New Year Wishes for 2009

As 2008 comes to an end and the start of a new year is upon us, I thought it appropriate to make a "top 10" list of New Year wishes as CEO of Seniorsfirst. To add a little fun, I included both my professional and personal top 10 wishes.........................

1) Funding Approval for the Kirkhaven Replacement Project- we need the State health department's approval and funding assistance to keep our project moving forward.

1a) Buffalo Sabres start a Winning Streak- I'm getting tired of them winning one and losing one.

2) Improved Occupancy at Valley Manor- If we can get them to give us a look, they'll see that we have the best value and life style of any independent living facility.

2a) My ice skating rink works- I've spent countless hours rigging this rink on my front yard so it better get cold and stay cold so we can enjoy it.

3) Reasonable and Manageable Medicaid Rate- the Governor is threatening more Medicaid cuts in his proposed State budget, but lets hope it doesn't turn out to be devastating.

3a) My Wife finds Happiness and Success in her New Career- after 20 years serving as an Assistant District Attorney, Jennifer is leaving to pursue other opportunities & challenges.

4) Successful Growth of our At-home Services and Adult Day Programs- these are great community based support programs that just may be the best kept secret in Rochester.

4a) Buffalo Sabres make the Playoffs- I can't go another year without them in the playoffs!

5) New York State Licensure of our Assisted Living Facility- it has been over 2 years since new regulations required us to apply for licensure, and the State still hasn't finalized.

5a) A Granddaughter- I love all 3 of my grandsons, but now I need a little girl to spoil.

6) Continued Progress with our Culture Change Movement at Kirkhaven- we have made great strides and it only gets more exciting as we continue along our Pathway.

6a) Success with my First Novel- I enjoy writing and have decided to try my hand at writing a novel. Even if it never gets published, I will still enjoy the thrill of writing it.

7) Successful Management and Maximization of the MDS Resident Assessment & Reimbursement Tool- this skill will likely become the life-blood of our nursing home operation, so it is critical that we get it right.

7a) Stock Market Bull Run- like everyone else, my net worth took a nose dive in 2008 and could really use a comeback in 2009.

8) Successful Start to our Kirkhaven Capital Campaign- our Kirkhaven Replacement project will need support from our generous donors to help with the financing needs.

8a) An Exotic and Fabulous Vacation- our vacations to Hawaii and Italy seem like a decade ago, so I think it is time to plan the next get-away.

9) Stable and Content Workforce- our staff is key to the quality of our service. Low turnover and high job satisfaction translates to high quality care.

9a) Buffalo Sabres Win the Stanley Cup- hey it's my list and I can wish for anything.

10) Happiness, Peace and Good Health for All!

10a) Happiness, Peace and Good Health for All!

Thanks for visiting my Blog in 2008 and be sure to visit me often in 2009 to keep apprised of what's happening at Seniorsfirst from a CEO perspective. In closing, here are a few pictures of the week:

Santa (me) and his helper (Jen)

Santa giving gifts to residents at Kirkhaven

Sharing some Christmas Cheer with Family

Santa has a gift for everyone

HAPPY NEW YEAR EVERYBODY!

What do "Choosing a Nursing Home" and "Buying a Toaster" Have in Common?

To most people, choosing a nursing home and buying a toaster would appear to have very little in common. But apparently to the "brilliant minds" at the Center for Medicare and Medicaid (CMS), not so.


Now I must admit, whenever I am in the market for a new appliance, I always check out the Consumer Reports online prior to buying. I figure I don't buy a toaster or washer and dryer very often, so what do I know about which brand is best. Should I go with Brand X, Brand Y or Brand Z?

Appliances can be tricky you know. Fortunately, it can all be "dummied" down to a few basic elements: Features, Performance Ratings, Energy Efficiency & Cost. And then, to make it even easier for us, the Consumer Guides will assign a nifty little "star system" so all we need to do is choose the appliance with the most stars and voila, our work is done!

