Some people spend their entire lives on Nantucket island. But when it comes to the final years, their options can get pretty limited.

Nantucketer Fran Karttunen spends about seven hours a day with her husband at Nantucket's only skilled nursing facility, Our Island Home. And the first thing she wants to show me when I walk in? The view out the window.

“We're looking straight across the Salt Marsh, the creeks, to Brant Point, and the red light comes on just at sunset,” said Karttunen. “And we also have a very good view of the tides rising and lowering.”

The view is beautiful. But Our Island Home has major problems. It was built by the town more than thirty years ago, and its in really rough shape. Almost everything has issues: the roof, the electrical system, the plumbing, fire safety—it needs to be rebuilt. But the question is: where?

“That's the thing about being an island is that we can't just use a facility down the round in a neighboring town. We have to provide here,” said Karttunen.

Last fall, Nantucket's town government started planning a new Island Home. It would be much harder and more expensive to rebuild the facility on site. So, the town is considering moving the Island Home inland next door to Sherbourne Commons, an assisted living facility in the pine woods on the south side of the island. But for some Nantucketers, the Island Home's waterfront view is invaluable. But for Karttunen, the Island Home's waterfront view is invaluable.

“I felt that this siting is really strongly therapeutic to the residents here,” said Karttunen. “And I felt that perhaps there was some lack of imagination on the part of the people who were planning to move this facility basically out into the scrub pines.”

So, Karttunen started a petition on The title? “Our Seniors Need A View! Keep Our Island Home Where It Is!” To date, more than 500 people have signed it.

“I mean anybody would wanna look at that view,” said Nantucket town manager Libby Gibson.

She's involved because the Island Home is owned and operated by the Town. That's unusual. It's one of the only municipal nursing homes left in Massachusetts, and it operates at a huge loss: about $4 million every year. The island's tax-payers pick up the bill. For the town, Gibson said,  it can't be all about the view.

“Can it be more efficient? And cost-effective? It's a big project either way, $30 or more million dollars,” Gibson said.

Some aren't so sure the view is so important. Like Gail Ellis, director of nursing at Our Island Home. She's observed that just a small percentage of residents actually spend time looking at the view.

“I would say less than a quarter,” Ellis said. “I mean staff, visitors, are the people who love it the most. The people that live here, it's all about what their lives are like. Not where they're living their lives.”

This winter, the town hired consultants to help with the decision. In March, those consultants recommended relocation away from the waterfront. That's because the facility is at risk of storm surge from hurricanes. Jude Rabig was one of the town's consultants. She says that after Hurricane Katrina, that's a deal-breaker for the state.
“The government scrutinizes the site that you're proposing to use. We experienced with Katrina death to people in nursing homes who were subjected to water.. And the inability to move those people, to evacuate them, created havoc,” Rabig said in a presentation to Nantucket's Board of Selectmen.

Still, many people weren't convinced. Couldn't the town try raising the elevation of the site? Or lifting the building? But director of nursing Gail Ellis thinks the inland site at Sherbourne Commons is probably the best option.
“I think the Sherbourne site is... do I feel that that's a compromise? Yes. Do I think it's the safest and healthiest compromise? Yes. Would I miss this site? Oh, most certainly,” said Ellis.

Nantucket's Board of Selectmen is set to make a decision on the location at their meeting this week. After that, the island's voters will get their say at an upcoming town meeting.