The tax-subsidized skilled nursing home Laurie Care Center (LCC) is continuing a push to improve quality through innovations in residential care.
With a ribbon cutting June 8, LCC celebrated the addition of a new "smart" technology option in residents' room to provide greater quality and efficiency of care.
For an extra $7-8 a day, residents can opt for a SmartCare Room that with a network of non-obtrusive sensors can help seniors avoid falls, alert staff to potential issues and offer greater reassurance to family about the status of their loved one.
Lights automatically come on when someone enters the room. There are sensors in the floor of the bathroom that detect water that might cause a senior to slip and fall. A bed occupancy sensor detects whether a senior is getting up a lot during the night. There are sensors at the toilet and shower in the bathroom as well as at the microwave and refrigerator and in the furniture all geared to alert not just staff of what the resident is doing throughout the day. Among other things, the sensors can show if a fall has occurred or whether a residents is sleeping more during the day.
But the service isn't just for staff, a web portal allows family to monitor a resident's activity so that they can take action or begin asking questions. The system can be set up to notify the family caretaker of anomalies.
SmartCare Consultants, which provide the service, are also developing an app for smart phones so that family members can receive alerts about the resident even when they're on the go.
Part of Good Shepherd Nursing Home District, LCC scored below average (2 out of 5 stars) in its 2012 Medicare review though the facility passed inspection and was fully licensed.
The 2013 Medicare review seems to reflect improvement as LCC earned an average rating overall (3 out of 5 stars). The review is based on nurse staffing with more consideration for registered nurses, a health inspection and up to 20 quality indicators. These three categories are weighted and then compared to other facilities in its peer group and across the nation.
GSNHD Administrator Lance Smith has said that LCC is working to get the right care team in place. Among other staffing changes, LCC has a new director of nursing and dietary manager.
One setback has been in the position of facility administrator. Ben Bryant started as the new facility administrator for LCC in late March, but recently resigned without giving cause, said Smith.
The hiring process is now back to square one for this position, and Smith is again interim facility administrator.
The state also recently reviewed the care one of the residents was receiving for a wound that was not healing. The facility received a citation because proper documentation of treatments had not been done.
Page 2 of 4 - According to Smith, both nurses caring for the resident said they had done the wound care as prescribed but had not documented the treatments due to computer problems.
As far as the state is concerned, however, if a treatment isn't documented, it wasn't done, Smith said.
The patient is doing well now, Smith said, and the facility's plan of correction has been approved by the state and a more detailed report and check up will be done to ensure the issue is fixed.
Scheduled to upgrade to a different computer program for full electronic record-keeping in approximately 60 days, LCC has temporarily gone back to paper documentation to ensure that everything is recorded until the transfer is complete to the new system.
There has also been some flap over peacocks at the facility.
For the enjoyment of residents, the facility has five peacocks living in its courtyards, but recently sought to remove them due to the large amount of animal waste they generated.
Smith acknowledged that some people in the community were unhappy with the decision because of the residents who enjoyed watching the birds.
But it is a health issue, he said, that they learned of after having the birds on the grounds.
The colorful birds are non-domesticated animals and having them on the premises could result in multiple citations for the facility.
The trouble is the sheer amount of waste that gets everywhere from tables to sidewalks. While there was an outpouring of offers from the community to volunteer to pick up and dispose of the waste, Smith said there is simply too much occurring throughout the day for volunteers to keep the courtyards clean in a timely way.
Birds are known to carry contagions. If a resident's wheelchair goes through the animal waste, it can end up being tracked back inside as well as getting on the hands of the resident.
While there are residents who like the birds, Smith said there are also residents who do not like them and won't go into the courtyard because of them.
Trying to find middle ground on the issue, the facility plans to build pens to hold the peacocks so that residents can still see them but in a controlled way. Smith has asked The Funny Farm Petting Zoo to temporarily house the peacocks until the pens can be built.
January 2013 annual health inspection
• Staff did not review the State Certified Nurse Aide Registry for six out of nine randomly sampled employees hired between Jan. 20, 2012 and Jan. 8, 2013.
Date of correction: Feb. 14
Page 3 of 4 - Environmental Deficiency
• One of five corridors did not have handrails on both sides of the hallway as required for evacuation in the event of an emergency.
Date of correction: Feb. 22, 2013
Fire Safety Deficiencies
• Did not have a two-hour-resistant firewall separation: Common wall between nursing home and assisted living portions of the building did not have a two hour fire resistance rating and the two-hour firewall door between the two sides was being propped open with a wooden wedge.
Date of correction: Feb. 1, 2013
• Did not have approved construction type or materials: Facility failed to ensure protective fire rated walls and ceilings were intact. Holes were found in the wall of the TV and phone room with cable wire passing through the holes. A hole was also found in the ceiling of the kitchen.
Date of correction: Feb. 5, 2013
• Did not have corridor and hallway doors that block smoke: A one inch gap was found around the kitchen door onto the dining room. The exit door for the Special Care Unit utilized a roller latching mechanism for an egress door.
Date of correction: Feb. 5, 2013
• Did not have exits that are accessible at all times: Two of 12 facility exit doors did not comply with code requirements for locking arrangements. The exit door from the therapy room contained a controlled access magnetic lock and the door was listed as an emergency exit. A 15 second door near the small dining room corridor did not release upon activation of the fire alarm. A recent lightning strike had apparently affected the door release mechanism.
Date of correction: Feb. 8
• Did not have emergency lighting that can last at least 1 1/2 hours: Facility failed to provide emergency lighting controlled by light switches inside two of three medication rooms and in the building stairwell to illuminate one of three required exit stairwells.
Date of correction: Feb. 10
• Did not have a written emergency evacuation plan: Facility did not show a smoke zone evacuation plan - a plan to evacuate from one smoke zone to another without full evacuation of the facility.
Date of correction: Feb. 22
• Did not have properly maintained smoke detectors: One smoke detector was located 12 inches from an air supply vent. The reception area did not have a smoke detector.
Date of correction: Feb. 14
• Did not have heating and ventilation systems properly installed: Facility failed to provide correct application of sprinkler heads for the entire building - affecting one of five smoke zones. There was a mixture of quick response and standard sprinkler heads in two areas. When a system is converted to quick response or residential sprinklers, all sprinklers in a compartmented space must be changed.
Page 4 of 4 - Date of correction: Feb. 14
• Did not have properly installed electrical wiring and equipment: Facility failed to ensure electronic supervision of all sprinkler system valves for one of four systems.
Date of correction: Feb. 14
• Did not inspect sprinkler system: Records showed only one quarterly inspection for sprinkler system 4 and records of inspection missing for second and fourth quarter for system 1, missing third quarter for system 2 and 3.
• Did not mount portable fire extinguishers in compliance with NFPA 10 standards: Three extinguishers were placed five feet four inches off the floor. Depending on the weight of the extinguisher, they must either be no more than five feet or three and a half feet above the floor.
• Did not properly ventilate: Ventilation duct in the kitchen did not function when tested. Men's and women's public restrooms did not have functioning exhaust ventilation to the outside.
• Did not maintain electrical wiring: Wiring for ventilation fan above men's and women's restrooms did not have a junction box.