Advancing the Tradition of Catholic Senior Living Responding to...

A d v a n c i ng t h e T r a d i t i o n o f C a t h o l ic S e n i o r L i v i ng

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Responding to Changing Needs Through Service

Innovation & New Models of Care

October 31, 2015 / 3:15 PM

Responding to Changing Needs Through Service Innovation & New Models of Care

Saturday, October 31, 2015 / 3:15 PM

A d v a n c i n g t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g

Moderator:

Robin EggertPresident and CEO

REALM




Presenters:

Carol CassellVice President of Managed Care, ArchCare

Diane HoodCOO/CFO, Mary’s Woods at Marylhurst

Tina SandriCEO, Carroll Manor Nursing & Rehabilitation

Center

Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 2015 / 3:15 PM


PRESENTERCarol Cassell

P A G E 4




Who Is ArchCare?

P A G E 5

ArchCare is the

Continuing Care

Community of the

Archdiocese of

New York




Federal Reform – Affordable Care Act

New York State Medicaid Redesign

Shift in payment from government to providers and

payers

Shift from institutional care to home and community-

based care

Impact of social determinants

Value Based Purchasing – benefit design and

payment

Influencers of Transformation

P A G E 6




Where We’ve Come From

P A G E 7

Parish IntegrationArchCare

TimeBank

IDD PACE

Centers of Excellence for

Neurodegenerative Diseases PACE Alternate Care site

Mobile health clinic

Care Navigation Call Center

Community Resources

+

13 Counties 70% Home and Community-Based Care

6,000 Served Daily

2015: Together, We Can…




ArchCare’s Ministry 2015

P A G E 9




PACE a program of all-inclusive care for the elderly

ArchCare Positioning:

Leader and Learner

P A G E 10

Provider-sponsored comprehensive managed care

Federally-recognized model of care for frail elders

Monthly Medicare and Medicaid capitation

Comprehensive care Full range of Medicare and Medicaid services

Medical, restorative, social and support services

No limits, no co-payments, no deductibles

Interdisciplinary care team with day center as “hub”




PACE Philosophy

P A G E 11

Honors what frail seniors want:

To stay in familiar surroundings

To maintain autonomy

To maintain a maximum level of function

Physical, social and cognitive




Who Does PACE Care For?

P A G E 12

PACE serves individuals eligible for both Medicare and Medicaid benefits.

> 50% of dual eligibles are in fair or poor health, which is double the rate for other Medicare beneficiaries

⅓ of dual eligibles have significant limitations in activities of daily living, compared to 11 percent of other Medicare beneficiaries

The prevalence of chronic conditions is higher among dual eligibles

These individuals encounter numerous difficulties in coordinating benefits between the Medicare and Medicaid programs, and these coordination issues are often a major barrier to getting needed health care services.*




Scope of services is all-inclusive managed by an

Interdisciplinary Care Team (IDT) in an integrated,

effective and timely manner Primary care and medical specialty care

Home care / personal care

Home delivered meals

Transportation

Prescription drugs

Transitions across care settings

Advance care planning and end-of-life care

Emergency care

Acute care

Long-term care (including SNF)

How Does PACE Work?

P A G E 13




Population Health

Management

– Today and Tomorrow

P A G E 14

Yesterday/Today

Provider Focused

Today/Tomorrow

Patient/Person/

Population Focused

What matters

to you?

This is what I

can do for

you

EXAMPLES

Care Management

Personal Care Aides

Adult Day Care

Memory Care

Music Therapy

Home Environment

Social Supports



Care Navigation

P A G E 15



Time Bank

P A G E 16

Connects people in the

community to support

each other

Matches people with

time and skills to meet

each other’s needs

Services include

friendly visits, tutoring,

grocery shopping,

cooking and many

more!

Provided escorts to the doctor for 4

years for a 92-year old

Connected an ArchCare employee

with an 88-year old where he

regularly helps her with her computer

and smart phone, she critiques the

novel he is writing

88-year old poet led a workshop for

ArchCare employees on how to treat

older adults with dignity; also teaches

memoir writing to immigrants

Time Bank Members…………



Next Steps

P A G E 17

Enhance assessments embracing personalized care

Enhance care coordination with enabling technology

Pilot new interventions supporting home-based care



Living a Quality Life

P A G E 18



PRESENTERDiane Hood

P A G E 19




Successful Models for Home &

Community Based Services

P A G E 20




Continuing Care Retirement Community

Independent Living

Assisted Living

Special Care Unit

Marie Rose Center

Opened in 2001

439 Residents

80% in Independent Living

Mary’s Woods at Marylhurst

P A G E 21




Launched in 2009

Created to offer additional one-on-one support to residents

Organic growth model

Exclusively served clients residing at Mary’s Woods up until 2014

Mary’s Woods Home Care

Services

P A G E 22




Companion Care

General assistance with companionship, domestic housekeeping tasks, and

transportation services

Personal Care

Hands-on assistance with activities of daily living such as dressing,

ambulation, and hygiene

Complex Care

Our full-time Registered Nurses oversee caregiver assistance with complex

tasks such as catheter care, vital signs, and oxygen use

Medication Services

A state-licensed Comprehensive In-Home Care Agency, Mary’s Woods

Home Care Services provides a wide array of medication services

Levels of Service

P A G E 23




Organic Position Growth Registered Nurses

Personal Care Attendants

Operations Coordinator

Client Care Manager

Office Assistant

Caregivers (Personal Care Attendants)

Full-time and on-call caregivers

Full-time caregivers must provide 30, 32 or 40 hours of availability. Their hours are

guaranteed by providing availability that fits the need and by providing additional

training/shadowing options for caregivers to enhance customer service and client care

knowledge

On-call caregivers provide 20 hours of availability and can be promoted to full-time

based on fit and availability

All admininistrative staff are trained in caregiving and are expected to assist as needed

Secure partnerships with premier staffing agencies and other home care agencies

ensure we always say, “yes!”

