The Good, The Bad & The Unknown

I thought I would share some updates with my Blog readers to keep you posted on how things are going. To make it easier and more organized, I'll separate my comments into three categories:

The good, the bad and the unknown!

Let's start with the good stuff because everyone prefers good news..........................

• We hit 90% occupancy for the first time in quite a while at Valley Manor. You may recall that we initiated an "occupancy enhancement program" this year and it seems to be working, as occupancy has increased from 85% to 90%. We have now set our sights on phase 2 of our program which we hope will take us to 92% occupancy.


• We are running at 97% occupancy at Kirkhaven. Additionally, the "Medicare Maximization" program we initiated has increased our average Medicare rate 6.4% and our Medicare utilization 4%. The combination of these 2 items plus an increase in our Medicare Part B (therapy services provided to our long-term residents) is estimated to bring an additional $275,000 in revenue for 2009.


• We have raised $35,000 towards the Valley Manor courtyard renovation project and have selected the proposal of choice from the 3 bids received. Total cost is expected to be around $50,000 so we will continue our fund-raising campaign while hopefully implementing at least phase 1 of the project early this summer.
• We have had no further reported cases of Legionella at Kirkhaven other than the one resident who is now back at Kirkhaven and doing fine. We are awaiting the test results of the water samples taken from various sources in hopes that it will help us identify where the problem was. After taking the test samples, we conducted a complete "heat & flush" of the water system, which eliminates any bacteria that may have developed within the system.
• We recently compiled the results of our "Evaluate your Supervisor" surveys and once again our leadership at both Kirkhaven and Valley Manor were scored outstanding by their staff. On a scale of 1 to 5 (with 5 representing the best score), Valley Manor leadership averaged a 4.5 and Kirkhaven leadership averaged a 4.0. Staff evaluate and rate their supervisor on 12 distinct leadership qualities. We use this program to ascertain leadership training needs and to ensure that we are providing quality support and leadership to our staff. I am very pleased with these results and the fact that our leadership has the courtesy and courage to offer their staff this opportunity to provide direct feedback.


• The NHL Stanley Cup final round begins and the match up is a great rematch between last years finalists. My money is on the new kids and the Pittsburgh Penguins over the defending Cup champion Detroit Redwings in 6 games. It's time for a new champion!

The bad news fortunately is light.....................

• We still haven't received our 2009 Medicaid rates, so we continue to get paid at the old 2008 rate. This is starting to create a cash flow issue. The passed State budget established the broad methodology of the 2009 Medicaid rates, but apparently calculating and issuing them is going to take a while. In the interim, the State is more than happy to be paying us the lower 2008 rate.


• We found it necessary to make a change in our assigned primary care physician at Kirkhaven. You may recall that after 25 years with the same physician group, due to retirement we needed to make a change last October. We are now with the Rochester General Hospital Physician's Group and very pleased with the medical administration and medical director services they are providing. However, the primary care physician they assigned to Kirkhaven did not work out and thus they have worked collaboratively with us to assign a new primary care physician effective June 1.


• First my beloved Buffalo Sabres didn't make it to the Stanley Cup playoffs, then my newly adopted playoff favorite Washington Capitals get bounced out by the Penguins. So I decide to root for the Chicago Blackhawks and they lose out to the Redwings. Maybe I should start watching the NBA playoffs!

Now for the unknown...................

• Can we maintain our momentum and occupancy at Valley Manor? We know we have some planned move-outs coming up soon, but we are also entering the prime season for move-ins. 90 % occupancy is good, but 92% and higher is better!


• The initial evaluation and projections suggest that the 2009 Medicaid rate methodology will be good for us once we finally get it. How good or if so is still an unknown risk until the actual rates are issued.


• Will the economy make a dramatic comeback in the second half of 2009? We have begun to see signs of improvement in the first half, but the fall was so great that we need more than signs of improvement to right our investment portfolios and strengthen the economic engine of our country.


• Will our Kirkhaven Replacement Project, which has been put on hold until the economic outlook is more certain, resume momentum. We haven't completely stopped planning for this project, but where we go from here and when is still a big unknown.


• Who will win the 2009 Stanley Cup and will the Buffalo Sabres do anything to ensure they make the playoffs next year? What will I do with all my time once hockey season is over?

I'm off to Saratoga, New York to attend our State Association's annual Spring Training Institute and Exhibition. Great opportunity to stay abreast of current issues and trends in the field, as well as to network with peers across the State.

Thanks for visiting my Blog and see you next time!

What's in the water?

What is in the water?

That's a question all health care facilities need to ask on a regular basis. You might be surprised to learn that very often the presence of Legionella bacteria exists in many water distribution systems of large buildings including hotels, factories, apartment complexes, hospitals and nursing homes.


Cooling towers, associated with the central cooling systems in these buildings, have long been thought to be the major source for Legionella, but that is not always the case. Other sources include mist machines, humidifiers, whirlpool spas, drinking fountains and any place where standing water and organic sediment can stimulate the growth of Legionella bacteria.


