GRAND TRAVERSE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES BOARD 9:00 AM Conference Call Phone: 1-888-585-9008 (Conference Room # 286-824-941) *2 mute/unmute
MAY 29, 2020 AGENDA
On April 14, 2020 Governor Whitmer signed into effect Executive Order 2020-48. In an effort to reduce the spread of COVID-19 by limiting the number of people at public gatherings, this order suspends the rules and procedures for governmental entities requiring physical presence at meetings and hearings and it temporarily alters the rights of the public to be present at meetings. The public may participate through the toll-free call-in number referenced above.
1. CALL TO ORDER – 9:00 a.m. Grand Traverse Pavilions – John Rizzo, Chair, Grand Traverse County Department of Health and Human Services Board
2. FIRST PUBLIC COMMENT/INPUT Any person shall be permitted to address a meeting of the Grand Traverse County Department of Health and Human Services Board which is required to be open to the public under the provisions of the Michigan Open Meetings Act, as amended. (MCLA 15.261, et.seq.) Public comment shall be carried out in accordance with the following Board Rules and Procedures: 1. Any person wishing to address the Board shall state his or her name and address. 2. Persons may address the Board on matters which are relevant to Grand Traverse Pavilions issues. 3. No person shall be allowed to speak more than once on the same matter, excluding time needed to answer Board Members questions. The Chairperson shall control the amount of time each person shall be allowed to speak, which shall not exceed three (3) minutes. (1) Chairperson may, at his or her discretion, extend the amount of time any person is allowed to speak. (2) Whenever a group wishes to address the Board, the Chairperson may require that the group designate a spokesperson; the Chairperson shall control the amount of time the spokesperson shall be allowed to speak, which shall not exceed fifteen (15) minutes.
3. COUNTY LIAISON REPORT
4. APPROVAL OF AGENDA
5. CONSENT CALENDAR The purpose of the consent calendar is to expedite business by grouping items to be dealt with by one Board motion without discussion. Any member of the Board, or staff may ask that any item on the consent calendar be removed and placed elsewhere on the agenda for discussion. Such requests will be automatically respected.
If any item is not removed from the consent calendar, the item on the agenda is approved by a single Board action adopting the consent calendar.
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A. Review and File HANDOUT#
(1) Minutes of the 4/27/20 Board Meeting 1 (2) Lau Thank You 2 (3) Horn Thank You 3 (4) Wick Thank You 4 (5) Slaby Thank You 5 (6) Ramsden Thank You 6 (7) The Compass – May 7 (8) P.E.P. Talk Employee Newsletter – May 8 (9) Media Report – April 9
6. ITEMS REMOVED FROM CONSENT CALENDAR (1)
7. GRAND TRAVERSE MEDICAL CARE -- Korvyn R. Hansen
A. General Information (1) COVID-19 Update Verbal (2) Reimbursement Update 10 (3) Video Recording 11
B. Chief Executive Officer Board Report 12
C. Business (1) Financial Report 13
D. Medical Staff (1) Kaitlyn Troutman, NP 14
G.T.P. Announcements (1) March Service Excellence Award 15 (2) Concert on the Lawn Goes Radio Retro 16
8. SECOND PUBLIC COMMENT/INPUT Refer to Rules under First Public Comment/Input above.
9. CLOSED SESSION (1)
10. ADJOURNMENT
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GRAND TRAVERSE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES BOARD 1000 Pavilions Circle, Traverse City, MI 49684
MINUTES OF THE APRIL 27, 2020 MEETING
PRESENT: John Rizzo, Cecil McNally, Ralph Soffredine Board Kory Hansen, Rose Coleman, Robert Barnes, Lindsey Dood, Darcey Gratton Staff Gordie LaPointe Commission ABSENT: GUESTS:
The regular meeting of the Grand Traverse County Department of Health and Human Services Board was called to order remotely at 9:04 am by Board Chair John Rizzo due to the Executive Order 2020-48 signed by Governor Whitmer to limit the number of people at public gatherings. This order suspends the rules and procedures for governmental entities requiring physical presence at meetings and hearings and temporarily alters the rights of the public to be present at meetings. Grand Traverse Pavilions provided a toll-free call-in number to the public to join the meeting and for the ability to make public comment.
Public Comment
Linda Pepper – requested an update on the Pavilions current PPE and procedures to protect the residents from COVID-19 and also inquired about using Zoom for a virtual board meeting.
Claudia Bruce – shared her opinion on Hansen’s memo regarding the video recording proposal and shared her support and reasoning to record and publish future meetings.
Andi Gerring – shared her opinion on Hansen’s memo regarding the video recording proposal and shared her support and reasoning to record and publish future meetings.
County Liaison Report – LaPointe shared discussions at the most recent county board of commissioner meetings. Topics of discussion included daily updates on COVID-19 procedures, adequate PPE and funding for those in need. LaPointe also shared that Board members recently discussed hazard pay for 190 county employees. Most commissioners felt that hazard pay was not warranted at this time with the county only having 19 COVID cases and voted 5-2 against a $1000 stipend. Topics to be discussed at the next county board meeting will be on a proposal letter to the Governor pleading the case for the northern Michigan region to consider the difference between northern and southeastern regions with COVID cases. Commissioners are concerned that businesses will not survive and plan to ask for the Governor to base decisions on regional statistics. Commissioners also plan to discuss a millage to construct a new Senior Center or to use a capital fundraising campaign.
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Approval of Agenda – Chair Rizzo asked if there were additions, changes or corrections to the agenda. Motion was made by Soffredine to approve the Agenda as presented, seconded by McNally and carried unanimously.
The purpose of the Consent Calendar is to expedite business by grouping items to be dealt with by one Board motion without discussion. Any member of the Board or staff may ask that any item on the Consent Calendar be removed and placed elsewhere on the agenda for discussion. Such requests will be automatically respected.
REVIEW AND FILE
(1) Minutes of the 3/27/20 Board Meeting (2) Wilson Thank You (3) Lau Thank You (4) Saier Thank You (5) The Compass – April (6) P.E.P. Talk Employee Newsletter – April (7) Media Report – March
Motion was made by Soffredine to approve the Consent Calendar as presented. Motion seconded by McNally and carried unanimously.
Items Removed From Consent Calendar – none
COVID-19 – Coleman gave an update on the Pavilions continued efforts of handling COVID-19 pandemic, including securing PPE, visitor restrictions, employee screening, enhanced sanitizing, social distancing and communication, among others. New procedures are implemented as required and recommended. Since the last board meeting, masks are now being worn by all employees and are handled through the screening process. Employees are required to enter and exit through one location of the building for screening, temperatures and to insure masks are worn appropriately with all staff performing hand hygiene. The PPE levels remain constant with the exception of facemasks which have been very hard to get. However, Coleman shared she was able to source a higher quality mask for the clinical staff from a local company. Coleman noted that these new masks have been secured for direct care staff who perform one on one resident care. These new masks can be wiped down with an alcohol wipe and reused. Coleman confirmed that the Pavilions has not had any COVID-19 cases. Coleman stated that staff are still vetting the admissions and re-admissions very closely which are in isolation for 14 days upon entering the facility. The Pavilions has not been asked to take any COVID patients from the community. Coleman stated Traverse City has a regional hub that would be filled with COVID positive patients prior to a facility who is COVID negative before receiving any of those patients. On March 31, an infection control survey through the state of Michigan was conducted and everything was found to be in good order. In addition, the Governor ordered an iPRAT infection control survey which is on a local level through the health department. Coleman stated that survey was conducted over the phone during the 3rd week of April and everything was found to be in good order as well. These local surveys are to assist facilities in obtaining PPE and to assist with potential education if needed and will follow up weekly. Coleman shared potential problems with window visits with not all residents having an exterior window to receive these visits. Now that the weather is nicer, staff are looking into solutions to arrange outside visits as soon as the Stay At Home Order is lifted. Currently the residents are able to go out in the courtyards to enjoy the outdoors. Coleman noted that nursing homes are on tier 3 of the reopen phase so with that, she doesn’t foresee us being
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allowed to have any visitors in the facility for months yet. Hansen further discussed the rationale behind the government creating hubs.
First Quarter Overtime Report – Hansen reviewed the written report indicating that overtime for the first quarter was 6.12% of payroll which compares to 6.48% from the 4th quarter of 2019 and Hansen stated he expects it to decrease further through the 2nd quarter.
1. First Quarter Annual Plan 2020 Update – Hansen reviewed the highlights from the first quarter and explained due to COVID-19 many goals were placed on hold at the beginning of March. Hansen reviewed recruitment and retention strategies and shared that he is in the research phase with management to purse the use of foreign born workers. McNally inquired about training staff with our restrictions. Coleman stated that even with staff using facemasks, they do still maintain space between employees but the training is held in a bigger space so there has been no issues with training when needed. 2. Superior Health Quality Alliance Quality Initiative – Coleman reviewed directives and incentives of the Superior Health Quality Alliance. Coleman stated a program for nursing facilities has not been sent out yet but she is expecting more information soon to hopefully report more to the Board next month.
PACE North Grant Award – Hansen shared that PACE North applied and received a $49,812 grant from Michigan Health Endowment Fund to provide new telehealth services. Hansen also shared that PACE applied for the small business SBA loan, through the paycheck protection program which allows the loan to be forgiven by retaining staffing levels through the pandemic. The loan amount was about $191,000.
Chief Executive Officer Report – Hansen reviewed his monthly report for March. The big focus for the month has been on COVID-19 pandemic with daily updates, call and webinars with various sources including trade groups and government agencies which necessitate changing policies and procedures as mandated. Hansen reviewed the census at PACE North and stated that three participates are expected to be enrolled May 1. Participates are currently being served in the home and not being brought to the PACE Center. The county auditors came for their fieldwork at the Pavilions in March and also wrapped up a separate audit for PACE and the Foundation. Volunteers hours have decreased in March due to restrictions. Admissions continue to drop with few being admitted from the hospital due to cancelled surgeries and no community referrals. Hansen stated that the Pavilions is getting some financial relief through the Cares Act. The federal government has allocated over one hundred billion to help health care providers and released the first 30 billion of that and the Pavilions received $240,000 grant after the first round based on 2019 Medicare billings and Hansen is expecting a 2nd round of disturbed funds of around the same amount. The Pavilions also received a Medicaid advance of approximately $90,000 in March. Other opportunities are either loans or advances through Medicare that would have to be paid back. Hansen is evaluating the need to go through that process or not. Staff remain assisting residents as much as possible with activities to keep them active and facilitating video conference meetings with their families. Soffredine inquired about vacant nurse positions. Coleman stated there are only two or three openings for the midnight shift. The big need is still for CNA’s and there are still not many available as they remain employed. Coleman further explained that the need for CNA staffing has diminished with the lower census.
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Financial Report – Dood reviewed the financial operations report for March, 2020. Dood outlined revenue and expenses compared to budget for each of the Pavilions’ programs that include the Medical Care Facility (skilled nursing), The Cottages (Assisted and Independent Living) and Adult Day Services. Additional information was provided on respective census and accounts receivable along with the total cash ending balance. Dood summarized the review of vouchers for the month that were in order without exception. The Social Accountability Summary was reviewed indicating the amount of uncompensated care provided and volunteer hours for the month. Motion made by Soffredine to accept the financial operations report as presented. Motion seconded by McNally and carried unanimously.
Request to Purchase – Air Handler Blower – Hansen reviewed the request to purchase two new air handler blowers. Two bids were received and the recommended bid was for ABI based on it being the lowest bid. Motion made by McNally to approve the bid from ABI for $47,470.00 to replace Cherry and Dogwood air handler blowers. Motion was seconded by Soffredine and carried unanimously.
Request to Purchase – MSA1 Upgrade – Hansen reviewed the need to upgrade the Mass Storage Array (MSA1) for storage. Four bids were received and the recommended bid was awarded to Ollar Consulting based on lowest bid price. Motion was made by Soffredine to approve the MSA1 Upgrade as presented for $26,174.56. Motion was seconded by McNally and carried unanimously.
Video Recording – Hansen reviewed his memo for the board to consider on the topic of video recording board meetings. Hansen also shared data from a survey of the thirty-three other county medical facilities all of which who responded do not video record their board meetings. LaPointe stated that he and Hansen spoke with attorneys regarding requirements on recording meetings and found that once the minutes were published the video could be destroyed. However, from past experience with the county, LaPointe stated this type of transparency would encourage more participation with the public sector. Soffredine stated his support of the recordings if there were no issues with record keeping relating to time and cost. His only concern was to have people coming in under the current restrictions. Coleman confirmed that recording is not mandated by any open meetings act so the Pavilions is not able to accommodate outside people coming in to record at this time. Rizzo agreed that until the restrictions were lifted, a video recording would be held off until the board could meet in person. All Board members agreed to support the recordings being posted for up to 90 days. Hansen stated that if the board is inclined to pay for it, then he would look into options with recording the meetings with the pavilions own equipment verses a third party. Motion was made by Sofferedine to approve video recording future meetings, but to have Hansen bring a proposal to the May meeting with a process on options to proceed with future meetings. Seconded by McNally and carried unanimously.
Grand Traverse Pavilions Announcements - (1) March Service Excellence Award - Hansen reviewed weekly winners (2) McNally shared that he was fine with using a video conference for future meetings like Zoom and also inquired about a facebook link that was not working on the website. Hansen stated he would look into it.
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Public Comment/Input
Andi Gerring – Stated she would continue to pay for the videos if they were not going to be displayed on public television and also shared her concerns on the board not getting responses on specific questions brought up regarding staffing levels each month.
Linda Pepper – commented on how difficult it is to recognize voices and the different impressions received through voices with no video and suggested using Zoom. Pepper also thanked the staff for keeping the residents safe during these challenging times. LaPointe shared government agencies were asked not to use zoom due to the security issues and suggested to speak with the county’s IT Director on other options that they have used.
