Professional Documents
Culture Documents
Building
EMPLOYEE
RETENTION
PLUS:
• Avoiding On-Call Coverage Pitfalls
• Handling a Media Crisis
• Developing Employee
Immunization Campaigns
www.whca.com
www.wical.org
Does Your Rehab
Provider Offer All This?
• trained, experienced • Medicare claims and • national client services
therapists and assistants denials management resource group (clinical,
dedicated to improving the indemnification PPS, financial expertise and
lives of your residents • long-term care current regulatory guidance
• local rehab manager and programming consultation)
facility-specific program • continuous quality • accurate and timely resident
manager improvement screening
• therapists skilled in current • measurable, outcomes- • full range of census-building
CPT codes and their uses driven services (clinical, programs
• therapists paid for all their financial and administrative • corporate compliance
time in your facility tools available) program/HIPAA committee
• staff development and • local, regional and national • facilitate cash flow
training programs education services
• ongoing clinical care
strategies
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welcome
WELCOME TO THE premier edition of Continuum magazine, a unique publication dedicated to the issues and
interests of Wisconsin’s long term care provider community. You have received Continuum by virtue or your being
a valued member of the long term care continuum, hence the title.
The Wisconsin Health Care Association (WHCA) and its dedicated assisted living division, the Wisconsin Center
for Assisted Living (WiCAL), wanted to create a publication that presents positive, practical and authoritative infor-
mation to the Wisconsin long term care community. You and your staff members provide valuable and dedicated
service to Wisconsin’s frail, elderly and disabled residents, and this magazine is devoted to helping you in your mis-
sion to protect, serve and care for these individuals.
Currently we intend Continuum to be published bi-annually, released each Fall and Spring. There will be no sub-
scription or cost to you. Each issue will provide articles and information of interest to the leaders of the long term
care community. We hope that you enjoy this premier edition and would welcome your input for future editions.
To provide comments, input or reaction to this premier edition, please access the online version at www.whca.
com. There you will also fi nd additional information about the valu-
This magazine is devoted able benefits and opportunities offered by WHCA and WiCAL.
Join !
Wisconsin Center for Assisted provider community. The WHCA/ Quality Improvement and
Living, WiCAL, is the dedicated WiCAL staff represent over 115 years of Education: The mission of WiCAL
division of the Wisconsin Health collective service to the long term care includes assisting members to continue
Care Association (WHCA) and the community. being national leaders in the provision
Wisconsin affi liate of the National Advocacy: With three lobby- of assisted living services. Educational
Center for Assisted Living (NCAL). ists on staff, two of whom are attor- programs and quality initiatives are
Wisconsin’s assisted living and senior neys, WiCAL is a leading and cred- a core element of WiCAL efforts.
housing providers are welcomed to ible voice within Wisconsin’s legis- Educational programming places a pre-
explore the benefits of membership of lative and regulatory arena. On the mium on practical, evidenced based,
WiCAL. national level, NCAL is a recognized information to allow you to receive the
Membership is free of charge for advocate in Washington D.C. on greatest value. Training opportunities
the balance of 2008: No obligation to issues impacting the assisted living are provided in various formats and
continue and no tricks. Give WiCAL a community. mediums to allow you to manage your
test drive, and let us earn your future Communications: Having a costs and valuable time.
membership. Director of Communications on staff To begin to experience the ben-
Expertise: WiCAL has the back- provides WiCAL the ability to advance efits of WiCAL membership, at no
ing and experience of the WHCA, the policy agenda, enhance the image cost through 2008, simply go to
the oldest trade association repre- of members, and assist members in www.wical.org and click on “Join
senting Wisconsin’s long term care proactive and reactive media efforts. WiCAL.”
www.SamuelsGroup.net
www.StoneOffice.com
Authorized Dealer
Editor
Saara Raappana
18 CAPITOL BEAT: State Races will Affect
Long Term Care Providers
Marketing and Research Associate The Wisconsin State Legislature and
Zach Swick handfuls of U.S. Congressional races are
Project Manager heating up this fall. Here’s how their results
Rick Jablonski could affect you.
Account Leader
page 12
Patricia Nolin 20 STAKEHOLDER SPOTLIGHT:
Heather Breummer
Account Representatives Heather Breummer, Executive Director on
Denise Creegan, Janet Corbe, the Board of Aging and Long Term Care,
Steve Hall, Scott Pauquette, talks about filling the shoes of founding
Mark Verceles, Cherie Worley Director George Potaracke, the Medigap
Layout & Design Helpline and how the BOALTC can make
Calvin Harding & Emma Law your life easier.
