2008 - UHS-Pruitt Corporation - Commited to Caring | UHS

Pathway to Greatness
Quality Report FY2008
2008
Our Family, Your Family, One Family; Committed to Loving, Giving and Caring; United in Making a Difference.
Our Family, Your Family, One Family,
Table of Contents:
Introduction from our CEO................................................................................ 3
Cultivating a Culture of Transparency - A Quality Overview......................... 5
Celebrating our Successes.................................................................................... 6
Exceeding Customer Expectations...................................................................... 7
Reflections of Quality.........................................................................................11
Embracing our Partners (Employees)..............................................................15
Refining Quality Through Resource Linkages.................................................18
Recognizing our Future Opportunities............................................................20
Conclusion...........................................................................................................26
Committed to Loving, Giving and Caring.
Dear Quality Partner:
For the third year, we are proud to release our Quality Report FY2008 entitled “Pathway to Greatness”. In sustaining our
efforts to maintain a transparent organization to our partners in quality – customers, health care professionals of UHS-Pruitt
Corporation, external members of our profession, as well as state and federal reimbursement and regulatory agencies, we
present to you this report.
This past year was, once again, a year of progress, as we continued our transformation from traditional skilled nursing care
to an integrated model of post-acute services. Our strategic plan dictates our continued focus on four key elements: Great
Quality, Great People, Great Sustainability and Great Financial Stability. To that end, you will find evidence of our new and
continued programs to further these objectives. You will see our progress as well as our opportunities to improve; we continue
to believe in self-analysis through the use of quantifiable data as we travel down our “pathway to greatness”.
We were fortunate to welcome UniHealth Post-Acute Care of Durham in Durham, North Carolina; UniHealth Post-Acute
Care – Moncks Corner in Moncks Corner, South Carolina; and UniHealth Post-Acute Care – Orangeburg in Orangeburg,
South Carolina, to our family of providers. These centers have been instrumental to our strategy while continuing our
expansion that benefits the quality of care delivered to those communities we serve.
We hope that you will celebrate with us the successes we have achieved this past year while recognizing our future
opportunities. We believe that through expectation, reflection and refinement, we will continue in our quest to provide
an improved level of service. Transparency is an important ingredient to our success, as it not only allows everyone to see
ourselves as we are, but provides a stimulus to becoming better as an organization. As one of our quality partners, we look
forward to your input as we continue our “commitment to caring”.
With kindest regards, I am
Sincerely,
Neil L. Pruitt, Jr.
Chairman & C.E.O.
UHS-Pruitt Corporation
NLP/ms
3
4
Cultivating a Culture of Transparency A Quality Overview
UHS-Pruitt Corporation is passionate about our commitment to quality care and services. In 2002, our
organization committed to the Quality First Pledge that is rooted in seven principles that cultivate an environment
of continuous quality improvement, openness/transparency and leadership. We support the American Health
Care Association’s definition of quality: The totality of features and characteristics of a service that meet or exceed
customer expectation and need. We expect quality to be reflective of our performance in the delivery of health care
services each and every day. This includes quality within our operational, clinical and fiscal performance, as well as
our quality performance in establishing and maintaining customer and employee relationships.
Transparency is a new concept to the long-term care industry. It has received much attention in the last few years
from the industry stakeholders and customers. Our goal is to make this document easily understood by all who
read it. UHS-Pruitt Corporation understands that each stakeholder and customer has an opinion on what should
be communicated transparently by the organization. It is our goal to publish, in this limited-spaced document,
those common themes that support quality that are shared by most. However, if there are areas related to quality
in our Healthcare Centers that are not included in this report, we welcome an open dialogue and encourage you to
contact us.
We embrace quality care and services as we follow our Strategic Plan and Vision Statement: To Be Innovators
in a Seamless and Superior Healthcare Delivery System to the Communities We Serve. UHS-Pruitt strives to
meet the needs of the post-acute environment, providing services throughout the long-term care continuum, i.e.,
nursing homes, hospices, adult day health, and home and community-based services. Our organization promotes
consistent quality standards within all provider divisions. As contained in this report, quality is measured and
validated in a variety of statistically- and evidence-based methodologies. Additionally, we seek to validate quality
on a personal level: in the smiles of our patients, families and partners.
