Vrable Healthcare, Author at THE GRAND

As Valentine’s Day Approaches

February 5, 2021

Dear Families, Friends and Staff Members

ValentineFebruary and Valentine’s Day are about love.  As Valentine’s Day approaches, The GRAND would like to make it easy for our community, family, and friends to send our residents and your loved ones a special message to let them know someone is thinking about them on this holiday.

We ask you to take this as an opportunity to make a person’s day feel special. We would like to invite you to send a Valentine’s Day Message to your loved one or to any resident to brighten their day.

Send a message to one of our residents letting them know someone is thinking about them by going to http://www.grandofdublin.com/resident-valentine-messages.

Blu Johnson, Administrator

Resident Valentine Messages

Send a Special Valentine’s Day Message to a Resident at The GRAND of Dublin

February and Valentine’s Day are about love. As Valentine’s Day approaches, The GRAND would like to make it easy for our community, family, and friends to send our residents and your loved ones a special message to let them know someone is thinking about them on this holiday.

We ask you to take this as an opportunity to make a person’s day feel special. We would like to invite you to send a Valentine’s Day Message to your loved one or to any resident to brighten their day.

Send a message to one of our residents letting them know someone is thinking about them by filling out the form below. If you do not a have a specific resident you want to reach, simply leave the Resident Name field blank.

Please select a valid form

Managed Care Insurance

Managed Care Insurance

Jessica Leffler
Business Office Coordinator
The GRAND of Dublin

When it comes to insurance, there are many different types and this can cause confusion among both residents and family members. Managed Care Insurance is a common type of insurance that is sometimes hard to understand how it works. For example, there is many types of Medicare that are managed by other insurance companies such as Aetna and Humana. Both Managed Medicare’s and Traditional Medicare have similarities, such as both require a 3 day inpatient hospitalization prior to admission to a Skilled Nursing Facility, have a 100 day benefit period and require a sixty day break in between benefit periods to be covered.

Unlike Traditional Medicare, where the facility is able to determine if the person is still at a skilled level of care or not, Managed Medicare is managed by the insurance company such as Aetna and Humana and require updates from the Skilled Nursing Facility to determine continued eligibility. Often times, these Managed Care plans only offer the beneficiary only about fourteen to twenty-one days even though their policy states they have up to a hundred days available. When an update is requested, the Skilled Nursing Facility is required to send updated skilled notes, therapy notes, physician notes and orders and other items they may ask for. Based upon these items, the insurance company then either decides to continue paying for the resident’s stay or they issue a NOMNC, which is a Notice of Medicare Non Coverage. Once the NOMNC is issued, the resident or family is able to call a third party entity, known as Livanta to file an appeal if they do not agree with the decision. During this appeal process, the resident will continue to receive all skilled care including therapy services. If it is found that the NOMNC is upheld, the resident has 48 hours’ notice to discharge. If the resident wins the appeal, they will be assigned another review date by the insurance company, usually a week later.

COVID-19 Vaccinations

The GRAND of Dublin is pleased to announce our enrollment in the Long Term Care Pharmacy Partnership Program through the CDC.  This program will provide safe COVID-19 vaccinations for our residents and staff.  The CDC has recommended Healthcare workers and long term care residents as the highest level of priority for the first distribution of the vaccine.  These vaccinations will be offered free of charge to our residents and staff, and your loved ones.

The COVID-19 vaccine is projected to be available later this month pending emergency use authorization by the FDA.  The 2 types of vaccines that are projected to be available in Ohio are Moderna and Pfizer, mRNA type vaccine).  Both will require 2 doses to be given, 3-4 weeks apart.  Trial studies have shown a 95% efficacy rate after the 2nd dose. Less than 10% of those in the trial had any side effects with fatigue being the most common.  No vaccines are 100% effective but this will greatly reduce your risk of getting sick with COVID-19 and spreading the virus.