Advertising Art
Carrie Smith 22 INDEX OF ADVERTISERS/
©2008 Naylor, LLC. All rights reserved.
ADVERTISER.COM
The contents of this publication may not be
reproduced by any means, in whole or in
part, without the prior written consent of the
publisher.
page 16
PUBLISHED AUGUST 2008/WHC-B0208/8315
©www.istockphoto.com/Eric Hood
Due to the many and varied physi- have been proven to be most effec-
cal, physiological, psychological and tive in achieving the highest rate of
social changes that accompany the immunizations, particularly for staff
normal aging process, the risk of infec- members.
tion increases as people age. Plan your program: Include all
Many chronic diseases and condi- staff members and departments when
tions that frequently accompany the establishing your vaccination team and
aging process increase the aging resi- plan out your entire calendar of efforts
dent’s risk for infection. Congregate toward education and encouragement.
living environments, with multiple staff Culminate the planning with leader- An immunization
and visitors coming and going, further ship visibly being among the fi rst to be
increases the risks of transmission. immunized and serve as role models campaign
Major objectives of your infec-
tion control program are prevention
for staff members to follow.
• Maintain Leadership Support:
doesn’t have to
and control. “Breaking the chain” of
transmission of infectious agents is an
Stay on top of the campaign by mon-
itoring ongoing reports. Monitor
be a massive
essential element of infection control.
One proven prevention opportunity to
success, identify where efforts and
education are needed, and incorpo-
undertaking of
break the chain is the immunization of rate this information into current management and
workers and clients. and future efforts.
Educating and encouraging cli- • Promote Program Consistency: staff time.
ents to receive their vaccinations is Use steady, repetitive reminders and
an important (and for nursing homes, educational posters, newsletters,
required) step in prevention efforts. As paycheck stuffers, and information
important are the efforts you should be sheets.
taking to ensure the highest level of • Make Vaccinations Convenient:
employee immunizations to reduce the Offer opportunities for employees
opportunities of transmission. Rather to be vaccinated. If you do not have
than a single “reminder” to staff, qualified staff to administer shots,
On-Call Coverage
Avoiding Wage and Hour Pitfalls
By Mindy Rowland Buenger, Dewitt Ross & Stevens, S.C.
“HEY, ARE YOU going to be around the-clock coverage 365 days a year is a
this weekend? I might need you to necessity, it is important to be aware of
come in.” what is compensable time so that you
“Don’t go too far from home this do not mistakenly fi nd yourself con-
weekend; it looks like I’ll need you to fronted with wage claim-based restric-
come in to pick up a shift. I’ll give you tions placed on an employee for on-call
a call and let you know which one.” time.
“Looks like we’re going to be busy Whether to compensate for certain
with some admissions this week- on-call time is one of the more contro-
end—I’m going to want you to be at versial areas of litigation arising under
the ready. So stay in town and be able the Fair Labor Standards Act (FLSA).
to get here on 15 minutes notice.” The reason is simple: whether on-call
Ever made a comment like this to time is compensable is very fact-spe-
one of your employees? It sounds inno- cific and, unfortunately for employers, © Ghubonamin | Dreamstime.com
cent enough—a simple inquiry into there are not any bright-line rules to
an employee’s availability to work a follow. That said, there are some guide-
weekend shift or a mere request that lines that can assist you in avoiding a The ramifications
an employee be within range in case
things get busy.
claim. This article provides a road map
of those guidelines.
for an employer
But before you know it, you can fi nd
yourself liable to pay on-call time to SOME HISTORY
running afoul
your employees. The above three state-
ments present progressively higher lev-
Back in 1944, the United States
Supreme Court fi rst decided that hour-
of the wage
els of expectation and commitments ly, non-exempt employees were enti- and hour rules
that an employer might communicate tled to be compensated in certain cir-
to an employee on a Friday afternoon. cumstances where the employee might relative to on-call
Whether any or all of these might con- be called upon to work, i.e., where the
stitute the employer having to compen- employee is on-call. Federal regula- coverage can be
sate the individual for “waiting” or “on-
call” time requires a detailed examina-
tions shortly followed suit, identifying
the following standard: “if the employ-
significant.
tion of the totality of the circumstanc- ee cannot use the time effectively for
es, as well as the previous dealings his [or her] own purposes,” then the on-
between the employer and employee. call time is compensable.