We at UHS-Pruitt recognize that our passion for quality is fostered by a culture where the truth must be heard and
by an unwavering resolve to do what must be done, through patience and listening, humility and understanding,
and, finally, accountability and enforcement. In an effort to remain true to our organization’s Vision, we try not
to focus on what we have accomplished from year to year, but what we said we would accomplish, no matter how
tough the measure. Only through a culture of transparency will UHS-Pruitt continue to demonstrate sustained and
efficient quality care and services that our customers expect and appreciate.
5
Celebrating Our Success
This is our third annual Quality Report. When looking back on the opportunities for improvement to which we
committed, it is reassuring that our organization continues on the “right track” for promoting and delivering quality
care and services to our patients. It was also an eye-opening experience for us to realize that, although we are committed
to quality and strive to integrate it into the daily activities within our Healthcare Centers, sustained quality must be
recognized over the course of time.
UHS-Pruitt identified future opportunities in the 2006 Quality Report that significantly influenced quality advancement
within our Healthcare Centers. Our organization incorporated our goals and opportunities within our strategic plan so that
we continued to refine our quality service. With each passing year, we celebrate our progress in meeting our goals, adjust
our strategic plan, and continue to strive to meet the expectations of our customers. We would like to take this time to
share the progress and results identified in 2008 as compared to what was committed to in 2006 and 2007.
Customer Satisfaction:
Our customer satisfaction scores showed modest improvement from 2006 to present (2008). Our organization’s executive
leadership team is committed to improving customer service . Each member of our executive leadership team developed
specific and targeted action plan approaches for their divisions that will impact directly or indirectly our overall customer
satisfaction. We are continuing to identify specific areas through our “drill-down” processes that will provide us with the
information needed to target and enhance our existing customer service programs (refer to page 8).
One of our most noted successes in improving customer surveys was the establishment of our Senior Care Partner Program
in 2006. Due to the achievements noted, the Senior Care Partner Program is not listed as a future opportunity but rather a
formalized program implemented in over 40 of our Healthcare Centers (refer to page 8).
Quality Programs:
UHS-Pruitt took a critical look at our 2006 and 2007 goals. We understand that focusing on too many clinical systems can
dilute the resources needed to strengthen other clinical systems that are considered more significant. Stakeholder values
are considered in our processes for evaluating and prioritizing the clinical systems on which we should focus our resources
(refer to pages 9-12).
As outlined in our 2007 Quality Report, our organization restructured our operational and clinical resource staff to form
regional teams. This cross-divisional collaborative partnership between our Healthcare Center’s Operations Division and
the consulting and educational services of United Clinical Services has proven to have a direct impact on our Healthcare
Centers’ quality in 2008.
UHS-Pruitt also achieved noted successes in our 2006 “Go for the Gold”. This program, like the Senior Care Partner
Program noted above, is not listed as a future opportunity but rather was incorporated as a formalized program for 2007
and continuing in 2008 (refer to page 12).
UHS-Pruitt is continuing to strengthen the 2006 Opportunities of Electronic Data Collection as reflected in our 2007
Future Opportunities (refer to page 20).
Partner Satisfaction:
The success of Healthcare Centers is determined by the hands and hearts of our Partners. Our organization developed a
wide variety of Partner programs in 2006 and 2007. UHS-Pruitt is especially proud of the results of our 2006 Great Jobs,
Great Money, Partner Referral Program (refer to page 15).
We will continue to monitor the success of the Partner programs described in this report in an effort to meet, recruit and
maintain high quality Partners.
6
Exceeding Customer Expectations
We are challenged by the demands and perceptions of quality as addressed in the 1986 Federal OBRA
regulations, the March, 2000 and the October, 2008 additions to the Office of Inspector General’s Compliance
Plan for Nursing Homes, Sarbanes-Oxley, CMS-Quality Improvement Organizations, and expressed by
multiple national interest group organizations, providers and patients. Although all nursing home customers
have varied opinions on what constitutes quality in a nursing home, it is up to us to ensure that we listen
and acknowledge their opinions. We collect these opinions through a variety of methods: customer surveys,
published reports, regulatory surveys, rule revisions, etc.
Industry resources limit nursing homes in developing separate programs to meet the quality expectations
of all customers. Yet from those valued customers, we derive common themes. Our organization builds on
those themes in an effort to integrate quality performance within our Healthcare Centers’ cultural framework.
