Efforts on Facility Operations & Plant

1996 Lanzikos, McDonough & Associates Management Report

  • Review of management and governance structure of OIH.
  • Major findings included:
    • Seek rate relief from Medicaid program.
    • Alternative forms of ownership/management may not be beneficial as lose oversight of day-to-day operations and may impact rate relief efforts.
    • Deficit examined and strategies to bring down the deficit are limited.
    • Staffing levels and physical plant are standard with current standards.

2007 and 2009 reports from BruJan Consulting and Demarco Architects

  • Providing an update to the 2007 presentation to provide acknowledgement of the bankruptcy status of Sherburne Commons, they presented 4 options in 2009:
    • Status quo (continue with increasing annual losses and an obsolete building with an institutional operational model).
    • Close OIH. Residents would move to off-island facilities or remain home.
    • Find an outside operator.
    • Make the investment to upgrade OIH to make it less costly to operate and less institutional.
    • This last option was the focus of more review to construct a new facility at the same location of the Sherburne Commons building (with potential repurpose of current building) as well as a design for the current East Creek Site was formulated.
    • No action was taken on these recommendations at that time.

September 2012 – OIH Workgroup developed

  • Appointed by the Select Board to do an in-depth review of the finances and operations of OIH.
  • 4 recommendations were presented for exploration and further community discussion.
    • Develop community-based care to be delivered to people in their homes rather than as residents of a skilled nursing facility.
    • Develop a Village Model which brings existing elder services together.
    • Build a smaller facility abutting the Sherburne Commons building
    • Sell current location to Land Bank to offset building new facility.

Reports:

April 2014 SED Associates Mechanical Engineer Assessment

  • Current facility’s current building systems (HVAC, plumbing, electrical) reviewed.
  • Multiple system replacement or upgrades were recommended.

Reports:

April 2015 Annual Town Meeting

  • Multiple capital requests submitted for current building upgrades related to SED Assessment.
  • Authorization to borrow $1,000,000 for costs associated with design of new facility.

June 2015 Feasibility Study

  • Engaged SMRT Architects. After review of multiple sites, including phased or new build on the current site, it was initially determined a new facility adjacent to the Sherburne Commons building was the most feasible. Siting single phase construction, resident disruption, model/living environment, parking, future expansion options, and cost as leading reasons.
  • Specific issues were later found including artifacts and costs of acquiring additional land.
  • Community outreach on findings began September 2015 through January 2017.

Reports:

October 2015

  • SMRT presented Feasibility Study to Select Board

November 2015 Special Town meeting

  • Due to in an advertent error to do debt exclusion in April 2015 vote, re- authorization of original funds for designs of a new facility was sought. Opposition to the inclusion of the word ‘new’ was discussed. This passed with authorization of $1,000,000.

December 2015 Engagement with SK Advisors & Rabig Consulting through SMRT

  • A joint effort to explore and determine bed size, model of care, financial pro-forma for options identified, demographic projections, and recommend an operating and staffing plan for OIH.
  • Final report provided January 2017 and explored financial options based on a four 10-unit small house model (30 skilled nursing beds and 10 rest home level of care beds). 

Reports: 

October 2016 Annual Town Meeting

  • Multiple capital requests submitted for current building upgrades while future of OIH options continue to be explored.

October 2016 Special Town meeting

  • Voters passed a citizen article requiring the formation of a workgroup to resolve financial and otherwise unanswered questions or open issues related to the relocation, design, staffing, site control and demographics.

Reports:

November 2016

  • Select Board voted to explore plans for a new facility to be located at Miacomet Road (Sherburne Commons site).

Reports:

December 2016 OIH Workgroup was formed

  • Presentation to Select Board in March 2017 identified seven areas for further clarification.
  • 2 main recommendations were:
    • More in-depth review of the current East Creek Road site
    • Any warrant article brought forth needs to also address commitment to continue to own and operate a skilled nursing home in the future.

Information:

December 2016 OIH Building Committee appointed

  • Committee charged to perform document and design review for a new OIH.
  • Also took a step back and reviewed work from the past 10-12 years, examined models of care (small house, traditional, etc.), additional site reviews, and examined potential capital costs associated with potential options.
  • The two focus sites were Miacomet Road (adjacent to Sherburne Commons building) and the current East Creek Road site.  

Reports:

January 2017 SMRT, SK Advisors & Rabig Consulting final report

  • Examined financial options based on a four 10-unit small house model (30 skilled nursing beds and 10 rest home level of care beds) on the Miacomet Road site.
  • Conceptual plans developed by SMRT accompanied this report.
  • Explanation of current site logistics explained. Options for the existing site, including Landmark House relocation were explored further by Select Board directive after the January 2017 report.
  • Discussion with State Senator and Representatives on issues regarding OIH related to its current and future status and matters involving DPH that may impact future decisions on a new facility.
  • December 2017 Letter to MA DPH Commissioner Bharel related to our questions and concerns sent.

Reports:

March 2017

  • OIH Workgroup and Building Committee report update to Select Board

April 2017 - Annual Town Meeting

Four articles were put forth to authorize the borrowing of $30,000,000 for design and construction of a new facility along with the purchase and related sewer and zoning changes of private property adjacent to the Miacomet Road lot (Sherburne Commons).

While by a narrow margin, the article(s) did not pass.

October 2017 - Select Board review of facility upgrade project status

  • Discussion on April 2017 ATM outcome occurred resulting in a refocus on next steps and potential for a later discussion.

November 2017 

  • Select Board discussion about possible actions to take to move forward with a new plan for OIH: The Board voted that Town Administration start searching for a firm to make recommendations on operating options, cost estimates, demographics and determine the feasibility of building at the current location.
  • Discussion with State Senator and Representatives on issues regarding OIH related to its current and future status and matters involving DPH that may impact future decisions on a new facility. 

