GRAND TRAVERSE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES BOARD 9:00 AM Conference Call Phone: 1-510-338-9438 Access code # 126 650 1938 Password: 49776635
June 26, 2020 AGENDA
On June 18, 2020 Governor Whitmer signed into effect Executive Order 2020-129. 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.
During public comment, the public may participate with the provided link on the website by “raising your hand” to be called on by staff or by using the call-in number referenced above and your last 4 digits of your phone number will be announced.
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.
Page 1 of 50 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.
A. Review and File HANDOUT#
(1) Minutes of the 5/29/20 Board Meeting 1 (2) Heikkila Thank You 2 (3) Watson Thank You 3 (4) Courtade Thank You 4 (5) Lau Thank You 5 (6) The Compass – June 6 (7) P.E.P. Talk Employee Newsletter – June 7 (8) Media Report – May 8
6. ITEMS REMOVED FROM CONSENT CALENDAR (1)
7. GRAND TRAVERSE MEDICAL CARE -- Korvyn R. Hansen
A. General Information (1) COVID-19 Update Verbal (2) Apprenticeship Institute CNA Training Program 9
B. Chief Executive Officer Board Report 10
C. Business (1) Financial Report 11 (2) GTP Foundation Board of Trustees 2020-2021 12 (3) COVID-19 Wage Adjustment Resolution 2020 – 2 13
D. Medical Staff (1)
G.T.P. Announcements (1) May Service Excellence Award 14 (2)
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 MAY 29, 2020 MEETING
PRESENT: John Rizzo, Cecil McNally, Ralph Soffredine Board Kory Hansen, Rose Coleman, Robert Barnes, Lindsey Dood, Darcey Gratton Staff
ABSENT: Gordie LaPointe Commission 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
Beatrice Edmund – Inquired about who owned the Pavilions and shared her concerns about her son’s mental health while staying at the Pavilions with no visitors during the pandemic.
Andi Gerring – Stated she shared a memo with the Board due to the time allowed for a public comment would not suffice. Gerring shared her concerns with the Pavilions lack of thinking outside the box when considering the resident’s well-being.
Andrew Ingresol – Shared his families concerns of not being allowed to have window visits.
County Liaison Report – none
Approval of Agenda – Chair Rizzo asked if there were additions, changes or corrections to the agenda. Motion was made by McNally to approve the Agenda as presented, seconded by Soffredine 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.
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REVIEW AND FILE
(1) Minutes of the 4/27/20 Board Meeting (2) Lau Thank You (3) Horn Thank You (4) Wick Thank You (5) Slaby Thank You (6) Ramsden Thank You (7) The Compass – May (8) P.E.P. Talk Employee Newsletter – May (9) Media Report – April
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, new weekly reporting is now required under the CDC and for the county under EMR Resource. The Pavilions report daily Monday-Friday regarding PPE supplies, COVID testing and available rooms to show the ability to maintain a safe environment. Coleman stated that a tab has been shared on the website called Weekly Family Updates as part of the CDC guidelines to notify families of any positive cases of COVID. Per the Governors direction, since April, most of Administration staff have been able to work remotely and plan to return June 1 under phase 4. Outpatient therapy was able to re-open in mid-May with many new procedures in place with reduced capacity. Adult Day Services should be able to re-open with the same restrictions in mid to late June. Coleman has drafted up a policy for window visits to implement once the Stay At Home Order is lifted. Residents are getting outside in the enclosed courtyards and participating with in-room exercises. Coleman stated that Centers for Medicare & Medicaid Services (CMS) has created a 3 phase re-opening plan for long term facilities and noted CMS rules over when facilities open not the Governor. Coleman stated once the guidelines from the Michigan Department of Licensing and Regulatory Affairs (LARA) is received, the re-opening process could take at least 6 weeks due to the 3 different phases lasting 2 weeks each. Coleman shared the process of video conferencing to keep the residents engaged. McNally inquired about testing. Coleman stated tests are being done through doctor’s orders and have all come up negative. Coleman shared her concerns with mass testing.
Reimbursement Update – Hansen shared positive news regarding nursing homes would receive a 2.3% net Medicare increase for fiscal year 2021, under a proposal announced by the Centers for Medicare & Medicaid Services. At the state level for Medicaid, the budget is unknown right now with a $3.2 billion budget shortfall for the current fiscal year and another $3 billion deficit for next fiscal year 2021. Hansen is waiting on what kind of federal money the state may receive, which could determine the level of cuts.
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Video Recording – Hansen reviewed recording proposals presented to the board and stated he was open to either option. McNally suggested paying for a videographer and both Soffredine and Rizzo agreed. Motion was made by McNally to pay $50 towards a videographer to have the meetings recorded and shared on public television once the board can start meeting in person again. Seconded by Soffredine and carried unanimously.
Chief Executive Officer Report – Hansen reviewed his monthly report for April. With a decrease in census, Hansen met with senior management to suspend capital purchasing projects and reduce staffing due to the COVID-19 pandemic. Several administrative, clinical management and social work positions having a reduction in hours, while several other positions were eliminated, furloughed or remain unfilled through attrition. Hansen shared that the Pavilions received payment from the Federal government under the CARES Act totaling $496,766. In addition, Medicaid made an advance payment under $93,000 that will be recovered through the cost settlement process at a later date. The state also deferred the April provider tax payment of $129,000 until August. The Foundation received a $5000 grant from the Grand Traverse Regional Community Foundation for a thermal temperature camera to assist with COVID-19 regulation requirements for the staff screening process. Continued to show staff appreciation through this difficult period by providing meals, which will occur several times during Nursing Home Week in May.
Financial Report – Dood reviewed the financial operations report for April, 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.
Kaitlyn Troutman, NP - Attending Privileges - Hansen reviewed the request of Kaitlyn Suzanne Troutman, NP, to have attending privileges as recommended by Medical Director Dr. April Kurkowski, M.D. Kaitlyn is joining Sound Physicians, to serve nursing homes and assisted living facilities. Motion was made by Soffredine to approve Kaitlyn Suzanne Troutman, NP, for attending privileges, seconded by McNally and carried unanimously.
Grand Traverse Pavilions Announcements - (1) April Service Excellence Award - Hansen reviewed weekly winners (2) Concert on the Lawn Goes Radio Retro
Public Comment/Input
Andi Gerring – Shared her concerns of no window visits, no recording of the teleconferences and no plans in place to stock PPE. Gerring also requested for her written comments and memo to be posted with the minutes.
Meeting adjourned at 9:58 am
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Signatures:
John Rizzo – Chair Grand Traverse County Department of Health and Human Services Board
Korvyn R. Hansen, Assistant-Secretary
Date: June 26, 2020 Approved Corrected and Approved
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Page 7 of 50 Page 8 of 50 Page 9 of 50 Page 10 of 50 MICHIGAN COUNTY MEDICAL CARE FACILITIES COUNCIL | JUNE 2020
DIRECTOR: MARTHA T. BERRY EMPLOYEES RISING TO COVID-19 CHALLENGES BY JAMESON COOK/MACOMB DAILY NEWS
artha T. Berry Executive Director Kevin Evans credits his employees for overcoming their fears and workplace Mchallenges to provide care to its more than 200 elderly residents during the COVID-19 crisis.
Evans appeared Wednesday in front of a committee of the Macomb County Board of Commissioners for his quarterly report for Martha T. Berry Medical Care Facility, a public skilled-nursing center in Mount Clemens that operates in partnership with the county.
Evans referred to the approximately 330 employees as “heroes” as they worked under the conditions of knowing they could contract the virus and infect their loved ones at home. In fact, 25 staff members have contracted the virus. A handful of staffers Martha T. Berry Administrator Kevin Evans (foreground) have had a family member or relative die from COVID-19, he said. poses with staffers during a brief break in their work to keep residents safe from the coronavirus (courtesy photo) “It has taken its toll on staff,” he told commissioners over a remote meeting by video. “They have lost brothers, moms and dads and staff. “Our turnover actually went down in April, which is counter uncles, as well as the knowledge of knowing they may have been intuitive to what was happened here. They just said, ‘We need to the one that knowingly came into the facility, had COVID and be here.’” shed it before they actually were aware that they had this.” “I am just so proud of the team and what we have done.” He said they’re also worried they could also bring coronavirus to patients. The first employee who tested positive infected several To help encourage employees to stay, the facility began offering other people. free child-care to workers who are parents, Evans told The Macomb Daily. They also provided masks to employees to use at “It goes both ways,” he said. “The reality is, it’s a fear. We don’t home. have the contact tracing that we’d like to have. We don’t know how it happens, if they brought it in from a family member or if The facility has a capacity of 217 patients, and typically is about 95 they brought it to a family member. That fear is every day as they percent full, averaging 207 residents. However, that has dropped come into direct contact providing care for people they know are to 174 as of Friday, Evans told The Macomb Daily. The statewide COVID positive.” average capacity is 83 percent.
