WALA WATCHc.ymcdn.com/sites/ewala.org/resource/resmgr/WALAWatch/...WALA Watch is the newsletter of the Wisconsin Assisted Living Association. Published in March, June, September, and

WALA

WATCH A T T H E F O R E F R O N TO F A S S I S T E D L I V I N GI N W I S C O N S I N

WALA — Wisconsin Assisted Living AssociationDECEMBER 2016 VOL. 21, NO.4

Compliance Strategies in Assisted Living Page 18

The Next Move to Increase ReimbursementPage 4

This Isn’t Your Father’s HIPAAPage 8

INSIDE

WHAT IS YOURSTRATEGYWHAT IS YOURSTRATEGY

W A L A W A T C H A T T H E F O R E F R O N T O F A S S I S T E D L I V I N G I N W I S C O N S I N

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WALAWISCONSIN ASSISTED LIVING ASSOCIATION

Advocacy. Education. Communication.Your WALA Team.

EXECUTIVE DIRECTORJim Murphy

OPERATIONS AND COMMUNICATIONS DIRECTORSarah Bass

EDUCATION MANAGEMENT DIRECTORVictoria Lauersdorf

EDUCATION PROGRAM COORDINATORAmanda Ryan

DIAMOND PROGRAM DIRECTORDennis Yadon

OUTREACH DIRECTORTodd Smet

OPERATIONS COORDINATORNichole Mickelson

PO Box 7730Madison, WI 53707-7730

Phone: (608) 288-0246 • Fax: (608) 288-0734Email: [email protected] • Website: www.ewala.org

WALA BOARD OF DIRECTORSPresident: Mike Pochowski, Brookdale Senior Living, MilwaukeePresident Elect: Glen Choban, Capri Communities, WaukeshaPast President: Michael Edwin, Wipfli LLP, MadisonTreasurer: Thomas Buresh, CPA, CFP, PFS, SVA Certified Public Accountants, S.C., Madison (Retired)Secretary: Tina Thill, Sanctuary Care Group, Chilton

Debra Barth, New Perspective Senior Living, Sun PrairieBruce Beckman, Five Star Senior Living, MadisonSteve Campbell, Campbell Family Homes, LLC, ViroquaGlen Choban, Capri Communities, WaukeshaMichael Collins, Senior Care Realty, Sun PrairieChris Kenyon, M3 Insurance, MadisonBrad Klitsch, Direct Supply, MilwaukeeMary LaMothe, S.T.A.T., StoughtonBob Lightfoot, RN, Reinhard Boerner Van Deuren S.C., MadisonChad Liptow, Maplecrest Manor, Inc., RiponHolly Pitas, Holly’s House AFH, StoughtonKaren Schacht, Sylvan Crossings, Madison WI Cindy Senke, Artisan Senior Living, MadisonLisa Stueland, Laureate Group, Waukesha

WALA Watch is the newsletter of the Wisconsin Assisted Living Association. Published in March, June, September,

and December by the Wisconsin Assisted Living Association. Reprint permission available from WALA.

All rights reserved. Promotional information and rates are available by contacting WALA.

We reserve the right to decline promotions submitted for publication.

PRESIDENT’S CORNERBy Mike Pochowski, WALA Board President

Over the past several months, we have been preaching the importance of remaining active in WALA’s advocacy efforts. In particular, Family Care and workforce shortages are a huge concern and we need to remain proactive and at the forefront of these issues.

There are a number of ways you can remain engaged and proactive.

You can support WALA’s Advocacy Committee. The Advocacy Committee serves the membership and provides strategy and direction on regulatory and legislative issues facing our industry. In particular, the Advocacy Committee is in the early stages of its goal planning for 2017. Please let us know if you have any suggestions of issues that the Advocacy Committee should address in the upcoming year.

Inviting the legislators in your area to visit your community is another way you can be more proactive. Doing so allows you to directly communicate with your legislator about the issues you and your associates face on a daily basis. WALA is always available to help assist you in setting up a legislative visit. In fact, the upcoming holiday season provides a great opportunity to have your residents, families, and associates meet their legislator!

We are also in the early stages of planning for our 3rd Annual WALA Legislative Day. This event will take place in early spring of 2017. The event will showcase guest speakers, the ability to connect with other WALA members, and WALA will also setup meetings for you to meet with your legislator and/or staffer. Best of all, the event is free! Stay tuned to the WALA website for more information about this and other future advocacy events.

Finally, the WALA PAC is an important tool for WALA’s advocacy efforts. Elected officials play an important role in how our industry is regulated. The WALA PAC enables us to support elected officials, both Democrats and Republicans, who understand senior living and who are in a position to support policies that enhance the lives of seniors. No contribution is too small and every dollar helps ensure that critical priorities are addressed. A more robust WALA PAC will support these efforts and strengthen our ability to serve you and our residents. Please consider making a contribution to the WALA PAC. You can contribute anytime throughout the year by contacting Sarah Bass at WALA.

