WASHINGTON COUNTY SAMARITAN COMMITTEE. Samaritan Health Center October 23, 2014



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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 WASHINGTON COUNTY SAMARITAN COMMITTEE Samaritan Health Center October 23, 2014 West Bend, WI 7:00 a.m. Present: Michael Bassill, Ralph Hensel, Roman Schulteis, and Daniel Stoffel. Excused: Jeffrey Geib. Also Present: Campus Administrator Matt Furno, Samaritan Accountant Jeff Werner, Director of Nursing Kathie Braun, The Fields House Manager Jessica Trapp, County Attorney Kim Nass, Purchasing Agent Bill Kurer, and Chief Deputy County Clerk Linda Doro. Chairperson Stoffel called the meeting to order at 7:00 a.m. and read the Affidavit of Posting. MINUTES Moved by Mr. Schulteis, seconded by Mr. Bassill to approve the Samaritan Committee minutes of September 25, 2014, as presented. Motion carried. AWARD BID FOR THE FIELDS ATTIC REPAIR & BALCONY INFILL PROJECT Moved by Mr. Schulteis, seconded by Mr. Hensel to award the Fields Attic Repair and Balcony Infill project to C. G. Schmidt, in the amount of $41,251. Motion carried. APPROVE SAMARITAN CAMPUS COLLECTIONS POLICY Moved by Mr. Bassill, seconded by Mr. Schulteis to approve the Samaritan Campus Collections Policy as presented. Motion carried. APPROVE MEMORANDUM OF UNDERSTANDING (MOU) BETWEEN ADRC AND SAMARITAN CAMPUS Mr. Furno requested that this agenda item be deferred to a future meeting to allow for additional review and modification to the MOU. Moved by Mr. Hensel, seconded by Mr. Bassill to authorize the Samaritan Campus Administrator to continue the development of the MOU between ADRC and Samaritan Campus. Motion carried. APPROVE REHABILITATION SERVICE AGREEMENT - GREENFIELD REHABILITATION AGENCY, INC. Moved by Mr. Bassill, seconded by Mr. Hensel to approve the renewal of the Rehabilitation Service agreement with Greenfield Rehabilitation Agency, Inc. for one year effective December 1, 2014, through November 30, 2015. Motion carried. ACCOUNTS RECEIVABLE MONTHLY REPORT Mr. Werner presented and reviewed the accounts receivables through August, 2014, for the Skilled Nursing Facility, RCAC, and the CBRF.

Samaritan Committee October 23, 2014 Page 2 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 CASH BALANCES MONTHLY REPORT Mr. Werner presented and reviewed a cash balance report for Samaritan and Fields of Washington County for September 30, 2011, through September 30, 2014. CAMPUS ADMINISTRATOR'S REPORT Accounting Assistant Update Mr. Furno reported Trisha Holbrook was hired for the Account Assistant position and she will start on Monday, October 27, 2014. CMS Guidance on CPR Outings Requirements Report Mr. Furno reported the Centers for Medicare and Medicaid Services, Department of Health & Human Services has changed its guidelines and is now requiring all activity aids to be CPR certified. Currently, only the Activity Director is CPR certified, therefore, at least three activity aides will be certified to cover the Samaritan Health Center activities. The cost for these CPR certifications is approximately $1,000. NEXT TENTATIVE MEETING DATE The next Samaritan Committee meeting is tentatively scheduled for Thursday, November 20, 2014, at 7:00 a.m. in the Samaritan second floor conference room. ADJOURNMENT Moved by Mr. Bassill, seconded by Mr. Schulteis to adjourn the meeting at 8:07 a.m. Motion carried. Brenda J. Jaszewski, County Clerk

SAMARITAN COMMITTEE REPORT To: Samaritan Committee Members From: Matt Furno, Campus Administrator Date: November 20, 2014 RE: Greenfield Rehabilitation ACE Presentation ACTION QUESTION: Should the members of the Samaritan Committee by apprised of the ACE Program being offered to our residents by Greenfield Rehabilitation Agency? DISCUSSION: A. ACE (Advancements in Clinical Excellence) Programs B. Presenter: A. J. Ettmayer, PT and Rehab Director at the Samaritan Campus C. Full menu of Ace Programs: Fall Prevention & Balance Training Dining Adaptation Continence Management Dysphasia (Swallowing Issues) Communication Management Pain Management Self Care Management Wound Care Management Memory Care Management Positioning & Contracture Management Back on Your Feet COST: A. None ATTACHMENT: A. None RECOMMENDATION: A. Motion to concur with the use of the ACE Programs for our Samaritan Campus Residents offered by Greenfield Rehabilitation Agency.