While mRNA is new in vaccine development, this technology has been used successfully in cancer treatments. The goal of mRNA vaccines is to give your body the tools it needs to fight COVID-19 effectively and/or prevent you from getting it at all.  According to the CDC, mRNA vaccines give cells instruction for how to make proteins that are unique to the virus. Our bodies recognize the protein should not be there and it builds antibodies that will know how to fight the virus if we are infected in the future.

None of the proposed vaccines contain live or killed virus particles like many other vaccines. 2 treatments has been shown to be safe and is required to make sure your body has enough antibodies to fight off COVID-19.

Facility will continue all required precautions and use of personal protective equipment (PPE) after vaccinations are administered per CMS and CDC guidance. Current information suggests that the vaccine takes 4 weeks after the 2nd dose to generate antibodies.

Are you asking yourself, “how do I sign up myself or my loved one for the vaccine”?

As soon as the vaccines have been authorized, our pharmacy partner will contact the facility.  The facility will then begin the consent process for our staff and residents.  It is crucial to make sure that the facility has current contact information and that consents are responded to promptly.

The vaccination clinic dates and times will be announced and posted for residents and staff.  Once we have set times or know more specifics, resident families will be notified.

Day After Thanksgiving Salad

Day After Thanksgiving Salad


  • 1 tablespoon butter
  • 3/4 cup chopped walnuts
  • 1 tablespoon sugar
  • 1 package (8 ounces) ready-to-serve salad greens
  • 3 cups cubed cooked turkey breast
  • 1 small red onion, sliced
  • 1 medium sweet yellow pepper, sliced
  • 1 cup grape tomatoes, halved
  • 1 cup chow mein noodles
  • 3/4 cup jellied cranberry sauce
  • 3 tablespoons seedless raspberry preserves
  • 2 tablespoons balsamic vinegar
  • 4-1/2 teaspoons vegetable oil
  • 1 tablespoon water


  1. In a small skillet, melt butter over medium heat. Add walnuts; cook until toasted, about 4 minutes. Sprinkle with sugar. Cook and stir until sugar is melted, 2-4 minutes. Spread on foil to cool.
  2. In a large bowl, combine the salad greens, turkey, onion, pepper, tomatoes, noodles and sugared walnuts. In a blender, combine the remaining ingredients; cover and process until smooth. Pour over salad and toss to coat.

Nutrition Facts
1-1/2 cups: 464 calories, 21g fat (3g saturated fat), 78mg cholesterol, 136mg sodium, 40g carbohydrate (23g sugars, 4g fiber), 32g protein.

Answering Admissions Questions

Answering Admissions Questions

by Danielle Batdorff, BSHA/HIS
Director of Admissions
The GRAND of Dublin

If a person has never been through the process, the thought of entering a skilled nursing or rehab facility can be a little overwhelming. It’s natural to have several questions. We’ve put together a list of the most commonly asked questions to help you better understand what to expect.

What is skilled nursing?

Skilled nursing is a type of intermediate care in which the patient or resident needs more assistance than usual. This setting is designated for physical, occupational, and speech therapies, to aide in strengthening the patient who has a goal of returning to their home at baseline. Skilled nursing services are offered to patients who need IV medications administered, who may have wound care needs, or who may need teaching on medication management, an example of this would be newly diagnosed diabetics.

What is the difference between short-term care and long-term care?

Short term care is a temporary solution that may last from a few days to a few months. Long term care is typically utilized for in-house placement for the duration of the patient’s life.

What social activities are offered?

Skilled nursing facilities offer a full calendar of social events and activities. Residents are encouraged to join in as many activities and social events as they like. Some examples include; art classes, ice cream socials, bingo and cards, game and movie night, quest performers and church services.

In addition, they offer wellness programs, exercise classes, beauty salons, small dining areas, café and restaurant style dining rooms, and outdoor sitting and walking areas.

What should I bring with me?

It is recommended that you bring comfortable clothing for working out in therapy along with good fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork).

What are the rooms like?

Some facilities offer both single and double occupancy rooms. Each facility has its own characteristics which make it unique and sets it apart from the other down the street. An example; The GRAND offers single occupancy rooms with walk-in showers, individual heating/cooling units, refrigerators, Wi-Fi and cable. Patient’s medications are locked securely in each patient room and we strive to provide a home like atmosphere.

