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Moving to STX and want to expand our business.  

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marmalex
(@marmalex)
Active Member

Hello,

My wife an I are seriously thinking of relocating and expanding our business to STX. We currently live and work in Las Vegas and operate a very small Elderly Home for Individual Residential Care out of our house. My wife is a Hospice RN, specializing in end of life care. We currently have a license in the State of Nevada to give such care. My question is has anyone heard of any laws pertaining to giving such care to persons in your home? Is a license required on STX. if so, who do i need to contact, and what are the number of beds allowed in such facilities? We are insured, bonded, and licensed to give such care here, however i know that license will not be recognized in the VI's. I can possibly travel to STX on Thursday of next week for a first PMV. I hate to sound like a mainlander, but i will have to cram as much into that initial visit possible. Hopefully to include:

Meeting a Realtor.
Shopping at a local grocery store.
Talking to as many locals as i can.
Finding any informational tools from the Health Department.
Finding a referral agency for Senior Placement.
Getting info for Broadband.
Potentially finding an agency to fill Nurse Aid openings.

We are very excited about this potential move. Any info would be greatly appreciated.

Thanks for your time,

Mike

ReplyQuote
Posted : February 24, 2012 2:17 am
Alexandra
(@Alexandra)
Trusted Member

Most of your medical and license related questions could likely best be answered by the hospital, health department and department of licensing. Nurses aides might be possible to locate through the nursing program at UVI, as they'd have a steady supply of new trainees who might want some work as they continue in the nursing program.

Your wife might also want to talk to one of the Travel Nurse companies to see if it makes sense for her to come initially as a travel nurse while the two of you pursue setting up your business licenses and get a property prepared to provide home health care services. That would assist your wife with getting plugged into the local heath care circle of influence so she could make the contacts necessary to work effectively in this facet of health care on the island. The travel nurse companies also assist with getting RN's their reciprocal license in the USVI so they can work here. Any help in such a process is invaluable!

Alexandra Bentley
Great House Real Estate
St. Croix, USVI

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Posted : February 24, 2012 4:55 pm
marmalex
(@marmalex)
Active Member

Alexandra,

Thanks for the response. These are questions we need to find out. We are wrestling around with the idea of her being a travel nurse. Which companies are located on the island if you know? We do have our business here as well. We were hoping to bring someone with us. We do not want to do anything illegally so everything must be in order before that happens. I know for a fact it took just over 6 months for our complete license here. Does anyone know how fast or slow the License Bureau takes in St. Croix? My hope was to rent out a large house for at least the first 6-12 months to orient ourselves with the communities. After that we really want to purchase a large house, 7+bedrooms if everything goes as planned.

Is it just better to stop in and see licensing? I have called but i know how government agencies can be.

I see you are in real estate, have you heard of any of "Group Homes" or "Residential Care Facilities", for the elderly on STX? We are not trying to be competition but we are curious as if they exist? Like i said, we would be bringing our own residents with us. I would hate to rent/buy a house and a license does not exist and we end up leaving before even moving there. We are just a young family, without huge bank accounts, looking to give the best care possible, with an excellent view, for our residents.

This has been our dream and any help is greatly appreciated. I have flight benefits so i could travel to STX soon, for an initial visit.

Thanks,
Mike

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Posted : February 24, 2012 6:28 pm
OldTart
(@OldTart)
Expert

Is it just better to stop in and see licensing? I have called but i know how government agencies can be.

I went through all the DIY hoops when I opened a business on St Thomas. Even though I'd already lived here for 11 years and knew many "in the know" people, it was a real chore, to put it mildly. In my first two years in business, I finally found a professional who, upon retiring from the Department of Licensing and Consumer Affairs, had thrown his expert hat into the family's long established business consultancy operation. When the annual business license renewal came around he would, for a very reasonable fee, get the required tax clearance letter from the IRB (Internal Revenue Bureau), complete the necessary paperwork, pick up my cheques to DLCA and the Department of Health and then promptly come and deliver my new license in due course.

I'd guess there are equally reputable business consultants on St Croix who perform the same services and their knowledge and expertise is well worth their fee. I would absolutely suggest that you go to the DLCA office on STX to see what you would need and then go from there.

Good luck and all the best!

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Posted : February 24, 2012 7:21 pm
Native Son
(@Native_Son)
Advanced Member

Contact Tracy Sanders, RN, at Continuum Care (340) 772-2273.

Nurse Sanders moved here to STX from LA some years ago with her husband (who is a doctor). She started a hospice called Continuum Care, and she will have answers for your questions.

Continuum Care took care of my mother and my wife's mother in our home until they passed away. The care was excellent.

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Posted : February 24, 2012 7:44 pm
Alexandra
(@Alexandra)
Trusted Member

in that kind of health care, it isn't a matter of competing. There is never enough space in such facilities to go around. I have heard of very little of that type of service on STX and it would likely be well received by life long islanders and transplanted elderly alike.

For most business licenses, the applicant has to live on the island for a period of time and provide local references from people who have lived here at least 5 years. It can be tough for new arrivals to arrange that.

