Upfront Healthcare Magazine Issue 5

HEALTHCARE

Quarterly for LTC Professionals

SHORT STAFFED Are there enough nurses to go around? Nationwide, admins are panicking.

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TECH TALK Robotics, VR, telemedicine– technology is changing the game. Catch up.

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MAKING CONNECTIONS To grow and thrive, facilities need to connect with their communities. Here’s how.

October 2019

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PENNED

“It has become appallingly obvious that our technology has exceeded our humanity” “Imagination is more important than knowledge. For knowledge is limited, whereas imagination embraces the entire world.”

-Albert Einstein

Everywhere you go, you may hear that technology is changing the world. Some people embrace it–they say it’s a tool that has made our lives better. Others fear it, saying that it possesses us and steals our time.

But I opine that nothing in this world happens “to” us, it happens “because” of us.

The healthcare industry is no exception to this rule. This issue features technology and how it is revolutionizing healthcare. At SpecialtyRx, our pharmacy has embraced robotics, HIPAA compliant text messaging apps, software that automates workflow as well as calculates proper dosing.

Seemingly it does it all….or does it?

Pharmacy and healthcare have been built around one premise since forever: Care. And what better way to express that care than through human interaction?

EXECUTIVE DIRECTOR Joseph Kubulak EDITOR-IN-CHIEF Rebecca Lieberman CREATIVE Esther Schwartz ADVERTISING Ricky Blau PUBLISHER GCNY Marketing MAIN OFFICE: 3611 14th Ave | Suite 422 Brooklyn, New York | 11218

October 2019

This October, was pharmacy month, and I presented awards to special employees who understand that the patient is more than just a number. I spoke about when I first entered pharmacy.

In my last year of school, the pharmacy I worked at was up for sale. I asked my grandmother if she would assist me with a loan for a down payment. My grandmother was my BFF. She helped me, and I paid her back and took care of every expense you could imagine with her home. She repaid me by being my inspiration and she also laughed at every one of my jokes. (Did I mention she was my BFF?).

She was my constant reminder that every patient I took care of was someone’s family and was someone’s BFF. Pharmacy was personal. When my daughter, Lexy was born, every child who screamed while waiting in their parent’s arms for their prescription became harmony with the daily sounds of the pharmacy and almost….. a comforting sound. There was love wrapped around that child in the shape of their mom or dad’s arms. Lexy…..inspiration number two.

So technology has not robbed us of anything. Instead it has given us a gift of time. To do what we do the best. Care…………Love……..dream and imagine and create a better place, a better life for our patients. It has given us time to be what we are……the best part of humanity…..

God bless you all.

Joe Kubulak V.P. of Operations and Business Development, SpecialtyRx

CO N T E N T S

06 10 16 24 30 34 40

Industry Currents

Flu shot news, staying calm at work, and more tidbits

Senior Care Renovations The complete guide to making big changes in your facility

Inside the So-Called Nursing Shortage Is your facility shortstaffed? Is there anything you can do about it?

Revolutionize Senior Care with Tech Technology has changed the world–including the healthcare industry.

Connecting to the Community GCNY Marketing’s Joseph Blumefeld helps facilities plant roots and attract residents

Youth is not Wasted Seniors are getting younger.

Your recreation department had better keep up.

Meeting Patients with Patience Respond to difficult patient complaints with empathy and efficiency.

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October 2019

Trusted By 100+ Facilities.

And Counting.

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Our experienced pharmacists guide every step of the packaging process.

5

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Stay seamlessly connected with FacilityLink™.

Helping you make life happen.

Discover how our five CareCores™ commitments empower you to care, lighten your daily workload, and ensure you always have the goods you need for your facility to do great things.

Upfront Healthcare

October 2019

industrycurrents

MEDICINE

WHO Warns: This Year’s Flu Vaccine May Not Be As Effective As Usual You should have received your flu shot by now, as we’re getting to the time that the disease begins to make its mark in the United States.

Unfortunately, this year’s vaccine may not cover strains of the virus that could reach our shores. he World Health Organization said in late September that two strains of the flu that are present in South America were not included in the flu vaccine that is available in North America.

These strains are influenza A/

H3N2 and influenza B/Victoria.

The flu vaccine protects against three (or four, depending on which vaccine you get) strains that scientists think will be prevalent in the U.S., but those decisions are made in February.

The WHO also believes that the H1N1 strain used in the current vaccine will prove to be effective this flu season.

Even though the strains that are being seen in South America are a concern, experts say it’s too soon to know if that will be the predominant strain of the flu that will travel through the U.S. this winter.

Due to that, it’s still advised that everyone receive a flu vaccine.

Even if you still get the flu, getting vaccinated could very well mean that the effects of the virus are not as severe.

Seniors and people with underlying health problems should avoid anyone with flu-like symptoms. If high-risk people show signs of the illness, they should be examined immediately and be considered for flu antiviral drugs.

Remember that if you or anyone in your care hasn’t been vaccinated yet, that it takes up to two weeks after you receive the shot for the antibodies to build up resistance in your body, so now is the time to get vaccinated.

●

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industrycurrents

HIRING

Patient-Driven Payment Model Leading to Layoffs of Therapists at SNFs The Patient-Driven Payment Model (PDPM) as part of a Medicare Part A stay at skilled nursing facilities was only in effect for a matter of days when consequences were seen in the industry.

PDPM replaced the Resource Utilization Group classification system this past October 1, as the federal government is hoping the change will cut back on Medicare having to pay for unnecessary therapy services.

Skilled nursing companies are adjusting to the expected loss in revenue by taking measures like cutting staff and slashing pay.

Skilled Nursing News reported that Genesis HealthCare eliminated around 6 percent of its 10,000 employees who specialize

in rehab and therapy work.

Signature HealthCARE told Skilled Nursing News that their therapists took a “small pay adjustment” in order to preserve jobs.

Ageis Therapies reported a decline in per-diem labor, and they will make staffing decisions based on patient care needs at each of their locations, while Reliant Rehabilitation also reported some reductions in their workforce.

