2006 Heritage Grove Annual Report

1
2006 Heritage Grove Annual Report

• We help people with complex mental health
  problems successfully live in our community

2
View from the Administrators
Office

• 2006 was a year for consolidating gains while
  beginning a long look at the challenges ahead for
  Heritage Grove. We continued our Expanding
  Community Services program with Comprehensive
  Mental Health. Mental Health Professionals and
  Nurses provided resident support and staff
  training to assist with our mental health
  programs.
• We finished all the loose ends from our
  Renovation Project the HVAC system for the
  resident bedrooms was completed in February. For
  the first time in this buildings history, we
  were able to maintain an even 75 degrees during
  both the very hot days of summer and the very
  cold days of early winter! It was gratifying to
  see our residents and staff comfortable despite
  the season.
• In March we began pharmacy service from Memorial
  Hospitals Pharmacy. What an improvement to have
  daily delivery of all residents medication and
  have a Pharmacist on our Interdisciplinary Team!
  
• We continued our participation with the Qualis
  Health Nursing Home Quality Initiative Project.
  Along with 34 other Washington State nursing
  homes, we joined a national initiative to improve
  quality indicators in four clinical areas,
  increase Resident Satisfaction and develop Staff
  Satisfaction and Retention levels.
• We also began implementation of a far reaching
  cultural transformation process using guidance
  from the Pioneer Network. We began developing a
  more resident centered environment where direct
  care staff and residents take the lead in
  creating more homelike routines and activities.
• We were fortunate to have all our employees
  attend Investment in Excellence training along
  with Memorial Hospital employees. This exciting
  program teaches positive approaches to personal
  and workplace change. The training complimented
  the endeavors in our Quality Improvement
  Initiative and cultural transformation model.
• As all these experiences came together this year,
  they brought a vision for the future of Heritage
  Grove and ideas for accomplishing our goals along
  the journey. With many thanks to our Board of
  Directors, friends and supporters, we celebrate
  2006 as a very good year!
• 
  
  Kylle Fish, Administrator

3
Nursing Services

• In 2006, our pharmacy services changed from
  Evergreen out of Spokane to Memorial Hospital
  here in Yakima. Having almost immediate access
  when medications change has been very helpful. At
  the same time, we went high tech with new coded
  med carts and Acudose towers. The nurses are
  thrilled with no more bingo cards and counting
  narcotics. We also really benefit from having a
  Pharmacist on the Team!
• We continue to have a variety of students
  who do their psych rotation here at Heritage. In
  addition to YVCC, we now have Heritage College
  and ICNE/WSU nursing students. We have enjoyed
  their visits and enthusiasm and look forward to
  the new year. Several of them have asked to do
  their preceptor ship here, which is the last
  requirement before they can take their licensing
  board examinations. This is a HUGE compliment to
  all our staff who have created an outstanding
  learning experience and made them feel welcome.
• Several of our Nursing Assistants are in
  school advancing their careers, some in nursing.
  It is great to see. KEEP UP THE GOOD WORK! Since
  schedules have changed, we have hired 12 new
  Nursing Assistants. They bring with them many
  skills and experience. WELCOME ABOARD!
• In 2005, we hired our first Nurse
  Technician. She was so successful, we decided to
  expand this use of nursing students further. In
  2006, we had 5 Nurse Technicians who have been
  very helpful while gaining valuable experience as
  part of their training.
• We continue to promote Cultural
  Transformation and Resident Centered Care.
  Bathrobes to Breakfast is now throughout the
  facility. This allows residents to have a more
  leisurely rise for breakfast. In addition, meals
  are no longer served on trays in China Grove or
  Gardens Café. Interestingly, our challenge with
  this concept comes from the more independent
  diners who have grown accustomed to tray service
  over the years.
• As our nursing department heads Into the
  Blue for 2007, we are working on setting goals,
  promoting positive attitudes and praising,
  encouraging ideas and suggestions to involve
  direct care staff in decision making where ever
  possible.
• Diana Buckalew, RN, Director of Nursing Services
  

