Continuum Magazine (fall/winter 2008)

Fall/Winter 2008

A publication for Wisconsin’s Long Term Care Profession by

Building EMPLOYEE

RETENTION

PLUS: • Avoiding On-Call Coverage Pitfalls • Handling a Media Crisis • Developing Employee Immunization Campaigns

www.whca.com www.wical.org

Does Your Rehab Provider Offer All This? • trained, experienced • Medicare claims and therapists and assistants denials management dedicated to improving the indemnification lives of your residents • long-term care • local rehab manager and programming facility-specific program • continuous quality manager improvement • therapists skilled in current CPT codes and their uses

• national client services resource group (clinical, PPS, financial expertise and current regulatory guidance consultation) • accurate and timely resident screening

• therapists paid for all their time in your facility

• full range of census-building • measurable, outcomesprograms driven services (clinical, financial and administrative • corporate compliance tools available) program/HIPAA committee

• staff development and training programs

• local, regional and national • facilitate cash flow education services

• ongoing clinical care strategies

To discover more about how Peoplefirst Rehabilitation can help your facility, please contact:

Scott Hale Senior Director of Business Development

888.836.8819 office 216.570.2656 mobile [email protected]

COPYRIGHT

© 2008 Peoplefirst Rehabilitation CSR 82165

www.peoplefirstrehab.com

welcome WELCOME TO THE premier edition of Continuum magazine, a unique publication dedicated to the issues and interests of Wisconsin’s long term care provider community. You have received Continuum by virtue or your being a valued member of the long term care continuum, hence the title. The Wisconsin Health Care Association (WHCA) and its dedicated assisted living division, the Wisconsin Center for Assisted Living (WiCAL), wanted to create a publication that presents positive, practical and authoritative information to the Wisconsin long term care community. You and your staff members provide valuable and dedicated service to Wisconsin’s frail, elderly and disabled residents, and this magazine is devoted to helping you in your mission to protect, serve and care for these individuals. Currently we intend Continuum to be published bi-annually, released each Fall and Spring. There will be no subscription or cost to you. Each issue will provide articles and information of interest to the leaders of the long term care community. We hope that you enjoy this premier edition and would welcome your input for future editions. To provide comments, input or reaction to this premier edition, please access the online version at www.whca. com. There you will also fi nd additional information about the valuable benefits and opportunities offered by WHCA and WiCAL.

This magazine is devoted to helping you in your mission to protect, serve and care for individuals.

Join Wisconsin Center for Assisted Living, WiCAL, is the dedicated division of the Wisconsin Health Care Association (WHCA) and the Wisconsin affi liate of the National Center for Assisted Living (NCAL). Wisconsin’s assisted living and senior housing providers are welcomed to explore the benefits of membership of WiCAL. Membership is free of charge for the balance of 2008: No obligation to continue and no tricks. Give WiCAL a test drive, and let us earn your future membership. Expertise: WiCAL has the backing and experience of the WHCA, the oldest trade association representing Wisconsin’s long term care

Sincerely, Brian R. Purtell WiCAL Executive Director and WHCA Director of Legal Services

! provider community. The WHCA/ WiCAL staff represent over 115 years of collective service to the long term care community. Advocacy: With three lobbyists on staff, two of whom are attorneys, WiCAL is a leading and credible voice within Wisconsin’s legislative and regulatory arena. On the national level, NCAL is a recognized advocate in Washington D.C. on issues impacting the assisted living community. Communications: Having a Director of Communications on staff provides WiCAL the ability to advance the policy agenda, enhance the image of members, and assist members in proactive and reactive media efforts.

Quality Improvement and Education: The mission of WiCAL includes assisting members to continue being national leaders in the provision of assisted living services. Educational programs and quality initiatives are a core element of WiCAL efforts. Educational programming places a premium on practical, evidenced based, information to allow you to receive the greatest value. Training opportunities are provided in various formats and mediums to allow you to manage your costs and valuable time. To begin to experience the benefits of WiCAL membership, at no cost through 2008, simply go to www.wical.org and click on “Join WiCAL.” FALL/WINTER 2008

C O NTINU U M

3

From conception... to construction... to completion... The Samuels Group Corporate Headquarters LEED® Registered Facility Constructed by The Samuels Group

Our Healthcare Construction teams are continually trained, accredited, and/or certified in such Healthcare Constructor programs as: ASHE, OSHA, Indoor Air Quality, LEED®, and others

The Samuels Group and Stone Office Group are combining their expertise in healthcare construction and interior design to provide our clients an easy solution to being ‘green’.

View our work portfolios at

www.SamuelsGroup.net www.StoneOffice.com

Authorized Dealer

Call us today to see how our Innovative, Over Achievers will bring you Smar t Solutions. The Samuels Group 311 Financial Way Suite 300 Wausau, WI 54401 715.842.2222

CONTRACTORS. INNOVATORS. OVER ACHIEVERS.

Stone Office Group 311 Financial Way Suite 302 Wausau, WI 54401 715.845.5654

S m a r t

S o l u t i o n s

contents Continuum is published for the Wisconsin Health Care Association and the Wisconsin Center for Assisted Living 121 East Wilson Street, Suite L200 Madison, WI 53703 608-257-0125 Fax: 608-257-0025 www.whca.com/www.wical.org Managing Editor Brian Purtell Editorial Associate Erin Celello

Fall/Winter 2008

7 CLINICAL CORNER: Breaking the Chain How immunizations can play a key role in your facility’s infection control efforts.

9 HR 4 LTC: ON CALL COVERAGE: Avoiding Wage and Hour Pitfalls The ramifications for an employer running afoul of wage and hour laws can be significant. How to ensure you’re doing what’s best for you and your employees.

11 FALL CONVENTION ROUNDUP Great reasons why this year’s 57th annual convention is a can’t-miss opportunity!

Published by

12 BUILDING EMPLOYEE RETENTION Naylor, LLC 5950 NW 1st Place Gainesville, FL 32607 800-369-6220 or 352-332-1252 Fax: 352-332-3331 www.naylor.com Publisher Mark Migliore Editor Saara Raappana Marketing and Research Associate Zach Swick Project Manager Rick Jablonski Account Leader Patricia Nolin Account Representatives Denise Creegan, Janet Corbe, Steve Hall, Scott Pauquette, Mark Verceles, Cherie Worley Layout & Design Calvin Harding & Emma Law Advertising Art Carrie Smith ©2008 Naylor, LLC. All rights reserved. The contents of this publication may not be reproduced by any means, in whole or in part, without the prior written consent of the publisher.

page 9

Staff turnover is a profession-wide challenge, but these steps can make you an “employer of choice” in long term care.

16 MEDIA MATTERS: Handling a Media Crisis: How to Come Out on Top No organization, despite its best efforts, is immune from a crisis. Use these top tips to handle the media in any situation.

