How far can we stretch?

If you are a faithful reader of my Blog, you are aware that at Kirkhaven we have been "patiently" waiting for the State to retroactively begin paying nursing homes the new, updated Medicaid rate effective all the way back to April 1, 2009.


For Kirkhaven, this promises to increase our rate approximately $25 a day and retroactively reimburse us for nearly 1.5 million dollars. Since the State is merely shifting capped Medicaid dollars between nursing homes across the state, they can actually afford to do this. There will be winners and losers when the new rates are paid, and fortunately Kirkhaven is among the expected winners.


The reason for this is in part because Kirkhaven is one of only a few nursing homes who is still receiving a cost-based Medicaid rate calculated from its initial 6 months of operations back in 1984. A lot has changed since then and our cost structure today is very different from what it was back then. While our rates include an inflation factor adjustment, it hasn't kept pace with our real cost increases or inflation.


A recent survey of our peer nursing homes showed that our $155/day Medicaid rate is well below the $183/day peer average. As a result, we are forced to operate at a lower cost per day than our peers while still providing the same high quality of care. This same peer survey showed that over the past 10 years, Kirkhaven's operating costs have increased 36.3% versus the peer average of 64.5%. Our salary costs per bed increased 33.2% over the same 10 year span versus the peer average of 55.6%. And while the peer average staffing per bed increased at a rate of 10.5% over the past 10 years, Kirkhaven's staffing per bed decreased 2.4%.


These are not statistics we necessarily wanted to aim for, but rather had to hit in order to maintain fiscal integrity. With a federal quality rating from CMS of 4 stars, Kirkhaven has attained the envious status of a low cost-high quality nursing home. But how far can we stretch?



In 2010, we pushed our available line-of-credit to the limit and implemented a 6-month austerity budget to keep our cash flowing while we waited for the "imminent" Medicaid rate upgrade. We have literally used every option available to us to out wait the State, but how far can we stretch?


Our Board of Governors has authorized us to continue to leverage our operation in anticipation of the new Medicaid rates rather than cut our staffing and expenses even further. We have requested some level of relief from the State and will continue to do what we can to bridge the gap while we wait for the State to pay the new rates. But how far can we stretch?


2011 promises to start out in much the same fashion as 2010. Still getting paid $155/day for Medicaid residents, who comprise nearly 70% of our resident population and who cost us on average $216/day. We will continue to operate on an austerity budget and hold off on any wage increases, new positions and discretionary expenses. We will advocate and lobby for the State to fulfill its promise of updating the Medicaid rate. And we will wait and pray that we can continue to make ends meet while the State gets it's house in order.


But how far can we stretch?

Recognizing our Dedicated Employees

We recently held our annual recognition luncheon at Oak Hill Country Club and had the opportunity to recognize those individuals celebrating major length of service tenure, volunteer service and exceptional service awards.

I'm not really sure how many recognition functions I have attended over the past decades, but I do know that I keep trying to come up with new and innovative ways to say thank you for the dedicated service of staff and volunteers.

This year I thought it would be fun to take many of my past remarks and themes and create a super-sized, all-in-one, one size fits all, mega recognition presentation. I called it my "greatest hits" collection of recognition presentations.

Perhaps my most memorable remarks were the years 1990 and 2000 when I did the "What's Hot and What's Not" routine to illustrate how much things have changed within our workplace, even though so many of our staff have been with us all along. I listed the "hot items" of each decade such as:

• voice-mail/e-mail/texting

• fax machines/e-mail/scans


• pagers/cell phones/smart phones


• recycling/energy efficiency/go-green


• DOS/Windows/Office

Yes, over the years a lot has changed, but our staff & volunteers represent the one thing that has not-loyal, dedicated and caring individuals.

One year I compared our staff & volunteers to the everyday things in our life that we come to depend on:

• The alarm clock that wakes you up

• The hot shower that revives you


• The coffee that stimulates you


• The car or bus that gets you to work

I spoke about how miserable our day is when any of these things we depend on lets us down, like:

• Power failure shuts off alarm


• Out of hot water, shower runs cold


• Forgot to turn on the auto coffee maker


• Car won't start or the bus runs late

I marveled at how our staff and volunteers all represent the dependable things in our life. So many depend on them and they have not let us down.

Another year, I shared that there were 4 approaches to deliver my sincere appreciation and thanks for their dedicated service:

1. Emotional (where I get all mushy and huggy and say a heartfelt thanks)
2. Paternalistic (handshake, pat on the back and say thanks for all you do)
   
3. Rational (tell you how much you mean to those you serve and thank you on their behalf)
   
4. Analytical (equate what your years of service means by the numbers)

I wrapped up my remarks by saying that no matter how one chooses to say it, the common denominator is you have given a lot and contributed vastly to our success for which we are greatly appreciative.

