Solving Challenges with Collaboration: Catholic Senior...
Transcript of Solving Challenges with Collaboration: Catholic Senior...
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 i c S e n i o r L i v i n g
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Solving Challenges with Collaboration: Catholic Senior
Living + Women Religious Congregations
October 27th, 2018 / 1:30 PM
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 i c S e n i o r L i v i n g
Facilitator:
Nancy HooksVP of State Partnerships
LeadingAge
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 i c S e n i o r L i v i n g
Presenter:
John BarnumSVP & CFO
Liberty Lutheran
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 i c S e n i o r L i v i n g
Presenter:
Sr. Sandra Schmidt SBSCouncilor
Sisters of the Blessed Sacrament
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 i c S e n i o r L i v i n g
Liberty Lutheran7002 Butler Pike
Ambler, PA 19002
Incorporated in Pennsylvania 2001
Parent company and sole member that
provides oversight and management
services to Affiliates
Budgeted revenue $82,500,000
Active employees approximately 1,200
425 Independent Living apartments
18 Independent Living cottages
238 Personal Care beds
217 Skilled Nursing beds
80 Assisted Living apartments
978 Total
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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 i c S e n i o r L i v i n g
Paul’s Run9896 Bustleton Ave
Philadelphia, PA 19115
Incorporated in PA 1977
Life plan community
223 Independent Living
apartments
100 Personal Care beds
120 Skilled Nursing beds
Active employees 399
Artman250 N Bethlehem Pike
Ambler, PA 19002
Incorporated in PA 1916
Life plan community
126 Personal Care beds
(includes 19 Memory Care
beds)
61 Skilled Nursing beds
Active employees 253
Mary J Drexel Home d/b/a The Hearth at Drexel
238 Belmont AvenueBala Cynwyd, PA 19004
Incorporated in PA 1887
Acquired January 2008
80 Assisted Living beds
(including 20 Memory Care
beds)
20 beds Memory Care
Active employees 95
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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 i c S e n i o r L i v i n g
Liberty Lutheran Housing & Development Corp d/b/a
The Village at Penn State260 Lions Hill Road
State College, PA 16803
Incorporated in PA 2002
Acquired June 2012
Life plan community
138 Independent Living apmts.
18 Independent Living
cottages
12 Personal Care beds
36 Skilled Nursing beds
Active employees 160
Liberty Village d/b/a The Manor at York Town
2010 York RoadJamison PA 18929
Incorporated in PA 2015
Acquired October 2017
64 Independent Living
apartments
Active employees 50
Liberty Community Services d/b/a
Liberty at Home250 N Bethlehem Pike
Ambler, PA 19002
Incorporated in PA 2005
Home Health, Home Care,
and Hospice Services
Active employees 124
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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 i c S e n i o r L i v i n g
LCFS7002 Butler PikeAmbler PA 19002
Incorporated in PA 1966
Agency that provides services
to senior citizens through the
West Philadelphia Senior
Center and In Home Support
Program
Active employees 23
Lutheran Congregational Services
1923 Hanover AveAllentown, PA 18109
Incorporated in PA 1973
Acquired July 2010
A social ministry
organization providing
education and facilitation of
ministries
Active employees 2
Liberty Lutheran Foundation
250 N Bethlehem Pike Ambler, PA 19002
Incorporated in PA 1991
Responsible for the
implementation and
administration of fund
development and investment
management
Active employees 3
4
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 i c S e n i o r L i v i n g
July 2016 Sisters of the Society of the Holy Child Jesus
▪ Agreement still active
▪ Initial move-in of approximately 6 sisters to The Hearth at Drexel,
assisted living
▪ Additional move-ins ongoing as needed and available for the future
January 2017 Sisters of the Blessed Sacrament
▪ Agreement still active
▪ Initial move-in of approximately 50 sisters to Paul’s Run, all levels
of care
▪ Additional move-ins ongoing as needed and available for the future
Liberty’s Experience in Collaboration
with Realm Group
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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 i c S e n i o r L i v i n g
▪ Preliminary Planning
▪ Internal congregational processing
▪ Tours of a variety of communities
▪ Final selection of community
▪ Consultant Assistance
▪ Oversite of process – Realm Group
▪ Movers
▪ Room design / Furniture assistance
Highlights of the Coordination Process
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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 i c S e n i o r L i v i n g
▪ Detailed Agreement
▪ Rates
▪ Services and Community Life
▪ Third party reimbursement (Medicaid process)
▪ Level of care determination / Assessments
▪ Transition of Sisters
▪ Executive Director, Katrina Wise, and Realm direct
day-to-day involvement
▪ Controlling available units
▪ Staff / Prior care givers / Job fair
Highlights of the Coordination Process
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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 i c S e n i o r L i v i n g
Presenter:
Mary Alice RyanPresident & CEO
St. Andrews Resources
for Senior System
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 i c S e n i o r L i v i n g
▪ Faith based NFP – affiliated with Giddings Lovejoy Presbytery, Episcopal Diocese of St. Louis, & the United Church of Christ’s regional Missouri Mid-South Conference
▪ 20+ communities in Mo and IL
▪ Home and Community Based Services
▪ Serves 10,000 seniors and their caregivers a year
St. Andrew’s Resources for
Seniors System
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 i c S e n i o r L i v i n g
I. The Sarah Community –St. Louis
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 i c S e n i o r L i v i n g
▪ Franciscan Sisters of Mary convened a meeting of
local religious women congregations, (1) describing a
common need to relocate the care given to their
senior and infirm sisters and (2) to explore the
possibility of working together towards a solution.
