The pandemic has devastated the nursing home field, sickening residents and staff, and taxing the entire labor force. On a brighter note, it also has shined a light on the best that nursing homes can be, particularly in the area of technology.
From innovations in telemedicine, to patient and staff communications, nursing homes have stepped up to meet the pandemic — and enhanced their operations in the process. McKnight’s rewarded such advancements through its 2020 Excellence in Technology Awards program.
“This year we saw how nursing homes, when faced with a crisis, can use technology as a solution in areas ranging from patient care to staffing to outreach to family satisfaction,” said John O’Connor, editorial director for McKnight’s. “While that impresses me to no end, it doesn’t surprise me as nursing homes are adept at pivoting to meet changing needs.”
Not all of this year’s winners employed technology in response to the pandemic. Others won for new approaches to safety and rehabilitation, falls, mobility or other areas where technology made a difference.
An independent panel of long-term care and senior living experts judged the entries for the eighth annual competition. Stanley Healthcare was the Platinum Sponsor of the competition.
A small chain of nursing homes operating throughout West Virginia, AMFM previously had considered incorporating virtual medicine into its operations but found the options unsatisfactory.
That is, until the pandemic prodded it to look again.
The company’s selection and use of the Eko CORE digital stethoscope and Eko Telehealth services won it a Gold Award in the Quality category.
AMFM officials said they settled on Eko because the platform includes a stethoscope that reliably transmits sounds from the heart, lung or bowels to an iPad, storing data in an electronic health records system that can be read by an internal team of nurse practitioners or rounding physicians.
“It became the replacement for any type of medical appointment that would have required an external medical professional, from a check-up to a consultation for symptoms that could have been related to COVID-19,” said system administrator Jaren Painter. “That was especially important overnight because it prevented patients from having to go to the ER when no [on-site] doctor was available.”
AMFM drop-shipped completed kits to its 18 locations, almost all of them in extremely remote locations. Painter and his team then provided training, with support from Eko. Implementation reduced referral costs associated with routine visits. It also allowed nurse practitioners to work from home instead of billing the company for travel between those distant locations, and it reduced IT support by 20% by limiting the need for visiting clinical staff to use their own systems within AMFM buildings.
“This solution has literally paid for itself,” Painter said. “Once COVID is over, we’re definitely keeping it, especially for the night-time calls.”
Eko is also running the chain’s video conferencing platform now, and the company expanded it to a 19th location, added last summer. Overall, AMFM has made 2,000 virtual visits on behalf of its patients since launching its telehealth program.
Other Quality winners:
Silver: Ebenezer Ridges Care Center of Burnsville, MN, deploys iPad carts and assigns them to patients as the center converted its post-acute rehabilitation unit into a COVID-19 support site for the state of Minnesota. Staff members use the iPads to deliver treatment plans; specialists such as dietitians and psychologists use them to serve patients remotely; and patients use them to stay connected with family and friends.
Bronze: Mission Point of Belding in Michigan’s recreation director spearheaded an effort to set up Zoom conferencing to provide religious services, live music and even pet therapy visits. At the same time, a converter allowed her to repurpose a “dead” TV channel and begin livestreaming activities, which led to a 40% increase in leisure program participation.
Transitions: ProMedica Senior Care
ProMedica Senior Care (formerly known as HCR ManorCare) this year garnered a Gold in the Transitions category for its work expanding its transitional call program. The company used a call center to steer post-discharge communication before and during the COVID-19 crisis.
The call program includes three calls to the patients in the two to three weeks after discharge. It started as a pilot program in 13 centers, with an additional 28 added through early 2020 and the remaining 127 ProMedica Senior Care sites added in the second quarter of 2020. For the call program, ProMedica contracted with the Nexus Health Call Center.
“Due to COVID-19, patients that return home are often reluctant to attend much-needed follow-up appointments or accept home health services due to fear of infection,” Terri Russell, national director of case management, wrote in the company’s contest entry. “[ProMedica’s] Transitional Call Program includes tactics to address these concerns by educating them.”