By doing so, we promote overall efficiency in delivering services, which also allows our quality programs
and systems to meet the demands of multiple
customers. One of many examples includes the
OBRA regulations requiring the nursing home to
have a Quality Assurance Committee and the OIG’s
Compliance Plan recommending a Compliance
Committee. Both noted committees have
basically the same function in performing quality
improvement activities; therefore, our Healthcare
Centers establish one performance improvement
committee whose functions meet the demands of,
and complement, both sets of requirements.
We value the voice of the customer, especially those
closest to us… our patients and their families. We
are humbled by their decision to choose us to be
their provider at a delicate time in their lives. We
are committed to caring for them as outlined in our
Mission statement: Our Family, Your Family, One
Family; Committed to Loving, Giving and Caring;
United in Making a Difference.
Customer Satisfaction Surveys:
In an effort to hear our customers’ unified yet individualized voice, our organization is willing to listen. UHSPruitt promotes a culture of quality and transparency by allowing all customers to report positive and/or
negative issues anonymously, regardless of the reporting method utilized. We maintain this removes barriers
to customer reporting and encourages feedback. Not only have we carried on our position of having a toll-free
customer service line, but we also remain committed to using an external agency, My InnerView, to conduct
customer service surveys in all Healthcare Centers. We are so dedicated to this effort that we have increased
surveys to semi-annual events for the family/patient survey process and monthly for those patients who have
been discharged back into the community. In addition our leaders in the Healthcare Centers are evaluated on
their center performance related to customer service scoring. The survey process provides an excellent avenue
for quality data collection and analysis for our Healthcare Centers, so much so that, survey scores are one
measure upon which the Healthcare Center administrators are assessed during performance evaluations.
7
In 2005, in an effort to improve our organization’s customer service,
UHS-Pruitt embarked on a formalized Customer Service Program as
an extension of our Committed to Caring initiatives.
Family Survey HCC Average:
Overall Facility Satisfaction
70
70
69
71
71
The Customer Service Program is based on 17 Tenets of Customer
Service. These Tenets are simple statements about making customer
service work. One Tenet is reviewed each day during “Tenet Time”.
Examples are “Take the extra step to make a difference”, “Choose a
positive, can-do attitude each and every day” and “Take time to speak
to everyone”.
UHS-Pruitt developed a customer service training program which
has now been woven into the Partner Orientation Program and
annual in-service programs. Doing this has ensured that each
employee will receive seven hours of customer service training when
they begin employment with us and a refresher each year thereafter.
This past year saw our Family/Patient Surveys scores remain the same
as 2007 in the areas of Overall Satisfaction and Recommendation
to Others. We are not satisfied with these results; however, we do
understand that our model of care has also been changing over
this period. We are experiencing a larger segment of our patient
Healthcare Center population being patients who are with us a short
period of time and then returning to the community. We believe that
because of this, our Family/Patient Surveys may not be as accurate
an indicator as they once were. We have taken steps to get a better
picture of our customer service initiatives. To this end we have
initiated the following:
•
Family/Patient Surveys are completed semi-annually. We
believe that this will provide a better picture through the
surveying of more patients, due to length-of-stay decreasing
in our centers.
•
We are putting a greater emphasis on Discharged Survey
information. This is collected monthly from patients that
have been in our centers and have returned to a community
setting. Having higher acuity patients for shorter periods
of time requires that we understand their needs and capture
their feedback.
•
Most initial survey questionnaires are general in nature. The
general nature of the questions provides a sense of strengths
and weaknesses, but does not provide insight into the cause
of the score received. To help us with this insight, we have
implemented a “Drill Down” survey process. These survey
tools are used at centers that have experienced a decline in
their overall satisfaction score and that are below the UHS-
68%*
Jun 05
Oct 05
May 06
Mar 07
Mar 08
Family Survey HCC Average:
Facility Recommendation to Others
72
71
70
72
71
68%*
Jun 05
Oct 05
May 06
Mar 07
Mar 08
HCC = Healthcare Center
*National Proprietary Multi-Facility Organizational Score
8
Pruitt average. This resulted in nineteen centers being placed into this program. Areas are identified
in each center that need improvement based upon the initial survey analysis, customer and staff
observations, and consultation with the center’s leadership. “Drill Down” surveys are then sent to
family/patient members to get further indications of what the true concern and solution might be. We
are currently in the process of evaluating the data coming in from these surveys and will be making
Performance Improvement Plan adjustments as appropriate.