Meeting adjourned at 10:22 am
Signatures:
John Rizzo – Chair Grand Traverse County Department of Health and Human Services Board
Korvyn R. Hansen, Assistant-Secretary
Date: May 29, 2020 Approved Corrected and Approved
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Traverse City Record-Eagle Sunday, April 12, 2020 features/obituaries 7C television deaths obituaries BRENDA LYNN NICHOLAS J. LEONE, GERBER, 70, of Traverse 60, of Cedar, passed away ‘Downton Abbey’ Doyle H. Pierman City, passed away on Thursday, April 9, peacefully at Cherry Hill 2020 at his home. Died April 5, 2020 creator shifts gears Haven Assisted Living on A full obituary will be TRAVERSE CITY — man; son-in-law, Larry Friday, April 3, 2020. published in a later Doyle Hubert Pier- Reeder; and 10 sib- She is the mother of edition of the Record- man, 95, of Traverse lings. Steve Seeburg Jr. She Eagle. with series ‘Belgravia’ City, passed away Doyle is survived by graduated from Traverse Please share a memory Sunday, April 5, 2020 his six children, NEW YORK (AP) — Ju- memories of their dead City High School. with Nicholas's family by at home surrounded Stephanie Reeder, Brenda was a veteran, visiting his tribute page lian Fellowes’ latest ad- children and laying claim by several of his lov- David (Marilyn) Pier- serving in the United at www.reynolds- dictive series about Eng- to the future of the grand- ing family members. man, Holly Whitlock, lish social classes kicks off child whom they have in Doyle was born on Doyle Pierman, Lau- States Marines Corps. jonkhoff.com. with a party. Mind you, not common. Jan. 16, 1925 to the ren (Frank) Blossom She was a former The Reynolds-Jonkhoff just any run-of-the mill, “I wanted to have late Carl and Wanda and Valley (Michael) teacher. Funeral Home and high society bash. “Bel- these two women who (Clark) Pierman. He Ufer; 16 grandchil- Please visit Cremation Services is married Jacquelin M. dren; many great- gravia” on Epix starts with came from very different www.lifestorytc.com to serving the family. Valley on Aug. 23, grandchildren; one one of the most famous powerbase. It wasn’t that share your thoughts and 1946. great-great-grandson; NEIL EDWARD FECK, parties in history. one was powerful and the more. Honorably Doyle and his sister, Eileen The family chose Life 65, of Traverse City, died On June 15, 1815, the other was not. It was they served our Country in Pierce. Story Funeral Home. April 1, 2020. Duchess of Richmond were both powerful, but the United States Marine The funeral service celebrat- He is the husband of threw a magnificent ball they were powerful in Corps in WWII from 1943-45. ing Doyle's life will be an- Gloria Feck; father of in Brussels for the Duke of different ways,” says Fel- He was a Disabled American nounced at a later time. Joshua Feck, Jacob Feck Wellington. It just hap- lowes. Veteran and earned two Purple Interment has taken place at VELDA WOLF, 93, of and Jessi Smith; pened to coincide on the “I wanted them to have a Hearts. the Peninsula Township Ceme- He lived in the Kalamazoo tery. Traverse City, passed grandfather of five. Neil very day that Napoleon’s common issue, a common area for more than 50 years, Memorial contributions in his away April 9, 2020. is the owner of Heritage troops stormed into Bel- interest, that would yoke and worked for Consumers memory may be directed to Graveside services will Wood Floor Specialists gium. them together against Power for more than 30 years. First Congregational Church or take place on Monday, and a Jehovah Witness Only days later, British their will,” he adds. “And Doyle and Jackie were mem- to a charity of one's choice. April 13, 2020 at 2 p.m. at Elder. forces — including many it seemed to me for them bers of First Congregational Please visit www.reynolds- St. Mary's of Hannah A memorial service will of the very aristocratic sol- to share an illegitimate Church. He enjoyed gardening, jonkhoff.com to share your Cemetery. A celebration be held at a later date. diers attending the ball — grandchild is a good way working on projects for his kids memories with the family. of her life will take place Please visit would die battling Napo- to do that.” and refinishing furniture. The family is being served by at a later date. www.lifestorytc.com to leon at Waterloo. “I liked “Belgravia” is the latest Doyle was preceded in death the Reynolds-Jonkhoff Funeral by his wife, Jacquelin; parents; Home and Cremation Services. The family is being share your thoughts and the idea of starting the Thedrama Record-Eagle from a writer - 04/12/2020 who Page : C07 granddaughter, Bethany Pier- cared for by Reynolds- more. The family chose story off with that incred- has created an award- Jonkhoff Funeral Home. Life Story Funeral Home. ibly glamorous, incred- winning career focusing ibly tragic event,” says on key turning points in Fellowes, the man behind English history — the Shirley J. Wick “Downtown Abbey.” early 1930s of “Gosford For more obituaries, The story then jumps Park,” the end of the Geor- Died April 3, 2020 25 years to Belgravia, a gian era in “Vanity Fair,” ALDEN — Shirley Traverse Pavilions. please see Page 6C. planned enclave of white the early 1920s in “Down- Joyce Wick, 92, of She was very com- townhouses with black ton Abbey” and, in a new Alden, passed away fortable and content. railings in a tony part of series now streamable, the at Grand Traverse Family visits to the London. It was a planned 1870s with “ The English Pavilions in Traverse nursing home were city-within-a-city, built on Game.” City on April 3, 2020. happy times for her. marshland. “It’s a part of “Julian has such a pas- Born Dec. 26, 1927, Shirley is survived London that’s it’s always sion for certain sections in Detroit, she was the by her two sons, Larry daughter of Cecil E. K. (Kathleen) Wick, of fascinated me,” Fellowes of history. He gets so Mason and Mabel Brighton, and Gary J. says. involved in the details of (Smith) Mason. (Linda) Wick, of Tra- Two families — one each and is therefore such Shirley graduated from Cooley verse City; also, four grand- Careers are made aristocratic and the other a good storyteller — cre- High School. On Sept. 26, children, David, Debra rising from the middle ates such a compelling 1947 she married John Ken- (Lambrix), Laura (Perry) and class — find out that they narrative — that you’re neth Wick at St. Olaf Lutheran Gerald; and six great-grand- in the Classifieds ... are connected, for better drawn through those slic- Church. children, Jackson, Benjamin, To place an ad, call 231-946-2653 or worse, by a baby con- es of history,” says Greig, A former resident of Redford Grady, Mayson, Olan and Levi. or visit www.record-eagle.com/classifieds ceived by the children of who plays the middle class Township and Plymouth, Shirley will be laid to rest at Shirley moved to Alden on Glen Eden Memorial Park in each family in those heady matriarch. Torch Lake in 1985. She en- Livonia next to John. days before Waterloo. “Belgravia” first started joyed sewing, knitting, cook- Share a memory of Shirley at The show stars Tamsin life as a 2016 book by ing, reading, crosswords, and www.reynolds-jonkhoff.com. Greig and Harriet Walter Fellowes, and he found it family visits at the lake. The family is in the care of the as the matriarchs of the relatively easy to adapt his She lived at the lake after Reynolds-Jonkhoff Funeral two families, two grand- own 400-page novel into a John's passing in 1994; in Au- Home and Cremation Services. mothers defending the six-part TV series. gust, 2016 she went into Grand
Copyright (c)2020Page The 10 Record-Eagle, of 59 Edition 04/12/2020 May 7, 2020 8:55 am (GMT +4:00) Powered by TECNAVIA 2B OBITUARIES/features Traverse City Record-Eagle Tuesday, April 14, 2020
The Record-Eagle - 04/14/2020 Page : B02 obituaries
Velda M. Wolf Ima M. Slaby Robert W. Herzberg Jr. Died April 9, 2020 Died April 11, 2020 Died April 11, 2020
TRAVERSE CITY — light, moral compass TRAVERSE CITY — C., in 1979; and by his Velda Marie Wolf, 93, and best friend and Robert William father in 2016. of Traverse City, we share her legacy of Herzberg Jr., 65, of He loved and adored passed on peacefully fairness, friendship Traverse City, went to his nieces and at home on Thursday, and joyful living. be with his Lord Jesus nephews, Kris Wilcox April 9, 2020, with her Besides her hus- Christ on April 11, and Alijah Helmar, of adoring family at her band and parents, 2020, following liver Key West, Florida, side, reuniting with Velda was preceded failure and pneumonia Dana Lynn and Madi- her husband, Don, in in death by her nine complications. His lyn Rose Peeples, of eternity. siblings and their family was by his side. Madisonville, Velda was born on spouses, Art (Beulah), Robert was born on Louisiana, Caitlin June 17, 1926, on the family Nellie (Louie), Delbert (Elma), TRAVERSE CITY — Ima M. (Evone); and brothers-in-law, July 16, 1954, in Sagi- Skelcey, of Buffalo, farm near Grawn, to Lovina Ethelyn (Slim), Louise Slaby, 104, a lifelong resident Albert Snyder and Chandler naw, to Robert New York, Eliza Rose (Lola) and Raphael (Ray) Sax- (George), Robert (Evelyn), Mar- of Traverse City, passed away Ketchum. William and Helen Mary and Alexsandr ton. She attended Interlochen garet (Tony), Gordon (Kate), on Saturday, April 11, 2020. Surviving her are her daugh- Marie (Deming) Skelcey, of Wyoming, and Traverse City schools, and Bill (Jane); her sisters-in- She was born in Empire Town- ter, Joella (William) Seymour, of Herzberg Sr. He was Michigan; aunts graduating from Central High law, Doris Wolf and Deanna ship on Jan. 13, 1916, the Derwood, Maryland; daughter- baptized at Trinity Martha Shores, of Mt. in 1944. On Jan. 17, 1948, in Miller; brothers-in-law, Stan- daughter of Clarence and in-law, Myrna Slaby, of Tra- Lutheran Church. He gradu- Morris, Dorothy Rettmann and Traverse City, she married her ley, Paul, and Brian Wolf, and Katherine (Birdsey) Aldrich. verse City; sister-in-law, Evone ated from Douglas MacArthur Sandra Richmond, of Saginaw; loving husband of 68 years, Bernie Miller. She graduated from Traverse Aldrich, of Traverse City; High School class of 1972. the children of the late grand- Donald E. Wolf, who preceded She is survived by her chil- City High School in 1934. grandchildren, Kristine Wood- Robert and his family skied mother, Frieda (Bleck originally her in death in 2016. dren, Curtis (Jeanne) Wolf, On April 12, 1936, Ima mar- land (Jon) of Gilberta, Illinois, night and day at Bintz Apple of Auburn) Herzberg, of Sagi- "Vel" was a homemaker early Marilyn (Robert II) Weber, and ried Jerome T. Slaby, with Scott Slaby of Grand Rapids, Mountain. Robert's mother al- naw who had a big family of 14 on, raising three children with Donald S. Wolf; grandchildren, whom she spent 66 happy Karyn Seymour (Leo), of ways made sure homework children. Don in the home they built and Angel (Sam Ellis) and Lisa years. She and Jerry shared a Poolesville, Maryland, Victoria was completed before they He enjoyed family reunions shared for 60 of those years. At Wolf, Nick, Chris (Suzie), love of the outdoors, camping, Dial (Paul), of Boulder, Col- could go skiing. They loved and fun times with many, many 40, she went to work at Chef Danielle and Hayley Weber, fishing, and traveling. Ima was orado; great-grandchildren, skiing together as a family and cousins of Glenn and Martha Pierre/Sara Lee Bakery, retir- McKenzie and Cade Wolf; and employed at the Milliken De- Jack and Georgia Woodland, he and his siblings were never Shores, Joe and Thelma ing after 27 years of dedicated her treasured great-grand- partment Store. After retire- Dana and Calvin Dial; and just dropped off. Robert and Herzberg, Tom and Liz Ratti; service. As the youngest of 10 daughter, Eva Skye Gifford, ment, they enjoyed 30 winters many nieces, nephews and his family also enjoyed family Thorris Grief, Joe and Penny growing up during the Great (who adored her 'gramma in their Sebring, Florida, home. cousins. trips. Some special trips in- LaDrigue, Robin Shafely, Jef- Depression, she learned to be gigi'); brother-in-law, Jack Ima took many art classes Cremation has taken place. cluded Disneyland and the frey Marr, Russ Shafely, a wise and thrifty shopper, (Marge) Wolf; sisters-in-law, over the years and loved creat- Interment and graveside ser- Grand Canyon in 1959, and the Jonathan Stevens, Dorothy finding "on sale," "re-sale" and Bridie and Joanna Wolf, and ing beautiful things. She was vice will be held at Oakwood World Fair in 1972 in Washing- Rettmann and daughters, San- "yard-sale" bargains through- Marie Arsenault; as well as proficient in needlework, espe- Cemetery at a later date. ton. dra Richmond, Otto and Arlene out her life. She spent little on many dear nieces and cially cross-stitch, and painting The family wishes to express He enlisted on Dec. 5, 1973, Berner, of Auburn; late grand- herself, however, using what nephews. with oils. Her homes were dec- their deep appreciation for the in the United States Army. He parents, Russell and Mickey she saved to buy generous The family would like to ex- orated with antiques collected love and care Ima received served in the 583rd Ordinance (Crossland) Bennett family, gifts for her loved ones. press their deepest gratitude over the years enhanced by her over the last eight years from and was a specialist techni- and cousin, Sally Keith Pol- Mom especially enjoyed go- to the Traverse City Munson exacting sense of color and the staff at Hawthorne Cottage, cian. He received the National manteer. ing to Bingo; yard sales; gar- Healthcare Home Hospice placement. Her lifelong passion her assisted living residence, Defense Service Medal-Marks- The calls at home and hospi- dening; and feeding the deer, Team for their compassion and was researching and recording and from the staff at the Pavil- man M16. He taught 50 British tal from Rob's loving family ducks, squirrels, and birds in guidance. Memorial contribu- her family histories. ions rehab center during her fi- officers to ski the German and friends were greatly ap- her backyard ("but not those tions may be directed to Mun- Preceding her in death were nal days. Alps. He was honorably dis- preciated. nasty crows"). She rarely son Hospice at http://www.mu her beloved husband, Jerome Arrangements are being charged on Nov. 17, 1975. He The family thanks Munson missed games involving the nsonhealthcarehospice.org. T. Slaby; her cherished son, made by Reynolds-Jonkhoff was proud to have served his Medical Center for his care. Spartans, Wolverines, Lions, Burial will take place Jerry A. Slaby; sisters, Louise Funeral Home and Cremation country. Thanks also to Shannon and or especially her beloved Wednesday, April 15, 2020, at Ketchum , Rhea Snyder; Services. He worked in the family busi- the staff at Medilodge at 2950 Tigers. 2 p.m. at the St Mary's of Han- brother, Eugene Aldrich ness Delta Duplicating/Copy La Franier Road for your care Her favorite pastime by far, nah cemetery, with a brief ser- Sales and Service and moved of Rob and compassion and however, was doting on her vice. A celebration of Velda's Rodger M. Jabara to Traverse City. kindness to Rob's mother, He- family. She hosted celebra- life will be held at a later date. He was a member of the len Marie, and sisters, Kath- tions for every birthday and Please share your memories Died April 4, 2020 D.A.V., N.R.A, and American leen and Karen Marie. holiday, with special gifts and of Velda with her family by way Military League from the very Thank you to Reynolds- wonderful buffet meals, of her online guestbook at TRAVERSE CITY — Rodger is survived beginning in 1981. Jonkhoff Funeral Home for the capped each year by a Christ- http://www.reynolds- Rodger M. Jabara, 72, by his wife, Kathy; He leaves his mother, Helen care they have shown. mas to remember. She lived a jonkhoff.com. of Traverse City, died sons, Jason, of Port- Marie Herzberg, of Traverse Cremation has taken place simple and modest life, but al- The family is being cared for peacefully at his land, Oregon, and City; sisters, Dr. Kathleen M. per Rob's wishes. ways paid it forward, leaving a by the Reynolds-Jonkhoff Fu- home on April 4, Brandon, of Loveland, (Greg) Skelcey, of Saginaw, Expression of sympathy may surplus of good to the benefit neral Home and Cremation 2020. He was born Colorado; brothers, and Karen Marie Yowell, of go to a charity of your choice. of all. She was our guiding Services. July 3, 1947, the son Yousef "Yogi," of Traverse City. Please visit www.reynolds- of Mohammed "Al- Mancelona, and Robert was preceded in jonkhoff.com to share your bert" Jabara and Mary Fayze (Marlene), of death by his brother, Michael memories with Rob's family. Clarine R. Olson (Mellem) Jabara. Kalamazoo; along He graduated from with many nieces and Died April 4, 2020 Death Mancelona High School and nephews. TRAVERSE CITY — death. went on to earn his degree in He was preceded in death by Copyright (c)2020Page The 11 Record-Eagle, of 59 Edition 04/14/2020 CAROLYN LEE “TINY” Please share a memory Clarine Ruth Olson, She is survived by Business Management at his parents; siblings, Fatyma May 7, 2020 8:53 am (GMT +4:00) ROESNER, 89,Powered of Tra by -TECNAVIA with Carolyn’s family by 87, of Traverse City, her brother, Marvin Northwood University in Mid- (Tom) Horrocks, Omar Jabara verse City, passed away visiting her tribute page passed away at Mun- Bunn, and numerous land. and June (David) Basom. son Medical Center nieces and nephews. In 1969, Rodger married Due to the current circum- Saturday, April 11, 2020 at www.reynolds-jonkhoff. on Saturday April 4, Her surviving children Kathy (Bunetta) Jabara, mak- stances with the coronavirus at Cherry Hill Haven of com. 2020. She was born in are Gregory M. Eikey ing their home in Mancelona. pandemic, it will be necessary Kalkaska. The Reynolds-Jonkhoff Elk Rapids on Sept. (Debra), Jill A. James He worked in construction to hold a memorial gathering at A full obituary will be Funeral Home and Crema- 27, 1932. and Penny M. which led him to life at Schuss a later date. published in a later edi- tion Services is serving For anyone who Kroesing (Jeffery). Mountain. His start was in lay- Gifts of remembrance in tion of the Record Eagle. the family. knew Clarine, her She has 12 grandchil- ing footings for the chair lifts Rodger's name may be di- family was her light and legacy. dren, Erin Bruce (Quincey), and went on to his being ski in- rected to the Mancelona She had such pride in all their Krisi Lane (Peter), Eric Eikey, structor, Ski Patrol member, United Methodist Church, 117 accomplishments and trea- Kollin Eikey (Jaime), Elaina and employee-then-owner of Hinman St., Mancelona, MI film sured being a Mother, Eikey (fiancé Will), Karson Pro Sport Center, a.k.a. 49659; the First Congrega- Grandma, Mimi and Great- Eikey, Jaclyn Eikey, Brian "Schuss Mtn. Ski Shop." As tional Church, 6105 Center Grandma. Hafner, Katie Hafner-Fournet the Schuss Mountain Golf Club Road, Traverse City, MI 49686; ‘The Last Dance’ Clarine will be fondly remem- (Brad), Kelly Kehl (John), An- grew, Rodger earned his mem- or the charity of one's choice. bered for her quick wit and sto- drea Thomas (Kyle) and Alex bership in the PGA, going on to Share a memory about rytelling, shy smile and Kroesing (fiancé Bethany); and become Director of Golf for Rodger and with his family at youthful appearance, and love nine great-grandchildren, Har- director talks project Shanty Creek/Schuss Moun- www.reynolds-jonkhoff.com. for a good book. She sur- bor and Saylor Bruce, Lachlan tain Resorts. Rodger and his family are in rounded herself with beautiful Lane, Kate Eikey, Radley, During his earlier years, he the care of the Reynolds- things, such as classical mu- Poppy, and Cosmo Hafner- could be found fly fishing on Jonkhoff Funeral Home and on Jordan’s Bulls sic, fresh flowers, artwork and Fournet and Logan and Easton the Jordan River with his Cremation Services. her treasured bunny collection. Thomas. brother Omar. The Associated Press what would have been Her grandchildren and great- In her memory the family asks this season’s NBA Finals. grandchildren remember her for gifts to be directed to Wills David William Colbath Jason Hehir was a kid It will run over five Sun- for her love of board games and Memorials, In Memory of in the stands in Boston days ending May 17, with and cribbage, and downtown Clarine Olson, Central United Died April 10, 2020 Garden on April 20, 1986, two one-hour broadcasts visits shopping for toys and Methodist Church, 222 Cass each week. books, and holiday celebra- Street, Traverse City, MI TROY — David W. Dave loved to watch the day that Michael tions. 