He said when the pandemic hit here in March, a few employees Nursing homes throughout the nation have been at the forefront left due to concerns. But in April turnover was half of the normal of the coronavirus pandemic as many of them have had high rates rate of between six to 12 employees for a month. of positive cases, and high death rates. The elderly have been particularly susceptible to dying from COVID-19. “When we communicated what we were going to be doing and how we needed their help, they were heroes,” he said of his — CONTINUED ON PAGE 2 —
In This Issue CMS NewsPage...... 11 of 50 2 State News...... 9 www.mcmcfc.org National News...... 6 Marketplace...... 11 COVID-19: PAYMENT FOR DIAGNOSTIC LABORATORY TESTS
Earlier this year, CMS took action to ensure America’s patients, CoV–2 or the diagnosis of the virus that causes COVID–19 health care facilities, and clinical laboratories were prepared to making use of high throughput technologies. Laboratories can respond to the 2019-Novel Coronavirus (COVID-19). To help bill Medicare for these tests using: increase testing and track new cases, CMS developed two HCPCS codes that laboratories can use to bill for certain COVID-19 • U0003: Infectious agent detection by nucleic acid (DNA or diagnostic tests. Health care providers and laboratories may bill RNA); severe acute respiratory syndrome coronavirus 2 (SARS- Medicare and other health insurers for SARS-CoV2 tests performed CoV-2) (Coronavirus disease [COVID-19]), amplified probe on or after February 4 using: technique, making use of high throughput technologies as described by CMS-2020-01-R. • HCPCS code U0001 for tests developed by the Centers for • U0004: 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV Disease Control and Prevention (CDC) (COVID-19), any technique, multiple types or subtypes • HCPCS code U0002 for non-CDC laboratory tests for SARS- (includes all targets), non-CDC, making use of high throughput CoV-2/2019-nCoV (COVID-19) technologies as described by CMS-2020-01-R. • Laboratories and other health providers can also bill Medicare • Neither U0003 nor U0004 should be used to bill for tests that for tests using CPT codes created by the American Medical detect COVID-19 antibodies. Association, provided testing uses the method specified by each CPT code: For COVID-19 tests that do not use high throughput technology, • CPT code 87635 for infectious agent detection by nucleic acid Medicare Administrative Contractors developed payment tests for dates of service on or after March 13 amounts for claims in their jurisdictions that will be used until we • CPT codes 86769 and 86328 for serology tests for dates of establish national payment rates though the annual laboratory service on or after April 10 meeting process. There is no cost-sharing for Medicare patients.
Finally, for dates of service on or after April 14, 2020, Medicare — Centers for Medicare and Medicaid Services pays $100 for laboratory tests for the detection of SARS–
CMS ANNOUNCES DIRECTOR: MARTHA T. INDEPENDENT BERRY EMPLOYEES RISING COMMISSION TO ADDRESS TO COVID-19 CHALLENGES SAFETY AND QUALITY IN FROM PAGE 1 NURSING HOMES Twenty Martha T. Berry As a part of President Trump’s Opening Up America Again patients have died, 14 at the effort, the Centers for Medicare & Medicaid Services facility and six after being (CMS) announced a new independent Commission that transferred to a hospital. will conduct a comprehensive assessment of the nursing home response to the 2019 Novel Coronavirus (COVID-19) Forty-six patients have tested pandemic. The Commission will provide independent positive, and 194 have tested recommendations to the contractor to review and report negative. to CMS to help inform immediate and future responses to COVID-19 in nursing homes. This unprecedented effort Sixteen patients have fully builds upon the agency’s five-part plan unveiled last April to recovered, and 20 more are in ensure safety and quality in America’s nursing homes, as well recovery isolation and should as recent CMS efforts to combat the spread of COVID-19 be fully recovered soon, he Evans within these facilities. Tomorrow marks the beginning of said. Older Americans Month and, as we take this time to honor seniors, CMS remains committed to enacting policies that As of May 11, Michigan’s nursing homes had 2,874 positive benefit our Nation’s seniors. cases of COVID-19 among its employees and residents. At least 687 Michigan nursing home residents have died from — Centers for Medicare and Medicaid Services COVID-19 complications.
| MICHIGANPage 12 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 2 — WITHOUT FUNDING AND RESOURCES, CMS’ NEW NURSING HOME TESTING GUIDANCE ‘HOLLOW’ BY MAGGIE FLYNN/SKILLED NURSING NEWS
Without the funds and the resources needed to meet COVID-19 “Saying states should be doing regular testing at nursing homes, I testing recommendations, the federal government’s guidance on don’t think that this is going to move the needle in a major way, reopening nursing homes could create more confusion for skilled just because most states don’t have testing,” Grabowski told SNN, nursing facilities — and more challenges on top of the considerable adding that a testing requirement like New York’s is being set strain they already face in combating the spread of the illness. without actually providing the tests to SNFs. “I don’t know how any of these actors, at a state or federal level, believe this is actually “At a high level, I really think this is a bit of a hollow requirement,” going to meaningfully change testing unless they actually go in and David Grabowski, a professor of health care policy at Harvard make those tests available.” Medical School and a member of the Medicare Payment Advisory Commission (MedPAC), told Skilled Nursing News on May There are ways states can do this, he added. Some states have 20. “You’re telling nursing homes and states to test all staff and made use of the National Guard to perform tests at nursing residents regularly, yet not actually the providing the tests to them, homes, while others, such as Massachusetts, provided SNFs with and I think that’s a real mistake.” the tests directly — though Grabowski acknowledged that the latter effort didn’t quite turn out as the Bay State would have The Centers for Medicare & Medicaid Services (CMS) released hoped. guidance on reopening nursing homes on May 18. But his point was that there are ways to provide the tests to nursing While allowing states flexibility in how the criteria in the guidelines homes, and that leaving it to the states or even facilities to secure should be implemented, the agency emphasized that SNFs should testing would not do much to increase tests to the needed level. be among the last institutions to reopen as communities try to move out of their various stay-at-home phases. Even if that testing is provided, the capacity of states to process the tests is another matter entirely. Many nursing facilities have The guidelines detail several parameters for testing and COVID-19 existing relationships with commercial labs, but those relationships community infection status that SNFs ideally should meet before are based on normal test volumes, Laxton told SNN. It’s not certain moving toward reopening, including the requirement to have that a given lab could process a sudden surge of polymerase chain baseline testing for all residents and staff — and the capacity to reaction (PCR) tests from a SNF, he told SNN. subsequently test staff once a week. The importance of timely results is also a factor — so much so But states have the ability to choose how they measure their SNFs’ that when provider PruittHealth was looking for private labs readiness to emerge from visitation lockdown, and some of them, to bolster its COVID-19 testing, chief clinical officer Fran Rainer such as New York, have adopted even stricter measures for told SNN in April that turnaround time was a major consideration testing than those in the CMS guidelines. in their choice of lab. That’s because PruittHealth found that COVID-19 symptoms tended to only show five to seven days after The CMS guidance is helpful in the flexibility it offers, Christopher exposure. Laxton, the executive director of AMDA — The Society for Post- Acute and Long-Term Care Medicine, told SNN on May 20. That’s That raises another complicating factor: Labs can typically process important, given that COVID-19 testing strategies should be PCR results in 24 to 48 hours, Laxton noted. tailored to the clinical situation, according to AMDA’s policy statement on testing, released the same day — though before — “In terms of being able to use the test results in a productive way, CMS put out the reopening guidelines. they need to be back in the clinician’s hands within that timeframe,” he explained. “Anything beyond 48 hours — in essence, the test “However, it doesn’t go very far in terms of the considerations of results become useless. What we’ve heard is that some of the what a testing strategy should look like,” Laxton said. processing labs, when they’re placed with high volume, those get delayed a week or even two weeks, which essentially makes it a This omission is striking because in New York and elsewhere, SNFs pointless exercise.” have reported serious hurdles to securing enough tests. Though CMS administrator Seema Verma has emphasized that states Laxton also pointed out that the language of the guidance memo have sufficient testing capacity, this doesn’t always match what is ambiguous; even though CMS says access to adequate testing Grabowski has heard and what other reports seem to suggest: includes the capacity to give all SNF residents and staff a baseline Namely, that some states have the capacity to test or provide — CONTINUED ON PAGE 4 — testing while others do not.
| MICHIGANPage 13 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 3 — WITHOUT FUNDING AND RESOURCES, CMS’ NEW NURSING HOME TESTING GUIDANCE ‘HOLLOW’ FROM PAGE 3
COVID-19 test and then re-test all staff weekly, it also notes that tests can cost anywhere from $100 to $175 each, he told SNN, state and local leaders could adjust the requirement for weekly staff and when it comes to testing thousands of staff, that will add up. testing based on virus circulation in the community. Though some states are requiring private insurance companies to cover this testing, not all of them are doing so — and even with “Is the survey team going to tag you if you don’t test?” Laxton that coverage, staff could have to pay a deductible or a copay. And asked rhetorically. “These are all very much open questions, and we that’s assuming the staff have access to insurance, which is not know that our members, nursing homes, are risk-averse.” always a given, Laxton noted.
The issue of testing is “hugely consequential,” he told SNN, given On a national level, the American Health Care Association (AHCA) the fact that AMDA’s data show that nationally, around 20% of staff estimated that testing each nursing home resident and staff test positive with universal testing and have to be quarantined for member just once would cost $440 million, and argued that it two weeks, putting already short-staffed SNFs into an even greater shows the need for additional funding from the Department of workforce pincer. Health and Human Services (HHS).