These changes are being made because the under the old system, the final amount of reimbursement from Medicare was directly tied into how much therapy services were provided at a facility. Now, under PDPM, the reimbursements are linked to each resident’s condition. PDPM, which was

approved in July 2018, was designed to put the patient and their families more in control of care decisions.

Rehab providers are responding by investing in more specialized services like speech therapy and cardiac care, instead of more blanket physical or occupational therapy.

Therapists are also taking action.

In the first four days it was open, nearly 17,000 people signed a Change.org petition urging the Department of Health and Human Services to reconsider the change to PDPM. In the petition, the therapists are concerned about their employment and a potential decrease in resident care. ●

Upfront Healthcare

October 2019

industrycurrents

HIRING

Expect a Rise in Cost of WorkRelated Health Insurance Plans in 2020, but Options May Increase The open enrollment period for most large companies in the United States is approaching, and it’s forecasted that the trend of rising health insurance costs will continue for 2020.

When considering costs for your employees, you will need to reserve more in your budget for this line item again next year.

The total cost of an individual’s insurance is expected to rise 5 percent from an average of $14,642 in 2019 to $15,375, according to the National Business Group on Health. That total includes the amount put in by both employer and employee, with the insured footing about 30 percent of the overall bill by way of premiums.

This news comes just as a national survey found that employer-based health insurance is becoming more and more unaffordable.

The Kaiser Family Foundation’s annual study found that the average premium went up between 4 and 5 percent, but workers’ wages only increased by 3.4 percent.

Ways to Control Your Healthcare Costs Despite the increase in cost, experts are predicting that more options will be offered.

In 2018, around 40 percent of employers offered only high deductible plans, but that number is expected to shrink to 25 percent for 2020. These could include some cost savings in return for less

flexibility in the choice you have in providers. In association with this, you may start seeing a term called accountable care organization. This is when employers work together with insurers to create a network of primary doctors and specialists that works together to care for a patient.

Virtual Care Options Expected to Increase Providers have been offering virtual visits via phone or videoconference, usually at a much lower cost than a physical office visit. More than half of the employers surveyed by the National Business Group on Health reported that they will offer more of these programs in the coming year. ●

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industrycurrents

INDUSTRY

Stay Cool Under Pressure: 6 Tips from Expert Nurses The Atlanta Journal Constitution recently published an article on how nurses can stay calm when chaos is forming around them. These tips can easily be applied, however, to anyone who works in skilled nursing or other medical facilities.

1 2 3

Keep a Calm Exterior

Regardless of the emotions you’re feeling, appearing composed on the outside will help others feel more secure and help them focus on the task at hand.

Stick to the Plan Most places have protocols for nearly every situation. This goes for your emotions as well. Know your triggers, so you can come up with a plan to effectively cope when it occurs.

It’s Not Your Emergency Even though you may be dealing with an emergency, it’s not your emergency.

Focus on your job and the tools you’re equipped with to get through the stressful situation. Afterwards, you and your team can assess emotions that came with the process.

4 5 6

Ask Questions People may have a

hard time explaining a problem but asking questions can help pry necessary information out of them and keep them on track. Asking questions also gives your brain time to think critically instead of just reacting.

A Small Amount of Levity Can Go a Long Way While it’s important

to read the room, so to speak, a small amount of humor can break the ice in a tense situation and can cause everyone else working the situation to cut back on their tension a little bit.

Be the Voice of Reassurance

Chaotic situations are naturally falling apart at the seams, and it’s your job to make sure that doesn’t happen. Let whoever you are helping know that they are in the right hands and you will handle it from here. ●

Upfront Healthcare

October 2019

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SENIOR CARE RENOVATIONS

YOU CAN GET THERE FROM HERE The ultimate guide to renovating your senior care facility in a financially smart, practical way.

BY J O H N W. B AU M G A R T E N

Upfront Healthcare

October 2019

PHOTO: JOHN W. BAUMGARTEN ARCHITECT W ITH ICON INTERIORS

BROOKSIDE HE ALTHCARE & REHABILITATION CENTER.

Every architect wants to design a new building, but for most senior care centers, it might not be fiscally feasible to contemplate new construction.

Almost every owner would like to add a new program or service to enhance resident quality of life and

increase their bottom line. Most will tell you that their building is tight for space and that their renovation budget is even tighter. As senior care architects, that’s what we are constantly challenged to overcome.

A good strategic plan followed by a thoughtful renovation is our answer.

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SET GOALS. GET SPECIFIC.

This first step is to identify and prioritize a set of strategic planning

specific goals, you must make a firm commitment to them to achieve a successful outcome.

goals. Setting very general goals such as “improving our census” or “creating a homelike environment” is a common misstep. These are the ultimate goals, but you need to identify specific strategies to get there.

“Providing more resident amenity areas” and “creating a fine dining program” are two possible strategies to create a home-like environment.

Adding a Memory Care unit is certainly a way to improve a senior centers’ census. Whatever your

HIRE THE RIGHT PEOPLE.

A key ingredient in the success of any senior care alteration is the selection and involvement of a senior care architect who specializes in the renovation of senior care facilities. Senior care facility design requires a thorough knowledge of specific governing codes, specialized systems/equipment and an understanding of the physiology and varying acuity levels of seniors.

As with any endeavor, you need to work with the right people.

“THE DESIGN APPROACH MUST HAVE A GOOD PHASING STRATEGY AT ITS CORE.”

We have found that bringing in an architect quite early in the planning process is an important first step. Our clients frequently ask us to be their strategic planning partners during the goal– setting stage, allowing us to test the feasibility of a concept from the perspectives of constructability, code compliance

and cost.

GET THE MOST FOR YOUR MONEY.

Once specific planning initiatives have been identified, the architectural and engineering team must undertake a spatial and infrastructure survey to gain a thorough understanding of the existing conditions in the areas to be altered. This knowledge base allows a design to “go with the flow” of the infrastructure, avoiding potentially expensive relocations.

We like to call this process “creating an aesthetic surplus”. In other words, the construction dollars saved by designing with the existing infrastructure instead of against it can be applied to aesthetics, giving clients more bang for the buck.