We understand the struggles you face on a daily basis and we want to help in any way we can. Thank you for your continued support and please let me know - or the WALA staff - if you have any questions, comments, or concerns.

STAYING ENGAGED AND PROACTIVE IN WALA ADVOCACY THROUGH THE HOLIDAYS

Mike Pochowski


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MURPHY’S MUSINGSBy Jim Murphy, WALA Executive Director

2017 – AND BEYOND. WHY ARE YOU STILL IN BUSINESS?As early winter approaches and fall time moves into the past, I am pondering the next and future years.

As this is being written, the election is fast approaching and while I could update this story after the election, I suggest in many ways it does not make much difference in my pondering who won on November 8. This election cycle has been one of the most disturbing I have seen in my 68 years and it gives me pause to consider our future as an assisted living world. The lack of respect for each other we have seen nationally and in our own State of Wisconsin has been contrary to the reasons I moved to Wisconsin and have been part of assisted living for two decades. My core values of mutual respect, collaboration and understanding of other’s viewpoints are assailed at every turn.

In my 20 years with WALA I have seen many challenges faced by providers but now I am more concerned than ever before. With the rapid growth of assisted living in Wisconsin (with over 54,000 licensed beds/apartments and over 3,800 communities) competition is at an all-time high. I have seen providers who, in the past, have always had a wait-list now struggle with new initiatives to keep their communities full. The low reimbursement from Family Care or legacy waivers only compounds the difficulty to provide the care necessary to support those in need. The Bureau of Assisted Living tells us complaints are increasing rapidly - often due to lack of adequate care. Then add in the caregiving workforce crisis, and we have a volatile mix that makes it even more difficult for you as providers.

The assisted living providers that I know are in this business because they are heart centered and want to provide good care for the residents they love. But with all the concerns I raised above, I have seen a number of good providers sell, close down, limit admissions, or reduce the care they can provide. Our workforce crisis research shows that qualified residents are not being admitted due to reduced staffing across the state. You cannot stay in business if you cannot make a fair return on your labor and investment.

I bring all this up as a way to step back and seriously consider why we all do this. Regardless of who will be in the White House on January 20, these are real issues that will not go away.

As 2016 wraps up this month, I ask, WHY DO YOU CONTINUE TO RUN YOUR ASSISTED LIVING? I am really not a cynic but I am seeking to connect with those who face all these issues – and many more – and still come to work each day. Send me your heart, send me your vision, and send me the strategies you use to see joy in tomorrow. Why do you continue? What is your motivation and drive? How do you face the challenges? Please send your thoughts and comments to [email protected].

I will publish a summary of the best stories I get from you so please let me know if you will allow me to use your name. Let’s shine a light in 2017 on why this tough business can still give us joy, hope, and satisfaction for caring for those in need.

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WALA’s MISSION

STATEMENTWisconsin Assisted Living Association’s mission is to support providers in

enhancing the best quality of life for residents in assisted living in Wisconsin through

advocacy, education, communication,

and quality initiatives.

Open your doors to WALA!

Do you have a meeting space that you could host a WALA seminar in? Call Victoria at WALA to see if you space

would work! (608) 442-0378 or [email protected]

ATTENTIONWALA Associate

Members

Jim Murphy


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As the elections wrap up – WALA’s advocacy has just started to ramp up. Since August, WALA members have participated in ten WALA In-District Legislative Days at assisted living communities across Wisconsin. WALA focused on meeting with Senators and Representatives who are members of the Joint Finance Committee, Senate Committee of Health and Human Services, and Assembly Committee on Aging and Long-Term Care, but we also met with legislators outside of those committees. In the next few months, we will start to meet with new legislators and the incumbent alike to advocate for assisted living during the upcoming budget process.

As you may be aware, Wisconsin’s long-term care providers are in the midst of a workforce shortage crisis that has left our members across the state with fewer caregivers. We have heard from many of you who are struggling with vacant caregiver positions with no qualified applicants, and increases costs and regulatory oversight. Currently, 1 in 7 caregiver positions remain vacant and 18% of the state’s LTC providers report they have been forced to deny admissions in the past year due to insufficient staffing.

To address workforce concerns among Family Care providers, the Wisconsin Assisted Living Association, Residential Services Association of Wisconsin (RSA-WI), WHCA/WiCAL, and LeadingAge Wisconsin released a budget request in September, requesting $40.4 million GPR in the 2017-19 biennial budget.