Not too long ago, when we held our luncheon at a winery, I noted in my remarks the similarity between fine wine and fine staff. I concluded by saying:

• You represent the cream of the crop

• Like fine wine, you come from good stock


• You have distinguished yourself by not being just one of a bunch


• You have flourished in your environment


• You have matured into fine staff


• You have an aura of excellence compatible with the finest wine and best of class

Then there was the year I said our staff were all 3rd class ticket holders. I shared that in the days of the stagecoach there were 3 classes of tickets:

1. First Class could remain seated during the entire trip no matter what happened.


2. Second Class could also remain seated, until there was a problem at which time you had to exit the stagecoach until the problem was resolved. You could stand off to the side and watch as others worked, but could not re-board until the problem was fixed.


3. Third Class definitely had to get off if there was a problem, because it was your responsibility to help fix the problem.

The moral of my remarks was that what impressed me most is that we have so many 3rd class ticket holders at Seniorsfirst. Some organizations have too many 1st class ticket holders who expect to be catered to, waited on and pampered. Other organizations have a lot of 2nd class ticket holders who will ride along until there is a problem, but then become detached spectators. But the 3rd class ticket holders at Seniorsfirst get out and push when the going gets tough. They accept the call for servant leadership and understand that in our resident's and client's eyes, third class is really first class.

Finally, there was the time in 2003 that after attending a seminar on "The Disney Way", I spoke how the principles that Walt Disney set for his staff were not unlike the values and principles shared by all of our staff:

• Treat others as you would want to be treated yourself

• Focus on the customer


• Create a magical and enjoyable experience for all you touch


• Safety first, courteousness second and efficiency third

Yes, over the years I have found many ways to recognize the dedicated and amazing service that our staff and volunteers represent. But perhaps the most meaningful way to recognize their contributions is to simply reflect on how each uniquely touches and makes a difference in the lives of those they serve.


Congratulations to all our staff. You are all caring and loving individuals and although there are many ways to say it, it is my pleasure to simply say a heartfelt "thank you"!

Summer Time Fun at Valley Manor

This past week the staff at Valley Manor held their summer picnic out on the courtyard at Valley Manor. A staff committee planned the event and with help from the HR and Food Service staff, summer time tropical fun was in full bloom.



It started with cold, refreshing tropical drinks and a food buffet that included chicken, pork, white hots, veggie burgers, potatoes, rice, salad and more. Perhaps the biggest hit was the home-made tropical beef dish provided by Brent in the maintenance department. Who knew that Brett could fix up dinner as well as he can fix up equipment?





After lunch, the competition began and it got very competitive as staff played for extra raffle tickets to increase their chance of winning any of the many prize packages on display. I don't like to brag, but the CEO plays a mean game of "ladder ball" and "can jam"!





It was a hot and sunny day, which made the ice-cream desserts a welcomed treat and nobody seemed to mind the occasional watering from some errant squirt guns. Staff never seem shy about shooting the CEO.......... although it is all in good fun.




Good food, fellowship and fun was the order of the day at the Valley Manor staff picnic. I really enjoy watching the staff have at fun at work and I cherish the opportunity to jump in with them. For a few hours we forgot about our work roles and just enjoyed each others company as we got silly and had some good old-fashioned summer fun.


When the party was over, it's back to work. But our batteries are recharged, our bodies refreshed and our hearts lifted as we resume our work roles and come together again as a team, serving our residents and clients.


Thanks for all you do every day. Individually, you are all unique and wonderful individuals. Together, you are an amazing staff!

Getting Wet & Wild at Kirkhaven!

Kirkhaven held a fun water day event that both residents and staff had a wet & wild time with. A picture tells a better story, so "read on" and enjoy...................



Double-fisted and dangerous!






















Just shoot me already








Death by water can be fun?

Approach at your own risk!

I may be the pastor, but I'll shoot if you make me.

I got you covered.

That has to hurt!

Don't mess with my residents!

Don't mess with the "Terminator"!

Everybody messes with this guy.

I got your back Mable.

That still hurts!

I mean business!

Still Friends!

The Sage Project

After months of planning and planting, the Seniorsfirst "Sage Project" rolled out with great fanfare and success this past weekend at the annual Park Avenue Festival.

The Sage Project was an idea designed to blend public relations, resident activities and fund-raising into a fun event. Every year the Park Avenue merchants hold a massive festival that attracts thousands of people looking for crafts, food, entertainment and fun. Since Kirkhaven resides on the avenue, we often participate in some small way. But this year we decided to step it up a notch.

