(This story is by Nora Doyle-Burr of the Valley News, in which it first appeared Oct. 24, 2017.)
[W]HITE RIVER JUNCTION — Residents displaced by the recently announced closing of the Brookside Health and Rehabilitation Center are likely to have a difficult time finding a new residence nearby, potentially creating a hardship for those with families in the Upper Valley.
While people familiar with the situation say there are nursing home beds available in New Hampshire and Vermont, precious few of them are in the Upper Valley.
Compounding the challenge for families is the need to not just find an available bed, but to make sure it is in a facility that can meet the particular needs of a patient and also accepts whatever kind of insurance coverage that person has.
The nearest facilities — the 100-bed Hanover Terrace Health and Rehabilitation and the 110-bed Genesis Lebanon in New Hampshire — are both full, their directors said Monday.
On Oct. 13, the Centers for Medicare and Medicaid Services announced that it would stop making payments to Brookside Health and Rehabilitation Center for new patients admitted after Oct. 29, due to repeated health and safety violations. Payments would continue for current patients for 30 additional days, according to the CMS news release.
Residents and their families were informed last week that Brookside will be closing its White River Junction facility at the end of that 30-day period, on Nov. 29.
“We simply did not have the support, systems and resources to address all the deficiencies, accordingly,” Brookside’s administrator Paul Kovacs wrote in an Oct. 19 letter to residents and their families.
Deficiencies found in inspections conducted in recent months by the Vermont Department of Disabilities, Aging and Independent Living’s Division of Licensing and Protection have included food safety, staffing levels, a gap in contracts between providers of rehabilitation services that left some patients without such services for a time, and failure to ensure that patients see their doctor regularly.
In the next two weeks, Brookside staff will work with patients and families to schedule the patients’ relocations, Kovacs wrote.
“We will make sure this transition is as seamless as possible to you and your loved one,” he wrote.
Kovacs was in a meeting and unavailable for comment when a reporter stopped by Brookside on Monday. He also did not return a phone message.
In the days since the announcement, Brookside residents and their families have reached out to Hanover Terrace, Genesis and other area nursing homes.
As of Monday, Brookside had 33 of its 67 beds occupied, and no residents had yet been relocated, said Tom Ralston, the president of Brookside’s residents council.
Martha Chesley, the administrator for Hanover Terrace Health and Rehabilitation Center, estimated her facility had received about 20 referrals from Brookside as of Monday.
“I’ve certainly been giving a lot of tours to families (and) answering a lot of questions,” Chesley said.
Chesley has established a waiting list and said she would try to get Brookside patients in as beds become available.
“One of our priorities of course is to help as much as we can with placing the residents that are local so they won’t have to go farther away,” she said. “Certainly with the families that we’ve met with, it’s really been very devastating.”
The story was similar at Genesis Lebanon, according to Dottie Ruderman, the center’s director. The 110-bed facility has a waiting list of between 15 and 20 patients, she said.
The picture wasn’t any better for those seeking care at Orange County’s only nursing home — Gifford Health Care’s 30-bed Menig Nursing Home in Randolph Center, which is also full and has a waiting list of between 80 and 100 people, said Brooks Chapin, the facility’s director of nursing.
Chapin, who worked as a case manager at Gifford Medical Center for a time, said she could find a bed for a patient in need, but, “We would sometimes have to say it may not be within the vicinity that you want.”
The 39-bed Cedar Hill Health Care in Windsor, where staff have also been fielding calls from Brookside residents and families, has “limited bed availability at this time,” said Patricia Horn, the facility’s director.
Jeanne Moore, a spokeswoman for the 102-bed Springfield Health and Rehabilitation Center, declined to comment for this story.
Ralston said his name is on waiting lists at nearby nursing homes. His wife lives in Wilder, and he hopes to stay close to home.
“I’m just hoping that something local opens up,” he said.
Ralston said residents and their families are in a wide variety of situations now that the facility will be closing, “the worst being the residents that (due to dementia or other memory disorder) don’t even know it’s transpired.”
Some family members are at odds about what’s in the best interest of their loved one, Ralston said.
One family from Maine is trying to sort out whether to allow their loved one to stay in Vermont or to take him or her home to Maine, Ralston said.
“It’s trauma,” he said. “Nobody’s happy about the situation.”
In addition to seeking a nursing home nearby, Ralston also needs to find one that accepts Vermont Medicaid, which he relies on to cover the cost of his care.
Hanover Terrace, Genesis Lebanon, Cedar Hill and Menig all accept Medicare, Medicaid — both Vermont and New Hampshire Medicaid in the case of the New Hampshire facilities — as well as private pay and commercial insurance.
The 135-bed Grafton County Nursing Home in North Haverhill, New Hampshire, accepts Medicare and both states’ Medicaid, as well as private pay, said the nursing home’s administrator, Craig Labore. As a county nursing home, Labore said, his facility runs a higher-than-typical rate of Medicaid patients of about 78 percent.
The 156-bed Sullivan County Health Care in Unity, New Hampshire, has an average census of 133, said Ted Purdy, the administrator.
“We do have some availability and would be happy to accept referrals from Brookside residents,” Purdy said in an email.
Sullivan County does not accept Vermont Medicaid, but Vermont residents could apply for New Hampshire Medicaid should they relocate to the Granite State, he said.
The 53-bed Woodlawn Care Center in Newport, New Hampshire, is full and has a waiting list, said its administrator and owner, Christopher Martin.
He typically has about 60 percent Medicaid patients, with Medicare, private pay and Veterans Affairs payments making up the rest.
Like the Sullivan County facility, Woodlawn does not accept Vermont Medicaid, so patients have to relocate to New Hampshire and reapply for Medicaid.
In addition to finding an available bed in a conveniently located facility that accepts their insurance, patients must also find a facility capable of undertaking their care.
Most area facilities said they are capable of taking most patients, providing services such as physical, occupational and speech therapies, as well as wound care and some intravenous treatments, but most are not able to accept patients in need of a ventilator.
Some administrators also said some mental and behavioral health issues can also be difficult for them to manage.
For example, Woodlawn does not have a locked dementia unit, Martin said.
While he can accept some patients with dementia, he cannot take them if they are “actively wandering.”
Ralston, 62, who has lived at Brookside for four years, is paralyzed from the armpits down and lacks the use of his hands. He said he requires that his new home have Wi-Fi, which he uses to read the daily news.
He also emphasized the importance of a caring staff, which he said he has found at Brookside. There are two types of staff, Ralston said.
“Staff that work for the residents and staff that work for the money,” he said. “I’d like to stay away from staff that work for the money.”