This increase should be directed towards the direct care and services portion of the “capitation rate” payment arrangement for Family Care managed care organizations in order to allocate dollars directly to providers. This portion of the MCOs monthly capitation rate would be increased by approximately $65 per enrollee and would require MCOs to increase reimbursement payments for each provider type (CBRFs, RCACs, and AFHs) by, on average, 2.5% in each year of the 2017-19 biennium.

Learn more on how you can support WALA’s advocacy efforts as we head to the Capitol in the coming months. Go to www.ewala.org/LegislativeDays for more information or contact Sarah Bass at WALA.

Thank you to the following assisted living communities who graciously hosted WALA In-District Legislative Days: • SpringBrook Assisted Living • Sienna Crest – Dodgeville • Valley VNA • 28 Pines AFH (Total Care Group) • Laurel Oaks • MapleCrest Manor • Parkview Gardens • The Deerfield • Lincoln Village • Elizabeth Residence - Bayside

THE NEXT MOVE TO INCREASE REIMBURSEMENT

According to the Alzheimer’s Association, one in eight people over the age of 65 has some form of Alzheimer’s. Further, nearly half of seniors ages 85 and older have it. Compounding this trend is the fact that by 2030, the population of seniors is expected to double, reaching nearly 74 million. This is a message to senior living providers that existing residents who are not necessarily considered to have cognitive impairment may very well need some level of memory care (MC) programming and related assistance. As such, is MC becoming a necessary component of all seniors housing and care facilities? A look at current development trends coupled with rapidly changing demographics suggests the answer is yes.

A recent survey of nearly 300 leaders at seniors housing and care facilities found that a majority of respondents (61%) believed that Alzheimer’s/MC would experience the most growth in 2016 as compared to the rest of the acuity spectrum. Further, when asked which elements of the continuum of care they have construction projects planned for, the top two answers were AL and Alzheimer’s/ MC at 41% and 40% respectively. Clearly, MC is a big part of senior living’s present and future. Providers can ill afford to neglect incorporating MC capabilities into their facilities. In this article, we discuss the ever increasing need for MC services in all seniors housing and care facilities, examine the opportunities and challenges MC providers face.

The Effects of Aging at Home The population of seniors age 82 to 86 is expected to more than double within the next 15 years creating strong demand for quality senior care options. As medical advances and technology continue to develop, seniors will likely be able to stay in their own homes for longer. What effect does this have on care providers? Seniors are choosing senior living facilities as a last resort once they can no longer remain at home, thus the acuity level of seniors entering these facilities has increased significantly from where it has been historically.

PROVIDERS BUILD AND EXPAND TO KEEP UP WITH DEMANDBy Jessica Rosenberg, Lancaster Pollard

Continued on page 7


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With new advances in technology and medicine, seniors have the ability to be cared for at home, or take care of themselves, for longer than in the past. Therefore by the time potential residents think about moving into senior living facilities it is often because they don’t have another option. In many cases, this is due to MC related issues such as wandering, loss of mental cognition, etc.

The Industry Responds

The growth of AL and MC can be attributed to operators and investors recognizing the need to enhance existing facilities by expanding their product line to include MC units. This will increase their ability to retain residents and allow them to stay at the facility should they need MC care. It is becoming more and more important for IL and AL facilities to add specialty MC wings in order to complete their continuum of care.

According to NIC MAP data, the senior housing occupancy rate as of 2016 remained the same as 2015 at 89.7%. This is expected to stabilize in 2017 at 90%. With respect to inventory and absorption, current 2016 growth rates declined slightly but are expected to increase in 2017. For 2017, NIC forecasts an increase in construction in concentrated markets. Much of the product that will be coming online in the foreseeable future caters to seniors with higher acuity levels, such as assisted living (AL) and MC. Clearly the percentage of seniors housing and care growth that is MC has grown significantly since 2011.

Not only have MC expansion trends grown, but the new construction of standalone MC facilities has been increasing as well. According to NIC, there were 29,090 MC units at freestanding facilities as of 2Q16. The average construction activity represents nearly 11% of existing inventory, a dip from late 2015 but still well above levels in 2009.

While it is important for developers to continue to build and expand the number of MC beds available, it is also crucial to not lose site of the care aspect associated with this development. With higher acuity residents comes increased oversight and ultimately increased labor costs. The training and development of staff is a critical component to success in the MC segment.

Continued from page 4

1 U.S. Census Bureau 2 http://www.lancasterpollard.com/NewsDetail/lancaster-pollard-seniors-housing-survey-2015


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Remember that famous commercial line: “This isn’t your father’s Oldsmobile”? It was meant to send the message that Oldsmobile had dramatically changed its style to appeal to younger buyers. Perhaps HIPAA compliance needs a similar promotional message that HIPAA has dramatically changed. No longer can HIPAA compliance be met by simply posting a Privacy Notice and having a binder of policies and procedures.