Before being discharged, patients receive information on “yellow flag” and “red flag” issues related to their conditions. Although patients are directed to contact their treating facility with concerns, the call center also begins connecting with patients within 48 hours of discharge.
Conversations cover changes in condition — especially around the warning flags — and future appointments, home health services, and receipt of medication and durable medical equipment. Nexus callers also can refer patients to county-specific resources for food support or transportation to medical appointments.
NexusConnexions reports monthly data back to each center, which ProMedica said has improved its ability to inform Medicare Advantage payers and others that it is providing successful transitions.
Other Transitions winners:
Silver: New Jersey-based CareOne uses the self-navigating Ava Telepresence Robot and earned recognition for its ability to limit contact and improve remote monitoring and telehealth services during the pandemic.
Bronze: Gurwin Healthcare System in Commack, NY, collaborated with local physician practices on advanced remote monitoring of blood pressure, heart rate, pulse oximetry and other vitals, both pre-admission and post-discharge.
Keep It Super Simple: Hearthstone Nursing and Rehabilitation
After taking over a bankrupt senior care center, Caraday Healthcare was able to reduce its reliance on agency staff at Hearthstone Nursing and Rehabilitation with the Kare app. The Round Rock, TX, facility’s success resulted in a Gold showing in the Keep It Super Simple category.
Administrator Trudy Venette used the Kare platform to hire for a range of positions, and posted job descriptions, available shifts and applicable pay rates. The first workers accepted shifts within an hour.
Kare vets the employees and provides accessible background check and licensure information for operators — and the provider can choose the most qualified respondents for open shifts.
“With the Kare platform, I could pick the same people everyday,” Venette said. “And if I liked them, I’d give them a 5 (rating) and they’d get their pay faster. So they really worked hard to get that 5.”
Providers pay an hourly rate to workers and an additional per-hour fee to Kare. Kare then allows operators to hire staff they’ve recruited through the app without charging a headhunting fee.
Venette has been an administrator for 30 years. She told McKnight’s that she is not a major tech user but was able to set up Hearthstone’s account and navigate the app with ease. She attributed the use of Kare with helping the community eliminate all agency staff — and save significant money — within 30 days of site takeover.
During the pandemic, Hearthstone has run the state’s largest COVID-19 unit, with a 95% success rate. Venette said Kare worked with the community to make sure anyone it hired for shifts were only working there. Kare also provided immediate access to staff information required during more routine surveys.
Other Keep It Super Simple winners:
Silver: Maryland-based Nexion Health established a companywide VoiceFriend partnership with multilingual capabilities to communicate with residents, families and staff about COVID-19 and more.
Bronze: Duncanville Healthcare and Rehabilitation Center in Texas implemented technology such as Zoom and telehealth visits as it established a COVID-19 unit.
Safety: Village on the Green, a Lifespace Community
Lifespace Communities’ Village on the Green earned a Gold in the Safety category for integrating high-tech safety features across campus during a recent $56 million expansion and renovation.
The community near Orlando, FL, includes a skilled nursing area that benefited from upgrades such as a hardwired nurse call system with duty stations and mobile devices equipped to provide immediate responses — often without having to enter a room. Nurse call, intercom and wander management alerts are integrated in the same system.
“We look for technology that enables us to keep residents safe and healthy, as well as systems that potentially prevent issues from occurring,” said Tracy Smalley, director of program management for Lifespace.
Lifespace worked hand in hand on the project with Direct Supply, which custom-designed around the community’s desired technology selections and coordinated infrastructure including cabling, device installation, programming, testing and staff training.
The campus’ memory care and assisted living areas also received a new Accutech wander solution. Other campus enhancements included a new video surveillance system, digital signage displays, a pendant-based wireless emergency nurse call system and broader Wi-Fi coverage.
The campus is part of the 4% of Florida senior living communities that have received the governor’s Gold Seal for demonstrating excellence in quality. Smalley says leveraging technology in a coordinated manner will allow the community to continue its 5-star Centers for Medicare & Medicaid Services-rated care and improve its services for a growing dementia population.
