Jump to minutes: February 12, June 11, October 8
Archived Minutes: 2008
Video Conference Schedule for 2009 TEAC VIDEOCONFERENCE SCHEDULE 2009
All TEAC Videoconferences will take place on the 2nd Thursday of the chosen month from 11:00 a.m. to 1:30 p.m. Central Time on the following dates at the following locations:
DATES
2/12/09
6/11/09
10/8/09LOCATIONS
Tennessee State Veterans Home
2865 Main Street
Humboldt, TN 38343
(731) 784-2448Ben Atchley Sate Veterans Home
One Veterans Way
Knoxville, TN 37931
(865) 862-8100QSource
3175 Lenox Park Blvd. #309
Memphis, TN 38115
(901) 682-0381Tennessee State Veterans Home
Home Office Executive Conference Center
345 Compton Road
Murfreesboro, TN 37130
(615) 225-1816
Minutes for February 12, 2009 (Revised 2/24/09)
MEMBERS PRESENT: Erica Ammons, Meredith Burrus, Russell Caughron, Polly Darnall, Cheryl Hopgood, Linda Jennings, Laurie Loughlin, Brenda Mayo, Thelma Merrill, Cyndi Milenski, Linda Miller, Ryan Myracle, Sherry Poole, Shara Stodola, Roxanna Thomas, Brenda Wallace, Carol Wesson, Ken White, Linda Williams, Sarah Yates
GUESTS: Carol Mace – State Government Liaison
TEAC requested the State Government Liaison’s presence at this meeting because discussion topics included the State of Tennessee.Laurie convened the meeting at 11:00 a.m.
Laurie asked the members to share recent developments at their facilities and organizations.
Shara told the group that she and others committed to culture change have been warming the soil at the Tennessee State Veterans Home in Murfreesboro for over a year and are now ready to launch the Eden Alternative. She has shown the introductory videotape to the Resident Council, and they are now deciding neighborhood names. In other news, no clinical deficiencies were found in their last inspection.
Meredith declared that Community Care of Rutherford County is focusing on cross-training staff so they will have universal workers. So far there are 16. Also, 3 old wings on the property are being demolished to make way for small houses.
Cyndi stated that Cornerstone Health Services Group as a company is well on its way toward Edenizing. Carol Ende, the Eden Alternative Director, has visited all 6 of their facilities. Leaders in each of their homes have “vision gatherings” at which they will decide how to move forward. Conference calls are held with all department managers so all will have a part in realizing their facility’s Eden vision. Their residents prefer to be called “neighbors” or “buddies”.
Carol W. informed the members that Tennessee Health Management’s home in Lewis County is Eden-educating all key staff, and animals are being introduced into neighborhoods. A major issue aired at a recent Resident Council meeting is the lack of privacy, the inability of residents to lock their doors, particularly bathroom doors. Discussion ensued regarding the efficacy of staff door keys and automatic unlocking devices, but those are very expensive and would not conform to fire codes.
Linda W. surprised the group with her true tale of how a lone Girl Scout, in her quest for her one remaining badge, is fundraising for the design and building of a gazebo on the Ivy Crest ACLF property! The elders will enjoy this addition.
Erica advised that the Ben Atchley State Veterans Home will be adding a different species of veteran – a retired military dog – as a resident soon. The home has been hosting elegant anniversary dinners for residents and their spouses using china donated by a Knoxville merchant. They encourage intergenerational activities with the Girl Scouts and the Boy Scouts. They have started quilting and cooking groups. Brenda added that they held Certified Eden Associate training in December. They have raised garden beds, and Lowe’s provided the food and equipment for a cookout.
From the Tennessee State Veterans Home in Humboldt, Polly noted that there are several ways in which VA homes are different. The Veterans Administration does its own surveys. Also, their residents are mostly men, whereas the residents in other homes are mostly women. Men can be more assertive with their wants and needs, and the VA homes tailor programs to those needs. Also, because of their service to their country, veterans are held in higher regard by staff and receive positive attention from several military and community organizations. As an example, the National Guard has come to do landscaping and provided golf carts. The most difficult aspect of culture change has been getting staff to keep each new resident on the schedule he or she is used to instead of putting them on an institutional schedule. She feels that training will change this.
Linda J., our representative from THCA (Tennessee Health Care Association) reported that at the most recent AHCA (American Health Care Association) conference, she was most impressed with the Pioneer Network’s presentation on quality assurance, during which it was stressed that while nursing homes are commonly referred to as being “institutions”, they are really “communities” providing services and housing for a lot of people who would otherwise have nowhere else to go. She affirmed that 162 long-term care facilities in Tennessee are in the Advancing Excellence program run in conjunction with QSource, our Quality Improvement Organization.
