Kirkhaven Project Progresses

Here I am "entertaining" residents on the Special Care Unit.

I've been spending a fair amount of time lately with the Kirkhaven Replacement Project, but I must admit, it is exciting and fun. This past week we were busy sharing the findings and pictures from our recent site visit to Wisconsin. Amanda and I reviewed this with the Kirkhaven Senior Leadership team and then again with the Board. We also compared notes with Karen (Food Service Director) and Etta (Assistant Director of Nursing) who recently traveled to Minnesota to participate in an educational session entitled "Life happens in the Kitchen". Last week, a group of us also met with a food service consultant who specializes in health care to brainstorm and receive advice on our design and operation vision as it relates to kitchen design and food service. We have a few more site visits and reviews to perform, but we are getting very close to understanding and developing our design vision.

I thought the Board meeting last week was great! There was very positive activity and time well spent on exploring and understanding our strategic vision for Kirkhaven. Good questions, dialog and a sense of consensus. The Board support is very strong and obvious as indicated by their approval of our moving forward with a land purchase offer. I'll keep you posted on any developments with this exciting leg of our journey. Any offer will include many contingencies related to the work and long journey that remains ahead of us and includes: finalizing the design, ensuring project financial viability, certificate of need submission and approval, HEAL-NY grant application and approval for equity funding, project financing approval, local zoning approvals. We then can begin development of construction documents, initiate construction request for proposals, implement capital fundraising campaign, start construction. Did I mention we still have a lot of work and a long journey ahead of us.

I met with Jim Genthner (Chair of Development Committee) this week and we had a good discussion pertaining to a strategy and what needs to be done now to prepare us for a major capital campaign to raise funds for the Kirkhaven Replacement Project. We agreed to pursue the assistance of a consulting firm out of Seattle, Washington called Benevon. I was introduced to the firm and its Founder/CEO when I attended their sponsored educational session at our State Association's Spring Institute in Saratoga. I was very impressed with their campaign strategy and approach. They offer a very reasonable training program and extensive resources to assist organizations with their own campaigns. We will proceed to investigate and prepare ourselves for what could become a 1-3 million dollar major capital campaign to roll out in 2009.

Haven't spent much time with Valley Manor the past few weeks, but Cheryl and Jim have things well under control. I did touch base with Greystone and they assure me they are working hard on our project. We have scheduled a meeting with them and a select group of key board and leadership staff to hear and discuss the preliminary recommendations prior to taking same to the full Board. That meeting is scheduled for July 22 and I am hopeful that it will kick-start some initiatives and strategies at Valley Manor similar to the emphasis currently at work at Kirkhaven.

I worked my routine weekend administrator rotation duty at Kirkhaven this Saturday. It's always hard to squeeze this assignment into an already busy week, but I always enjoy the opportunity to spend time on the floors with residents and staff. As usual I find myself in awe of what great staff we have and how hard they work. I will confess that having recently spent time observing the operations of other "culture change" homes, I notice even more the wonderful growth opportunities we have to improve the quality of life of residents living in our antiquated nursing home. I can't wait to make it different and so much better for all!

Speaking of being busy. Did I mention I'm due for a vacation. Time sure does fly and I haven't been on an extended vacation (week or more) since a year ago last July. I had a nice 4 day vacation after Christmas when Jen and I spent time with my family down in Williamsberg, but that's about it. So I'm looking forward to spending July 2-13 at our cottage on Indian Lake. My daughter's family is joining us for a few days and can't wait to have them and the grand kids with us. We have planned a nice family reunion for my parents who are coming up to celebrate their 60th wedding anniversary. I hope to also spend time just boating, swimming, golfing, hiking and sitting by the open fire in the evening down by the water with an adult beverage and a moon-lit sky. Nice...........

When we return, our newest grandson (Logan) has his baptism at our church on Sunday, July 13. Then I'll be back at work, rested and recharged to jump back into the fun. I so appreciate knowing that I have such a capable team to keep things moving smoothly with or without me. Have a great week everyone and I'll be back on my Blog upon my return.

Wisconsin Site Visit

With over 100 pictures to choose from its difficult
to decide which ones to share on my Blog, but
here are a few.