▪ Reasons to relocate included (1) an increase number
of Sisters needing a higher level of care, (2) increased
staffing costs, and (3) the sale of property.
▪ 5 leadership representatives from 4 congregations
were present at first meeting.
▪ Listed various needs &
▪ how they might work together in addressing them.
Our Journey began in 1996
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 i c S e n i o r L i v i n g
▪ The Daughters of Charity of St. Vincent de Paul,
▪ Franciscan Sisters of Mary,
▪ Society of the Sacred Heart,
▪ School Sisters of Notre Dame,
▪ and Sisters of Loretto.
The Sarah Community Founding Members
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 i c S e n i o r L i v i n g
▪ Established committee structure:
▪ Legal, Research, Facilities, & Financing and
Services
▪ Potential grants were discussed.
▪ Each committee discussed what information
they needed to proceed.
▪ Attorney present -- legal challenges.
▪ Discussion with SSM DePaul Hospital on
facilities and land available.
Year One
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 i c S e n i o r L i v i n g
▪ Education on the development process
and what it involved
▪ An exercise with the interested members:
▪ what they are envisioning,
▪ what do they want to accomplish,
▪ how they see moving forward,
▪ what are the challenges and opportunities,
▪ what time and money is available,
▪ and how to organize the group.
Year One (continued)
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 i c S e n i o r L i v i n g
▪ Over the next months
▪ Looked at legal models.
▪ Discussed financing potential/models & financial input from group.
▪ Reviewed state and federal regulations.
▪ Hired actuarial study on potential usage by orders.
▪ Reviewed information from Intercommunity project in Chicago.
▪ Looked at potential sites.
▪ Began timeline.
Year One (continued)
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 i c S e n i o r L i v i n g
▪ An inter-congregational endeavor.
▪ Open to the laity.
▪ Provide a continuum of care.
▪ Design would promote community life, including a chapel and common open space which would double as space for individual congregational gatherings.
▪ Clarified this was a collaboration of five religious congregations and not connected to the archdiocese; however did meet with the archbishop to communicate what we were doing and why.
Decisions Made
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 i c S e n i o r L i v i n g
▪ Budgets.
▪ Certificate of Need process.
▪ Market feasibility study.
▪ RFP for architectural firms.
▪ Finalized legal structure.
▪ Continued financing discussions.
▪ Began plan for start up of operations and
marketing.
▪ Finalized architectural plan, interior design,
and construction documents.
Year Two
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 i c S e n i o r L i v i n g
▪ Received cost estimates for all parts of
project.
▪ Issued tax exempt and taxable bonds.
▪ Began construction and renovation.
▪ Visited with orders to explain project.
▪ Visited with employees of orders to talk about
potential jobs.
▪ Worked closely with representatives of health
system on how they would partner .
▪ Plan for moving in sisters.
Year Two (continued)
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 i c S e n i o r L i v i n g
Opened in January 1999
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 i c S e n i o r L i v i n g
▪ Consultant throughout the process.▪ Program design.
▪ Worked with congregations on their planning for informing their members about project, on how to meet the special needs of religious members, and on forming the NFP entity.
▪ Facility Design.
▪ Coordinating all team members (attorneys, architect, contractor, interior designer, etc.).
▪ Operational budgets.
▪ Assisted with planning and execution of financing (Tax Exempt Bonds).
St. Andrew’s Involvement
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 i c S e n i o r L i v i n g
▪ Retained as Management Company:
▪ Refined operational budgets.
▪ Planned and executed marketing campaign.
including all marketing materials and ads.
▪ Worked with congregations on moves into the
community.
▪ Hired and trained initial staff, including Executive
Director.
▪ Worked with local discharge planners at hospitals.
▪ Set policies and procedures.
St. Andrew’s Involvement (continued)
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 i c S e n i o r L i v i n g
Anna (SNF) 44 of 110 40%Veronica (ALU) 43 of 98 44%Naomi (ILU) 26 of 112 23%Total 113 of 320 35%
▪ School Sisters of Notre Dame, Franciscan Sisters of Mary, and Daughters of Charity have the largest number of Sisters (in that order).
▪ In addition to those Sisters listed we currently have two Carmelite Sisters and a Sister of the Most Precious Blood.
# of Sisters at The Sarah Community
Today
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 i c S e n i o r L i v i n g
II. St. Andrew’s at Francis Place
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 i c S e n i o r L i v i n g
▪ Mr. Bernard Huger of Greensfelder, Hempker and Gale
approached St. Andrew’s with this opportunity.
▪ He had been in contact with the Franciscan Brothers.
▪ Franciscans built and operated Price Memorial nursing
home in the city of Eureka, MO for over 30 years.