49684. Colbath, 92, of Tra- Detroit Tigers base- Jordan scored a playoff- “I’m happy if we can Clarine expressed often that To honor her life a service will verse City, passed ball and University of record 63 points. bring a little bit of light she lived a full, happy life with be held at a future date and will away Friday, April 10, Michigan Football. He It was a Christmas gift to people in a dark her family and friends as her be posted. 2020 in Commerce was always looking from his father, who stuck time here,” Hehir said. focus. Clarine was a member Our family would like to ex- Charter Township, for ways to help oth- a note promising “Two “Sports are such an in- of Central United Methodist press our sincere and heartfelt Michigan. ers, either through his tickets to the Air Jordan delible part of our cultur- Church, P.E.O., Traverse City thanks to the Covid-19 staff at Dave was born on accounting business Show” in his stocking al fabric and lacking that May 6, 1927, to or by lending a help- Garden Club, Traverse City Munson Medical Center and that holiday season. It’s ... there’s a significant Golf and Country Club and In- Reynolds-Jonkhoff Funeral Lemuel and Dora ing hand to his friends a gift Hehir will never hole in enjoyment that terlochen Center for the Arts. Home for taking such wonder- (Oram) Colbath in and neighbors. But people feel, the escape She held board positions with ful care with Clarine. Their Adrian. Dave was raised in most of all, he loved spending forget, though his current G.T.R Community Foundation thoughtfulness and caring Adrian, and attended Adrian time with his wife and family. seat for another Jordan that people can feel from and Munson Healthcare Foun- comforted us when we could High School where he gradu- Dave and Rita had their night show of sorts is consider- everyday life that sports dation. She had a giving nature not personally comfort her or ated in 1945. After graduating time ritual: a game of Racko, ably better. brings us.” and supported the mission of each other. We are eternally high school, Dave served in the hot fudge sundae, their Chris- Hehir is the director The accelerated launch many community charities. grateful. U.S. Navy during WWII. After tian devotional, and then off to of the ESPN and Net- has only added to a hec- She was preceded in death Please share a memory with his service, he earned a bache- bed. Dave and Rita shared a flix production “The tic time for Hehir and his by her parents, Thelma and Clarine's family by visiting her lor's degree in accounting at lifetime of wonderful memories Last Dance,” a 10-part team. the University of Michigan. Af- together; they loved to travel, James Bunn; a brother, Eldon tribute page at www.reynolds- documentary series that There has been much Bunn; and son, Steven Eikey. jonkhoff.com. ter graduation, Dave went to and enjoyed their time keeping debuts April 19 and tells anticipation about the She was married to DeVere L. The Reynolds-Jonkhoff Fu- work for a public accounting up with their family. Eikey and Richard W. Olson, neral Home and Cremation firm. It was on his first day that Dave is survived by his the story of Jordan’s final documentary, which in whom also preceded her in Services is serving the family. he met his wife, Rita Steimel, daughters, Janet Swain (Wes), Chicago Bulls season in Hehir’s mind came to- on Dec. 26, 1950. On Oct. 20, of Petoskey, Carol (Brad) 1997-98 that culminated gether much faster than Denice Kathryn Burke Herrmann 1951, Dave and Rita married in Pines, of Troy; several nieces in a sixth NBA title. such a project usually Jackson. After living in Jack- and nephews, who were very Hehir’s task: Take 10,000 does. Died March 19, 2020 son for some time, Dave and special to him; grandchildren, hours of archived foot- “Normally, to do an Rita lived in Boyne City, Cadiz, Tiffany Murphy, of Kalamazoo, hourlong archival docu- KINGSLEY — Kathy cousins, aunts and age, add interviews with Kentucky, and in 1967 arrived Megan (Nick) Berti, of Troy, more than 100 people, mentary from start to was born in Northville uncles. The family in Traverse City, where they Wilson Pines, of Troy, Madison and turn it into about 8 ½ finish, it takes about to Thomas and Joan would like to thank lived for over 50 years. (Grant) Goodspeed, of Troy; Burke. She grew up in dear friend Wendy Dave worked alongside his and great-grandchildren, hours of television. a year from the incep- Wixom with her three Rogers of Kingsley, wife in his accounting busi- Damian, Silas and Ava. “I wouldn’t call it a tion of the idea to the siblings on Loon for all her support, ness, Peninsula Business Ser- Dave was preceded in death challenge,” Hehir said. research to doing all the Lake. Kathy attended help, caring, and vice. He was a member, elder by his wife of 66 years, Rita; “I would call it a privi- shooting to getting it all Walled Lake schools. comfort during this and deacon at the Presbyterian his parents, Lemuel and Dora lege.” together, storyboarding it Kathy is survived by difficult last year. Church in Traverse City, where Colbath; brothers, Norm and The series was moved out, mapping it out, edit- her son, Elvis Hank Kathy was prede- Dave and Rita had been 50- Jack Colbath; and son, up two months to provide ing, getting notes back, Herrmann (Hank) of ceased by her mother, year members. Stephen Colbath. Stanton; her father, Tom Joan Burke. content-starved fans with it takes about a year,” Burke, of Kingsley; her brother, Kathy was a devoted and lov- something new to watch Hehir said. “We’re doing Glen (Karin) Burke, of Traverse ing mother, loved her family To view or create during the coronavirus 10 of those. And we had City; brother, Daniel Burke dearly, and loved her Lord. pandemic. ESPN was a little bit over two years (Pat), of North Carolina; sister, There will be a private family an obituary, please visit: originally planning to to do it so we’re already Jean Burke, of North Carolina; memorial at a later time. obituaries.record-eagle.com release the documentary working at five times our and several nieces, nephews, in June, coinciding with normal rate.” Traverse City Record-Eagle Sunday, April 19, 2020 obituaries 7C
Louise Brunelle Helen J. Cussins Neil Edward Feck Died April 12, 2020 Died March 23, 2020 Died April 1, 2020
LELAND — Louise them, one of which TRAVERSE CITY — Neil is survived by Brunelle, 85, of Le- was a prize winner at Neil Edward Feck his loving wife of over land, passed away an art show in Naples. (Moore), 65, passed 26 years, Gloria B. peacefully on Easter Louise also loved to away on Wednesday Feck; three children, Sunday, April 12, travel. She and Bill April 1, 2020, at Mun- Joshua (Amber) Feck, 2020. visited well over 20 son Medical Center in Jacob (Janel) Feck, Louise was born at states, many foreign Traverse City. Neil and Jessi (James) home on May 2, 1934, countries, and sailed was born on May 9, Smith; five grandchil- in Kewadin, to the late aboard the Freighter 1954, to Clara Belle dren, Ezra, Sofie, and Jerry and Erma Marie Armco in the Great Wilkins in Jackson. Matilda Feck, Adriana (Sutter) Nemec. Lakes, where Louise A lifelong resident of and Sebastian Smith; Louise married Harold Brown bested the Captain in a game TRAVERSE CITY — Helen Joy bastopol, California. Traverse City, Neil graduated four stepchildren, Tina Hous- Jr. on Dec. 9, 1950, in Elk of Gin. New Zealand was defi- (Crabtree) Cussins, 71, of Tra- Helen and David enjoyed from Traverse City High School ton, Angela (Ron) Wiebe, Rapids. Together they had nitely a favorite destination, verse City, passed away on traveling all over the United in 1972. He was locally known Mishael (Mickey) Wise and three children, Skip, Lynn and having gone there twice. Monday, March 23, 2020 with States and Canada in their in the Grand Traverse region as Bruce Wise; eight step-grand- Sue. Throughout her life, Louise will be greatly missed her husband, David; two many RVs. They loved ship the owner of Heritage Wood children, Alex (Shanyia) Hous- Louise was an outstanding by her family and friends. nieces, Ann and husband, cruises; they traveled to Alaska Floor Specialists. Neil was ac- ton, Mason Houston, Cameron mom and grandma. She was Louise is survived by her hus- Harry White, and Charlotta eight times, and the Baltics on tively involved as a member of Gibson, Jordan (Aaron) Taylor, the cook at East Bay Elemen- band, Bill; son, Skip Brown; Valentine; and lifelong friend, the maiden voyage of the the East Traverse City Congre- Alayna Webb, Jayla Wise, tary School in her early years. daughter, Lynn (Dan) Gail Bader, at her side. Viking Star out of Bergen, Nor- gation of Jehovah's Witnesses. Kialie Wise, Braxtyn Wise; She and Harold then went on Steinebach and daughter, Sue Helen was born at the Tra- way. Helen liked to pass her He was a wonderful husband, three brothers, Albert Feck, to own and operate the Briar (Dirk) Sawusch; grandchildren, verse City Osteopathic Hospi- time with reading, photography loving father, proud grandpa, Joseph (Phyllis) Moore, Ter- Hill Motel in Traverse City and Sara (Andy) Bogard, Carrie tal on Dec. 19, 1948, to the late and gardening. She was also a and a one of a kind friend. Neil ence "Mack" Moore; two sis- the Granada Inn in Kalkaska for (Eric Warnes) Brown, Katie Harold T. and Dorothy (Haines) member of the Black Hatters was big-hearted, generous, ters, Teresa (Chuck) Renaud, many years. They were mem- (Rich) Koths, Beth (Ed) Fan- Crabtree. Although she was Club of Traverse City, a group and loved to help others. Fa- Kelly (Julio) Neff; and several bers of the Presbyterian tozzi, Emily (Jake) Weiderman born in Traverse City, she with her fellow high school vorite pastimes that were nieces, nephews and cousins. Church in Traverse City. and Lukas Sawusch; great- spent most of her growing up alumni, retired Sheriff Depart- spent with friends and family He was preceded in death by Harold passed away in 1991 grandchildren, Fisher, Noah years in Elk Rapids and Ke- ment employees, and several were fishing for Walleye and his mother, Clara Belle Wilkins, after a chronic illness. and Corbin Bogard, Ivy and wadin, eventually moved to other organizations in and out Perch, including fishing adven- and sister Lea (Feck) Thrush. Louise was also a realtor for Ben Baillie, Henrik Koths, Traverse City in 1977. of the Grand Traverse County tures in Canada's remote At this time due to gathering over 30 years. Her warm smile Maddie Weiderman; sisters, Helen graduated from Elk area. lakes, or sharing a meal. He restrictions, the funeral date is allowed her to excel at any- Joyce (Ron) Grammer, Jane Rapids High School and at- TheSurviving Record-Eagle Helen - are 04/19/2020 her hus- also enjoyed traveling with his to be determined. Page : C07 thing and everything she did. (Jack) Orr, Linda Newhouse, tended Northwestern Michigan band, David Cussins; her wife, playing guitar, scuba div- While working as a realtor she Pat (Gordy) Converse; many College. She started out typing nieces, Ann White and Char- ing, and playing chess. met Bill Brunelle, who was also nieces and nephews; Bill's book manuscripts for writers lotta Valentine; nephew, Robert a realtor. On May 30, 1998, children, Richard "Rick" (Carol) Glenn Ruggles and Doug Stan- Oman; great-nieces and - Louise married Bill. She and Brunelle, Kathleen (Pat) Fabian ton; and worked for 23 years at nephews; and many cousins. Edwin A. Ramsden Bill loved to golf and would and Greg (Sue) Brunelle; and Grand Traverse County Sherif- Helen is preceded in death by Died April 15, 2020 play as often as they could. Bill's grandchildren, Megan, f's Office as a clerk/matron, her parents, Harold and They wintered in Naples, Nicholas and Kelly. and was able to take an early Dorothy (Haines) Crabtree; sis- TRAVERSE CITY — was exercising, Florida, for 17 years and en- Louise was preceded in retirement as Administrative ter, Laura Oman; step-father, Edwin A. Ramsden, spending a total of 1.5 joyed volunteering for the death by her daughter-in-law, Assistant to Sheriff Harold Barr Max Yankee; and step-sisters 90, of Livonia, and hours each day doing Champions Tour Event held at Janet Brown; and her first hus- in 2000. Helen was held in high and -brothers. more recently of Tra- 30 minutes of station- various courses in the Naples band, Harold Brown. regard for her humor, abilities A Celebration of Helen's Life verse City, passed ary biking, 30 minutes area. She was the captain of The memorial service cele- and skills, and the way she service will take place at an an- away on Wednesday, of bands, 50 pushups, the many volunteers for the brating Louise will be held at a completed duties in the office nounced time in late May or April 15, 2020. 50 sit-ups, and other 10th hole on all of the courses later date. A notice will appear by her fellow employees of the June. Born in Kingston to exercises that he was and did a fantastic job of keep- in a future edition announcing GTC Sheriff's Department. The family is being served by the late Roy Frederick determined to con- ing everyone in line. She also the date and time. Helen and David Cussins Reynolds-Jonkhoff Funeral and Gladys Pearl tinue at the young age enjoyed getting autographs Memorial contributions in her married on Dec, 8, 2001, in Se- Home and Cremation Services. (Kreger) Ramsden, Ed of 90. from the pros, most notably honor may be directed to Free- spent the majority of Above all else, Ed Gary Player and Hale Irwin. dom Builders Missions. his childhood and will be remembered The National Cherry Festival www.fbmissions.org adult life in metro De- for his innate ability to was very special to Louise. The family would like to thank Nicholas J. 'Nick' Leone troit. He spent his keep pushing forward She was the first female presi- Culver Meadows for taking time as a young man without being phased dent of the festival and served such good care of Louise the Died April 9, 2020 tinkering around with by any and all limita- as the Queen Mom for many past few months. old cars and cruising down tions. His quiet determination CEDAR — Nicholas be found with his dear years. Please visit www.reynolds- Woodward Avenue, before tak- and ridiculous sense of humor J. "Nick" Leone, 60, friend for over 40 Louise was a gifted quilter. jonkhoff.com to share your ing up the family business of will be greatly missed by all was a long time resi- years, Paul Barrett, Her family and Bill's cherished memories and condolences bricklaying. who knew and loved him. dent of Cedar, born working on the race all of the quilts she made for with the family. Ed served our country honor- He was the loving father of May 4, 1959, in Pon- sled. Nick had so ably in the United States Janell (Kevin) Clayton and tiac, the oldest of many friends and was Armed Forces, first in Japan Linda (Scott) Maxwell; proud William 'Bill' Laakko three children to Don- always willing to and then in Korea as part of the grandfather of Kelly, Katie ald C. and Margaret come and help if Died April 16, 2020 first landing forces on the Pu- (Liam) Allen and Kendra (AJ) H. Leone. Nick needed. It didn't mat- san Perimeter. LaCross. He is also survived by KEWADIN — William ing father and passed away peace- ter what it was, he Following his return from the his sister, Sandy Mutter; his "Bill" Laakko, 83, of grandfather of his fully in his sleep on would be there in a war, he married the late Lutie brother, Richard Ramsden; Kewadin, passed children's and then April 9, 2020. flash to lend a hand and was (Page) Ramsden in 1954. They and many other beloved family away peacefully on his grandchildren's Nick was predeceased by his always willing to come back to were married for over 63 years members. April 16, 2020 at projects, activities ac- father, Donald C. Leone. He is help you get the job finished. and raised two wonderful Due to social distancing re- Meadow Brook Nurs- complishments, and survived by his mother, Mar- Nick sacrificially gave of his daughters in a home that he quirements, graveside services ing Home in Bellaire. successes. garet H. Leone; brother, John time and talents to those built with the help of his father will take place next to his wife Bill was born on May The Laakko family (Susan) Leone; sister, Mary around him. and brother. at a later date. 23, 1936 in Ironwood, resided in Birming- (Brian) Jackowski; nieces and Never having children of his A voracious reader who fre- In lieu of flowers, the family the son of Waino and ham. They were cot- nephews, Shannah (Gary) Bird, own, he was very close to his quently bought used books by requests that donations be Eldena Laakko. His tage owners on Grand Charlotte (Mitch) Black, Chris- nieces and nephews. He never the bag, Ed could sit in silence made to the Grand Traverse childhood was spent Traverse Bay since tian Leone, Necole (Dan) forgot their birthdays and al- for hours engrossed in a story. Pavilions at https://www.gtpav in Mass City and the 1960s. Bill and Beitzel, Anthony (TommLynn) ways went to great length to When he wasn't reading the ilions.org/donate/. Houghton. Beverly made this Reno, Dante (Megan) Leone; find that "perfect card" that latest spy novel or making Kindly share thoughts and He attended River- their permanent home and his dear friend, Paul (Mary) would bring a smile and a corny jokes that were empha- memories of Edwin at side Military Academy in 1997. Barrett. hearty laugh to all. Nick loved sized by his toothy grin, Ed www.reynolds-jonkhoff.com. in Gainesville, Geor- Bill did not "retire Nick moved to Traverse City babies and small children and gia, graduating in 1954. He well" and wanted "something at the age of 12 and graduated always went out of his way to then went to Ohio State Uni- to do." With his banking, ac- from Saint Francis High School send them a little something. Carolyn Lee 'Tiny' Roesner versity where he played counting and tax certification in 1977. He attended North- Nick had a love for the out- Died April 11, 2020 hockey. Bill honorably served as an Enrolled Agent, he western Michigan College for doors and liked to hunt and in the U.S. Army 1957-59. He opened a business in Acme, two years, later transferring to fish every chance he got. He TRAVERSE CITY — was an avid bridge then continued his education The Cross Group, representing Michigan State University, liked spending the day on the Carolyn Lee "Tiny" player and was in a at Northern Michigan Univer- clients before the IRS and do- where he belonged to the water with his friend, Paul. He Roesner, 89, of Tra- bridge club for many sity getting a degree in Eco- ing taxes and accounting for Sigma Phi Epsilon Fraternity. enjoyed going for long walks in verse City, passed years. She had a great nomics. His career then took 20 years. He graduated with two bache- the woods with friends or by away Saturday, April appreciation for any- him to Detroit where he worked Bill passed away of Chronic lor's degrees. Nick worked at himself. His big heart, his smile 11, 