April 24, 2019
Announcement to Residents, Family, Team Members and Vashon Island Community Members:

When Transforming Age affiliated with Vashon Community Care (VCC) in 2017, we committed to developing a business plan that would continue the mission of providing high quality senior living and care choices on Vashon Island and sustain the facility for many years to come. Today, we are sharing what we have done over the past 16 months, what we’ve learned and how we plan to move forward on our commitment.
Since January of 2018, when we began to manage the facility, we have taken many steps to improve the VCC operation, including:

• Improving record keeping and staff communications by purchasing new computers and implementing full Electronic Medical Records using Point Click Care (PCC).
• Broadening pharmacy services by converting to a full-service senior housing pharmacy, compatible with PCC. This provided monthly on-site pharmacist record review and audits, nurse in-service education and enabled us to admit patients requiring IV therapies.
• Increased the admission rate by hiring a full time Admissions and Marketing Manager and implementing a dedicated admissions portable phone.
• Increased Medicare/HMO from historical 1-2 patients, to 6-9 patients average census.
• Enhanced all employee benefits by adding a 403(b) retirement plan, offering more health insurance options at lower employee premiums, and generated savings of over $100,000 each year for VCC.
• Improved worker safety and reduced worker compensation claims from 15 open to 1 open.
• Improved quality of care and compliance for both, Assisted Living and Skilled Nursing, going from a 2 Star to 5 Star rating in skilled nursing.

All these efforts, however, have not resulted in financial sustainability for VCC. In fact, since the affiliation TA has supported VCC with over $2 Million in cash contributions and has not collected any management fees. The main reason for this is that a skilled nursing operation is not sustainable on Vashon Island because the cost to provide skilled nursing services significantly exceeds the reimbursements we are able to collect.

In addition, the higher Medicare/HMO census we were able to achieve required additional nursing and therapy staffing and without available work force, VCC has relied heavily on agency staffing from off the island to fill this need at a 50% premium over regular wages.

Furthermore, skilled nursing Medicaid reimbursement is set to be cut by $38/day per resident, reducing revenue by approximately $166k annually.

The conclusion therefore is that in order to be sustainable long-term, VCC must discontinue its skilled nursing operation while continuing to provide much needed senior living and care choices to Vashon Islanders. In
order to accomplish this goal, we are discontinuing skilled nursing services. We are working with regulators, residents and families on a plan that ensures resident’s continued safety and proper care.

As part of the repositioning of VCC, we are adding a much-needed higher level of Assisted Care and Memory Care option for Vashon Islanders who have higher care needs and/or suffer from cognitive diseases such as Dementia or Alzheimer’s. This will enable Vashon Islanders to remain on the island close to loved ones in a comprehensive, high quality care setting.

Furthermore, we are planning on significant capital upgrades and a comprehensive renovation of the community to improve the aged physical plant at VCC. We hope for continued community support for those capital improvements so, together, we can make VCC the best it can be. We look forward to building a team of local advisors to support VCC in this effort.

We will work with VCC residents, family and staff during this transition. We will continue to provide therapy to short-term nursing residents until their skilled stay has concluded. We will work with all long-term skilled residents and families for appropriate placement at either VCC or a provider partner. For future skilled nursing needs, Transforming Age communities in Seattle as well as skilled nursing communities of our LeadingAge state association partners across the Puget Sound region will be available to provide rehab and long-term care services.
We remain mission-focused to deliver high-quality care to our residents. We are also committed to enhancing our physical plant and expanding the services available in our Assisted Living and future Enhanced Assisted Living and Memory Care wing. 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. If you have any questions, please feel free to ask the VCC management team.