Hospital hopes new housing can ease ‘Nantucket Shuffle’

As part of a major renovation of Nantucket Cottage Hospital, 83 units of housing are being built to recruit — and keep — critical workers.Craig F. Walker/Globe Staff

NANTUCKET — Pauline Skok was struck by the beauty of this island the first time she stepped off the ferry, on a work assignment in 2016. So after years of working as a traveling nurse, she decided to take a job at Nantucket Cottage Hospital.

Skok knew that this summer playground of the upper crust, with its historic charm and picture-perfect beaches, had a shortage of affordable housing. But she was not prepared for the struggle she would face next.

The veteran nurse wanted a stable, year-long lease — but instead drifted through eight residences over two and a half years. Every time she moved, she wondered: “How much more can I do?”

Skok’s experience is so common that it has a name — “the Nantucket Shuffle” — and the local hospital, a major employer on the island, is taking an unusual step to address it.

Hospital officials plan to build up to 83 units of housing for staff across the street from a completely rebuilt hospital building, which will open to patients next month.

They hope their new apartments, which still need local approval, would help them attract and retain staff while providing a new option for some of the workers — middle-income families upon whom this island economy relies.

“We can’t wait,” said Dr. Margot Hartmann, chief executive of Nantucket Cottage Hospital, a rural facility with about a dozen beds and 250 employees. “If the town and the community don’t solve [the housing crisis], it’s still one of the threats to our mission.”

Nantucket’s housing conundrum stems from several factors. Rental units are hard to find, and when they’re available, they can be pricey. (Think $3,000 a month and up for two bedrooms.)

Landlords of even modest apartments and cottages don’t have much incentive to offer annual leases; they can charge so much in the busy season that a three-month summer rental can be as profitable as a moderately priced 12-month lease.

More than half of the land on the island is preserved, so building isn’t allowed there. And there’s the NIMBY element: When housing projects are proposed, neighbors don’t always warm to them. A plan to build 64 apartments on town-owned land — a mix of affordable and market-rate units — is currently stalled in court.

Home prices on Nantucket have grown at a much swifter pace than even the hot Boston market, said Tucker Holland, the town housing specialist. Those looking to buy a home find very few options under $1 million.

“There’s been a real erosion of year-round housing stock,” Holland said. “If somebody local here wants to buy . . . we’re competing against the seasonal buyer who maybe works on Wall Street or the investor who wants to purchase and rent it out on Airbnb.”

So members of the middle class sometimes bounce from one temporary residence to the next, never quite feeling settled.

At one point, Skok, the nurse manager at Nantucket Cottage Hospital, rented a basement apartment. Going “home” meant inching down a narrow staircase, diverting her eyes from the spiders on the walls, and sitting in the dark.

“It was to the point where I’m not sure I can do this anymore,” said Skok, 59. “I came to work in tears.”

She later found a comfortable cottage but was forced to move out this summer when her landlord decided to put the home up for sale. At the next temporary apartment, she had trouble sleeping through the sounds of mice in the walls.

Skok eventually found another cottage where she secured a one-year lease and now pays more than $2,000 a month for one bedroom.

Many of Nantucket’s wealthier residents are aware of the island’s housing problem and have written big checks to try to solve it.

Bruce A. Percelay, a Boston developer who owns a home on the island, donated $10 million to Nantucket Cottage Hospital in 2016 with this string attached: The hospital must develop housing for its staff. Percelay and his wife, Elisabeth, have two young sons who were born at the hospital.

“There is a shadow market here of low-quality, low-cost housing,” he said. “It is unfortunately where a lot of people with no alternatives go. And we don’t want our nurses, our staff, going there.”

Pauline Skok, a nurse manager at the hospital, could not find reliable long-term housing. “It was to the point where I’m not sure I can do this anymore,” she said. “I came to work in tears.’Craig F. Walker/Globe Staff

The $120 million project to build a new hospital and employee housing is funded almost entirely by donors, including wealthy titans of tech and finance who spend their summers on the island. Ten million dollars also came from Massachusetts General Hospital, which is affiliated with the Nantucket hospital and belongs to the same parent company, Partners HealthCare.

The current island hospital building is 61 years old and showing its age. The heating, cooling, and water systems are costly and inefficient. The building has only one operating room, so procedures must be postponed every time a patient is in labor and might need a caesarean section. There is little privacy for patients or staff.

The new hospital building, more than 100,000 square feet, was designed to solve these issues.

The hospital serves year-round residents who need or want to stay on island for primary care, maternity care, minor surgeries, and other services. But there are days when weather makes it impossible for anyone — even those with private jets and yachts — to make the 30-mile journey to the mainland. So Nantucket’s doctors and nurses must be ready to respond.

Dr. Frank O’Connor, a surgeon on the island, recalled a patient who severed his thumb in an accident earlier this year.

“They couldn’t fly him out because the weather was horrific, so I had to take him to the OR and reattach his thumb as best I could,” O’Connor said. The patient went to Boston for surgery the next day.

“The fact is, there isn’t always the option to go elsewhere for health care when people live on an island,” Nantucket philanthropist Wendy Schmidt said in an e-mail. Schmidt and her husband, former Google CEO Eric Schmidt, donated $5 million to the island hospital.

Nantucket’s housing problem has many local employers searching for solutions. David W. Martin, chief executive of the Nantucket Island Chamber of Commerce, has daily conversations with business leaders about housing. “It’s probably the most discussed topic,” he said.

Like the hospital, some employers have decided to build their own housing. For Nantucket Community Sailing, the costs of renting houses for sailing instructors increased so rapidly that the nonprofit organization decided to build a dorm. The $2.4 million project is scheduled to be completed next year.

Hospital officials routinely have to find housing for traveling nurses, visiting physicians, and other staff. They currently own or manage about 30 older units of housing, a mishmash of single-family homes and duplexes.

But these units are not designed for the hospital’s needs, and space is often wasted, with just one person taking up a two- or three-bedroom home, said Christopher Glowacki, the hospital’s managing director of strategy and development.

The new apartments that hospital officials are planning to build are for temporary workers and employees transitioning from temporary to permanent jobs. They will be one-bedroom units that can be combined, if needed, to create larger apartments — similar to an extended-stay hotel.

Hospital officials hope the housing project will win approval from local officials and construction work can begin, in 2019.

“We’ve lost a lot of people we’ve recruited — people who said, ‘Yeah I’d love to come.’ Then they spend three weeks looking for housing, they say ‘No, I can’t find a place to live,’ ” Glowacki said.

It’s a problem even for the higher-paid members of the staff, including O’Connor, the surgeon, who was recruited to Nantucket last year.

O’Connor spent 26 years in the Navy and is now one of two full-time general surgeons on the island. He hopes to grow his practice in the new hospital, where the operating rooms will allow for more frequent and more advanced procedures.

But for O’Connor, too, the decision to move to this island hinged on finding a place to live. He and his wife bought a house for about $1.4 million.

“The hospital actually gave me a down payment for a house,” O’Connor said. “Otherwise, I probably wouldn’t have come here.”