Amanda and our project architect, Brian Trott,
joined me on a 2-day site visit to Appleton &
Oshkosh, Wisconsin to look,listen and learn from some pioneers who have built "culture change"
nursing homes similar to the model we anticipate for the new Kirkhaven. Our trip was amazing!

Our journey started at 6:30 a.m. at the Rochester airport where we caught a flight to Chicago with a connecting flight to Appleton. After picking up our rental car we drove the 20 miles to Oshkosh to visit our first stop- Evergreen Retirement Community. The CEO spent the entire afternoon with us, talking and
touring us around their beautiful home comprised
of 8 neighborhoods of households with 9 residents
in each household. The households were awesome
with 9 private rooms around a large common area that comprised a kitchen/dining area, living room, activity area and spa with easy access to an outside courtyard. Although it provided for the necessary staff and operational amenities, it looked and felt like home. Each household connected to a large shared area that housed common services.

After our first site visit we were so excited we could not stop talking and designing our own home. We drove back to Appleton, checked into our motel and went out for dinner and more discussion. We went thru many napkins as we kept designing the images that flowed thru our heads.
The next day we headed out to our second visit at Brewster Village. Here we met with many staff and got a grand tour of their magnificent facility. It too used the household model but with a few different twists. Some we liked, some we didn't. The highlight was the central town square where each household connected to and included a grand atrium glassed dome that gave a feeling of being outside on the square. Here is where residents would find the beauty shop, fitness center, ice cream parlor, workshop and so much more.

Our final stop was just down the road at Peabody Manor where we were told by experts to first drive around the campus and take notice of the individual entrances to each household. It was so divine. The households were comprised of 12 residents each that had a living and activity room and shared a country kitchen with the adjoining household. The facility was beautiful and we loved the individual household entrances, but it was amazing how evident it was that they had not really adopted culture change in their operations, only in their physical building.

At the end of the trip, we were tired but pumped with information and even a greater passion for our mission. Amanda and I both liked the same things and Brian was able to get a greater understanding of what we are looking to design. Poor Amanda caught a bad cold the second day and struggled through the day, but it didn't damper her enthusiasm. Our flight home had a slight delay that resulted in our returning home after midnight, but that was the only kink in our itinerary (except giving us smoking rooms instead of what we asked for).

Our objective now is to share our information and vision with the Board and others to ensure we all stay consistent in our objectives. We have a few more site visits to make before we feel we have done complete due diligence with this leg of our evaluation.

Next week should be busy with the Seniorsfirst Board meeting, our staff recognition luncheon at Casa Larga Vineyards, Senior Leadership meeting and several other project meetings. This is really starting to get fun. Stay tuned for more updates.

Staying Cool to Beat the Heat!

Kirkhaven CNAs and Amanda enjoy a tribute to nursing assistants recognition luncheon held at the Holiday Inn and sponsored by Lifespan.

Below, Kirkhaven honorees receive their certificate and token of appreciation.

We continue to make progress with respect to the Kirkhaven Replacement Project. On Monday,the Seniorsfirst Strategic Planning Committee met and viewed a short video on Culture Change. The video does an excellent job orienting viewers to what the Culture Change movement is all about. The video will be shared with the full board at a future board meeting.

I'm really excited about having completed a phase 1 HEAL-NY application grant to seek funding assistance from the Department of Health for 50% of our Project planning & consultant fees. Our strategy is to divide our Project into 3 phases. Phase 1 includes the planning & design, Phase 2 includes the construction documents & construction phase, Phase 3 includes the sale or transition of the existing Kirkhaven building. We are hopeful that our grant request for $60,000 in planning & consultant costs will be approved, followed by approval of a Phase 2 grant request for the more substantial funding request to assist with the construction project equity requirement. We'll keep our fingers crossed as we await approval of the first grant request approval.

The Valley Manor Repositioning Project continues along with Greystone Communities continuing to compile and study the data. We expect their recommendations later this month or next and anxiously await for this report and presentation to management and the board.

And speaking of Valley Manor, Conversity training was in full swing last week as all staff are attending sessions held by Sequeta. The staff feedback has been as positive and appreciative as we experienced at Kirkhaven.