PUTTING THE PLAN IN PLACE.

Armed with a design program and a road map of the existing conditions, the schematic design phase can almost begin. Our experience has taught us that when altering a senior living building, the how is as important as the what. In other words, the design approach must have a good phasing strategy at its core. For example, it may be necessary to create swing/ temporary space before a given

Upfront Healthcare

October 2019

area can be renovated. If this is not clearly identified for prospective contractors/bidders, it will most often lead to cost overruns during construction.

The next step is establishing a realistic preliminary budget estimate. A seasoned senior care architect should have real-time cost data to draw from based on projects they have completed which are similar to yours. Since a phasing plan and a study of the existing conditions have both already been done, the preliminary cost estimate will relate to your building’s physical situation, instead of being calculated in a vacuum. As an owner or administrator, you have an important role to play in the budgetary process. You and your vendors must identify the costs of “owner provided” systems and equipment such as telephone, data, medical and business equipment and furnishings. Failure to account for the cost of furnishings, fixtures and equipment (FF&E) will lead to a “cost surprise” further down the road.

between departmental end users/ stakeholders and the architect are a critical first step. This is where the design professional gains a detailed understanding of programmatic priorities, spatial interrelationships/ hierarchies and specific FF&E requirements for each service area being altered and/or relocated.

First draft floor plans are a byproduct of the user group process.

Plans are reviewed, altered and ultimately signed-off-on by Stakeholders. This allows the project to move forward into the design development phase (DD).

So, you have the right architect, design program, existing conditions knowledge base, budget and a phasing strategy in place. Now you can start the schematic design phase.

The DD Phase brings the architect’s engineering and interior design sub-consultants into the picture. Preliminary mechanical, electrical, plumbing, fire protection and structural drawings are brought to a 30% completion level. At this early stage, any significant coordination issues with the floor plans and infrastructure can still easily be addressed. Any required floor plan changes are made and are again signed-off-on by stakeholders.

During DD, initial interior design concepts will be presented. The goal is to make basic material selections so these costs can be factored into the project budget (specific colors/ manufacturer selections will come later).

Schematic design should be a collaboration between client and architect. User group sessions

At the end of the DD phase, the preliminary budget is tested to make sure the project remains on-

track. If required, modifications to the 30% level drawings are made to eliminate any budget variance. With a sign-off by all stakeholders, the project moves into the construction documents phase (CD).

THE FINAL PHASE

In the CD phase, drawings are developed to construction level.

These are the documents (drawings and specifications) that a contractor will use to build the project. These same drawings are filed with and approved by the local building authorities having jurisdiction. The budget is again tested at the 60% completion level, after final interior design colors, materials and fixtures have been selected.

Once CD’s are completed and approved by the local building agencies, the project can be bid/ awarded and the construction can begin. As we all know, renovating an occupied senior care facility is not easy. However, since a phasing strategy was developed early, a good road map should already be in place. Working with an experienced Senior Care contractor is just as important as working with a seasoned Senior Care Architect.

Your contractor should be familiar with Interim Life Safety Standards and should be comfortable working with your housekeeping and maintenance staffs to establish a daily “working rhythm”. The

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phasing plan will establish swing space needs, dust/construction partition locations and when HEPA filtration fans are needed. However, it’s the Contractor’s execution of the plan that will allow construction to proceed steadily and safely.

bringing in a seasoned senior care architect, being an active partner in the design and development process, working with an experienced contractor and drawing upon the experience and passion of your staff. ●

Altering your senior care facility can seem daunting. But you can get there from here by establishing and committing to specific goals,

John Baumgarten, R.A., AIA, LEED AP, is president and founder of the firm of John W. Baumgarten Architect, P.C., an award-winning, full-service

architectural firm serving proprietary and not-for-profit healthcare and senior care organizations. JWB specializes in the master planning of complex phased nursing home modernization projects, providing an integrated approach to architecture, interiors and engineering. Learn more at JWBArch.com.

Upfront Healthcare

October 2019

INSIDE THE NURSING S

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The lack of nurses in senior facilities like nursing homes is a widely neglected issue across the country which requires prompt attention and realistic strategies to overcome it. Although nursing remains one of the fastest-growing professions, most just don’t want to work in nursing homes. While the issue is addressed, the fact of the matter is that nursing homes are short-staffed, which affects both the current nursing staff at the facility and residents there.

SO-CALLED SHORTAGE

BY R OS E WA L K E R

Upfront Healthcare

October 2019

Nurses have a huge contribution in the healthcare field.

They are tirelessly working people who devotedly give their time, interest, and knowledge for each patient. From monitoring the patient to fulfilling their medical needs, nurses are the glue that keeps medical facilities running.

WHY ARE NURSES AVOIDING NURSING HOMES?

There are some reasons which have led to a shortage of nurses in nursing homes. Each one has a huge

low for their hard work. After working a full shift (or even more) on a daily basis, coupled with emergency appearances on weekends, they expect to be rewarded

impact on the personal and professional life of a nurse.

financially. According to the U.S. Bureau of Labor

Although they are reluctant to quit, they do in order to

Statistics, however, registered nurses working at

stop fighting an uphill battle that takes place at most

nursing homes earn a salary that’s below the average

facilities. We spoke with Rachel Davidson of Staff

amount for the position. In 2018, the average RN

Blue, a New York-based staffing agency that matches

earned $71,730 per year, but that figure for those at

available nurses with healthcare facilities.

nursing homes and other residential care facilities was

Unacceptable salary packages Nurses expect a handsome income for their services.

Unfortunately, the packages offered to them are too

only $63,990. When the salaries are not enough, good nurses are naturally going to go where the money is.

AGED NURSING STAFF

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Statistics show that by the end of 2030, one in every five individuals will be a senior citizen. Naturally, nursing homes will have to keep up with a projected increase in residents, which will also mean adding staff. There are also more people in nursing homes and longterm rehabilitation facilities due to hospitals discharging patients more quickly. But Davidson says that recruiters find that new staff is being sabotaged by existing staff when they get on-board at a nursing home. “(Veteran nurses) are making sure to discourage them from staying at the facility, telling them what a terrible place it is to work,” Davidson said. “It is up to the management and supervisors to make sure that all staff is treated with respect and appreciation, so they do not feel threatened by new staff.”