18 CAPITOL BEAT: State Races will Affect Long Term Care Providers The Wisconsin State Legislature and handfuls of U.S. Congressional races are heating up this fall. Here’s how their results could affect you.

page 12

20 STAKEHOLDER SPOTLIGHT: Heather Breummer Heather Breummer, Executive Director on the Board of Aging and Long Term Care, talks about filling the shoes of founding Director George Potaracke, the Medigap Helpline and how the BOALTC can make your life easier.

22 INDEX OF ADVERTISERS/ ADVERTISER.COM

page 16 PUBLISHED AUGUST 2008/WHC-B0208/8315

FALL/WINTER 2008

C O NTINU U M

5

MPRO Leads! When it comes to Informal Dispute Resolution, MPRO is a trusted expert in Independent Third Party IDR Review. MPRO works with state agencies and provider associations nationwide to meet and exceed IDR needs. MPRO incorporates evidence-based techniques with a quality improvement process built in. See what we can do for you. Kathy Matuszak, IDR Project Manager (248) 465-7419 or [email protected] MPRO is proud to serve the state of Wisconsin

Paid for by MPRO under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services. 8SOW-MI-T1-08-23

391876_MPRO.indd 1

7/17/08 2:04:54 PM

Multiple services with a single focus: Your Success • Medicare and Medicaid Reimbursement Services • Billing Services • Information Systems & Support • Budgeting & Strategic Business Support • Advisory & Tax Services • Accounting & Audit Services • Financial Consulting Services For more information, contact: JT and Associates, LLC 700 Pilgrim Parkway, Suite 200 Elm Grove, WI 53122 Gary Johnsen Phone: 262-789-9945 Adam Teresinski Fax: 262-782-8766 6 CONTI NUUM www.whca.com 388024_JTAssociates.indd 1

6/19/08 1:50:22 392034_Focus.indd PM 1

7/21/08 11:55:23 AM

clinical corner Breaking the Chain Dedicated Immunization Campaigns are Vital for Employees and Residents THE CORE VALUE mission in your organization undoubtedly includes providing the best care and service to your clients and residents. As part of that mission, licensed and unlicensed congregate living settings must maintain vigilance in their infection control prevention efforts to protect clients and workers. There is increasing focus on infection control in all settings, and regulatory compliance, liability risk, and reputations can hinge on provider efforts in this area. Due to the many and varied physical, physiological, psychological and social changes that accompany the normal aging process, the risk of infection increases as people age. Many chronic diseases and conditions that frequently accompany the aging process increase the aging resident’s risk for infection. Congregate living environments, with multiple staff and visitors coming and going, further increases the risks of transmission. Major objectives of your infection control program are prevention and control. “Breaking the chain” of transmission of infectious agents is an essential element of infection control. One proven prevention opportunity to break the chain is the immunization of workers and clients. Educating and encouraging clients to receive their vaccinations is an important (and for nursing homes, required) step in prevention efforts. As important are the efforts you should be taking to ensure the highest level of employee immunizations to reduce the opportunities of transmission. Rather than a single “reminder” to staff,

immunization campaigns targeting staff and volunteers should be adopted as a means of increasing immunization rates. Staff Influenza Immunization Campaigns: The Centers for Disease Control and Prevention recommends all staff, except for those individuals allergic to the vaccine or eggs, should be encouraged to receive the influenza vaccine. Dedicated campaigns, which culminate with annual vaccination efforts, have been proven to be most effective in achieving the highest rate of immunizations, particularly for staff members. Plan your program: Include all staff members and departments when establishing your vaccination team and plan out your entire calendar of efforts toward education and encouragement. Culminate the planning with leadership visibly being among the fi rst to be immunized and serve as role models for staff members to follow. • Maintain Leadership Support: Stay on top of the campaign by monitoring ongoing reports. Monitor success, identify where efforts and education are needed, and incorporate this information into current and future efforts. • Promote Program Consistency: Use steady, repetitive reminders and educational posters, newsletters, paycheck stuffers, and information sheets. • Make Vaccinations Convenient: Offer opportunities for employees to be vaccinated. If you do not have qualified staff to administer shots,

©www.istockphoto.com/Eric Hood

By Brian Purtell, JD and Betty Brunner, RN, BS, NHA

An immunization campaign doesn’t have to be a massive undertaking of management and staff time.

FALL/WINTER 2008

C O NTINU U M

7

consider connecting with local providers to host a community clinic where your employees will be able to participate. • Reach the Resistors!: There is a category of employees who steadfastly refuse to be vaccinated. Fear and misunderstanding are at the heart of many of these individuals’ objections. There is a wealth of materials available to educate employees, dispel myths, and confront fears. Identify why some

people are reluctant, and shape the message to counter these issues. A particularly powerful tool is the use of a declination form an employee signs, which includes an acknowledgement of their understanding of the risks and benefits to themselves, their families and the clients they serve, regarding their decision to decline the vaccine. • Evaluate the Program: Monitor employee immunization rates this season to measure performance.

Use this information to continue to hone the message and establish goals for next season. There is no reason to reinvent the wheel for such programs, and an immunization campaign doesn’t have to be a massive undertaking of management and staff time. Once the framework for a campaign is established, most of the work is done; annual reviews of any changes or goals are all that is necessary. Most importantly, proven programs are readily available, including complete toolkits, which contain sample letters, fact/myth sheets, presentations, declination forms, flyers, paycheck inserts, and much more. The “Immunization Toolkit,” available at www.medqic.org, contains just about anything an employer could need in the development and implementation of an employee campaign. While this toolkit was developed for nursing homes, it is scalable and equally appropriate for use in assisted living communities. Brian Purtell is WiCAL’s Executive Director and WHCA’s Director of Legal Services. Betty Brunner is the Vice President of Development of Pathway Health Services. She can be reached at elbrunner@ pathwayhealth.com

That’s why you’ll find more opportunity to grow at HCR ManorCare. As one of the nation’s leading providers of short-term post-acute and long-term medical care, our size gives you more opportunity to take your career further and in new directions. There’s sure to be a location near you. Join us!

Please contact the appropriate center to find out about open positions: ManorCare of Appleton Ph: 920-731-6646; Fax: 920-731-5177; Email: [email protected] ManorCare of Fond du Lac Ph: 920-923-7347 Ext: 223; Fax: 920-922-4737; Email: [email protected] ManorCare of Green Bay East Ph: 920-432-3213; Fax: 920-432-0614; Email: [email protected]

Geneva Lake Manor A Nursing & Rehabilitation Facility Geneva Lake Manor is a Sixty Bed facility. We offer 24 hour skilled nursing care along with short term rehabilitation services.

ManorCare of Green Bay West Ph: 920-499-5191; Fax: 920-499-8959; Email: [email protected]

At Geneva Lake Manor we strive to provide a continuum of high quality healthcare services. Our care management model leads the patient through the heathcare continuum by providing the appropriate level of care to each patient, utilizing resources necessary to achieve optimal outcomes.

