Skilled nursing options minimal for Outer Banks veterans

By on July 12, 2017

The late Col. L.L. Lewane with daughters Gloria Land, Sue Goodrich and Victoria Peters. (Family photo)

The decision to place a loved one in a skilled nursing facility can be difficult, even under the best of  circumstances.

Many factors come into play, including how well resources match up with a prospective patient’s  needs, the facility’s rating and how close it is to family and friends who will want to visit regularly.

But with average rates running around $248 a day — $90,500 annually — the biggest factor for many families is cost and which facilities will accept programs like Medicare and Medicaid.

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For Outer Banks residents, at least Outer Banks civilians, there is only one “choice” —  Peak Resources in Nags Head. Fortunately, it accepts Medicare and Medicaid.

Local veterans, however, are not so fortunate.

More than 5,000 veterans live on the Outer Banks, making up about 10 percent of the population. Most depend on benefits from the Department of Veterans Affairs (VA) to cover their medical expenses, benefits that they earned from their years of service. That means they often can only receive medical care from facilities that are VA connected and accept VA benefits as payment. Peak Resources is not one of them.

“They usually build these VA centers in major cities where the majority of soldiers may live. So the rural soldier, they’re just out of luck,” says Sue Goodrich.

Goodrich came face-to-face with this problem when her father, Col. L. L. Lewane, broke his hip a year and a half ago. It was quickly apparent he would need full-time nursing care.

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“You just don’t know what to do when you’re in this situation, trying to get your father the best care. And we would have brought him home, but I couldn’t with the stairs in my house,” Goodrich said.

Col. L.L. Lewane

It took Goodrich and her two sisters two years to apply for and start receiving VA benefits for their father, something Lewane hadn’t wanted to do before breaking his hip.

During that time, Lewane was paying out of pocket for care at Peak, with his daughters just minutes away and able to visit him every day.

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Once his VA benefits arrived, they were faced with a burdensome choice.

They could move their father to a VA-connected facility an hour and a half away in Elizabeth City, or they could keep him at Peak for $6,900 a month.

“My father was 87, and he was very vulnerable. He was close to all three of his daughters. I didn’t want to move him away from his support,” says Goodrich.

In the end, they made the decision to keep Lewane at Peak as long as they could, paying over $100,000 for his care. Between the cost and other troubling factors, they eventually moved him to the VA-connected Kindred Care in Elizabeth City, where he passed away a month later on Jan. 7, 2017.

Goodrich visited him every day.

“It was a lot of work. And there were a lot of tears. My dad had fought in Vietnam and Korea. He was a career Army officer, so he had earned his benefits. Is this what our soldiers deserve?” says Goodrich.

As terrible as Lewane’s situation was, he was in many ways much more fortunate than other Outer Banks veterans.

Goodrich continues to be thankful that they were able to use her father’s savings to pay for his care at Peak and keep him close to home.

The number of U.S. veterans living below the poverty level is on the rise, at 6.9 percent as of 2012. As of 2015, 8.3 percent of Dare County residents live below the poverty level, and the median household income is just over $54,000.

Given the same choice that Sue Goodrich had to make, it is hard to imagine many Outer Banks veterans and their families would have $100,000 or more lying around for skilled nursing care.

When Goodrich found out in April 2016 that Peak Resources was not VA connected, she reached out to our local VFW Post 10950, asking for help to rectify the problem.

Since then, Col. Carl Reiber, commander of the VFW and vice Chairman of the Veteran’s Advisory Council, has taken up the cause of getting Peak VA connected, as well as bringing other much-needed medical services to Outer Banks veterans, like mental health care and physical therapy.

The issue was personal for him beyond simply wanting to help fellow veterans.

Reiber served with Lewane in Vietnam, and also had to pay out of pocket for his wife’s care at Peak when she spent seven weeks there.

He approached Peak and asked them to begin the application process with the VA. As of now, that application process has been going for 14 months.

“I took it on, and it’s been a torturous process. There is a barrage of paperwork,” says Reiber.

Col. Lewane with  great-granddaughter Grace Chesire, granddaughter Brittany Love Brome, and at top, daughter Sue Lewane Goodrich.

Besides the paperwork, Peak will have to be inspected by the VA before it can become connected, and may have to make renovations or staffing changes in order to meet the VA standard of care, if they receive an offer from the VA at all. Peak Resources says they are still waiting to receive one.

“The process can be really drawn out,” says Winbourne Evans, director of admissions for Peak Resources in Nags Head. “We have applied for it and somehow it’s hung up on the VA end. Now we’re just waiting to learn the ruling. We are hoping to get the contract. It would be so wonderful to have.”

Peak Resources Inc. owns seven skilled nursing facilities throughout North Carolina, only some of which are VA connected. While it would seem that Peak wants the Nags Head facility to be able to accept VA benefits sometime soon, Reiber worries that even if they receive an offer, they might just not accept it.

“Getting the offer out of VA is only half the battle. Then we have to get Peak to accept what VA is offering and they’re not generous,” explains Reiber.

Depending on the terms of the contract the VA presents to Peak Resources, Peak might receive about the same amount of money per patient as they would have if the patient paid out of pocket, or they might be offered something considerably lower.

If the offer is low, or if Peak has to make considerable changes to their operations to reach VA standards, such as increasing the staff to patient ratio, they may elect to not take it.

“Peak is a for-profit business. They’ve got a perfect right to say ‘no thank you,’ ” says Reiber. “But if Peak says they’re not gonna do it . . . I don’t think there’s a next step.”

All that is left now is to wait and see if the VA makes an offer, and if Peak is willing to accept that offer. Meanwhile, the well-being of 5,000 Outer Banks veterans hangs in the balance.

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Comments

OBXyeah

Friday, Jul 14 8:53 pm

The VA to inspect? That is a joke!! I have seen up close and personal VA care, Deplorable!!
Anything connected to the VA is slow!!

Good luck Colonel!!

Alice Ann Hengesbach

Friday, Jul 14 6:40 am

Thank you to all of Col. L. L. Lewane’s family and to Col. Carl Reiber. Both of these families will do anything to take care of their own. The situation is even more dire for those who do not have a personal advocate. Hopefully, under the leadership of these fine people the rest of Dare County will step forward to help bring the VA-connected programs to PEAK. “I support veterans” needs to be more than just a bumper sticker. Again, I am grateful for all those who are taking action.

Sue Goodrich

Thursday, Jul 13 5:25 pm

Dear Kitty Hawk Deplorable,

The five thousand “Rural Soldiers” now have a commendable advocate for them here on the Outer Banks.
Col. Reiber has cracked a National Issue at the grass root level.
Standing Steady, shoulder to shoulder with Col. Reiber, our Veterans and all people so that all of us could receive excellent nursing care as well as being able to use earned VA benefits for care, rehabilitation and treatment on the Outer Banks.
Salute to you, Col. Reiber.
Thank you.

Kitty Hawk Deplorable

Thursday, Jul 13 9:28 am

Great work by Colonel Reiber and VFW Post 10950. Cracking a National issue at the grass roots level takes determination.

The care model developed by the VA to assist Veterans with service connected disabilities is well-meaning, but forces people out of their communities for warehousing at VA facilities in larger metro areas.

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