ISSUES WITH RECRUITMENT

Most nursing homes are aware of the shortage of nurses, yet they find that they can’t find good nurses on a consistent basis. Administrators and human resources departments spend lots of time vetting candidates, hiring, and training nurses, only to realize that they aren’t a good fit after they start.

Davidson says this is one of the key mistakes healthcare administrators make – they waste time trying to find ideal candidates,

and that adds additional stress on existing staff.

“That’s what we do – we’ll recruit the nurses and make sure they’re good,” explains Davidson. “We do all the pre-checks, we do an interview, and by the time we send them, they’re ready to go.”

Staffing agencies have a pool of nurses who have already gone through hurdles like passing physicals and background checks, so the hiring process is streamlined and efficient.

INCREASED WORKLOAD LEADS TO EXHAUSTION

When a facility is short-staffed, this puts increased pressure on the remaining nursing staff, and it becomes rather difficult for them to manage the workload.

Their patient load increases, their shifts are lengthened, and they get fewer breaks. Since it becomes very difficult for them to manage the lengthy routines, their own physical and mental health begins to deteriorate. That leads to them quitting their job because the grind of long hours at a below-average salary is not ideal.

Davidson calls it’s a catch-22 – if

there was more staff and nurses weren’t as stressed, they would find it easier to work. All the floors should be covered fully so caseloads are not too hard. Nurses generally enjoy their work if they know they have a manageable workload and they won’t be overworked or overburdened. “(We allow) you to hire dozens of high-quality nurses at the same time,” Davidson says of Staff Blue.

“We send nurses in bulk – a batch of eight, nine, 10 nurses at once.

By hiring many nurses at once, the caseload is shared equally by the group.”

NO ACKNOWLEDGEMENT OF NURSES’ DEDICATION

Perhaps the saddest and most unfortunate part of the nursing field is the lack of respect and acknowledgement they feel they get from their administration. They are as important as doctors and surgeons in the healthcare field, yet they are not treated with the same amount of reverence for unknown reasons. Davidson feels that building a relationship with each nurse is the main reason that they will stay – management needs to build loyalty.

That can be done by installing

“New staff is being sabotaged by existing staff when they get on board at a nursing home.”

Upfront Healthcare

October 2019

TIPS TO KEEP NURSES FROM BURNOUT Since many facilities are understaffed, your current nursing staff is probably working overtime. The inevitable reality: burnout. But it doesn’t have to be. Follow three simple tips to improve your staff’s work lives.

1. Invest in nurses’ mental health Nursing is a hard job. Facilities can offer stress training programs, phone counseling sessions and self-care support that helps nursing professionals identify the symptoms of burnout.

2. Praise and encourage your team Simple efforts made by leadership — like acknowledging hard work and providing general support — can give nursing professionals the sense that the long hours they log actually matter to the patients and facility alike.

3. Address staffing needs head-on Studies indicate that nurses are happier when they have more control over their schedules. Nurses often pick up more shifts when they have that coveted flexiblity.. Staffing agencies can also save lots of time and energy while preventing nurse burnout.

a rewards program and giving incentives for things like coming in on time regularly and not skipping shifts. Gift cards can be given to those who go above-and-beyond, and birthdays and other holidays should be acknowledged. Show that you’re involved in the lives of the nurses.

LACK OF TECHNOLOGICAL ADVANCEMENTS

Davidson notes that many nursing homes are in the stone age when it comes to technology.

“Too many nursing homes are still using paper and pen to record medications and patient files; nurses don’t want to work at those facilities.”

Making an investment in technology pays off with an increased efficiency in staff, but she believes that too many administrators are caught up in the cost and training time involved in implementing new systems instead of having an eye on the big picture.

Nursing home residents provide unique challenges The average nursing home resident is in a chronic state of not being able to take care of themselves, but their condition is not severe enough to require hospitalization. This is a delicate situation for everyone involved. Patients may resent the situation they’re in and show hostility towards the nurse, and family members can notoriously be difficult to deal with. Also, due to the age and condition of many residents, they cannot be restored to full health and the death rate is naturally high. All these factors can eventually take an emotional toll on a nurse.

There are also frustrations when doctors aren’t present.

Nurses might notice something that requires a change in treatment orders, but even the slightest modification needs approval from the doctor. That can require long periods of time to leave messages and wait for call-backs.

WHAT CAN NURSING HOME ADMINISTRATORS DO?

The lack of quality nurses at nursing homes is at a critical level, according to Davidson.

“Nurses are an essential part of the healthcare industry,

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The bridge from them to you.

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Upfront Healthcare

October 2019

and if they’re neglected, this

simply due to the numbers game.

recent shift due to lack of time or

industry will fall apart.”

There aren’t enough nurses to spend

resources. Thirty percent of the

the required amount of time for

respondents reported high levels of

Neither the administration nor the patients can afford the absence or shortage of nurses anymore.

each resident.

According to a study published

Regardless of the profession,

in the Journal of the American

an overworked staff can lead to

Geriatrics Society this summer, 72

errors. In healthcare, errors can be

percent of nearly 700 RNs surveyed

catastrophic. Even if no errors are

said that they missed at least one

made, patients can be neglected

necessary case task on their most

burnout at their job.

So, how can NHAs kickstart their staffing efforts back to acceptable levels to create a more stable environment in their facility?

REASONABLE SALARY PACKAGES

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“Even if no errors are made, patients can be neglected simply due to the numbers game.”

Administrators need to study the amount of money they are offering nurses versus what they can make elsewhere. In any field, there will be people who are excellent at their job and those who do enough to get by.

While nurses must have a passion for what they do to succeed, it’s only natural that the cream of the crop are going to gravitate to the best jobs. Many feel the best jobs are the ones that pay the most. If a nursing home nurse is on the lower end of the pay scale, many will see it as a stepping-stone to a better job within the profession and facilities will only be able to retain less-desirable nurses. Salary is a huge motivator for both recruitment and retention.