December 2017 

  • Letter to MA DPH Commissioner Bharel related to our questions and concerns sent.

May 2018 engaged CliftonLarsonAllen (CLA)

  • CLA explored financial impacts and operational analysis of OIH.
  • Updates were presented in October and December 2018 that presented financial models for 45 or 40 bed configurations, anticipated square footage, and related operational and capital costs.
  • Recommended engagement of Architect to assist in feasibility and conceptual design renderings. Efforts for this began September 2018.


March 2019 Feasibility study engaged LWDA

  • Conduct an architectural/engineering feasibility study to explore what it would look like, what steps would be needed, and potential cost to either renovate or build a new facility on the existing site (East Creek Road).

May 2019 

  • Hosted a Charrette to explore schemes developed.
  • Presented two schemes to Select Board September 2019 with CLA. Both schemes represented a phased 2-story construction for a 45-bed facility.

June 25, 2020 Annual Town Meeting

  • Due to the Covid-19 Pandemic, many articles originally intended for the warrant were tabled or not acted upon, including a proposed operating override to fully fund Our Island Home without reliance on uncertain sources such as Retained Earnings. The next Annual Town Meeting has been set for April 5, 2021 and discussion as to potential warrant articles is pending. An operating override will require a town meeting vote and a ballot vote at an election. The companion ballot vote for the 2020 Annual Town Meeting OIH operating override was approved at the June 16, 2020 Annual Town Election; however a new vote will be required if this proposal proceeds to the 2021 ATM.

September 11, 2019

  • Select Board notes that all plans and studies are conceptual and would to review input from key Stakeholder and the general public before deciding on what to move forward with.

June 16, 2020 Election and Ballot Questions (Election held before ATM)

  • Ballot question #1 for OIH $5M override to fund Operations (Yes: 1,232   No: 564   Blank: 64) 

June 25, 2020 Annual Town meeting (rescheduled from April)

  • Select Board to determine what warrant articles to sponsor. Current discussion includes:
    1. Prop 2 ½ override to cover revenue shortfall in the amount of $5M due to continued operating deficit. If override success, Town’s ability to raise revenue is permanent and must pass Article at ATM and ballot question. (Placed on ballot on June 16, 2020 but removed in motion on warrant. Place override in Enterprise budget Article 15 on June 2021 ATM)
    2. Seek authorization for design and associated cost funding for phased construction on the East Creek Road site. (Not pursued at this time).
  • Due to the COVID-19 Pandemic, many articles originally intended for the warrant were tabled or not acted upon, including the proposed operating override for Our Island Home to fully fund the facility without reliance on uncertain sources such as Retained Earnings. This article will be placed on the next Annual Town Meeting in 2021. An operating override will require a town meeting vote and a ballot vote at a subsequent election. While the companion ballot vote for the 2020 Annual Town Meeting OIH operating override was approved at the June 16, 2020 Annual Town Election, a new vote will be required for 2021.  

July 2020

  • An internal group was organized to start planning efforts for OIH and a facilitator was engaged for a meeting on July 28, 2020 help determine consideration factors including facts vs assumptions; core community values; options and possibilities – with associated strengths, weaknesses, opportunities and threats (a so-called SWOT analysis); and, a plan to obtain public input.

July – September 2020: 6 facilitated discussions held

  • July 28 and August 10: Internal Town group (Town staff, Select Board and Fincom representative(s), key OIH supervisor staff)
  • September 8: facilitated discussion with OIH Nursing staff
  • September 10: facilitated discussion with activities staff, OIH Residents and Ombudsman
  • September 11: facilitated discussion with OIH family members and Friends of OIH 
  • September 16: facilitated discussion with OIH ancillary (non-nursing) staff 
  • September 17: facilitated discussion with Community Senior leaders and service providers 

October 14, 2020

November 17, 2020

  • Select Board hold first session of Facilities Master Plan Workshops, mentions OIH but focus is on Town offices and municipal buildings 

January 12, 2021

  • Select Board holds second session of Facilities Master Plan Workshop focus on town employee housing and public amenities (including OIH and the Senior Center, Concession, and public restrooms). 
  • Common discussion theme was a new OIH built at an alternate location (potentially adjacent Sherburne Commons) and current East Creek Road location would be utilized for a Senior/Community Center pending remaining Stakeholder meeting feedback.

January – April 2021 facilitated Stakeholder discussions continue

  • January 6: facilitated discussion with Council on Aging
  • January 16: facilitated discussion with Advisory Committee of Non-Voting Taxpayers
  • January 28: facilitated discussion with Nantucket Rotary Club
  • February 5: facilitated discussion with Nantucket Civic League
  • March 12, 16, 17, 19, 23, and 26: facilitated discussion with neighbors of the East Creek Road and Miacomet/ South Shore Road locations were scheduled (3/16, 3/19, 3/23 and 3/26 were cancelled due to no response from abutter invitees for attendance). Members of the Senior Center Committee and Nantucket Center for Elder Affairs were invited as well as but most members already attended in a group held previously. Total attendance was 6 individuals.
  • April 22, 26, 27, 28 and 29: facilitated discussions with general public were scheduled (4/22 cancelled due to no attendance). Total attendance was 8 individuals and 1 letter received.  

May 26, 2021

June 5, 2021 Annual Town Meeting

  • Select Board seeks authorization for the Prop 2 ½ override for OIH Enterprise fund operating budget in Article 15

 

To access to past documents regarding the Our Island Home Proposed New Facility, visit the Town of Nantucket Archives Page.