2020, at Cherry one with a good sense in accounting and banking. Lymphocytic Leukemia. Hon- GTR Equipment for 27 years, and his constant teasing and Hill Haven of of humor and had an Bill's greatest love was his oring Bill's wishes, cremation where he did snow plow instal- laughter will be missed by Kalkaska.Carolyn was infectious family; his wife of 57 years, has taken place. lation and custom fabrications. many. A victory in Heaven, for born in Detroit on laugh.Carolyn is sur- Beverly; his grown children, Due to COVID-19, a Celebra- In his spare time he enjoyed sure. Wave that checkered flag Nov. 13, 1930, to Ivor vived by her daugh- Keith (Betsy), of Clayton, Mis- tion of Life will be held in the being a mechanic on the Long- buddy - you're home! and Esther (Philipp) ters, Amy (Ronald) souri, Wayne, of Los Angeles, Summer. ton/Barrett Racing Team #68 The family will be gathering Lee. She grew up in Royal Oak. Christy, of South Haven, Jane California, and Liisa (Kevin) Mc In accordance with Bill's in- for over 30 years. He was also sometime in late spring or Tiny attended college at Bay James, of Spring Lake; grand- Cracken, of Lake Helen, volvement and interest, Memo- part of Team 73 Holeshot Rac- summer to celebrate Nick's Path University in children, Aaron Bischoff, of Florida; his five grandchildren, rial Contributions may be made ing, which became Team 24 life. Massachusetts.Tiny worked as Paw Paw, Alexander Hyde, of Annelise, Will, Charlotte, to the Torch Lake Township two years ago. These were Please share a memory with a secretary at the television Spring Lake, and Ellen Hyde, Robert and Cross. Bill was al- EMS, P.O. Box 713, Eastport, both Soo I 500 teams, and he Nick's family by visiting his station WJBK in Detroit.In of Traverse City; and sister, ways an active, proud and car- MI 49627. had been to every Soo race for tribute page at www.reynolds- 1956, she married Charles Nancy Crisler, of Bloomfield the last 24 years. His team had jonkhoff.com. VanNorwick; together they had Hills. Carolyn was preceded in Copyright (c)2020Page The 12 Record-Eagle, of 59 Edition 04/19/2020 won two world championships. MayThe 7, 2020 Reynolds-Jonkhoff 8:50 am (GMT +4:00) Fu- two daughters, Amy and death by her parents, and sis- Powered by TECNAVIA Vickie Anne Newhouse The racing community was like neral Home and Cremation Janie.In the 1960s and early ter, Barbara Rarey.No service Died April 2, 2020 a second family to him. Almost Services is serving the family. '70s, Tiny and her family spent is planned at this every Tuesday night he could many wonderful summers and time.Memorial contributions in MESA — Vickie Village Market in Elk weekends at their beloved cot- Carolyn's honor may be di- Anne Newhouse Rapids. tage on Glen Lake. Because of rected to Cherryland Humane passed away peace- Vickie is preceded in their great love for northern Society, 1750 Ahlberg Road, fully on Thursday, death by her mother deaths Michigan, the family made Traverse City, MI 49696; or Ju- April 2, 2020, in Mesa, and her brothers, their dream come true by mov- venile Diabetes Research JOHN FLYNN, 75, ALEX R. PEPLINSKI, 85, Arizona. Devoted Brent, John, Michael ing to Traverse City from Foundation, (JDRF), P.O. Box wife, mother, aunt, and Doyle. Traverse City, passed of Traverse City, passed Bloomfield Hills in 1973.During 37920, Boone, IA 50037- grandmother, and She is survived and away on April 5, 2020. away, Friday, April 17, the mid to late '70s, Tiny and 0920.Please share a memory friend, she cared much loved by her He is survived by Betty 2020. Chuck owned and operated with Carolyn's family by visit- deeply and was loved husband and best Flynn, of Florida; A Memorial Mass will Van Norwick's, a clothing/fine ing her tribute page at by many. Her home friend, Frank "Mike" brother, James "Jim" be announced in a future goods store that was located www.reynolds- was always open, and many of Newhouse; daughters, Jen- Flynn, of New York; edition in the Record- in Traverse City.Tiny had im- jonkhoff.com.The Reynolds- her children's friends called nifer (Jason) Wightman, daughter, Kelly Flynn, of Eagle. mense love for animals, espe- Jonkhoff Funeral Home and Stephanie (Thomas) Fabatz cially dogs. She owned many Cremation Services is serving her Mom or Mimi, as she was Traverse City, and John Please visit affectionately known. Her most and Kara (Jared) Newhouse; dogs during her lifetime. Tiny the family. -loved vacation spot was Dis- her grandchildren, Colby, Declan Flynn, of Florida; www.lifestorytc.com to ney World. She loved her visits Aryana and Justin; sisters grandchildren, Amanda share your thoughts with and passed this love on to her Peggy (Glen) Kole and Pam and Adam Ladd, Ashley the family and more. children. (Dan) Fuller; brothers, Clark Flynn, Kayla and The family chose Life Vickie was born May 25, Carpenter and Larry (Sally) Rachael Flynn; and great Story Funeral Home, 1949, to Dorothy (Snover) Car- Leduc; great-grandchildren; -grandchildren, Traverse City. Careers are made penter. After graduating from and many nieces and Savannah and Ava Mancelona High School in nephews. Genton. in the Classifieds ... 1967, she married the love of The family will hold a memo- Please visit her life, Frank "Mike" New- rial service at a later date. www.lifestorytc.com to To place an ad, call 231-946-2653 house April 17, 1970. She In lieu of flowers, the family is or visit www.record-eagle.com/classifieds taught cosmetology at North- asking that donations be made share your thoughts. western Beauty Academy and to the Lewy Body Dementia The family chose Life was a long-time employee at Association. Story Funeral Home. www.record-eagle.com MICHIGAN COUNTY MEDICAL CARE FACILITIES COUNCIL | MAY 2020
COUNCIL SHIPS 100 CASES OF FACE SHIELDS TO MEMBERS
orking into the evening Tuesday, April 28, the council’s Vickki Dozier and Renee Beniak prepped 100 cases of face shields Wfor shipment to council members across Michigan, along with a small token of the council’s appreciation for all the work being done by facilities to keep their residents safe.
CMS OFFERS NEW UPDATES ON COVID-19 IMPACT ON NURSING HOME COMPARE, FIVE-STAR BY PATRICK CONNOLE/PROVIDER MAGAZINE
The Centers for Medicare & Medicaid Services (CMS) has Home Compare, but they will not be used to calculate a released a memo (QSO-20-28-NH) with updates on Nursing center’s Five-Star inspection rating, the agency said. Home Compare (NHC), Five-Star Quality Rating System, public staffing information, and a list of frequently asked The Quality Measure and Staffing domains of Five-Star will questions (FAQs). be updated on April 29 as they are not impacted by the CMS blanket waivers because they rely on data from before Included in the new information, CMS said it will temporarily March 1, 2020, according to a summary of the changes by hold constant the inspection domain of Five-Star to prevent the American Health Care Association/National Center for an unequal impact on the rating for those facilities that receive Assisted Living (AHCA/NCAL). a survey during this time of the COVID-19 pandemic. This freeze will begin with the scheduled Nursing Home Compare In other developments, CMS said it will use Payroll-Based update on April 29, 2020. Journal staffing data to publicly report the average number of staff on site at each nursing facility each day (both nursing CMS will post the results of any health inspections conducted staff and total staff) and will also post aggregated data at a on or after March 4, 2020, on the landing page of Nursing — CONTINUED ON PAGE 3 —
In This Issue CMS NewsPage...... 13 of 59 1 State News...... 13 National News...... 4 www.mcmcfc.org MEMBERS GO ABOVE AND BEYOND TO KEEP RESIDENTS SAFE AND HAPPY DURING CRISIS
‘50s Day at Maple Lawn
Parades to thank staffs at Bay County and Tuscola County
Well-deserved treats at Thornapple Manor and Lapeer/Suncrest
Clowning around at Thornapple Manor
| MICHIGANPage 14 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 2 — CMS OFFERS NEW UPDATES ON COVID-19 IMPACT ON NURSING HOME COMPARE, FIVE-STAR FROM PAGE 1
state and national level. The publicly posted information will On other issues, AHCA/NCAL said providers must know that include all staff listed in section 2.3, Table 1 of the PBJ Policy even as states begin to lift their stay-at-home orders, nursing Manual, AHCA/NCAL said. facilities must continue to maintain current restrictions on visitors. As a reminder, CMS released guidance on March 13 that This information will be based on data submitted for the fourth required all nursing centers to significantly restrict visitors and quarter of 2019. CMS says this information can be used to help nonessential personnel, as well as restrict communal activities. local, state, and federal agencies plan for how much personal protective equipment (PPE), testing, and other resources The CMS guidance indicates that individuals other than essential providers may need. Providers can also use this information health care staff and visits for end-of-life situations should no along with the CDC PPE burn rate calculator. longer enter nursing facilities until further notice.
The CMS memo also includes a FAQ document that addresses Even though certain states may be lifting their individual stay- CMS guidance in the areas of visitation, surveys, waivers, and at-home orders, nursing facilities must continue to follow this more. The FAQs provide information on topics including: directive from CMS until new guidance is received. For help communicating these policies, please see AHCA/NCAL’s sample • Individuals entering and leaving the nursing center, including letter to families on restricting visitors. visits by health care personnel, visitation for compassionate care situations, and residents who want to leave the facility Assisted living communities must follow any applicable state against medical advice; guidance. If no state guidance is issued, the association • Surveys and infection control self-assessment, including recommends they follow AHCA/NCAL guidance and continue the ongoing suspension of standard surveys and the restricting the number of people entering the facility. recommended use of the infection control-focused survey protocol for self-assessment on infection control practices and For all long term care communities, these restrictions remain preparedness; critical safeguards to help protect against the spread of • Waivers of federal requirements, including those related to COVID-19, AHCA/NCAL said. in-facility and inter-facility cohorting; and • Additional information on resident cohorting, separation, Finally, on April 23, CMS updated its 41-page COVID-19 and admission. Frequently Asked Questions (FAQs) on Medicare Fee-for- Service (FFS) Billing guidance. This guidance is directed to AHCA/NCAL noted that CMS reminds providers that a negative all providers of Medicare Part A and Part B services, including test for COVID-19 is not a prerequisite for discharging a resident skilled nursing facilities. to a nursing facility from the hospital; however, consistent with current guidance, admissions decisions should be made A general billing requirements FAQ related to using the “DR” based on the resident’s clinical status and the ability of the condition code and “CR” modifier on claims to indicate that the accepting facility to meet their care needs and infection control Medicare payment is conditioned on the presence of a “formal requirements. waiver” has been updated and should be reviewed by billing staff, AHCA/NCAL said. Providers that can’t meet the needs of the residents due to PPE, staffing, or other issues should not accept the person. The SNF-specific FAQs are on pages 34-35 and have not changed since last updated on April 10, the association said. CMS is allowing civil money penalty (CMP) funds to be used for purchasing devices such as tablets or web-cams, as well as accessories, with a maximum of $3,000 allowed per facility to help with communications between residents and their families or friends, the association said. To apply to receive CMP funds for this purpose, contact the state agency’s CMP contact. FOLLOW THE MCMCFC ON
For questions related to the Nursing Home Compare website FACEBOOK AT and the Five-Star Quality Rating System, CMS said to email FACEBOOK.COM/MCMCFC [email protected].
For questions related to the FAQs, email DNH_TriageTeam@ cms.hhs.gov.
| MICHIGANPage 15 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 3 — THE SPOTLIGHT ON NURSING HOMES HAS NEVER BEEN BRIGHTER. LET’S KEEP IT THAT WAY BY ALEX SPANKO/SKILLED NURSING NEWS
Over the years, nursing home operators have found themselves in We cannot afford to follow this playbook. There simply cannot be a the spotlight for negative reasons — usually in the wake of isolated next story with the size and scope of the one we’re currently living stories of abuse and neglect, or tales of owners who bilked the through each day. government for money at the expense of quality care. After privately getting out their frustrations about the way they’re But the industry has never been at the center of national being portrayed in the media, leaders in the space must embrace conversation, the nexus of a gradually unfolding American tragedy, and amplify not just the feel-good stories of celebrations through the way it is today. nursing home windows and nurses going above and beyond for their residents — but also the good-faith attempts at getting to the COVID-19 has thrust both the systemic failures and quiet grace root of the problems blossoming all throughout the country. inherent in the nursing home industry into daily news reporting across the country. As the devastating death toll continues to climb, An April 21 New York Times story about the precarious state journalists and the general public are being forced to consider the of nursing homes’ finances even before the crisis serves as the fractured state of senior care funding and oversight in ways they perfect example of a piece that leaders should spread far and wide. haven’t before. There’s nothing in it that would surprise anyone who’s spent more than six months in the industry, but that’s exactly the point. I know there’s a lot of frustration among the operators whose yeoman’s work during this time — the long hours on the phone The person calling for the heads of every nursing home operator with suppliers of personal protective equipment (PPE), the in the comments section of a local news story might not know that mourning of deaths alongside family members and caregivers, the Medicaid often doesn’t cover the cost of long-term care in many scramble to comply with near-daily regulatory updates — is getting states, forcing even the best providers to make difficult staffing and buried under body counts and finger-pointing. capital investment decisions.
But the leaders in this space can’t let the national focus on nursing The family scared out of their wits for the safety of their ailing loved homes go to waste. one in a nursing facility has never had to unravel the complex reimbursement dynamics that every nursing home CFO must Senior care has the attention of the United States and the world balance each day to keep the lights on. right now. Instead of shying away from the spotlight, and hoping it’ll go away with a few carefully worded “no-comments,” post- The local reporter staring down death tolls and getting no acute and long-term care leaders must grab the microphone and comment from a facility operator might not realize that a complete not let go until the media glare invariably drifts elsewhere. freeze on non-essential surgeries cut off a vital Medicare funding source — at the same exact time that the cost of PPE skyrocketed My current fear is that the wide network of stakeholders in senior by more than 6,000% for some items. care — operators, residents, regulators, lawmakers, lawyers, families, and anyone under the age of 65 today who might need Shocked and outraged people are looking for someone to blame that kind of care in the future — won’t learn much of anything from right now. But there’s no one scapegoat whose downfall will make this crisis. things better.
The absolute worst long-term outcome for nursing homes is a There’s also no one person whose bright idea will fix everything. replay of the well-worn pattern these stories usually follow. It’s up to all of us to explain the depth of the problems to anyone A newspaper or television station reveals a case of neglect or abuse, who will listen; find partners and leaders willing to get into the or a specific pattern of failures. An outraged public demands weeds with us; and lay the groundwork for a transformation of how answers. Local officials and politicians rail against the owners and we fund and provide senior care in this country. operators, who receive fines or even criminal punishments for their actions. Everyone pats themselves on the back, convinced the Many of the best advocates for the people who live and work in problem has been solved completely, and officials and the media nursing homes have rightfully described the setting as forgotten go back to pretending that the post-acute and long-term care during the COVID-19 pandemic. landscape doesn’t exist — until the next sordid story kickstarts the cycle anew. — CONTINUED ON PAGE 5 —
| MICHIGANPage 16 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 4 — CMS TO USE STAFFING DATA TO ASSESS PPE NEEDS; FREEZES STAR RATINGS BY DANIELLE BROWN/MCKNIGHT’S LONG-TERM CARE NEWS
Providers’ staffing totals will be used to address their personal purchase equipment that can help residents communicate with protective equipment needs during the coronavirus pandemic, family members during this time of isolation,” she said. according to a new memo from the Centers for Medicare & Medicaid Services. In addition money collected from fines will pay STAR RATINGS FREEZE for tools that will help residents communicate with their families during the pandemic lockdown. The CMS memo also announced a freeze to the inspection domain of nursing homes’ current star ratings on the Nursing Home CMS announced the moves April 24, explaining that it will be Compare website following the suspension of certain survey publishing a list of the average number of staff members onsite at inspections during the coronavirus pandemic. In late March, the facilities each day. The information will be used to direct adequate agency announced that it would suspend standards surveys PPE and testing to nursing homes. for nursing homes and prioritize inspections regarding Immediate Jeopardy, infection control and self-assessments. The agency also is now waiving timeframe requirements for submitting resident assessment data (Minimum Data Set) and staff In Friday’s memo, the agency said the targeted inspection plan data (Payroll-Based Journal) by certain deadlines. The waivers won’t resulted in a great shift in the number of nursing homes inspected impact the updates to the quality measures and staffing domains and how they’re conducted. being used for the April update on the rating system, which is set for Wednesday. “This would disrupt the inspection domain of the Nursing Home Five Star Quality Rating System because many nursing homes that LeadingAge President and CEO Katie Smith Sloan said in a would normally be inspected, will not, thereby over-weighting statement that the organization was “pleased” with the move. and impacting the ratings of those facilities that are inspected. The organization added that it’s still seeking additional clarification This could then potentially mislead consumers. Therefore, we from CMS on clinical and financial operations regarding 1135 will temporarily maintain and hold constant the health inspection waivers, however. domain of the rating system,” the memo stated.