•
During discharge from the
W e welcome
centers, a patient or family
your Feedback,
member is given a card that
Comments, Compliments,
and suggestions
thanks them for allowing us
to provide healthcare services
to them. This card asks them
to give to us any immediate
comments or concerns that they
would like to share. This “immediate “ feedback mechanism
allows the centers to resolve issues related to customer service
in a much more timely manner than waiting to receive survey
results.
We Welcome Your Comments About Your Visit.
Thank you for choosing us for your medical needs. In an effort to serve you better, you will be asked, if you have
not been already, to fill out a patient satisfaction survey. Your thoughts and suggestions are very important to us.
Please take a moment to complete and return the survey.
In the meantime, if you would like to give us immediate feedback concerning any subject or staff member(s),
please feel free to do so below. If you noticed a staff member doing something special, please let us know.
Name (Optional)
Telephone (Optional)
While we continue to work on areas that need improvement, we are happy to report that in five areas reviewed
by My InnerView (Five Top Items Showing Consistent Improvement), UHS-Pruitt Corporation scored above
National Proprietary Multi-Facility Organizations and the My InnerView National Data Base in four of the five
areas. The five areas that were scored are:
• Choices and Preferences • Patient-to-Patient Friendships
• Religious/Spiritual Opportunities • Quality of Rehabilitation Care
• Commitment to Family Updates
Choices and Preferences
Patient-to-Patient Friendships
86.6%
83.6%
Religious/Spiritual Opportunities
85.3%
86.5%
83.2%
83.4%
85.2%
81.4%
82.2%
UHS-Pruitt
Nat’l MultiFacility Org.
UHS-Pruitt
My InnerView
Data Base
Quality of Rehabilitation Care
82.2%
82.6%
Nat’l MultiFacility Org.
My InnerView
Data Base
UHS-Pruitt
Commitment to Family Updates
86.5%
84.0%
82.4%
79.0%
UHS-Pruitt
9
Nat’l MultiFacility Org.
My InnerView
Data Base
UHS-Pruitt
Nat’l MultiFacility Org.
My InnerView
Data Base
Nat’l MultiFacility Org.
My InnerView
Data Base
Our Hospitality Services Programs are still in their infancy. Yet, we
are moving forward and are in the process of providing the following:
Selective menu choices for our patients.
•
In-room meal service that includes fine linen, a flower or an
after dinner mint.
•
Concierge service that provides local restaurant locations and
menus, hotel options and transportation needs.
•
Guest services for scheduling of spa times, meal times, meal
selections, and beauty salon times.
Senior Care Partner Impact
72
70
Percent Satisfaction
•
68
66
•
Personal satellite television programming.
•
Daily newspaper delivery.
62
•
Digital Signage in the hallways and patient rooms that inform
patients and visitors of the time, day, local weather, menus of
the day, activities, educational events, etc.
60
64
Oct 05
HCC with Senior Care Partners
Mar 07
Mar 08
HCC without Senior Care Partners
In 2006, UHS-Pruitt launched its industry-leading Senior Care
Partner Program. The Senior Care Partner is a registered nurse whose
primary responsibility is to be a liaison between the Healthcare
Center and the patient/family. Through ongoing educational
programs focusing on the communication and the expectations
of all involved in caring for the patient, The Senior Care Partner
Program promotes partnerships that share the responsibilities and
accountabilities in providing quality patient care and services. In
2008, over 40 of our Healthcare Centers have Senior Care Partners
Programs.
We are looking forward to the coming year as we continue to see
the impact this program has on our quality. In 2008, we added a
Partnership in Caring Coordinator who will oversee and promote the
Senior Care Partner program in all locations.
In 2006, UHS-Pruitt created its “Green Sweep” program that
continues today. Our organization’s Chief Executive Officer, Chief
Operations Officer and other leaders make annual, unannounced
visits to each of our Healthcare Centers, utilizing a standard tool and
scoring focusing on areas as seen through the eyes of our customers.