Most of us come into contact with Legionella more often than we likely recognize. Fortunately for most healthy individuals our normal defense systems fend off the bacteria with little of no ill effects. Legionella is not contagious, or in other words you can't "catch it" from someone else. The Legionella organism is aerosolized in water and people inhale the droplets which carry the bacteria into their body. Another passage way is through aspiration or choking such that secretions in the mouth get past the normal choking reflexes and instead of going into the esophagus and stomach, they enter the lungs. Smokers and patients with aspiration precautions are most at risk for this common mode of transmission.


Contact with Legionella is not normally serious except with high-risk individuals such as heavy smokers, those with lung disease and the frail elderly with low immune systems and risk of aspirations. Symptoms are flu like with fatigue, weakness, high fever, nausea, ache, diarrhea and stomach discomfort.


Treatment for Legionella is the use of appropriate antibiotics and is generally defensible with excellent outcomes. For people whose immune systems are compromised, prolonged hospitalization, complications and death can occur. Often, Legionella is not tested for or diagnosed and the symptoms are simply treated similarly and appropriately as for pneumonia or flu with the same excellent outcomes.


At Kirkhaven, we had a resident hospitalized and diagnosed with Legionella last week. It appears to be a very isolated case and the resident is back at Kirkhaven and doing very well. We have undertaken a comprehensive heightened awareness for any other suspected cases and have initiated appropriate precautions and testing to mitigate risk and identify the possible source. We have several standard preventative maintenance programs that have been in effect for years to minimize the risk of Legionella growth, but recognize that no plan is 100% effective.


We are working collaboratively with the Health Department, who is well versed and experienced in working through the many incidents of Legionella that occur in similar situations. Our team of clinicians, medical staff, facility maintenance and administration is doing a great job addressing the issue and communicating effectively. It makes me very proud and comfortable knowing that all the proper steps are being taken in response to this incident.


If it turns out to be an isolated incident of no major consequences, we will be thankful and appreciative of the response team's immediate and appropriate actions. If it turns out to be a systemic problem that requires remediation, we will be equally thankful and appreciative of the response team's immediate and appropriate action.


Legionella is a problem that can exist in any environment and requires constant attention to control and abate. The risks to individuals is much greater in hospitals, nursing homes and places where individuals with compromised immune systems reside. Understanding the risks and knowing the precautions are important.


Thank you to the Kirkhaven response team for ensuring the continued safety and comfort of our residents. You are an awesome and dedicated team!

We Are Family!

We adopted the slogan "We are Family" a few years back at Seniorsfirst when we held our annual summer picnic. It seemed like a logical choice as our picnic included an old-fashion family barbecue, lawn games, ice-cream social, fun and fellowship. Who can forget the water pistol wars and the soaking most of received.



Next week is Spring Fling at Seniorsfirst, another family tradition that we truly enjoy. We celebrate the arrival of Spring with a week of special fun events and games. Each day will be a theme dress-down day: pajama day, crazy hat day, go-green day, Italy day, t-shirt day. There will be free food, treats and plenty of family competition as we compete for various prizes in games of skill, chance and silliness.



Coming up in June will be our annual recognition luncheon where we honor members of our Seniorsfirst family who have reached a milestone level of years of service with our organization. We will hold this event at the prestigious Oak Hill Country Club and will celebrate together our appreciation for service and dedication of both our staff and volunteers.



Family fun and celebration is an important part of life at Seniorsfirst. Our communities are really just large families made up of the residents who live there, the staff who work there, and the volunteers who serve there. We spend a great deal of time together and the relationships we build connect us as one extended family.



We work hard and our family life is not always easy. The challenges can be over-whelming at times. We deal with illness and death on a regular basis within our family. We struggle with economic challenges like most other families. We have internal spats when we don't always agree, but then forget and forgive. But most of all, we celebrate and enjoy family life.



I am reminded of the importance of family in our lives as this past weekend I had the joy of spending much time with my immediate family. My son, daughter-in-law and grandson from Raleigh, North Carolina came for a visit as we also celebrated the 1 year birthday of another of my grandsons who lives here in Rochester. It was only the second time that all 3 of my grandsons were together and as they grow older it was special to see them begin to form a relationship together.



Pictures tell the story better than words, so here are some shots of how I spent my extended weekend enjoying family. Like so many of you, I am so blessed to have such a wonderful family, both at home and at work.................


Jen and Me with our youngest grandson Logan James on his 1st birthday

Cousins Dylan John and Logan James checking out the balls

Dylan shops at "Wegmans" at the Strong Museum of Play

Jen spending time with grandson Dylan visiting us from Raleigh

Our family here in Rochester- daughter Kristin, Son-in-Law Dan with Brennan & Logan

Cousins Dylan and Logan playing with the sand box

Daughter-in-law Melissa watching the cousins play together

Dylan reads our dog Jessi a bedtime story


Thanks for visiting my Blog. See you next week!