Industry news Archives - 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

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 Update May 15, 2020

May 15, 2020

Dear Families, Friends and Staff Members,

Governor DeWine announced this week that massage therapy, acupuncture, cosmetic therapy and tattoo parlors will be re-opening. Beginning Thursday, May 21st, campgrounds in Ohio will be permitted to reopen followed by gyms, fitness centers and non-contact sports leagues on May 26th. Public pools which can meet required safety protocols may also reopen in the 26th. Ohio childcare providers could reopen May 31st.

The governor addresses many businesses and sectors of the economy.  However, due to the risk posed to the elderly and immunocompromised, we are aware of no proposal to ease or update restrictions for Skilled Nursing Facilities.  So, we will continue to work diligently to reduce spread and exposure.

Mitigating Actions:

Risk mitigation started in early March and continues.  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.  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 are also discussing issues with and following the guidance of our Medical Directors and Attending Physicians daily.

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

COVID-19 Update April 7

April 7, 2020

Dear Families, Friends and Staff Members,

We hope this message finds everyone doing well, staying safe, and remaining in good health and spirits.  Everyone’s cooperation and embrace during this crisis has been exceptional.

We are asking for families to refrain from bringing in items to their loved ones. It is difficult, but another way that we are attempting to mitigate risk as we continue to learn more about the spread of this very serious virus. We are asking at this time, that this request also include mailed in items. The only items we are able to accept currently, are ESSENTIAL items. This would include items such as medications or incontinence supplies. Please understand, as soon as we are able to safely decrease restrictions, we happily do so!

I feel it is important to continue communications between our loved ones, family members, the community and medical professionals.  If you wish to be on our email distribution list, please reach out to The GRAND of Dublin at (614) 889-8585.

I will again direct you to our facility Facebook page.  The GRAND’s Facebook page is located at https://www.facebook.com/thegrandofdublin/ or by searching for The GRAND of Dublin on Facebook. At the facility’s page you can leave messages directly for our loved ones.  If you wish to leave a message, go to the following link and your message will be delivered. http://grandofdublin.wpengine.com/resident-messages/

To schedule a Skype video or group phone call, please call the facility at (614) 889-8585 and ask for the activity department, social work or email grand-family@grandofdublin.com for scheduling.

For safety, the facility continues to monitoring daily temperatures and respiratory symptoms of all staff members, our loved ones and essential visitors. We continue to monitor the latest information from local and state of Ohio Departments of Health, the CDC and the Centers for Medicare and Medicaid Services (CMS).  We remain in close contact with our medical doctors and have protocols in place for dealing with residents if they were to exhibit symptoms of the virus.

I want to thank each of you for your cooperation and understanding during this trying time. Please reach out to the facility at (614) 889-8585 with further specific questions.  Please stay in touch and stay safe.  We will get through this together.

Sincerely,

Blu Johnson
Administrator

COVID-19 Update March 23

March 23, 2020

Dear Families, Friends and Staff Members,

I want to update each of you on measures we are taking to help improve communication with our loved ones. The GRAND of Dublin and Vrable Healthcare have purchased tablets to set up skype accounts dedicated to allowing family, friends and residents the ability to more freely communicate during this unsettling time.  We have also set up conference call lines for scheduled group calls.  While quarantines increase, it’s unlikely all family and friends can even congregate in one area to call a loved one.  With scheduled conference line times, family and friends from across the world can dial in for a group call with their loved ones.

If you are interested in scheduling a Skype video call or group phone call, please call the facility at (614) 889-8585 and ask for the activity department or email the facility at grand-family@grandofdublin.com for scheduling.  We will start scheduling these calls effective Monday, March 23, 2020.

I again want to thank everyone for their patience while we deal with this national emergency.  Our staff has been nothing short of amazing in this crisis.  While more and more business shuts down, our staff continues to make the trek to work each and every day to care for those we love.  I especially want to thank our staff members.   Long Term Care workers are a special group.  I have seen this firsthand as we deal with this difficult situation.   Our staff is leaving their own families at home to care for our residents and your loved ones.  Our staff continues to come to work while dealing with the uncertainty of day care, school closings and general uncertainty regarding this issue.

I feel it is important that we establish a method for increased communications between our residents, family members, community and medical professionals. To achieve this goal I want to establish lines of communication with all resident family members and friends.

Please continue to check our facility Facebook page for general updates.

On behalf of myself, The GRAND of Dublin and Vrable Health Care, I want to thank each of you for everything you are doing to ensure our residents are taken care of with as little interruption as possible.  Please reach out to the facility at (614) 889-8585 with further specific questions.

