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Helen Porter Achieves CMS Five Star Performance Rating for First Time
MIDDLEBURY--Helen Porter Healthcare and Rehabilitation Center has achieved it’s first-ever “5- Star Rating” from the Centers for Medicare and Medicaid Services (CMS), which is the highest CMS level of rating for quality of care, staffing and results from health department inspections. In addition to notifying the facility, the data is published on the CMS “Nursing Home Compare” website where it is available to the public.
On this web site, CMS explains the rating system and why it is important for consumers to understand and monitor. “Nursing homes vary in the quality of care and services they provide to their residents. Reviewing health inspection results, staffing data, and quality measure data are three important ways to measure nursing home quality”.
According to CMS, the Nursing Home Compare rating system “allows consumers to compare information about nursing homes. It contains quality of care and staffing information for all 15,000 plus Medicare- and Medicaid-participating nursing homes and includes data which reflects nursing home specific performance on on-site health department inspections, staffing ratios and several quality of resident care measures”.
The data is provided to CMS by individual nursing homes on an ongoing basis using a form called the Minimum Data Set. The information collected includes the residents' health, physical functioning, mental status, general well-being and quality of care information like whether residents have gotten their flu shots, are in pain, or are losing weight.
In terms of staffing, federal law requires all nursing homes to provide enough staff to adequately care for residents. However, there's no current federal standard for the best nursing home staffing levels according to the CMS site. ”Nursing homes must have at least one RN for at least 8 straight hours a day, 7 days a week, and either an RN or LPN/LVN on duty 24 hours per day. Certain states may have additional staffing requirements. LNAs provide care to nursing home residents 24 hours per day, 7 days a week. The amount of physical therapy service hours depends on the needs of the resident” according to CMS.
Helen Porter Administrator, Jim Darragh, shared this news with the entire Porter Medical Center community earlier this week in an email. “This accomplishment reflects the outstanding work you all do each and every day to provide a quality home for our residents and short stay patients. I am proud to work with such caring and compassionate people who are truly dedicated to this important segment of healthcare and the elderly population we serve. I’m particularly impressed with the improvement in our health inspection score; which directly reflects our adherence to both federal and state regulation regarding all aspects of our nursing home operations and all areas and departments” he wrote.
According to Darragh, ratings such as this are important, but he emphasized that it also is important for people to come and visit any long-term care facility, meet the staff and view the physical features of the nursing home before making a final decision. “At Helen Porter, we are so fortunate to have incredible activities programming, short-term rehabilitation services, special end- of-life rooms and programs and a beautiful courtyard for our residents” he said.
In concluding his message to the staff, Darragh added: “This achievement reflects the continued hard work and focus in the area of clinical care and other outcomes such as, frequency of re- hospitalizations, successful discharges home, percentage of residents who receive both influenza and pneumococcal vaccines, just to name a few. Please except my most sincere appreciation and thanks for all that you do to make this a quality place to live and a true community asset that contributes significantly to the PMC mission: To improve the health of our community, one person at a time”.
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ARCH “Family Center” addition planned for Helen Porter Healthcare and Rehabilitation Center (HPHRC).
MIDDLEBURY--Building upon a collaboration which has already resulted in the creation of three “home-like” end-of-life rooms for area residents, Helen Porter Healthcare and Rehabilitation Center (HPHRC) and Addison Respite Care Home (ARCH) have agreed to move forward with another community service project— the construction of a new “Family Center” addition at Helen Porter. This project, which will be funded via a local fund-raising effort, will establish a new entrance, waiting area, kitchenette, bathroom and two private meeting rooms for families to use as they support a loved one residing in an ARCH Room.
ARCH’s vision, to expand end-of-life care options for patients who can no longer remain at home, began as a community initiative in 2004. The mission of this non-profit organization is to; “establish a home for the terminally ill, providing quality of life and support for families regardless of their ability to pay.” The ARCH rooms offer a local alternative of care similar to that provided at the Vermont Respite Home located in Williston.
Each room is furnished and decorated with a focus that acknowledges it as a patient’s residence during their final months, weeks, days or even hours. The staff, caring for these patients and their families, is specifically trained for the unique needs that come with the challenges and gifts that occur during the dying process.
Many of our residents, friends and neighbors have now experienced the personalized and compassionate care that is being delivered in the three ARCH rooms notes Daphne Jensen, Chair of the ARCH Board and longtime Hospice Volunteer.
