Guest House Nursing And Rehabilitation

Staffing

Our department heads consist of myself, our RN DON, RN ADON, RN MDS Coordinator, Director of Rehab, LPN Medicare Coordinator, Social Services Director, certified Bookkeeper, certified Activities Director, Treatment nurse, and registered Dietary Manager. Our floor staff consists of LPNs and CNAs + a CNA Supervisor and CNA lead. We staff floor clinical personnel at 50% higher than the state mandate.

Safety

Aside from higher staffing rates, maintenance ensures that equipment is inspected and working properly on a routine basis. We keep open connection with our local Ombudsman (Resident Advocate) to ensure resident rights are being respected. All grievances are handled by my Social Director and me and are forwarded to the Ombudsman if all parties do not feel that issues were reconciled. Fall mats and other assistive devices are widely implemented to mitigate potential injury. Only one major injury reported within the last quarter and was highly suspected to have been the result of the resident’s fall at home, not in the facility, but was still investigated and treated as if it was from a fall in the facility. Call light systems interconnect all the way to the front of the ward so that call lights can be identified even if personnel are around 2 corners of the building + ward clerk pages overhead if a call light is not answered within 30 seconds. Social Director also meets with residents to assess their personal feelings of safety and security. We also have good and working relationships with outside authorities if ever needed.

Community Transitioning

We follow the state standard “Section Q” for Medicaid Waiver services (when Medicaid is applicable) to transition into the community. This program goes through the Office of Aging and Adult Services to secure sitters in the home and supplies transition coordinators that work with the nursing facility. In addition, residents discharging from therapy often have orders for home health. We always put a plan together for a safe discharge.

Transportation

We offer transportation services at no cost for medical appointments/services only. Medicaid offers transportation services but will have to be set up by the resident or family. We can pick up initially from the hospital, but we do not transport back home due to liability potential.

Dining

Since the facility is split into “neighborhoods”, each neighborhood has their own dining area, as well as a main dining area in the center of the facility. Currently, most residents prefer to dine in their native neighborhoods as aides bring their trays in insulated carts to provide hot meals. We offer a wide range of menu items that also include an alternate meal option, as well as an always available menu. Our dietary manager assesses the residents’ preferences upon admission and when necessary.

Complaints

The complaint procedure model is structured as such: Resident (or loved one on their behalf) states grievance to staff member, who relays to myself, Administrator. Residents often approach my office themselves to file the grievance. Grievances are documented and the investigation/procedure begins, aiming to reconcile the issue within 72 hours or provide an acceptable reason if issue cannot be resolved. Grievances are documented, kept, and reviewed routinely by the Ombudsman and state surveyors. If the grievance cannot be resolved, it can be brought to one of these agencies either by the residents themselves or the facility, preferably the latter. All findings and steps are reported to the resident and/or their responsible party.

Costs of Living

I am a bit unclear on the inquiry of the cost of living. I can say that Medicare (traditional or a managed care within our network) pays for 100% of the stay if resident is in for therapy only. Medicaid + Social Security pays for 100% of a long-term-care stay. Resident can private pay $250/day if no insurances are applicable. All meals, utilities, linens, toiletries, nursing supplies, and other items vital to care are included in this rate. The only common additional items/services identified that would require funds out-of-pocket are personal clothing, beauty shop services, and personal bills. Our facility is also unique in that a television, internet, cable, and land-line phone service are also included for each resident at no additional cost. If you only meant the cost of living in the physical, general area of West Monroe, I would say moderate-low. Residents rarely need to access goods outside of the facility.

Communication

The standard for communicating with a resident’s Responsible Party (the person/people they name as their primary contacts) include notifying them of all order changes, falls, accidents/incidents, changes in condition, moving rooms, treatment changes, therapy updates, treatment refusals, scheduled appointments, care plan updates, new diagnoses, and for policy/billing/general clerical updates. Families are called often. Residents and their RPs can also add any event/incident/variable to the list that they would like to be notified of, and families and residents may absolutely call each other at any time. Resident may install a phone to use on our service, may use the phone in their neighborhood, at the nurse’s station, or can request a staff member to call a family member. I have even called families for residents per their request in my office.

Length of Stay

A resident may discharge at any time they please. We do offer short-term therapy stays, respite/hospice, and have had folks come in and out as their lives and conditions change. While we often advise and organize discharge planning meetings, even a long-term-care resident can discharge at any given point. Residents may also leave the building and return without formally being discharged. Therapy residents must return by midnight same-day to remain on census, long-term residents on Medicaid can be out 14 midnights (but no more than 3 consecutive) per year to remain on census and remain covered by insurance. Private-pay residents may leave however long they would like but will be issued a bed-hold fee if they plan to return. Respite/hospice care are billed through Medicare via the hospice agency at no cost.

Pets

I do know that pets are more than welcome to visit! I actually need to check on our policy on if pets are allowed to stay the entire length of the resident’s stay, but I am positive that they can visit. Naturally, this is assuming they are well behaved and that any potential messes are mitigated. I have several family members who bring their dogs to visit every day.

Feel free to print out this email to go over with loved ones and address any more questions in the meantime. This is a lot of information to consume at once, so I am sure that as you digest it, more questions will come up. You are also more than welcome to visit or send a visitor and I will personally provide a tour.

Shoot me an email, text, or call when needed. I am more than happy to elaborate further. We currently do not have a waitlist and are accepting both skilled and long-term residents.