Heartland of Pewaukee Ph: 262-523-0933; Fax: 262-523-1674; Email: [email protected] Heartland of Platteville Ph: 608-348-2453; Fax: 608-348-2944; Email: [email protected]

Our subacute and skilled services offer an alternative to prolonged hospital stays. In addition, our general restorative program is designed to provide long term care for those who can no longer be cared for at home due to illness, injury frailty or other impairment.

Heartland of Shawano Ph: 715-526-6111; Fax: 715-524-5708; Email: [email protected] Heartland of Washington Manor Ph: 262-658-4622; Fax: 262-658-1503; Email: [email protected]

Under the direct supervision of a physician the interdisciplinary team designs and implements a goal oriented, individualized plan of care to maximize patient outcomes in a cost effective manner.

We offer excellent benefits including medical, dental, and 401(k)! EEO/Drug-Free Employer

211 S. Curtis St. Lake Geneva, WI 53147 Phone: (262) 248-3145 Fax: (262) 248-3564

Apply online at www.hcr-manorcare.com

P E O P L E

|

8 CONTI NUUM 1 www.whca.com 391467_Manor.indd

S T R E N G T H

|

C O M M I T M E N T

7/17/08

11:28:44 387784_Geneva.indd AM 1

7/22/08 2:08:30 PM

HR4LTC On-Call Coverage Avoiding Wage and Hour Pitfalls By Mindy Rowland Buenger, Dewitt Ross & Stevens, S.C.

“HEY, ARE YOU going to be around this weekend? I might need you to come in.” “Don’t go too far from home this weekend; it looks like I’ll need you to come in to pick up a shift. I’ll give you a call and let you know which one.” “Looks like we’re going to be busy with some admissions this weekend—I’m going to want you to be at the ready. So stay in town and be able to get here on 15 minutes notice.” Ever made a comment like this to one of your employees? It sounds innocent enough—a simple inquiry into an employee’s availability to work a weekend shift or a mere request that an employee be within range in case things get busy. But before you know it, you can fi nd yourself liable to pay on-call time to your employees. The above three statements present progressively higher levels of expectation and commitments that an employer might communicate to an employee on a Friday afternoon. Whether any or all of these might constitute the employer having to compensate the individual for “waiting” or “oncall” time requires a detailed examination of the totality of the circumstances, as well as the previous dealings between the employer and employee. Regardless, however, employers need to be aware that certain requirements or restrictions very well may be considered “hours worked,” even if there is no actual exertion by an employee. And, as you well know, “hours worked” translates into compensable time for the employee. Why do you need to care? In the long term care field, where around-

the-clock coverage 365 days a year is a necessity, it is important to be aware of what is compensable time so that you do not mistakenly fi nd yourself confronted with wage claim-based restrictions placed on an employee for on-call time. Whether to compensate for certain on-call time is one of the more controversial areas of litigation arising under the Fair Labor Standards Act (FLSA). The reason is simple: whether on-call time is compensable is very fact-specific and, unfortunately for employers, there are not any bright-line rules to follow. That said, there are some guidelines that can assist you in avoiding a claim. This article provides a road map of those guidelines. SOME HISTORY Back in 1944, the United States Supreme Court fi rst decided that hourly, non-exempt employees were entitled to be compensated in certain circumstances where the employee might be called upon to work, i.e., where the employee is on-call. Federal regulations shortly followed suit, identifying the following standard: “if the employee cannot use the time effectively for his [or her] own purposes,” then the oncall time is compensable. Generally speaking, the more restrictions you place on your employees as to their freedom and movement to engage in activities of their choosing, the more likely it is that the time will be considered “hours worked” and therefore compensable under the FLSA. The ramifications for an employer running afoul of the wage and hour rules relative to on-call coverage can

© Ghubonamin | Dreamstime.com

The ramifications for an employer running afoul of the wage and hour rules relative to on-call coverage can be significant.

FALL/WINTER 2008

C O NTINU U M

9

FACTORS TO CONSIDER While a determination of whether on-call time must be paid is factually specific, the following list of factors is instructive: • Existence of an on-premise living requirement • Length of any required time limits for responding to calls • Geographical restrictions on the employee’s movements while oncall • Frequency of actual calls during such time • Ability or inability of employees to trade “on-call” responsibilities with other employees • Number of employees working on-call in a given department

be significant. An employee who prevails on a wage claim is entitled to two, sometimes three years’ back pay, as well as his/her attorneys’ fees. Also note that employees cannot “waive” wage claims. That means that you cannot come to any sort of agreement with your employees that on-call time is not compensable. PROACTIVE MEASURES The best practice, of course, is to establish a policy in which both you and the employees are clear as to whether or not an individual’s time is to be compensable when an employee is not performing his/her typical job duties. Make a determination on the front end of whether the on-call time you require of your employees rises to the level of “hours worked,” by analyzing that time

• Whether the use of a pager could ease any restrictions on the employee • Whether the employee actually engaged in personal activities while on-call • Whether an agreement existed between the employees and the employer regarding compensation while on-call, and whether employees were aware of such an arrangement at the time of accepting the position • Geographical location of the employer • Effect of requiring compensation for on-call activities both as to the employer and the employee

under the above standards and meeting with an attorney if you have any concerns about whether you should be compensating your employees for the on-call time. It is also beneficial to you to remember that just because an employee is engaging in compensable on-call time, he/she does not have to be paid at the standard wage rate for that employee. The employee only need be compensated for the “hours worked.” Wage rates for on-call time can differ from an employee’s regular rate, although minimum wage and other over-time provisions still apply. For example, an employer must assure that the employee’s overall wage rate during a pay period be at or above the applicable minimum wage. This is particularly important if you are going

Choices

®

When life is limited, aging in place is what people want. When the focus of care shifts from curative to palliative, VITAS focuses on enhancing patients’ comfort and overall quality of life. As an advocate for the rights of those at the end of life, our VITAS team of hospice experts helps patients remain at home.

to have an employee whose normal pay rate is at or just slightly above minimum wage. Establishing an on-call pay rate that would be significantly lower than such an employee’s wage could create a situation where their work week average hourly wage would be below the required minimum wage. Likewise, employers must also keep in mind that waiting time and on-call time counts as hours towards overtime expectations for non-exempt employees. As an extreme, if an employer were to indicate restrictions sufficient to constitute an entire weekend being regarded as “hours worked,” including overnights, that employer would quickly encounter a situation where the employee would have 48 hours worked over the course of only two days. CONCLUSION If you are like most health care facilities, you want to balance the need to occasionally require an employee to report to work when necessary against the need to compensate employees not actually working during that on-call time. To do so, employers need to take a close look at their on-call policies and procedures and ensure that those policies and procedures allow for the ability to call an employee in if necessary, without unduly restricting the employees’ freedoms.

At VITAS, patients and families come first.

