A Rhode Island nursing home that had turned to a grassroots funding campaign that included a resident-run bake sale to avoid closure has announced a new plan to stabilize finances and remain open.
Faced with approximately $100,000 of monthly losses, Linn Health and Rehabilitation in East Providence is in the process of transforming into The Loft at Linn. It will retain a portion of its skilled nursing beds but is also reworking one floor into a memory-care focused assisted living wing.
The change should stabilize Linn Health enough to ensure all 70 residents and more than 150 staff members can count on retaining their positions into the future, said Rick Gamache, CEO of Aldersbridge Communities, the nonprofit organization that runs Linn Health.
“Whereas Medicaid reimbursement for nursing homes remains grossly inadequate, Rhode Island Medicaid payments for assisted living are fairer,” Gamache told McKnight’s Thursday. “Our conversion from SNF to AL memory care will cut our losses by more than 50%.”
Gamache explained that achieving that 50% mark for Linn Health would ensure Aldersbridge as a whole would be breaking even financially.
Transitioning licensed beds has become a more common response to heightened regulatory and financial pressures lately. Even more conversions could be ahead too. In the McKnight’s Outlook survey taken at the end of 2023, about 19% of respondents said they would consider converting skilled nursing beds to a different license type if the federal government finalizes its proposed minimum staffing requirements.
Still waiting for the state
The ambitious plan to create The Loft at Linn would transform the facility’s second floor to include 22 private assisted living rooms. Some current staff will also need to be retrained to meet the requirements of new roles in assisted living.
“We have obtained grant money to convert shared nursing home rooms into private studio apartments, and we are seeking more funding to renovate the halls, dining room, etc.” Gamache said.
He also explained that some of the grant funds were set aside for staff training. Avoiding any layoffs was a priority, he added.
Renovations are two-thirds complete, Gamache told McKnight’s, and residents are already moving into the new apartments. Staff chose 22 residents with dementia diagnoses but who require only one care worker to assist them with activities of daily living.
Those residents are still being treated under skilled nursing rules, however, while Linn waits for approval and certification from state and federal regulators. That approval could take anywhere from a month to a year, Gamache said, though he hopes the red tape will be cleared quickly.
A pathway for nonprofits
The partial transition to assisted living was a matter of survival, according to Jamie Sanford, Linn Health’s administrator.
“We didn’t want anyone to leave Linn, nor have to be sold to another organization or close our doors,” she said. “This tenacity inspired and drove us to find and implement a survival strategy. It was important to us and to the families to keep caring for all of the residents who depend on us.”
Linn Health’s financial situation is all-too common for nursing homes across the country, but its strategy to remain open is likely best suited to nonprofit facilities, Gamache told McKnight’s.
“I suspect that most, if not all, nursing homes in Rhode Island and around the US have some residents with a dementia diagnosis who require a one-person assist that could be cared for in a Medicaid assisted living,” he explained, “but there are very few providers who will choose this direction. I see not-for-profits like us evolving in this way, but most assisted living is investor-owned or publicly traded, and the model is set up to produce income.”
While some red tape remains for the struggling facility, a sense of hope is building among leadership and in the community.
“At first, the conversion plan was met with skepticism on everyone’s part,” Gamache said. “Now, as we are closer to opening, there is excitement and enthusiasm. I am confident we will meet our goals.”