In addition, as AMDA noted in its policy statement, the idea of Grabowski agreed, arguing that most SNFs want to supply their “universal testing” is not as clear as it might sound. One definition workers with personal protective equipment (PPE) and universal might involve testing all residents and staff regardless of symptoms, testing — but they’re just one part of a bigger ecosystem that’s while another might involve keeping facility-wide testing only to already pushed to the brink. sites with outbreaks. “That’s only going to happen if somebody purchases those for them To be on the safe side, many of AMDA’s nursing home members and actually provides them,” he told SNN. “I don’t think nursing are going to act as though the new guidelines are mandates to test homes … are going to be able to bid against other actors in the everyone on a weekly basis, Laxton told SNN. system and get tests and PPE to their buildings unless we help provide it to them.” But that raises another major challenge: the cost of testing. PCR
UPDATED MDS 3.0 ITEM SETS V1.17.2 AND TECHNICAL DATA SPECIFICATIONS NOW AVAILABLE
In response to State Medicaid Agency and stakeholder specs errata (v3.00.4) Final 04-30-2020 in the Downloads requests, CMS has updated the MDS 3.0 item sets (version section of the MDS 3.0 Technical Information page. 1.17.2) and related technical data specifications. These Supporting materials including the 1.17.2 Item Change changes will support the calculation of PDPM payment History report and the revised 1.17.2 Item Sets can be codes on OBRA assessments when not combined with accessed in the file: MDS 3.0 Final Item Sets v1.17.2 for the 5-day SNF PPS assessment, specifically the OBRA October 1 2020 zip also posted in the Downloads section of comprehensive (NC) and OBRA quarterly (NQ) assessment the MDS 3.0 Technical Information page. item sets, which was not possible with item set version 1.17.1. This will allow State Medicaid Agencies to collect Please confirm with your State Medicaid Agency if your and compare RUG-III/IV payment codes to PDPM ones and State will be requiring the calculation of the PDPM payment thereby inform their future payment models. codes on the OBRA assessments when not combined with a 5-day SNF PPS assessment. The changes to the technical data specifications that support these modifications are contained in the Errata — Centers for Medicare and Medicaid Services v3.00.4 which can be accessed in the file: MDS 3.0 data
| MICHIGANPage 14 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 4 — VERMA: COVID-19 MSA ANNOUNCES DATA WILL APPEAR FURLOUGH DAYS FOR ON NURSING HOME STAFF COMPARE The novel coronavirus (COVID-19) has created an unprecedented situation that impacts how the state BY ALEX SPANKO/SKILLED NURSING NEWS operates and delivers services. Due to budgetary constraints, it has become necessary for the State to Centers for Medicare & Medicaid Services (CMS) administrator implement temporary layoff days. Seema Verma on May 13 confirmed that newly required COVID-19 data will eventually appear on Nursing Home Compare, with the As many of you are aware, it was announced last week first public information expected to be released by the end of this that State employees would be furloughed one day each month. week. Staff in the Medical Services Administration (MSA) will be laid off on Fridays, starting this week and lasting “Ultimately, it will go on Nursing Home Compare, so that people through July. For reference, see the list of days below: can look up the specific nursing home and have the report on what happened,” Verma said on a Thursday morning call with reporters. • Friday, June 5, 2020 • Friday, June 12, 2020 In addition to building-by-building information on the consumer- • Friday, June 19, 2020 facing website, the COVID-19 data will also be presented in a • Friday, June 26, 2020 separate trend analysis from CMS, the administrator indicated. • Thursday, July 2, 2020 (Friday is July 4th holiday observance) “Obviously, we want to make sure it’s scrubbed and it’s cleaned,” • Friday, July 10, 2020 Verma said. “We have to get the data from CDC. We want to do • Friday, July 17, 2020 our own analysis, as well, to sort of put out some broad parameters • Friday, July 24, 2020 of what we’re seeing, so that that’s easy and digestible.” On these days, there will be limited to no availability CMS issued an interim final rule at the start of May, requiring of staff. Providing access to services for our operators to submit weekly information about COVID-19 infections Medicaid beneficiaries remains our utmost priority; and deaths to the agency and the Centers for Disease Control & accommodations have been made to ensure that this Prevention (CDC). The goal, according to CMS and the CDC, is to furlough minimizes barriers to care. While our operational help officials track coronavirus hotspots while also providing full responsiveness and timeliness will not be what you are transparency to the public. accustomed to, MSA staff are committed to responding as quickly as possible. Your understanding and patience are The first round of information is due this coming Sunday, though greatly appreciated as we continue working to help our fines for non-compliance do not kick in until June 7. state move through this public health emergency. If you have any questions or concerns, please call 1-800-292- Evan Shulman, director of CMS’s nursing home division, on 2550 or email [email protected]. Wednesday indicated that while thousands of facilities had reported data, thousands more still needed to sign up for an — Medical Services Administration account with CDC’s National Healthcare Safety Network (NHSN) portal and begin sending in information. “Tell us when we’re going to see that information.” A lack of specific public data around coronavirus infections and deaths in nursing homes has been a major source of frustration for Verma insisted that nursing homes were always required lawmakers, resident advocates, and families. Earlier this week, Sen. to provide information about disease and deaths to local Bob Casey of Pennsylvania grilled CDC director Robert Redfield health departments and praised the industry’s work to keep about the delay in federal reporting, which Redfield described as residents and families informed. an “operational” issue. “I want to be very clear with you that families have that “I need to hear from you today: Why has there been a delay — a information today, and they’ve had it for weeks,” Verma three-month delay — in basic information that families and people said. “We’ve heard from family members across the country within a community need about the outbreaks in nursing homes, that have said: ‘It’s great. I’m getting these phone calls. My the number of cases, what is happening in nursing homes?” Casey mom’s okay, but I know that there’s coronavirus in the nursing said during a Senate hearing on the nation’s coronavirus response. home.’”
| MICHIGANPage 15 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 5 — TRUMP ADMINISTRATION ISSUES GUIDANCE TO ENSURE STATES HAVE A PLAN IN PLACE TO SAFELY REOPEN NURSING HOMES On May 18, under the leadership of President Trump, the Centers Given the critical importance in limiting COVID-19 exposure in for Medicare & Medicaid Services (CMS) announced new guidance nursing homes, CMS recommends that decisions on relaxing for state and local officials to ensure the safe reopening of nursing restrictions be made with careful review of the following facility- homes across the country. The guidance released today is part of level, community, and state factors: President Trump’s Guidelines for Opening Up America Again. It details critical steps nursing homes and communities should take • Status of COVID-19 cases in the local community prior to relaxing restrictions implemented to prevent the spread of • Status of COVID-19 cases in nursing homes coronavirus disease 2019 (COVID-19), including rigorous infection • Adequate staffing prevention and control, adequate testing, and surveillance. The • Baseline test of all residents, weekly testing of all staff, vulnerable nature of the nursing home population requires practicing social distancing, and universal source control for aggressive efforts to limit COVID-19 exposure and to prevent the residents and visitors (e.g., face coverings) spread within facilities. The recommendations issued today would • Access to adequate personal protective equipment (PPE) allow states to make sure nursing homes are continuing to take the • Local hospital capacity appropriate and necessary steps to ensure resident safety and are opening their doors when the time is right. This also serves to help State and local leaders are urged to regularly monitor the factors states and nursing homes reunite families with their loved ones in a for reopening and can adjust their plans accordingly, depending on safe, phased manner. local data about the circulation of the virus in their community. CMS is committed to taking critical steps to ensure nursing homes are “Coronavirus has had a devastating impact on nursing homes, prepared to response to COVID-19. and as we reopen America, we want to make sure we are doing everything we can to protect our most vulnerable citizens,” said The guidance released today can be found here: https://www. CMS Administrator Seema Verma. “Our focus continues to be the cms.gov/medicareprovider-enrollment-and-certificationsurvey safety and quality of life of nursing home residents and while we are certificationgeninfs-states-and-regopolicy-and/nursing-home- not at a point where nursing homes can safely open up, we want to reopening-recommendations-state-and-local-officials make sure communities have a plan in place when they are ready to reopen.” The frequently asked questions can be found here: https:// www.cms.gov/files/document/covid-nursing-home-reopening- Because COVID-19 poses an elevated threat to vulnerable elderly recommendation-faqs.pdf nursing home residents, CMS recommends additional criteria for nursing homes advancing through phases of reopening, to — Centers for Medicare and Medicaid Services complement the Trump Administration’s broader Opening Up America Again framework. CMS is recommending that nursing homes do not advance through any phases of reopening or ALL VOTERS TO RECEIVE relax any restrictions until all residents and staff have received results from a baseline test. In addition, CMS recommends that ABSENTEE VOTER state survey agencies inspect nursing homes that experienced a APPLICATIONS significant COVID-19 outbreak prior to reopening. Finally, CMS recommends that nursing homes remain in the current state In an effort to allow Michigan residents to continue proper of highest restriction even when a community begins to relax social distancing, Secretary of State Jocelyn Benson announced restrictions for other businesses, and should be among the last to her department will mail absentee voter applications to all reopen within the community, to ensure safety of the residents. registered voters in the state. The applications will be for Nursing homes may receive visitors during phase three, which is both the primary election in August and the general election when there has been a sustained decrease in COVID-19 cases. A in November. Once a voter fills out the application, they can variety of factors must go into making this decision, including states either mail it or take a picture and email it to their local clerk. not only relying on case count, but assessing the individual nursing home and other local factors. Visitors must be screened and wear a While the pandemic is ongoing, Michigan voters showed their cloth face covering at all times. preference for voting by mail during the election earlier this month. The May 5 election had record turnout and 99 percent The guidance released today encourages state leaders to of those who participated voted via mail. collaborate with the state survey agency and local health departments to decide how these criteria should be implemented. — Secretary of State’s Office
| MICHIGANPage 16 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 6 — FACILITY LOCATION DETERMINES COVID OUTBREAKS, RESEARCHERS SAY BY AMY MENDOZA/PROVIDER MAGAZINE
Where a nursing facility is located has a great deal to do with COVID: It’s as important,” Mor said. “If you are a larger facility whether its residents have a case of COVID-19, said a panel of versus a smaller facility, there is more traffic. Larger facilities simply researchers in a May 7 webinar. According to preliminary research have more staff, more people coming in and out of them. That’s presented, larger facilities located in urban areas with large more traffic and more likelihood that someone will be coming in populations, particularly in counties with a higher prevalence of from the outside with COVID.” COVID-19 cases, were more likely to have reported cases. Grabowski added, “This is a system problem, not a bad apple problem.” He Characteristics that were not associated went on to say that the system has not with a facility having a COVID case adequately supported nursing homes included Five-Star Rating on Nursing during this pandemic. Home Compare; whether or not a facility had a prior violation with infection; or Mor’s team also found a strong correlation whether it was for-profit, part of a chain, between the number of skilled nursing or having a high Medicaid census. These facility (SNF) cases in the building that test factors had no correlation with whether the positive and the number of positive cases facility had cases of COVID-19, said the in that county. researchers. The researchers reported that even while nursing facilities are in “It’s about where you are and not who you are,” said David lockdown, the COVID-19 virus is spreading and pointed to the Grabowski, PhD, professor of health care policy, Department of asymptomatic presentation of the virus and the lack of testing as Health Care Policy, Harvard Medical School. “What we’re seeing factors. in our data is it tends to be larger facilities—urban facilities in areas with more cases—that tend to be the facilities with COVID “As we know, it is spreading via asymptomatic and pre- cases.” symptomatic cases, and what we’ve learned is that in facilities that have been closed for weeks, we are seeing cases emerge,” said The finding was supported by preliminary research presented Grabowski. “Those cases are emerging because of staff who don’t by Vincent Mor, PhD, IMPACT principal investigator, professor, know that they have the virus are coming in to work.” Florence Pierce Grant University, and professor of health services, policy and practice, Brown University School of Public Health. The reality of the problem played out in a SNF in Massachusetts, said Grabwoski. The facility went into lockdown in mid-March. In In a partnership with Genesis HealthCare, Mor’s team used early April, the facility was scheduled to become an all-COVID-19 real-time electronic medical record data to track epidemiology facility—all the long-stay residents were to be moved out. Every of COVID-19 in nursing centers across 30 states. The preliminary resident in the building was tested for COVID-19, and over half analysis was consistent with Grabowski’s findings that larger tested positive with no symptoms, he said. About 60 percent facilities in urban communities with COVID cases are more likely of the staff were also tested, and of those, 40 percent tested to have outbreaks. positive.