Serving the Milwaukee area since 1994 For information, call 414.257.2600 Referrals: 1.800.93.VITAS • www.VITAS.com

10 CONTI1NUUM 391423_Vitas.indd

www.whca.com

7/17/08 7:32:38 PM

Mindy Rowland Buenger is partner at DeWitt Ross & Stevens S.C. She can be contacted at 608-252-9320 or [email protected]

DON’T MISS THIS YEAR’S 57TH ANNUAL FALL CONVENTION THE WISCONSIN HEALTH CARE ASSOCIATION (WHCA) and the Wisconsin Center for Assisted Living (WiCAL) invite you to join us for our 57th Annual Fall Convention. This year’s convention is offering 21 valuable educational sessions of interest to all providers and their staff. During and after educational sessions there will be plenty of social and networking opportunities, including a cruise down the Fox River complete with food, refreshments and music. Educational offerings include: • Building the Foundation for Excellence and Customer Satisfaction • The “Bug” Stops here – Infection Prevention & Control in Long Term Care • Preventing Culture Change Meltdown, Tools to Turn Your Dining Vision into Reality • Turning Complaints into Compliments: Creating a Culture of Continuous Quality Improvement as a Strategy to Managing Complaints and Grievances • Lessons Learned: Provider Insight Gained from Litigation Experience • The Secrets to Exceptional Customer Service Every Day • Breaking Free from the Old Education Model in Long Term Care • The Power of Ethical Marketing

• Medicare and Medicaid Maximization “Unlocking the Doors” • Implications of the Fair Housing Act on Wisconsin’s Assisted Living Community • Comfort, Compassion and Dignity: Means to a Better End: F309 • Getting the Right People on Board: Recruiting, Screening, and Hiring a Quality Workforce • And many, many others! In addition, the Fall Convention will feature an opening keynote address by Donna Manring on “Transformation Leadership” and the WHCA 2008 “Shining Star” Awards Luncheon. Each year, WHCA’s Fall Convention provides a great venue for education, networking, and sharing ideas. Join us this year on October 1-3, 2008, at the Radisson Convention Center in Green Bay!

ADDITIONAL INFORMATION For additional information or needs please call the WHCA/WiCAL office (608-257-0125) or contact George W. (Skitch) MacKenzie, NHA at [email protected].

COMPLETE PROGRAM DESCRIPTIONS AND REGISTRATION INFORMATION CAN BE FOUND AT WWW.WHCA.COM OR WWW.WICAL.ORG. ONSITE REGISTRATION ALWAYS WELCOME! FALL/WINTER 2008

C O N TINU U M

11

©www.istockphoto.com/Dmitriy Kalinin

Building Employee RETENTION It’s a balancing act! But dedicated efforts can transform your facility into an “employer of choice.”

12 CONTI NUUM www.whca.com

By Brian Purtell

IN ORDER TO provide the highest level of care and services lenged to retain qualified and committed employees in all sec-

long term care community’s greatest challenges in the coming or become an “employer of choice” may mean the difference between future success or continued challenges.

3. Establish goals/targets for improving retention rates.

➥

years. Steps taken now to put a facility in a position to remain

2. Identify the causes underlying staff turnover.

➥

cate that workforce development will be one of the Wisconsin

1. Identify current turnover rates, including differences in rates among categories of employees.

➥

tors of operation. But demographic and workforce data indi-

➥

to their clients, long term care providers are continually chal-

➥

4. Develop an action plan to address causes and reach identified goals/targets. 5. Implement the action plans as written. 6. Evaluate the implementation of the action plan. 7. Update and revising the action plan as directed by the evaluation process.

➥

➥

The key is that long term care employers need to increase their knowledge base as to what actually impacts employee retention. Rather than relying on gut feelings or making efforts based on what the employer “thinks” the employee wants or needs, employers need to approach retention efforts with the sophistication that they would apply to other quality improvement efforts, using recognized processes to guide them. The sidebar shows seven steps to follow in taking on the challenge of improving employee retention. The steps in the sidebar are, in all likelihood, instantly recognizable, as they follow a common quality improvement cycle process. But you may not have viewed employee retention in this context. Applying the same analysis a health care provider applies in addressing a clinical improvement effort, for example, will provide focus and a

➥

Instead of lamenting about the difficulty of recruiting applicants for open positions, we must closely examine our efforts to retain our current caregivers. Certainly, most providers appreciate the value of their dedicated staff, but it is healthy to reexamine the techniques used to retain those vital assets. There is ample evidence to support investment in dedicated retention programming. Staff longevity and lower turnover correlates to higher customer satisfaction and quality measures, as well as regulatory results. It also reduces inefficient use of scarce resources related to recruitment, new employee orientation and training. It is therefore critical to examine what actually correlates to employee retention. Identifying those factors will allow employers to focus their energies on those areas that are both correlated to retention and within the control of an employer.

workable framework for taking on the retention issue. While the process is not a magic pill, it can help you organize your efforts and provide a map to achieving your goals more efficiently. NO QUICK FIX Employers fi rst must recognize that the effort to improve employee retention requires prolonged and dedicated effort, including ample staff involvement. And before you establish your

Long term care employers need to increase their knowledge base of what actually impacts employee retention. FALL/WINTER 2008

C O N TINU U M

13

retention goals, you need to determine your current retention and turnover rates in all categories of staff. Determining your current retention and turnover rates will (1) establish your baseline; (2) identify where you should focus your efforts; (3) identify strengths that you can apply in the development of your action plan; and (4) provide measures upon which you can establish goals and targets. Establishing your baseline enables you to measure your future performance. Reviewing where your retention and turnover are greatest allows you to target your efforts. Once you’ve done that, you should establish specific goals/targets to work toward. The simple act of goal setting has been demonstrated to accelerate performance improvement. As part of this review and goal-setting process, examine your expenses related to retention and recruitment. Where are you spending your money? Is it efficient or even productive? Are you placing expensive classified ads in newspapers that either do not even reach your target audience or do not yield qualified and attractive applicants? NOT ALL RETENTION IS GOOD; NOT ALL TURNOVER IS BAD. Simply setting a goal of keeping all of your current employees is unrealistic. More important, it ignores the possibility that some of your current staff contribute to the turnover issues you are facing. Further, the employees that you want to retain, your top performers, will likely resent the efforts made toward those who are not. DON’T GUESS; USE EVIDENCE A growing body of research and evidence is available to guide your retention efforts. Just as a physician or nurse is guided by authoritative research in making clinical decisions or a facility is guided by an establishment of policies and protocols, so too should an employer be guided by research in 14 CONTI NUUM www.whca.com