Other Safety winners:
Silver: Green Valley Healthcare and Rehabilitation Center in North Richland, TX, held a COVID-19 “safety sing-along,” a viral, infomercial-like production preaching infection control to the tune of “If You’re Happy and You Know It.”
Bronze: Life Enriching Communities of Montgomery, OH, improved outcomes and reduced falls risks with the use of artificial intelligence-based VSTBalance to assess resident mobility and inform staff interventions.
Innovator of the Year: Rocky Knoll Health Care Center
Four years ago, Rocky Knoll Health Care Center invested in a device that uses vibration to reduce atrophy and pain in low-mobility patients receiving therapy.
The county-owned skilled nursing facility in Plymouth, WI, continues to use its VibeTech equipment in that capacity, but it is now working closely with the manufacturer to develop and measure the effectiveness of modified versions meant to serve other resident populations.
For its efforts, Rocky Knoll garnered Gold in the Innovator of the Year category.
In 2018, staff created a pilot to study how well memory care residents would tolerate the device, which imparts low-intensity vibrations tuned to contract muscles in the legs and low back to simulate standing and walking. In 2019, data showed a 45% reduction in falls over a three-month treatment period versus the previous three months.
Rocky Knoll later received a grant to develop the portable VibeSitPRO, which uses the same technology without requiring residents to transfer from a wheelchair to get the benefits. A prototype is being tested now in conjunction with VibeTech and local aging, dementia and Alzheimer’s organizations.
“If successful, this multisite, cross-continuum of care approach will be replicated in cities across the country to reduce falls and improve the quality of life for one of the most critically underserved populations,” Rocky Knoll Administrator Kayla Clinton wrote in her entry. “The new technology can be administered not just by therapists, nursing staff and life enrichment staff, but more importantly, it will also be able to be operated by loved ones and other nonprofessional caregivers … from the comfort of the end user’s favorite chair or their wheelchair.”
Staff members are quick to see how much residents like the device, said Life Enrichment Director Janine Bolz.
“When residents are invited to work on the device, they are excited to participate and to see how it can make them feel stronger and increase their confidence regarding their abilities,” Bolz told McKnight’s.
Other Innovator of the Year winners:
Silver: New Jersey-based CareOne uses Rex, a hands-free robotic rehab device that promotes mobility for people with a range of impairments, and Obi, a robotic arm that encourages independent self-feeding.
Bronze: Health PEI, the single health authority of Prince Edward Island, Canada, implemented the Rendever virtual reality platform in its long-term care homes and is beta testing the new Connection Corner, which allows residents to interact with each other’s avatars in a virtual living room.
High-Tech, High-Touch: Pikeville Nursing and Rehab
Pikeville Nursing and Rehab, located in the heart of Kentucky’s rural coal country, is putting technology at the heart of its approach to patient care. Its vision has resulted in a Gold for the 106-bed independent skilled nursing home in the High-Tech, High-Touch category.
This year, Pikeville instituted a remote patient monitoring system of its diabetes patients that transmits blood sugar readings to cloud-based software using a cellular connection. Partner clinicians can then access that information immediately, rather than the next time they are on site.
“Results are much faster, and monitoring is a lot better because it automatically populates our spreadsheets,” said Administrator Derrick Bevins. “We close that gap, and our providers can react immediately and treat the patient.”
The system also generates weekly reports that allow the community to spot trends.
In addition, Pikeville partnered with TapestryHealth to implement a transitional care program. It begins with a call home and an appointment with the community’s nurse practitioner, and the service can coordinate with caregivers or home care staff to ensure post-discharge instructions are being followed and that the patient has no new health obstacles.
Bevins says the program can reduce hospital readmissions and helps the community differentiate Pikeville from competitors. But patients also appreciate that it can help them manage common challenges including medication management and scheduling of follow-up care.
Other High-Tech, High-Touch award winners:
Silver: Candian long-term care provider Shannex implemented Tenera Care’s wearable technology as a monitoring tool for falls and as a tracing tool during COVID-19.
Bronze: Gurwin Healthcare System of Commack, NY, instituted daily telehealth checks in its memory care unit to modify care plans as needed during the COVID-19 pandemic. n