What does Medicare cover?

Medicare part A covers skilled nursing care under certain conditions for a limited time.

  • You must have a qualifying hospital stay. This means you meet the minimum 3 night inpatient hospitalization requirement.
  • You have part A and days left in your benefit period.
  • Your doctor has ordered skilled services due to a medical condition which requires the need for 24/7 nursing care and therapy services offered 5 to 6 days a week.

Medicare covered services include;

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical and Occupational Therapy
  • Speech-Language Pathology Services
  • Medical Social Services
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers ones health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary Counseling

Medicare information be obtained through Medicare.gov

How do I find out what my insurance will cover?

Insurance benefits and eligibility will be checked prior to admission to the building, but you may also call the member services number on your card and a customer service representative will provide you with details of your coverage options.

What is the next step and what can I expect once I select a facility?

Once you have selected a facility you will notify your hospital social worker and he/she will send the referral to the building for review. You may choose to tour the building. Your clinical is then reviewed by the admissions and nursing team to make ensure the facility can clinically manage your stay, and then the hospital liaison will visit you in the hospital to answer any questions you may have. If you need an authorization from your insurance to admit, the facility will then start that process. Once authorization has been received the facility will communicate with the hospital social worker.

What are your staffing ratios?

At The GRAND skilled setting, our ration is 1:12 or 1:13, with an STNA on each hall. Our staffing ratios are significantly above average.

How often is therapy provided and will I have a schedule?

Therapy is provided at the discretion of your ordering physician, the therapy team, and your needs. You can ask for a specific schedule if that works better for you. At The GRAND, the therapy team will meet with you either the day of your arrival or the next day.  An example, some prefer mornings, some prefer afternoons and some prefer to have their therapies separated. Meaning occupational therapy may be planned for the afternoon and physical therapy planned for the mornings.

What sets your facility apart from the others?

The GRAND offers several amenities that set us apart from our competitor’s. We have Digger and Finch pub, our ice cream parlor, Movie Theater, beauty salon, pharmacy, chapel, licensed in-house therapy team and team of dedicated nurses and STNA’s and low patient/staff ratios, we offer outstanding service to our residents.

What are your visitation hours and/or restrictions?

Each facility will have set hours of operation. The most common hours of operation most facilities follow are 8am to 8pm, 7 days per week. The GRAND’s hours are 8:30am to 8pm, Monday through Friday and 9am to 8pm, Saturday and Sunday. There may or may not be restrictions on when visitors can be with their moved one. The GRAND does not have such restrictions and provides security 7 nights per week.

Medicaid Pending

Medicaid Pending

Jessica Leffler
Business Office Coordinator
The GRAND of Dublin

MedicaidAs the Business Office Coordinator, working with all types of insurances is a daily occurrence within the facility. Medicaid Pending is different from typical insurance as BOC’s work with the family to gather information to submit to Job and Family Services (JFS) so the resident is able to get Medicaid. Some common things that JFS require when applying for Medicaid first is to fill out the application, which includes income information such as all bank account balances, life insurance policies (cash value amount is required) , social security, retirement accounts, pensions, annuities, etc. Also, if there is any properties such as cars or houses in the residents name, or if there is a spouse in the community. Other documents that are required is proof of citizenship which includes social security cards, birth certificates and drivers licenses.

If a resident owns a house, they are able to keep possession as long as they plan on returning to their house at some point and they submit that in writing to JFS. If there is a spouse in the community, JFS allows the spouse to keep the house and cars, and does not include their income in the residents break down of financials and assets. Medicaid has recently changed to this in the past few years, as many are still nervous that they will lose their homes and all the income just to receive Medicaid.

All assets combined need to be under $2000 to qualify for Medicaid. If they have more than the required limit, they are able to spend down the funds, which would include paying the residents bill privately at the facility and purchasing any items that the resident would need. One applying for Medicaid often has a misconception that they are able to gift property or funds that they have to a family member so they do not lose the items, but this can disqualify them from receiving Medicaid and delay the process for up to five years due to a penalization.