Eligibility does not ensure capability. developing retention efforts. Search and review the available literature on the subject as the basis for your analysis and action plans. IT’S NOT ALL ABOUT MONEY Determining the relative importance of employee wages provides a perfect illustration of the use of empirical evidence in guiding retention efforts. There is the notion that if an employer simply raises wages, retention rates will increase. But this is counter to the evidence. Wages clearly impact an employee’s decision to remain at a job, but research indicates that wages, while important, are not an exclusive or prime motivator. Resist the temptation to throw up your hands at increasing retention rates when wage increases are not feasible. Data suggests otherwise. What data going back three decades does suggest is a relationship between

retention and employee satisfaction. Employees may rank pay as the most important contributor to their job satisfaction, but this is too easy an answer to a more complex question. Closer examination of more detailed data reveals that factors such as interaction, professional status and task requirements tend to more strongly correlate to an employee’s decision to leave or stay in a job. Here’s more specific evidence. The largest aggregated Wisconsin long term care workforce data compiled by My InnerView, Inc., indicates that the most significant factors relating to employee job satisfaction are: • Assistance with job stress • Attentiveness of management • Care/concern of management • Comparison of pay • Appreciation of supervisor Many of these factors are well within the control of employers. While

© Styf22 | Dreamstime.com

management rates at or near the lower end of employee satisfaction factors, employees tend to rate their level of satisfaction with their direct supervisor at or near the top, both nationally and in Wisconsin. Management, are you listening?

This data, which may prove uncomfortable to some managers, should be seen as a spectacular opportunity. Your employees quietly have needs similar to those you seek to address within

your client population—attention, assistance, and appreciation. If this surprises you, consider what you do, either directly or through your managers, to truly address your employee’s non-pay-related issues such as stress, appreciation and management attentiveness. While addressing some of those issues might be complicated by managers’ own stresses, some of this management stress and workload could be minimized by a consistent, motivated workforce. The evidence therefore shows that the long term care provider community has opportunities for improvement in addressing the issues most important to their workforce, but improving employee engagement doesn’t necessarily require spending a lot of money. Wise investments and productive uses of scarce resources bring a demonstrated return on investment, both in better employee retention and better client satisfaction. It is far better to invest in those areas that produce results and that are actually within the control of an employer. The data outlined above provides an illustration of what measures are possible, and it must be noted that your greatest opportunities for improvement listed may not be the same for your workforce. So measure your specific workforce issues, needs, and areas of importance. Without actually measuring your level of employee satisfaction, you are simply guessing or hoping that your efforts will hit the mark. RETENTION BEGINS AT HIRE Screening and reference checks will tell you if someone is eligible for hire. The fact that someone is “eligible” doesn’t necessarily make them him or her a good fit for your organization. Eligibility does not ensure capability. Resist the temptation to just fi ll spots with a warm body out of urgency. At the same time, explain and seek buyin for those staff members that may have to bear some of the burdens—and additional shifts—until a good match is made.

Many issues of capability can be addressed with sufficient training, education and support. Data demonstrates that effective training is an area where there is room for improvement, and doing so significantly contributes to employee retention. This hold true for the new hire and the current employees. When an individual is not adequately prepared and equipped for the position, they are far more likely to leave sooner. Additionally, ill-equipped employees contribute to the stress and dissatisfaction of your current staff, who end up picking up their slack. As part of your analysis of the causes of turnover, include examination of your orientation, training and mentoring programs. A modest additional investment in those areas may translate into greater employee longevity. MAKE RETENTION A TEAM EFFORT AND GOAL Gathering data, establishing causes, developing action plans and measuring results will require input from your entire staff. Explain the purpose and benefits to obtain accurate information, and to dispel rumors that will naturally spread among staff if such efforts are made behind closed doors. Becoming an employer of choice, one where you have the luxury of highly qualified and motivated applicants, does not happen overnight. Do not expect that a few kind words and an employee recognition party to immediately transform your facility. Expect to commit time and resources with long range goals in mind. The efforts you make now will positively impact your operations for years to come. Brian Purtell, WiCAL Executive Director and WHCA Director of Legal Services, is also a partner at DeWitt Ross & Stevens S.C. He can be reached at [email protected], [email protected], or [email protected]

FALL/WINTER 2008

C O N TINU U M

15

media matters Handling a Media Crisis How to Come Out on Top By Erin Celello

IN THE LONG TERM care community, where both money and time are tight, and clients are in need of round-theclock services, media relations can understandably rank near the bottom of the priority list. However, no organization, despite best efforts, is immune from events that have potential to damage their reputation and community goodwill. Accidents, incidents, natural and man-made disasters, system breakdowns, human errors, and professional misjudgments can all lead to media coverage that too often seizes only upon the negative. In the midst of a media “investigation,” it might seem as though there is little that you can do to manage it. However, this couldn’t be farther from the truth. In reality, there are several steps you can take to expertly and efficiently deal with the media in the midst of any crisis. DON’T BUY AN EXTINGUISHER AFTER THE FIRE STARTS Crisis Communications in Healthcare defines a crisis as anything that “suddenly and unexpectedly has adverse effects on a healthcare organization, or its patients, staff, or community.” If a resident is severely injured, and the family goes to the media as a result, you could have a crisis on your hands. There might have been nothing you could have done to predict the accident or prevent it, but you can plan for it. While large businesses, Hollywood stars, national, state, and local governments have the luxury of teams of individuals that actually prepare and drill 16 CONTI NUUM www.whca.com

for crisis communications, on a smaller scale you can do the same. Take your pick of situations you regularly see in the news, and gather your management team to determine your communications goals for potential scenarios, draft talking points to work from, and practice delivering them for when a crisis does hit. DENIAL ISN’T A RIVER IN EGYPT Even the best long term care providers are only one disgruntled employee or dissatisfied family member away from having to respond to a potentially negative media inquiry. The first step is acknowledging that a media crisis could happen; the next is planning for it. Before crisis strikes and you find yourself at the other end of a reporter’s microphone, take some time to think through what your key messages might be. The first thing you want to do is evaluate your audience and identify what you most want them to know. This might include correcting erroneous information, providing an alternative viewpoint (your side) to the story, or reminding the audience of important information. Any crisis communications response should also follow the “CCO Template”: answers or statements given to the media should indicate compassion (express sympathy, regret, condolences), conviction (state that assumptions cannot be made, a full investigation is ongoing, et cetera), and optimism (indicate that once the facts are clear, action steps will be determined and the right thing will be done).

In all but the rarest of communications crises, the number one thing you don’t want to do is attempt a disappearing act.

Point:

Should:

By:

ONE

Express empathy, listening, caring or compassion.

• Using personal pronouns; • Acknowledging the legitimacy of fear, anger, or other emotion; • Using a personal story if appropriate.

TWO

State the key message(s).

• Limiting the total number of words to 27; • Limiting the total length to 9 seconds; • Using positive, constructive, and solution-oriented language; • Offering additional, supporting information by way of facts, studies, or other credible third-party sources of information.

THREE

State future actions.

• Listing specific next steps; and/or • Providing contact information for obtaining additional information as appropriate.

FOUR

(if there is time) Repeat the key messages.

Summarizing or emphasizing the three key messages.