With the enactment of HIPAA/HITECH, the final rules and regulations for the most part which went into effect in September of 2013 – HIPAA changed from what had been primarily a Privacy Rule focused compliance mandate with related Policy and Procedures – to a whole new world of compliance which is focused upon the Security Rule of HIPAA, with much greater emphasis on technology and data security.

In the past year a revived HIPAA compliance audit program has commenced which will impact organizations of all sizes and sectors of healthcare, both Covered Entities and Business Associates under HIPAA. The pre-audit email notices from the federal agencies in charge of HIPAA compliance – the Department of Health and Human Services and Office for Civil Rights (HHS/OCR) have already gone out to many and we know that the Senior and Assisted Living sector are included within the potential target list for these audits. It’s been reported that the renewed audit program, which will focus much more on compliance with the Security Rule of HIPAA, will become a permanent ongoing compliance audit program, driven primarily by email notifications

that will request a production of documents by electronic submittal within ten (10) business days of receipt. Let’s stop right here. For all of you who are subject to the HIPAA Security Rule because you either receive, store, handle or transmit ePHI (which would include electronic claims submittal) we can ask one simple question which is: Could you produce a documented HIPAA Security Risk Analysis (SRA)? Preferably a one that’s been conducted in the past year and not outdated.

If your answer is No, or I don’t know – you need to determine the answer to that question immediately, as without the ability to produce a SRA, you’re almost certainly in danger of exposure to HIPAA’s mandatory Willful Neglect penalties which carry mandatory minimum fines that start at $10,000 per violation and go dramatically up from there. By the way, in case you were wondering, there is no ‘first offense’ warning and the HIPAA compliance documentation of your software vendor attesting to their compliance DOES NOT qualify to meet your own HIPAA compliance obligation, they are separate and distinct. The lack of having a proper SRA can be harsh, just recently the technology support partner of the Catholic Archdiocese in Philadelphia, which operated senior living facilities paid a $650,000 penalty arising from the theft of a mobile device that contained the ePHI of their residents – all because they were subject to a willful neglect finding because they had not conducted the mandatory SRA.

The message needs to be sent: This isn’t your father’s HIPAA compliance world any more. It’s changed and if you haven’t already

THIS ISN’T YOUR FATHER’S HIPAABy Jeff Grady, Three Pillars Technology Solutions LLC

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taken the appropriate steps, you need to change your approach to HIPAA compliance as aside from the potential audit and penalty exposure, those who operate within the healthcare sector are going to find that the larger healthcare organizations are performing greater due diligence on their partners and associates, and they will no longer be willing to risk association or continue to do business with partners and organizations that cannot prove their proper state of HIPAA compliance. Please take action now to review your compliance status to make sure it’s up to current standards and expectations for today’s HIPAA before it’s too late. It’s not your father’s HIPAA any more.

Below is a simple seven step program to address HIPAA compliance and data security:

1. Conduct a proper HIPAA Security Risk Analysis, including: a. Full ePHI inventory and data flow description along with an inventory of all IT that handles, stores or transmits your ePHI b. Identify likely and potential risks and vulnerabilities to your ePHI c. Identify existing controls and protections and assesses their adequacy d. Develop an action plan to address any compliance gaps and have an ongoing risk management program in place

2. Review and Update as necessary Policies and Procedure Documentation for the Privacy, Security Rules and Breach Notification

3. Compile a list of all Business Associates and conduct proper due diligence on their state of HIPAA compliance

4. Regularly conduct proper user training on HIPAA compliance for both the Privacy and Security Rule.

5. Have a Breach/Security Incident Response Plan prepared in advance.

6. Insure that you have Cyber Liability coverage and fully understand what it does and does not cover and the limitations on that coverage which exists

7. Make sure that you have adequate back-ups for your data and that you have a business continuity and disaster recovery plan that has been reviewed and tested.

Jeff Grady is the senior director of Three Pillars Technology Solutions LLC which provides expertise to address the data security and compliance needs of clients, with a focus on those impacted by HIPAA within the healthcare sector. He is the originator of the Real World HIPAA™ compliance solution, and holds the privacy and security sector credential of HCISPP - HealthCare Information Security and Privacy Practitioner (HCISPP – ISC2).


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This fall WALA went around the state having conversations between the Regional Directors from the Bureau of Assisted Living and providers. Each of the regional directors brought forth the most common concerns seen by the department to provider in their region in an effort to bridge the gap of communication between providers and their regulatory agency. Below is a summary of some those concerns from the bureau.

Renewing of Licenses and Increasing Capacity When you are increasing capacity, it is not as simple as just crossing out the number on your renewal of license. The request to increase your community’s capacity should come with a letter, the fee, program statement, and floor plan where the increase in capacity will be. To ensure that there are proper space requirements for the residents you serve, your measurements will need to be reviewed by the surveyor.