10
Reflections of Quality
UHS-Pruitt Corporation takes pride in our quality framework, which recognizes that sustained quality care and
services can only be achieved through continuous performance improvement activities. Those activities include,
but are not limited to, identifying customer needs and expectations, measuring and analyzing performance data,
forming quality action teams of empowered employees to develop performance improvement plans, and reevaluating performance outcomes for successful results.
UHS-Pruitt took a critical look at our clinical outcomes and goals from 2006, 2007 and 2008. We recognize that
outcomes vary depending on the patient population within each Healthcare Center, and that those individual
centers should not always be compared to each other in measuring quality. We also recognize that even though the
Minimum Data Set is not a suitable data source for reflecting and measuring quality, it is, unfortunately, the one
most utilized throughout the country. Understanding that we need outcome benchmarks that are comparable so
that our Healthcare Centers can measure their clinical outcomes in relation to others, we will continue to utilize
the MDS clinical outcomes for High Risk Pressure Ulcers, Post-Acute Pain, Physical Restraints and Incontinence.
With our Healthcare Centers transitioning into the “post-acute” era, we are caring for a more acutely ill population
than in the past. We understand that the traditional nursing-home care provided over the last 30 years will not
meet the needs of the current aging population. With a high-acuity patient population, there may be occasional
undesirable quality outcomes. Utilizing an aggressive performance improvement process that includes real-time
data collection, our Healthcare Centers will be able to anticipate and intercede on those potential quality outcomes
in a timely manner; allowing us to positively impact the quality of care our patients receive.
Enhanced Quality MeasurePost-Acute Pain (PAC)
0%
6%
.7
22
0%
.1
21
.0
22
8%
66
7.
8.
20
%
%
14
.1
3%
38
.3
0%
17
.9
0%
20
.8
19
.2
47
48
.0
0%
0%
.6
52
.0
51
0%
0%
51
.8
9%
0%
55
.5
0
0%
.7
.0
52
53
.5
0%
%
Low Risk Incontinence
UHS-Pruitt
UHS-Pruitt
State*
State*
National
National
2006/Q4
2008
00%
00%
0%
7.0
0%
0%
2004/Q4
11
2005/Q4
2006/Q4
2007/Q4
2008/Q4
2004/Q4
2005/Q4
2006/Q4
2007/Q4
0%
3.2
0%
2.6
UHS-Pruitt
State*
National
2.1
9%
4.1
5.2
0%
6.2
7%
7.3
6.5
6.2
1%
14.
5%
10.
10.
60%
10.
10.
30%
00%
00%
16.
18%
01%
50%
12.
14.
30%
00%
14.
14.
18.
18.
00%
40%
17.
89%
12.
00%
14.
13.
37%
13.
38%
48%
00%
15.
2008/Q4
Enhanced Quality MeasurePhysical Restraints
Enhanced Quality MeasureHigh Risk Pressure Ulcers
15.
2007/Q4
6%
2007
8.3
2006
2008/Q4
Each graph illustrates the percentage of patients in our Healthcare Centers exhibiting the indicated quality measure compared to state and national data.
*State bars represent the average score for measures in Georgia, North Carolina and South Carolina.
UHS-Pruitt
State*
National
1.1
88
1.0
2
1.0
1.0
00
4
30
5
1.0
20
06
1.0
6
91
2
1
44
4
North Carolina Case Mix Index
1.0
We recognize that our customers may find it difficult to determine quality care
and services between our Healthcare Centers and other healthcare centers. This
is due to the fact that there are varying systems, methodologies and data sources
utilized within the nursing home industry for collecting and analyzing quality
data with non-standardized measures. Through these varied systems and sources,
our Healthcare Centers compare and discern key outcomes that alert them to
weaknesses in the reporting system’s methodologies, as well as opportunities to
improve the delivery of quality services.
UHS-Pruitt
State
Quality Measures/Quality Indicators:
The QM/QI data measurements are retrieved from each patient’s MDS assessment
that is electronically submitted to an external agency database. The assessment
indicators are aggregated into 34 clinical care measurements in 13 domains.