▪ Price Memorial was a Five Star Skilled Nursing Home.
▪ Only five brothers left in this Province, all of retirement
age, and they were interested in finding the right
sponsor to assume their mission.
▪ They were willing to give the facility to a not-for-profit
organization that would keep its Catholic heritage.
St. Andrew’s at Francis Place (cont.)
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 i c S e n i o r L i v i n g
▪ Mr. Huger was also in contact with the
Ursuline Sisters who were looking for a new
location for their sisters who require skilled
nursing home care (SNF).
▪ The Sisters were very interested in the
opportunity but stated from the beginning
that they did not operate or wish to operate
licensed nursing homes.
St. Andrew’s at Francis Place (cont.)
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 i c S e n i o r L i v i n g
▪ Brothers gave facility to the Ursuline Sisters
and St. Andrews in 2014.
▪ Sisters’ sponsorship met the requirement that
this stay a Catholic affiliated community.
Received canonical approval from the
Archbishop of St. Louis.
▪ Financial:
▪ Ursuline Sisters invested $$.
▪ St. Andrew’s did all development consulting
services as their contribution of ‘sweat equity”.
Details of the Arrangement
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 i c S e n i o r L i v i n g
▪ Ursuline Sisters and St. Andrews each a Member.
▪ 50-50 sponsorship with certain reserve powers for each. Ones of most interest are:
▪ St. Andrew’s makes decisions on the operation of the facility.
▪ Sisters make all decisions needed to keep it as a Catholic institution.
▪ The board members:
▪ 5-7 members.
▪ St. Andrew’s will always have one more than the Sisters.
Legal: Sponsorship and Board
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 i c S e n i o r L i v i n g
▪ Price Memorial requested that if the facility is
sold within five years from the turnover
(2014), they will recoup the money from the
sale after repayment of any debt (Ursulines,
St. Andrew’s and any outstanding loans).
▪ The amount will be on a sliding scale basis,
20% declining every year.
▪ Brothers leased their home on campus for $1.
Arrangement with Franciscans
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 i c S e n i o r L i v i n g
▪ Health Navigator is a full time LPN who supports
the coordination of health services for the 50+
age Sisters of a women’s religious order.
▪ Services provided:
▪ Hands-on care is not provided but coordination
and oversight of care needs.
▪ Conducts assessment to track baseline health
issues and progression.
▪ Conducts in-home safety assessments..
▪ Communicates changes to assigned liaison.
III. Navigator Program
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 i c S e n i o r L i v i n g
▪ Individualized health care plans.
▪ Educational programs & activities for healthy
lifestyle choices.
▪ Accompanies sisters to physician
appointments. Visits, if in hospital, and acts
as advocate.
▪ Conducts a holistic, systematic, ongoing and
criterion-based evaluation of work being done.
Navigator Program (continued)
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 i c S e n i o r L i v i n g
Presenter:
David NolanChief Operating Officer
On Lok / PACE
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 i c S e n i o r L i v i n g
▪ Preventive care
▪ Primary care
▪ Medications
▪ Acute care
▪ Transportation
▪ Meals
▪ Medical Specialists
What is PACE – Comprehensive services
for the frail elderly
▪ Dental
▪ Emergency Care
▪ Behavioral and mental health
▪ Long-term care, including nursing facility when needed
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 i c S e n i o r L i v i n g
▪ Capitation funding (per member per month):
▪ Combines Medicare, Medicaid and private payments
▪ Program has full financial risk
▪ Alignment of care needs and financial interests
▪ Monitors elders closely – takes action early to restore health, and control cost
What is PACE (cont.)
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 i c S e n i o r L i v i n g
Who does PACE serve?
▪ Eligibility:
▪ 55 years or older
▪ Resident of PACE
service area
▪ State-certified to need
nursing home level
care
▪ Can live safely in
community at time of
enrollment
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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 i c S e n i o r L i v i n g
▪ Seek out and advocate for the poor and
needy especially families
Dominican Sisters of Mission San Jose
▪ To stand in solidarity w/young, poor and
vulnerable
Both seeking solutions to aging population
Sisters of the Holy Family Fremont
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 i c S e n i o r L i v i n g
▪ Leadership
▪ Collaboration between orders
▪ Change management
▪ Physicians – Transition to On Lok docs
▪ ADHC attendance
▪ 24/hour staffing
▪ Understanding each other’s culture
▪ Bringing larger community onto the campus
Challenges
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 i c S e n i o r L i v i n g
▪ This experience changed us
▪ Small population required adaptation
▪ Changing populations being served
▪ Behavioral health, substance use
Perspective
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 i c S e n i o r L i v i n g
Thank you.John BarnumSVP & CFO
Liberty Lutheran
www.libertylutheran.org
Mary Alice RyanPresident & CEO
St. Andrews Resources for Senior System
www.standrews1.com
David NolanChief Operating Officer
On Lok / PACE
www.onlok.org
Sr. Sandra Schmidt SBSCouncilor
Sisters of the Blessed Sacrament
www.katharinedrexel.org
Nancy HooksVP of State Partnerships
LeadingAge
www.leadingage.org