PROPER EDUCATION AND TRAINING

Nurses must be trained and educated properly. This includes investing in regular training opportunities for staff so they remain in-tune with their everchanging line of work.

HAVE A GOOD RELATIONSHIP WITH YOUR STAFFING AGENCY

Davidson says having a good

relationship with a staff agency will allow you to get what you need in an emergency. “A healthy, long-term relationship with a staffing agency allows us to provide those nurses on standby for you when you have an emergency.”

Staffing agencies can also handle unexpected holes in your schedule. “If our nurse can’t make it in, we’ll replace her or him,” Davidson assures.

PROVIDE GREAT BENEFITS

In addition to pay, nurses are looking for better health benefits.

As mentioned, rewards and other tangible rewards need to be considered by administration and human resources in order to keep nurses happy with their current working conditions.

THE TAKEAWAY: BUILD RELATIONSHIPS WITH YOUR NURSES

Building a relationship with a nurse is the only way a nurse will feel any loyalty to you and want to stay. Show that you have their back by paying them better. Have

a staffing agency available to cover for unexpected callouts, this way nurses don’t have to have it in the back of their minds that they might have to work for several hours after their scheduled shift ends. Create an incentive program to reward your best nurses, which, in turn, will increase word-of-mouth that your facility is a great place to work.

Invest in technology and training to make the parts of the job that you can control a bit easier.

Nurses are looking for better pay and benefits, especially health benefits. Davidson says that in addition to better pay and health benefits, “Work environments at the nursing homes need improvement, administration and HR need to be ahead of the game and keep orienting and training nurses on a consistent basis to keep a shortage at a minimum.

“If the nurses are not overwhelmed with their caseloads, they are less likely to leave.”

If nurses are competing to work at your facility, you will never have to worry about a long-term shortage again. While there are major underlying factors that will make the nursing home industry a difficult one for nurses for the foreseeable future, you can control your world to make your place an ideal longterm destination for nurses. ●

Upfront Healthcare

October 2019

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How Technology is Revolutionizing Healthcare Technology is turning the world on its head and has rapidly changed the way we do just about everything. We live in an age of speed and convenience as a result of advancements in technology, and we can take advantage of these innovations in the healthcare industry.

BY C H R I S H U G H E S

Upfront Healthcare

October 2019

Global healthcare is in the middle of a cutting-edge revolution with the introduction of various digital technologies like telemedicine, robotics, and virtual reality (VR) in-home care.

communicate with their doctors or health providers. It is projected that telemedicine will eventually surpass traditional office visits as the primary approach of healthcare in America.

That’s not to mention care that people can get at home through smart devices. The Apple Watch and other wearable tech can now be used to track heart rates and detect abnormalities to potentially alert someone of a heart issue that can be addressed before damage or a serious medical event occurs.

Patients now prefer to use these virtual visits to communicate with their healthcare providers as they find it easier and faster. For instance, patients who suffer from strokes or any neurological diseases frequently need rehabilitative care that does not require personal contact with the healthcare provider. They can use these remote options to ease their stress and get the service they need.

Let’s dive into these technologies that are making enormous strides to create a better future for the healthcare industry.

TELEMEDICINE

Telemedicine has been around for more than 40 years, but it has really become a part of more peoples’ lives in the past decade or so. It was designed to connect doctors to patients in rural areas. It is still used for this purpose; especially as rural hospitals are continuing to shut down at an alarming rate.

Technology has, however, evolved this process to include a way for people busy with work, parenting, and anything else to see a doctor quickly through the use of video technology like Skype, Facetime, and other tech that healthcare companies employ.

It is now straightforward, safe, and cost-effective for patients to

Both the healthcare providers and the patients benefit from telemedicine. The benefits include:

Easy accessibility for everyone. Individuals who are unable or unwilling to leave their comfort zones to seek medical care are now covered. Patients may be unable to leave their home for various reasons, and many people have an outright fear of the doctor’s office. Telemedicine has now made it easy for patients to receive medical care without a problem.

Increased Revenue and Cost Savings. With telemedicine making it possible for more patients to be diagnosed in less time, the revenue generated by physicians and hospitals is increasing significantly.

Also, medical practitioners are likely to save in office costs like staffing,

rent, and other peripheral expenses.

This does not only apply to healthcare providers, as patients also spend less on expenses that relate to healthcare, such as traveling expenses, smaller copays, and having to pay for unnecessary tests and lab work.

Increased Volume.

Telemedicine is so dynamic and flexible that it makes it possible for healthcare providers to attend to a higher number of patients in a shorter period by optimizing their schedule. Doctors don’t have to worry about squeezing in patients, people showing up late for appointments, and other pitfalls that cause delays in the office.

As the years go by, more and more people will be accustomed to virtual healthcare visits through the phone or computer, so the growth of this part of the industry is expected to continue.

ROBOTICS

Robotics have also been revolutionizing the global healthcare industry in recent decades. Robotics research has now been made paramount as it aims at handling a gamut of tasks, from performing surgeries to extending healthcare services to those with disabilities.

More and more companies are providing massive amounts of funding to increase the use of robotics in the healthcare field.

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“ Robots increase independence and offer seniors a more comfortable lifestyle.”

Upfront Healthcare

October 2019

Robot Hospital Helper These bots help to reduce the workload on doctors and nurses in the hospital. They can be used in delivering messages and samples to hospitals in an efficient and faster fashion. Examples of such robots are TUG and Hospi; they are delivery bots that navigate the hospital halls by carrying a GPS that is set to a final destination by doctors or other medical professionals. These robots help medical personnel focus more and spend more time attending to the welfare of patients.

Paraplegics Get a New Lease on Life A paraplegic’s chances at living the most normal life possible is increased with the advancement of robotics technology. A new “exoskeleton” has given new hope to paraplegic patients who may have been resigned to the fact that they may never walk again. The technology is a wearable one, and it helps to reactivate the functionality of the legs to enable them to walk again on their own.