As the Business Office Coordinator, I am there to help any residents and family members with any questions/concerns that they may have with Medicaid or any other insurances. It can be an intimidating process and lengthy, so it is my job to make it easier for them as they are already dealing with transitioning into long-term care, or working on getting themselves stronger to go home.

Flu Season is Here

Flu season is here!  The GRAND of Dublin is now offering flu vaccinations to our staff and residents.

Flu season typically starts in October each year and peaks between December and February.  No year is a good year to get the flu, but this year is especially bad due to the Covid19 Pandemic. If you can avoid the flu, this will help reduce the burden on our already overwhelmed healthcare systems and prevent the transmission to at-risk populations like children not old enough to receive the vaccine, our precious elderly population, and those with compromised immune systems. The risk to these populations is severe.

You should do everything you can to prevent the flu, including handwashing, hand sanitizing and staying home when you are ill or exhibiting symptoms.  Handwashing and other preventative measures can help stop both COVID 19 and the flu.  Remember, both share many of the same symptoms (fever, chills, cough, sore throat, muscle aches, body aches, headache, and fatigue).  There is a risk this year of having both the flu and COVID 19 at the same time.   Providers will know more on how to treat the illness if they can rule out the flu do having a flu shot.  Keep in mind, it takes 2 weeks after vaccination to achieve full immunity, so social distance and keep away from those with flu like symptoms.

We ask that our residents, staff, families, and friends that may be visiting our centers get their flu shots.  CDC estimates that less than half of the population received their flu shots last year.  There are many fears and myths surrounding the flu shot.

  1. “It will give me the flu.” (It won’t).
  2. “It has so many bad side effects.” (Major side effects are very rare).
  3. “It won’t work anyway, they don’t know what type of flu we will have” (While it’s not perfect, it is based on the 4 biggest strains from the previous flu season).
  4. “Don’t need it, the flu isn’t anything serious”. (While some are only ill for a few days and experience minor symptoms, others may have severe illness and even death).
  5. “I will catch COVID while waiting to get my flu shot”. (Communities are offering outdoor clinics, one-on-one appointments and are required to follow proper prevention protocols).

So this flu season, wash your hands often, use hand sanitizer liberally, disinfect surfaces frequently, wear your mask, social distance, stay home when you are ill AND get your flu shot!



COVID-19 Update May 29, 2020

May 29, 2020

Dear Families, Friends and Staff Members,

Governor DeWine announced during his regular press briefing Tuesday afternoon that he is creating the Congregate Care Unified Response Team, which will start aggressive COVID-19 testing in all Ohio nursing homes.

All staff members in nursing homes will be tested.  Based on subsequent information received from the Ohio Department of Health (“ODH”), it is unclear at this time if ODH will test all residents.  Once ODH clarifies if mass resident testing will occur, we will update you as we are made aware of the next steps.

Continued Safety Measures:

The steps taken to limit risk and exposure include, but are not limited to, screening and monitoring staff, essential visitors and residents with temperature checks, oxygen levels, and vital signs up to three times daily. The Grand is encouraging social distancing and limiting visitation to only necessary situations including ancillary deliveries (food, drugs, etc.). We have asked staff not to work at other jobs and pushed all to “STAY HOME” if not at work. We have increased intensity and frequency of disinfection and cleaning. We aggressively review and screen all admissions. We currently have adequate supplies of protective equipment for staff and residents. We are monitoring the situation daily and adapting as needed to continue to provide the best quality of care. We discuss issues with and follow the guidance of our Medical Directors and Attending Physicians daily.

Communication Options:

If there are any specific updates about your loved one, rest assured, we will contact you directly.  We still encourage you to reach out to our residents.  The telephone is a viable option.  Remember you can leave a message for our residents at http://grandofdublin.wpengine.com/resident-messages or schedule a Skype call by emailing grand-family@grandofdublin.com.

We Remain In This Together,

Blu Johnson, Administrator