Importantly, studies have shown that when communicators limit the number of messages they relay in a crisis situation to three, and ensure that those messages are relatively brief (about nine seconds or 27 words in length), that information is comprehended and retained better by those listening. A model for preparing your crisis messages might look something like this: Preparing what you most want to communicate—that your facility strives for the highest possible standards and regularly exceeds them— and thinking through what you will say in a crisis, even if it hasn’t yet happened, can make all the difference of the light in which your facility might be cast in the reporter’s story.

THERE WAS ONLY ONE HOUDINI In all but the rarest of communications crises, the number one thing you don’t want to do is attempt a disappearing act. Avoiding reporters altogether or issuing a statement only makes it appear as though you have something to hide. Remember, the media hates a vacuum, and if reporters can’t get a comment from you, it does not mean they will simply throw up their arms and move on to the next story. Rather, they’ll search high and low for someone who will tell your story for you, and you lose all control over what messages are relayed. Instead, a better tactic is to arrange a specific time for an interview. Then, determine who the best spokesperson will be, and work with that person

to anticipate reporter questions and practice delivering the key messages you developed long ago. For too long, Wisconsin’s long term care provider community has been frustrated by its portrayal by media outlets. However, the historic “bunker mentality” of many only contributes to these frustrations. Preparation for and tackling a media crisis headon are steps towards turning around the manner and tone of coverage we unfortunately too often see in the long term care community. Erin Celello is the WHCA Director of Communications. She can be reached at erin@ whca.com

Angela Scheit 262-880-8883

Wisconsin Medical Supplies, Inc.

391891_WMS.indd 1

5200 Washington Ave. Suite 105 Racine, WI 53406 Tel: (262) 631-0100 Fax: (262) 631-0200 [email protected] www.wmsinfo.com

Spring Valley Health Care Center Spring Valley Home Health Services Valley Villas Assisted Living

7/22/08 2:46:47 389759_Spring.indd PM 1

Caring for Generations www.svhcs.org

FALL/WINTER 2008

C O N TINU UM 7/16/08

17 PM 2:17:40

capitol beat State Races Will Affect Long Term Care Providers WITH THE SLEW of ads and endless coverage on 24-hour cable news outlets, it might seem like the Presidential election is the only one this fall. But the Wisconsin State Legislature and handfuls of U.S. Congressional races are heating up as well. While certainly the national races will have an impact on Wisconsin’s long term care provider community, the state elections will likely have as much, if not more, direct impact on the long term care landscape. All the November elections are important, because the party in the majority chairs all committees and establishes the agenda in both the U.S. and state legislatures. The number of open seats and the narrow majorities currently held in the Wisconsin Senate and Assembly contests will make for an interesting and hard-fought state election season. The importance of elections goes beyond how a candidate might present him or herself. Voters are not only deciding who will represent them, but also have a say in what key issues are important to them. The results of the upcoming elections will impact Wisconsin’s long term care community shaping the agenda with potential impact for years to come. For example, here are some long term care issues that were discussed and debated in the 2007-08 session of the Wisconsin Legislature: • A proposed increase in the nursing home bed tax from $75 to $127 per month, or funding nursing home reimbursement increases with GPR (general purpose revenue dollars); • Legislation requiring DHS to establish standards for staff training, staffing levels, and standards for security at adult family homes, residential care 18 CONTI NUUM www.whca.com

apartment complexes, communitybased residential facilities, and nursing homes; • Legislation imposing a $12 annual assessment on all occupied residential care apartment complexes (RCACs) to fund one ombudsmen position, legislation relating to additional oversight of group homes, community-based residential facilities, and adult family homes; and • The expansion of Family Care, and legislation relating to mandatory overtime hours worked by health care workers employed by health care facilities. The success or failure of any of the above items was certainly impacted by the political makeup of the Legislature. So too will the future of these or similar initiatives depend on the Nov. 4 election results. It is therefore incumbent upon the provider community to remain active and vocal on issues of importance to your operations. To highlight the significance of these elections, here is a snapshot of the Wisconsin political landscape going into Election Day: • Democrats currently control the Senate, 17- 14, with two vacant seats due to the resignations of Democrat Sen. Roger Breske and Republican Sen. Carol Roessler. The seats up for election are currently split evenly, eight to eight. • For the Republicans to assume control of the Senate, it will require keeping all of their current seats and gaining two seats currently held by Democrats. • With respect to the 99-member Assembly, Republicans control the House with 51 Republicans, 47

© Rmgb_ol | Dreamstime.com

By Jim McGinn

The upcoming elections will impact Wisconsin’s long term care community for years to come.

Democrats, and one Independent. Eleven Assembly veterans, six Republicans and five Democrats have announced their plans to retire. • For the Democrats to assume control of the Assembly, it would require keeping all of their seats and gaining three seats. And again, while all elections are important, it appears that a great deal of attention will be focused on the races for the State Assembly. Since many of the Assembly races are considered close, with many involving primaries, we can certainly expect hard fought races by both parties as they seek the prize of majority status. On the State Senate side, of the 16 Senate seats up for election, both parties are focusing on the following seats: • Senate District 8: Sen. Alberta Darling (R-River Hills) vs. Rep. Sheldon Wasserman (D-Milwaukee) • Senate District 10: Sen. Sheila Harsdorf (R-River Falls) vs. Alison Page (D-River Falls) • Senate District 12: Jim Holperin (D-Eagle River) vs. Tom Tiffany (R-Rhinelander) • Senate District 18: Jessica King (D-Oshkosh) vs. Randy Hopper (R-Fond du Lac) • Senate District 22: Sen. Bob Wirch (D-Kenosha) vs. Ben Bakke (R-Kenosha) • Senate District 30: Sen. Dave Hansen (D-Green Bay) vs. Chad Fradette (R-Green Bay) • Senate District 32: Sen. Dan Kapanke (R-LaCrosse) vs. Tara Johnson (D-LaCrosse) Some may tire of the relentless election ads as the elections draw closer, but the long term care provider community must use the election season as an opportunity to educate the candidates on the issues of significance to providers, their staff and clients served. Consider inviting the candidates to meet with your staff and residents. Prepare a few points of most significance you would want to impart to the candidate. Keep in mind the volume of information these individuals are presented on the campaign trail. Consider preparing a concise written explanation of your issues that can be taken by the candidate or their staff.

PROFILES

WISCONSIN LEGISLATURE HISTORY Wisconsin’s bicameral Legislature is made up of the Senate with 33 members and the Assembly with 99 members. According to the State of Wisconsin Blue Book, members of the Assembly originally served for one year, while Senators served for two years. An 1881 constitutional amendment doubled the respective terms to the current two and four years, respectively. Wisconsin’s 33 Senators are elected for four-year terms, with 16 Senators elected in evennumbered districts in a presidential election year, and the 17 Senators in odd-numbered districts elected in a gubernatorial election year. The primary election will be held on Sept. 9, with the general election on Nov. 4.