Regardless, however, employers need Generally speaking, the more
to be aware that certain requirements restrictions you place on your employ-
or restrictions very well may be con- ees as to their freedom and movement
sidered “hours worked,” even if there to engage in activities of their choosing,
is no actual exertion by an employee. the more likely it is that the time will be
And, as you well know, “hours worked” considered “hours worked” and there-
translates into compensable time for fore compensable under the FLSA.
the employee. The ramifications for an employer
Why do you need to care? In the running afoul of the wage and hour
long term care field, where around- rules relative to on-call coverage can
be significant. An employee who pre- under the above standards and meet- to have an employee whose normal pay
vails on a wage claim is entitled to ing with an attorney if you have any rate is at or just slightly above mini-
two, sometimes three years’ back pay, concerns about whether you should be mum wage. Establishing an on-call pay
as well as his/her attorneys’ fees. Also compensating your employees for the rate that would be significantly lower
note that employees cannot “waive” on-call time. than such an employee’s wage could
wage claims. That means that you can- It is also beneficial to you to remem- create a situation where their work
not come to any sort of agreement with ber that just because an employee is week average hourly wage would be
your employees that on-call time is not engaging in compensable on-call time, below the required minimum wage.
compensable. he/she does not have to be paid at the Likewise, employers must also keep
standard wage rate for that employee. in mind that waiting time and on-call
PROACTIVE MEASURES The employee only need be compen- time counts as hours towards overtime
The best practice, of course, is to sated for the “hours worked.” Wage expectations for non-exempt employ-
establish a policy in which both you and rates for on-call time can differ from ees. As an extreme, if an employer
the employees are clear as to wheth- an employee’s regular rate, although were to indicate restrictions sufficient
er or not an individual’s time is to be minimum wage and other over-time to constitute an entire weekend being
compensable when an employee is not provisions still apply. regarded as “hours worked,” includ-
performing his/her typical job duties. For example, an employer must ing overnights, that employer would
Make a determination on the front end assure that the employee’s overall wage quickly encounter a situation where the
of whether the on-call time you require rate during a pay period be at or above employee would have 48 hours worked
of your employees rises to the level of the applicable minimum wage. This is over the course of only two days.
“hours worked,” by analyzing that time particularly important if you are going
CONCLUSION
If you are like most health care
facilities, you want to balance the need
Choices
to occasionally require an employee to
® report to work when necessary against
the need to compensate employees not
actually working during that on-call
When life is limited, aging in place is time. To do so, employers need to take
what people want. a close look at their on-call policies and
When the focus of care shifts from curative to procedures and ensure that those poli-
palliative, VITAS focuses on enhancing patients’ cies and procedures allow for the abil-
comfort and overall quality of life. As an advocate for ity to call an employee in if necessary,
the rights of those at the end of life, our VITAS team without unduly restricting the employ-
of hospice experts helps patients remain at home. ees’ freedoms.
10 CONTI1NUUM
391423_Vitas.indd www.whca.com 7/17/08 7:32:38 PM
DON’T MISS THIS YEAR’S
57TH ANNUAL FALL CONVENTION
THE WISCONSIN HEALTH CARE ASSOCIATION (WHCA) and
the Wisconsin Center for Assisted Living (WiCAL) invite you
to join us for our 57th Annual Fall Convention. This year’s con-
vention is offering 21 valuable educational sessions of interest
to all providers and their staff. During and after educational
sessions there will be plenty of social and networking oppor-
tunities, including a cruise down the Fox River complete with
food, refreshments and music.
Educational offerings include: • Medicare and Medicaid Maximization
• Building the Foundation for Excel- “Unlocking the Doors”
lence and Customer Satisfaction • Implications of the Fair Housing
• The “Bug” Stops here – Infection Act on Wisconsin’s Assisted Living
Prevention & Control in Long Term Community
Care • Comfort, Compassion and Dignity:
• Preventing Culture Change Melt- Means to a Better End: F309
down, Tools to Turn Your Dining • Getting the Right People on Board:
Vision into Reality Recruiting, Screening, and Hiring a
• Turning Complaints into Compli- Quality Workforce
ments: Creating a Culture of Con- • And many, many others!
tinuous Quality Improvement as a In addition, the Fall Convention will
Strategy to Managing Complaints feature an opening keynote address by
and Grievances Donna Manring on “Transformation
• Lessons Learned: Provider Insight Leadership” and the WHCA 2008 “Shin-
Gained from Litigation Experience ing Star” Awards Luncheon.
• The Secrets to Exceptional Custom- Each year, WHCA’s Fall Convention
er Service Every Day provides a great venue for education, net-
• Breaking Free from the Old Educa- working, and sharing ideas. Join us this
tion Model in Long Term Care year on October 1-3, 2008, at the Radis-
• The Power of Ethical Marketing son Convention Center in Green Bay!
ADDITIONAL INFORMATION
For additional information or needs please
call the WHCA/WiCAL office (608-257-0125) or
contact George W. (Skitch) MacKenzie, NHA at
skitch@whca.com.