The conversation then turned to possible uses for federal CMP (Civil Monetary Penalty) funds and questions about how they have been utilized in other states. Carol M. answered that Arkansas has dedicated them to long-term care facility renovations and Florida has dispensed them for innovative programs.
Carol M. then suggested that TEAC approach the Nursing Home Administrators Board and offer to do some culture change training during their Board meetings with the hope that the Board will add culture change to the curriculum required for Nursing Home Administrator certification.
Laurie adjourned the meeting at 12:50 p.m.
Minutes for June 11, 2009
MEMBERS PRESENT: Brenda Alexander, Jackie Correro, Russell Coughran, Sandra Edmonds, Conita Grigsby, Beth Hercher, Wanda Hicks, Linda Jennings, Deborah Johnson, Laurie Loughlin, Barbara Meadows, Jamie Parker, Ali Pate, Joy Reilly, Kelly Sikes, Ronnie Steinberg, Shara Stodola, Virginia Vollmer, Linda Williams, Lora Woodward, Sarah Yates, Renee ?
GUESTS: Carol Mace – State Government Liaison
TEAC requested the State Government Liaison’s presence at this meeting because discussion topics included the State of Tennessee.Laurie convened the meeting at 11:05 a.m.
Laurie reviewed resources that TEAC offers to its members. The Eden Alternative website, www.edenalt.org, contains the principles, history and activities of The Eden Alternative with information on state, national and international levels and comes out of the Eden Home Office in Wimberley, Texas. Our own TEAC website, www.tneden.org, is run out of Nashville and contains meeting minutes, program information, training opportunities and member news. TEAC also has a library with extensive collections of books, tapes and CDs relating to culture change. TEAC members are able to borrow these items, which can help greatly in familiarizing staff, residents and family members with the Edenizing process. To borrow any of these items, contact Carol Mace at Carol.Mace@tn.gov.
Shara stated that federal VA (Veterans Affairs) nursing homes have been mandated to Edenize. She explained the difference between federal and state VA homes. To be eligible to enter a federal VA nursing home, 100% of one’s illness/injury/incapacitation has to be a direct result of one’s military service. To be eligible to enter a state VA nursing home, the only criteria for veterans is that they must have served in the United States military at some time and been honorably discharged.
Ronnie is beginning a new study of Edenizing homes, hypothesizing that there is a relationship between the type and degree of culture change a home institutes and the quality of life for staff and residents. She is eagerly seeking homes to volunteer for this study. Before launching the survey, she will run proposed questions by a focus group of long-term care administrators to make sure the final survey questions elicit the most relevant and meaningful data. She will seek agreement from each home visited and assure confidentiality to all participating staff members. To participate, please contact her at Ronnie.J.Steinberg@vanderbilt.edu.
Carol shared information relative to culture change imparted by Karen Schoeneman, Deputy Director, CMS Division of Nursing Homes, at a recent webinar about the new Interpretive Guidelines to be released on 06/17/09. CMS (Centers for Medicare and Medicaid Services) encourages discussing potential changes with all staff, residents and family members who will be affected by that change prior to implementation. Some of the recommendations shared were: whenever a resident is presented with the choice to stay with the status quo or adopt a change, it is important to let the resident know that if he/she opts for change, all his/her needs will still be met; individualized care through consistent staffing improves outcomes; and, when feasible, having medication orders changed to dispense before and/or after meals or upon rising and/or retiring (based upon each resident’s medical needs) rather than at other times can often free up staff time considerably. To view the new Interpretive Guidelines after they are released on 06/17/09 (which you are all urged to do), go to www.dhhs.com and click on “State Operators Manual”. Linda J. expects that these guidelines will wrap culture change and a homelike quality into a lot of F-tags.
Virginia, a volunteer at the Alexian Brothers campus on Signal Hill, recommends www.secondjourney.org as a proactive website on aging and maintaining good quality of life.
Sandra, Renee, Kelly and Joy reported the goings-on at the Tennessee State Veterans Home in Humboldt. Residents and staff have fallen in love with Morris, a stray cat they have welcomed into the facility. Their Lifestyles program encompasses many different facets of living. A Taste of Home treats residents with foods not typically served in the dining room. The nursing staff holds dance class, teaching classics like the Hokey Pokey, and the social workers have organized a book club. The staff on the special needs unit devises perks appropriate for their residents.
Linda W. told the group that residents of Ivy Crest ACLF so enjoyed their recent pontoon boat ride on Tims Ford Lake that they requested having rides in spring, summer and fall. One of the residents is 97 and had never been on a boat before.
Barbara informed the members that QSource is facilitating an AHRQ (Agency for Healthcare Research and Quality) survey throughout Tennessee gathering staff attitudes about the levels of patient safety. The anonymous information gives valuable feedback to administrators, who aren’t always aware of certain patient care details.