Centralized Application Submission Changes are taking place with the centralized application submission process as Alfred Johnson relayed at the Assisted Living Forum on November 8. They are hiring three new employees and changing some processes so initial licensing can run smoother. Emphasized that complete application packages are essential to making sure that your applications are efficiently processed. The bureau will not accept an application if it is has missing information. The most common issues are with the fit and qualified - making sure you have the proper financial statements in order and your compliance history. No submissions to the regional offices are accepted - some regions will send them back to you, some will send them on to the central office. Make sure you send the directly to the central office was a common theme.

Self-Reports Regional Directors have been having issues with self-reports coming to them without proper identification of what facility is sending them the information. Make sure you have the license number on top of the self report or at least the address and name of the community. The bureau is wasting valuable time and resources going to other locations because the community was not identified properly in the self report.

The Regional Directors reiterated that if you are in doubt of whether to report something - you should report it to be on the safe side. Often self reports can help explain the whole story. For example, a family member makes a complaint about something that happened to their loved one while at your community. The bureau will then check to see if you, the provider, were proactive and submitted a self report. If so, they will connect the two and be able to see what you as a provider has done to handle the situation. If not, it sends alarm bells to the bureau that you are not being pro-active as you

should be in your community and may warrant further investigations and citations.

Death Reporting Memo 16-008 - Centralized Reporting of Client/Patient/Resident Death Determination was published in the later part of June this year. The purpose of the memo is “to provide information to CBRFs and AFHs and other health care facilities required to report deaths related to physical restraint/seclusion, psychotropic medications, or suicide…” Within the memo are direct links to the code that describes the requirements for reporting. RCACs are not listed as being part of this memo, although it was recommended that deaths in RCACs be self-reported as a best practice.

As of July 1, 2016 all deaths being reported must go to the centralized Office of Caregiver Quality. More details on these changes are available at https://www.dhs.wisconsin.gov/dqa/memos/16-008.pdf

Top 3 Citations for the Entire State Below are the top three citations for the entire state of Wisconsin. They are separated by type of facility. Under each is the code language and some helpful information we have received from the bureau.

RCACs 89.23(4)(a)2 – Services Nursing services and supervision of delegated nursing services shall be provided consistent with the standards contained in the Wisconsin nurse practice act. Medication administration and medication management shall be performed by or, as a delegated task, under the supervision of a nurse or pharmacist.

89.34(16) - Tenant Rights – Medications Except as provided for in the service agreement or risk agreement, to have the facility not interfere with the tenant’s ability to managed his or her own medications or, when the facility is managing the medications, to receive all prescribed medications in the dosage and at the intervals prescribed by the tenant’s physician and to refuse a medication unless there is a court order.

89.28(1) - Risk Agreement As a protection for both the individual tenant and the residential care apartment complex, a residential care apartment complex shall enter into a signed, jointly negotiated risk agreement with each tenant by the date of occupancy.

CBRFs 83.35(3)(d) - Service Plans Updated Annually or on Changes Individual service plan review. Annually or when there is change in

CONVERSATIONS WITH BAL: TOP CITATIONS AND OTHER FINDINGS FROM THE BUREAU

Continued on page 12


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a resident’s needs, abilities or physical or mental condition, the individual service plan shall be reviewed and revised based on the assessment under sub. (1). All reviews of the individual service plan shall include input from the resident or legal representative, case manager, resident care staff, and other service providers as appropriate. The resident or resident’s legal representative shall sign the individual service plan, acknowledging their involvement in, understanding of an agreement with the individual service plan.

83.47(2)(e) – Other Evacuation Drills This includes tornado, flooding, or other emergency or disaster evacuation drills – and shall be conducted at least semi-annually.

83.43(1) – Environment safe, clean and comfortable The CBRF shall provide a living environment that is safe, clean comfortable, and homelike. All common dining and living areas shall contain furnishings appropriate to the intended use of the room.

AFHs

88.05 (3)(a) – Home Environment An adult family home shall be safe, clean and well-maintained and shall provide a homelike environment.

Some examples of cites on this kitchen table not being used for dining and instead using TV trays on a regular basis in the living

room. Locks on the refrigerator to prevent compulsive eating – instead BAL suggested that redirection is a better solution and is not a violation of their rights. Not having curtains on the windows, no clothing in the bedroom, not painting your walls, broken furniture and not having a clean environment to live in.

88.05(4)(d)2.b – Fire Evacuation Annual Evaluation Each resident shall be evaluated annually for evacuation time, using the department’s form. All services providers who work on the premises shall be made aware of each resident having an evacuation time of more than 2 minutes.

88.07(3)(a) – Prescription Medications Every prescription medication shall be securely stored. Making sure that you have the original order in the original packaging from the pharmacy.