SAMARITAN COMMITTEE REPORT To: Samaritan Committee Members From: Matt Furno, Campus Administrator Date: November 20, 2014 RE: The Fields Attic Repair and Balcony Infill Project Update ACTION QUESTION: What is the status of The Fields Attic Repair and Balcony Infill Project? DISCUSSION: A. The total amount of the bid is $41,250 and the breakdown is $22,880 for the attic repair and $18,371 for the balcony infill project. B. The construction agreement was signed by the County on Thursday November 6, 2014 and mailed on Friday November 7, 2014. C. I phoned Rebecca Schloer, Project Manager for CG Schmidt and informed her that the signed contract was on the way. I also reminded her of the December 19, 2014, deadline. D. Current Project status. COST: A. $41,251 ATTACHMENT: A. CG Schmidt letter to Bill Kurer, Purchasing Manager. RECOMMENDATION: A. None.

SAMARITAN COMMITTEE REPORT To: Samaritan Committee Members From: Matt Furno, Campus Administrator Date: November 20, 2014 RE: Chapter 55 Update ACTION QUESTION: What is the status of the Chapter 55 Program Reimbursement Funding? DISCUSSION: A. Chapter 55 admissions to the Samaritan Health Center: 2013 = 14 total admissions / 12 total residents 2014 = 16 total admissions / 15 total residents B. Samaritan Health Center is Washington County s Chapter 55 Protective Placement Facility. Placement at the Samaritan Health Center is not an automatic and/or mandated admission from the County. It still requires that the individual can meet all the Chapter DHS 132 admission/stay codes and that the Licensed Nursing Home Administrator is in agreement that the Facility can safely care for the individual and can protect the other residents. C. Additional expenses may be incurred due to the need for additional staffing to safely care for the individual being protectively placed and for the safety of other residents. D. In the near future, the County will need to address the ever growing population of individuals with dementia and mental illness. A couple of possible options, to address this need, are the consideration for a locked Unit or a Specialized Unit. E. There is a definite concern that the more Chapter 55s admitted to the Samaritan Health Center will yield a reduced number of regular Skilled Nursing admissions. Due to the behavioral issues that typically accompanies the Chapter 55s, we are receiving more negative comments from residents, family members of the residents, visitors and staff. F. In the near future some of the programmatic issues will be addressed with the interdepartmental team. COST: A. The cost of each admission will vary per stay. B. VG s admission and stay yielded a loss of $50,000 for Samaritan Health Center. ATTACHMENT: A. None RECOMMENDATION: A. Motion to support the County Administrator s Plan to fund Chapter 55 placements and for a more permanent solution.

SAMARITAN COMMITTEE REPORT To: Samaritan Committee Members From: Matt Furno, Campus Administrator Date: November 20, 2014 RE: Traffic Patterns regarding Samaritan Campus Parking Lot ACTION QUESTION: Should the Samaritan Committee support a modification to the present traffic pattern regarding the parking lot in front of the Samaritan Campus? DISCUSSION: A. Directly behind the Annex is a small connecting road that connects the Samaritan Campus parking lot with the PAC parking lots. This small road is presently two directional (east & west) and I would prefer that it would be a west only road. I don t believe there should be an exiting into a senior community parking lot. B. I have discussed this matter with Josh Schoemann, Jay Shambeau, Scott Schmidt and Scott Derge. Each have offered positive suggestions and some of which we have taken advantage of to improve the situation. Along with Jay s staff, we have been able to eliminate some of the parking slots to provide better visibility. Scott Schmidt has begun dialogue with the City of West Bend to ascertain if there is a possibility to change the enter lane just west of the Annex to an exit lane going east onto Highway 33. C. We are also planning to provide improved signage within the areas of concern. D. Jay Shambeau has issued a request to the employees at the PAC to please exit their parking lots by way of Indiana Street instead of through the Samaritan Campus parking lot. COST: A. Undetermined at this time. ATTACHMENT: A. Two photos. B. Jay Shambeau s email. RECOMMENDATION: A. Motion to support a permanent change to the present traffic pattern of entering and leaving the Samaritan Campus front parking lot.