There was some serious training going on last week at Kirkhaven as well. All members of our clinical team spent 2 intense days of classroom training on the MDS (which concluded with a formal exam). The MDS is the driver of our Medicare reimbursement rates and beginning in 2009 will also drive our Medicaid rate. Understanding how to maximize reimbursement via the MDS is critical to our future success.

Here is Amanda with our MDS trainer, Leah, who really knows her stuff and was a great teacher. Kudos to all our team members who attended and enhanced their MDS knowledge.

Scott, Cass, Mary Scorsone and I met last week to strategize more about our payroll policies and ensuring they are adequately meeting the Department of Labor requirements with regard to meal breaks and time clock calculations. We will be presenting some suggestions for further discussion at the next Senior Leadership meeting. At this meeting we will also be discussing the topic of "Internal Marketing" led by Jim Payne.

This week, Amanda and I will be flying out to Wisconsin, along with our architect, to visit 3 Culture Change nursing homes. Our objective is to look, listen and ask questions so we can learn from others mistakes and success. We had another site visit, to a facility in Buffalo, cancelled last week when the Health Department showed up at their facility for the annual survey. We will look to reschedule in the near future.

Hope you are all finding ways to stay cool and beat the heat. I have been out in my kayak a lot lately and find the cool water breeze a great respite from the humidity. I also love to jog when the temperatures get hot (go figure). I took a golf lesson finally and it really helped, so maybe I'll start playing some more golf.

I spoke with Jean Boyle last week and her surgery went very well and she is recuperating and rehabbing at the Fairport Baptist Home (or as I say- conducting some mystery shopping). Have a great week everybody and stay cool!

Jim's Top 10 List

I admit it, I love lists. I find them very comforting and use them constantly to help organize my life. So this week's blog is some random ramblings and my" top 10 List" that illustrates my top 5 Challenges and my top 5 enjoyments in my CEO position.

Top 5 Challenges:

• Government Bureaucracy- the health care field in New York is extremely regulated, which wouldn't be such a negative thing if the bureaucrats in charge weren't so clueless and the system wasn't so complicated that objectives get totally lost and all we end up with is more red tape, higher costs and less time to accomplish our goals.
  
• Minimal Margins- in this business it is tough to make a profit. Much of the revenue comes from 3rd party government contracts or private pay residents/clients with limited assets. Your revenue doesn't increase much from year to year which means it always seems like you're fighting to make ends meet. There are so many things about our business that I would love to enhance, but no margin-no mission.
• Governance Structure- the not-for-profit arena functions with a voluntary board of directors providing the governance oversight. They hire the CEO, who is then charged with the operational responsibility of the organization. Creating the right governance structure that allows the board to positively impact the organization while recognizing the primary organizational skills lie with the staff, is a delicate balance. I want the board experience to be rewarding and enriching, but it can't become a hindrance to the organization's operation.
• Customer Expectations- I'm as bad as anyone when it comes to high expectations and little tolerance for bad service, but it is frustrating to try to meet unreasonable expectations. Our customers include government regulators, residents, families, staff to name a few. They all have expectations of perfection and in this complicated field with limited resources and high regulations, perfection is often an unreasonable expectation. Doesn't mean we don't aim for it, but it sure is a challenge and frustrating when you miss your target and get nailed for it. Thank God for those who take the time to notice the good things we do.
• Information Overload- I've been in this business for 25 years now and it was never this bad. Is it possible for us to be to connected and accessible. E-mail, faxes, voice-mail, junk mail, spam, internet, list-serves, conference calls, cell phones, lap-tops, blackberry's, and the list goes on and on. I easily spend half my day just keeping up with the information and correspondence that crosses my path, and I still carry a briefcase home every night with the stuff I didn't have time to get to. Information is powerful, but it sure is much harder to screen out what you need from the onslaught of data.
  