4
Social Services, Admission and
Discharge Planning

• We had another great year in Social Services. To
  quote a sage philosopher, (Kermit the Frog) Life
  is a series of meetings and partings, that is the
  way of it. We had 37 new residents come to
  Heritage grove in 2006. That represents many
  hours of reassuring new residents as they adjust
  to life here, ongoing behavior management and
  care planning as well as walking along side as
  families say their final goodbyes to their loved
  ones placed in our care.
• As a part of our involvement in Qualis Health
  Nursing Home Project, we focused on Depression
  Screening. We specifically looked at those
  residents who are no longer able to attend
  activities on their own. With interventions, we
  found some came out of their shell a bit,
  while others are at peace with their solitude.
• As the whole staff heard of and learned about
  cultural change toward a more home-like
  environment, Social Service staff reinforced
  these concepts in staffing and problem solving
  meetings. Through our Dementia Task Force, we
  successfully tried out concepts of household
  building to make our Gardens East Special Care
  Unit more homelike and cozy.
• The SS Director continued training all Heritage
  Grove staff in the Mandt Technique of
  understanding behavior and developing
  relationships to work more effectively with our
  residents. Each employee receives 4 to 6 hours
  of re-certification annually.
• Into The Blue training from YVMH laid the
  ground work to improve communication with other
  staff/departments and approach situations from a
  positive framework.- Yvonne Halley, BSW-Social
  Service Director

5
Medical Records and Reception

• Two new full time employees joined our staff of
  three in Medical Records during 2006. Both
  brought many skills and valuable experience in
  data management, coding, filing and reception to
  our department! Even before a resident is
  admitted, Medical Records is busy getting all the
  necessary forms and information to make the
  residents medical record ready for Nursing and
  Social Services. After admission, we do all
  clinical data entry for the Resident Assessment
  Instruments and ensure accurate and timely
  transmission of that data to DSHS. This generates
  the payment rate for each resident! In order to
  stay on top of all the changes, we have
  instituted our own check and balance systems.
  During the past three quarters, there have been
  no defaults or errors in our transmittals to
  DSHS! As well as data entry and management, we
  do all the filing and transcription for the
  nursing departments. We also enter all Care Plan
  information including physicians orders and
  treatment plans at admission and quarterly for
  all residents. The four Nurse Case Managers
  dictate quarterly reports on each resident which
  we then type and file. We also type all of the
  dictation for the consulting psychiatrist who
  rounds weekly in our building. Another
  responsibility of our department is arranging
  transportation for resident medical appointments
  outside the facility. We schedule appointments
  and then make arrangements with Dial a Ride or
  with our own Van Driver to transport residents.
  In 2006 our Van made 240 trips for medical
  appointments! Dial A Ride did 193. Because we
  also serve as the Main Reception Desk, we get to
  know our residents and their families well. All
  three of us enjoy a great deal this opportunity
  to personally connect with those we serve!
  --Pauline Davis, Medical Records Director

6
Dietary Services

• Along with preparing meals and snacks three times
  daily for more than 90 residents. the Dietary
  Department began implementing a selective menu
  for residents last year. In 2006 the selective
  menu was expanded to a daily basis. Residents are
  quite happy to choose between two entrées at
  lunch and dinner meals!
• The dining rooms have been improved by making
  them look and feel a little more home like. We
  have put tablecloths into two of our dining rooms
  and in the other two we are using colorful
  placemats. When the residents are served their
  meals, the food and beverages are taken off the
  trays and placed on the table for the residents.
  We have also added color to the rooms by adding
  more decorations.
• The heating and air conditioning installed in the
  kitchen has been a very pleasant improvement
  during the hot summer of 2006. Staff is
  comfortable when the weather is either hot or
  cold.
• We continue to meet regularly with resident
  council to improve meal service, snacks, and
  coffee service.
• We have replaced an oven and added a freezer in
  the kitchen during 2006. These additions have
  made duties in the kitchen easier to accomplish.
• New flooring in the dish area helps ensure the
  kitchen is kept clean and sanitary.
• Employees are using what they have learned at
  Into the Blue training to help resolve conflicts
  among themselves and to set and achieve goals for
  dietary services. Early last year when we
  started discussing some goals for the department,
  the employees were not very receptive. After
  they started attending Into the Blue classes,
  they came back with the attitudes of we can do
  this and started giving ideas to help with the
  implementation of the goals!
• Evelyn Maxwell, Director of Dietary Services