One of the travel nurse companies that places people on STX is "Worldwide". The number I have for them is 866-633-3700

Alexandra Bentley
Great House Real Estate
St. Croix, USVI

ReplyQuote
Posted : February 24, 2012 8:54 pm
marmalex
(@marmalex)
Active Member

"For most business licenses, the applicant has to live on the island for a period of time and provide local references from people who have lived here at least 5 years. It can be tough for new arrivals to arrange that."

Do you know what the typical time period for business licenses are? References as well? And this is why i wanted to start now. Well it is great to meet all of you. It sounds like i need to start meeting you all, in person, very soon! It is good really. This way we can build all that trust over the next year. It is sounding like a travel position a temporary employment maybe the way to go. My wife is currently pregnant, so an immediate move is probably out of the question, as far as our health insurance is concerned.

Thank you all so very much. You have been a wealth of information already. If only the people here were so nice. That is one of the main reasons why we have decided to try and relocate to STX.

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Posted : February 24, 2012 9:45 pm
East Ender
(@east-ender)
Expert

I second contacting Tracy at Continuum. I have heard of a few group homes on St Thomas, but the problem is the pay source. Hospice and palliative care are very new concepts here.

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Posted : February 24, 2012 11:16 pm
Alexandra
(@Alexandra)
Trusted Member

When I applied for my real estate license, I had to have been on the island for at least 3 months. I had to provide 3 references from people who had lived on the island for 5 or more years each. I had it a bit easier than many new arrivals as my fiance had lived here for about 4 years at that time and we had a network of friends who had been here long enough that coming up with references didn't take too long.

You might be wise to make a PMV soon and make some contacts with long-time residents while you are here on your trip... then stay in touch with them when you go back to Vegas to plan your eventual move. By the time you head this way to live and apply for a biz license, you may have the contacts you need for the references necessary to apply for your licenses.

Networking is important in most businesses and it's especially helpful in the relocation process. Very few people move here with an extended family along for the new life. Transplants tend to adopt each other as extended family and to support each other in times of need and hang out on holidays together if they aren't able to spend them with family back home, etc.

Alexandra Bentley
Great House Real Estate
St. Croix, USVI

ReplyQuote
Posted : February 25, 2012 2:07 am
roadrunner
(@roadrunner)
Trusted Member

A business like yours is BADLY needed on STX. There is no inpatient hospice, and there is only one "home for the aged" (as the sign says).

Families end up taking care of their elderly relatives, and while that's an honorable thing to do, it often simply becomes too much for the family, who also need to keep their jobs, raise children, have a social life, accomplish things off-island, etc. (Even if they have nothing else going on in life, sometimes caring for an older adult is just simply not physically possible for the family, as I'm sure you know!) It is not uncommon for an elderly relative to be taken to the hospital by the family and for the family to not return to pick them up when the hospital deems them ready to go home. It's a horrible thing to do, yes, but I can also see how the demands on the family become too much and they don't know what else to do because the resources available on island are so minimal.

I hear that many families who are able to do so send their relatives to a stateside nursing home when the time comes. The one that exists on STX is perpetually full. It would be wonderful for people who were born and raised on island to know that they don't have to spend their last years in a strange place and for families to know their loved ones are well cared for and within easy visiting range.

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Posted : February 25, 2012 6:23 pm
ian112
(@ian112)
New Member

Hi Mike,

I don't know anything about opening a business here on STX, but I am a nurse and would like to pass on a little advice for your wife. The RN licensing process took about 3-4 months for me to hear back once I submitted it. They do make you jump through some hoops, such as having two letters of recommendation from your employer, pictures, etc. It would definitely be much easer to submit the paperwork from the States. Also, the Nurse Licenser Board is located on St. Thomas, so it is not a place you can just drop in and see how your paperwork is coming along, but I do recommend calling often to check on the status to ensure it gets looked it. It can be a very frustrating process if you are in a hurry to get it, so it is best to start early.

As far as travel nursing goes, the companies I spoke with didn't help to get your license down here, but would reimburse the $75 licensing fee once you secured a job with them. "RN Network" was a travel company recommended to me by a retired island nurse.

My husband and I only moved to St. Croix last August, so I can vividly remember having so many questions and uncertainties about Island life as a "mainlander." Our realtor, Sharon Early ( 340.719.2002) was a great help to us in finding the perfect house when we moved here. She is from the States, but has lived here for years and knows the island very well!

You mentioned you want to go to a local grocery store. I highly recommend Plaza Xtra. They have two locations, and usually have the best selection and prices. It takes a while, but once you get used to the stores you will realize that although they may not have the brands you are used to, they do have pretty much everything you need.

Feel free to personal message us with any other questions. Hope this helped & Congratulations on your pregnancy!

Amy

ReplyQuote
Posted : February 25, 2012 7:22 pm
Iris Tramm
(@Iris_Tramm)
Trusted Member

A business like yours is BADLY needed on STX. There is no inpatient hospice, and there is only one "home for the aged" (as the sign says).