With so many of our residents being avid gardeners, we decided to engage them in an herb growing activity and then pot and sell the herbs at the Park Avenue festival to raise funds and awareness towards our wonderful home. The Sage Project involved residents from our nursing home, assisted living home and adult day program. It extended to our staff and several community volunteers.

It literally began with seeds and tending of the gardens. It then proceeded to potting and arranging. Finally it came to the event set-up and sale. With the help of a "Bright Spot" that advertised our event on the local news the day before and a beautiful day that brought out huge crowds, the foot traffic into our courtyard along Park Avenue resulted in plenty of sales. I was amazed at the positive interaction between customers and residents. I was pleased to hear the pleasant comments about our Kirkhaven home and the Sage Project. I was humbled by the show of gratitude and support from the volume of sales. On more than one occasion, people would simply give us a donation or tell us to keep the change.

The project was a great success on every level. The residents enjoyed the meaningful activity and the opportunity to interact with each other, staff and the community. Seniorsfirst enjoyed wonderful public relations in getting the good word out into the community about our innovative communities and services. We sold over a thousand dollars in herbs with the net proceeds to go towards our resident activity funds.

As our VP of Marketing said afterwards, "the smiles on the faces of the residents and staff/volunteers add another million dollars in value to the project!" With the lessons we learned and the success we had, we will definitely bring the Sage Project back next year.

The Man Behind the Room

For the past 18 years, when there was a need for a group of people to meet and dialog on important work related to the Kirkhaven mission and operation, chances were the meeting was held in the Wilcox Board Room.

In 1992, when the south wing addition was built, the conservative but eloquent board room was named after one of Kirkhaven's premier pioneers-Harris Wilcox. For those who often use the Wilcox room and utter its name regularly, I thought you might appreciate a bit of history about the man behind the room.

Harris Wilcox, a prominent area businessman, internationally renowned Auctioneer and Realtor, Chairman of the Board of Harris Wilcox Inc, a generous benefactor of Charitable, Civic and Youth Organizations and a lifelong devotee to American Agriculture, was born in Bergen, NY on 1919 and recently passed away in July 2010.

Mr. Wilcox was a devoted Christian and member of the Bergen Presbyterian Church who lived his life in direct relationship to his faith. He was Chairman of the Board of Directors of Kirkhaven from 1980-1985, the period of Kirkhaven's initial start-up and development. A time of both challenges and opportunities that might never have been navigated successfully had it not been for the unique style incorporating knowledge, energy, humor, stamina, and the "larger than life" presence that defined Harris Wilcox.

When I first met Mr. Wilcox, I was a 27 year-old, still "wet behind the ears" Director of Finance. I was in awe of the man and his gentle, yet determined, command of every encounter. His kindness and chivalry stood out among all others in the room and when he spoke, people would hang on his every word. His command of the English language, his tact, his decisiveness rarely left an inkling of doubt that if Harris was behind a project, the project would get done.

I remember the trials and tribulations Kirkhaven encountered with respect to the initial funding requirements of our H.U.D. financing program. The head bureaucrat at H.U.D. was a woman named Helen Moore, who dragged us through every regulation, code & rule she could find before we finally received project approval. The tactful, yet humorous, gentleman that Harris Wilcox was, could not resist taking a parting shot at the mortgage closing when he declared with much pride and determination, " We give thanks for this blessed day, for Lord knows we have been through hell-an-more".

As I sat through the funeral of Mr. Wilcox, I could not help but to reminisce about how far Kirkhaven has come since those early start-up days. Slowly we are losing the great pioneers, like Philip B. Price and Harris Wilcox, whose vision and dedication have led us to where we are today. But although these pioneers are gone, their memories and the lessons they taught us remain as a gift for all of us to carry forward.

My wish is that each of us will remember and respect the "presence" of Harris Wilcox whenever we sit in the Wilcox Room. The presence of a gentleman.......the authority of a born leader. Mr. Wilcox had it right when he would say, "Chivalry is not extinct" and "We have a Great God and a Wonderful Savior".

Thank you Harris for all you have given Kirkhaven. "Well done Thou Good and Faithful Servant".

BLOG Respite

If you are a regular visitor to my weekly Blog, you have probably noticed that I haven't been very timely or active with my Blog of late. Not sure why, but I guess I have just been busy with summer or have hit the "Blog wall".

It has been 2 years since I began my Blog and while I really enjoy the writing and sharing of stories, my creative energy and time appear to be fading.

Perhaps once summer ends I'll find that inner source of imagination and desire to capture my thoughts and share them with you within my Blog again. Until then, have a great summer.

Dream big, dream often.............................Jim.