Staffing Model

P A G E 24




Hours of Service

P A G E 25




Telephony

Employees clock-in, clock-out, record

mileage, and document using the client’s

home phone

Service Plans

Service plans are created and shared

through use of a central cloud-based software

Charting and Documentation

Documentation is recorded through the telephony system and stored in the

cloud for further analysis and review

Real Time Tracking

Late or missed time punches and incomplete service plan tasks are reported in

real time through the software dashboard, email, and SMS

Technology Integration

P A G E 26




Off-campus services initiated - thinking “expansion”

Bend, Coast line, Salem-growth opportunities

Market study

Develop a community outreach representative role

Community education and navigation services.

Continue building partnerships to provide all levels of service to

seniors

Branding – know your brand

Medicaid contract possibilities

Review and evaluate and regroup

Next Steps for Mary’s Woods

P A G E 27



A d v a n c i n g t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g P A G E 28



PRESENTERTina Sandri

P A G E 29




Urban hospital-based SNF in NE Washington, DC. 4th largest

nursing home in DC with 252 beds

Sub-acute rehab, long-term care, memory care, and independent

living for retired priests

Average age 85+ and ALOS 2.75 years

Strong census at 96-97%

Facility of choice for joy/care/respect, quality, robust activities

program, daily mass, rehab

85% Medicaid, 10% Medicare, 3% managed care

Carroll Manor Profile

P A G E 30




To nurture our community’s culture for

growth and reputation for quality while

existing under a struggling parent hospital No raises for many years

Internal and external wage inequity issues

Recruitment and retention issues

Poor access to capital for aging building

Lower priority to most acute growth initiatives like ED, MRI, COE

Collective bargaining organizations on the horizon at the hospital

What was in our abilities to foster growth?

The Challenge (Why)

P A G E 31




Innovation would surround processes rather

building new service lines or building and

grounds

Goals were to increase or grow:

Retention and recruitment

Quality

Employee morale

Marketability to hospitals

Growth Reimagined

P A G E 32




Multi-year journey to earn PTE in 2012– 4th in US and

1st in Catholic care

American Nurses Credentialing Center designates PTE

status for work environments where nurses can excel

PTE earned via evidence-based practices and individual

assessments for each nurse via survey

https://www.chausa.org/publications/catholic-health-

world/article/june-15-2014/carroll-manor-in-washington-

d.c.-earns-pathway-to-excellence-distinction

Pathways to Excellence

(What)

P A G E 33




1. Nurses control the practice of nursing

2. Environment is safe and healthy

3. Resident care and practice concerns are

addressed

4. Orientation prepares new nurses for the work

environment

5. DON is qualified and participates in all levels of the

organization

6. Professional development is provided and utilized

12 PTE Practice Standards

P A G E 34




7. Equitable compensation is provided

8. Nurses are recognized for achievements

9. A balanced lifestyle is encouraged

10. Collaborative relationships are valued and supported

11. Nurse managers are competent and accountable

12. A quality program and evidence based practices are

used

PTE Standards continued

P A G E 35




Grand champion: DON

All of nursing leadership

Department PTE Champions, including Administration

PTE Coordinator - gap analysis, timeline oversight,

education, document prep and data gathering, engagement

The PTE Team (Who)

P A G E 36




Increased intentionality in internal

communications – intranet, electronic bulletin

boards, newsletters, contests, fun/learning fairs

Developed shared governance structure to

participate in operations and impact work

environment to optimize resident-centered care

via internal councils

Notables from the Journey

P A G E 37




Nations 1st LPNs nationally board certified in

gerontology via grant funding at local college

Requires 1 year of experience, 16-hour review

coursework and national exam

24 CEUs every two years

NFLPN.org

More Notables…

P A G E 38




Admin/DON/organizational support

Strong nursing involvement and diversity of opinion

Resident-centered care and cultural change

CNA career ladders

Nursing leadership board-certified

Practice change via research and evidence-based

practices

Positive results from self-assessment

SWOT Strengths

P A G E 39




Refocus and modify practice standards

Increase autonomy and decision making

Leadership skills

Accountability and follow-through

Increase IDT collaboration

Staff engagement

Professional growth and development

SWOT Opportunities

P A G E 40




Cost to apply is $1,500

License fee based on # of beds - $22K for CM

Employee buy-in essential and leadership

willingness to nurture self-governance

Considerations to PTE Status

P A G E 41




innovation accelerator platform for

aging

A2DC events:

Technology and isolation

Speed dating – entrepreneurs, funding, providers,

government, academia, associations

On the Innovation Horizon

P A G E 42


A d v a n c i n g t h e T r a d i t i o n o f C a t h o l i c S e n i o r L i v i n g P A G E 43

Facilitated

Conversation,

Questions and

Answers



Carol CassellVice President Managed Care

Archcare

[email protected]

800.373.3177

www.archcare.org

Be Inspired.Tina SandiCEO

Carroll Manor

[email protected]

202.854.7807

www.provhosp.org

Robin EggertPresident and CEO

REALM

[email protected]

800.995.5184

www.realmgroupinc.com

Diane HoodCOO/CFO

Mary’s Woods at Marylhurst

[email protected]

503.675.2004

www.maryswoods.com

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