Both Grabowski, using data from 20 states, and Mor’s team “So this shows you it is coming into buildings,” said Grabowski. data from Genesis investigated what differentiated facilities with “It’s not about symptoms. It’s going to come into these buildings COVID-19 from those without COVID-19. The Genesis facilities, through asymptomatic staff, and like this [facility] in Massachusetts, in Mor’s preliminary analysis, found those that had a positive the outcomes are often dire.” COVID case, compared with the facilities that did not have a positive case, have more total number of beds and were located Regarding the lack of testing, the researchers called for a system in counties that had a higher number of positive COVID cases per to test and monitor staff and residents. “We’re not going to get hundred thousand. Both Grabowski and Mor indicated that these a handle on COVID-19 [facilities] until we get a systematic testing characteristics were strongly differentiating. and surveillance system,” Grabowski said.
“So it’s a function of traffic; that is, if you’re in an environment In addition to calling on federal leaders to implement testing all where there are a lot of people in the community who have — CONTINUED ON PAGE 8 — COVID, the patients in the building are more likely to have
| MICHIGANPage 17 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 7 — FACILITY LOCATION DETERMINES COVID OUTBREAKS, RESEARCHERS SAY FROM PAGE 7 over the country for all residents and staff, the researchers called The research findings were presented during a webinar titled, for adequate access to personal protective equipment, infection “COVID-19 in Nursing Homes: Pragmatic Research Responses control personnel and infrastructure, hazard pay, practicing to the Crisis,” hosted by The National Institute on Aging good cohorting, COVID-specialized post-acute care facilities, (NIA) Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) and investment in home- and community-based services to be Collaboratory. included in policies to support nursing facility residents and staff. The NIA IMPACT Collaboratory works to build the nation’s The researchers highlighted the need for national data, including capacity to conduct pragmatic clinical trials of interventions number of cases and fatalities for residents and staff. As embedded within health care systems for people living with previously reported, the Centers for Medicare & Medicaid dementia and their care partners. To learn more, visit https:// Services has released a QSO memo addressing the interim impactcollaboratory.org. final rule requiring SNFs to report to National Healthcare Safety Network (NHSN) on COVID-19, as well as to provide notifications To listen to the webinar, go to https://impactcollaboratory.org/ to residents, their representatives, and families. The American special-grand-rounds-covid-19-in-nursing-homes-pragmatic- Health Care Association/National Center for Assisted Living said research-responses-to-the-crisis/. these requirements were to go into effect with the publication in the Federal Register of the interim final rule on May 8.
MICHIGAN NATIONAL GUARD ASSISTS WITH COVID-19 TESTING FOR LTC FACILITIES
The Michigan National Guard has joined a collaborative assigned to support this long-term care facility testing effort with the Department of Health and Human Services mission. Separate teams have recently supported Michigan (DHHS) and State Emergency Operations Center (SEOC) Department of Corrections facilities throughout the state. to assist with voluntary COVID-19 testing for staff and These three-member teams include a certified medic residents at the request of long term care facilities across to conduct the testing and two members to assist with Michigan. paperwork, logistics, and non-medical tasks. Teams are equipped to perform testing, or to train staff members TO DATE: to perform testing at the discretion of the long term care facility. From May 7-14, the Michigan National Guard assisted the Upper Peninsula Health Department, DHHS, and SEOC by All team members have tested negative for COVID-19 completing testing at seven long term care facilities in the and have been self-isolating in accordance with Centers Upper Peninsula. for Disease Control (CDC) guidance to ensure health and safety and to protect Michigan communities. The teams From May 15-22, Michigan National Guard testing teams wear personal protective equipment, including Tyvek suits, assisted in Oakland, Genesee, Kent, Muskegon, Washtenaw, face shields, nitrile gloves, and face mask (N-95 or surgical, Wayne, Ingham, Saginaw and Macomb counties. as appropriate).
Support to DHHS testing is expected to continue, based Information around this outbreak is changing rapidly. The on DHHS priority, through the end of May with Kalamazoo, latest information is available at Michigan.gov/Coronavirus Calhoun, St. Clair, Ottawa, Berrien, Gratiot, Bay, Eaton, and CDC.gov/Coronavirus. Grand Traverse and Livingston counties. — Michigan National Guard The Michigan National Guard has more than 60 trained testing teams ready to assist, 15 of which are currently
| MICHIGANPage 18 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 8 — MICHIGAN’S CARES ACT AID RANKS NEAR BOTTOM OF NATION WHEN RATED BY COVID-19 CASES
The state of Michigan will receive $3.9 billion in direct federal states are rural with low population and few states have very aid as part of the $150 billion federal stimulus package passed high population, so it’s not unusual to see that kind of outcome,” in March to help address coronavirus-related expenses, but the Peters said. amount dwindled when measured by the number of COVID-19 cases or deaths. Discussions are ongoing in Washington, D.C., to amend the CARES Act funding so states can use it on expenses for which Michigan’s allocation ranked in the top 10 among the states, but they had already budgeted — expenses the state may not be able it got relatively little considering the number of known cases of to meet because of decreased tax revenue during the pandemic. COVID-19 that Michigan has reported — a figure that topped 45,000 this week. “… under the current language, federal funds can’t be used to back fill revenue losses or support existing state costs, which is Michigan comes in near the bottom of the rankings at No. 44 the No. 1 thing we need,” Weiss said in an email. “The need for among the states when measured by the number of positive tests Congress to provide additional direct support to state and local for the COVID-19 virus ($87,119 per positive test) and No. 46 governments is critical.” when measured by the number of COVID-linked deaths in the state ($925,773 per death), according to an Associated Press The Michigan Health & Hospital Association said the most recent analysis. round of CARE Act funds to hospitals appeared to be more fairly distributed because it was based on the number of COVID-19 Henry Ford Hospital in Detroit has been playing Journey’s “Don’t patients rather than patient revenue. Stop Believin’” for the past week when COVID-19 patients get discharged. The Detroit News In the most recent allocation to hospitals announced Friday, 30 Michigan “high-impact” hospitals will receive a little more than States with less severe outbreaks got a disproportionately large $900 million because they cared for more than 100 COVID-19 share of the grant money, according to the analysis. patients through April 10 and $95.6 million for care to low-income and uninsured patients. Part of the issue is the formula for dispersing the money included a floor amount of $1.25 billion per state, regardless of the state’s Of the $95 million allocated to the 30 Michigan hospitals caring population or how hard it was hit by the coronavirus. for low-income patients, roughly $41.3 million will go to hospitals in Wayne County. It’s not yet clear what the specific breakdown States like Wyoming, which had 604 cases of COVID-19, got an will be for the major Detroit hospitals. allocation that breaks down to more than $2 million per positive test of COVID-19. Alaska got $3.4 million per positive test, In addition, 249 rural hospitals and health clinics will receive though it has reported 368 cases. $326.1 million through the CARES Act allocations to rural hospitals. Wyoming’s $1.25 billion allocation is equal to 80% of the state’s annual general budget, according to the Associated Press. During the first distribution of CARES Act funding to hospitals in March, the distribution formula “unfairly penalized” state The country’s hardest-hit states, New York and New Jersey, hospitals, “despite having one of the highest numbers of cases received about $24,000 and $27,000, respectively, for each in the country,” said Ruthanne Sudderth, a spokeswoman for the positive coronavirus test. Michigan Health & Hospital Association.
