Officials at Salem Memorial District Hospital are looking into options for expanding long-term care after a presentation by the daughter of an Alzheimer’s patient at the June SMDH board meeting.
However, SMDH’s hands may be tied by state regulations, which require a high occupancy rate county-wide before the number of long-term care beds can be increased.
Sara Wells-Barton told the board she has been unable to find a suitable facility for her mother, Johnita Wells, a longtime local schoolteacher, now retired, who was diagnosed with Alzheimer’s and dementia about five years ago. The 18-bed SMDH long-term care wing is full and has a waiting list.
“I’ve been taking care of her for five years, but had to look elsewhere for care because it was just too much for me,” Barton said. Barton has two small children at home, her husband travels for work and the family is in the process of moving.
“We’ve been looking for places for mom to stay,” she said. Her mother stayed at a facility in Rolla last year, but Barton was unhappy with the care she received and is now in a “battle” with that facility.
Wells has been staying at Salem Residential Care but needs additional care under state rules due to her condition, Barton said. Her other options in Dent County are Seville Care Center and Salem Care Center, both privately owned, which she eliminated due to cost and other concerns. She is now looking at Steelville, she told the board.
“I called long-term care (at SMDH) and they tell me it’s a four-year waiting list,” she said. “I don’t have four years for my mom, I just don’t… It’s already been five years, and she’s lost the capability of writing her name, she can’t speak and communicate clearly, and just dressing is a hard thing to do.
“The community has pointed me out of Salem to other places like Steelville. My mom served as a teacher for 33 years. Think of how many children she touched. There’s not one time that I go to Walmart and someone doesn’t say, ‘Oh, your mom, she was an amazing teacher.’”
Barton said she is concerned about the Baby Boomer generation growing older and the need for more and more long-term care in the near future. Barton cited statistics that show Alzheimer’s is the only disease among the 10 leading causes of death in the U.S. that can’t be cured, prevented or slowed.
Nearly six million Americans are living with Alzheimer’s, and that doesn’t include dementia. She also cited an 89 percent increase in deaths due to Alzheimer’s between 2000 and 2014.
“So, what do we do with that? We have to plan and prepare for this right now,” she said.
She added, “I’m here as a voice, that’s all, because I’ve struggled and struggled, and I’m still struggling. It’s a devastating disease, and I just want my mother to be taken care of. I think she deserves that. People deserve that.”
“My mom was diagnosed at 60. That is very, very young. We shouldn’t be dealing with this but we are.”
Her mother has been in and out of SMDH over the past year, she said. “And the service has been great, and it continues to be great. And they call and check up on her and they’ve really been a support to me.”
She also complimented the board. “You are all here because you want this hospital to serve the community, and I truly believe that.” Barton said.
“I hope with the love of our community I know you have, and with the love of our elders, you can try to expand the long-term care,” she said. “Even if that’s 10 years after you build on to the hospital.”
Administrator Kasey Lucas said SMDH recognizes the need for more long-term care beds, but can’t expand without a Certificate of Need required by the state. The state controls what can be expanded, how and when, he said.
To obtain a Certificate of Need and add beds, the hospital must show that occupancy of long-term care beds in Dent County is at 80 percent or higher for a six-quarter period, Lucas said. Occupancy county-wide is currently around 66 percent.
“It’s not just one facility,’’ he said. “It’s all the beds in the county. When we look at our facility, we are near 99 or 100 percent pretty much all the time.”
One option would be to work with the other facilities in the county to increase their occupancy over 80 percent.
“Maybe there are some opportunities to do some things,” he said. “Maybe there are things we can do to start addressing that.”
Another option would be looking at establishing a specialized long-term care facility specifically for Alzheimer’s patients. A specialized unit may fall under a different set of rules for establishing need.
“We see the need (for more long-term care.) We would love to do something,” said Chris Strickland, chief operating officer, “At this point it’s just a matter of regulations. That’s going to be a problem everywhere.”
He added, “We do see some opportunity to start a discussion with all the long-term facilities here, and look at the detail.”
Both are under new management, he said.
Lucas said the question is how to get the other facilities in the county to 80 percent.
“It just depends how open people are to having that discussion,” he said. “It’s those requirements we have to contend with if we are going to expand any service.”
SMDH has ordered an MRI machine to be installed next summer as part of the hospital expansion project.
“There are different requirements for each service. We fell underneath those requirements for the MRI so we were able to expand,” he said. “It’s a challenge with every service we provide to make sure we fall within that Certificate of Need.”
Barton said she is always looking for a solution and appreciates the hospital’s efforts to provide the services needed.
“I’m not just giving you the seed and saying ‘Take this seed and plant it and cultivate it,’” she said. “I’m willing to do whatever I need to do as well. If I need to have a petition, I’ll get 1,000 signatures. I will do it whatever I need to do.”