Sincerely,

Blu Johnson
Administrator
The GRAND of Dublin

 

 

 

 

COVID-19 Update March 20

On behalf of The GRAND of Dublin and Vrable Healthcare, our concerns go out to all those impacted by COVID-19.  As always, our focus remains on the health and safety of our residents and staff.

We continue to monitor the latest information from local and state of Ohio Departments of Health, the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS) and the World Health Organization (WHO). We have been participating on conference calls with the Governor’s office and ODH.  We are we are working diligently to required preventative measures to manage the situation safely and effectively.

As we work together to manage through this national emergency, we would like to share how The GRAND of Dublin is addressing the evolving situation and the proactive, preventative steps we are taking to minimize disruption to patient care and customer service. The GRAND of Dublin is:

  • Working on additional means of communication, including group and video calling.
  • Remaining fully staffed and continuously working on contingency plans.
  • Dedicating resources to the monitoring and evaluating responses to clinical and operational challenges arising from the outbreak.
  • Maintaining daily communication with our vendors, residents and families.
  • Assessing contingency plans across our organization designed to withstand the uncertainty of the outbreak.
  • And as always, committed to maintaining clinical best practices in the care, cleaning, and infection control.

We will continue to monitor the situation and react as quickly and efficiently as possible, always keeping the best interest of our loved ones at heart.  If you have any questions, concerns, or encounter any extraordinary circumstances regarding this situation, please reach out directly to us by contacting me at (614) 889-8585.

Sincerely,

Blu Johnson, Administrator
The GRAND of Dublin

 

COVID-19 Update March 17

March 17, 2020

Dear Families, Friends and Staff Members,

As the nation and the healthcare industry continue to deal with the unprecedented Covid-19 pandemic, I want to thank everyone for their patience while we deal with this national emergency.  I especially want to thank our staff members.   Long Term Care workers are a special group.  I have seen this firsthand as we deal with this difficult situation.   Our staff is leaving their own families at home to care for our residents and your loved ones.  Our staff continues to come to work while dealing with the uncertainty of day care, school closings and general uncertainty regarding this issue.

 

I feel it is important that we establish a method for increased communications between our residents, family members, community and medical professionals. To achieve this goal I want to establish lines of communication with all resident family members and friends.

A periodic / general informational email list is being established so you can receive updates concerning any federal, state, local Covid-19 updates as well as any updates from the facility.  If you wish to be a part of this distribution list, The GRAND of Dublin asks that you contact us to have your email added.

I would also direct you to our facility Facebook page.  We strive to keep this updated with pertinent information. The GRAND of Dublin’s Facebook page is located at https://www.facebook.com/thegrandofdublin/ or you can go to your Facebook page and search The GRAND of Dublin. The facility has set up their page to allow family and friends to leave messages directly for their loved ones.  If you wish to leave a message for one of our residents, you can do so at the following link and your message will be delivered to the resident. http://grandofdublin.wpengine.com/resident-messages/

The GRAND of Dublin is always taking steps to protect our residents and limit exposure.  While some steps have been unpopular, we only take these steps as mandated by the government and to protect those we all love. The GRAND of Dublin has been mandated by the Federal Government to restrict visitors from the facility with the exception of staff, medical professionals, emergency personnel, local/state/federal officials and family members of residents who are actively experiencing end of life symptoms.  We have also been advised to restrict group activities in the facility to ensure we are following social distancing recommendations given to us by the Centers for Disease Control.  The following activities or programs will be affected by this restriction:

  • Care Conferences
  • Therapy Activities
  • Leave of Absences by Residents
  • Breakfast, Lunch and Dinner in the dining room.
  • Routine Ancillary Physician appointments unless it is an emergency

For safety, the facility is monitoring daily temperatures and respiratory symptoms of all staff members, residents and visitors.  We remain in close contact with our medical doctors and have protocols in place for dealing with residents if they were to exhibit symptoms of the virus.  In preparation for this outbreak, we have made arrangements to order and obtain extra supplies to ensure our staff has what they need to complete their jobs. We continue to monitor our supply stock daily and react accordingly.  We are working in close coordination with our vendors and sister facilities to keep supplies adequately stocked.   At this point in time we have no shortages or outages.

 

Please keep in mind, we will not be able to address specific patient concerns in informational announcements, but will communicate any change in condition to a resident’s responsible party if the situation arises.  We recognize this is a very difficult time for everyone involved.   We will continue to work diligently with families to find alternate means of communication so our residents do not miss out on the important contact that occurs with family.  We will continue to monitor and react to recommendations and updates from local state and federal agencies regarding the Covid-19 outbreak.