“We are encouraged by the mention about using PBJ data CMS added that results of health inspections conducted on or to determine PPE needs. We hope this results in appropriate after March 4, 2020, will still be posted publicly but not be used amounts of PPE for nursing homes who need it urgently,” Smith to calculate a nursing home’s health inspection star ratings. The Sloan said. memo also answered several frequently asked questions related to the agency’s actions regarding visitation, surveys, waivers and “Additionally, we are pleased that CMP funds can now be used to other guidance.
THE SPOTLIGHT ON NURSING HOMES HAS NEVER BEEN BRIGHTER. LET’S KEEP IT THAT WAY FROM PAGE 4
While hospitals have been hailed as the domain of heroic doctors In the days and weeks after the September 11 attacks, as a and nurses, long-term care facilities were largely left out of PPE middle-schooler growing up in the suburbs of New York City, I and testing prioritization efforts. Plans to support them once the thought there’d never be another day in my entire life without outbreaks began have been scattershot and poorly organized; the images of burning towers and falling bodies in every even New York Gov. Andrew Cuomo — who has received newspaper and on every TV newscast. praise for his handling of the COVID-19 response — publicly admitted last week that he had no idea why his own state health It may have taken months or even a year, but that day certainly department still requires nursing homes to re-admit coronavirus came. And it happened so gradually, I can’t tell you when the patients despite the danger of spreading the disease. world’s attention shifted.
The stories of deaths and disarray in the American nursing home It’s hard to believe here in the trying spring of 2020, but the infrastructure have ensured that the space is forgotten no more media narrative will move on eventually. It’s up to the leaders — but only as long as the virus continues to spread and take the in the industry to make sure that their voices are heard before lives of the people in its care. they’re forgotten once more.
| MICHIGANPage 17 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 5 — MULTIPLE STATES TAKE STEPS TO SHIELD NURSING HOMES FROM LIABILITY AMID COVID-19 — BUT RULES VARY BY MAGGIE FLYNN/SKILLED NURSING NEWS
Health care providers across the continuum have grappled with are available; the first round of COVID-19 inspections found that major challenges in providing care for patients with COVID-19, and 36% of facilities were not following proper hand-washing protocols, several states have taken steps to shield them from lawsuits related while 25% did not demonstrate proper use of personal protective to care provided during the national emergency. equipment (PPE)
Skilled nursing facilities are often included in those liability Illinois addressed this issue through an April 1 executive order protections, but the extent to which the protections apply vary from Gov. J.B. Pritzker, with a similar stipulation regarding gross from state to state, and there are some key differences in how the negligence or willful misconduct; it covers health care facilities, states are phrasing their rules. professionals, and volunteers. Michigan’s executive order, issued March 29, protects hospitals and health care workers from liability The patchwork quilt of liability rules is further complicated by local for taking necessary steps to protect Michigan residents in an efforts to initiate civil and criminal investigations into nursing homes emergency, according to a March 29 release. with significant COVID-19 outbreaks. The mayor of Joliet, Ill., for instance, late last week called on Gov. J.B. Pritzker to launch a Other states that used executive orders to address the issue state Department of Public Health probe into a facility where 22 of legal immunity for health care providers include New Jersey residents and one staff member died from the virus. and Iowa, according to an April 13 e-mail from Lisa Sanders, a spokeswoman for LeadingAge, which represents non-profit senior One state over, Carmel, Ind. mayor Jim Brainard wrote a letter to housing and care providers. one nursing home that allegedly refused to perform COVID-19 testing as directed, warning the administrator that they could be A letter from the association to Department of Health and Human charged with negligent homicide if testing was not conducted Services (HHS) Secretary Alex Azar sought clarification on the and residents or staff subsequently died. The administrator, at legal immunity for health care facilities, especially SNFs and least according to the mayor’s office, eventually complied with the assisted living facilities, under the Public Readiness and Emergency testing directive. Preparedness (PREP) Act and Azar’s March 17 Notice of Declaration under the PREP Act for medical countermeasures against STATE-BY-STATE VARIATIONS COVID-19, she noted.
The state of New York has become the epicenter of the global The letter, dated March 25, sought “an express confirmation” COVID-19 outbreak, with 211,550 cases reported as of April 16, that SNFs and ALFs are considered “covered persons” under according to the Centers for Disease Control and Prevention (CDC). both the act and the declaration, as well as a clarification that At the beginning of the month, the state took action to grant immunity under both the act and the declaration would extend to “qualified immunity” to a range of health care providers, including circumstances where “covered countermeasures are either scarce nursing homes, through the Emergency Disaster Treatment or unavailable.” Protection Act included in the state’s budget for fiscal year 2021. That issue is particularly important given the shortage of tests The Emergency or Disaster Treatment Protection Act in New York and PPE, as well as shortfalls in drugs, respirators, and ventilators, takes steps to protect health care facilities and professionals from LeadingAge argued in the letter. liability that could stem from treating COVID-19 patients under conditions related to the public health emergency, according to “In order to support SNFs and ALFs providing treatment to elderly the act text itself. and at-risk individuals afflicted by COVID-19, it is essential that they be shielded from liability and costly litigation due to shortages This immunity does not extend to harm or damages caused by beyond their control,” the letter said. willful or criminal misconduct or gross negligence, but it will cover harm or damages if they stem “from a resource or There are other states that have laws providing immunity for staffing shortage.” providers when the governor declares an emergency; Sanders identified these as Indiana, Louisiana, Maryland, and Virginia in the That exemption tracks with guidance around protective equipment April 13 email. from the Centers of Medicare & Medicaid Services (CMS), which has indicated that it will not punish providers for infection-control LeadingAge Connecticut, the Connecticut Association of Health issues caused by a lack of adequate supplies. That said, providers Care Facilities (CAHCF), and the Connecticut Association for will still be on the hook for improper use of supplies such as they — CONTINUED ON PAGE 7 —
| MICHIGANPage 18 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 6 — MULTIPLE STATES TAKE STEPS TO SHIELD NURSING HOMES FROM LIABILITY AMID COVID-19 — BUT RULES VARY FROM PAGE 6
Healthcare at Home jointly sent a letter to Robert Clark, the While this order, like the others, excludes liability immunity for general counsel of the office of the governor, requesting clarifying damage or injury caused by willful misconduct, gross negligence, or provisions to ensure that immunity language submitted by the bad faith, it is notable in that it does not restrict the protection to Connecticut Hospital Association could include their respective COVID-19-related treatment or care, AGG noted. fields; the letter, provided by Sanders, was undated. It also does not affirmatively protect the legal entity providing the SNF associations in other states have requested immunity for health care service, though it does protect the staff, Hedy Rubinger, care provided during the COVID-19 emergency; the Florida one of the authors of the alert and a partner at AGG, told Skilled Health Care Association sent a letter to Gov. Ron DeSantis on Nursing News in an April 16 interview. April 3 requesting liability immunity for “any health care facility or health care professional” providing services in the emergency “It’s maybe implied, but the way it’s drafted, it is unclear as to and in good faith. whether it provides protection to the legal entity that holds the license, whether that be a SNF, an ALF, a hospital,” she explained. A spokeswoman for the FHCA said that as of April 17, there was no response from DeSantis’ office on the issue. That makes it essential for SNFs to document every step they take in providing care if it deviates in any way from the standard practice In Washington and Pennsylvania, provider associations have also — as well the reasons for doing so, according to AGG. requested legal immunity as they battle COVID-19. In both cases, the letters mentioned shortages of PPE, and in the case of the Another reason that documentation is so crucial is the fluidity Washington state letter, the bevy of providers writing cited the of the guidance SNFs need to follow, Rubinger said. Keeping shortage of PPE as an area of potential civil liability – even though contemporaneous documents of what they do and why can help the equipment is being reused and conserved in accordance with SNFs when they — or another party — is looking back at what guidelines from the CDC and the Washington State Department happened in March through the lens of what’s now known April, of Health. she said.
In an April 15 statement, the American Health Care Association Some examples of practices that should be documented include (AHCA) — which represents thousands of nursing homes and the SNF’s optimization or redistribution of staffing, isolation assisted living providers — pointed out that the recent coronavirus measures for residents who don’t have COVID-19, the use of cloth stimulus bill does include some additional federal liability protection masks, and the optimization of PPE, Rubinger told SNN in a follow- for volunteer health care workers during the COVID-19 emergency. up email on April 16. It also pointed out the PREP Act immunity protections, noting that Secretary Azar issued a letter in March calling on state governors to PPE is a particularly crucial area. As providers try address staffing protect health care professionals from medical liability. challenges and shortages of masks and gowns, they need to be prepared for those challenges to feature prominently in future But those measures do not go far enough to provide sufficient legal litigation, as Christy Tosh Crider, chair of the health care litigation protection, AHCA added. group at the law firm Baker Donelson, noted on a recent webinar.
“We encourage every state to extend sovereign immunity provisions Rubinger also pointed to securing PPE as an example, highlighting to the long-term care providers and other health care sectors it as a key area of documentation — and one that could get easily associated with care provided during the COVID-19 pandemic,” overlooked as the number of COVID-19 cases in long-term care the association said. facilities continues to mount.
DOCUMENTING EVERYTHING “We’ve been trying to get them to keep records, also, to really document [the difficulty] and what they’re doing in terms of Perhaps an example of the different nuances is highlighted by a outreach for COVID testing, PPE,” Rubinger explained. “In most of recent executive order from Georgia Gov. Brian Kemp, which our clients, it’s all-hands-on-deck trying to work within the supply would limit the liability of employees, staff, and contractors at chain. And when the president of a company is working on that, it’s health care institutions and medical facilities during the COVID-19 not necessarily documented. They’re not typically documenting emergency, according to a client alert from the law firm Arnall what they’re working on — they’re just doing.” Golden Gregory (AGG) published on April 16.
| MICHIGANPage 19 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 7 — PROVIDERS URGED TO FIGHT COVID-19 LAWSUITS BY DOCUMENTING ‘EVERYTHING’ BY DANIELLE BROWN/MCKNIGHT’S LONG-TERM CARE NEWS
A legal expert is urging providers to “Treat it as if you’re going to have to document everything related to their turn it over to a regulatory body, and response to the coronavirus pandemic. ask yourself is this communication It’s a move that could help providers sending the right message about our defend themselves in a potential organization’s commitment to put lawsuit stemming from their response. proper PPE in place for the protection of our residents and the protection of “Documentation is critical. Document, our frontline caregivers,” she added. document, document your efforts,” Christy Tosh Crider, chair of Baker Next round of stimulus funding not Donelson’s Health Care Litigation expected this week Group and the Women’s Initiative, said Tuesday. She issued the warning Medicaid and Medicare Advantage during a webinar hosted by the providers, along with coronavirus Society for Healthcare Organization Purchasing Professionals hotspots, will be the focus of the next round of stimulus funding, (SHOPP). according to Clif Porter, senior vice president of government affairs for the American Health Care Association. Many providers may be subject to lawsuits in the coming months due to unfortunate patient outcomes from the new coronavirus, Porter noted that the first $30 billion of the $100 billion health fund she warned, adding that procurement officers may become included in the stimulus package that was released Friday focused “critical witnesses” in such litigation. In fact, the first known on Medicare fee-for-service providers. lawsuit filed against the site of the first known U.S. outbreak, in Kirkland, WA, was filed Friday. “The second round is pending and that will likely be issued in the early part of next week,” Porter explained. In addition, the Florida Health Care Association came under fire over the weekend, when a USA Today article noted that the “I think it’s clear, at least to the skilled nursing sector, that this round group had written the governor to ask for blanket immunity for at least intuitively should be a significant and a meaningful round of healthcare providers from COVID-related lawsuits. stimulus because the majority of our revenues, as you know, is from Medicaid,” he added. Tosh Crider said the focus of future lawsuits likely will involve staff members who have tested positive for the disease returning to He also noted that the third round of stimulus funding would work; struggles to get personal protective equipment; and staff address assisted living and any other gaps that were missed in the training on how to effectively use personal protective equipment. first two tranches.
“What’s unfortunate is that you’re going to be judged against a standard six months from now that is not the standard today and NRC HEALTH SHARES wasn’t the standard yesterday, or last week,” she said. RESEARCH REPORT ON “You need to be documenting as each new piece of guidance CONSUMER SENTIMENT comes out. As you and your organization respond to that new piece of guidance, document what you knew, when you knew it The spread of Covid-19 continues to affect every aspect and what your response was,” she urged. of life for both healthcare providers and consumers. Our latest nationwide research highlights the increased For procurement officers at the corporate level, she warned that concern over the pandemic, how consumers are thinking they should be documenting all of their decision-making and about healthcare, and their desires for alternative care. struggles regarding PPE. Click to view: Consumer Sentiment Data on Coronavirus “Every piece of that you should treat as if it will have to be turned – April 10 over some day in litigation. Treat your documentation as if I’m going to have to deal with it during an opening statement to a —NRC Health jury,” Crider said.
| MICHIGANPage 20 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 8 — CONTRACT REHAB PROVIDER TO PAY $4 MILLION, JUSTICE DEPARTMENT ANNOUNCES
Encore Rehabilitation Services LLC (Encore) has agreed to pay $4.03 million to resolve allegations that Encore violated the False Claims Act by knowingly causing three Michigan skilled nursing facilities to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary or skilled, the Department of Justice announced today. Encore, based in Farmington Hills, Michigan, provides rehabilitation services to patients at over 600 health care facilities, including skilled nursing facilities, in over 30 states.