7
Resident Activities and Behavioral Support

• The activity department wears many
  hats throughout the day. We are responsible for
  the residents supervised smoke breaks, group
  activities, individual activities, shopping, and
  transportation for appointments. There are 6
  resident smoke breaks throughout the day
  supervised with the assistance of the nursing and
  social services departments. There are up to 20
  smokers that come out during the assigned times.
  We pass out smoking aprons to protect their
  clothing along with their cigarettes. To further
  ensure the safety of our residents, staff light
  their cigarettes for them and make sure the
  cigarettes are put out appropriately before
  leaving the designated area. Residents have a
  designated shopping days for items that they wish
  to have purchased for them such as cigarettes,
  pop, candy, clothing, and other personal items.
  In addition to the weekly shopping, some
  residents like to go out and personally purchase
  items for themselves with activity staff
  providing transport and supervision. We have a
  cabinet and two locking refrigerators that store
  the residents personal pop and goodie supply.
  Many times throughout the day the activity staff
  is requested to get out some of these items for
  the residents consumption. A few residents
  attend their own church on the weekend. For
  those who have no transportation, we provide
  transportation services to and from their church.
  We also work closely with Medical Records to
  provide resident transportation to and from
  scheduled medical appointments. Token economy is
  a specialized behavioral group scheduled twice a
  week. Residents who attend can earn tokens for
  demonstrating appropriate behavior. Every
  Thursday, residents are able to turn their tokens
  in for various items such as perfumes, lotions,
  clothing, hair cuts, phone cards or to go out to
  lunch . The third Tuesday of every month,
  residents are invited to attend Resident Council
  where residents are able to bring up any issues
  that they wish to in a private setting. Activity
  staff closely interacts with the residents
  throughout the day, either through group
  activities or individual activities. There are
  many residents who are unable to initiate any
  activities on their own and rely on staff to
  provide activities for them. Activity staff
  provides 11 activities for these residents such
  as reading, w/c walks, conversing, and sensory
  stimulation. Activity staff provides additional
  11 interventions with residents when theres an
  increase in behaviors or to meet special needs.
  When the weather is nice, we try to take as many
  residents outside as possible. Theres a group
  of residents that enjoy going on community walks
  as a way to exercise and enjoy the outdoors.
  Activity staff also assists the nursing
  department during meal times by helping bring
  residents to the table, passing out trays, and
  cleaning up. Residents look forward to the many
  special events that we have throughout the year.
  We successfully put on an annual Fair Comes To
  Heritage Grove that takes place during the same
  time as the Central Washington State Fair for
  residents who are unable to attend the CWSF due
  to medical issues. During the summer, our
  residents look forward to attending the Bears
  Baseball games. They also enjoy the country
  drives throughout the year and the feeding of the
  ducks during spring/summer. We also put on a
  Resident Christmas party and invite residents
  family and friends to join us. The past few
  years, weve had to have two parties in order to
  accommodate the number of family in attendance.
  Early in the year, we put on a Luau to remind us
  that summer is not too far away. Speaking of
  summer, our residents look forward to their
  annual BBQ put on with the help of all staff. We
  also celebrate monthly birthdays and holidays
  throughout the year. This past year, we even
  celebrated Twinkies birthdaywhich the residents
  thoroughly enjoyed! -Moretta Miley, COTA/L,
  Activity Director

8
Environmental Services and Facility Maintenance

• Housekeeping and Laundry
•        This past year staff in the Housekeeping
  and Laundry Team has been being trained to do all
  the jobs in both areas. All are doing well with
  the training even though some of the tasks are
  less familiar. I am very happy with the way all
  just jumped in and did the best they could. We
  purchased a new washing machine in Laundry which
  is more quiet and gets the wash done in less
  time! We also began doing some things a little
  differently for the new year. Housekeepers are
  taking ownership of each section of the building
  that we work on as if was our own home. We will
  be paying attention to not only the cleaning, but
  also the whole look and smell of the area. So
  when we leave at the end of the day, we can take
  pride in our area just as we do at home. This is
  our Residents Home and we want it to look its
  best.--Vicky Flint, Environmental Supervisor

