NCD Happenings. Quality Matters. Clinical Excellence. Quarterly Newsletter July By Mike Beal, President, Nursing Center Division

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1 NCD Happenings Quarterly Newsletter July 2014 Quality Matters By Mike Beal, President, Nursing Center Division Quality matters. It matters in the care we provide, how we treat our employees and how we run our centers. Residents and families expect and deserve quality care, and it should be our focus to meet their expectations. Quality care reduces rehospitalizations and length of stay and creates happy residents and families. In turn, these satisfied residents and families complete positive online reviews and refer us to others. Quality also creates an environment where employees are valued and feel empowered to spend 30+ years with Kindred. It creates deficiency-free surveys and five-star nursing homes. Quality is the essence of everything we do. We are doing a good job, but still need to focus on this important cornerstone and continue to raise our own standards. Consider this how will you add quality to what you do today? Mike Beal Clinical Excellence By Dr. Marc Rothman, Chief Medical Officer, Nursing Center Division Whether you call what we do longterm care, short-term rehab, custodial care, post-acute care, or subacute care, CLINICAL EXCELLENCE starts with high-quality nursing care for each individual resident and patient. Avoidance of pressure ulcers and falls, monitoring and responding to infections and outbreaks, and effectively treating pain are examples of the CORE quality items that are reflected in state regulatory visits, CMS Quality Measures, and the five-star rating system used on the Nursing Home Compare website. Avoidance of harm or abuse, the presence of a robust Quality Improvement or QAPI process, and other aspects of patient-centered care are also essential: nutrition, recreation, and attention to psychosocial issues are all key. Are the staff members familiar with the policies and procedures that are in place to guide the care of patients, and do they use the tools and processes available to them to troubleshoot new problems when they are detected? Beyond the quality CORE needed for all nursing centers, Clinical Excellence for Kindred now involves caring for patients with higher acuity than any nursing center would have dreamed of admitting years ago. The clinical skill sets of our nurses, dietitians, aides, and social services team has risen with each passing year. Many, many centers now routinely admit patients with feeding tubes, indwelling catheters for dialysis or oncology, complex medication regimens, intravenous lines for (sometimes multiple) antibiotics, trachs, and even vents in a few cases. Clinical Excellence not only means knowing how to care for these complex patients and devices, but also how to embrace and work with a larger and more spread-out team of professionals: physical, occupational and speech therapists, respiratory therapists, medical attendings and subspecialists, too. Is there clear documentation of everyone s efforts, and evidence that members of the team are actually communicating, not just acting individually or in a silo? It s the latter that leads to miscommunication and missed opportunities to prevent harm or catch it early enough to prevent any further harm. Continued on following page.

2 Clinical Excellence today also means knowing how to detect a change in condition (using a Stop-and-Watch, for example), knowing how to effectively communicate with a supervisor or a physician about it (using the SBAR tool, for example), and regularly monitoring things like rehospitalizations, which are often unnecessary and can cause harm themselves. Another example of Clinical Excellence involves using the electronic health record (Point Click Care) to its fullest potential to investigate an event, or to ensure a smooth, safe transition for a patient being admitted or discharged. Clinical Excellence in our nation s nursing facilities will always be centered around high-quality patient care in the CORE. But in 2014, Clinical Excellence also involves so many other things. I think of it as concentric rings around the core, with layers of new skills, competencies, and systems that need to be mastered. Thriving in this brave new world of post-acute and long-term care medicine will take a strong culture of education, quality improvement, and teamwork and a great team of caregivers, which Kindred is already lucky enough to have! Dr. Marc Rothman AHCA/NCAL Bronze National Quality Award Congratulations to Kindred Nursing and Rehabilitation Rawlins! They have received the 2014 Bronze National Quality Award. This award is the first of three distinctions possible through AHCA/ NCAL National Quality Award program, which honors skilled nursing and post-acute care centers across the nation that have demonstrated their commitment to improving quality care for seniors and individuals with disabilities. We are proud to recognize that nearly 95% of our centers have received one of these distinctions with Kindred Nursing and Rehabilitation Mountain Valley receiving the Gold award in Deficiency-Free Surveys proud 2 By Christian Aquilino Kindred has had four deficiency-free surveys this year, which is a huge accomplishment in the current survey environment of A deficiency-free survey is a survey where no federal f-tags are cited for any area during the survey. The following facilities had achieved this goal in 2014: Kindred Transitional Care and Rehabilitation Greenbriar Kindred Transitional Care and Rehabilitation Laurel Lake Kindred Hospital Dallas Subacute Unit Kindred Transitional Care and Rehabilitation Lafayette Please congratulate these facilities on a job well done. to be deficiency free