All, Thank you in advance for considering this request. FYI that Scott Schmidt, County Engineer and I recently met with Matt Furno regarding the traffic patterns around the Samaritan Campus. Matt has a great concern regarding resident and visitor safety with traffic "cutting" through the parking lots. This has been a long-standing traffic pattern and one that is utilized by many visitors and employees. The Planning and Parks employees have been encouraged (directed) to no longer utilize the Samaritan parking lot exit as a shortcut for departing East onto Hwy 33. All Planning and Parks staff in personal or county vehicles now exit onto Indiana Ave. Also, as of today, about 15 parking spaces have been eliminated on both side of this bottleneck area. This should assist with sight distances when approaching the bottleneck from either side. I am convinced that if most of our employees stayed out of this area the problem would be greatly alleviated. This may cause some stacking and back-up issues on Hwy 33 and Indiana Ave. Employees might need to put their patience for the seemingly "long" traffic light :) at this intersection. Scott Schmidt is checking with the City of West Bend for other possible exit alternatives on Hwy 33. Future exit alternatives with the city will likely take some time. Please contact Matt Furno or myself if you have questions. Jay Jay Shambeau Planning and Parks Administrator Washington County Planning and Parks Dept. 333 E Washington St., Suite 2300 West Bend WI 53095 jay.shambeau@co.washington.wi.us 262-335-4445

EAST WASHINGTON STREET ENTER ALTER TO EXIT RIGHT TURN EXIT ENTER INCREASE SIGHT LINE ELIMINATE 7 STALLS TO IMPROVE SIGHT DISTANCE AND ELIMANTE PEOPLE WALKING IN THIS AREA INSTALL APPROPRIATE SIGNAGE (KEEP RIGHT OR STOP IF NEEDED ELIMINATE 6 STALLS TO IMPROVE TRAFFIC PATTERN SAMARITAN HEALTH CENTER

SCHMIDT ROAD GOVERNMENT CENTER ENTER CLOSED H M H M ENTRANCE EAST WASHINGTON STREET MH MH MH ENTER ENTER EXIT ENTER ALTER TO EXIT RIGHT TURN INDIANA AVENUE ENTER PUBLIC AGENCY CENTER SENIOR CENTER SAMARITAN HEALTH CENTER

SAMARITAN COMMITTEE REPORT To: Samaritan Committee Members From: Matt Furno, Campus Administrator Date: November 20, 2014 RE: November 2014 - October 2015 Goals for Samaritan Campus ACTION QUESTION: Should the Samaritan Committee agree with the proposed November 2014 - October 2015 Goals for Samaritan Campus? DISCUSSION: A. Matt Furno, Samaritan Campus Administrator has completed his first years of employment with Washington County. B. Joshua Schoemann, County Administrator and Daniel Stoffel, Chairman of the Samaritan Committee completed their evaluation of Matt Furno s 1 st year s work performance. C. Joshua Schoemann and Daniel Stoffel have approved the November 2014 - October 2015 Goals for Samaritan Campus. COST: A. Undetermined at this time. ATTACHMENT: A. November 2014 - October 2015 Goals for Samaritan Campus RECOMMENDATION: A. Motion to support the November 2014 - October 2015 Goals for Samaritan Campus.

November 4, 2014 TO: Josh Schoemann, County Administrator Dan Stoffel, Samaritan Committee Chairman Samaritan Committee FROM: Matt Furno RE: November 2014 - October 2015 Goals for Samaritan Campus Physical Structure Related Goals A. The Fields Attic and Balcony Construction Project B. Improve Samaritan Health Center Parking Lot Traffic Pattern C. Reduce the Cold Air Flow for the Receptionist When the Siding Doors Open Financial Goals A. Reduce the Dollar Amount from Accounts Receivable Over 90 Days B. Increase the Cash Balances for The Fields and Samaritan Health Center C. Develop and Maintain Separate Capital Accounts for The Fields and the Health Center D. Develop ADRC Reimbursement Funding to Cover Chapter 55 and Related Admissions as well as a Reimbursement Accounting to Replenish the Fund when Medicaid Covers the Stay E. Improve the Overall Numerical Census through Increasing the Number of Admissions F. Investigate, Develop and Implement, with the Assistance of Staff and Omni Care a Campus-Wide Formulary Resident Program Goals A. Dementia Care Redesign Maintain a Working Knowledge and be Proactive with State Issues as well as Preparing the County with Options to Address the Growing Need B. Chapter 55 County System Modification Assist with the Development of a Full Geriatric Protective Placement System C. Explore and Recommend 1. Samaritan Health Center Locked-Unit 2. New SNF or CBRF Facility/Unit to Address the Growing Need for Acute Dementia Care D. Develop and Implement a Resident Enrichment Program Organizational Management Goals A. Develop and Conduct Quarterly Management Meetings (including: problem solving, training, reporting and vision casting) B. Develop and Conduct Bimonthly Individual Direct Report Meetings C. Reevaluate the Current Organizational Structure and Modify if Needed Staff A. Develop and Implement an Activity to Promote Positive Morale B. Provide a Gift Distribution to Promote Positive Morale