Top 5 Enjoyments:

• The Relationships- In my position I have the opportunity to meet and interact with many people from peers, staff, residents, families, volunteers, consultants, business partners. Every relationship is different and every relationship makes a difference in my life. At home, I am an introvert, but at work I am an extrovert and enjoy my relationships with others as much as anything else I do.
• Leadership- They say some people are born leaders. I don't really know, but I do know I love providing leadership. I lead using the principles of servant leadership and it has served me well. I enjoy leading by example and helping others become better leaders themselves. As CEO, I am in the perfect position to be a leader and I revel in the responsibility and expectation.
• Mission- I really love that I have the opportunity to do good in my work. It is not about making money or being the best, but just about providing a beneficial service for someone in need. Sure, I admit I sometimes dream about owning my own company and making a billion dollars on some novel invention, but that is just a fun diversion. In my real life, I take great pride and satisfaction knowing that I am making a difference in many people's life because of what I do, not because of what I accomplish.
• Autonomy- I am blessed to have a great deal of autonomy in my job. Yes, I report to a board of directors and like anyone else, I have goals and responsibilities that I am accountable for. However, no one sits outside my office door and watches over me or tells me what to do or how to do it. As CEO, I make those decisions and I love the challenge and opportunity that affords me.
• Crisis Management- don't get me wrong, I don't look forward to a crisis. However, they do come along now and then and are part of a CEO's job. Crisis come in various levels and scope, but I can count a handful of whoppers that I have managed in my career. A resident who fell down a stairwell in a wheelchair and died, a top executive of the organization who died suddenly of a stroke, a community recall of our lobster bisque during a fund-raiser because of suspected contamination, an outbreak of Salmonella in the water supply at our facility. While I don't wish these things to happen, they do happen and I actually find I am at my best when under pressure with others counting on me.

Wow, I have created yet another list to organize my thoughts and my life. I feel better already. Have a great week and watch for my next blog posting to get caught up on what's happening from the CEO's perspective.

Memorial Day & Board Week

So how did you spend your Memorial day weekend? I spent Saturday doing yard and garden work until enjoying the latter part of the day and evening at a neighborhood party. Sunday I went golfing with my brother-in-law and picked up right where I left off last year by not breaking 100. I guess I will break down and use the golf instruction gift certificate my wife bought me last Christmas. Monday we hosted a small family graduation celebration for our nephew who graduated from Potsdam SUNY college and is now off to earn his masters. What a beautiful 3-day weekend. I hope you all got a chance to enjoy and relax in your own special way!

Back at work on Tuesday saw a lot of productive time squeezed into a short week. I was able to finish off a comprehensive "White Paper" that summarizes the critical financial issues and options pertaining to our Kirkhaven Replacement Project. This paper is the culmination of a lot of strategic analysis and review that provides clarification and a road map around the major financial related hurdles we will need to navigate. The Kirkhaven Replacement Project currently has 3 distinct major elements that we are actively working on:

* Facility vision & design
* Site location
* Financial considerations

The Financial Considerations White Paper is being presented and discussed at next week's Building & Ground's committee meeting and then will be distributed for information to the Board. If you would like an advance copy, please send me an e-mail request and I will send you the document file.

At the Kirkhaven Board meeting, the board was introduced to our ace nursing administration team. Nadine, Etta and Michelle presented an educational sound-byte to orient the board to the structure and goals of the nursing department. Jim III was introduced to the board and shared some of his background and immediate department goals. The balance of the meeting was dedicated to reports and discussion pertaining to Amanda's facility operations update report and the progress reports from the Resident Life and Building & Grounds Committee. We have a very supportive and active board that cares about our residents and our mission.

At the Valley Manor Board meeting, we dedicated all our time to a progress report by the Greystone team. They are only about 60% into the project so the emphasis of their presentation was more on an orientation of their organization, personnel, experience and project approach. They outlined the project deliverables and timeline and gave the board some initial impressions from their earlier site visit and review to date. They are aiming for the August 6 Seniorsfirst Board meeting to present their final report and recommendations. We are blessed to have some key board member participation and support with this critical and challenging project of major significance.