Each Healthcare Center utilizes the QM/QI reports within their performance
improvement activities to assess and compare with other clinical data sources
for trends that have the potential of impacting the quality of care an individual
patient or multiple patients may receive. Customers may view each Healthcare
Center’s Quality Measure/Quality Indicators on CMS’s Nursing Home Compare
web site at www.medicare.gov. The data present on this web site is usually posted
two quarters behind the “real-time” data present in the Healthcare Centers.
The QM/QI data may be skewed by the patient population within our Healthcare
Centers. If the overall acuity level is higher in our Healthcare Centers than
our peers within the same state in which we operate, our QM/QI Measures
may be higher in relation to the population and not necessarily related to poor
performance. The charts to the right, Georgia Case-Mix Index and North
Carolina Case-Mix Index, compare UHS-Pruitt Corporation’s patient acuity
with that of all facilities in each state. As clearly noted below, our acuity is higher,
which is reflected in the Quality Measures.
To further analyze our QM/QI data for use in our performance improvement
activities, we use a software program that receives all MDS data as submitted to
the state. This program adjusts each Healthcare Center’s patient population for
risk “to level the playing field”. In this risk adjustment method, Healthcare Centers
are not penalized for their patient population if they specialize in a specific
FY 2005
FY 2006
FY 2007
FY 2008
1.4
1.2
82
9
1.3
2
26
1.2
9
00
1.2
1.3
04
4
2
71
3
15
4
Georgia Case Mix Index
95
All UHS-Pruitt’s Healthcare Centers collect data from multiple systems and
sources that impact quality care and services, e.g., clinical, operational, billing,
staffing, etc. This data includes structural, process and outcome measures that
are routinely included in each Healthcare Center’s performance improvement
activities. However, for the purposes of this section, we will utilize measurement
systems from varying sources that focus on quality of care and clinical data.
FY 2004
1.2
Because of this, all of UHS-Pruitt’s Healthcare Centers utilize performance
improvement policies that support a standardized and consistent process of data
collection, analysis, follow-up and evaluation within the organization.
UHS-Pruitt
State
FY 2005
FY 2006
FY 2007
FY 2008
Advancing Excellence in America’s
Nursing Homes:
UHS-Pruitt is proud to announce
that all of our Healthcare Centers are
participating in the National Advancing
Excellence Campaign as of December
2006. Out of the eight campaign goals,
our centers choose four they identified
as opportunities for improvement. They
are:
• High Risk Pressure Ulcers
• Physical Restraints
• Post-Acute Pain
• Customer Satisfaction
Please refer to the graphs in this booklet as reference.
12
Health Deficiency Index Risk Adjusted
0.92
0.86
1.00*
0.90
0.79
0.76
0.59
FY 03
FY 04
FY 05
FY 06
FY 07
FY 08
*Average for all Healthcare Centers in Georgia, North Carolina, and
South Carolina
Please note that the FY07 bar increase in the above HDI graph
was due to the acquisition of Healthcare Centers. This bar includes
regulatory survey data results from those centers prior to becoming
part of the UHS-Pruitt family.
To develop and encourage an ongoing culture of quality,
our organization recognizes and celebrates those
Healthcare Centers that received a deficiency-free survey.
The following centers have achieved deficiency-free
surveys since 2003:
• Georgia War Veterans Home- Russell Building
• Heritage Healthcare of Blue Ridge
• Heritage Healthcare of Elkin
• Heritage Healthcare of Farmville
• Heritage Healthcare of Fort Oglethorpe
• Heritage Healthcare at Grandview
• Heritage Healthcare of Jasper
• Heritage Healthcare of Toomsboro
• The Oaks of Carrollton
• The Oaks at Limestone
• The Oaks at Peake
• UniHealth Post-Acute Care- Athens Heritage
• UniHealth Post-Acute Care- Fairburn
• UniHealth Post-Acute Care- Santa Rosa
In 2007, UHS-Pruitt is proud to announce the following
Healthcare Centers received deficiency-free regulatory
surveys:
• Heritage Healthcare of Blue Ridge
• Heritage Healthcare of Fort Oglethorpe
• Heritage Healthcare of Jasper
• Heritage Healthcare of Lilburn
• Heritage Healthcare of Toccoa
• The Oaks at Peake
In 2008, UHS-Pruitt is proud to announce the following
Healthcare Centers received deficiency-free surveys:
• Heritage Healthcare of LaFayette
• Heritage Healthcare of Swainsboro
• Heritage Healthcare of Wilkes
• The Oaks at Carrollton
• The Oaks at Carrollton Assisted Living
• The Oaks at Peake
• The Oaks at Peake Assisted Living
• UniHealth Post-Acute Care- Austell
• UniHealth Post-Acute Care- Santa Rosa
13
area of care. The risk adjustment takes into consideration the acuity of
the patients within the Healthcare Centers by assigning them into low,
medium and high risk groups for each domain and ranks them on how
well they are doing with that particular measure after risk adjusting for
their population. The ranking reveals how well the Healthcare Center
prevents decline or worsening of conditions based on the risk group in
which the patient was placed. High-risk groups have a certain degree of
expected decline whereas low-risk populations should not have decline.
