Windemere outperforms in quality care survey

Against a backdrop of cost pressures and labor shortages nursing homes face across Massachusetts, Windemere Nursing and Rehabilitation Center out-performed the majority of state nursing homes in five categories, according to a recently released Department of Public Health (DPH) Quality of Care Survey.

Windemere ranked better than 83 percent of nursing homes in the state according to the survey completed in October and received November 2. “This is quite an accomplishment for our staff,” Windemere administrator Ken Chisholm told The Times. “It is pretty good for a little Island nursing home to finish at 83 percent.”

The ranking was based on a formula that calculated measurements in five categories over the course of three surveys. Each category included separate criteria and a DPH designation of met or not met.

Windemere met 38 of 39 requirements in the category of administration; 32 of 33 nursing requirements; 27 of 27 resident rights requirements; 12 of 12 kitchen/food service requirements; and 20 of 21 environment requirements.

For example, a requirement met under administration was to make prompt efforts “to resolve grievances the resident may have, including those with respect to the behavior of other residents.”

Of the two requirements noted as not met, one was related to making survey results readily accessible to residents and the other was related to performance reviews and in-service education based on reviews for every nurse aide.

In the category of resident rights the nine requirements include “an ongoing program of activities designed to meet the interests and physical, mental, and psychosocial well-being for each resident.”

Windemere’s overall survey performance measurement was based on standard surveys conducted in 2008, 2009, and 2010 and a complaint survey conducted in 2010, according to DPH.

“This nursing facility met 129 out of the 132 critical requirements in all five categories. The number of deficiencies not met as a result of complaint investigations was 1. The facility’s score after adjustment for scope and severity is 128,” DPH said in a cover letter that accompanied the results. “83% of all facilities had a score of 128 or lower. The statewide average facility score is 121.”

The complaint was related to a failure in reporting process and was quickly corrected Mr. Chisholm said.

Last Thursday, Mr. Chisholm and director of nursing Marie Zadeh invited employees of the Island’s only nursing home to a choice of a special breakfast or dinner served by managers.

“This major achievement is only possible due to the outstanding employees who are committed to the residents that they care for, our great volunteers that allow us to significantly improve the quality of life of our residents, and our wonderful residents and families,” Mr. Chisholm wrote in a letter to employees announcing the survey results.

The survey announcement followed an annual update Mr. Chisholm provided to employees in which he described changes, improvements, and challenges largely overshadowed by the transition to the new hospital building.

In his report made available to The Times, Mr. Chisholm highlighted expected improvements that include relocating a relatively new nurse-call system from the old hospital building to Windemere, and establishing an in-house pharmacy dispensary that will make the Island nursing home only the second in the state to be so equipped.

Efforts are also underway to make the nursing home more “home-like” by purchasing new furniture for resident rooms and adding window treatments throughout Windemere, he said.

Mr. Chisholm also outlined challenges facing the nursing home. These include an urgent need for facility upgrades and repairs to the building’s boiler system and overall structure.

The struggle to stay in the black is also going to get tougher. Mr. Chisholm said the nursing home could expect no increase in Medicaid, which accounts for 70 percent of Windemere’s business, due to the state’s financial crisis.

As of July 1, 2010, Masshealth is also no longer paying for certain dental services utilized by adults, and Windemere must now absorb those costs.

Operating a nursing home anywhere in the state, but especially on the Island, is daunting.

In 1994, its first year of operation, Windemere lost $1.8 million and in 1996 filed for court protection under chapter 7 of the federal bankruptcy code. Windemere emerged from bankruptcy two years later but continued to struggle financially. After a period of huge losses, hospital officials managed to staunch the flow of red ink to an acceptable level and in 2004 Windemere ended the year with its first-ever profit.

Windemere ends its fiscal year on Dec. 31. Mr. Chisholm told The Times he expects to end the year in the black. “But not by much,” Mr. Chisholm said.