Other states with high numbers of cases, including Massachusetts, “The methodology used patient revenue; Michigan hospitals are and Illinois, received less than $100,000 per positive case, paid well below the national average as a percentage of Medicare, according to the AP’s analysis. largely due to our payer mix and many efficiencies our members have adopted over the years,” Sudderth said in an email. U.S. Sen. Gary Peters, D-Bloomfield Township, said that’s part of what happens when a federal formula includes a minimum But, she said, “we’re encouraged to see some of the more amount for each state, regardless of its size. He blames that on recently announced allocations be targeted toward those hardest the Senate’s “natural bias” toward small, rural states. hit by the virus as well as rural hospitals.”
“Rural states have a disproportionate influence in the U.S. Senate — Detroit News because each state gets two senators, and a large number of
| MICHIGANPage 19 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 9 — MDHHS NEWS MICHIGAN COVID RESPONSE FEE SCHEDULE RELEASED COVID MDHHS issued the COVID-19 Response Fee Schedule which DATA outlines coverage of codes to allow flexibility to protect the health and welfare of beneficiaries and providers while maintaining access to vital services during the COVID-19 pandemic. This database reflects codes and coverage MDHHS BULLETINS AND changes that are intended to be time-limited, and MDHHS will notify providers of its termination (please note, this LETTERS change in termination of coverage has been updated to align with recent policy updates). Medicaid Bulletin MSA 20-36-COVID-19.pdf discusses COVID-19 Response Policies: Clarification on Notice to This fee schedule can be found at www.michigan.gov/ Terminate Policies and Processes, and is issued on May 20, medicaidproviders >>> Billing & Reimbursement >>> 2020. This bulletin is being sent to All Providers. Provider Specific Information>>> COVID-19 Response. Medicaid bulletins can be accessed on the web at www. We encourage providers to revisit this fee schedule as michigan.gov/medicaidproviders, click on Policy, Letters & updates to coverage have been made in response to recent Forms. policy changes. The following proposed policy has been issued for public MICHIGAN’S COVID-19 HOTLINE NOW OFFERS comment: FREE, CONFIDENTIAL EMOTIONAL SUPPORT COUNSELING 2039-COVID-P.pdf - COVID-19 Response Policies: Clarification on Notice to Terminate Policies and Processes. Confidential emotional support counseling is now available 24/7 at no cost to Michiganders who call the state’s COVID-19 Comments may be forwarded to the email noted on the hotline. The service is part of a federally funded grant policy’s transmittal sheet. Proposed Medicaid policies may program implemented by the Michigan Department of be accessed here on the MDHHS website. Health and Human Services (MDHHS) Behavioral Health and Developmental Disabilities Administration (BHDDA) in The following proposed policy has been issued for public partnership with the Michigan State Police. comment:
Callers to the COVID-19 hotline will hear a recording that 2019-Pharmacy-P.pdf - Implementation of a Single begins by saying to press “8” if they would like to speak with Preferred Drug List (PDL) a Michigan Stay Well counselor. The counselors, though not licensed professionals, have received specialized training from Comments may be forwarded to the email noted on the the Substance Abuse and Mental Health Administration’s policy’s transmittal sheet. Proposed Medicaid policies may (SAMHSA) Disaster Technical Assistance Center on how to be accessed here on the MDHHS website. provide emotional support to residents of federally declared disaster areas. A major disaster was declared in Michigan on Friday, March 27, due to the COVID-19 pandemic. Michigan Stay Well counselors are available any time, day or BHDDA hopes that adding Stay Well counseling services to night, by dialing the COVID-19 hotline at 888-535-6136 and the hotline will provide callers with relief from the mental pressing 8 when prompted. Language translation is available health impacts of the COVID-19 pandemic. for non-English speakers.
“Emerging or lingering anxiety, distress, irritability and loss State employee volunteers also continue to answer general of hope are important feelings to recognize in ourselves COVID-19 questions on the hotline. The current hours for and others, and it can help to talk to someone,” said Dr. general questions are 8 a.m. to 5 p.m., Monday through Debra Pinals, psychiatrist and MDHHS medical director for Friday. behavioral health. “If it’s helpful, the counselors can also provide callers with referrals to local mental health agencies To access a variety of emotional support resources in the wake and substance use disorder support services.” of the COVID-19 crisis, visit Michigan.gov/StayWell.
| MICHIGANPage 20 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 10 — INGHAM COUNTY MCF — CEO-ADMINISTRATOR
Ingham County Medical Care Facility is seeking a Chief Executive uniformly deliver care and service Officer (CEO)/Administrator to provide executive leadership for the • Ability to direct all administrative functions of Ingham County organization. Medical Care Facility and represent the facility to the Ingham County Board of Commissioners and the community in general. RESPONSIBILITIES: • Master’s degree in business administration, health services Reporting to the Board of Directors, the CEO/Administrator: administration, public administration or closely related degree preferred • Is responsible for the overall operation of Ingham County MCF • Establishes short- and long-range goals, objectives, plans and SALARY: DOQE policies subject to approval of the Board • Represents Ingham County to professional organizations, HOW TO APPLY: governmental agencies, other health care institutions, the financial community and other external public groups Expressions of personal interest and recommendations, held in strict confidence, may be directed to: QUALIFICATIONS: Deffet Group, Inc. • Leadership style that is based on integrity, trust and respect Phone: 740.666.7600 • Approximately 10 years of management experience, including Email: [email protected] responsibility for financial management, human resources management, organization design and administration and DEADLINE: Open until filled nursing care services, including five years of management experience in a long-term care setting POSTED: May 27, 2020 • Skills in strategic planning, operations and leadership • Ability to develop and implement a management system that will enable the provision of a high level of care to the residents CONFERENCE AND and meets or exceeds all regulatory requirements MEETING UPDATES • Ability to manage all areas of the facility and ensure that department directors have the resources to consistently and MCMCFCEVENTS------Aug. 16-19, 2020 Nov. 5-6, 2020 FACILITIES SOUGHT FOR Michigan Counties Fall Financial Annual Conference Conference INFLUENZA STUDY Radisson Hotel, Crystal Mountain Resort, Flu season can be particularly brutal for residents of nursing Kalamazoo Thompsonville homes and other post-acute and long-term care (PALTC) Oct. 22-23, 2020 facilities. That’s why nationally recognized LTC researchers from Fall DON Meeting Brown University are collaborating with Insight Therapeutics to Mission Point Resort, begin the second year of a large-scale, quality improvement Mackinac Island study to evaluate the impact of the annual influenza vaccine choice on LTC facility residents’ hospitalization risk.
If interested in participating, go to join.nhflustudy.com to MCMCFC STAFF answer a brief questionnaire to see if you qualify. Renee Beniak, Derek Melot, Participating facilities will be allocated to receive one of Executive Director Director of Communications two Centers for Disease Control and Prevention (CDC)- [email protected] [email protected] recommended flu vaccines for adults at no cost. Participating Meghann Keit, Casey Benda, facilities also will receive a free supply of the vaccine for staff. MCMCFC Governmental Conference and Continuing In addition, the Foundation for PALTC Medicine will receive a Affairs Liaison Education Coordinator $100 donation for each facility that enrolls. [email protected] [email protected]
Please contact Insight Therapeutics, LLC, at Vickki Dozier, [email protected] or 757-625-6040, if you need Executive Assistant additional information. [email protected]
| MICHIGANPage 21 of COUNTY 50 MEDICAL CARE FACILITIES COUNCIL COMPASS JUNE 2020 — 11 — P E P T A L K VOLUME 8, ISSUE 6, J U N E 2 0 2 0
Thursdays @ 7:00pm Starting June 4 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
Jimmy Buffett Tribute, Featuring Jim Hawley
The Backroom Gang
Dig a Pony: A Beatles Tribute
Announcement Pending
MILESTONE ANNIVERSARY Samantha Neahr: 40 Years WOW! 40 years! Thank you, Sam, for being so easy to work with and a great CNA to all the residents. You make work enjoyable. In 40 years you have welcomed and trained so many new people. Everyone remarks about how approachable you are. We appreciate all of your hard work and dedication. Thank you for being you and for being with us for 40 years!
Page 22 of 50 P E P T A L K VOLUME 8, ISSUE 6, J U N E 2 0 2 0 P A G E 2
GRILLING SAFETY TIPS As warmer weather hits, the smell of food on the grill fills the air. Ac- cording to the National Fire Protection Association, nearly 9,000 home fires each year involve grills, so it’s important to brush up on barbecue safety. Consider the following grilling safety tips: Grill outside only. Don’t grill in a garage, porch or other enclosed space, even if it’s ventilated. Choose a safe location. Keep your grill on a flat surface at least 10 feet away from your house, garage or other structures. Check for leaks. Make it a habit to check the gas tank hose before using it for the first time each year. Never leave your grill unattended. Fires can double in size every minute. Keep children and pets at least 3 feet away from where food is being prepared or carried. Clean the grill regularly. Keep it clean by removing grease or fat buildup.
