Best Long-Term Care Team 2011 Winner

Congratulations to CNR Center for Nursing and Rehabilitation!

Posted on: September 14, 2011

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Sponsored by Crossroads Hospice

CNR Center for Nursing and Rehabilitation - Beth Abraham Family of Health Services - Brooklyn, NY

Brenda Torres, recreation manager and volunteer coordinator, has been working for the organization for almost 17 years and has witnessed the dedicated, skilled and compassionate work of CNR's team. The facility operates on a person-centered care model that upholds the core values of caring, diversity, integrity and creativity.

Here are highlights from Brenda's winning entry. Congratulations to the CNR team!

Traditionally it is thought that a nursing home "team" is comprised of the physician and the nurse. But our team is not traditional in any sense, as it consists of our residents, their families, the interdisciplinary staff and dedicated volunteers. Our team is a family and I truly believe that we have the best long-term care team.

Showing Initiative

Our residents live the spirit of life from the moment of their arrival. The CNR staff goes above and beyond to ensure that the dignity and honor of each resident is preserved, especially as their journeys come to an end. As part of celebrating our residents' lives, we have created The Legacy Program. The Legacy Program captures snapshots of residents' lives through video messages, writings, poems and songs. These snapshots are recorded and provided as gifts to the family members from their departed loved ones. As one resident described it: "The missed moments in life are not forgotten and we are able to share with our loved ones all of the 'I never told you' and 'I didn't tell you enough' moments, which are now captured for a lifetime."
As an additional remembrance of residents' lives, we have created handmade quilts, sewn by residents, their families, our staff and volunteers. These quilts are created with personalized themes that define the resident as a person and preserve his or her memory.

Innovative Programming

Technology gives us the freedom to be connected. Our Hi-Touch, Hi-Tech program removes all boundaries and connects our residents to their loved ones across the world. Birthdays, weddings, holidays and all other occasions can be shared through video conferencing. Our residents are able to interact with their families in real time, as if they were in the same room.

Multimedia

Using this technology, residents are also able to connect to virtual volunteers who provide virtual reading, teaching, yoga demonstrations, dancing and live tours of the many attractions our city has to offer.

We've also incorporated Interactive Rehabilitation Exercise System (IREX) into our rehabilitation program. IREX is an immersive and interactive computerized virtual rehabilitation system that allows patients to receive physical and occupational therapy by participating in virtual environments. The system simulates activities such as race-car driving, drum tapping, soccer and volleyball while collecting and recording vital data during each treatment session. Our residents have fun immersing themselves in a virtual world while improving their sensory, cognitive and motor skills.

Recruitment/Retention

Our retention and recruitment process is one of a kind as it allows the residents to be part of the panel that interviews potential CNR employees. After all, this is their home. At CNR, both the facility and the residents take pride in our staff. Our resident council nominates employees who they believe exemplify the core values of CNR and influence the facility's annual recognition awards on different areas of distinction.

Teamwork

The fierce Blizzard of 2010 paralyzed New York City, halting commuter trains, subways and buses. However, the storm did not stop the commitment and dedication of the CNR team. Several staff members slept in the facility overnight, many carpooled, and all worked extensive hours helping where they could to ensure resident care would not be compromised. Our team's dedication enabled us to admit a resident during one of the worst storms this city has faced, all because we wanted to achieve a common goal: 100 percent occupancy. Our team always rises to the occasion, even in the midst of a crisis.

Adaptability

CNR has faced strong economic challenges that have had implications on our job security and financial viability. In the midst of this hardship, our staff came together to form an ecumenical prayer council. This meeting occurs every morning and includes team members of various faiths: Christians, Jews, Muslims and Buddhists. Though we may have come from many different walks of life, the team is held together by the conviction to overcome these challenges.

Our efforts have resulted in various successes such as a positive CARF survey conferring accreditations in three clinical areas. During this time, we also transitioned to a smoke-free facility, had a successful Department of Health survey and implemented an EMR system, all while maintaining a 98.83 percent occupancy rate. Our team's dedication and commitment to a higher standard of excellence fosters an environment of constant change and encourages adaptability.

Knowledge

Our organization believes in our employees and heavily invests in their personal and professional growth and development. Continuing education programs enhance our knowledge base while keeping us current to today's trends. The tools provided ready us to face the challenges of this competitive industry. Our team is empowered and strives to provide the best quality of service to our residents. We believe education should not be limited solely to our staff, but also to the community we serve. This is demonstrated by the many wellness programs, community board advisory meetings, and health fairs we sponsor.

Our administrator uses the Leadership, Innovation and Growth (LIG) management framework to foster an environment that is conducive to supporting employee growth. Every department is asked to present on their leadership strategies, innovative initiatives and departmental activities that promote growth, while embracing the tenets of clinical, legal and fiscal balance. Each manager is given the autonomy to lead their staff in a manner that meets their individual learning styles. Thiss innovative approach has successfully brought our team together and encourages us to work harder for a common goal.

The CNR team is a collective of compassionate, creative and dedicated members of our community, who have demonstrated leadership by going above beyond the call of duty. Our team struggles, sacrifices and endures hardships that most will never quite understand. We stay true to our caring mission because deep down inside we are fulfilling the greater purpose - love.