On behalf of myself, The GRAND of Dublin and Vrable Health Care, I want to thank each of you for everything you are doing to ensure our residents are taken care of with as little interruption as possible.  Please reach out to the facility at 614-889-8585 with further specific questions.

Sincerely,

Blu Johnson
Administrator
The GRAND of Dublin

Understanding Skilled Nursing

Understanding Skilled Nursing

Jada Palm
Hospital Liaison
The GRAND of Dublin

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 and is typically provided for rehabilitation and allow for recovery outside of a hospital. Long term care is typically utilized for in-house placement for the duration of the patient’s life, providing permanent custodial assistance.

What social activities are offered?

The GRAND social activities - skilled nursingSkilled 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 well-fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork).

The GRAND Skilled Nursing roomWhat 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 part A will pay as follows:

  • Days 1-20 – pays at 100% with no patient responsibility
    (Remains $0 co-insurance for 2019)
  • Days 21-100 – patient responsibility of $170.50 per day co-insurance
    (2019 co-insurance will be $170.50)

Additional information can 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 ratio 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?

The GRAND therapy - skilled nursingTherapy 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.

The GRAND of Dublin Main StreetWhat 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 loved one. The GRAND does not have such restrictions and provides security 7 nights per week.

Dance Your Way To Fitness!

by Sara Katula
Activity Director
The GRAND of Dublin

Regular exercise can help older adults stay independent and prevent many health problems that come with age.  Reduced physical activity is one factor that contributes to reduced strength and stamina in the elderly.  Physical activity not only benefits us physically but emotionally as well.  Exercise reduces the symptoms associated with anxiety and depression and can lead to improved moods and increased feelings of well-being.

fintess

The GRAND of Dublin adds many different types of exercise programs into our activities calendar. Some of the different types of exercises we offer are morning stretch, walking club, exercise bingo, and chair exercises. We also incorporate other physical activities such as balloon volleyball, bowling, corn hole, and basketball to keep our seniors active while having fun at the same time.  

In January of this year, we started a new exercise program called Zumba Gold. Zumba is a new dance fitness program that has become popular over the years across the globe.  Zumba Gold is a new version of the program that is tailored to the needs of the elderly. The design of the class is to introduce easy to follow choreography that focuses on balance, range of motion, and coordination.  Zumba is also a good way to socialize and have fun! Trained Zumba fitness instructors at more than 2,000 locations nationwide, including fitness clubs, community centers, YMCAs, rehabilitation centers, and retirement communities, offer the program. Cindy, our Zumba fitness instructor for The GRAND will be teaching a 30 minute class twice a month for any resident who would like to participate.

Fitness GRAND of Dublin

Every time Cindy has taught this class we have had a full room and positive feedback. Many residents state they enjoy the music and learning the dance moves. “Zumba is fun and does not feel like exercise!” states one of our long term residents.  

Involuntary Discharges and Transfers to Face Scrutiny

Involuntary Discharges and Transfers to Face Scrutiny

Corey J. Ohalek
Associate General Counsel
Vrable Healthcare, Inc.

Recently, the Office of Inspector General (OIG) announced it would increase federal oversight regarding involuntary discharges and transfers issued by SNF’s. Specifically, the OIG will be focusing on “whether State agencies have effectively investigated and enforced proper transfer and discharge procedures.” The OIG noted that “discharge/eviction was the most common complaint to the Long-Term Care Ombudsman Program.” Also, the OIG indicated that, due to the quantity, it is worth investigating involuntary discharges and transfers. CMS has estimated that “as many as one-third of all residents in long-term care facilities are involuntarily discharged.”

Involuntary discharge

One of the main areas of review for the OIG is the “lax or ineffective State enforcement.” The OIG plans to review how the State LTC Ombudsman address involuntary transfers and discharges and “the extent to which State survey agencies investigated and took enforcement actions against nursing homes for inappropriate involuntary transfers and discharges.” The State LTC Ombudsman is not the only entity that the OIG is focused on in its review and it will also review the” extent to which nursing homes meet CMS requirements for involuntary transfers and discharges.”

Although the OIG’s main focus will be the actions and/or inactions of State agencies, the OIG’s actions should place all SNF’s on notice to review and adhere to the state and federal regulations regarding involuntary transfers and discharges. “State ombudsman and enforcement agencies may strengthen their involuntary discharge and transfer enforcement activities to ensure that they are not perceived as being lax or ineffective.”

Find more information here.