CALIFORNIA AVOCADO SUPER SUMMER WRAP Makes: 4 servings Ingredients 1 ripe avocado (cut into chunks) ½ cup plain nonfat Greek yogurt 4 tsp. lime juice ½ cup blueberries ½ cup carrots (grated) ¼ cup red onion (chopped) 2 cups fresh arugula (chopped) 12 oz. cooked chicken breast (cubed) 4 8-inch whole-wheat tortillas
Preparations In a medium bowl, mash half of the avocado chunks with yogurt and lime juice. Add the remaining ingredients, including the rest of the avocado chunks. Mix gently. Top each tortilla with ¼ of the filling mixture. Roll up each tortilla and tuck in ends. Slice in half diagonally, securing with toothpicks, if needed.
Page 23 of 50
P E P T A L K VOLUME 8, ISSUE 6, J U N E 2 0 2 0 P A G E 3
The EXPERT in anything was once a BEGINNER
Lexi Akey Joshua Chubbs Catilynn Fogarty Mikaylah Henderson Universal Worker I.S. Intern Universal Worker Universal Worker
Emma Kangas Abby O’Brien Sara Sievers Universal Worker RN Universal Worker
JUNE 2020 IN-SERVICES MILESTONE ANNIVERSARY Due June 30, 2020 Jennifer Johnson: 30 Years Relias: Mandatory - ALL STAFF: Bloodborne Pathogens Jennifer has been with the Pavilions since Relias: Mandatory - ALL STAFF: Severe Weather and 6/4/1990 - 30 years! She has worn many hats Tornado Watch and Warning in her years of service and does so with a willing- Relias: Mandatory - ALL STAFF: All Page and Code Status ness to help all departments and with a Relias: Mandatory – LICENSED NURSES AND smile. Jennifer has served in clinical administra- tion for the past 10 years supporting all of the CERTIFIED NURSE AIDES: Care of the Cognitively Impaired clinical departments with efficiency and kind- Relias: Mandatory – COTTAGE MED PASS TRAINED STAFF: ness. She is an integral Medication Administration: Avoiding Common Errors part of our organiza- In-Person: Mandatory – CERTIFIED NURSE AIDES: Annual tion. Over the past 5 Clinical Skills Competency years, Jennifer has be- come a grandmother to June 22-25, 2020 by appointment only, two beautiful grandchil- Call Staff Development to sign up for a time slot dren. Thank you, Jen- nifer, for your 30 years of Relias Link: https://gtp.training.reliaslearning.com service to the Pavilions!
Page 24 of 50 VOLUME 8, ISSUE 6, J U N E 2 0 2 0
Just for a moment, forget what you have heard about sunshine, skin cancer and harmful ultra-violet radiation. Summer has arrived and that means hotter and sunnier days are here! When natural sunlight hits the skin it triggers the body’s production of Vitamin D. Vitamin D is also known as “the sunshine vitamin.” It is a crucial ingredient for overall health; pro- tects against inflammation, lowers high blood pressure, helps muscles, improves brain function and may even protect against cancer. Low levels of vitamin D can cause heart disease, prostate cancer and dementia. Your body is meant to be in the sun, and exposure to sunlight during the day is crucial to your wellbeing. It is advised to get at least 10-15 minutes of sunlight daily. Exposure to sunlight has a huge impact on battling depression, seasonal affective disorder and sleep quality. Ac- cording to Forbes, “in 2012, 60 million Americans filled prescriptions for sleeping pills, up from 46 million in 2006 (as reported in The New York Times).” Adding a little sunshine to your life can even promote weight loss! The warmer months allows for fun outdoor activi- ties. Go on a hike, take up a new sport, go for a run, bike around your neighborhood or even plan a camping trip. You will be surprised to see what spending a little time outdoors can do for your health.
Retirement is not the end of the road. It is the beginning of the open highway.
Three long-time employees of the Pavilions began their retire- ment in May. Peggy (ADON) and Mark Baranski (MDS Coordina- tor) (left) retired after 30 and 15 years respectively. Shawn Burt (Social Worker) (right) had more than 18 years of experience. They will all be missed. We are thankful for all of their years of service and wish them many, many miles on their open highway.
NATIONAL NURSING HOME WEEK The week-long celebration presented many opportuni- ties to win prizes, including this guessing game. Can you name all of the employ- ees in the hive? Congratula- tion to Sadie Lovano who successfully named all eight
employees correctly!
Gratton Darcey 8.
Prance Amanda 7.
Baranski Mark 6.
Edmonson Holly 5.
Sych Heidi 4.
Leach Katy 3.
Baranski Peggy 2.
Spencely Drew 1.
Page 25 of 50 MAY, 2020 Media Report
Broadcast Report:
WTCM-FM: Recruitment/Join the Team Broadcast advertising ran from May 1 – May 31, 2020. Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
WTCM-AM: Recruitment/Join the Team Broadcast advertising ran on May 7, 11, 20 and 29, 2020. Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
WKLT-FM/WBCM-FM: Recruitment/Join the Team Broadcast advertising ran from May 1 – May 31, 2020. Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
WCCW-FM: Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
WCCW-AM (ESPN) Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
WJZQ-FM Concerts on the Lawn – Goes Radio Retro Broadcast advertising ran from May 28 – May 31, 2020.
Record Eagle: General Recruitment May 3, 2020 Grand Mission May 10, 2020 General Recruitment May 17, 2020 Concert on the Lawn May 24, 2020 Concert on the Lawn May 31, 2020
North Coast/Record Eagle: General Recruitment May 2, 2020 General Recruitment May 9, 2020
Page 26 of 50
Digital Campaign Results
Digital Career advertising begins May 20, 2020 Digital Obits advertising begins May 15, 2020 May digital campaign results and updated campaign performance overview.
50,804 impressions in May from people in Northern Ml who have interests/behaviors relating to job seeking, job searches, nursing jobs, etc. That's 804 over contract amount at no cost to you! 91 clicks in May to the website, which equates to a 0.18% CTR that is almost double the 0.1%national average for targeted digital! That's an increase from 79 clicks and a 0.16% CTR in April! Top Geographic Areas: Traverse City, Cadillac, Mancelona, Charlevoix, Lake City, and Lake Ann. Placing their pixel would allow for us to track additional branding and conversion actions for them.
Obituary Ad online Results:
Obituary advertising begins 5/15/2020.
63,216 views in the exclusive Obituary Sponsorship position in less than one month ... reaching the assisted living demographic of 50+. (Note - 57,637 of those were in the 2 weeks of May alone) 21 people clicked through website to view page for donations. (Note: 17 of those were in the first 2 weeks of the campaign.)
Page 27 of 50 Page 28 of 50 Page 29 of 50 through UMHR will be a good indicator as to the potential success of hiring and assimilating foreign-born Certified Nurse Aids in the same manner.
The monthly Safety Committee meeting was May 12. Mallory presented a summary of April’s employee incident/ accident statistics. There were 12 employee incidents during April. There were 60 restricted days and 0 lost time days. The Safety Committee discussed the need for a descriptive emergency code system. A committee was formed and will meet in early June to create a proposal for the new system.
On May 1, Allen initiated writing the articles for the May Legacy Magazine as a special edition celebrating the dedication of our staff as they care for our residents and prevent the spread of COVID-19 in our facility.
On May 2, Allen completed a guest article “Caregiving During COVID-19 at Grand Traverse Pavilions” – to be reprinted in Grand Traverse Woman Magazine celebrating our clinical leadership and front-line caregivers.
On May 4, Allen met with Jena Capriccioso, Marketing/Development Administrative Assistant, and Jessi Weir, Marketing/Development Assistant to discuss the action items for Marketing and Event planning for the organization. Specifically, the team discussed service line recovery efforts and re-organizing community engagements through the Concerts on the Lawn to a broadcast format, including the solicitation of sponsorships to make the event a low/no-cost endeavor.
On May 4, Allen worked with Rose Coleman, Chief Operating Officer - Clinical Services to implement the initial “Family Weekly Update” of services and organizational processes/policies in response to the COVID-19 pandemic. The intent is to produce the updates from information provided by Coleman, and then post them on the organizations web site for resident responsible parties and families to review for valuable/important information regarding resident care status.
On May 8, Allen and Weir coordinated the Annual Events Committee via phone conference call to update the Committee on options to restructure the annual fundraising event Concerts on the Lawn into a virtual format. The concept to rethink the summer concert series has received initial support from Title Sponsor Serra Subaru of Traverse City, the Michigan Council for the Arts and Cultural Affairs and Media Partner Midwestern Broadcasting, however the platforms being considered; either social media or a radio broadcast are still being vetted. Additionally, initial discussions with the local bands has confirmed their willingness to participate once the Governors Executive Order allows groups of ten to “gather”.
On May 8, Allen coordinated with Environmental Services for the installation of the “National Nursing Home Week” banner to celebrate the event internally.
On May 11, Allen coordinated with the TBAISD Career Tech Center for the delivery of more than seventy-potted flower plants to be distributed throughout the Pavilions facilities to enhance beautification and morale. Several of the plants were directed to Human Resources for a daily drawing for employees during National Nursing Home Week as appreciation for our teams extraordinary efforts. Page 30 of 50 2
On May 18, Allen conducted an on-air interview with Christal Frost regarding the revised format for the Concerts on the Lawn Goes Radio Retro.
All volunteer activity suspended in mid-March continued throughout the month of May due to the threat of COVID-19, therefore, no volunteer hours are reported in May.
The total Social media post reach for May was 13,788 individuals. There were 49 “Page Followers” in May. The Facebook announcement featured on May 1: “Hope, Springs, Eternal, Just like the ducks returning to the Grand Traverse Pavilions” that featured a video clip of ducks had an estimated reach of 8.7K and 663 engagements. The Facebook post featured on May 14: “ Birthdays Have Not Been Cancelled....Vera Riley recently turned 103 years young, and so far she has received over eighty “Happy Birthday” well wishes…Please remember the importance of notes and well-wishes to our Residents, and your elderly loved ones. The community can send electronic notes of encouragement to [email protected]” had an estimated reach of 5.2K and had 1,204 engagements.