HONORABLE MENTIONS

Honorable Mention for Employee Programs:
NHC Healthcare Sumter - Sumter, SC

NHC's Employee Engagement Program strives to get employees more involved in decisionmaking throughout the facility. Initially, they divided up the department managers between three nursing stations. Each team was given the charge to make the unit the best it could be. Few rules were outlined and no specific goals were set; each team was encouraged to form their own objectives. Once the competition began, many new activities started happening on each unit. After initial success, they decided to take the project to another level. They reassigned the teams and involved even more employees. They further expanded the project to get the teams to conduct quality assurance programs for their units. Since beginning this project, they have had numerous positive outcomes: expanded activities program, decrease in falls, decreased use of restraints, decreased employee turnover and an increase in resident and family satisfaction. The key to success has been constant evaluation of the program by department managers. The Employee Engagement Program has developed a group of employees who are not only committed, but also enthusiastic.

Honorable Mention for Embracing Technology:
Milner Community Health Care - Rossville, IN

Recently, Milner has adopted state of the art technology to streamline its medication management process including electronic medical administration records (e-MARs), computerized physician order entry system (CPOES) and an InSite Remote Dispensing System. This medication dispensing system inputs prescriptions electronically and stays in one location, reducing human error and improving resident safety. In the traditional model of 30-day blister cards, nurses prepared medication passes manually and record medication information by hand in large binders. On average, nurses spent about 2-3 hours for each medication pass. With the closed looped medication management system, the facility electronically inputs medication orders and sends them to the pharmacy. The pharmacy receives the order and the medications are delivered to the facility to put in the remote dispensing unit on-location. They can dispense the medication on-demand and record medication information on handheld devices. Using remote dispensing with the e-MARs has given the nurses a significant amount of extra time to spend with residents.

Honorable Mention for Innovative Clinical Programming:
Bartley Healthcare Nursing and Rehabilitation - Jackson, NJ

A recent example of BHNR's innovative programs is the partnership with two area health care systems to reduce re-hospitalizations for patients with diagnoses of CHF, myocardial infarction and pneumonia. By reducing re-hospitalizations for these three diagnoses, partners benefit by not being penalized by CMS, and by managing the diseases in place, BHNR increases length of stay and provides a positive patient experience. To provide a higher level of excellence in reducing pressure ulcers, BHNR has sent nurses and frontline staff to be certified in wound care. This certification process enabled the nurses to expand their knowledge of the etymology of wounds, approaches to wound prevention and best practices in wound healing and share their new expertise with the full clinical team.

Honorable Mention for Facility Turnaround:
Crawford Skilled Nursing and Rehabilitation Center - Fall River, MA

When the DON and administrator took over the management of this nursing center three years ago, it had recently suffered an unfavorable survey. Since then, it has gone from 2 stars to a 4-star rating. It went from having a census problem to a having waiting list. It went from having a staffing shortage to having a surplus of resumes. The initiative of Crawford's management team is displayed daily as they help each member excel by going above and beyond. We transformed from a sleepy nursing home to a vibrant transitional care center. They were asked to do more with no additional time, but everyone stepped forward. The entire clinical team rounds frequently to assure that only the best of Crawford is presented.

Honorable Mention for Recruitment and Retention:
Cristwood Nursing and Rehabilitation Center - Seattle, WA

The facility is made up of five neighborhoods, each with their own unique resident focus. The team on the Dogwood Terrace secure neighborhood specializes in compassionate dementia care and is known for using teamwork to meet residents' needs. The staff of Dogwood love the residents that they serve and it shows. The average tenure of the dedicated team in the neighborhood is over 11 years of service, with a third of the staff with 15 and more years! One of the hallmarks of the team is that they are great collaborators. The team works as a whole, building on ideas, creativity and knowledge of the group. The team takes a holistic approach to care, including families to the degree they wish. They see themselves as partners with families to provide the very best care, and seek to understand every resident's history, personality, culture, faith, education, habits and interests.

Honorable Mention for Continuing Education:
The Hill at Whitemarsh - Lafayette Hill, PA

The team at The Hill at Whitemarsh shows initiative in constantly looking for ways to improve the level of service and resident care. The team recently welcomed a new DON, Susan Park, who worked her way up in the industry, starting out as a CNA. She gained experience and obtained her RN, eventually becoming the DON. That experience has provided her with a unique perspective and leadership capability that allows her to understand the everyday challenges the staff face on a regular basis.
The rest of the staff is also building upon their knowledge. Several CNAs are studying to achieve an LPN license and some LPNs are taking courses toward an RN license. Many RNs and LPNs help other staff learn and grown in their jobs.

I had a one week experience at a nursing home that disturbed me severely. The state visited this facility 7 times out of 4 months. I resigned for fear of losing my license. As I interview for other LTC facilities, I am given ratios of 1:24 nurse:patients or more. The turnover rates are extremely high. I just have to say how very happy it makes me to know that better facilities exist and are given recognition for their efforts. Thank you for giving me some hope for future prospects and for taking good care of your residents!

Mary Jo Newport, RN	December 24, 2011
Lakewood, OH

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