➥
tors of operation. But demographic and workforce data indi-
2. Identify the causes
cate that workforce development will be one of the Wisconsin underlying staff turnover.
➥
long term care community’s greatest challenges in the coming
3. Establish goals/targets for
years. Steps taken now to put a facility in a position to remain improving retention rates.
➥
or become an “employer of choice” may mean the difference 4. Develop an action plan to
between future success or continued challenges. address causes and reach
identified goals/targets.
➥
Instead of lamenting about the dif- The key is that long term care 5. Implement the action plans
ficulty of recruiting applicants for open employers need to increase their as written.
positions, we must closely examine our
efforts to retain our current caregivers.
knowledge base as to what actually
impacts employee retention. Rather
➥ 6. Evaluate the implementation
Certainly, most providers appreciate than relying on gut feelings or mak- of the action plan.
➥
the value of their dedicated staff, but it ing efforts based on what the employer
is healthy to reexamine the techniques “thinks” the employee wants or needs, 7. Update and revising the
used to retain those vital assets. employers need to approach reten- action plan as directed by
➥
There is ample evidence to support tion efforts with the sophistication the evaluation process.
investment in dedicated retention pro- that they would apply to other quality
gramming. Staff longevity and lower improvement efforts, using recognized
turnover correlates to higher customer processes to guide them. The sidebar
satisfaction and quality measures, as shows seven steps to follow in taking workable framework for taking on the
well as regulatory results. It also reduc- on the challenge of improving employ- retention issue. While the process is
es inefficient use of scarce resources ee retention. not a magic pill, it can help you orga-
related to recruitment, new employee The steps in the sidebar are, in all nize your efforts and provide a map to
orientation and training. likelihood, instantly recognizable, as achieving your goals more efficiently.
It is therefore critical to examine they follow a common quality improve-
what actually correlates to employee ment cycle process. But you may not NO QUICK FIX
retention. Identifying those factors will have viewed employee retention in this Employers fi rst must recognize that
allow employers to focus their energies context. Applying the same analysis a the effort to improve employee reten-
on those areas that are both correlated health care provider applies in address- tion requires prolonged and dedicated
to retention and within the control of ing a clinical improvement effort, effort, including ample staff involve-
an employer. for example, will provide focus and a ment. And before you establish your
TWO State the key message(s). • Limiting the total number of words to 27;
• Limiting the total length to 9 seconds;
• Using positive, constructive, and solution-oriented language;
• Offering additional, supporting information by way of facts, studies, or
other credible third-party sources of information.
FOUR (if there is time) Repeat Summarizing or emphasizing the three key messages.
the key messages.
Importantly, studies have shown THERE WAS ONLY ONE HOUDINI to anticipate reporter questions and
that when communicators limit the In all but the rarest of communi- practice delivering the key messages
number of messages they relay in a cations crises, the number one thing you developed long ago.
crisis situation to three, and ensure you don’t want to do is attempt a dis- For too long, Wisconsin’s long term
that those messages are relative- appearing act. Avoiding reporters care provider community has been
ly brief (about nine seconds or 27 altogether or issuing a statement only frustrated by its portrayal by media
words in length), that information is makes it appear as though you have outlets. However, the historic “bunker
comprehended and retained better something to hide. mentality” of many only contributes
by those listening. Remember, the media hates a to these frustrations. Preparation
A model for preparing your crisis vacuum, and if reporters can’t get a for and tackling a media crisis head-
messages might look something like comment from you, it does not mean on are steps towards turning around
this: they will simply throw up their arms the manner and tone of coverage we
Preparing what you most want and move on to the next story. Rather, unfortunately too often see in the
to communicate—that your facility they’ll search high and low for some- long term care community.
strives for the highest possible stan- one who will tell your story for you,
dards and regularly exceeds them— and you lose all control over what Erin Celello is the
and thinking through what you will messages are relayed. WHCA Director of
say in a crisis, even if it hasn’t yet hap- Instead, a better tactic is to arrange Communications. She
pened, can make all the difference of a specific time for an interview. Then, can be reached at erin@
whca.com
the light in which your facility might determine who the best spokesperson
be cast in the reporter’s story. will be, and work with that person
Angela Scheit
262-880-8883
© Rmgb_ol | Dreamstime.com
in the majority chairs all committees care workers employed by health care
and establishes the agenda in both the facilities.
