Piñon Management’s success in long–term care operations is fueled by a fundamental commitment to a basic premise that recognizes and values each individual we serve and work with. Programs implemented by Piñon Management have been recognized by Departments of Health, ombudsmen and provider agencies in several states for their innovative approach to improving quality of life and quality of care for the residents they serve. Following is a chronological look at some of our success stories.
For the second issue in a row, a CHCA member community has been featured in AHCA/NCAL’s Provider Magazine.
Rowan Community’s employee recognition programs were featured in the November Provider article: Recognition and Gratitude Make Big Impact.
The Denver, Eden Certified, Pinon facility has implemented programs to boost employee satisfaction. “It’s really the little things that make a difference,” says Maxine Roby, Rowan’s administrator. Among other things she has hired a massage therapist for two hours each week to give rub downs to facility staff on the house.
“It’s a great morale booster,” says Roby.
Also simple, but not obvious, is nourishment. “there’s always food for staff in the lounge,” she says. We make sure extra meals are in there so that staff can get lunch or dinner.” In addition, the facility maintains a pantry of donated food items for staff to discreetly take home, no questions asked.
An employee no-interest loan program is another perk for Rowan employees. “It’s not been used very often, and it has never been abused,” says Roby, who recognizes some people need a little extra help, especially in this economy. “we’ve never had problems getting the money paid back, and its handled with confidence.”
Another hit with staff is the facility’s on-site barber shop and beauty salon, which serves both residents and employees. “They do waxing, cuts, color, manicures and pedicures,” Roby says. “It’s very convenient for staff members.”
Consistent assignment and self-scheduling policies have garnered high approval ratings from staff, Roby adds.
“We treat our employees the way we would want them to treat the residents,” she says. “We give as much empowerment and leeway to staff as we can because we ask so much of them in return.
Rowan’s tuition program covers up to $1500 for employees to attend classes related to their jobs. The facility recently sent three CNAs to anew Eldercare Specialist certificate program at Arapahoe Community College in Littleton. The program is designed to expand the traditional role of the CAN so they become specialists in working with elders. The certificate program addresses leadership principles, such as decision making, problem solving, and conflict resolution. Rowan covered the cost of tuition as well as transportation and books for the CNAs.
Roby emphasizes that being very selective about who she hires also makes a big difference in the long run. While she admits the benefits are not the best, she never recruits someone who is more interested in pay scale.
“If all you offer is money, then it’s meaningless,” she says. “We are very selective in our hiring process.”
On June 30, 2009, Piñon Management completed a successful one-year project with the Fort Bayard Medical Center in Silver City, New Mexico. Piñon was brought in by the New Mexico Department of Health to serve in a management⁄consulting role in this state-operated nursing home to assist in regulatory compliance education and system development. Piñon Management was recognized by government officials for clinical systems put in place as well as contributing to greatly improved surveys.
Piñon Management was instrumental in hosting a “Culture Change 101” seminar on February 9, 2009 in Albuquerque, New Mexico in partnership with the Innovation Network (New Mexico’s culture change coalition), the New Mexico Health Care Association and the New Mexico QIO. Over 100 participants from the health department, ombudsmen and provider community from skilled nursing and assisted living were in attendance to listen to presenter Nancy Fox, Piñon’s Chief Life Enhancement Officer and former Executive Director of the Eden Alternative.
Piñon Management was hired in July 2008 to serve as operator and manager of the New Mexico state facility, Fort Bayard Medical Center, to assist in restoring Medicaid certification, developing leadership strategies and implementing operational systems. Piñon was successful in immediately providing an Interim Administrator and Director of Nursing team, regaining Medicaid certification and funding through successful compliance surveys, assisting in recruitment and hiring permanent leadership staff and implementation of a model operational system. Piñon was able to bring in a team of qualified consultants to assist in operational, administrative, financial, culture change, social work, admissions, dietary, human resources, activities and health information as part of this turn–around project. Piñon has been successful in moving the program forward and will transition leadership back to the State of New Mexico in March 2009.