Treating Seniors Each day, the population of seniors who are 65 and older is growing.

The pressure to give adequate healthcare to this group of people is now getting more intense due to the ongoing increase in their population that is only forecasted to grow even more in the coming decades.

Robots are now being harnessed and automated in performing some home-care activities. The mobile-assistive robotics market has been loaded with automation technology like Paro and Pepper.

They help in providing simple and

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essential services like detection of an accident, which is later reported to medical personnel. They can also be used as therapeutic entertainment for elderly people living with depression or dementia.

These robots create a sense of independence, enhances productivity, and gives a comfortable lifestyle in homes of seniors.

they want to go, even if they can’t physically travel there. VR also gives seniors nearly endless ways to keep their minds active. VR can be applied in several therapies, which include nature, music, art, history, pets, and more.

Virtual reality creates a lifestyle of wellness and happiness for our elders.

VR IN-HOME CARE

Virtual reality is very prominent in the world of video games and the entertainment industry. However, its applications are not only limited to these exciting things – virtual reality is also becoming a force in the healthcare industry. VR is being used to train more skilled health professionals, improve patient care, and develop innovative treatment options.

Here are some benefits of VR inhome care:

Pain/Emotion Management.

VR can be used for patients in the form of pain management therapy.

VR helps patients to learn to manage their reactions, and even things like fear of heights. Also, VR can be used in substance abuse programs and to curb disorders like social anxiety.

Improved Quality Lifestyle for Seniors VR helps seniors maintain a quality lifestyle, even as their physical capabilities may diminish.

VR tech can help take them where

SENIORS ARE BECOMING MORE AND MORE CONNECTED

Technology isn’t only for our youth anymore, as seniors are now also benefitting from the technological innovations being rolled out. Seniors truly need support, and technology can help them maintain a sense of independence.

Emergency Care or Help Aside from the benefits of entertainment and being more easily connected to family and friends, seniors can get help during different cases of emergency. Personal emergency response systems or fall detectors makes it easy for them to get rapid help.

Seniors can take wearable tech along with them everywhere. With this, they can swiftly call for help anytime they need immediate assistance.

Routine Home Care Some seniors prefer to stay in their homes, which can be a significant

concern if they are left on their own.

Luckily, technology has now made it easier to call for an emergency when they need immediate and responsive medical care.

There are apps designed that will facilitate fast, responsive treatment from healthcare professionals for the elderly. Seniors can be easily taught how to use and these apps themselves and call for help whenever they need them at any time of discomfort or emergency.

Hospitals, nursing homes, and senior rehab facilities can tap into this great advantage as seniors are now online. Mobile applications that can be used for an emergency at any point in time can be developed, especially for seniors, to prevent any casualty from taking place.

Of course, technology does have its downfalls, as along with typical phone scams that have targeted the elderly for years, seniors need to be aware of predators trying to take advantage of them via email and social media channels. It is vital for young people in their life to teach them the right way to use these new-age tools and routinely check in on them to make sure that no one is trying to take advantage of them.

However, while there are disadvantages, the continued use of technology will continue to benefit the healthcare industry – and patients as a whole – for generations to come. ●

Upfront Healthcare

November 2019

Bringing People Together Joseph Blumenfeld, founder and creative director of GCNY Marketing and healthcare marketing expert, weighs in on how nursing homes can harness the power of marketing to connect with the community, engage with locals, and experience a rise in resident census

BY R E B E C C A L I E B E R M A N

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bothering to understand who they are, their culture, and their lifestyle, you have a lot of work ahead of you. By tapping into the community culture, you’re creating emotional connections and establishing yourself as a mainstay of the community.”

Tip #1 Partner with a Local Nonprofit.

“A nursing home is not a hospital,” says Joseph Blumenfeld, owner of GCNY Marketing and mastermind behind countless successful nursing home PR campaigns. Hospitals, explains Mr. Blumenfeld, are for purposedriven stays. Patients are reassured by good surgery outcomes and don’t care if the lunchroom only serves bologna sandwiches.

LTC facilities, on the other hand, are not only about the rehab (although that’s a big part of it.)

“You’re there for the long haul– you’re there for more than three months,” explains Blumenfeld.

According to the National Nursing Home Survey, the average length

of stay for patients currently in nursing homes is 892 days, or 2.44 years. When prospective residents are considering facilities for such a lengthy stay, there are a lot of factors involved.

The rehab aspect is paramount, and boasting good outcomes is arguably the most important factor in deciding at which facility to stay.

But when an LTC facility builds a connection with the community, it taps into an emotional connection– creating a welcoming and familiar environment that reassures potential residents with the lure of a home away from home.

“If you’ve just plunked yourself in the middle of a community without

One way of creating deep roots with a community is by showing them that you share important values. “When you partner with a soup kitchen, Christmas toy drive, or local volunteer fire department, you’re showing the community, the target audience, that you’re involved, you really care, and you’re not just here to profit off of them.”

GCNY worked with national client Centers Healthcare to align their Bannister, RI facility with the community and increase public awareness. Bannister Center partnered with a local celebrity, Chef Walter Potenza, who runs a huge local soup kitchen that sustains the community’s needy.

In addition to his charitable contributions, Chef Walter offers cooking demos that promote healthful eating. Bannister Center leveraged Chef Walter’s reputation by opening the facility to the community and exhibiting health

Upfront Healthcare

October 2019

shows, where the chef demoed delicious and wholesome recipes.

Chef Walter also reinvented Bannister’s menu for an unparalleled dining experience that now reflects his healthy eating values.

Queens in New York, Blumenfeld set out to help the facility interact on an individual level. “There are a lot of veterans in the LTC community, and we wanted to give them the respect they deserve.”

The result: Through advertising and TV spots with the celebrity chef, the community saw a familiar face– and their trust in Bannister Center increased.

The Grand encouraged their veteran residents to create personal wish lists–things they always wanted to do all their lives, but never got a chance. Then, The Grand collected the wish lists–and helped each veteran achieve one seemingly unattainable object on their list.