U.S. and state legislatures. The number The success or failure of any of the
of open seats and the narrow majorities above items was certainly impacted by
currently held in the Wisconsin Senate the political makeup of the Legislature.
and Assembly contests will make for an So too will the future of these or similar
interesting and hard-fought state elec- initiatives depend on the Nov. 4 elec-
tion season. tion results. It is therefore incumbent
The importance of elections goes upon the provider community to remain The upcoming
beyond how a candidate might present active and vocal on issues of importance
him or herself. Voters are not only decid- to your operations. elections
ing who will represent them, but also
have a say in what key issues are impor-
To highlight the significance of these
elections, here is a snapshot of the
will impact
tant to them. The results of the upcom-
ing elections will impact Wisconsin’s
Wisconsin political landscape going into
Election Day:
Wisconsin’s
long term care community shaping the
agenda with potential impact for years to
• Democrats currently control the
Senate, 17- 14, with two vacant seats
long term care
come. For example, here are some long due to the resignations of Democrat community for
term care issues that were discussed Sen. Roger Breske and Republican
and debated in the 2007-08 session of the Sen. Carol Roessler. The seats up for years to come.
Wisconsin Legislature: election are currently split evenly,
• A proposed increase in the nurs- eight to eight.
ing home bed tax from $75 to $127 • For the Republicans to assume con-
per month, or funding nursing home trol of the Senate, it will require
reimbursement increases with GPR keeping all of their current seats and
(general purpose revenue dollars); gaining two seats currently held by
• Legislation requiring DHS to establish Democrats.
standards for staff training, staffing • With respect to the 99-member
levels, and standards for security at Assembly, Republicans control
adult family homes, residential care the House with 51 Republicans, 47
years in the nursing home setting and three within the assisted liv- Why the interest is allowing Ombudsman
ing field. Given the impact and influence the BOALTC has on the access to RCACs?
Every person has the right to advoca-
Wisconsin long term care landscape, Continuum sat down to chat cy. It is frustrating when a consumer calls
with the “new” leader. with an issue and all we have authority
to do is to refer them to the DQA for help,
Remind us about who and what is the associated with the BOALTC? rather than trying to resolve it informally.
BOALTC? George has been the huge help in my
The Older American’s Act mandated transition since his retirement at the end If you had two suggestions to give the
states to develop independent advocacy of 2007. His 27 years of experience have long term care provider community, what
agencies. Wisconsin’s Ombudsmen pro- paved the way for me, and I intend to would these be?
gram actually predates the mandate, but continue building upon the foundation he 1. The Board is an advocacy organi-
the BOALTC fulfills the federal expec- has established. I really want to continue zation. Providers should not hesitate in
tation. Its mission is to advocate for the to work collaboratively with the other working with us, as often our staff can
interests of the state’s aging and disabled stakeholders in Wisconsin’s long term diffuse issues before they arise to a regu-
population, inform consumers of their care community. While we may occa- latory level. We also are here to provide
rights, and educate the public at large sionally differ on the path, we all have services, including training with providers
about health care systems and long term the same goals of serving and protecting on topics such as resident rights, advance
care. Wisconsin’s elderly and disabled citizens. directives, restraint reduction, abuse pre-
vention, and person directed care.
Who is the “board” of the BOALTC? Are there activities beyond operating the 2. The expansion of Family Care
The actual board has seven members, Ombudsman program? and other waiver programs will con-
all appointed by the Governor to serve We are clearly recognized for the tinue to bring significant change to the
five-year terms, and approved by Senate Ombudsman program, but we also have Wisconsin long term care landscape. It is
Committee. Board membership includes the Medigap Hotline and the Volunteer more important than ever that we work
individuals with varied experience in Ombudsman program, which we are in together to best serve our citizens. If a
health, long term care, or advocacy for the process of expanding to La Crosse, provider has a problem with one of my
seniors. Green Bay and Eau Claire areas. In the staff, they should contact management
past, we have heard provider concerns of Board, as often issues are because of a
Has it been difficult to fill the shoes of about the Volunteer program, but once breakdown of communication. My staff
founding Director George Potaracke, everyone has a better understanding, is extremely committed to the consum-
someone who was so prominently there can be tremendous benefits. We will ers in long term care.
discharge planners
vansville Enhancing the life of every resident.
M A N O R
MEDICARE CERTIFIED FACILITY (608) 739-3186
SKILLED NURSING & REHABILITATION FACILITY
Fax: (608) 739-3486
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is ideally located between the metropolitan areas of Madison and Muscoda, WI 53573
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Evansville Manor is a modern 83 bed skilled nursing facility,
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470 Garfield Avenue, Evansville, WI 53536
(608) 882-5700
Park View Home, Inc. Park Place North
Senior Care Center Independent Living Apartments
RETIREMENT COMMUNITY
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22 CONTI NUUM
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