Navigator Homes of Martha's Vineyard

About Navigator Green House Residences

The founder, Dr. Bill Thomas, wanted a name invoking a place where people grow and thrive to address loneliness, helplessness, and boredom found in institutional nursing homes.

The overall resident room area is 278 SF, including 67 SF for the bathroom. The bedroom alone is 211 SF.

Resident Rooms: 8’ 0”; Corridors: 8’ 4”; Common Areas: between 9’0”- 10’6”

Yes. The NHMV Homes will be constructed using proven energy efficient design techniques, including:

An energy efficient thermal envelope featuring a disaster resistant, highly insulated exterior concrete wall system, a well-insulated slab on grade floor, and fenestration meeting typical green energy standards. Heating and cooling will be provided by an electrically based air source heat pump system. Due to the thermal mass provided by the exterior envelope and floor, no additional heating sources are required. Solar photovoltaic panels are being considered as a further carbon offset.
Wastewater will be compliant with the local board of health and MVC water quality policy.

Who Will Live in Navigator Green House Homes?

All Windemere residents are eligible to transfer to NHMV.

In addition, the normal Green House selection criteria consider the medical needs of the applicant.

A Patient Review Instrument (PRI) assesses someone’s ability to perform activities of daily living – it then scores the amount of help they need and demonstrates the need for 24-hour care or an inability to safely return to their personal home of origin. This ensures Medicaid is not paying the highest cost of care for someone who may qualify for support through short term homecare intervention. A physician can make the determination, but all nursing homes require someone moving in who does not have the resources to pay, independent of insurance, to have a PRI to ensure payment and compliance with insurances/ regulations.
Note: Some clinical therapy requirements are beyond the scope of the Green House, for example, patients on ventilators.
Note: Behavior is one of the criteria; A person whose behavior threatens others is not eligible.

Yes, along with patients with conventional long term nursing care needs.

We are building a skilled nursing community to replace Windemere’s skilled nursing facility. This is not a retirement home, nor is it an assisted living facility. Those eligible who to live at Navigator Homes have the following characteristics:

In the spectrum of medical support required, skilled nursing provides 24/7, on-site, full-time nursing support. Assisted Living provides medical support only on an “as needed” basis.
Skilled nursing patients need help with at least two activities of daily living (feeding, washing, dressing, toileting, etc.) and have at least one nursing need (medication administration, feeding tube management). These are not people who are newly retired; they are generally 80+ years old and in need of extra care.

By law, NHMV cannot discriminate based on geographic origin

Of the 158 residents of Windemere since 2019, 136 previously lived in Dukes County and those who didn’t all had family on the Island who wanted their loved ones here so that they could provide supportive care.
Under government payor and state regulations pertaining to anti-discrimination concerning access to health care and housing, if admission to the skilled nursing community is requested, that admission cannot be denied or favored based on where a person lives.
These regulations apply to Windemere currently. Members of our team are aware that a similar concern was expressed when Island Elderly Housing was being developed. History shows that this concern never became reality. The fact is that very few people ever consider relocating away from family to a new community when they are most in need of more support.

Yes. NHMV seeks to serve Island Families.

This happens often in other Green House communities. A husband and wife or any couple, (or sometimes siblings) can certainly be supported functionally in one room if desired, but under current Medicaid and Medicare law, that room could not be converted to a dually charged “semi private room” so they would still need to pay for two rooms in order to maintain the space requirements, staffing, and meal economies for 14 people, as there cannot ever be more than 14 people living in the house. In these cases, the second room is converted to a private den space for the couple by removing the bed and adding a love seat or two recliners. Also, insurance will cover only those who require skilled nursing care, so if a spouse does not qualify for skilled nursing care, those costs must be covered by private pay.

Note: With NHMV on-island, it would be more practical to visit every day and eat meals with the spouse but not sleep there.

Costs for living and care at Navigator Homes

The Medicaid and Medicare daily rates are set by the state. The private pay rates are market driven and based on comparable private pay rates in this market.

In order for the Navigator Green House community to be economically sustainable, it must attract a mix of private pay and Medicaid beneficiaries. As earlier testimony to the Planning Board has demonstrated, one of the Hospital’s requirements of a collaborator in the new Windemere was that at least 50% of the beds would be dedicated to Medicaid beneficiaries.

This number is an increase from the current number of Medicaid beneficiaries living at Windemere.

The daily rates in 2022-2023 are:

Private Pay – Long Term Stay: $600/day x 365 = $219,000/year
Medicaid – Long Term Stay: $328/day x 365 = $120,000/year
Medicare – Short Term Rehab: $500/day x 365 = $182,500/year

Some meds are covered, and some are provided through the residents’ Medicare Part D coverage.

Yes. Navigator is currently accepting names and contact information details. Please contact Polly Brown at 508-524-3986 or at [email protected] to provide your name or that of your loved one.

Life in Navigator Green House Homes

Casework furniture like dresser, night table, bookshelves are fine. Upholstered furniture like chairs need to meet fire code fire rating combustion standards. You can select your own window treatments, for example, drapes, but they must meet fire code standards. Photos and artwork are also welcome.

No. Like home, you can eat whenever you want.

No. Like home, you can eat wherever you want.

Yes. Residents are welcome to assist the aides in cooking if that is desired. Otherwise, the enhanced Certified Nursing Assistants called “Shahbazim” will prepare the meals for the residents.

Yes. A visitor can stay for a limited time, not more than 2-3 days. They could stay in the guest room, or in the resident’s room.

Residents of the house decide on house rules. Any pet would need to be compatible with the residents in the home. Some homes proactively procure and care for a house pet.

Yes, if the resident is over the age of 21.

What is Happening to Windemere?

Yes.

When NHMV Green House Residence gets built, Windemere residents with skilled nursing needs will have a home at Navigator.

What Effect Will Navigator Green House Homes Have on the Neighborhood?

A traffic study, with a peer review, has indicated minimal traffic impact. Because the residents do not drive, and because 30 of the employees working in the Green House Community will be able to walk to work from their apartments, minimal traffic disturbance is anticipated.

While not exactly known, residents are not frequently leaving the Skilled Nursing homes by ambulance, nor are ambulances expected to frequent the community.

NHMV Non-Profit Status

Yes. NHMV is a 501c3 non-profit, public charity registered with the Secretary of State of the Commonwealth of Massachusetts. The tax ID number is 84-5182763.

Martha’s Vineyard Hospital/NHMV Workforce Housing

76 beds: 46 for hospital employees and 30 for Navigator Homes employees.

The rents will be tied to the employees’ income so that they are not paying more than 30% of their income towards housing.

FAQs