Tip #2 Focus on the Individual.

“When you think of marketing, your mind goes to broadcasting, going big, being loud,” says Blumenfeld. “But targeting individuals–especially when trying to make connections–is one of the best ways to develop strong ties with your community base.”

Working with The Grand Rehabilitation and Nursing at

Joseph’s favorite story: The Grand resident George Fink, a WWII veteran, served as an army driver, delivering tanks throughout Europe. He wished he could get the opportunity to drive a tank again and relive the memories of his youth. For his 92nd birthday, The Grand staff made his wish a reality, tracking down a WWII-era tank and surprising him with a birthday

drive.

The outcome: The campaign was picked up by local TV stations.

Thousands of Queens members were overcome by the heartfelt stories captured by the media, and proud of their community’s efforts in giving respect to those who served bravely.

The Grand planted deep roots in individual families and touched hearts everywhere.

Tip #3 Find the Community’s Interests.

“Communities are different. What works in Manhattan doesn’t work in Kansas,” advises Blumenfeld.

His suggestion? Find out what the community loves–and tap into that.

Blumenfeld illustrates this tip with another campaign he ran with Centers Healthcare. When Centers opened two new facilities in Buffalo,

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the Buffalo Sabres. “It makes sense, because they both have shared values: both Centers and Sabres set goals, and reach them.”

The popular ice hockey team is seen by millions each year in their ice hockey arena and across the country. And the majority of their fan base, of course, is in Buffalo, creating a huge overlap with the facilities’ potential residents.

Marty Biron, Goaltender for Buffalo Sabres

New York, the Buffalo market didn’t know who they were. They needed to become a familiar–and beloved– figure in Buffalo, and fast.

“We could have inched our way up the ladder by putting ads out and knocking on doors, but we decided to go big and put the Buffalo Centers right in the public eye.”

To do that, they discovered what the community loves most–and harnessed the public power of the largest hockey team in the region,

Buffalo Sabres win 4 to 7

Goaltender Marty Biron is the Centers spokesman and promotes their advanced rehab capabilities and amazing outcomes, recommending Centers as the primary choice for phenomenal rehab. And the Buffalo community sees the face of a team they know and love on local television, fostering familiarity and creating connections.

Bonus Tip: Publicize Everything.

Many facilities tend to invest a lot in local community efforts but

forget to communicate that to the public–from promoting in advance to post-event positive exposure.

According to Blumenfeld, it’s not necessarily about the big advertising bucks. “It seems impressive to buy a TV spot or paid media buys in national newspapers. But there are other cost-effective ways to get it done.

“Every community has its own little circulars that locals interact with on the daily. And connecting via social media is essential these days, building an online touchpoint and publishing constant updates of the goings-on in facilities.”

Another way to get public is organic reach through innovation.

“If you’re doing something exciting, bigger news outlets are more likely to pick it up and publish it.”

From exciting rehab activities like horse therapy to innovative rehab tech, there’s no shortage of ideas that can potentially get plenty of attention. “All you need is some creativity.” ●

Upfront Healthcare

October 2019

Gaming, dancing, and VR: it seems that seniors are getting younger. Keep up with trends in senior living and round out your recreation department with more than just bingo.

Getting Younger.

BY S A R A G R U N WA L D

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Upfront Healthcare

October 2019

It doesn’t take a specialist to see that the elderly of tomorrow will differ from those of yesterday.

Today’s youngsters have access to more technology than their grandparents ever thought possible.

But with those benefits and conveniences comes a change in dynamics.

As healthcare professionals, it’s our job to learn what those changes might mean for our care approach.

After all, our responsibility to our golden-aged population is not based solely on providing adequate care, but on developing enriching experiences as well. In earlier times, this might have meant providing access to activities such as card games, board/parlor games, and Bingo. But when Fortnite-savvy youth will grow old, they will bring with them a different set of

THIS ACIVITY CAN IMPROVE AND PREVENT COGNITIVE IMPAIRMENT ISSUES.

interests—many of them focused on technology.

So, the question begs: How can we cater to these interests, while simultaneously encouraging connective experiences with one another? Modern experts may have some ideas: GET GAMING!

Some might think that board games are old hat, but the fact is, new tabletop experiences are still in high demand. Many modern adults get together for ‘game days’—playing out elaborate adventures on their dining room table. Some more popular titles are based on science fiction themes, such as Nemesis, or lush nature adventures, such as Wingspan.

If those games seem a bit too complex to present to elders, never fear. There are also some more simplistic options, reminiscent of vintage creations. Some popular choices for groups include geometric delights like Azul, or deductive reasoning challenges, like Code Names.

And what about video games?

There may have been some conflict over the years about the potential benefits and risks of technological gaming, but evidence continues to mount on the cognitive and academic skills that may be nourished with moderate use. In children, video games have proven

to encourage positive effects on a variety of mental processes— including perception, attention, and memory. Recent studies on the effects of video games on senior brains showed similar results, encouraging the theory that this activity can improve and prevent age-related cognitive impairment issues.

Thanks to modern developments in technological design, video games can also benefit seniors in another way: social interaction.

Through both remote and inperson features, players can invite their friends to join in on the fun, with series games like Super Mario Party , Overcooked, and Raving Rabbids. Many multiplayer games encourage the development of vast virtual communities, where players can interact with one another and share their common interests. Such activities may be beneficial for more timid seniors who need a less-direct way to ease into social interaction.

These kinds of activities are not only great for getting residents to communicate with one another; they’re wonderful for mental stimulation as well. Studies show many common declines in memory and mental capacity related to age can be prevented with simple lifestyle changes. In short: an active mind is a healthy mind.

GET DANCING!

The individual expressions and

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themes may change, but dance has never gone out of style. Professionals working to care for the elderly should make a point to study the musical trends of their patients’ generations, and bring those themes into new music and movement activities. Doing so might have more benefits than you realize.

At this point, it’s relatively common knowledge that gentle exercise can help with age-related stiffness and arthritis. But did you know that dance in particular also helps improve mental function?