COMPUTER HARDWARE & SOFTWARE American Data PO Box 640 Sauk City, WI 53583 Phone: (608) 643-8022 Fax: (608) 643-2314 Toll Free: (800) 464-9942 E-mail: [email protected] Web: www.american-data.com Four of American Data‘s Wisconsin clients using ECS - Electronic Chart System are being honored this year by the Wisconsin Forward Award Program! St. Francis Home and St. Mary‘s Care Center, recipients of Excellence Award; St. Clare Meadows Care Center, recipient of Mastery Award; and Franciscan Skemp HealthCare, recipient of Proficiency Award.

MOBILE X - RAYS Accurate Mobile Imaging 2895 Algoma Blvd. Oshkosh, WI 54901 Phone: (920) 230-9729 / (920) 230-XRAY Fax: (920) 233-6877 E-mail: [email protected] Web: www.accurateimaging.net “Wisconsin’s First Digital X-Ray Team” Our Accurate Imaging Team provides your facility with state-of-the-art digital portable x-ray services. Your patients stay where they are most comfortable, their home. We commit in providing our clients with the highest quality, most accurate, and dependable on-site digital diagnostic imaging services. We offer competitive pricing!

Jim McGinn is the WHCA Director of Government Relations. He can be reached at [email protected].

PHARMACIES

PHARMACIES

Experience Group Purchasing Power at its Best HPSI has a network of local, regional and national contracts that allow members to enjoy subtantial volume discounts and low prices on a wide range of products, services and equipment. Stephanie Langan Purchasing Consultant 319.899.2803 p [email protected]

392781_HPSI.indd 1

Alliance Pharmacy Services, LLC 407 Pilot Court, Ste. 200 391017_Alliance.indd 1 53188 7/10/08 5:46:57 PM Waukesha, WI Phone: (262) 513-3333 Fax: (877) 578-7760 Toll Free: (877) 578-7756 E-mail: [email protected] Web: www.apswi.com Wisconsin based, Alliance and Alliance Pharmacy at Chippewa Valley are institutional pharmacies formed in response to needs of LTC communities not satisfactorily serviced by larger national pharmacy providers. Leaders in providing high quality comprehensive pharmaceutical services, we work with a reputation built on attention to detail, service and outstanding communication.

7/22/08 8:12:23 PM

FALL/WINTER 2008

C O N TINU U M

19

stakeholder spotlight A focus on individuals who are influential in the Wisconsin long term care community

This Edition: Heather Bruemmer, Executive Director/State Ombudsman, Wisconsin Board on Aging and Long Term Care (BOALTC).

Building on the Foundation AS OF JAN. 1, 2008, Heather Bruemmer has served as the executive director of the Board on Aging and Long Term Care (BOALTC), replacing the retired George Potaracke who served as the leader of the BOALTC since its creation in 1981. Heather has been with the BOALTC since 2000 and has served within the Wisconsin long term care community for more than 20 years, including eight years in the nursing home setting and three within the assisted living field. Given the impact and influence the BOALTC has on the Wisconsin long term care landscape, Continuum sat down to chat with the “new” leader. Remind us about who and what is the BOALTC? The Older American’s Act mandated states to develop independent advocacy agencies. Wisconsin’s Ombudsmen program actually predates the mandate, but the BOALTC fulfills the federal expectation. Its mission is to advocate for the interests of the state’s aging and disabled population, inform consumers of their rights, and educate the public at large about health care systems and long term care.

associated with the BOALTC? George has been the huge help in my transition since his retirement at the end of 2007. His 27 years of experience have paved the way for me, and I intend to continue building upon the foundation he has established. I really want to continue to work collaboratively with the other stakeholders in Wisconsin’s long term care community. While we may occasionally differ on the path, we all have the same goals of serving and protecting Wisconsin’s elderly and disabled citizens.

Who is the “board” of the BOALTC? The actual board has seven members, all appointed by the Governor to serve five-year terms, and approved by Senate Committee. Board membership includes individuals with varied experience in health, long term care, or advocacy for seniors.

Are there activities beyond operating the Ombudsman program? We are clearly recognized for the Ombudsman program, but we also have the Medigap Hotline and the Volunteer Ombudsman program, which we are in the process of expanding to La Crosse, Green Bay and Eau Claire areas. In the past, we have heard provider concerns about the Volunteer program, but once everyone has a better understanding, there can be tremendous benefits. We will

Has it been difficult to fill the shoes of founding Director George Potaracke, someone who was so prominently 20 CONTI NUUM www.whca.com

be holding introductory meetings this fall to help address provider concerns. Can you explain the Medigap Helpline? The Medigap Helpline is staffed by licensed insurance counselors to help all Wisconsin citizens with questions and problems related to health insurance, Medicare Supplements, long term care insurance and other health plans. This is a resource for all ages. Providers should also be aware of this resource when they are trying to help a client with insurancerelated issues. It is one of my priorities to continue outreach efforts with this program and get the word out about this resource. Why the interest is allowing Ombudsman access to RCACs? Every person has the right to advocacy. It is frustrating when a consumer calls with an issue and all we have authority to do is to refer them to the DQA for help, rather than trying to resolve it informally. If you had two suggestions to give the long term care provider community, what would these be? 1. The Board is an advocacy organization. Providers should not hesitate in working with us, as often our staff can diffuse issues before they arise to a regulatory level. We also are here to provide services, including training with providers on topics such as resident rights, advance directives, restraint reduction, abuse prevention, and person directed care. 2. The expansion of Family Care and other waiver programs will continue to bring significant change to the Wisconsin long term care landscape. It is more important than ever that we work together to best serve our citizens. If a provider has a problem with one of my staff, they should contact management of Board, as often issues are because of a breakdown of communication. My staff is extremely committed to the consumers in long term care.

BUYERS’ GUIDE

Enhancing the life of every resident.

M A N O R

(608) 739-3186

MEDICARE CERTIFIED FACILITY SKILLED NURSING & REHABILITATION FACILITY

Fax: (608) 739-3486 1000 North Wisconsin Avenue Muscoda, WI 53573 Executive Director: Tiffany Iverson

The facility is located on the northwest edge of Evansville, which is ideally located between the metropolitan areas of Madison and Janesville, Wisconsin. Evansville Manor is a modern 83 bed skilled nursing facility, providing 24 hour licensed nursing, special dietary services, and a wide variety of activity programs. A wing of 4,300 square feet is dedicated to rehabilitative therapy and education, and also has a separate entrance and parking lot for outpatient clients.

390848_GoldenLiving.indd 1

discharge planners

E

vansville

7/29/08 9:25:01 PM

PARK VIEW COMMUNITY CAMPUS

Evansville Manor 470 Garfield Avenue, Evansville, WI 53536 (608) 882-5700

Experience a tradition of caring Park View Home, Inc.