3 Reputation.com and Building a Positive Online Reputation By Maria Anderson, Online Reputation Manager, Marketing and Communications Consumer reviews online can greatly affect the perception of a business, and, second only to personal recommendations from friends and family, are the most trusted way people find information. Reviews are highly influential in the decision-making process for many people, and that number is only getting bigger as the number of internet users grows. In 2012, Kindred decided to take a proactive approach to handling online reviews, the reputation of our company and various points of service. Reputation.com was selected as the tool that we would use to track, monitor, report on, and get alerts for reviews that appear on third-party review sites (such as Google, Caring.com, and Yelp). Reputation.com is not where reviews are posted; it is an internal tool that aggregates live data from external review sites. In addition to providing alerts when a review is posted, Reputation.com gives us a variety of reports and different ways to break down the reviews and data to see our strengths and weaknesses. Another great feature is the Review Request er that allows users to generate an with links to external review sites to those patients/residents/family members that they have collected addresses from. The main benefit to using this feature is that it helps avoid issues that can happen when too many reviews are posted from the same IP address on the same review site. Google and most other sites monitor IP addresses and if they see too many reviews or new accounts and reviews coming from the same IP address, they may start to remove them because they feel that they are not legitimate. Building your online reviews slowly and carefully is very important. All NCD facilities have been asked to obtain one positive review per month on a trusted review site such as Google+ or Caring.com to achieve this. All executive directors should have access to Reputation.com through their facility account. If you do not know your facility login, have questions about online reviews or Reputation.com, or would like to set up a Reputation.com training, please contact Maria Anderson, Online Reputation Manager, at maria.anderson@kindred.com or

4 U.S. News and World Report Best Nursing Homes Nursing Homes in America by U.S. News and World Report, By Karen Lozado, Manager of Marketing and Communications This year our division was honored to have twenty centers, plus a subacute, to receive the U.S. News and World Report Best Nursing Home five-star designation. Since roughly 1.4 million individuals, including one in every 34 individuals 65 and older, will wake up in a nursing home, U.S. News wants to help families find good care, so they evaluate information published by CMS and acknowledge the highest ranking centers in all 50 states and Washington D.C. The designation is based on the CMS star rating in three categories: stateconducted health inspections, how much time nurses spend with residents, and the quality of medical care. Here are the facilities that have received this honor: KINDRED HOSPITAL CLEVELAND SUBACUTE UNIT KINDRED NURSING and REHABilitation MOUNTAIN VALLEY KINDRED NURSING AND HEALTHCARE LIVERMORE KINDRED NURSING AND REHABILITATION PARKVIEW KINDRED NURSING AND REHABILITATION RAWLINS KINDRED NURSING AND REHABILITATION WIND RIVER KINDRED NURSING AND REHABILITATION COMMUNITY KINDRED NURSING AND REHABILITATION GOLDEN GATE KINDRED NURSING AND REHABILITATION MAPLE KINDRED NURSING AND TRANSITIONAL CARE PACIFIC COAST KINDRED NURSING AND TRANSITIONAL CARE SOUTH MARIN KINDRED TRANSITIONAL CARE and REHABILITATION SIENA KINDRED TRANSITIONAL CARE and REHABILITATION AVERY KINDRED TRANSITIONAL CARE and REHABILITATION LAWTON KINDRED TRANSITIONAL CARE and REHABILITATION ROSE MANOR KINDRED TRANSITIONAL CARE AND REHABILITATION SMITH RANCH KINDRED TRANSITIONAL CARE AND REHABILITATION EAGLE CREEK KINDRED TRANSITIONAL CARE AND REHABILITATION BRIDGEWATER KINDRED TRANSITIONAL CARE AND REHABILITATION INDIAN CREEK HERITAGE MANOR HEALTHCARE CENTER KINDRED NURSING AND HEALTHCARE VICTORIAN

