SNOHOMISH — When the Snohomish Chalet finally closes, it will be the end of an era.
Delta Rehabilitation, known locally as the Snohomish Chalet, provides important care for people with brain injuries.
It is one of 21 Medicaid-funded closures in the state in the past three years, said Robin Dale, CEO of Washington Health Care Association, and it is the only one of its kind. Medicaid reimburses $220 per day from the state to agencies like Delta, “and it’s been that way since 2018,” Dale said. Costs for care continue to rise, and statewide annual shortfalls have hit $116 million, Dale said.
The cost for care versus Medicaid reimbursement is what pushed Delta to close, and the specialization is a second push. Chris and Carol Walsh tried to sell, but the building is too old and purchasing it would mean caring for brain-injured patients, a specialization with expenses that repel health-care business owners.
“Nobody wanted it,” said Carol Walsh. “If it’s Medicaid, there’s no margin for profit.”
Profit was never the motivator for the Walsh family. In 1975, Chris Walsh’s brother was in a car accident. Mike Walsh was 20, and on his way to classes at Everett Community College. A driver who had been drinking ran into his vehicle. A state trooper saved his life by administering CPR at the scene, but Mike Walsh still slipped into a coma for six months. He awoke unable to speak well due to brain injury. He was discharged and sent home. His family knew he needed specialized care.
“The hospital said ‘get him out,’ so we brought him here,” Chris Walsh said.
What formed out of that was The Chalet, a skilled nursing facility with programming that drew on medical need, and the relatively youthful population that gets injured in car accidents. Chris Walsh said the average age of residents is mid-50s to age 60. Activities have included trips to rock concerts and area casinos. The focus is on living life, not dwelling on the injury that derailed it.
“Most nursing homes are quiet,” he says when describing the comfortable feel of The Chalet. “When you walk down our hallways, you hear rock music.” He said the people there need that. “They’re not sick. They’re not ill. They just got injured.”
Chris Walsh said most health agencies are run by big businesses. The Snohomish Chalet is “a family run business, and this industry — it’s 99 percent owned by large corporations, and we tried to sell this place but the building’s turned 100 years (old).”
Five years ago, Carol said, the Chalet celebrated the building’s one-century mark. Visitors park on cracked concrete and walk through a front-door adorned with chipped red paint.
“We were forced to be creative and learn how to do things on a shoestring budget,” Carol said.
They did that with planning and support, mentioning a mostly long-term workforce and a 100-strong volunteer corps. Various churches and service organizations also donated resources.
Activities can stretch an already strained budget. Some work-arounds over the years included buying used equipment from other nursing homes and innovating with what was available. The gap between what is needed and what can be done is one many nursing homes and skilled nursing facilities have faced.
“There is a big shortfall between the cost of care and the reimbursement rate,” Dale said, referring to statewide funding.
Chris Walsh said the state is sorry to see them go. The specialization they provide is rare.
“Delta is the only skilled nursing facility in the state that exclusively specializes in traumatic brain injury,” Dale said.
The agency currently houses 100 people with brain injuries and other disabilities. Motor vehicle and motorcycle accidents are the main causes for brain injury, Chris Walsh said. Other causes are drownings, shootings and drug overdoses. The brain is damaged sometimes from a thump to the head that causes the brain to swell inside the skull, he said. Oxygen deprivation can also damage a brain, causing harm after six minutes without, Carol said.
It is not just the residents, employees and volunteers who will feel the loss.
The site is home to a multitude of community events, such as the annual Hub fundraiser for kidney disease awareness, hosted by City Council member Steve Dana in honor of his wife Noreen, who has kidney disease.
“We used to be the largest employer (in Snohomish) next to the school district,” Chris Walsh said.
The Chalet currently employs 134 people.
Their closure will also omit a hefty amount from municipal budgets. Walsh said utilities cost more than $114,000 a year. The combination of PUD, gas and sewer costs is “more than a quarter million.”
The funds to pay those bills come from residents, who are mostly funded by Medicaid, he said.
“We are the highest percentage of Medicaid (patients) in the state of Washington … (but) fourth from the bottom on reimbursement,” Walsh said.
Stated otherwise, that means Delta Rehab has more Medicaid patients than most but less reimbursement. The formulas for determining reimbursement have changed, he said, which is a push-factor in their choice to close. But, they both added, it’s time to retire.