Families end up taking care of their elderly relatives, and while that's an honorable thing to do, it often simply becomes too much for the family, who also need to keep their jobs, raise children, have a social life, accomplish things off-island, etc. (Even if they have nothing else going on in life, sometimes caring for an older adult is just simply not physically possible for the family, as I'm sure you know!) It is not uncommon for an elderly relative to be taken to the hospital by the family and for the family to not return to pick them up when the hospital deems them ready to go home. It's a horrible thing to do, yes, but I can also see how the demands on the family become too much and they don't know what else to do because the resources available on island are so minimal.

I hear that many families who are able to do so send their relatives to a stateside nursing home when the time comes. The one that exists on STX is perpetually full. It would be wonderful for people who were born and raised on island to know that they don't have to spend their last years in a strange place and for families to know their loved ones are well cared for and within easy visiting range.

Seconded. I can only imagine what is available here, and how inadequate -- if not outright awful -- it is.

In addition to just having options for us regular folk, high-end end-of-life care is going to be big business as the population ages and the Caribbean is the perfect place for it. STX has the space, the serenity, and a population that could be trained as hospice workers. It's really a shame we lost that regatta. I dunno what the story was there.

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Posted : February 25, 2012 7:32 pm
dougtamjj
(@dougtamjj)
Expert

The problem is that you won't get paid. I had my elderly mother here and had to keep her residency in the states to continue her medicare, medicaid. In our home state she qualified for home health care for eight hours a day in our home. Here nothing. She had COPD and in our home state her oxygen was covered as well as an oxygen consentrator. Here we had to pay for everything and provide all care including nursing ourselves. I did not leave my house here on St. Croix for two years because I could not leave her alone. Even in the states, all states are different. In South Carolina where my sister lives our mother could not get any home health care. She would have to go into a state run nursing home which is horrible. We had to take my mother back to our home state because her quality of life was horrible here and I was providing 24/7 on my own.

I don't mean to squash your dream but I cannot imagine you moving your clients here, finding doctors for them, being able to afford air conditioning, (which they would have to have), affording a huge house, being a young family, dealing with a new baby while trying to transistion your clients. It just doesn't sound fair to your clients to me. Not to mention if they have relatives that may want to visit them. Plane fare is crazy exspensive to St. Croix.

Just my opinion.

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Posted : February 26, 2012 1:29 am
Native Son
(@Native_Son)
Advanced Member

The problem is that you won't get paid. I had my elderly mother here and had to keep her residency in the states to continue her medicare, medicaid. In our home state she qualified for home health care for eight hours a day in our home. Here nothing. She had COPD and in our home state her oxygen was covered as well as an oxygen consentrator. Here we had to pay for everything and provide all care including nursing ourselves. I did not leave my house here on St. Croix for two years because I could not leave her alone. Even in the states, all states are different. In South Carolina where my sister lives our mother could not get any home health care. She would have to go into a state run nursing home which is horrible. We had to take my mother back to our home state because her quality of life was horrible here and I was providing 24/7 on my own.

I don't mean to squash your dream but I cannot imagine you moving your clients here, finding doctors for them, being able to afford air conditioning, (which they would have to have), affording a huge house, being a young family, dealing with a new baby while trying to transistion your clients. It just doesn't sound fair to your clients to me. Not to mention if they have relatives that may want to visit them. Plane fare is crazy exspensive to St. Croix.

Just my opinion.

Like I said, please call Tracy.

My mother AND my mother-in-law were both taken care of by Continuum Care. My mother-in-law had long-term health insurance, and my mother did not. Both were on Medicare/Medicaid.

At no time did Continuum have trouble getting paid. The nurses who came to my house, and the aides, were extremely professional...they became like part of the family, and even attended the funerals.

Continuum procured hospital beds, oxygen, medications...the full gamut of services. WE had absolutely NO issues.

If people want to haggle about the price of air fare when a family member is dying, they should NOT visit. When our moms passed away we had family come from as far away as Israel. If people care, they will come. If they care more about their wallet they should stay away.

WE NEVER paid a penny out-of-pocket for caring for our moms, who both passed away within a year of each other...my mom was 91 and died of congestive heart failure, and my mother-in-law had Alzheimers.

Do not let anyone scare you away. Talk to Tracy, she's in the business.

It was a very difficult time for both me and my wife, and without people like yourself we would have been even worse off. Thank God for hospice workers.

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Posted : February 26, 2012 10:17 am
East Ender
(@east-ender)
Expert

Again, funding is a problem. Home health care and hospice benefits under Medicare, are for intermediate, not total, care. In the VI, this includes Seaview home care and Premier, if they are still around, Continuum and La Paz Hospices. But someone has to take responsibility for that person during the hours home care is not there. Inpatient rehabilitation and skilled nursing care are paid through Medicare (not
Medicaid, which is called medical assistance here) with a cap and a co-pay. Medicare does not pay for long term care. Medical assistance pays for long term care in a certified facility. The territorial facilities, Herman Grigg and Queen Louise, provide 24 hour nursing care care but are not CMS certified. They are funded through the territorial government. Seaview is the only facility that is certified by CMS for medical assistance patients, and the number is capped by them at around 20 residents, although the facility was initially built for 60. That means that in a territory of around 120,000 people, there are 20 beds for citizens who need 24 hour care.

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Posted : February 26, 2012 11:43 am
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