5 Baron Achieves Gerontological Nutrition Certification By Karen Omietanski, MBA, RD, LD, Senior Director, Nutrition Services Registered Dietitian Melissa Baron of Kindred Nursing and Rehabilitation Great Barrington and Kindred Nursing and Rehabilitation Timberlyn Heights has become a board-certified specialist in gerontological nutrition. Melissa joins four other Kindred Registered Dietitians who have previously received this certification: Janet Gagnon, RD, Kindred Sellersburg, Sellersburg, IN Claire McCaughan, RD, Kindred Greenfield, Greenfield, IN Molly Ault, RD, Kindred Greenwood, Greenwood, IN Megan Spence, RD, Kindred Greenbriar, Nashua, NH The Commission on Dietetic Registration grants this specialist certification in recognition of an applicant s documented practice experience and successful completion of a comprehensive 150-question examination in the specialty area of gerontology and nutrition. Congratulations to Melissa, Janet, Claire, Molly and Megan on this achievement! By Karen Omietanski, MBA, RD, LD, Senior Director, Nutrition Services mg/ dl Over one-third of the patients in our nursing centers have diabetes. Research shows that patients who maintain their blood sugar in the zone (80 to 180 mg/ dl) have better outcomes. For resources to improve glycemic outcomes at your facility, go to KNECT > Nursing Center > Clinical Operations > Glycemic Management (middle column) > 01-Kindred NCD Glycemic Control Initiative. 5

6 Nursing Center Division Welcomes Joel Day as SVP of Finance By Blair Donovan, Summer Intern Joel Day, who has worked at Kindred for 22 years, recently took on the position of Senior Vice President of Finance for the Nursing Center Division. Day began his Kindred career working in the reimbursement department, where he spent four years. He then worked the next five years in the development and acquisitions department. From there, he spent thirteen years as Controller and Vice President of Finance in the Hospital Division. Day moved into his current job after the reorganization of the Nursing Center Division and the retirement of leadership. As SVP of Finance for the Nursing Center Division, Day serves as a leader and oversees the financial operations for the nursing center portfolio. It s a lot like my previous job in the Hospital Division with very similar responsibilities, said Day. The only difference is that my current role has a much more strategic direction related to growth and improvement opportunities. He has set high goals for the Nursing Center Division, which include creating a culture of teamwork, establishing empowered decision making, and to be the best in class. Day also wants to see growth from the Nursing Center Division, as well. Day lives in Indiana with his wife of 22 years and their two children, ages seven and two. He enjoys all sports, and is both a U of L and Hoosiers fan. 6

7 Kindred Transitional Care and Rehabilitation SouthPointe By Jared Houck, Executive Director The newest Kindred Transitional Care and Rehabilitation Center is slated to open August 2014 in Indianapolis, Indiana! Kindred Transitional Care and Rehabilitation SouthPointe will offer 100 short-term stay beds, 84 of which will be private. Several of the patient rooms will offer special fracture resistant flooring. SouthPointe will focus on short-term rehabilitation with an emphasis on orthopedic and cardiac rehabilitation. 7

8 A Walk to End Alzheimer s Gold Sponsor PROUD NATIONAL TEAM Kindred is excited to be a Gold National Team for the Alzheimer s Association s A Walk to End Alzheimer s and we look forward to seeing your competitive spirits come alive as we strive to raise funds to support this worthy cause. This year, we aim to have at least 100 Kindred teams participating and raise at least $250,000. The Alzheimer s Association is important to us because of our residents with dementia or Alzheimer s. We specialize in the care of individuals experiencing cognitive loss, due to Alzheimer s disease, building on the tradition of over 25 years that Kindred has offered the Reflections Program in many of our centers. You can visit to see what Kindred teams have already signed up and started raising funds. If you are the team captain, Karen Lozado and she will include you in a regular monthly call to share team building and fund raising ideas. It is important that we have at least one team captain at each of our locations. Together we can reach our goal and more! NEXT ISSUE The next NCD Happenings will be published in October If you have story ideas or content suggestions that could be used for the next newsletter, please submit your entry to karen.lozado@kindred.com by September 1, NCD Happenings can be found online on KNECT > Nursing Center Division > Publications. Please access and print additional copies of the newsletter for distribution as needed. 680 South Fourth Street Louisville, Kentucky Kindred Healthcare Operating, Inc. CSR , EOE 8