“Today’s settlement reflects our continuing efforts to protect patients and taxpayers by ensuring that the care provided to beneficiaries of government-funded healthcare programs is dictated by clinical needs, not a provider’s fiscal interests,” said Inspector General (HHS-OIG) requiring, among other things, the Deputy Assistant Attorney General Michael Granston of the implementation of a risk assessment and internal review process Department of Justice’s Civil Division. “Rehabilitation therapy designed to identify and address evolving compliance risks. The companies provide important services to our vulnerable elderly CIA requires training, auditing, and monitoring designed to population, but they will be held to account if they knowingly address the conduct at issue in the case. provide patients with unnecessary or ineligible services.” “The submission of claims for unreasonable, unnecessary or This settlement resolves allegations that Encore’s policies and unskilled rehabilitative services is improper and unacceptable,” practices at three Michigan skilled nursing facilities resulted in the said Special Agent in Charge Lamont Pugh III, HHS-OIG – provision of unreasonable, unnecessary, or unskilled rehabilitation Chicago Region. “The public expects that proper services will therapy or the recording of therapy minutes as individual therapy be provided and that tax payer dollars will not be wasted. OIG when concurrent or group therapy was actually provided. The Corporate Integrity Agreements help to ensure that contracted settlement relates to Encore’s alleged conduct at the Autumn providers, who have caused improper billing practices change Woods Healthcare Facility in Warren, Michigan between Sept. 1, their behavior.” 2012, and July 31, 2018, the Bay Shores Senior Care and Rehab Center in Bay City, Michigan, for the period from April 1, 2013, to The settlement resolves allegations originally brought in lawsuits April 6, 2017, and MediLodge of Yale in Yale, Michigan, for the filed under the qui tam, or whistleblower, provisions of the period from Oct. 1, 2010, to April 6, 2017. False Claims Act by Linda Anderson, Reza Saffarian and Audrey Theile, and Adam LaFerriere, former Encore employees. The “Billing federal healthcare programs for medically unnecessary False Claims Act permits private parties to file suit on behalf of rehabilitation services not only undermines the viability of those the United States and to share in any recovery. The amount to programs, it exploits our most vulnerable citizens,” said U.S. be recovered by the private parties in this matter has not been Attorney Matthew Schneider for the Eastern District of Michigan. determined. “We are committed to working with our federal partners to protect both vulnerable Michiganders and these helpful healthcare The matter was handled by the Civil Division’s Commercial programs.” Litigation Branch, the U.S. Attorneys’ Offices for the Eastern District of Michigan and the Western District of Michigan, and the “The resolution announced today demonstrates my office’s HHS-OIG. commitment to aggressively pursuing providers who utilize fraudulent practices to knowingly put their own financial self- The three qui tam cases are docketed as United States ex rel. interest over a duty to patients,” said U.S. Attorney Andrew Anderson v. Encore Rehabilitation Services, LLC, No. 2:14-cv- Byerly Birge for the Western District of Michigan. “It is 13759 (E.D. MI), United States ex rel. Saffarian, et al. v. Encore imperative that providers make healthcare decisions based upon Rehabilitation Services, LLC, et al., No. 1:16-cv-605 (W.D. MI), and a patient’s need for services rather than a self-serving desire to United States, et al., ex rel. LaFerriere v. Encore Rehabilitation maximize financial profits.” Services, LLC, et al., No. 1:17-cv-95 (W.D. MI). The claims resolved by the settlement are allegations only; there has been no Contemporaneous with the civil settlement, Encore entered determination of liability. into a five-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health & Human Services, Office of — U.S. Department of Justice
| MICHIGANPage 21 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 9 — HHS RELEASES FIRST $30 BILLION OF STIMULUS FUNDS, SNFS ARE INCLUDED BY PATRICK CONNOLE/PROVIDER MAGAZINE
The Department of Health and Human Services (HHS) has pandemic and those providers that are struggling to keep announced the distribution of the first $30 billion of the $100 their doors open due to healthy patients delaying care and billion stimulus fund, which skilled nursing facilities (SNFs) are cancelled elective services. This provision will aid providers in line to receive, according to a statement by Mark Parkinson, with declining occupancy rates. president and chief executive officer of the American Health Care Association/National Center for Assisted Living (AHCA/ Providers will be distributed a portion of the initial NCAL). $30 billion based on their share of total Medicare FFS reimbursement in 2019. This means that CMS, as with He noted that reporting that this stimulus fund was only for calculating the Accelerated and Advance Payments, has used hospitals was incorrect, as SNFs are included. net reimbursement based on claims to calculate the award amounts. Other highlights are the following: Total FFS payments were approximately $484 billion in 2019. • All Medicare providers will receive payments based on their A provider can estimate its payment by dividing its 2019 2019 Part A and Part B billings. Medicare FFS (not including Medicare Advantage) payments • AHCA/NCAL will provide more detailed information in a few it received by $484,000,000,000 and multiply that ratio by days, but a quick back of the envelope analysis indicates that $30,000,000,000. providers will receive roughly 6.2 percent of their 2019 billings. • HHS intends to get the money to providers directly. It may hit Providers can obtain their 2019 Medicare FFS billings from provider accounts as early as today, April 10, with the goal their organization’s revenue management system. Providers being no later than next week. should work with their financial management, revenue cycle • This is a grant. It is not a loan. divisions, or third-party billing contractors to arrive at their own estimates. Parkinson said this stimulus funding program is in addition to the Accelerated Payment Program. Providers can participate AHCA/NCAL provided this calculation example: A provider in both. billed Medicare FFS $121 million in 2019. To determine how much they would receive, use this equation: $121,000,000 / More details on the stimulus funding include that HHS is $484,000,000,000 x $30,000,000,000 = $7,500,000 partnering with UnitedHealth Group to deliver the initial $30 billion distribution to Medicare providers. Providers Also, in the coming weeks, funds will be released for will be paid electronically where possible. AHCA/NCAL providers in areas particularly impacted by the COVID-19 said providers who normally receive a paper check for outbreak, rural providers, low-volume Medicare providers of reimbursement from the Centers for Medicare & Medicaid services, providers who predominantly serve the Medicaid Services (CMS) will receive a paper check in the mail for this population, and providers requesting reimbursement for the payment as well, within the next few weeks. treatment of uninsured Americans.
All facilities and providers that received Medicare fee-for- The terms and conditions are within 30 days of receiving the service (FFS) reimbursement in 2019 are eligible for this payment, and providers must sign an attestation confirming initial rapid distribution. Payments to practices that are part receipt of the funds and agreeing to the terms and conditions of larger medical groups will be sent to the group’s central of payment. The portal for signing the attestation will be billing office. All relief payments are made to the billing open the week of April 13, 2020, and will be linked from here. organization according to its Taxpayer Identification Number. Visit HHS’ FAQ for additional information on eligibility AHCA/NCAL said as a condition to receiving these funds, and process. As AHCA/NCAL learns more about today’s providers must agree not to seek collection of out-of-pocket announcement and future distribution of funds, the payments from a COVID-19 patient that are greater than what association will release additional information. the patient would have otherwise been required to pay if the care had been provided by an in-network provider. Please email [email protected] for additional questions, or visit ahcancal.org/coronavirus for more information. This dispersal of funds is intended to provide relief to both providers in areas heavily impacted by the COVID-19
| MICHIGANPage 22 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 10 — ANALYSIS: PPE COSTS INCREASE OVER 1,000% DURING COVID-19 CRISIS BY JAMES M. BERKLAN/MCKNIGHT’S LONG-TERM CARE NEWS
Skilled nursing facilities and assisted living centers treating COVID-19 patients have experienced a 1,064% increase in costs for required personal protective equipment since the deadly virus started its rampage in the U.S.
The rise is even higher (1,084%) for those using nitrile gloves due to vinyl glove shortages or allergies, reported the Society for Healthcare Organization Procurement Professionals.
The group’s analysis attributes the huge price increase to supply-and- demand factors, as well as the increased number of items mandated for safety, and the call for frequent changes.
The independent group said it conducted the analysis to help senior care providers secure federal funding from we don’t get product, we don’t have staff show up. And if current and future emergency stimulus packages. Researchers we can get it, facilities can’t afford it. Unfunded facilities lead emphasized that findings are not based on estimates but rather to shutting down, and more importantly, not taking care of actual costs incurred by more than 5,000 SHOPP member residents.” facilities serving more than 125,000 seniors nationwide. Figures for the analysis were calculated using market pricing “It is mind-blowing,” said Ari Stawis, a SHOPP co-founder, plugged into Centers for Disease Control and Prevention director of professional services and development at Zimmet guidelines, per new guidance issued by the Centers for Health Care, and a former long-term care facility finance director. Medicare & Medicaid Services’ on April 2, 2020. The new guidelines call for numerous changes of protective equipment “It’s scary as hell because, first, it’s hard to get product, and, for every employee in a covered facility with a COVID-19- second, because of the situation in California,” he told positive patient. McKnight’s Long-Term Care News. He was referring to a West Coast facility that had to be evacuated Wednesday due to As more product comes into the market, prices should start to facility staff not showing up for two straight days due to recede, Stawis acknowledged, but the increase of government either having contracted the novel coronavirus or fears of it. “If — CONTINUED ON PAGE 12 —
| MICHIGANPage 23 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 11 — ANALYSIS: PPE COSTS INCREASE OVER 1,000% DURING COVID-19 CRISIS FROM PAGE 11
and situational requirements, combined with temporarily halted U.S. LEFT NEEDING manufacturing in China, created a lethal lag. Stawis explained that when COVID-19 originally broke out in “The numbers for what we’re dealing with are just crazy,” Stawis China around the beginning of the year, the U.S. sent a lot of said, noting that pricing changes have been volatile and safety products to help. But when the deadly virus landed on continue to change daily. “The only way to understand how American shores a couple of months later, Chinese industry was much of a crisis there is, is to see a report like this.” in the middle of a months-long shutdown and the favor couldn’t be reciprocated. GOWNS UP 2,000% There hasn’t been enough product since, and distribution The largest reported price increases have been for isolation vehicles have become unreliable as competition for safety gowns (2,000%), N95 masks (1,513%), 3-ply masks (1,500%) and products across the globe heats up. SHOPP nearly had a reusable face shields (900%). The most remarkable rise was for shipment from overseas to boost U.S. providers recently, but 3M N95 masks, which rose from $0.11 to $6.75 each (6,136% the cargo had a stopover in another country en route, and that increase), though they are currently unavailable, according to country decided to keep the safety products themselves. SHOPP. The speed and volatility of change is making it difficult to Soap (184%) and nitrile gloves (200%) were the only products of predict the future, Stawis observed. He praised federal officials the 11 listed to cost double or less. (See Exhibit 1.) for allowing advanced Medicare billing and payments so that providers won’t have to dip into their accounts receivable credit The SHOPP analysis breaks down per-patient-day costs for lines as quickly. He also recommended that providers ask their both pre-COVID and current conditions and requirements. (See vendors for flexible payment terms in these challenging times Exhibit 2.) Most products would need to be changed multiple and let them know payment terms might have to be extended. times per work shift, with some needing to be refreshed for every new resident encounter. Stawis emphasized the report is not pointing a finger at price gouging for big price increases. Rather, he returns to basic That’s a far cry from the pre-COVID-19 pricing and requirements, market forces, such as supply and demand, and distribution which essentially comprised gloves and soap and water, Stawis challenges. said. That amounted to about $0.35 per patient day, which would rise to about $2.36 per patient day when current CDC “The products themselves haven’t changed that much but guidelines are factored in. getting them from the factory to your hands at the nursing home has. Distribution factors, from being held up at customs, to Consider current pricing (as of Monday, April 6) and that figure being rerouted, to higher airplane freight charges than in the soars to $25.10 per patient day, producing the 1,064% jump. past,” he said. (See Exhibit 3 above.) Baseline price figures were established by using multiple facilities’ charges over a 12-month period. SHOPP figures were first given to state association executives starting Tuesday. The Health Care Association of New Jersey, led The analysis posed circumstances presented by a 100-bed by Jon Dolan, has been one of the most progressive in pursuing facility multiplied by 30 days for a total of 3,000 census days additional support. per month. Assisted living centers use about 25% less PPE than skilled nursing facilities based on different levels of resident SHOPP’s goal was to raise attention to the “dangerous” PPE interaction, SHOPP estimated. Item prices were reviewed by situation, Stawis said. Faygee Morgenshtern, CEO of People Powered Nursing, and Michael Greenfield, CEO of Prime Source Healthcare Solutions “We’re not doing this for one facility or one region,” he noted. and a co-founder of SHOPP. “This encompasses the entire nation.”
The SHOPP study does not take into account labor costs, which also have been subject to larger payouts, organizers pointed out.
| MICHIGANPage 24 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 12 — SARS-Cov-2 / COVID-19 Testing Methods
Michigan.gov/Coronavirus
Many questions regarding the applications and appropriateness of specific types of assays for COVID-19 testing have been asked. This brief note is intended to assist with understanding options and requirements surrounding each.
Each type of test is selected based upon which scientific questions and patient care outcomes it addresses. At this time, any test that is providing a diagnostic result for a patient MUST have FDA Emergency Use Authorization (EUA) approval or have met the stringent validation criteria provided by FDA. Tests are required to meet very specific national guidelines to perform this testing to ensure accuracy, ability to report properly, ability to follow-up on errors, the capability of performing quality control, and a host of other essential factors. The FDA website provides up to date lists of which assays are approved for diagnostic use. Visit www.fda.gov for further information.
Molecular – PCR: technically “quantitative real-time polymerase chain reaction.” This is currently the standard test for COVID-19 infection. This method looks for the presence of SARS-CoV-2 viral RNA present in the throat and back of nose, collected by “nasopharyngeal swab.” PCR tests most commonly provide fast throughput for large numbers of samples in a laboratory – from hundreds to thousands at a time.
There are rare false positives; if you test positive by PCR, you are very likely infected with COVID-19.
False negative results are possible: if the level of virus present is low due to infection very early or very late in the clinical course, low levels of virus present in nasopharyngeal swab may not be high enough to be detected by this method. If you have been infected with COVID-19 and have recovered, this method may give a negative result.
Serologic – antibody tests. These tests look for the presence of antibodies in a person’s blood – usually obtained by a “finger-poke” – against a viral protein. Unlike the molecular tests, tests for antibodies can detect those who have been infected and have now recovered. Serologic tests most commonly provide results for single samples at a time, intended for point of care applications.
Currently over 40 manufacturers have filed for FDA approval for point of care antibody tests. These tests are being offered for sale now, but none are currently FDA approved for routine clinical use.
Currently, there is not enough data on the antibody levels during the clinical course of COVID-19 infection to make conclusions on the clinical value of these tests.
It is Important to note at this time:
• These tests are investigative (experimental); • These tests are not diagnostic; • Clinical decisions should not be based on these tests alone; • Negative serologic test results do not rule out possible COVID-19 infection;
For more information, visit Michigan.gov/Coronavirus| . MICHIGANPage 25 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 13 — TA 21164 04/15/2020 • ositive results may be due to past or present infection with non o coronavirus strains, as these are common cause of “cold” symptoms (may include coronavirus strains: HKU1, NL63, OC43, .
Antigen Tests: these look for the presence of a molecule that is specific to the o coronavirus. or e ample, a protein that is present on the surface of the virus. ike molecular tests, antigen tests reveal the presence of the virus. nce the infection has resolved, the antigen disappears.
These tests are currently under development and may provide advantages over molecular tests when they become available.
t is important to determine if a test has received the appropriate . n intention to seek approval from is not the same as having provided required minimum data regarding safety and risk of harm to a patient. lease ensure if an serology is selected that it is performed in the correct laboratory environment. ny test that does not have an approved must have a full validation performed and data provided to . This results in the test being designated as a high comple ity test. f a test is listed as high or moderate comple ity it must be performed at a laboratory that meets all certification requirements. These types of test are T acceptable for providing a diagnostic result at any site that does not have the appropriate certification. waived test may be performed at sites that have obtained a certificate of waiver. o testing should ever be performed without meeting minimum federal requirements. or further information please visit www.fda.gov or www.cms.gov, especially as it pertains to proper use of tests.
For more information, visit Michigan.gov/Coronavirus.
T | MICHIGANPage 26 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 14 — MDHHS NEWS
STATE ESTABLISHES REGIONAL HUBS ON COVID-19 As additional Regional Hubs are identified they will be listed on this website, you are encouraged to check back frequently. In compliance with Executive Order 2020-50, a network of COVID-19 Regional Hubs has been established to meet the MDHHS ANNOUNCES EXPANDED TESTING ACCESS needs of nursing facilities. To serve as a Regional Hub, existing nursing facilities must segregate space that will exclusively care for Here are three important things we want every health care provider individuals residing in nursing facilities who are suspected to have to know about the latest testing guidance: Coronavirus or have been confirmed to have COVID-19 but do not require acute care provided in a hospital. The COVID-19 Regional • Any Michigander displaying mild symptoms or any Hubs are also designed to support the statewide hospital discharge essential worker still reporting to work in person, whether policy and facilitate admission into nursing facilities prepared to symptomatic or not, is eligible to get a test with an order treat COVID-19-affected residents. Admission to a COVID-19 from a health care provider. Regional Hub is limited to individuals transferred from a nursing • If your facility does not have enough swabs or other home or those discharged from a hospital. supplies to take a sample from everyone who should be tested, please provide a test order and direct the patient COVID-19 Regional Hubs are selected at the discretion of MDHHS to a nearby testing site. Testing sites can be found by visiting and LARA based on factors that include stated willingness to serve Michigan.gov/CoronavirusTest and entering the local ZIP as a hub facility, capacity to contribute to local need for services, code. It is important that the patient contact the site before proximity to acute care facilities experiencing high COVID-19 arrival to check hours and whether the location operates as a related demand, physical attributes of the facility to effectively drive-thru or by appointment. quarantine COVID-19-affected residents, performance history • For patients concerned about the cost of a test, the test is of the facility, and other factors deemed relevant by MDHHS. free for most individuals. Many insurance providers are waiving Participating facilities must also keep up to date with Centers for copays, and those with Medicaid or the Healthy Michigan Plan Medicare and Medicaid Services (CMS) and the Centers for Disease also have no cost. Control and Prevention (CDC) guidance and recommendations related to COVID-19 and inform employees of any changes. Testing remains critical. Based on recommendations by the Harvard Global Health Institute, we need to complete 15,000 tests Once designated as a Regional Hub, the facility must notify the statewide each day. Local Health Department (LHD) and the Regional Health Care Coalition of this designation and remain in contact with the LHD regarding bed availability throughout its designation. MDHHS will periodically reevaluate the need for COVID-19 Regional Hubs SNF PROPOSED PAYMENT and end this designation as the need for them subsides and residents within the COVID-19 Regional Hubs are discharged to the AND POLICY CHANGES appropriate setting. FOR FY 2021
Six facilities have already been approved to act as COVID-19 On April 10, CMS issued a proposed rule [CMS-1737-P] Regional Hubs: for FY 2021 that updates the Medicare payment rates and the quality programs for Skilled Nursing Facilities FACILITY ADDRESS COUNTY BEDS (SNFs). This proposed rule is part of our continuing MediLodge of 500 W. Genesee St., Saginaw 25 efforts to strengthen the Medicare program by better Frankenmuth Frankenmuth, MI aligning payment rates for these facilities with the costs 48734 of providing care and increasing transparency so that MediLodge of Grand 2950 LaFranier Road, Grand 26 patients are able to make informed choices. Traverse County Traverse City, MI Traverse 49686 County For more information: The Lodge at Taylor 22950 Northline Wayne 42 Road, Taylor, MI 48180 • Fact Sheet Advantage Living 16181 Hubbel, Wayne 24 • Proposed Rule: Submit comments by June 9 Center – Northwest Detroit, MI 48235 Advantage Living 25330 W 6 Mile Rd, Wayne 24 — Centers for Medicare and Medicaid Services Center – Redford Redford, MI 48240 Advantage Living 5555 Conner Ave, Wayne 30 Center – Samaritan 4th Floor, Detroit, MI 48213
| MICHIGANPage 27 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 15 — STATE ALLOWS FOR TEMPORARY REGISTRATION FOR NURSE AIDES Under the Governor’s executive order, EO 2020-49, a temporary registration as a nurse aide is being granted by the Department of Licensing and Regulatory Affairs to any candidate that has completed a state approved nurse aide training program. The executive order only waived the testing portion for an individual to be eligible for the temporary registration. State law requires that in order to become a nurse aide an individual must have completed a state approved nurse aide training program and have passed testing. Only the testing requirement was waived. The department does not approve any other training program a facility may be offering in lieu of what is an approved program under state law. An 8-hour course is not a state approved training program. Programs are approved based upon federal law that established the minimum contents of each state approved nurse aide training program. CMS did not waive the requirements regarding nurse aide training programs, they merely extended the four months that a nurse aide candidate who completed a state approved training program can work while awaiting testing. This was done because testing was closed due to the pandemic. Before you could only work for four months before successfully completing training. Now you can work past the four months until this emergency situation ends. The only temporary registration as a nurse aide is the one issued by the department under the executive order.