• Maintenance
• The Heating and Air Conditioning installation was
  completed just in time for the hot weather this
  summer! We are able to keep the building very
  comfortably in the mid 70s whether it is over
  100 degrees or only 10 degrees outside! The new
  system has a computerized maintenance program
  that allows us to track its functioning on-line.
  This is a great asset to our preventative
  maintenance because we can see even minor
  problems and correct them before they effect
  heating or cooling functions. We also completed
  several smaller projects this year. We
  installed a new floor sink for Housekeeping and
  renovated their housekeeping closet. Minor
  repairs to equipment,furnishings and yard
  maintenance kept us busy everyday. For future
  planning, we developed a five year Capital
  Projects list which will help guide decisions
  about further improvements in our physical plant.
  --Mark Overby, Director of Maintenance

9
Business and Administrative Support

• The business office continues to serve Heritage
  Grove employees and residents to the best of our
  ability. We are constantly streamlining
  procedures to make the office run smoothly and
  efficiently. We work closely with the
  Administrator and our consulting accountants to
  manage the finances and make sure all corporate
  responsibilities are met.
• We make all monthly vendor payments and process
  payroll for over 100 employees every other week.
  The office assists in hiring by doing the
  background checks and the new hire paperwork. We
  also maintain all employee files. It has always
  been a challenge to track the Medicare hours for
  payroll. We have designed a new form/method that
  makes this process more efficient and accurate.
  Employees really appreciated receiving their
  W-2's with the first January payroll.
• We do all Medicare, Medicaid, private and
  insurance billings. The state billing has become
  a bit more difficult with the state cost
  avoidance project requiring a Medicare and/or
  insurance denial before the state pays. We
  continue to work on this challenge. Therapy caps
  and new modifiers and edits for Medicare B
  therapies have been a bit of a challenge this
  year. The business office continues to work with
  families with Medicare D concerns.
• The business office also has a part in the
  admission process. Benefits are verified before
  admission. When the resident arrives, the
  business office meets with family and/or the
  resident to explain financial paperwork and
  expectations. We also assist family with
  Medicaid application and eligibility reviews.
• We serve as Representative Payee for Social
  Security benefits for many of our residents.
• We manage the resident trust accounts. There is
  a lot of activity in the trust account. The
  trust petty cash box is reconciled daily so that
  accounts are current and no account is overdrawn.
  The resident's cable television, guardian fees
  and insurance bills are paid through the trust
  account.
• The office serves as the print center for the
  facility. We make our own letterhead, business
  cards and name tags. We also serve as the
  purchasing department for the facility. Last
  year all old computers were replaced with new
  computers. We also maintain the file room. It
  is necessary to constantly cycle old records to
  off site storage to make room for current
  records.
• Into the Blue values have influenced more
  positive attitudes when working alongside various
  departments, vendors. We maintain friendly and
  efficient working relationships with vendors and
  various government entities. We work well
  together and are considerate of each others time
  constraints and work loads, which makes for a
  pleasant work environment. --Deb Funkhouser and
  Debby Matson, Co-Office Managers

10
Its All About People.Helping People

• Heritage Grove Employees
• Full Time 82 Part-Time 21
• Nursing Services 62
• Dietary Services 11
• Hskp/Laundry 6.5
• Activities 5
• Social Services 3
• Maintenance 1.5
• Administrative Services 2
  
• Medical Records 3
• Kylle Fish, Administrator
• Diana, Buckalew,Director of Nursing Services
• Paul Emmans, Jr., D.O. Medical Director

11
(No Transcript)
12
Heritage Grove Board of Directors 2006

• President, Jack Maris, Comprehensive Mental
  Health
• Vice President, Gail Weaver, Memorial Hospital
• Doug Bault, Memorial Hospital
• Bill Foster, Comprehensive Mental Health
• Connie Farina, Memorial Hospital
• Rick Weaver, Comprehensive Mental Health
• Dr. Greg Sawyer, Memorial Hospital
• Rick Linneweh, Memorial Hospital

13
(No Transcript)