She added: “Many testimonials and notes of gratitude have been received, including these words from a Bristol family— “It is with heartfelt thanks that my Mom had the opportunity to share her final journey with family and friends in an ARCH room. Her special loving caregivers continued to enjoy life with her in a warm and comfortable new room, which she loved! And, as her passing neared, her room became a “home away from home” for family, friends and caregivers, too. We feel so fortunate to have had the ARCH experience- a thoughtful space, an incredible staff whose care and love could not have been more supportive, and regular “courtesy carts” filled with treats to share with visitors…a final oasis for residents and their families. Addison County is so lucky that this service is available to all.”
“ Our community members deserve the best care possible during this poignant time”, Jensen notes. Another family expressed this hope in their appreciation, “On behalf of our mother, we cannot thank you enough for the extraordinary care Mom received in the Rehabilitation wing and in the ARCH room. Not only did Mom receive excellent attention, the staff brought our family food, drinks, pillows and hugs in the middle of the night. Thank you for making Mom feel so loved.”
Attentive to the ongoing needs of these patients and families, both HPHRC and ARCH have recognized the lack of space and privacy for the family members and friends present to the dying of a loved one. The importance and need of a “Family Center” is a logical addition that can no longer be postponed.
While planning for the Family Center continues, a second project is underway between ARCH and Porter Hospital to create an ARCH room on the Medical/Surgical floor of the hospital. While most people choose to die at home, very often this is not an option for those facing their final journey at Porter Hospital. The Porter staff, in recognition of the comfort that an ARCH room can provide their patients, attending family and friends, has approached ARCH to build a room there before the end of 2014.
It is hoped that these projects will demonstrate that ARCH, Porter Hospital and
HPHRC are very committed to the expansion of end-of-life care here in Addison County. “The ARCH Family Center and Porter Hospital ARCH room projects are meaningful elements of our community’s awareness to the love and attention we must give to those on their end-of-life journey,” said PMC President, James L. Daily. “We are very proud of our collaboration with ARCH at both Helen Porter and Porter Hospital to build upon the continuum of care available to our patients and residents.”
ARCH continues to identify the ongoing needs of Addison County relating to end-of-life care. Beyond the bricks and mortar, there should be a continued effort in education and conversation as it relates to death and dying. ARCH has partnered with other organizations to help bring forward issues surrounding Palliative Care and Hospice Care. Indeed, more can be done in preparation.
This year the theme for the collaboration of these five organizations is “Start the Conversation”. It encourages people to talk about death and dying, and complete their Advance Directives. The group is presenting at service organizations, faith communities and local exhibitions such as the Sustainability Expo. A free social event was held in May at 51 Main. Titled “Let’s Talk” and facilitated by Dr. Diana Barnard, the event incorporated several “skit-lets” which presented typical conversations between friends and family members about death and dying. There was food and a cash bar, in an atmosphere that was comfortable and informal for conversation. The latest paper resources for “Starting the Conversation” and Advance Directives were available, as well as people resources for particular questions—legal, medical, spiritual. The feedback from this event was very enthusiastic, so the group will provide this opportunity in other towns, with the next “Let’s Talk” at the Shoreham Inn, in October.
The group has a booth at Field Days and has created a website: www.addisoncountyconversations.org to provide more information and support to the community.
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HELEN PORTER HEALTHCARE AND REHABILITATION CENTER JOINS VERMONT’S HEALTH INFORMATION NETWORK
Second long term care facility in state to participate in network managed by Vermont Information Technology Leaders
BURLINGTON, VT – Vermont Information Technology Leaders, Inc. (VITL) today announced Helen Porter Healthcare and Rehabilitation Center located in Middlebury is Vermont’s second long term care facility to connect to the state’s health information network. Through a VITL interface, Helen Porter staff is now able to receive lab results, radiology reports and transcribed reports soon after the data has been generated from Porter Medical Center to provide more effective and timely treatment.
“In addition to connecting physician practices and hospitals to Vermont’s information network, long term care facilities are also an important component,” said John Evans, president and CEO of VITL. “As residents transfer from one health care setting to another and are treated by various physicians, their most current clinical information is available in one location, which aids in the coordination of care through more efficient treatment and elimination of unnecessary tests or hospitalization.”
Having this clinical information available right in near real time enables treatment to be given more rapidly at Helen Porter, possibly reducing unnecessary admissions to the hospital. In the near future, doctors and other treating medical staff, such as specialists, will be able to electronically and securely access clinical data from Helen Porter through Vermont’s health information network.
“We at Helen Porter Healthcare and Rehabilitation Center are proud to be among the first long-term care facilities in the State of Vermont to connect to the VITL network and continue our ongoing efforts to integrate clinical technology with highly compassionate care”, said HPHRC administrator Neil Gruber.