— Department of Licensing and Regulatory Affairs
MDHHS BULLETINS AND LETTERS
L 20-25.pdf – COVID-19 Response: Skilled Nursing Facilities Reporting Requirements. This letter was sent to Nursing Facilities.
Medicaid Letters can be accessed on the web at www.michigan.gov/medicaidproviders >> Policy, Letters & Forms >> Numbered Letters >> Click 2020 under Numbered Letters.
Medicaid bulletins can be accessed on the web at www.michigan.gov/medicaidproviders, click on Policy, Letters & Forms.
MCMCFC STAFF CONFERENCE AND Renee Beniak, Derek Melot, MEETING UPDATES Executive Director Director of Communications [email protected] [email protected] MCMCFCEVENTS------Meghann Keit, Casey Benda, June 1-4, 2020 Oct. 22-23, 2020 MCMCFC Governmental Conference and Continuing Spring Management Fall DON Meeting Affairs Liaison Education Coordinator Conference Mission Point Resort, [email protected] [email protected] Boyne Highlands Resort, Mackinac Island Harbor Springs Vickki Dozier, Nov. 5-6, 2020 Executive Assistant Aug. 16-19, 2020 Fall Financial [email protected] Michigan Counties Conference Annual Conference Crystal Mountain Resort, Radisson Hotel, Thompsonville Kalamazoo
| MICHIGANPage 28 of COUNTY59 MEDICAL CARE FACILITIES COUNCIL COMPASS MAY 2020 — 16 — Take Advantage of Your Learning Partner Tuition Discount
Why CSU? At Columbia Southern University, technology brings the classroom to you and our online degree programs give you the freedom to pursue your dreams, on your own terms, at your own pace, while studying anywhere you choose. CSU Offers » Complimentary Evaluation of Prior Education and Training » Flexible Start Dates » Textbooks Provided at No Cost » No ACT, SAT, GRE, GMAT Required » Flexible Learning » Multiple Course Schedule Options » Math and Writing Assistance Available » Career Services Available Learning Partner » No Application Fee 10% Tuition Graduate & Undergraduate Tuition Rates Discount † Tuition Learning Partners Per Credit Hour Per Credit Hour Undergraduate Courses $230.00 $207.00 Graduate Courses* $315.00 $283.50 Exclusive Doctoral Courses $375.00 $337.50 Tuition rate effective July 1, 2019. Rates are per credit hour. Most courses are three (3) credit hours. Tuition and fees are payable in U.S. funds. Tuition Rates are subject to change. For the Scholarships most current tuition information, please visit www.ColumbiaSouthern.edu/Financial. *The tuition rate for graduate courses per credit hour is $250 for all active-duty military members using military tuition assistance (not applicable for CSU learning partners). The lower rate is offered to keep the tuition rate at the DoD cap of $250. † CSU Learning Partners receive a tuition discount that is applied to the full tuition rate. Online Degree Programs Associate Degrees » Homeland Security Doctoral Degree » General Studies* » Human Resource Management » Business Administration » Business » Information Systems & Cyber Security Dissertation Opt. 1, Theoretical-Based Study » Criminal Justice Homeland Security Dissertation Opt. 2, Research Project-Based Study » Fire Science » Information Technology » Health Information Science » Occupational Safety & Health Certificates* Undergraduate Graduate Track I, Medical Coding Emphasis Fire Science Environmental Management Track II, General Curriculum Emphasis » Organizational Leadership Finance » Occupational Safety & Health » Psychology Fire Science Bachelor’s Degrees Master’s Degrees Health Care Management » Business Administration » Business Administration Hospitality & Tourism Finance Finance Human Resource Management Hospitality & Tourism Health Care Management Human Resource Management Human Resource Management Information Technology Information Technology Marketing International Management International Management Project Management Management Management Public Administration Marketing Marketing » Criminal Justice Administration Project Management » Emergency Services Management Occupational Safety & Health Sport Management » Occupational Safety & Health Project Management » Criminal Justice Administration Environmental Management Public Administration Arson Investigation » Organizational Leadership Sport Management » Emergency Medical Services Administration » Public Administration » Environmental Management Criminal Justice Administration » Fire Administration Emergency Services Management *These programs are not eligible for Federal Student Aid. Fire Investigation » Public Health Accredited Member Distance Education Accrediting Commission » Health Care Administration Community Health Education Emergency Medical Services Management 1101 17th Street, NW, Suite 808 Washington, DC 20036 (202)234-5100
MICHIGAN COUNTY MEDICAL CARE FACILITIES COUNCIL COMPASS | MAY 2020 ToPage learn 29more of about 59 our online degree programs, visit ColumbiaSouthern.edu/Partner or call 800.344.5021. Located in Orange Beach, Alabama. For more information about our graduation rates, the median debt of students— who 17 have completed — the program, and other important information, please visit our website at ColumbiaSouthern.edu/Disclosure. P E P T A L K VOLUME 8, ISSUE 5, M A Y 2 0 2 0
SODEXO INSTALLS NEW KIOSK IN EMPLOYEE LOUNGE MAY 2020 IN-SERVICES Due May 31, 2020 An exciting change is taking place in the employee lounge in the form of a new kiosk! Beginning Monday, May 4, employees will be Relias: Mandatory - ALL STAFF: Fire Safety: The Basics able to purchase food on all shifts, 24/7. Much like a self-service checkout lane at Meijer, employees will be Relias: Mandatory - ALL STAFF: All Page and Code Status able to grab the food item they want, scan it at the kiosk, and use a credit card to pay. “There are so many benefits to the kiosk sys- Relias: Mandatory – LICENSED NURSES AND CERTIFIED NURSE tem,” says James Hunter, Sodexo General Manager, “it’s fast, so AIDES: Understanding the Meaning employees can spend more of their break time relaxing and eating, Behind Behaviors rather than waiting for their food to be cooked and wait in line for a Relias: Mandatory – CERTIFIED cashier.” Hunter continued, “from an infection control perspective, NURSE AIDES AND UNIVERSAL now our cooks will just be cooking, not having to handle money and WORKERS: Oxygen Safety touch registers - I like that.”
Most of the food that will be available is prepared in the kitchen Relias Link: https:// gtp.training.reliaslearning.com Items such as salads, deli sandwiches, subs and granola snack packs will be available. They will also have food parings that can be warmed up, wraps and couscous, soup and sandwich. There will be some branded items, like chips, pop, and yogurt that come from a distributor, but most things offered will be made fresh daily in the kitchen. Food choices will be displayed in the café in the area where the salads and soups currently are. Employ- ees will have a good variety of items from which to choose. Menus will change frequently, like maybe fresh greens and chicken salad one day and a cobb salad the next day. An exciting app will be available in the near future that will allow employees to see the up to date menu, review nutritional value and pricing from their phone. Selections will begin slowly, but will continue to ramp up, adding more service and more food selections as the kiosk system gains momentum. Eventually they will be able to offer food like hot pizza slices in a box and the crowd favorite concert burger. During the initial startup, help will be available either by a Sodexo representative at the kiosk or an extension to call for assistance. However, if you have ever used self-service lines at the store, you will find the kiosk to be very familiar and simple to use. Bonappetit everyone!
Page 30 of 59 P E P T A L K VOLUME 8, ISSUE 5, M A Y 2 0 2 0 P A G E 2
May is...
#breakthestigma
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P E P T A L K VOLUME 8, ISSUE 5, M A Y 2 0 2 0 P A G E 3
Gabby Burfiend Kate Duffing Tobias Gray Breanna Hall Universal Worker Universal Worker Sodexo Server Universal Worker
Tetiana Odarchuk Amy Rushlow Kasha Sheiffele Jennifer Taylor Sodexo Server Universal Worker RN Universal Worker
Lindsey Neddo Erica Woods Universal Worker CNA
Page 32 of 59 P E P T A L K VOLUME 8, ISSUE 5, M A Y 2 0 2 0 P A G E 4 MEMORIAL DAY ‘TIS THE SEASON FOR Monday, May 25, 2020 STRAWBERRY CREAM PUFFS
INGREDIENTS For Cream Puffs 1 cup (236 ml) water 1/2 cup (113 g) unsalted butter 1/4 teaspoon salt 1 cup (125 g) all-purpose flour In case you thought it was about a BBQ 4 large eggs For Cream Filling: 1/2 cup (113 g) softened cream cheese, or mascarpone 1/2 cup (118 ml) sweetened condensed milk 1 teaspoon vanilla extract 1 cup (236 ml) heavy cream, chilled 1/2 cup (116 g) crushed strawberries INSTRUCTIONS
1. Preheat oven to 425F. Line a large baking sheet or two with parchment paper or silicone mats. Prepare a large piping bag tipped with a round or star tip; I used Ateco tip #847. 2. In a small saucepan, combine the water, butter and salt. Cook the mixture over medium heat until the butter melts and comes up to a simmer. Add the flour all at once, stirring with a spatula. The dough should come together within one minute, pulling away from the sides of the saucepan and forming a ball. Transfer the dough into a mixing bowl and cool for 7 to 10 minutes; dough should be warm to touch but not hot. 3. Begin adding the eggs, one a time, mixing thoroughly after each addition. Once all the eggs are added, continue mixing the dough for 1 minute. Transfer the dough into the prepared pastry bag and pipe 1 to 1 1/2 inch dollops onto the prepared paper or mat; leave a little space between each one. 4. Bake the cream puffs at 425F for 10 minutes, then reduce oven temperature to 350F and bake for an ad- ditional 25 to 30 minutes, until golden brown. Do not open oven door during the baking process; the cool air will cause the cream puffs to collapse. Once they are baked, allow them to cool completely on the tray. Once cooled, use a serrated knife to cut them open in half. 5. Prepare the strawberry filling. In a mixing bowl, combine the cream cheese, sweetened condensed milk and vanilla extract. Whisk together on medium speed until smooth and creamy. Pour in the chilled heavy cream, then whisk on high speed until a thick and fluffy whipped cream forms. Add the crushed strawberries last, folding them in by hand. 6. Transfer the cream into a pastry bag and pipe each cream puff full of the cream, closing them together. If desired, add sliced strawberries to each one of garnish. Place the cream puffs into the refrigerator and allow them to set for a few hours, or overnight.
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Broadcast Report: WTCM-FM: Recruitment/Join the Team Broadcast advertising ran from April 1- 14 and April 17-26, 2020. WTCM-AM: Recruitment/Join the Team Broadcast advertising ran from April 3 – April 26, 2020. WKLT-FM/WBCM-FM: Recruitment/Join the Team Broadcast advertising ran from April 1 –April 26, 2020. WKLT-FM/WBCM-FM: Recruitment/Join the Team Broadcast advertising ran from April 8 –April 26, 2020. WCCW-FM: Recruitment/Join the Team Broadcast advertising ran from April 8 – April 26, 2020. WCCW-AM (ESPN) Recruitment/Join the Team Broadcast advertising ran from April 8 – April 26, 2020.
PRINT … Record Eagle: Volunteer Appreciation “We Celebrate Volunteers” April 19, 2020 Grand Mission Advertising April 26, 2020 North Coast/Record Eagle: Volunteer Appreciation “We Celebrate Volunteers” April 18, 2020. General Recruitment April 25, 2020 MOMENTUM/ Record Eagle Grand Mission April 29, 2020 Young at Heart/ Record Eagle iOur Team has your back… (Wellness) April 29, 2020
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On April 16, Hansen, Coleman and Barnes, met to review the updated succession plan.
On April 23, Hansen, Dood, and Coleman had a conference call with Dave Herbel to discuss developments with Regional Hubs and Designated Units to care for COVID-19.
On April 30, Hansen attended a webinar on Courage Amid Chaos: Leadership’s Role in Calming the Storm.
On April 1, Deborah Allen, Chief Development and Community Engagement Officer attended the daily Pavilions Incident Command/Infection Control Meetings to provide communication support for internal and external messaging during the COVID-19 crisis. Allen also attended the daily phone conferences for the County Health Department Region 7 for COVID-19 updates in the region.
On April 14, Allen had a phone conference with the National Cherry Festival Directors where it was determined that it was necessary to cancel the 2020 Festival, including all Pavilions’ sponsored senior events.
On April 23, Allen initiated a “Greatest Need” Grant application with the Grand Traverse Regional Community Foundation for a thermal temperature stand along unit to assist with COVID-19 staff regulation requirements. The Grant request was for $5,000 toward the purchase of a unit.
All volunteer activity was suspended in mid-March due to the threat of COVID-19, therefore, no volunteer hours were reported in April.
The total Social media post reach for April was 21,766 individuals. There was an addition of 80 “Page Followers” in April. The Facebook announcement “Gratitude… a sign of the times” that extended thanks to Paul Britten with Britten Inc for the hand painted banners he created and the Traverse City Sign Shop for their “Heroes work here” sign reached 7,818 and had 1,594 engagements. The video produced for Super Hero Tuesday had an estimated reach of 4,046 and had 432 engagements.
Grand Traverse Pavilions Website received 16,225 visitors (page views) in April.
Coleman continues to lead and facilitate the Incident Command Team in efforts to prevent the spread of COVID 19 to our facility.
On April 24, the Grand Traverse County Health Department conducted an iPRAT survey via telephone and email.
In March, there were two facility reported incidents.
Throughout the month of April we had 24 admissions, including re-admissions from Munson Medical Center. We had 1 admission from our continuum of care and 0 from our waiting list. We received 62 referrals from Munson and 12 from other hospitals in the surrounding area. Two of our Rehab Center residents transferred up to long-term care. Page 40 of 59 2
There were 32 discharges for the month of April. Six residents passed away, 18 residents were discharged to home, 3 residents went to other facilities, and 5 were discharged to Munson.
There were 10 Medical record requests completed in the Month of April for Blue Cross and Blue shield of Michigan and Priority Health PPO insurance, Aetna Medicare advantage, various long-term care insurance carriers and individual record requests.
Holly Edmonson, Clinical Case Manager, actively participates in the Incident Command Team as the Infection Preventionist, maintaining daily Pre-admission screening for all potential admissions, COVID-19 daily timeline and Employee health screening, monitoring and follow up.
The daily interdisciplinary team meetings continue to benefit all involved with discussions of current issues involving resident care in the last 24 hours or 72 hours over a weekend/Holiday. Topics reported include the following: falls, skin incidents, abnormal blood sugars, weight loss, behavioral issues, pressure ulcers, and any other pertinent issues. With each meeting new and current issues with residents are discussed and reviewed and new information is shared.
In-services in April included: All Staff: All Page and Code Status, How to be Survey Ready Every Day, and Effective Communication. Certified Nurse Aides: myUnity Charting Course. Grand Traverse Pavilions CPR Certified Individuals: GTP CPR Overview.
Jamie Wilson, Director of Certified Nurse Aids and Katy Leach, Staff Development Coordinator, continued the employee monitoring system with 15 visits to staff that are systematically followed up with during their first 3 months of employment or on an as needed basis.
Staff Development participated in multiple COVID-19 Incident Command Team Meetings, created and distributed daily COVID-19 updates, and created multiple educational pieces for staff members. Staff Development assisted Human Resources with a grilled chicken lunch for staff members on April 25 and a grilled cheese and tomato soup lunch for staff members on April 28.
All of the dental, eye and podiatry clinics for nursing home residents were cancelled in April following the executive order to social distance then shelter in place.
Restorative and Functional maintenance program monitoring continued including daily Restorative program documentation by the Certified Nurse Aide (CNA) or therapist completing the program. The Clinical Case Manager reviews daily documentation to ensure programs have been completed, if the program was not completed at its scheduled time, follows up with Restorative staff to ensure appropriate documentation is recorded. In lieu of Group Exercise, Therapists have been doing Restorative programs and 1:1 exercise programs.