Please contact WALA with any questions on the above information. As a membership benefit, WALA welcomes your regulatory questions and concerns. We would like to know what products or education may be useful in the future to help navigate assisted living regulations. We know that the bureau can no longer provide the technical support they once did, and WALA is happy to offer support and guidance as the need arises for your assisted living community.

Continued from page 11

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Abundant Life Manor Affinity Health Care LLC (5 communities) Alexian Village (2 communities) AmericanWay (6 communities) Anchor Communities LLC Anita’s Gardens (3 communities) Appleton Retirement Community Arcadia Communities Senior Living of Beaver Dam Aspen Acres Assisted Living LLC Autumn’s Promise Assisted Living Azura Memory Care – Clinton Bell Tower Residence BrightStar Senior Living Bryant Homes (2 communities) Burpo CBRF Burr Oak Manor Calebria House Cambria House Campbell Family Homes (3 communities) Capri Communities (11 communities) Caring Alternatives (2 communities) Casa de Oakes, Inc. (3 communities) Christian FamilyCare Homes (3 communities) Clifden Court – North House Community Living Home Options Cottages Investment Group (2 communities) Country Meadows Family Care Creative Health Care Solutions (2 communities) Creative Living Environments LLC (6 communities) DEELYNN Home Care Deer Path Assisted Living (2 communities) The Deerfield CBRF Dianne’s Home in the Northwoods Divine Living AFH Eitsert Family Cares (3 communities) Elizabeth Residence (5 communities) Ella Besaw Center Evergreen Terrace LLC Faith Living Center Fresh Coast Partners (2 communities) Frontida, Inc. (7 communities) Gables on the Pond Genuine Care Adult Family Home Great Lakes Senior Living (4 communities) Hannah’s House East

HarborChase of Shorewood Harvest Guest Home Hawthorne Home Heritage Senior Living (13 communities) Hillside Gardens AFH Holly’s House Homestead Living Inc. Joyful Living Adult Family Home (2 communities) Langlade Hospital (2 communities) Laureate Group – Howard Village Living Tree Estates LLC Maplecrest Manor New Beginnings of Barron County New Perspectives Senior Living (11 communities) Oak Crest Villa One Penny Place Pabich’s Residential Facility Inc. PeopleServe LLC 5th Avenue A Place for Miracles Living Center II Platinum Communities (5 communities) Primrose Retirement Community of Wausau Rainbow Park Home Riley’s House Riverside Terrace Rosewood Manor Sebring Assisted Care Residence Senior Lifestyle Corporation (2 communities) Serving Hands Inc. at Evergreen Sophie’s Manor II, Inc. St. Michael’s Assisted Living Stardusk House Superior House AFH Sylvan Crossings (8 communities) Tender Reflections Assisted Living (2 communities) Touchmark on West Prospect (2 communities) Trinity Senior Community (3 communities) Villa St. Francis VNA Assisted Living Wayside Parkview Estates Wellington Homes of Wisconsin (7 communities) Willow Run (2 communities) Wind Point Villa AFH Wolf River AFH Wolverton Glen Assisted Living Woods of Caledonia, The

CELEBRATING OUR DIAMOND ACCREDITATION PARTICIPANTS

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WALA celebrates the 191 assisted living communities who are showing their commitment to continuous quality improvement as participants in the Diamond Accreditation Program! Join them – check out the Diamond Page of the WALA website for more information!

Please note that corporate names are used in instances where multiple communities participate in the Diamond Program.


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• Hiring & orientation planning• Leadership coaching & staff training • Curriculum evaluation, revision, & development

• Performance reviews & recognition programs• Client-driven special projects

Office: (608) 242-2453 Email: [email protected] Website: www.bdavisdirections.com

Employees matter - to you and the clients you serve. Hire and retain the people your clients deserve.

Artwork by Todd Smet, Outreach Director, WALATitle: “A day in the life...The moment that makes it all worthwhile”


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Call or email today to learn more about how we can help you and those you serve. E: [email protected] • P: 262.613.8819

www.equip-success.com

YOUR success is our MISSIONYOUR success is our PASSION

Have you heard about our FLAT FEE 24/7 consultant on call service?

• 24/7 RN on call services: For a flat monthly fee (and reassurance for your staff), have access to aresponsive, professional Registered Nurse any time of day or night

• 24/7 on call consultant services: For a flat monthly fee (and peace of mind), have access to anexperienced, competent consultant any time of day or night.