About VITL: Vermont Information Technology Leaders, Inc. (VITL) is a non-profit organization that assists Vermont health care providers statewide with adopting and using health information technology to improve the quality of care delivery as well as to enhance patient safety and outcomes. Comprised of a collaborative group of stakeholders including health plans, hospitals, physicians, other health care providers, state government, employers, and consumers, VITL is the designated health information exchange (HIE) for the state of Vermont and also the state’s federally-designated regional extension center. For more information, please visit www.vitl.net.
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New Hospice Room to be Established by ARCH at Helen Porter
MIDDLEBURY--An agreement signed earlier this month between Helen Porter Healthcare and Rehabilitation Center and Addison Respite Care Home (ARCH) will soon result in the creation of a new “Hospice Room” to be located within HPHRC.
“The new ARCH Hospice Room at Helen Porter ushers us into a relationship that promises to be exciting and dynamic” said ARCH board president Peter Jensen. “ARCH has admired the courage and commitment of Helen Porter as they have candidly assessed their model of care and concluded that change is necessary; the creation of this new, home-like hospice room is another positive step in this journey”, he said.
In recent months, Helen Porter has introduced a major new “Culture Change” program that will transform many aspects of both the facility and the programs to respond to the changing needs and expectations of our community.
“Nursing homes have a reputation of being very institutional in both appearance and in the services provided, we at Helen Porter are putting all of our energy and many resources into changing that here in Addison County, and the new ARCH Hospice Room is the latest step,” said HPHRC administrator Neil Gruber. The newly renovated hospice room, which will be located on the “Otter Creek Way” area at Helen Porter, is scheduled to be completed in early May. According to Gruber, the goal is to create a very comfortable, peaceful “home-like” environment for people unable to spend their final days in their own home.
The new room is only part of the overall delivery of hospice care, which is described as “a program of palliative and supportive care services providing physical, psychological, social and spiritual care for dying persons, their families and loved ones” according to Jensen. He says that the actual care for residents of the ARCH Hospice Room will be provided by “trained professionals from Helen Porter, Addison County Home Health and Hospice and Hospice Volunteer Services.”
“ARCH considers the culture of Helen Porter and the care it provides to be of critical importance to this new joint project and we embrace the opportunity to be located at HPHRC so that this collaboration can benefit many in our community”, he said. Referrals to the new ARCH Hospice Room at Helen Porter will be made by a person’s physician according to Jensen.
According to Gruber, this new space will be an invaluable resource for many local families who cannot care for their loved one at home during their final days, but who still want a home-like space that offers comfortable surroundings not traditionally found in a nursing home or hospital.
“We are excited about this new project and believe that it will be the first step in what we anticipate being a long, positive and growing relationship between ARCH and Helen Porter to better serve our community” Gruber said.
Helen Porter Receives Grant for New Culture Change Efforts and Programs
MIDDLEBURY--Helen Porter Healthcare and Rehabilitation Center has received a grant of $23,700 from the State of Vermont in support of its efforts to pursue a new “transformational project” to define, implement and evaluate an innovative model of resident care.
The grant comes from the “Enhancing Quality of Life” program via the Vermont Department of Disabilities, Aging and Independent Living (DAIL) and will support Helen Porter’s efforts to work collaboratively with their board, physicians, residents, families, staff and the broader Addison County community to change their long- established “medical model” of care to a new “social model/person-centered model” according to Helen Porter administrator Neil Gruber. “Our overarching goal is to pursue a culture change within our organization to enhance the quality of life for our residents and build a positive community that fosters high quality and compassionate care in a manner that promotes independence, respect and dignity”, he said.
According to Gruber, this process of “culture change” will not simply be a cosmetic improvement intended to improve how our organization appears internally and externally—it truly will impact and change the fundamental way that residents, families, staff and community experience the organization via very specific changes.
“The basis for this culture change project is our sincere belief that the traditional model of nursing home care and the current perspectives, interactions and relationships that exist within our facility and many others does not represent the very best environment for providing the highest quality resident care” he said.
“We have presented to our board of directors our plans to embark on an intensive period of transformation over the next several months that began with the drafting of a new Mission Statement and Vision Statement to serve as the foundation for our work. These statements will be our reference points and guide the many concrete actions, decisions and changes that we will pursue” Gruber said.
He added that these statements are being developed in concert with residents, families and staff, and will be based on a core list of “values”. “In our preliminary conversations with these internal members of our HPHRC family, the initial list of these values include: respect for each person as an individual, promoting the highest level of dignity for residents, promoting greater collaboration and teamwork, ensuring autonomy and independence, building a positive community, fostering healthy relationships and pursuing excellence in everything we do”.
