All Good Things Come to Those Who Wait!

At the January 2011 annual Seniorsfirst General Meeting, I used the theme "All good things come to those who wait". It was a "tongue-in-cheek" optimistic twist on what certainly was a frustrating year of delays, stagnation and waiting, Waiting and WAITING.................


Nearly 6 months later, it appears that good things do come to those who wait, especially if you push hard enough for what you passionately believe in.


We pushed hard with our state legislature to implement the NYS Medicaid rate revisions, that were suppose to go into effect April 2009. It took a combination of many personal visits with several of our elected officials in Albany and a group lawsuit filed against the state of New York, but the final 2011 state budget passed in April includes the promised Medicaid rate revisions. This revision will rebalance Medicaid dollars across the state at no net cost to the state. There will be losers and winners in the rebalancing. Kirkhaven will be a big winner when the rates are implemented and retroactively settled next month.


We pushed hard with the local NYS department of health in finalizing our assisted living licensing application and, after more than 6 years of administrative red-tape that has delayed the licensing of all active assisted living facilities, we finally received our official licensure notice.

We pushed hard and after months of inconveniences and disruptions to our routines, we have successfully completed a Kirkhaven redecorating project that spruced up our resident households with a much needed "face lift" while we wait for the day when we are able to totally replace our antiquated building with our household cottages.


There is still much that we are waiting for, but we will continue to push hard for these as well. We are working hard with our board and leadership staff on strategies to strengthen our Valley Manor occupancy and fiscal operation. We are working hard with our strategic partners and contacts to pursue available funding for our Kirkhaven Replacement project.


There never seems to be a lack of challenges, a detour to navigate or a frustration to overcome, but we'll keep pushing and continue to believe that "all good things come to those who wait!"


Anne DiCesare, RN (Assisted Living Manager) and I proudly displaying our license

Re-dedicating My Blog!

I know I haven't been faithfully blogging at the pace I was, but to tell the truth, it seemed like I was beginning to blog on the same tired topics and running out of interesting material. I also think that every new fad has its time and place and then its time for something new.

I thought about closing down my blog and then decided that perhaps it still could serve a useful purpose even if I only used it to share monthly or quarterly updates on our Seniorsfirst Communities.

Heck, there must be something worth writing about that is new and exciting at least periodically. So, I will re-dedicate my blog going forward to simply providing periodic updates on what's happening at Seniorsfirst from the CEO perspective.

You can check me out from time to time on our website at Seniorsfirst.com.

A Good Investment in Valley Manor!

With the year 2010 quickly coming to an end, it is a good time to reflect on the operations of our Seniorsfirst independent retirement community. While the nursing home business has been a cash challenge, our Valley Manor apartments has been a "cash cow".


Now don't get me wrong. We have had our challenges at Valley Manor over the past few years and the tough economic times have definitely impacted retirement communities. Seniors are much less apt to make major lifestyle changes in these uncertain times. They have seen their investment portfolios diminish, their income remain flat at best and selling their home has become a really big challenge. All of this has had a significant impact on occupancy and limited the number of seniors actively seeking, or moving into, retirement communities.


So how has Valley Manor fared this year?



Well, apparently folks have determined that a property investment in Valley Manor is a real good investment in these challenging times. If they can't take the volatility of the stock market and the fixed investment market is returning a dismal interest rate, many seniors have opted to invest their available capital in a refundable entrance fee apartment at Valley Manor. And why not? Real estate has a history of being a very good long term investment and a good hedge against both inflation and stagnation. In the case of Valley Manor, it is also a lifestyle investment in that it provides housing and a quality of life for the investor.


We have had a record number of new move-ins this year opt for the refundable entrance fee option and as a result expect to take in over 1.5 million dollars in entrance fees alone. This represents a 50% increase over our historical averages and despite a decrease in our current occupancy, we will end the year with ample cash to meet both our current obligations and escrow funds for future obligations.



We continue to benefit from our low, variable interest rate mortgage and we have allocated some of these savings towards a continuing occupancy enhancement program that includes both marketing and capital improvement initiatives. While we anticipate continued pressure and challenges with respect to occupancy, we also anticipate the continuation of high numbers of entrance fees.


We will continue to advertise what many seniors have already come to recognize- that Valley Manor Apartments is a very good investment!

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!