Advancing the Tradition of Catholic Senior Living Responding to...
Transcript of 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
Sponsored by
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
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
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
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
PRESENTERCarol Cassell
P A G E 4
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
Who Is ArchCare?
P A G E 5
ArchCare is the
Continuing Care
Community of the
Archdiocese of
New York
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
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
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
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…
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
ArchCare’s Ministry 2015
P A G E 9
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
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”
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
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
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
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.*
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
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
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
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
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
Care Navigation
P A G E 15
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
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…………
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
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
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
Living a Quality Life
P A G E 18
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
PRESENTERDiane Hood
P A G E 19
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
Successful Models for Home &
Community Based Services
P A G E 20
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
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
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
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
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
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
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
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
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
Hours of Service
P A G E 25
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
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
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
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
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 P A G E 28
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
PRESENTERTina Sandri
P A G E 29
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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 P A G E 43
Facilitated
Conversation,
Questions and
Answers
Responding to Changing Needs Through Service Innovation & New Models of CareSaturday, October 31st, 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
Carol CassellVice President Managed Care
Archcare
800.373.3177
www.archcare.org
Be Inspired.Tina SandiCEO
Carroll Manor
202.854.7807
www.provhosp.org
Robin EggertPresident and CEO
REALM
800.995.5184
www.realmgroupinc.com
Diane HoodCOO/CFO
Mary’s Woods at Marylhurst
503.675.2004
www.maryswoods.com