• Short and long term leases of assisted living communities: Investors choosewisely and choose well when they choose Equip to help them achievetheir goals

• Development of new assisted living communities from concept tocompletion: Our seasoned team of experts has helped dozens ofproviders realize their dreams of developing successful communities

• Regulatory turn around, preparation and submission of plans ofcorrection, and root cause analysis: Our team has a proven trackrecord of success in all of these areas and can help you today

• Training: We offer training in all CBRF modules as well as any tailoredtopic to meet your needs

At Equip, some of our most in-demand services include:

Catch up with us at WALA WONKA

aka WALA’s 2017 Spring Conference.

You’ll have another opportunity to “Get ‘Quippedwith Equip” and play for cash and prizes again.

www.cnc-ccls.com

Call or email Carmen Carothers, RN ‐ Nursing Director 800.236.CCLS x 233

[email protected]

Consulting Services Available ·DQA required nurse consultat ion ·POC development and implementation ·Liaison between you and DQA ·Medication reviews ·Nurse delegation ·Nurse assessment ·Mock surveys ·Client and staff sat isfact ion surveys ·Policy/Procedure development ·Init ial license applicat ion process ·Client specif ic training ·and MUCH MORE!

Accessing the best knowledge and expertise in one team of assisted living professionals ‐ CNC is here for you ⇒ Registered Nurse ⇒ Assisted Living Administrat ion ⇒ Specialist in Organizat ional Behavior ⇒ Unique team developed for your specif ic concerns

EXPERTISE backed by EXPERIENCE


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Make a plan with B. Davis Directions and S.T.A.T to

capture your 2017 continuing education hours. Schedule

Brandi & Mary to come to your community to educate and entertain your staff while they receive 75% of their

continuing education! Your staff will receive

education hours required by the state and covers the topics

YOU choose!

“Brandi has good enthusiasm…good knowledge and conversation in the room.

Information was something I can use when I walk away.”

“Mary puts a lot of energy and encouragement into her trainings. The classes are

informative yet fun.”

What are people saying about Mary and Brandi?

Contact Brandi at [email protected]

to schedule your 2017 trainings today.

Capture Your 2017 Continuing

Education!

To learn more about this event, visit

www.bdavisdirections.com


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Person-directed care is a philosophy guiding the way services and care can be provided in long-term care communities. In assisted living communities, PDC embodies the belief that residents should direct which services and care they receive. The emphasis is on the resident as the central decision-maker, instead of having decisions made by staff, other professionals, or family members. Residents are recognized as having the capacity to assess their own needs, determine how and by whom these needs should be met, and monitor the quality of services they receive.

PDC is an ongoing process, to establish a climate that fully empowers residents is a long-term journey involving an interactive process shared among residents, caregivers, other staff and management, and family members, all working together to honor residents’ rights to make choices in directing their daily lives. A PDC-based program attempts to incorporate the valuable input of all primary participants in the resident’s life. Their role is to provide support for residents to enable them to lead the kind of lives they want to lead.

PDC is also a movement of cultural change. Its roots can be traced back to the 1990s, when health care professionals, service providers, residents of long-term care facilities, and family members challenged long-term care practices. Dissatisfaction with institutional provider-driven model of care led to the development of both assisted living communities and the person-directed care movement.

What are the benefits of Person-Directed Care? Person-directed care is important because it can provide innumerable benefits for residents, their families, staff, and management of assisted living communities, including:

• Improved resident satisfaction with care • Increased resident sense of purpose and well-being • Improved resident feelings about the quality of their lives • Increased resident feelings of self-worth and self- confidence • Increased resident feelings of levels of control over their lives • Increased resident feelings that the assisted living community is home • Improved social relations among residents and between residents and staff • Reduced social isolation of residents • Improved staff satisfaction • Increased staff stability and reduced staff turnover • Increased family satisfaction with services and care • Residents and staff members are empowered, thereby increasing engagement

• Improved resident care, such as when staff have consistent assignments and as a result develop a high level of familiarity with residents, leading to early identification of changes in health, facilitating timely interventions

Successfully implementing a PDC program in your assisted living community – and, in the process, changing your culture – requires a commitment on the part of management, staff, residents, and family members to make it work. This process begins with the senior management of your residence. Senior management or owners set the direction for your organization and provide the administrative support necessary to implement the PDC program in your residence.

What can leaders do to support the cultural change process?

• Be clear about why a change is being implemented. • Understand what your staff are experiencing by actively participating in the change. • Decide how you will know if you have been successful.

The steadfast commitment and leadership by senior management to complement a PDC program is a key component in realizing the innumerable gains for the entire assisted living community.

WALA can help! This information is from WALA’s Compliance Strategies Manual – Person-Directed Care. If you would like more information on how to implement a person-directed program in your community go to www.ewala.org to order a copy of WALA’s Compliance Strategies Manual – Person-Directed Care.

