that VCC will launch a $3 million capital campaign this summer for building improvements. Initially, Transforming Age will front the money for the renovation of the skilled nursing facility, estimated to be about $350,000, McNamara said. Funds from the capital campaign will reimburse Transforming Age for those costs and provide for other building improvements.

Vashon Community Care is no longer accepting patients for its rehabilitation services, also slated for closure, and will determine within the next few weeks how many of the center’s 22 residents in the skilled nursing unit will remain at the facility and how many will have to move.

Last week, Transforming Age officials, including Executive Director of Vashon Community Care Mike Schwartz, held meetings for residents’ family members and longtime care center supporters and shared the recent news with them. In a later interview, McNamara and Schwartz said the determination of the services VCC will be able to provide — and which residents will be able to remain at VCC — will be made through a process with the state within the next few weeks. While they declined to state what some of the future services might include, McNamara said that VCC will not be able to provide the intensive care it currently offers in the skilled nursing unit. Both men said their goal is to retain residents, rather than move them to another facility.

“We will be working toward keeping as many residents here as possible,” McNamara said.

Currently, 13 of the 22 residents at VCC receive Medicaid; McNamara noted that each resident on Medicaid has a state case manager that will be working closely with VCC in the transition process.

State law requires a minimum of 30 days to move people from a facility, he said, but Transforming Age is allowing for 90 days, with the potential for some flexibility beyond that time frame. He and Schwartz also said that they will work with families to find placement in skilled nursing facilities as close to the island as possible.

VCC currently has 40 assisted living apartments, and those will remain as they are now and include a mix of residents who pay privately or through Medicaid. The long-term intent for the new area, however, is that it will be for people who pay privately; Medicaid will not be accepted for memory care or enhanced assisted living for new residents after this transition period, Schwartz said. The reason is that Medicaid pays $2,000 to $2,500 per month for assisted living or residential memory care, with costs well over $5,000 per month, McNamara said.

“The gap is not sustainable,” he added.

As word began to travel last week, many reacted strongly to the news, and Schwartz and McNamara acknowledged that the meeting with family members was hard.

“In the short term, this is difficult,” McNamara said.

Some family members spoke about that difficulty, sharing personal reactions to the news.

Julia Lakey’s mother, 97, has been a resident of VCC for 15 years, and Lakey talked frankly about what a potential move would mean.

“A move will hasten her death,” she said.

Her mother’s goal at this stage of her life is to die surrounded by the caregivers and staff she knows and loves at VCC, she said. Lakey also said she did not plan to tell her mom of the possible change before a determination is made.

“It will tie her in knots,” she said. “I know her really well, and I know how much it means to her to be at VCC.”

Calling the development at VCC “hugely wrenching,” she said the decision to close skilled nursing will have repercussions for the island as a whole.

“This is such a loss for our entire community, not just those of us immediately affected,” she said. “Where will any islander go when they need skilled nursing? Our few island group homes are small and could close at any time. We will all be forced to relocate, and our families and friends must deal with an expensive and lengthy commute to visit us.”

Lakey also said she believes Transforming Age’s decision is a sign of how society’s safety net is fraying.

“The needs of the extreme elderly and needs of the very young get swept under the rug because legislators have other people tugging at them,” she said.

Another islander, who spoke on the condition of anonymity, has had a family member at Vashon Community Care for more than 20 years. He often leaves VCC and visits family members at her home, she said, a welcome change from the institutional setting of the care center. She said that she is concerned about the psychological effects a move might create; in particular, she said, she worries he will experience severe depression if he must move to a new facility.

“It is going to be a major change if he has to leave,” she said. “It could be life threatening.”

She also said she understands that the financial situation is not sustainable at VCC and has not been for years.

“I do not blame them,” she said about Transforming Age, “but it is a real heartache, and it is going to be a challenge for this family.”

Former islander Ray Aspiri has been a longtime financial supporter of VCC. He attended last week’s meeting and afterward said he believes Transforming Age is focused on each individual and carrying out this transition in a caring way, but he also said he was disappointed in the news and taken by surprise.

“I am disappointed in the fact that they have not been sustainable in the last year and half, and secondly that their long-range is putting an inordinate burden on the community,” he said.

He noted that the original plan was for VCC to be sustainable within a year.

“I assumed they had done sufficient due diligence and had identified what the challenges were and how to overcome them,” he said.

For some, however, the creation of memory care services on the island is good news, and VCC representatives said they have already heard from some people interested in the care that will be provided.

Islander Hilary Emmer, who said she fully understands the challenges families at VCC are facing, noted the challenges she had in caring for her partner, Maeve Lambert, who was diagnosed with Alzheimer’s disease at age 60. Emmer cared for her at home for several years before placing her in a memory care facility in Gig Harbor. VCC was not an option.

“This island has nowhere to go for memory care, and I would have been ecstatic if Maeve could have stayed on the island,” she said. “I saw her once a week for two years, and had she been here, I could have seen her every day.”

For more than 20 years, Vashon Community Care was affiliated with Providence Senior & Community Services, which provided more than $2 million during that time, according to Providence’s Charlene Boyd. That partnership came to a close in 2017 after Providence declined to extend its long-running contract with VCC. Providence officials said at the time they believed the VCC board wanted a different kind of partner. The board of Vashon Community Care began looking for a new partner, and Transforming Age was the only entity interested. When an agreement was reached between VCC and Transforming Age in December 2017, both sides expressed enthusiasm.

Last week, Transforming Age’s President and CEO Torsten Hirche again spoke optimistically.

“We are confident that this plan will help us to better serve our residents, families, team members, and community by providing sustainability so that future residents of Vashon Island can have a choice on the Island to receive care and services,” he said.

Vashon Community Care’s roots on the island go back to 1928, when Goodwill Industries established a working farm and boarding house for destitute men on the property. It later became Island Manor Nursing Center, whose owner Jim Alexander announced in November 1995 that he intended to close the facility within 30 days. In what became known as a Christmas miracle, 31 islanders pledged $250,000 to guarantee the lease on the building, with an option to buy it. Along with the community ownership, there was a promise made that residents would not be forced to leave because of lack of funds.

Accounts from that time show supporters understood there would be challenges ahead. In 2010, Ted Kutscher, who was instrumental in the 1995 effort, recounted the experience in a Beachcomber column.

“We were blessed to be able to preserve quality care on the Island despite the challenges we faced in December 1995. I believe similar and new challenges will continue as the care center’s directors and Island citizens work to keep quality care on Vashon,” he wrote nearly a decade ago. “Such will be the ongoing mission of all of us.”

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