Park Place North

Senior Care Center

Independent Living Apartments

Park Place

Kids View

Independent Living Apartments

Childrens Learning Center

220 Lockwood St., P.O. Box 265, Woodville, WI 54028

Phone: 715-698-2451 Fax: 715-698-2363 www.parkview-cc.com

Rice Lake Convalescent Center ~ Proudly serving the Rice Lake Area for over 35 years ~ Conveniently attached to Lakeview Medical Center. Specializing in short-term rehabilitative stays. Also providing excellence in long-term care for those who need it. Let us help you transition from hospital to home.

products & services

• Medicare/Medicaid Certified • Physical Therapy • Outpatient Therapy Available • Occupational Therapy • Speech Therapy • Hospice Services • Accepts most Long-Term Care and Managed Care Insurance • Quality, Home-style Meals • Specialty Diets Available

391358_Phillips.indd 1

Across the street from beautiful Indian Mounds Park & Rice Lake 1016 Lakeshore Dr., Rice Lake

715-234-9101 Fax: 715-234-4021

7/17/08 8:31:13 AM LONG TERM CARE • ASSISTED LIVING RETIREMENT COMMUNITY

390904_Rice.indd 1

Are You Looking for a Purchasing Partner? UHF Purchasing Services is a focused group purchasing organization that provides members with outstanding supplier contracts, price audits, cost analysis and individual facility visits. UHF Purchasing Services works with members to maximize the value of their purchases. Control your costs, choose your options and enjoy the benefits of UHF Purchasing Services. To learn more about the complete UHF Purchasing Services program please call 1-800-388-1233, or visit our website at www.uhfpurchasing.com.

With…

UHF 7/11/08 9:43:53 389925_UHF.indd AM 1

It’s More Than Just FALL/WINTER 2008

avings

C O N TINU U M10:13:41 21 AM 7/8/08

index to advertisers ASSISTED-LIVING FACILITIES Evansville Manor............................................ 21

Park View Home, Inc. .................................... 21 Woodland Village, Inc.................................... 22

PURCHASING SERVICES HPSI Purchasing Services .............................. 19

COMPUTER HARDWARE & SOFTWARE American Data................................................ 19

MOBILE X-RAYS Accurate Mobile Imaging............................... 19

REHABILITATION SERVICES Golden Living Center Riverdale .................... 21 Peoplefirst Rehabilitation .....Inside Front Cover

CONSTRUCTION MANAGEMENT The Samuels Group .......................................... 4

PHARMACIES Alliance Pharmacy Services, LLC ................ 19 Phillips Pharmacies ........................................ 21

CONSULTANTS Focus on Energy ............................................... 6

SENIOR CARE REAL ESTATE Senior Care Realty, LLC ................................ 22

DME SUPPLIES Wisconsin Medical Supplies, Inc ................... 17

advertiser.com

FINANCIAL SERVICES JT and Associates, LLC ................................... 6

Accurate Mobile Imaging .................................www.accurateimaging.net ........................................19 Alliance Pharmacy Services, LLC...................www.apswi.com........................................................19 American Data ...................................................www.american-data.com..........................................19 Evansville Manor ...............................................www.evansvillemanor.com ......................................21 Focus on Energy.................................................www.focusonenergy.com ...........................................6 Geneva Lake Manor ..........................................n/a................................................................................8 Golden Living Center Riverdale ......................n/a..............................................................................21 HPSI Purchasing Services ................................www.hpsionline.com ................................................19 JT and Associates, LLC ....................................n/a................................................................................6 ManorCare Health Services .............................www.hcr-manorcare.com ............................................8 MPRO .................................................................www.mpro.org ............................................................6 Park View Home, Inc. .......................................www.parkview-cc.com .............................................21 Peoplefirst Rehabilitation .................................www.peoplefirstrehab.com............ Inside Front Cover Phillips Pharmacies ...........................................www.phillipsrx.com .................................................21 Rice Lake Convalescent Center .......................www.ricelakeinter.net...............................................21 Senior Care Realty, LLC ..................................www.seniorcarerealty.com .......................................22 Spring Valley Health Care Center ...................n/a..............................................................................17 The Samuels Group ...........................................www.samuelsgroup.net...............................................4 UHF Purchasing Services .................................www.uhfpurchasing.com..........................................21 Vitas Innovative Hospice ..................................www.vitas.com..........................................................10 Wisconsin Medical Supplies, Inc .....................www.wmsinfo.com ...................................................17 Woodland Village, Inc.......................................www.woodlandvillagenews.com ..............................22

GENERAL CONTRACTORS/ DESIGN BUILD The Samuels Group .......................................... 4 GROUP PURCHASING ORGANIZATIONS UHF Purchasing Services .............................. 21 HEALTH & REHABILITATION ManorCare Health Services ............................. 8 HEALTH CARE FACILITIES Rice Lake Convalescent Center ..................... 21 Spring Valley Health Care Center.................. 17 HOSPICE SERVICES Vitas Innovative Hospice................................ 10 INDEPENDENT INFORMAL DISPUTE RESOLUTION SERVICES MPRO ............................................................... 6 Long term HEALTHCARE FACILITIES Evansville Manor............................................ 21 Geneva Lake Manor ......................................... 8

What’s in a name?

EVERY EVERYTHING. RYTHIN HING. G.

changing the atmosphere

Nursing Homes

Transportation Services

products & services

Home Health Services Providing: Adult Day Care / Respite, In & Out Patient Therapies, Transportation, & Catering Services

Suring

Gillett

430 Manor Drive Suring,WI 54174

330 Robinhood Lane Gillett,WI 54124

(920) 842-2191

(920) 855-2136

Oconto

Home Health

101 1st Street Oconto,WI 54153

913 E.Main Street Suring,WI 54174

(920) 834-4575

A business’s name should be synonymous with its brand and area of expertise. That’s why Collins Realty Group, the Wisconsin firm born of real-world assisted living experience, has changed its name to Senior Care Realty, LLC. When it comes time for you to sell or buy senior living real estate, please remember our name and our commitment to helping you succeed.

Senior Care Realty, LLC, Where our name says everything you need to know.

(920) 842-4132

seniorcarerealty.com

Transportation

(920) 842-4040

w w w. w o o d l a n d v i l l a g e n e w s . c o m

22 CONTI NUUM 393641_woodland.indd 1

www.whca.com

®

7/25/08 4:12:57 391738_Senior.indd PM

1

7/18/08

12:47:49 PM

INSURANCE SOLUTIONS FOR SKILLED NURSING & ASSISTED LIVING FACILITIES Call or email Greg Syvrud at 608-288-2822 or 1-800-272-2443 ext. 2822 [email protected]

Madison, Milwaukee, Green Bay, Wausau, and Eau Claire

www.m3ins.com Innovative… Committed. Mortenson_EditorialAd.indd 1

R i s k P r o N e t

8/11/08 10:41:58 PM