Linda J. invites everyone to attend the THCA Annual Meeting in August. See Item #4 in the “Mark Your Calendar” section below for details.
Carol showed the cute information package Pickett Care and Rehabilitation Center has put together to promote Camp Pickett, which is for the children of staff. This intergenerational program was featured in McKnight’s Long-term Care News.
Shara, Sarah, Brenda, Lora and Jamie are pleased with the progress they are making at the Tennessee State Veterans Home in Murfreesboro. They have pretty much transitioned into consistent assignment. Currently, their techs are rating residents in terms of need for individual staff time for whatever reason – physical assistance, behavioral problems, and family issues – in order to equalize assignments. They had a very successful Nursing Home Week with residents enjoying Sports Day, Farm Day, 50’s Theme Day, 70’s Theme Day and, most especially, all the home-cooked food that was brought in. They have 140 residents in 3 units which have been named Freedom Hall, Heroes Hall and Patriots Place. Because Murfreesboro has year-round schools, they expect to have constant intergenerational activities. And they are getting ready to add animals to each unit according to the residents’ wishes. Carol assured them that waivers are no longer required for animals.
Russell declared that he is pleased to host the TEAC Videoconferences. TEAC is very grateful to all 3 Tennessee State Veterans Homes and to Beth, who hosts at the QSource office in Memphis.
Beth and Conita are organizing an Eden retreat day for members in West Tennessee. If you would like to be included, contact Beth at bhercher@tn.qio.sdps.org.
Conita related that Date Night is a huge hit at St. Peter Villa. They decorate the dining room elegantly and have music. It is wonderful to see the elders holding hands, either with each other or with spouses or significant others who come to the home for this event.
Covington Care Center has started on its Eden journey. Deborah said that they have taken down message boards and replaced them with mirrors and have opened a breakfast bar where residents can eat anytime between 7:00 – 9:00 a.m.
Ali and Jackie are new Certified Eden Associates from Applingwood Health Care Center in Cordova
Wanda is returning to long-term care after a hiatus and is excited about finding the best niche from which she can make a significant difference.
Ronnie suggested that every long-term care facility in Tennessee that can afford it obtain Wii, which is proving to be a wonderful recreational tool for residents.
Laurie asked the members to describe how the current economic crisis is affecting their homes’ Eden journeys. Some indicated that they have not experienced negative changes, but most revealed that they have had to scale back, mostly on outings and special events. From those present, census numbers appear slightly down in ACLFs but stable in nursing homes. Russell is relieved that there were no cuts in state funds for the next fiscal year but concerned because there will be no increases. Linda J. interjected that this will have an effect because facilities will have to pay higher prices for goods and services without receiving raises to offset them. Also, with Baby Boomers now poised to enter the long-term care system, serious strain will be put on resources. Many were both concerned and hopeful about the effects proposed healthcare legislation will have on costs, particularly about how health insurance or the lack thereof can impact the whole spectrum of healthcare in our country. Shara warned that long-term care, while competing with hospitals for qualified personnel, pays considerably less for the same positions and will continue to lose good workers as a result.
The members offered the following solutions and suggestions for compensating during this difficult financial episode:
The VA has cut out clinical reporting at changes of shift, cutting 2.5 hours per CNT (Certified Nurse Technologist) per week (and the employees don’t seem to mind).
Through a program funded by the current stimulus package which pays students aged 14-24 in a work/study program for up to 32 hours/week, Linda W. has 3 new workers who can take over certain tasks round the clock, freeing up staff time for culture change activities. If interested, contact your local Department of Education for details.
Several members mentioned that, while CEAT (Certified Eden Associate Training) is worthwhile and very good, it would really be helpful if the fee was reduced during this time. One suggestion on how the Eden Home Office could save money and be able to cut the seminar cost would be to hand out only 1 set of training materials per facility (as opposed to every person attending the training), which is all they feel they need to promote the Eden Principles.Laurie adjourned the meeting at 1:05 p.m.
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Mark Your Calendar:
1 TEF BOARD OF DIRECTORS MEETING – Thursday, 7/23/09, 7:00 p.m. at Germantown Cafe.
2. TNAHSA ANNUAL MEETING – Tuesday, 08/04 – Wednesday, 08/05/09, Marriott Franklin at Cool Springs, 700 Cool Springs Blvd., Franklin, 37067
3. TEAC MEMBERSHIP MEETING – Thursday, 8/13/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the “TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
4. THCA ANNUAL MEETING – Sunday, 8/16 – Wednesday, 8/19/09, Nashville Convention Center - “Hitting the High Notes of Quality Care”.