Grand Traverse Pavilions Website received 14,348 visitors (page views) in May. Employment Opportunities page visits totaled 1,133.
Coleman continued to lead and facilitate the Incident Command Team in efforts to prevent the spread of COVID 19 to our facility.
On May 12, the State of Michigan conducted a second infection control focused survey. There were no citations.
There were three retirements for the month of May: Mark Baranski MDS Coordinator (15 years), Peggy Baranski, ADON (30 years) and Shawn Burt, Social Worker (18 years).
In May, there were seven facility reported incidents.
Throughout the month of May we had 51 admissions, including re-admissions from Munson Medical Center. Five of those admissions were admitted from our continuum of care and 3 were from our waiting list. We received 98 referrals from Munson and 6 from other hospitals in the surrounding area. Seven of our Rehab Center residents transferred up to our long-term care.
There were 43 discharges for the month of May. Six residents passed away, 25 residents were discharged to home, 2 residents went to other facilities, 2 residents returned to the cottages, and 8 were discharged to Munson.
There were four medical record requests completed in the month of May 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.
Edmondson actively participates in the Incident Command Team as the Infection Preventionist, maintaining daily pre-admission screening for all potential admissions, Page 31 of 50 3
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 for May include: All Staff: All Page and Code Status, and Fire Safety: The Basics. Licensed Nurses and Certified Nurse Aides: Understanding the Meaning Behind Behaviors. Certified Nurse Aides and Universal Workers: Oxygen Safety.
Jamie Wilson, Director of Certified Nurse Aids and Katy Leach, Staff Development Coordinator, continued the employee monitoring system with 27 visits to staff that are systematically followed up with during their first 3 months of employment or on an as needed basis.
Staff Development created and distributed daily COVID-19 updates, and created multiple educational pieces for staff members.
The following orientations were completed: 7 CNAs, 4 Universal Workers, and 1 Licensed Nurse. Med pass training was completed with 1 Universal Worker. Staff Development continues to monitor and administer new hire immunizations. Staff Development initiated a review of all staff members’ health records to confirm that all immunization requirements have been meet.
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, a follows up with restorative staff to ensures appropriate documentation is recorded. In lieu of group exercise, therapists have been doing restorative programs and 1:1 exercise programs.
Quality Assurance Studies completed for May included: monitoring medication storage/ refrigerators to ensure proper temperature, and no ice buildup accumulates, as well as the completion of equipment checklist. This QA is completed weekly and all areas of concerns are addressed immediately.
A study done on call light response times was completed during the month. Kristen Packard, Director of Nursing, is monitoring call light response times via report to ensure calls are answered in a timely manner. CQI/ Nursing completed QA to ensure lights are answered timely and in a dignified manner.
A QA study was completed this month on repositioning / bed mobility to ensure the appropriate technique is used. This study was completed weekly during this month. An infection prevention QA for COVID-19 was completed weekly during the month of May to ensure staff understanding of virus and prevention of spread. All concerns Page 32 of 50 4 were addressed immediately.
A monthly study was completed on knowledge of CPR (Cardio Pulmonary Resuscitation) and the Policy for using the Nurse All Page system.
A quarterly study on Independent Safety of Residents outside the facility has been completed in May.
The CQI Coordinator and team continue to track psychoactive medication use.
Packard worked with the clinical administrative staff on schedules, revising policies, employee illness tracking, and ensuring compliance with infection control practices. Packard and the other administrative nurses have assisted in covering the employee screening and following up with employee illness. We have instituted a telehealth call between the employee and infection control nurse on the date of their call in. At this time, they are directed to stay home, return to work, and follow-up with their primary care physician. 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
We continue to revise policies and infection control practices as mandates are released by CMS. In the month of May, we began providing the residents with tissues to cover their mouth and nose during care as well as routine hand sanitizing. This is in addition to their routine handwashing. We continue to find new ways of providing meal service while maintaining social distancing. Other items under review include window visits, opening the courtyards, and family transporting residents to appointments, employee travel, and survey readiness. Window visits are expected to begin June 4 with the policy required several revisions throughout the month of May. The courtyards were opened at the beginning of the month and residents have been utilizing them. This has required only minor clarifications with regard to how to access the courtyards for those that do not have pavilion entrance, number of residents permissible at one time, option to go outside without accompaniment etc.
Packard 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. During the month of May, Packard worked with Medline to learn more about how the products will be delivered and disseminated throughout the organization. Packard is in the process of completing all of the order forms of which must include demographics, treatment orders, product information, and patient agreement.
With continued regards to the guidelines in place with COVID-19 and not being able to gather residents together for small or large group activities, Life Enrichment staff continue to spend part of their day/shift assisting residents on the pavilions with their daily care needs and meals along continuing to provide individual social visits, manicures, reading, playing board games, writing letters and more.
Kazim and Recreational Therapists have continued to see approximately 11 residents a Page 33 of 50 5 day (All Pavilions, Monday-Friday) to assist them in video chatting with their family members either by FaceTime, Google Duo, Facebook Messenger or ZOOM. In May, 241 video chat visits were held with each visit taking approximately 20 minutes. Holly continues to assist residents with telehealth appointments as well. Family members continue to contact their pavilion social worker or the recreational therapists to schedule the video chat. Residents continue to be very open to this new way of seeing and talking with their family members and have really enjoyed themselves.
Our Pavilions family community and the greater community at large, continue to bless our residents and staff with donations of puzzles, magazines, greeting cards with comforting words, food and snacks.
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 (OVS) television channel. Residents have asked to continue this way of playing bingo even when the COVID restrictions are lifted and they are able to play their beloved game in a group setting again.
The month of May also brought about ducklings being born in the Birch and Cherry Courtyards. The annual Ducks on Parade took place on a Friday afternoon with the ducklings and their mommas being led out of the courtyards, into the building and through activity rooms, to the back yard after a couple of weeks of getting bigger and stronger. A video was shared on the Grand Traverse Pavilions facebook page and garnered many “likes and shares!”
As the weather has become nicer out, many residents and staff are getting out into the courtyards on a daily basis to enjoy the fresh air and sunshine, with assurance to adhere to the social distancing guidelines.
Social services handed out 20 discharge surveys in May.
On May 7, Holly Kazim Dementia Services Director, Social Work supervisor participated in the MCMCFC Webinar with MyInnerview for the facilities annual resident/family satisfaction survey. The Pavilions is part of cohort 1, with surveys to be mailed out June 10 and returned by July 3. The results should be available around July 10.
On May 13, Kazim attended a webinar by Teepa Snow about Providing Dementia Care During COVID-19 Q&A.
On May 18, Kazim facilitated telehealth medical rounds with Dr Engel.
On May 21, Kazim attended a webinar Dementia and COVID-19: How to Help People Living with Cognitive Changes.
Holly Kazim has had regular weekly contact with Hospice providers and palliative care as their contact person regarding our rules of who is allowed in our facility and working out details for telehealth visits while assisting residents and providers during the telehealth visits. Two new palliative care consultations were set up in May and will be conducting Page 34 of 50 6 meeting through tele med.
Social workers continue to utilize more time facilitating social visits and keeping families informed.
May resident council did not take place however social workers met with residents individually to check in and completed minutes.
No tours for prospective residents were provided in May due to visitor restrictions.
The Wellness Center saw the following patients this month: Medicare A: 42; Medicare B: Outpatient: 18; Medicare B: Inpatient: 27; Private Insurance: Outpatient: 4; Private Insurance: Inpatient: 1; Work compensation: Outpatient: 0; Private pay: Outpatient: 0; Private pay: Inpatient: 2. Auto: Outpatient: 2; Auto: Inpatient: 0.
On May 5, Amy Coneset, Wellness Center Director, participated in a phone meeting with Tara Townsend, Physical Therapist and consultant from Impact Wellness and Rehab, regarding Wellness Center Outpatient Therapy reopening plan.
On May 7, Coneset, Timothy Zmudka, Speech and Language Pathologist, Jessica Cobb, Occupational Therapist, and Kathryn Holibaugh, Administrative Assistant, participated in the quarterly Utilization Management Review (UMR) meeting required for outpatient certification.
On May 18, The Wellness Center Outpatient Therapy department reopened to the community for skilled therapy needs.Therapy staff continue provide 1 on 1 in room exercise opportunities for residents who had been participating in group exercise as time allows.
For the Cottages, in the month of May, there were no admissions, two discharges, two in-house transfers, and one death. Nurse Practitioner Greg Morrison visited The Cottages weekly with a patient load of thirty-nine. No new patients acquired in May. A Foot Clinic was held on May 13 with 29 participants.
Due to visitor restrictions there were no tours of The Cottages in May, however Director Mack has been using technology to work with interested parties by sending photos, videos and virtually touring with multiple parties.
At the Cottages, mothers were celebrated on May 8 with a tea party, music virtually from Mary Sue Wilkinson, receipt of a wrist corsage and special treats. Life Enrichment Coordinators have kept busy facilitating virtual visits with residents and loved ones via FaceTime, Google Duo, and Zoom. Exercise continues daily, church services are well attended and Sundaes on Wednesday’s is a resident favorite. With the weather improving we have been able to hold social gatherings on the porches of The Cottages while maintaining social distancing requirements. With the Adult Day program closed in May, Life Enrichment Coordinator Musser is screening each Cottage resident daily and facilitating virtual visits for Willow residents.
