A regular Source column, Undercurrents explores issues, ideas and events developing beneath the surface in the Virgin Islands community.
Six months later, there’s no visible progress in resolving the territory’s nursing home crisis. The formal deadline for removing long-term nursing home patients from the only nursing care facility currently operating in the Virgin Islands, Sea View, is Jan. 30, and officialdom is silent on what – if any – plans there are to place them elsewhere.
According to some informed sources, the V.I. government is seeking another six months reprieve from the federal Center for Medicare and Medicaid Services that will allow it to continue operating limited services at the facility as it has been doing since last summer.
CMS, the regulatory arm of Medicare and Medicaid, “closed” the privately owned and operated Sea View as of July 1, 2015, because of deficiencies it said it had found there.
However, responding to appeals from the V.I. Department of Human Services, which has responsibility for Medicare and Medicaid clients in the territory, CMS agreed to a special arrangement whereby it would continue to pay for long-term clients already housed at Sea View until the local government could find a suitable alternative placement – or until the end of this month, whichever came first. Sea View was not allowed to accept new patients, either long-term (generally disabled or elderly patients) or short-term (such as patients recovering from stroke or surgery.)
Vivian Ebbesen-Fludd, commissioner of Human Services, has not responded to numerous telephone messages and emails over the past two weeks seeking comment.
Adeline Williams Connor, administrator at Sea View, spoke briefly with the Source twice and promised each time to call back with more information but didn’t.
Connor did say that current operations at the facility are “good” although “right now we don’t do rehab.” Asked about a possible extension of the Jan. 30 deadline, she said, “The commissioner (of Human Services) is working on that.” She also revealed that regulators were on St. Thomas last week for meetings about the situation.
Ebbesen-Fludd is on record opposing the transfer of V.I. patients to facilities stateside or to the only local facility that has been suggested as a possible alternative, the Roy L. Schneider Hospital/Schneider Regional Medical Center. In November she was quoted in a local publication saying that there was never consideration of moving patients to Schneider despite statements from some hospital board members suggesting otherwise.
In June there were 31 nursing home patients at the facility.
While they are the primary concern, the CMS restrictions also impact residents needing short-term care, such as a person who lives alone and who is temporarily disabled because of a knee replacement or a recovering stroke victim whose family is unable to provide full care, even temporarily. Such patients, many of them on private health care insurance rather than Medicare or Medicaid, used to add to Sea View’s revenues.
“Right now what a lot of our doctors are doing is just discharging straight to home,” said physical therapist Rasha Harris.
She indicated the situation is not dire. “We can come to your home right away” to provide rehabilitation services, similar to what Sea View used to offer. Also, she said, the numbers of residents who are affected is relatively small.
However, she added, “It is causing some people to hold off on their surgeries or to go off-island” where they may have support for their recovery period.
“So it is a major problem,” she said. “It’s one less service that we have on-island.”
Meanwhile, the larger, long-range issue is still awaiting resolution: How will the Virgin Islands provide ongoing nursing care for its aging population?