The project coordinator, Nancy Schaedel, is excited to have received this grant and is very enthusiastic to implement a number of new initiatives. “As we move forward, we do so in order to create a safe and caring environment, which fosters both positive relationships and a sense of community. We envision a home filled with love, dignity and quality service, and working together as a team to ensure a sense of collaboration and open communication, where every person is valued as an individual and as a member of a larger community” she said.
Beyond creating new Mission, Vision and Value statements, HPHRC will undertake a comprehensive effort to educate residents, family and staff about what “culture change” is and how to accomplish it. “Changing from a medical model to a social and person- centered care model will require that we change our appearance, philosophy and language, such as changing our terminology from “nursing units” to “neighborhoods” and giving these new neighborhoods names as selected by our residents, families and staff,” Gruber said.
“In our early conversations with our residents, families and staff about our plans to move forward with this project, we have received some important and specific feedback that could define our efforts including: less noise on the units, quicker answers to call bells, more privacy, freedom to eat what they want and knowledge of menu prior to meal service, a coffee shop that is always open, freedom to sleep as late as they want, clutter free hallways, and mirrors at wheelchair height,” he said.
Although the implementation of this culture change transformation will encompass many specific activities, outreach efforts, a new “wellness programs”, etc…over time, one of the primary programmatic changes Gruber envisions is the establishment of a new end- of-life “Namaste Care Program” for residents with Dementia. This program will be modeled on the highly successful program at the Vermont Veterans Home and will address the physical, spiritual and psychological needs of the residents.
In anticipation of this new program, the administration of HPHRC has already identified a physical space within the facility that can easily be transformed to serve as the Namaste Care unit. They also have received a donation of $4,500 from the family of one of their residents that Gruber anticipates using these funds to support the creation of this space.
According to Schaedel, this Namaste Care Program has been successfully implemented in several nursing homes and hospice organizations. She says that Namaste Care strives to maintain the highest quality of life possible for individuals with severe and terminal dementia. This care involves the creation of a special room that provides a quiet, peaceful environment for residents in the last stage of their disease. Meaningful activities are individualized for each resident and a continuous presence of staff members provide both physical and sensory stimulation. This “high-touch” care can be taught to all staff as well as family members. “The family members, particularly, appreciate the attention given to their loved ones,” she said.
She added “The need for programs that would be suitable for individuals with severe and terminal dementia is strong if we are to prevent them from progressing into a vegetative state and help them to continue to enjoy personal contact and stimulation.”
Schaedel says that Namaste Care provides residents and their families with quality care that addresses not only physical but also emotional and spiritual needs. “It reminds us that individuals with advanced dementia should not be isolated in their rooms, but need to live their last days in a pleasant environment receiving loving care from all staff and families,” she said.
The Components of our Namaste Care Program will include Development of a personalized mission statement, development of criteria to determine which residents would benefit, staff selected based on the desire to work with Namaste Care residents, special education and training, soothing and comfortable environments, comfort care approaches, special programming, and grief comfort and bereavement service referrals.
“As we move forward with this effort and these internal improvements, we envision that we will do so in communication and collaboration with other area organizations” Gruber said. “We have had preliminary conversations, for example, with members of the “Addison Respite Care Home” organization (which is developing plans for improving services to area people in hospice care), the “Living Well” organization in Bristol (which offers a variety of outreach programs and services to improve the quality of life of elderly people such as their “Living Arts” program), and others” Gruber said.
As a part of the culture change project and the implementation of the Namaste Care Program, Gruber says that Helen Porter will actively engage these organizations and others in our community in an ongoing dialogue regarding how we can collaborate with programming or long-term projects that will enhance and/or increase services available to the residents of HPHRC and the elderly population of Addison County more broadly.
“We are very excited to have received this grant, and we believe that our project will greatly improve the quality of resident care at HPHRC, and also serve as a model for other Vermont nursing homes” Gruber said.
National Quality Award and Recognition
During their trip to the AHCA conference in Chicago, Helen Porter Healthcare and Rehabilitation Center was also recognized as one of the 2009 recipients of the Step I National Quality Award presented by the AHCA and the National Center for Assisted Living. Last year 664 nursing and assisted living facilities from across the nation applied for the quality award at this level. “We applaud Helen Porter for having passed this first step that demonstrates their intention to begin a rigorous quality improvement program, and look forward to their moving forward to pursue the requirements for the Steps II and III awards in the coming years,” stated Bernie Dana, Chair, AHCA/NCAL National Quality Award Board of Overseers, one of the nine members that oversee the program.
Applicants for the Step I level award have a clear vision and mission for their facility and acknowledge key challenges that are embodied in the organizational profile section of the Malcolm Baldrige criteria. The Step I award recognizes providers that have developed a foundation to begin a journey of continuous quality improvement, and that they have taken the first step in corresponding with any public measures of performance.