COMPLIANCE STRATEGIES IN ASSISTED LIVING: A FOCUS ON PERSON-DIRECTED CARE

StoughtonHospital.com

900 Ridge StreetStoughton, WI 53589608.873.6611

We’re Here For You● Ambulatory Infusion Center● Geriatric Psychiatry● Home Health● Inpatient Rehab - Swing Bed

● Sleep Disorders Center● Surgical Services● Trusted Hands (Personal Care Service)


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Building a new assisted living facility? No doubt you’re feeling the pressures of budget constraints, timelines and heavy decision making. Thousands of choices (and questions). What furnishings? Which fixtures and equipment? You’ve already dedicated time and resources to weighing your options and reaching project milestones.

But at the end of the day, you’re still battling a balance of costs and quality. Costs are top of mind for any new construction project, but it is even more so for your industry. And still yet, quality and care are right up there. Before you break ground or shop around, there is one more resource you should consider: Focus on Energy.

Maybe you’ve heard of the statewide energy efficiency and renewable resource program already. It’s helped businesses manage rising energy costs and upfront investments since 2001. Energy-saving projects range from lighting and thermostats to boilers and many other big-ticket equipment. The Wisconsin program also provides energy design services and offers valuable product selection guidance through their network of statewide Trade Allies.

In today’s competitive markets, realizing even fractional margin gains and price breaks is necessary to meet investors’ demands. Available incentives can add up too – seriously thousands of dollars. So think about how your facility could benefit…

An energy efficient boiler could keep your residents comfortable, while allowing you to operate more efficiently. And here’s another bright idea for you: LEDs. They require very low maintenance and emit light more evenly, so you’re not just improving savings, you’re increasing safety throughout your building.

As a WALA member since 2007, Focus on Energy has empowered the people and businesses of Wisconsin to make sound energy decisions with enduring economic benefits – returning over three dollars for every dollar invested! Focus on Energy continues to support assisted living facilities in both new construction efforts and retrofitting existing buildings.

David Griffin, President of ElderSpan Management, leveraged incentives during the recent construction of a 200,000 square foot expansion operation for the All Saints Neighborhood in Madison. “Focus on Energy provided exemplary assistance to ElderSpan and All Saints in educating us on energy rebates available and directing us through the application process. They helped us realize more savings than what we originally expected. Don’t leave this opportunity untouched!”

In partnership with Wisconsin utilities, Focus on Energy makes it easy for you and your board to enhance comfort, control costs, and provide care to your residents. Yes, energy efficiency requires upfront investment, but it doesn’t have to put a dent in your budget. You may want to consider the program as a resource for your next construction or upgrade project. For more information, please visit focusonenergy.com or call 800.762.7077 to connect with your personal Energy Advisor.

BREAK GROUND WITHOUT BREAKING BUDGET - FOCUS ON ENERGY CAN HELP.

Screen shot from http://www.allsaintsneighborhood.org/memory-care/

Is Your Company Staffed By

Well Trained Employees

??? S.T.A.T. offers training that prepares your staff to make appropriate decisions that benefit your elder popula-tion. Our train-ing enhances your staff’s core competencies by expanding your employee’s capabilities and effective-ness. CALL TODAY! P.O. Box 662

Stoughton, WI 53589 We work with you and your staff for scheduled training needs. Knowledge is POWER!!

TRAIN TODAY

♥ ♥

Regulatory Training & CEU’s—It’s what sets STAT apart from the crowd.

Call: 608-444-2340

S.T.A.T.—Specialized Training and Techniques

By Mark Lydon, CEM, Energy Advisor, Focus on Energy – Business Incentive Program

22nd Annual Spring Conference: WALA Wonka March 15-17, 2017

83.15 Administrators Course April 4-20, 2017 - MadisonMay 9-25, 2017 - Brookfield October 10-26, 2017 - Plover (Stevens Point Area)

AFH, CBRF, RCAC Introductory Administrators Course Late Summer 2017

Fall Symposium & Golf Classic September 2017

UPCOMING EVENTS

www.ewala.org

WALA WATCHWisconsin Assisted Living AssociationPO Box 7730Madison, Wisconsin 53707-7730

608/288-0246Fax: 608/288-0734E-mail: [email protected]: www.ewala.org

PRSRT STDU.S. Postage

PA I DMadison, WI

Permit No. 984

WALA Membership Valid To:

Member View and Resident Spotlight help us connect WALA Watch to you, the members – but we need your stories.

Do you have a viewpoint on an important assisted living issue? Does one of your residents have a story to tell? Share it with us!

Send your stories and ideas to [email protected] or call me at (608) 442-0375. I would really like to hear from you! Sarah Bass Operations and Communications Director

WALAWANTSYOU!

Documents

WALA WATCHc.ymcdn.com/sites/ewala.org/resource/resmgr/WALAWatch/...WALA Watch is the newsletter of the Wisconsin Assisted Living Association. Published in March, June, September, and