Finances, lack of staff contribute to Life Care’s closing | Update

The only long-term rehabilitation facility on San Juan Island will close in about two months.

“This has been a very difficult decision for Life Care Centers of America,” said Todd Fletcher, vice president of western operations for the company.

Fletcher said Life Care of the San Juan Islands, which primarily serves seniors, is closing due to a combination of financial issues and a decreasing workforce. At the time of the closing notification, the branch had 60 employees and 35 residents.

“Our closing is because of our lack of financial viability and also our struggle in finding enough qualified staff members,” he said.

According to Fletcher, the island limits the market and staffing options. Also, some islanders choose Anacortes facilities, which can decrease patient numbers in Friday Harbor.

Fletcher couldn’t comment on the sales process until the Life Care facility has officially closed, but a staff member (employee 1), who wishes to remain anonymous, said the property is for sale.

Bev Mayhew, with PeaceHealth, said Life Care staff approached the health care provider about purchasing the center months ago, but the company, which operates the island’s hospital, declined. Staff would however, “like to be part of a community solution,” she added.

Since 1997, Life Care Center has offered 24-hour nursing, serving patients with diseases such as Alzheimer’s and Parkinson’s and inpatient and outpatient rehabilitation. It opened as a nursing home, under different ownership, in 1967.

Life Care operates 220 skilled nursing facilities across the country. Skilled nursing homes offer a higher level of care than other, live-in island facilities.

Another staff member (employee 2), who also wishes to remain anonymous, said the combination of low Medicaid reimbursements and a state infraction that prevented training additional staff, helped lead to the center’s closing. Most of those residents were Medicaid recipients, at the time of the closing notification.

At a public meeting on Monday, Sept. 25 to discuss options to save the center, a Life Care employee said it costs “significantly” more to operate the facility than the center receives in Medicaid reimbursements. The meeting was facilitated by local citizens.

Health care facilities receive reduced reimbursements for Medicaid patients, compared to those with private insurance. Neither the Village at the Harbour nor Hearthstone — the island’s only other live-in care facilities — accept Medicaid.

The Village staff helps with everyday activities, like showering and administering medicine, while Hearthstone specializes in long-term care for dementia and Alzheimer’s patients.

Medicaid is a state and federally funded program that provides insurance to low-income Americans.

Evan Perrollaz, who manages the Village, confirmed that four Life Care residents are moving to his facility. As of Sept. 21, there was one open vacancy at the Village and none at Hearthstone.

Employee 2 explained that the state placed a penalty on the facility after an inspection, but couldn’t provide details of Life Care’s violation. She said the punishment, which occurred within roughly the last six months, eliminated in-house training for Certified Nursing Assistants. CNAs take patients’ vital signs, as well as dress and feed them. They earn about $12 an hour at Life Care, said employee 1.

Nursing homes, like Life Care, require a certain number of CNAs, depending on their amount of residents, according to Perrollaz. The Village does not have such regulations, he added.

Employee 1 said the Life Care Center is 20 residents under capacity because they couldn’t hire enough staff to serve them. The limited staff forced them to close one of the facility’s wings about six months ago, she added.

Another employee, at the Sept. 25 meeting, said roughly 30 patients were turned away from the center in the last few months due to low staff.

Employee 2 said the center offered short-term housing for commuters or employees looking for permanent island homes, but long-term, affordable dwellings were hard to find.

Sue Herdy has lived at the Life Care Center since last December but will move to an Anacortes facility soon. She said her daughter “exhausted all avenues” trying to locate another island facility to serve her medical needs. When the 85-year-old broke her hip, she moved from Colorado to the island to receive physical therapy close to her.

Herdy explained that the facility’s manager came to her room to personally tell her about the closing. Employee 1 said staff were notified during a meeting on Wednesday, Sept. 13.

She added that staff, including single parents and nurses with newly built homes, were worried about options to find work on the island with limited employers.

“We never believed it would close because it is so vital to the community,” she said.

She speculated if the closing was due the company’s recent legal issues, while Fletcher maintained it is not.

According to a press release from the U.S. Department of Justice, Life Care Centers of America, Inc. settled a lawsuit for $145 million last October, resulting in the “largest settlement with a skilled nursing facility chain in the department’s history.”

The complaint states that from about 2006 to 2013, Life Care instituted corporate-wide policies and practices to receive the highest amount of Medicare reimbursements possible, despite patient’s’ actual needs. This resulted in “unreasonable and unnecessary therapy,” states the press release.

Medicare is a federal insurance program for Americans, 65 years old or more.

Despite the looming closure, the community is looking for ways to maintain the center.

According to San Juan County Council Chairman Rick Hughes, potential solutions include partnering with other counties to find senior care facilities close to the islands and purchasing a building and leasing it to a health care provider at an affordable rate.

“It’s a huge concern,” said Hughes after meeting with the county board of health and Duncan Wilson, Town of Friday Harbor administrator. “It’s so important to have a nursing care here.”

Hughes maintained to the Journal that these options are only being discussed as preliminary conversations.

“We can’t do anything in 60 days,” said Hughes. “These things take time.”

At the Sept. 25 meeting, Wilson spoke for his table, suggesting a roughly $.20 tax levy per $1,000 of assessed property value could be implemented, county-wide, to provide $1.2 million, annually, to fund a similar nursing home. He added that exact costs to fund a skilled nursing facility would need to be calculated before exact levy figures are set and that he was not speaking as an employee of the town.

The roughly 100 attendees of the Sept. 25 meeting brainstormed other possible solutions, including:

Merging a new skilled nursing facility with childcare,
Combining all of the island’s public hospital district’s into a task force to find solutions,
Forming a nonprofit to oversee the facility to fundraise and receive government funding,
Subsidizing a for-profit health care provider, similar to Life Care, the way the island’s hospital is subsidized through a hospital district levy.

Bill Williams, chairman of the island’s public hospital district, explained that although the facility will close in November, services could be brought back to the island, later.

Local partners have plans to meet this month, he told the Journal, including the hospital district board, county board of health, and PeaceHealth staff.

Williams explained that the hospital district board was unaware that the center’s “closing was this imminent,” but they will discuss possible solutions at their 5 p.m., Wednesday, Sept. 27 meeting at the county council chambers.

In the meantime, Life Care residents, like Herdy, are preparing to leave their home. There, Herdy watched deer graze in the backyard and read to fellow residents.

“I was desolate when I heard the news; it broke my heart,” she said. “I’ve enjoyed being here so much, but it’s closing, so I have no choice.”

Check the Journal for updates.

General manager Cali Bagby contributed to this article.