Other activity and development from the week include a final management decision and recommendation to take to the board concerning our 401(k) pension plan. After much analysis and dialog, we will recommend a plan administered through the team of Fidelity Investments and Morgan Stanley Advisors. On a related subject, another management decision was reached concerning our contract pension actuary for the defined benefit pension plan. After interviewing and reviewing competitive proposals we will hire the local firm of Gallagher & Associates to replace our long time actuary of Longacre & Associates. We also had a bisque fund-raiser planning meeting and our Chair, Jean Boyle, led us to some key decisions concerning setting the date of September 19 for our next 1-day sale event, aiming to add at least 1 additional site on the South or North side of town, and establishing some marketing/public relations ideas.

In other news, I continue to lead a RAHSA initiative to restructure our local membership association including the Criminal Background Check joint-venture program. This has turned into a major project and challenge that I am now committed more than ever to fix. I see a light at the end of the tunnel and hope to finish this off in a few more weeks.

On a sad note, I have received formal notice from Dr. Jurik that he is retiring form the medical field at the end of this September. He came to see me and ensured me that it is not the result of anything more than he is tired and ready to hang up his stethoscope. Unfortunately, his practice doesn't have adequate physician coverage to continue providing service to Kirkhaven, so we will be recruiting a new physician group. I am sharing this with you in advance of any official announcement just to give my Blog a sense of "you heard it here first" importance:)

Hey, be sure to keep Jean Boyle in your thoughts as she has a hip replacement surgery on Monday, followed by a 6 week recoupment and rehabilitation leave-of-absence. Folks are starting to send in their summer vacation requests, which is helpful for me to plan accordingly. I plan to be gone from July 3-13 for my time at the cottage on Indian Lake.

Have a great week and in closing, here is my practice attempt to drop in some pictures so in the future I can share some work related pictures to help capture the essence of the week.

Grandson's #1 and #3- Brennan Daniel holding his new baby brother, Logan James.

Grandson #2- Dylan John

NYAHSA Annual Spring Conference

The majority of my week was dedicated to attending our State Association's Annual Spring Conference held in Saratoga Springs. The weather was cool and rainy which made it easy to focus on the educational and networking opportunities that were plentiful.

I arrived Monday evening and met up with some of my peers for dinner before heading out to a vendor-sponsored networking party where I met up with many vendors and peers to share conversation and fellowship. Tuesday was full of educational seminars and vender exhibit followed by a NYAHSA sponsored dinner event. The entertainment was a group of political satirists called "Capital Steps" who has the audience in stiches with their skits, songs and jokes. As they acknowledged right up front, the current national and state political scene provides the kind of material they could only dream of!

Wednesday was another full day of seminars follwed by a half day on Thursday, ending with an outstanding closing session that focused on "warming up the workplace". All in all, I thought the seminars I attended were all outstanding. I always find that this conference includes the most relevant issues most closely aligned with the challenges we are currently facing. The information and education provided has a high percentage of immediate impact on both operational and strategic components of our business. I will be introducing some leadership and strategic concepts, that I picked up at the conference, in the very near future.

Thank you to the leadership team back home that kept things going while Amanda, Cheryl and I were attending this conference. I was able to stay connected via my e-mail and voice-mail, but it is always comforting to know that our team is deep enough to maintain operations without any problems when other key staff are away.

When we return to work next week after the long Memorial Day Weekend, we will hit the ground running, I will attend the Valley Manor Gentleman's breakfast and participate in a 401(k) planning meeting and a lobster bisque fundraiser planning meeting. We have our Senior Leadership Team strategy meeting and both the Kirkhaven and Valley Manor board of director's meetings.

I'm looking forward to the long weekend and plan to go out and watch the Senior PGA Open on Saturday. Jen and I are hosting a graduation diiner party for our nephew who graduates from college and I hope to get out to play my first round of golf on Sunday. Hope the holiday weekend brings everyone some well deserved R & R.