5. TEF BOARD OF DIRECTORS MEETING – Thursday, 9/10/09, 7:00 p.m. at Germantown Cafe.
6. TEAC VIDEOCONFERENCE – Thursday, 10/8/09, 11:00 a.m. – 1:30 p.m., in Humboldt, Knoxville, Memphis and Murfreesboro; see the “TEAC VIDEOCONFERENCE SCHEDULE 2009” for details.
7. TEF BOARD OF DIRECTORS MEETING – Thursday, 11/12/09, 7:00 p.m. at Germantown Cafe.
8. TEAC MEMBERSHIP MEETING – Thursday, 12/10/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the ‘TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
Submitted by Laurie Loughlin
Minutes for October 8, 2009 MEMBERS PRESENT: Russell Caughron, Wanda Hicks, Laurie Loughlin, Kort Nygard, Shara Stodola, Melissa Sweet, Kimberly Turner, Sarah Yates
Laurie convened the meeting at 11:00 a.m.
Following the decision made at our last TEAC Membership Meeting in August to reach out to like-minded organizations and learn what they are about and doing, Laurie, Wanda and Stephanie Gibbs attended the September meeting of TVAC (Tennessee Vulnerable Adult Coalition), an organization concerned for the well-being of all vulnerable adults, which includes but is not limited to the elderly. Their guest speaker, who was from the Tennessee Suicide Prevention Network, showed statistically how the propensity for suicide attempts increases among senior citizens but reinforced our own conviction that depression is not a normal outcome of the aging process. Due to the methods employed, males complete suicide much more frequently than females. Anyone who would like to learn more about recognizing suicidal tendencies and intervening to prevent the act can visit www.tspn.org for more information.
Representatives from the Tennessee Department of Commerce and Insurance are also TVAC participants, primarily concerned about the perpetration of fraud upon the vulnerable. They are seeking more data regarding attempts to defraud long-term care residents via any method (eg, phone calls, mailings, Internet, in-person visits). If you know or suspect this to be an issue at your facility, please contact Patsy Holt at Patsy.Holt@state.tn.us.
For more information about TVAC, visit their website, www.tvaconline.org.
Kort, who has been traveling around the country holding workshops on geriatric psychological issues, is considering doing 30-minute segments on different aspects of same during our 2010 videoconferences (dates to be announced). Kimberly believes that would be helpful because staff at her facility has to deal with increasing inappropriate behaviors of residents. Conita stated that at her home staff to staff inappropriate behavior has recently increased dramatically in the form of verbal explosions and bickering. Shara added that her employees are often undeserving targets of rudeness by residents’ family members. Russell thinks this descent into disrespect reflects what is happening in our country as a whole and is largely fueled by the increased stress many have been under for the last year due to the economic crisis. Wanda stated that this is a corporate issue. All agreed that, whatever the cause, lack of courtesy is not acceptable on any level, and that we must make more effort to promote person-centered care, which recognizes the importance of every individual whether resident, staff or family member.
Laurie reported that no members have responded to the request issued in the last Board of Directors Meeting minutes for suggestions for our non-Eden educational program this fiscal year. Kort asked those present for ideas and received some, which the Board will discuss at its November meeting. Shara feels strongly that the program needs to be geared toward the caregivers.
Conita told the group that Beth Hercher, the Memphis QIO (Quality Improvement Officer) led an Eden Alternative retreat in July for the management team at St. Peter Villa. It went so well that even those who initially resisted going were glad they went.
Kimberly mentioned that the social workers at the Tennessee State Veterans Home in Humboldt have organized lifestyle groups, and that their cat, Morris, has become fond of wheelchair rides!
Shara advised that the Tennessee State Veterans Home in Murfreesboro has an active Family Council. They have had to delay the official start of their intergenerational program, Camp Hero, due to the presence of the H1N1 flu in the Murfreesboro school system.
This was our final TEAC Videoconference of 2009. The Board of Directors will set dates for 2010 at its November meeting.
Kort adjourned the meeting at 12:35 p.m..Mark Your Calendar:
1. CEAT (Certified Eden Associate Training) - Wednesday, 10/21 – Friday, 10/23/09, 8:30 a.m. – 5:00 p.m., at Bordeaux Long Term Care, 1414 County Hospital Road, Nashville; contact Jim Hammond at education@edenalt.org to register
2. TEF BOARD OF DIRECTORS MEETING – Thursday, 11/12/09, 7:00 p.m. at Watanabe, 1400 McGavock Pike (at Riverside Drive), Nashville. Directions: Take Ellington Parkway North to Trinity Lane, turn right, turn left onto Gallatin Road, turn right onto McGavock Pike, go approximately 1 mile to Riverside Drive.
3. TEAC MEMBERSHIP MEETING – Thursday, 12/10/09, 11:00 a.m. – 1:30 p.m., in Nashville; see the “TEAC MEMBERSHIP MEETING SCHEDULE 2009” for details.
Submitted by Laurie Loughlin