On May 1, Dood attended a webinar by Miller Johnson titled “Elder Law Issues for Page 35 of 50 7
Caregivers During COVID-19 & Beyond”.
On May 6, 15, 20 and 27 Dood attended the Safe and Calm webinar by Leading Age.
On May 7, Dood had a telephone conference with Alex Bruno, Salesperson, with PointClickCare to discuss the potential for utilizing PCC in conjunction with myUnity for billing, A/P and general ledger. Learned of new PCC module to automate budget tracking and electronic approval of PO’s and invoices.
On May 18, Dood attended “An Investment Update from MERS” webinar.
On May 28, Dood held a call with Nicholas Cook to discuss Comdata’s pay card product.
During May, Barnes completed the review and purchase of a thermal scanning camera. The expected delivery date is 6-8 weeks due to high demand resulting from the current pandemic.
On May 6, Barnes and D. Mallory, Human Resources Director, continued discussions with representatives from Smartlinx and Deltek regarding employee evaluation software. Although promising at first, Barnes and Mallory have decided not to pursue further conversations with Deltek. Initially it was thought the Deltak software would integrate with Smartlinx. However, it was determined the two programs would not integrate, defeating the purpose of our working with Smartlinx to have a fully integrated system. A few days afterward, Smartlinx representative spoke again with Barnes and Mallory and asked them to work with Smartlinx to develop and test a new module that is being developed within Smartlinx.
On May 14, Barnes and Mallory joined with Teamster’s Business Representative for a discussion regarding employee facemasks. The union had a concern about the way the Pavilions was handling a fee for new facemasks if employees lose them. Avoiding a grievance, Barnes and Mallory were able to come to an agreement with the business representative on a different way to handle the lost mask fee.
Dan Butler, Information Services Director, worked with medical records to setup and test an ipad to be used for Telehealth.
Butler researched a mass communication product to be used to notify families of updates. Butler setup an account with Call-Em-All, which is a robo calling program that allows GTP to mass call resident families.
Butler made multiple trips to PACE North building site to review nurse call, security doors, and security monitoring (motion sensors). Butler setup a new office for the new nurse practitioner in the provider’s office.
Butler and Darcey Gratton, Administrative Services Director, worked with Dave Mengyan at Lux interactive throughout the month of May to create a custom visitor screening/log-in kiosk that will require visitors and employees to answer specific screening questions and to enter their name before they enter the building. This new Page 36 of 50 8 kiosk will have the ability to print out a visitor tag to help identify those that are in the building for residents or vendors visiting specific departments. During the month of May, all labor fees involved in creating this new software were waived by Lux interactive. These new kiosks are expected to be installed by the end of June .
Of the 19 external interviews scheduled for the month of May, a total of 12 individuals were extended conditional offers of employment.
Seven employees were hired in May. New employee orientations were held for 4 UWs; 1 licensed nurses: 1 CNA: and 1 Information Systems Intern. Fifty-five people have been hired in 2020.
In May, 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 43 applications received in May. Down from 83 in April and 97 applications received in March.
For the Month of May, there were a total of 7 terminations. Of those 7 terminations, 3 retired, 3 were voluntary and 1 was involuntary. There have been 60 terminations in 2020.
In the month of May, the CNA Bonus Program yielded payments of $50.00 to 55 CNAs; $100.00 to 15 CNA’s; $150.00 to 29 CNAs that met the requirements.
There were no employee referrals received through our Employee Referral Bonus Program in May. To date we have paid the bonus to 35 employees for referring individuals and we have distributed 11 $25 gift cards for referring an applicant who were not considered for employment.
In May, 51 employees utilized the Beech Gym.
National Nursing Home Week was celebrated during the week of May 10-16. Meals or snacks were provided each day of the work week.
The maintenance team completed 609 separate work orders during May. Additionally, there were 34 wheelchair work orders completed.
The monthly fire drill for the main building was May 20 at 4:00 PM. For the Cottages, fire drills occurred May 17 at 5:00 PM for Evergreen, May 4 at 9:00 PM for Hawthorn and May 14 at 8:00 PM for Willow. There were no actual fire codes in May. Cottage fire drills have been modified due to the COVID-19 pandemic. Code red pages are no longer called over the all-page system, to prevent main building staff from coming to the cottages. Fire drills are held just for the staff at the individual cottage, and using it as a training exercise for them (ensuring all staff know how to lock out the elevators, assist residents to their rooms, etc.).
There were 46 room preparations at the main building. including 38 for Rehab and 8 Page 37 of 50 9 from units Aspen through Elm. In addition, there was 1 preparation at the cottages due to room vacancies from discharges and residents moving between rooms.
During the month of May, there were 51 appointment bus runs and 0 group bus runs.
On May 18, Coggins met with Ken Goodhue and Dave Lyons of ABI Mechanical to assess the Willow domestic water boiler. Their recommendation was a complete replacement of the boiler, as the heat exchanger and burner needed replacement. Replacing these items would cost more than a new boiler. On May 20, ABI Mechanical replaced the Willow domestic water boiler.
On May 22, Maintenance staff changed out plumbing drain lines from the kitchen. These lines have experienced several leaks from the kitchen into the child care area over the last few years.
On May 28, due to heavy rain, the Pavilions buildings experienced minor water leakage into Maple Pavilion near the courtyard, the IS office area, and Evergreen cottage basement. The staff did a remarkable job of keeping the water at bay, as well as the subsequent cleanup.
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Page 39 of 50 Page 40 of 50 Page 41 of 50 Page 42 of 50 Page 43 of 50 Page 44 of 50 Page 45 of 50 Page 46 of 50 Page 47 of 50 Grand Traverse Pavilions Foundation Board of Trustees 2020/2021
Dennis Prout (2009) - President 2014
Cynthia L. Klingler (2009) - Vice President 2015
Christopher Chang (2010) - Treasurer 2017
Kory Hansen (2008) - Secretary 2008
Betsy Aderholdt (2017)
Bill Brown (2017)
Penny Hanks (2017)
John Harvey (2018)
Agnes Hayden (2009)
Deb Jackson (2015)
Brad Mackler (2017)
Barbra Mikowski (2013)
Ramona Pleva (2019)
Jenn Simmer (2019)
Anne Spieles (2009)
Jan Warren (2017)
Mike Watkins (2019)
06/2020
Page 48 of 50 GRAND TRAVERSE COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES BOARD 1000 Pavilions Circle, Traverse City, MI 49684 Telephone Number: 932-3000
Resolution 2020-2
Grand Traverse Pavilions/Grand Traverse Medical Care
COVID-19 TEMPORARY WAGE ADJUSTMENT
WHEREAS, Grand Traverse Pavilions (GTP) employs over 300 dedicated and conscientious staff, who provide healthcare and support services to over 300 vulnerable aging adults; and
WHEREAS, the state of Michigan has been under a declared State of Emergency since March 10, 2020 due to the COVID-19 virus pandemic; and
WHEREAS, GTP recognizes the unique and unprecedented circumstances of all staff needing to adjust to a new “normal” operating environment, incorporating modified routines and implementing and adhering to new policies and procedures at a rapid pace that are critical to the health and safety of both residents and staff; and
WHEREAS, in response to the COVID-19 pandemic, the State House and Senate have unanimously passed and the Governor has expressed she will sign, SB 690, providing, among other items, that certain direct care workers in skilled nursing facilities, a temporary two dollar per hour wage increase from July 1, 2020 through September 30, 2020; and
WHEREAS, GTP must comply with the law that will become effective upon the Governors signature; and
WHEREAS, GTP seeks to recognize every employee in an equitable manner, avoiding morale issues and desiring to extend the same economic incentive for all employees, encouraging the on-going efforts to combat the COVID-19 virus;
THEREFORE BE IT RESOLVED, GTP will provide those non-direct care workers, excluded from the SB 690, a temporary two dollar per hour wage adjustment for all hours worked between July 1, 2020 and September 30, 2020, with all other procedural requirements to be consistent with the Bill, subject to the Bill 690 becoming law.
APPROVED ____ DISAPPROVED ____ at the June 26, 2020 meeting of the Grand Traverse County Department of Health and Human Services Board.
______John Rizzo, Chair Grand Traverse County Department of Health and Human Services Board
______Date
Page 49 of 50 GRAND TRAVERSE PAVILIONS Service Excellence Award Program May 2020
Date: 05/06/2020 Employee: Marta Pratt Thank you for stepping up and helping everyone stay positive in these tough times! You’re always willing to assist with any questions by staff without ever putting them Awarded for: down. Our Cherry staff as well as our residents really appreciate your hard working, kind, and caring heart. Thank you, Marta! Position: ADON Nominated by: Kelli Kelley
Date: 05/13/2020 Employee: Nikki Dobson Nikki constantly goes above and beyond by helping with resident care and helping start Awarded for: the next shift off on a good foot with medications being passed. Thank you for your super hard work, Nikki! Position: LPN Nominated by: Kelli Kelley
Date: 05/20/2020 Employee: Kirk Mallow Many thanks for the great plumbing upgrade at Evergreen. Awesome job you and Rick Awarded for: did and it’s much appreciated! Position: Maintenance Nominated by: Jeff Valentine
Date: 05/27/2020 Employee: Khal Chriba Thank you for going above and beyond while taking care of the residents, you are Awarded for: extremely helpful and always willing to be a team player. Your hard work never goes unnoticed. Position: CNA Nominated by: Nikki Dobson
Date: Employee: Awarded for: Position: Nominated by:
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