I'm guessing a lot of people choose appliances this way and why not. It's not very personal and rather subjective based on a series of statistical reviews and results that are formulated by some unknown technicians using data, formulas and processes totally foreign to you and me. But come on, it's only a toaster for crying out loud! If you like the color and the price is within your range, go with the 5 star toaster and don't sweat the decision.

So if this process works so well with appliances, why not use it for other purchasing decisions?Well, many of us do. But not every decision in life can or should be "dummied" down to a simple 5 Star process.

I would put choosing a nursing home in this category, but CMS doesn't agree.

CMS has come out with its own version of a 5 Star system that takes this very personal and emotional decision and makes it all very "simple". Finally, choosing a nursing home for your loved one is as easy as buying a toaster! Simply look for the home with the 5 Star rating and voila, don't sweat the decision. It's only your mother's quality of care and life for crying out loud!

Thanks a lot CMS, but wait....................could there be a flaw or two in this simple process?

For starters, the data used is not current. It is also just a snapshot of the homes data at a given time and not necessarily representative of the on-going operation. Its formula penalizes homes that have Special Care units or who care for sicker residents. The survey and clinical data is totally subjective and inconsistent. At Kirkhaven, we have greatly improved on the documentation that drives the acuity rating of our residents and ensures we are receiving the appropriate reimbursement rate for the level of care we provide. According to the CMS 5 Star rating system, this increased acuity erroneously translates to "poor performance outcomes".

The bottom line is that you can't take an important decision like choosing a nursing home and make it fit into a simple 5 Star scoring system. Consumers need to study the data that is available and use it to ask good questions. Visit the homes you are considering and talk to the staff, residents and family members. Use your senses to observe and take adequate time to review and make your decision. References from friends and professionals in the field are much more reliable and accurate than anything CMS can conjure up from their limited data and real knowledge of the home.

So, what do choosing a nursing home and buying a toaster have in common? Absolutely nothing.................unless of course you're CMS.

Happy Holidays everybody!

Our People Make the Difference

I recognize that we have many customers at Seniorsfirst. Of course there are our residents and clients for whom we provide services for. In many cases, there are also family and friends that come to visit. I would even argue that the third-party payers, like Medicare, Medicaid and others are also our customers.

Everyone that we come in contact with as we go about our work and life at Seniorsfirst, represent our customers. As CEO, it is important to me that I recognize and foster excellent customer service and relations in every aspect of our organization.

In my role, I don't really provide direct care to residents and clients. Oh sure, I have periodic contact with them and practice good public relations in all my interactions, but when it comes to actually providing quality care and service, that responsibility lies with our direct care and service staff.

I'm talking about the "front-line" staff like the Certified Nursing Assistants, Home Health care Aides, Nurses, Technicians, Therapists, Chaplain, Food Service Workers, Housekeepers, Maintenance Workers, Social Workers.

I'm also talking about the "support staff" that provide the necessary infrastructure and assistance to enable the direct care staff and organization to function, like the Finance Office, Human Resources Office, Receptionists & Front Desk Staff, Security Staff, Secretaries & Clerical Office Staff, Marketing Staff, Resident Services Staff, Development Staff and Administration Staff.

My philosophy is that if I can keep our family of staff happy and joyful in their work, than Seniorsfirst will always be a happy and joyful place for our residents and clients. Sounds simple enough, but it is a challenge and something we must work at every day.

To monitor our success in this endeavor, Seniorsfirst routinely hires an outside, independent consultant to confidentially coordinate, compile and report on an employee satisfaction survey process and its results. We want to know how our employees are doing and how they rate their employment experience at Seniorsfirst.

We just recently completed the 2008 Employee Opinion Survey and the results are very impressive. We will be sharing summaries of the results with staff, residents, families and the board of directors in the weeks to come, but I'll give my Blog visitors an early peek.

At Valley Manor, with slightly more than half of the staff responding..............