Quality Assurance Studies completed weekly for April included, monitoring medication storage/ refrigerators to ensure proper temperature and ice buildup and completion of Page 41 of 59 3 equipment checklist. All areas of concern are addressed immediately. The DON is monitoring call light response times to ensure calls were answered in a timely manner. A study was completed on repositioning / bed mobility to ensure appropriate technique is used when repositioning a resident in bed. Weekly handwashing studies were completed in April to ensure proper hand hygiene was demonstrated. Weekly review on cleaning and storage technique of nebulizer machine and attachments as well as care for Bipap and CPAP machines. Infection prevention QA for COVID-19 was completed weekly to ensure staff understanding of virus and prevention of spread.
A monthly Quality Assurance (QA) study was done on knowledge of CPR (Cardio Pulmonary Resuscitation) and Policy on using Nurse All Page system was completed.
A quarterly Quality Assurance study on emergency cart inventory was completed this month. A random QA study was done on CNA behavior documentation in reference to psychoactive medication use to address any concerns regarding documentation.
The CQI team continued to audit and track the two QAPI groups initiated which include: Pressure Injuries and Psychoactive Medication use.
We continue to revise policies and infection control practices as mandates are released by CMS. In the month of April, we transitioned to using a blue mask made with plastic and fabric rather than a paper mask. Staff have been provided with the new mask and education. Other items under review include window visits, opening the courtyards, and family transporting residents to appointments.
We continue to work through managing employee illness and time off. Employees have been asked to refrain from coming to work if they are ill and can be off 7-14 days depending on symptoms and risk for exposure. Recently, we employed a new practice of having our infection control coordinator perform a telehealth call after the employee reports their symptoms to the employee tracking email. Following-up by phone allows us to learn more about the symptoms, other illnesses an employee may have, and risk of exposure, then better determine when a staff member can return to work.
Kristen Packard, Director of Nursing, has been working with Medline on the beginning stages of implementing Med B billing through Medline. Medline billing department will review our EMR for orders and charting, provide ordered dressing supplies for ostomies, catheters, and wounds, then bill Med B directly.
In April, there were 0 tours and 2 transfers from rehab long term care beds.
With the guidelines in place for not being able to gather residents together for small or large group activities, Life Enrichment staff are spending additional time visiting residents on all pavilions, providing manicures, reading, playing board games, writing letters and more.
The no visitation policy continued to be in effect throughout the month of April. Kari Belanger, Recreational Therapist has continued to see approximately 8-9 residents (Aspen-Rehab) a day (Monday-Friday) to assist them in video chatting with their family members either by FaceTime, Google Duo, Facebook Messenger or ZOOM. In April, Page 42 of 59 4
179 video chat visits were held with each visit taking approximately 15-20 minutes. Family members have been contacting Belanger directly or their resident’s Social Worker. Thus far, residents are very open and receptive to this “new technology” and have really enjoyed themselves. Holly Kazim, Dementia Services Director/Social Work Supervisor, continued to work with Elm family members on video chatting as well, as well as assisting other residents throughout the building, especially assisting those residents with needing to speak with a physician, Department of Human Health Services and hospice services.
We continue to receive random anonymous donations of jigsaw puzzles and other items that just magically appear in our activity rooms for the residents. We have a wonderful community – both here in the building among the staff and those in our community. Various staff members continue to take a cart around to residents to choose a items to use/work independently; also when resident(s) are done with a jigsaw puzzle, they continue to “recycle it back” to the staff to get a new puzzle.
Osborn Visual Solutions staff continued to email packets of “Daily Delights” that include word search puzzles, crossword puzzles, Sudoku puzzles, and coloring pages. Linda Burton, Recreational Therapist, is printing off these packets and passing them out throughout the building for residents and/or staff to do together.
The weekly Prize Bingo continued to be successful for the residents, as approximately 9-13 residents winning each week by utilizing the Osborn Visual Solutions television channel. Life Enrichment draws the bingo numbers and submit them to Courtney & Chelsea (at OVS), who will put 10 bingo numbers up each day, Tuesday-Friday. Residents play bingo by watching Channel 900, and when they feel they have a bingo, they let their caregivers know who will then inform Life Enrichment. From there the resident(s) will have a visit to verify the card and have a basket of prizes that the resident(s) can choose from.
Social services handed out 21 discharge surveys in April.
Kazim, continued regular weekly contact with Hospice providers and palliative care services to facilitate telemedicine visits. Dr. Engel conducted rounds remotely through Telemedicine.
Kazim continued to facilitate daily skype and/or Face Time visits with several family members. The more we do the better and more everyone is enjoying them. Hospice has provided opportunities to have additional staff connect with residents via duo. Community Mental Health worker, Marilyn, has also been able to visit with several residents on a weekly or bi-weekly basis.
Social Workers are encouraging increase social visits and keep families informed. April resident council did not take place, however, social workers met with residents individually to check in and complete minutes.
The Wellness Center saw the following patients this month: Medicare A: Twenty-five (25); Medicare B: Outpatient: One (1); Medicare B: Inpatient: Fourteen (14); Private Insurance: Outpatient: Three (3); Private Insurance: Inpatient: Two (2); Work Page 43 of 59 5 compensation: Outpatient: One (1); Private pay: Outpatient: zero (0); Private pay: Inpatient: One (1). Auto: Outpatient: Zero (0); Auto: Inpatient: zero (0).
Amy Coneset, Wellness Center Director, participated in a phone meeting with Lyle Townsend, Physical Therapist and consultant from Impact Wellness and Rehab on April 7 regarding Wellness Center status and response to COVID-19 pandemic.
Coneset performed Outpatient Fire Safety education to Wellness Center staff as required for outpatient certification during the month of April.
Therapy staff initiated screening of residents for therapy needs who had demonstrated a decline in functional mobility or ability to perform activities of daily living on facility Certification And Survey Provider Enhanced Reports (CASPER).
On April 23, Coneset attended the webinar COVID-19 and Ambulatory Care by Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Coneset attended the webinars Therapy in the World of COVID-19 and Physical Therapy Considerations of COVID-19 in Post-Acute Setting.
On April 30, Coneset attended the webinar Outpatient Therapy During the COVID-19 Pandemic presented by the American Physical Therapy Association.
Therapy staff continue provide 1:1 in room exercise opportunities for residents who had been participating in group exercise as time allows.
For the Cottages, in the month of April, there were no admissions, two (2) discharges, and two (2) deaths. Nurse Practitioner Greg Morrison visited The Cottages on April 7, 14, 21 and 28. No new patients were acquired in April with the caseload remaining at forty (40). Campus wide quarantine continues with restrictions on family, vendor, and outside agencies remain in place and are continuously enforced.
Cottage Life Enrichment Coordinators are making the best of each day for residents. Virtual visits with loved ones are encouraged. Residents are participating in exercise each day at their respective cottage in groups less than ten (10) with a distance of at least six (6) feet apart. Instead of Catholic Communion delivered, rosary is said. Residents at Evergreen and Hawthorn have enjoyed YouTube videos of musical performances, a virtual tour of The Butterfly House at Meijer Gardens, and virtual tours of Rome, London and Paris. Church services on Thursdays has been set up to view via Zoom. Bingo has continued twice a week with social distancing precautions in place. Some residents are getting involved by helping pass out mail or weekly menus.
There were no live tours of The Cottages in the month of April. Two (2) information packets were mailed and one (1) was handed out. Mack listened/watched provider updates related to COVID-19 on April 14, 15, 21 and 23. Residential Services leadership met on April 22 to discuss happenings in the first quarter of 2020 and plans moving forward.
The Adult Day Program was closed the entire month of April. Page 44 of 59 6
Willow residents kept busy by playing noodle ball, broomball, virtual sing-a-longs, virtual visits with loved ones, and watching various artists on YouTube. Life Enrichment Coordinator Musser continues to screen all Cottage residents daily and four UWs were trained in med pass in April. Clear window masks were obtained on April 20 and implemented at Willow Cottage to facilitate communication for a resident who reads lips.
On April 9, Dood attended a webinar by National Government Services discussing the details of the Medicare Advance Payment initiative related to COVID-19.
On April 10, Dood attended a webinar on changes to the court and notary systems due to the COVID-19 emergency and related restrictions.
On April 17, Dood attended a webinar by Plante Moran discussing the incentives for health care providers in the CARES act.
On April 1, 8, 15, 22 and 29, Dood attended the Safe and Calm webinars presented by Leading Age of Michigan
On April 30, Dood filed the Medicare required credit balance reports with NGS and WPS.
Dood and Hansen began efforts accumulating the necessary financial data this month in preparation for completing the Medicaid cost report for calendar 2019.
Barnes held two conference calls with a representative from United Methodist Healthcare Recruiters in continuation of investigating hiring foreign born workers.
On April 3, Barnes met with Mallory and Coleman to discuss how the current cell phone policy should be modified in light of the covid-19 pandemic. All agreed that cell phones represent a significant concern for the transmission of a virus from outside the pavilions into the facility. It was decided that personal cell phones will not be allowed on the pavilion floors. All personal cell phones must be left in lockers or in cars.
During April, Mallory, Barnes, and Hansen met to discuss a proposal from Teamsters Local 214 to provide hazard pay for all union employees. After review, it was decided that hazard pay is not warranted. There currently are no covid-19 active residents. Additionally, healthcare workers are engaged in an occupation that is inherently trained to handle serious health related conditions.
On Thursday, April 16, Hansen, Coleman and Barnes met to update the succession plan. There will be multiple retirements over the next few years that require succession planning because of the significant value in replacing those positions. Plans have been created for the successful transition of the positions identified.
On April 23, Coggins, Barnes, and Butler, joined a webinar put on by Konica Minolta in reference to their thermal imaging camera system. This system will scan for elevated temperatures of people entering the facility. This system will replace the manual screening we are currently performing for employees and potentially for visitors when allowed back in the building. Page 45 of 59 7
Bob Wild and Missy Crow, Information Systems Technicians worked many extra hours at the beginning of the month to prep laptops and test access for staff to work remotely. Fifteen laptops were rebuilt and software installed for additional staff to work from home.
Butler worked with Kazim to setup ipads to be used by staff to assist residents in communicating with their family during this lock down. Butler also setup two ipads for the cottages to be used for the same purpose. Butler also researched a mass communication product to be used to notify families of updates.
Butler made multiple trips to PACE North building site to review nurse call, security doors, and security monitoring (motion sensors). Butler relocated cabling to put a phone in exam room #1 to be used as an office in the future.
The IT department worked with Darcey Gratton, Administrative Services Director, on several different meeting platforms, like Zoom, WebEx, Go-To-Meeting, and Google Hangouts. Gratton is researching a good platform to be used for the monthly board meetings that would allow board members and the public to call in and run a professional meeting.
Of the 23 external interviews scheduled for the month of April, a total of 19 individuals were extended conditional offers of employment.
Recruitment is underway for the following open positions: 64 CNAs; 6 Universal Workers; 6 Licensed Nurse; and 2 Environmental Services based on full census. At current census levels, needed positions are about 20 CNA’s.
Fifteen employees were hired in April. Four new employee orientations were held that included 10 UWs; 2 licensed nurses: 2 CNAs: and 1 Maintenance. Forty-eight people have been hired in 2020.
In April, Pavilions job opportunities were posted on Michigan4Hire, Awesome Job Alert, Michigan Talent Bank, Black Diamond Broadcasting, Pure Michigan Talent, LinkedIn, Craigslist and Indeed.
There were 83 applications received in April. Down from 97 applications received in March, and up from 61 applications received in February.
For the Month of April, there were a total of 15 terminations. Of those 15 terminations, 8 were due to workforce reduction, 6 were voluntary terminations with 1 involuntary. There have been 53 terminations in 2020.
In the month of April, the CNA Bonus Program yielded payments of $50.00 to 40 CNAs; $100.00 to 9 CNA’s; $150.00 to 32 CNAs that met the requirements.
There were two employee referrals received through our Employee Referral Bonus Program. We paid out $250.00 to one employee for a successful referral for the month of April. To date we have paid the bonus to 34 employees for referring individuals and we have distributed ten $25 gift cards for referring applicants who were not considered for employment. Page 46 of 59 8
In the month of April, 49 employees were recognized for perfect attendance for the first quarter of 2020. Of those, 3 were selected in a random drawing for $100.
In April, 48 employees utilized the Beech Gym.
The monthly Safety Committee met on April 14. Mallory presented a summary of March’s employee incident/ accident statistics. There were 9 employee incidents during March, with 109 restricted days and 1 lost time day.
The maintenance team completed 616 separate work orders during April. Additionally, there were 45 wheelchair work orders completed.
The monthly fire drill for the main building was April 9, at 10:00 AM. For the Cottages, fire drills occurred April 23, at 2:00 PM for Evergreen, April 27, at 8:00 AM for Hawthorn and April 6, at 2:00 PM for Willow. There were no actual fire codes in April.
Fire drills are being conducted a bit differently due to the COVID-19 pandemic. Code red is no longer being called over the all-page system to prevent main building staff from going to the cottages. Fire drills are being held just for staff at the individual cottage and used as a training exercise, ensuring all staff know how to lock out the elevators, assist residents to their rooms, etc.
There were 32 room preparations at the main building, including 25 for Rehab and 7 from units Aspen through Elm. In addition, there were 3 preparations at the cottages due to room vacancies from discharges and residents moving between rooms.
During the month of April, there were 26 appointment bus runs and 0 group bus runs.
On April 7, ABI Mechanical completed the installation of a new controller on the Dectron air handler unit for the pool. This part controls the water and air temperature in the pool, as well as the humidity in the pool area. Once completed, Coggins installed a data logger in the pool area and verified operation of the new controller.
On April 8, our maintenance techs installed banners in the employee entrance tunnel from Britten Banner, thanking our staff for their hard work and dedication during this pandemic.
On April 13-16, Bay View Flooring completed the installation of new flooring in the Poplar Gym.
On April 27, Hobart removed the kitchen dish machine. Our maintenance team repaired moisture damage to the walls around the machine and added fiberglass reinforced plastic panels extending to the ceiling to prevent future damage. On April 30, Hobart completed the installation of the new dish machine.
On April 30, our maintenance team completed cleaning the air handler coils in the main building. As the cooling season is approaching, this will allow for better airflow to the individual pavilions.
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Page 48 of 59 Page 49 of 59 Page 50 of 59 Page 51 of 59 Page 52 of 59 Page 53 of 59 Page 54 of 59 Page 55 of 59 Page 56 of 59 Page 57 of 59 GRAND TRAVERSE PAVILIONS Service Excellence Award Program April 2020
Date: 04/01/2020 Employee: Allison Baker Assisting with other departments when needed and has a great positive attitude! Ali doesn't Awarded for: hesitate to help others out and has been very flexible with her schedule. Position: Child Care Assistant Nominated by: Darcey Gratton
Date: 04/08/2020 Employee: Mary Hanson Awarded for: Handing out meal tickets with her own money. WE are very appreciative. Love you girl Position: CQI Coordinator Nominated by: Sadie Lovano and Michelle Mullen
Date: 04/15/2020 Employee: Jamie Clark During these hard times Jamie rocks out our Cherry floor. She is always going above Awarded for: and beyond things that get done. We thank you, Jamie, from the bottom of our hearts. Your Cherry peeps. Position: CNA Nominated by: Nancy Hardy
Date: 04/22/2020 Employee: Shelby Brook Always helping her coworkers and making sure everyone n the team is doing ok. Awarded for: THANK YOU for all you do. Position: CNA Nominated by: Anonymous
Date: 04/29/2020 Employee: Cloe Sherwin Thank you from the bottom of my heart for day after day taking such wonderful care of Awarded for: my residents on Cherry. You are a rock star. Position: CNA Nominated by: Nancy Hardy
Page 58 of 59 Thursdays @ 7:00pm Starting June Join us for a summer of great music, shared between family and friends through our new broadcast format. Bringing you recorded concerts from our Grand Lawn directly to your own lawn, couch or kitchen table through the radio airwaves on WCCW 107.5FM.
• TRAVERSE SYMPHONY ORCHESTRA BRASS QUINTET • JAZZ NORTH • MIRIAM PICO & FRIENDS • GORDON LIGHTFOOT TRIBUTE • PETER, PAUL & MARY REMEMBERED • ANNOUNCEMENT PENDING • K. JONES & THE BENZIE PLAYBOYS • REMEMBERING PATSY CLINE, FEATURING JUDY HARRISON AND REBOOTED • GRAND TRAVERSE PIPES & DRUMS Concerts on the Lawn • JIMMY BUFFETT TRIBUTE, FEATURING JIM HAWLEY • THE BACKROOM GANG • DIG A PONY: A BEATLES TRIBUTE Goes Radio-Retro • ANNOUNCEMENT PENDING
Title Sponsor Support the powerful work of the Foundation Online free-will donations during the concerts will go directly to supporting the Grand Traverse Pavilions Foundation in efforts to care for the elderly Media Sponsors in our community. www.gtpavilions.org/donate Page 59 of 59