Piñon Management serves as ongoing consultant for the State and Veterans Nursing Homes in Colorado, providing monthly consultative work in a variety of operational areas in each home. Piñon was initially hired by the State of Colorado Department of Human Services to serve as Temporary Manager for the state’s new Veterans Nursing Home at Fitzsimons. The facility was facing decertification by Centers for Medicare and Medicaid (CMS) and was besieged with regulatory, fiscal, personnel and care issues. Collaborating with the Colorado Department of Human Services, Piñon was successful in immediately putting quality care systems in place, regaining State and VA compliance and improved surveys and was successful in all key operational areas: collecting nearly $2 million in accounts receivable, filling over fifty open positions which included hiring a quality internal management team, increasing census by over 50% and rebuilding public and Veteran community trust and support of the facility.
In 2003, the New Mexico Department of Health requested Piñon Management to serve as Deputy Receiver for the Los Amigos Care Centre in Santa Rosa, New Mexico, a HUD Property. Facing closure or potential sale, the facility was financially insolvent, had no licensed Nursing Home Administrator and limited community resources. Piñon Management came into the facility with a few days notice and provided onsite management and an Interim Administrator for seven months. Piñon staff aggressively worked on financial damage control, getting the facility Medicaid billing in place, completing minimum data set (MDS) assessments and establishing collection measures of unpaid accounts. Piñon staff assured quality of care for residents, provided daily staff oversight and worked with the Department to assess potential buyers for the facility. Piñon staff worked with the Department, Board of Directors, community and ombudsman in the eventual decision to close the facility, providing hands–on work to assure full regulatory compliance with receivership and closure statutes.
In addition to assistance in repositioning and stabilizing skilled nursing and assisted living homes, Piñon Management partners with many providers to offer pre–surveys, technical consulting in regulatory–required areas and ongoing education and training to staff. Key successes include:
In 2000, Piñon was asked to quickly take over the full management for five metro Denver facilities operated by the OMEGA Real Estate Investment Trust. All five had experienced multiple bankruptcies and had conditional licenses issued by the Health Department due to significant present and historic regulatory compliance issues. Over a 12–18 month period, all five facilities were able to regain full licensure due to great improvements in resident care, quality of new staff put in place and successful survey outcomes. All five remain a part of the Piñon Management family and have experienced greatly improved financial and operational outcomes, stable management teams and innovative quality models of care for both geriatric and special populations. One facility recently opened a state–recognized model for behavioral mental health residents. This newly designed environment and holistic model has allowed residents living in state hospitals for over 20 years to now be a part of a residential community of care.
In 1997, Piñon Management became the management company of Julia Temple Center in metro Denver. Julia Temple is Colorado’s oldest skilled nursing facility, serving residents with multi–stage behavioral Alzheimer’s and dementia. Prior to Piñon’s involvement, the facility had received over $50,000 in civil monetary penalties, was in a class action lawsuit, had 60% nursing pool usage and ongoing fiscal and regulatory issues. Piñon was able to attract top department managers, create a model program for dementia care and show great immediate improvements in regulatory compliance. This facility also has become an award–winning facility, partnering recently with OSHA as a model safety program and receiving other recognition from the Department of Health, Colorado Health Care Association and the Alzheimer–s Association. This facility recently was the only Colorado facility to receive recognition from hospice organizations for its excellent quality of care for end–of–life services. The facility has active resident and family councils and continues to have a full census and stable team of staff.
In 1993, Piñon Management took over the management of Hillside Manor in Denver, a facility besieged with a history of bankruptcies, management turnover, regulatory compliance issues and extremely poor resident care outcomes in serving a complex inner–city mental health and geriatric population. By 1994, the facility (renamed Spearly Center) had a deficiency–free state survey and continued to have excellent surveys over the next several years. By the late 1990s, Spearly Center had developed a state–wide, award–winning reputation for its model program for the mentally ill and was the only Colorado facility to receive the Department of Health ResQUIP award for innovation and excellence five years in a row.