• 89% are satisfied overall with the organization's leadership
• 96% are satisfied overall with the direct supervision they receive
• 64% are satisfied that they receive a fair wage for the work they do
• 88% are satisfied overall with their benefits package
• 94% are satisfied overall with the work environment and safety conditions
• 77% are satisfied overall with communication within the organization
• 85% would recommend Valley Manor as a good place to work
• 96% believe we provide true quality of care and services to our residents
• 81% would recommend Valley Manor to family and friends for service.

These scores far exceed industry standards (our consultant tells us) and have been attained and sustained for the past several years.

At Kirkhaven, with just under 50% of the staff responding......................

• 69% are satisfied overall with the organization's leadership
• 76% are satisfied overall with the direct supervision they receive
• 49% are satisfied that they receive a fair wage for the work they do
• 78% are satisfied overall with their benefits package
• 81% are satisfied overall with the work environment and safety conditions
• 61% are satisfied overall with communication within the organization
• 83% would recommend Kirkhaven as a good place to work
• 83% believe we provide true concern and quality of care to our residents
• 75% would recommend Kirkhaven to family and friends for service

These results represent great improvement from the previous year and in most cases are higher than what the national averages are within the nursing home industry. A similar survey conducted with over 200,000 nursing home employees of more than 400 facilities across the country revealed the following:

1. Job fulfillment satisfaction scored 72% versus 80% at Kirkhaven
2. Job security satisfaction scored 71% versus 77% at Kirkhaven
3. Supervision satisfaction scored 70% versus 76% at Kirkhaven
4. Work environment satisfaction scored 64% versus 81% at Kirkhaven
5. Pay satisfaction scored 50% versus 49% at kirkhaven
6. Benefits satisfaction scored 63% versus 78% at Kirkhaven
7. Leadership satisfaction scored 60% versus 69% at kirkhaven
8. Staffing satisfaction scored 57% versus 88% at Kirkhaven
9. Satisfaction in participatory management opportunities scored 52% versus 67% at kirkhaven
10. Overall satisfaction scored 65% versus 76% at Kirkhaven

The health care field is very demanding and challenging. The senior services and retirement community field is very competitive and challenging as well. But they can also be very rewarding and enjoyable for those who are called to serve their elders.

I am both humbled and proud of these results. I have great respect for the staff at our Seniorsfirst Communities & Services and pledge to continue to support them in as many ways as we possibly can to ensure their continued and improved customer satisfaction.

For we all know that......at Seniorsfirst- Our Staff make the Difference!

Thanks for visiting my Blog..................................Jim.

There but for the grace of God.........

I'm feeling a little introspective today as I read the morning paper's report about the death of a friend and peer. Kevin Nacy, president and CEO of Lakeside Health System died unexpectedly in his sleep early Friday morning.

As I read his short bio, I am struck by the eerie similarities in our lives. Kevin and I were both born in 1955 and at the age of 53 neither have had any significant illness or health problems. We both resided in Irondequoit and had 2 grown adult children, a son and a daughter. I can't help but wonder if, like me, he had encountered the wonderful experience of becoming a grandfather.

Kevin and I started our careers together, when we both worked as health care auditors for Blue Cross of Rochester. We both used our audit experience to land a finance position in a local hospital. Kevin went to Rochester General and I went to Nicholas Noyes Hospital. Shortly thereafter, we both took CFO jobs when Kevin went to work at Lakeside Hospital and I at Kirkhaven.

Similarily, we both became interested in health care administration and moved up within our respective organizations to become president and CEO. Kevin and I served together on various professional boards and our career paths would often cross within the health care community.

So why am I sitting here writing this Blog, while his life has come to a sudden end?

There is no answer to that question, but one can look to the scriptures to understand that both life and death are ours. Christ has conquered all fears in life, so that in death, we can live an eternal life with God.

All we can do is live our life on earth to the fullest, in the image of God who gave us faith, hope and love. I guess I'm feeling rather privileged today and expect I will have a greater appreciation for the things in my life. Death can be an inconvenient reminder of the true meaning of life.

So the world will keep spinning and the sun will set and rise as it does every day. Life goes on and so will we. Farewell Kevin and may you live in peace in heaven. There but for the grace of God, goes I.