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Deer Isle, Isle au Haut and Stonington, Maine.
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by Faith DeAmbrose
For a cost of roughly $2.5 million, the Island Nursing Home and Care Center is considering a total remodel of its facility and the addition of six additional nursing level spaces, or “beds” as they are referred to in healthcare speak.
The facility will be 30 years old this coming February and times have changed, explained administrator Marc Plourde, and not only times, but space and privacy needs, as well as needs for technology. Basic medical codes have changed too and a complete remodel will provide for additional resources, such as a special room for families and those in hospice care and an air conditioning system, which it does not have currently.
Last summer, INH began to discuss expansion as it eyed the attainment of bed rights from the troubled Penobscot Nursing Home, which had been in state-appointed receivership since 2008. Then, the state was seeking to remove the receivership and sell the bed rights to a for-profit company in the process of constructing a new home in Bucksport. In May, Plourde said the board of trustees decided to examine the addition of 20 beds—10 skilled nursing and 10 residential—and hired an attorney to intervene in the state’s motion to lift the receivership at PNH. INH also hired the Bucksport-based architecture firm of Lewis + Malm to design a concept plan for a 20-bed expansion.
On November 1, Plourde said the board opted not to pursue a 20-bed expansion—which was expected to cost roughly $7 million—but would look at the feasibility of a smaller scale expansion, as well as renovation. Cost was a factor in the decision, said Plourde. The board also on Wednesday, October 24, opted not to pursue the attainment of beds from the stock at Penobscot Nursing Home and dropped its legal quest for intervener status.
According to Plourde, the facility will still seek to add up to six beds, and those beds would strictly be private self-pay.
Given the complex nature of healthcare and its costs, the state has sanctioned a fixed number of beds for nursing facilities state-wide, and secures that number by not allowing the creation of beds that would cost the state money through Medicare or MaineCare (also called MaineCare neutrality). This is done through a Certificate of Need process administered by the Department of Health and Human Services. While INH would have to complete the Certificate of Need process to create new bed assets, the likelihood of success is greatly increased because self-pay would not add additional costs for the state.
Currently at INH, approximately 10 percent of its clients are self-pay, and that number has been as high as 25 percent in other years, said Plourde.
INH can make a good case for expansion; the facility has had a near 100-percent occupancy rate for the past four years, said Plourde. It is also ready for a renovation, especially as it embarks on a strategic “culture change,” a process that already has been years in the making and not yet complete.
The expansion and renovation are still in the “infant stages,” said Plourde, “there’s still a long way to go.” At present, a feasibility study is being conducted to determine needs. Once complete, the INH board of directors will review the study, as well as the concept drawings for expansion (which will have to be reconfigured slightly given the reduced scale of expansion) and make a decision about how best to proceed. Figured into the process will also be a chance for public input, said Plourde.
And, even if the plans are approved by the board, there is still the issue of raising $2.5 to $3 million, said Plourde, adding that a decision will likely be made by mid-summer. The next step would be a capital campaign, although Plourde noted that INH readily accepts donations anytime throughout the year.