In Nantucket's New Our Island Home, Staffing Is More Important Than The Building

To the editor: This is a paradox: It seems that, with Our Island Home, we are going from one extreme to the other, but each time the building remains the focus. We know from the pandemic that many residents died in skilled nursing homes rated five-stars by Medicare. The New York Times had a feature article about that. Many residents died in beautiful buildings meant to appeal to families deciding which skilled nursing home to choose.

What came from these revelations was awareness that quality of care is the most important part of a skilled nursing home. And essential to quality of care is nurse staffing at all levels, from certified nursing assistants to registered nurses.

As we have seen with the current Our Island Home, it is far less important that the building is below grade than that the nurse staffing is adequate. When my mother was a resident at OIH, from 2013 to 2017, she had superlative nursing at all levels.
My mother had the resources to have her choice of skilled nursing homes but she wanted to remain on the island, her home. Like most of the other OIH residents, she shared a room and a bathroom. But, in truth, any design features or amenities would have been lost on her because she was blind and bed-bound.

During the first go-round in planning the new building, the staff for the most part were not allowed to publicly express their preferences for a new nursing home. Only the administration spoke for OIH. The consultant, a nurse herself, canceled a meeting with OIH nursing staff that was intended to get their advice. Who better to know what a new facility needs than the full-time staff?

And here I mean everyone, not just the nurses. What do those in the kitchen believe is needed? A new nursing home may have to be built conceptually from the ground up. Start with the most basic requirements for a skilled nursing home facility in Massachusetts. The end product may resemble the current proposal but could be far less expensive, especially if staff are challenged to come up with cost savings.

So, in terms of the building, itself, we have gone from an old, below grade structure to a proposed state-of-the-art structure. These are the extremes. But keeping staff and staffing in focus, the building is an ancillary issue and should remain so.

Maureen Searle