Greystone Communities Comes to Valley Manor

We were thrilled to finally have the Greystone team arrive on Tuesday for their site visit at Valley Manor. Their team consisted of 5 individuals with distinct skillsets in the areas of physical plant, marketing, operations, finance and project manangement.
The Valley Manor team consisted of myself, Cheryl, Scott, Eric and Jim. We started our day with a 1.5 hour tour of the facility and grounds followed by a 1.5 hour information sharing and ideation session. We then continued our discussions over a working lunch before breaking out into smaller work groups to focus on the specific areas of physical plant, operations, marketing and finance. Other staff and some resident board members joined the breakout groups to participate in these strategy sessions.
After giving the Greystone team an opportunity to collect their thoughts and share notes, we all reunited for a wrapup session and discussion of next steps. On their way back to their hotel, I took on them on a quick stop to see Kirkhaven (from the outside) and to see what the Strathallen Hotel is doing to dress up the exterior of their old building.
I had an unrealistic hope that their arrival would instantly and magically
discover some "silver bullet" to solve all our problems. The truth being, they came, they looked and they listened. Then they confirmed what we already knew. The good news is that they also told us they have seen this before and that we were more timely them many in starting to take corrective action. They were optimistic that they would be able to present us with both short-term and long-term strategies to reposition us for improved occupancy. One of the team members stayed in Rochester an additional day to conduct a competitive analysis, while the others will return to Texas where they will continue to formulate our plan.
They will be back in a few weeks to share some initial feedback and process with the Valley Manor board at the May 29 board meeting. The project is not expected to be finished for another month or two at which time a final plan will be presented to the Seniorsfirst board. In the interim, they will continue to work with us, have additional site visits as needed and plug away at the project objectives. The broad perspective and experience they add to the talent and experience our own team brings to the table, should result in a comprehensive and effective strategic plan for the future direction and operation of Valley Manor.

In other news.................the HR Committee discussed and approved surveying our staff again in 2008 with the same Employee Opinion Survey used last year. They concurred that we should be surveying our staff annually, the same as we do with our resident customers. In 2009, they have opted to try using a national employee survey tool to enable us to benchmark our results with other organizations. Cass will spearhead a process to evaluate and select an appropriate survey tool to accomodate this objective........................
the Marketing Committee met for the first time with Jim sitting in the VP of Marketing and Community Services seat. The meeting included a lot of strategy discussion, planning and organization. The team of Jim and Cilla bring a new passion and vision that will be exciting to watch unfold. Aside from a good meeting, the other hilarious occurence at this meeting was the "unknown visitor". Seems there was a community networking group also meeting in the building and one of their participants mistakingly was directed to our Marketing Committee meeting. Between Jim, Cilla and I, we all thought the other had invited her to join our committee and just went with the flow. Ironically, she was in the marketing business and knew Jim. She fit in well and actually contributed to the meeting discussion. After the meeting, I asked Jim who she was and he and Cilla both said "beats me, I thought you invited her"(LOL). When we finally solved the mystery, it was really pretty funny...........
the Development Committee also met this past week and they spent most of the time talking about ways to engage our board more in fund raising and friend raising. Major gift giving and grant solicitation is a key ingredient to our fund raising strategy, but that can't be accomplished by Jean alone. Most not-for-profit boards are very active in the fund raising efforts and with the Committee's leadership, we hope to better engage our own board in this objective.

Was it me or were there a lot of things going on around the facilities last week? The Spring Fling events were fun and kept the place jumping with novel activities. Retirement parties, interviewing and touring prospective staff, Greystone visit and of course business as usual.

Friday afternoon, I attended a Workers Compensation Self-insurance Trust annual meeting held on behalf of another organization of which I serve on the board. It was very interesting to compare them to our own Self-insurance Trust and I was able to gain extensive insight into this subject matter that will undoubtably serve us well in our own program planning. I'm sure you're jealous that I got to spend my Friday afternoon at the Holiday Inn in Buffalo listening to this exciting topic presentation for 3 hours!

By week's end, I felt I had covered a lot of ground with a lot of different topics and meeting agendas. Not sure where the week went and I didn't have a lot of time for routine desk work, but I am tired and looking forward to my weekend.

This coming week I will be in the office for Monday morning and all day Friday only. In between, I will be attending our NYAHSA conference in Saratoga along with Amanda and Cheryl. Some good educational topics and always good networking opportunities make this conference a must to stay on top of current events in our field. I'm actually not bringing my golf clubs (a first) this time as I continue my quest to make golf an enjoyable pasttime and not an annoying obsession. I haven't even swung a club yet this year!

Hope you all have a great week..................