Senior dance groups, such as the SYZYGY Dance Project, are looking to spread the word about the mental health benefits of dance.

Preliminary studies even showed a connection between music and movement activities and the prevention of dementia, including

Alzheimer’s disease.

Place Swing Dance winners

Many dances can be easily modified for physical limitations and may help improve patient confidence. In fact, many seniors involved in these kinds of programs have attested to their social and emotional benefits—asserting that learning to dance, alone or with a partner, has helped them feel more confident in social situations, as well as improve their overall sense of wellbeing.

Michael Garland and Carol Constant - Texas State Dance Champions

Some seniors have even gone one step further—participating in (and winning!) dance championships all over the globe. Many insist they are in even better shape now than they were in their 30s and 40s.

Case in point: Sam West and Ellen Taylor Grand National Championship 1st

Sally Stalamy - Lifelong dancer and performer GET CREATIVE!

Whenever an industry is in need of new innovations, it’s important to think outside the box. That’s what groups like Generations United are doing, by bringing intergenerational care into the spotlight.

Intergenerational care is the integration of senior day care and the care of young children and teens into a single facility. While this may seem odd at first, studies have shown that intergenerational programs may decrease social isolation in seniors, while increasing their sense of confidence and wellbeing. In

Upfront Healthcare

October 2019

addition, researchers found that children and teens who participated in these programs developed a marked improvement in social and emotional skills compared to their non-participant counterparts.

GET VIRTUAL!

Thanks to impressive technological advancements, even seniors with mobility challenges can get in on the fun. Now, companies all around the world are giving back to the senior population through the innovative opportunities of virtual reality.

Through virtual experiences, seniors can take adventures they

have long believed impossible.

Injured former athletes can climb mountains once again. Severely arthritic patients can draw, paint, and sculpt as they once did in their younger years. Residents battling cognitive ailments such as Alzheimer’s and dementia have been able to experience enhanced comfort with virtual trips back in time. Virtual reality has even made it possible to revisit old memories, events, and places—such as a childhood home or vacation spot.

Some companies have even helped seniors make new memories, providing a virtual adventure to a place they’ve never been or a sight

they’ve never seen. Bedridden patients can experience the joy of a countrywide road trip or a swim in the ocean—all without leaving their room.

GET MORE!

In every effort, it’s important to remember that many limits are those that we impose on ourselves.

In the case of improving the senior care experience, we can and should do more, not just for the generations to come, but also for those currently in our care. Many of these strategies can be modified and applied to current senior living situations. ●

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Upfront Healthcare

October 2019

MEETING PATIENTS WITH PATIENCE 5 steps to dealing with difficult patient complaints

BY K E L L I E B R OY N

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Anyone working in a public service position has seen their (un) fair share of difficult situations. And patient care is no exception. While tough experiences cannot be entirely eliminated, they can be improved.

Check out these valuable tricks of the trade from veteran health care professionals.

stressful situations. Simply taking the time to make a patient feel heard can make all the difference in the

Sympathy is feeling for someone, but empathy is feeling with them.

STEP 1: REMAIN CALM

In any tense situation, meeting anger with anger only provides fuel for the fire. The key is to remain calm and collected, even if your patient isn’t. This will, in turn, encourage your patient to relax and help them be more receptive to what you have to offer.

Many healthcare and public service professionals stand by this tried-and-true technique: If you want a client or patient to stop yelling, try speaking more quietly.

The quieter you speak, the more they will need to lower their own voice to hear you, and the calmer they will become.

STEP 2: ACKNOWLEDGE THE PATIENT

Many professionals know from experience: People tend to yell when they feel as if no one is truly listening to them. That’s why it’s so important to acknowledge the patient’s feelings—especially in

you understand their side of the situation, and that you are able to match those feelings.

world on how the conversation progresses.

When someone in your charge is upset, it can be helpful to begin your counter-discussion with repetition.

To put it simply, repeat their feelings back to them. (Example: I understand that you are feeling upset/frustrated because…) This helps them know you are listening and attempting to understand their feelings.

STEP 3: PRACTICE EMPATHY

One of the best ways to make a connection with your patient is to make an effort to understand how they feel. Often, these types of issues are less about you and more about the situation itself.

Pain and anxiety—even hunger, if they’re being asked to fast—can make anyone short-tempered. This is where you have an opportunity to be a supportive shoulder for your patient; help them see that

While the capacity for empathy is an inherent trait, empathetic behavior is learned. It’s also different from ‘sympathy’, although the terms are often used synonymously.

In short: sympathy is feeling for someone, but empathy is feeling with them. For more information, check out this useful RSA short from Dr. Brene’ Brown.

STEP 4: DO WHAT YOU CAN

In some situations, steps 1-3 are the endpoint for what you can do for the patient. Thankfully, not all issues are so limited. Remember to utilize your creativity and forwardthinking when addressing each patient concern. There may be more that can be done for them than you initially think. The key to finding it is to take a moment, slow down, and remember that each room you walk into contains a human being, not just a patient.

No matter what your position in the facility hierarchy, it’s important

Upfront Healthcare

October 2019

to know your resources. Make sure you get to know what tools you have at your disposal for each patient— and take the time to get to know your fellow healthcare professionals.

One of them may be able to help.

STEP 5: SET LIMITS

Once you’ve reached this point, you may be thinking that what you’ve already done will be enough to satisfy a patient’s concern.

Perhaps, in a typical situation, it would. And yet, this is not a

typical situation. That’s why it’s also important to set clear limits when they have been reached.

If a patient’s anxiety or frustration is being overly demanding of your time, you have the right to make your boundaries clear. For example, in an applicable situation, you could say: “I will check on you in 30 minutes. We will see how you are feeling then and go from there.” Often, these boundaries can even help the patient feel more comfortable, since they know what to expect.

REMEMBER: WE ARE ALL IN THIS TOGETHER

In difficult situations, your supervisor is your greatest ally.

Familiarize yourself with the protocol within your company as to when you should approach them about patient situations, what verbiage you should use when dealing with a verbally abusive patient, and whom else you should consult when times get tough. ●

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