The ranking scale is 0-100, with 100 being the best.
Regulatory Surveys:
The Department of Health and Human Services-Office of Regulatory
Affairs and the Department of Health and Environmental Control
perform state and federal surveys that inspect the Healthcare Center’s
compliance with the federal OBRA regulations (42 CFR 483) and state
Long Term Care regulations. These surveys are performed on an annual
basis in which compliance to all the applicable regulations is inspected
(F-tags). Surveys are also conducted as indicated by reported complaints
or incidents. These complaint surveys focus on specific regulations
(F-tag) that reflect the complaint or incident. When the surveys identify
issues considered non-compliant with the regulations, deficiencies are
issued to the Healthcare Center. UHS-Pruitt recognizes that, although
survey processes vary from state to state and region to region, our
Healthcare Centers will address all deficiencies appropriately with the
necessary corrective steps.
To obtain a more accurate picture of where our Healthcare Centers are in
the regulatory processes, UHS-Pruitt has begun to utilize a risk-adjusted
process in benchmarking the varying survey processes and our resulting
deficiencies. This process is called the Health Deficiency Index (HDI).
This value is calculated by the following process:
1- Assigning points to every deficiency based upon the scope and severity
as follows: b,c= 0.5; d,e,f= 1.0; g,h,i= 2.0; j,k,l= 4.0. The points are added
together to get the Healthcare Center Health Deficiency Score.
2- For each state, we calculate the average Health Deficiency Score of that
state, separating proprietary Healthcare Centers from non-proprietary
Healthcare Centers.
3- To get the Health Deficiency Index for each Healthcare Center, we
take that Healthcare Center’s Health Deficiency Score and divide it by the
State’s proprietary Healthcare Center’s Health Deficiency Score.
Although national HDI benchmarking is not available, this data analysis
allows our organization to benchmark our internal survey performance
from a risk-adjusted perspective. We are proud to report a significant
decline in our HDI from FY2007.
In the last few years, the Centers for Medicare and Medicaid have initiated a demonstration project intended to
standardize the way regulatory surveyors conduct a survey and cite Healthcare Center deficiencies. The Quality
Indicator Survey (QIS) is a revised long-term care survey process that was designed as a staged process for use by
surveyors. The QIS is intended to improve the consistency and accuracy in which quality-of-care and quality-oflife deficiencies are identified by surveyors. UHS-Pruitt is proud to announce that UniHealth Post-Acute CareSanta Rosa received a deficiency-free QIS survey in 2008!
UHS-Pruitt Nursing Hours Per Patient Day
2.5 per patient day*
2008
2007
2006
2005
0
1
2
3
4
UHS-Pruitt takes pride in knowing that our Healthcare
Centers exceed state and federal staffing requirements. Our
patients’ well-being is our top priority. We understand that
direct care staffing levels that fall below these requirements
have the potential to jeopardize the quality of care that
patients receive. We also recognize that patient acuity
impacts the need to provide more direct care staff. This
chart depicts the average nursing hours per patient day for
all UHS-Pruitt Healthcare Centers in the states of Georgia,
North Carolina, and South Carolina along with the average
for all Healthcare Centers within UHS-Pruitt, for each of
the fiscal years ended June 30, 2005, 2006, 2007 and 2008.
5
The average nursing hours per patient day is calculated
by first gathering the total hours paid for the nursing
* Medicare National Nursing Hours Requirement
staff, which encompass the Director of Health Services,
Registered Nurses, Licensed Practical Nurses, Certified
Nursing Assistants, and Ward Clerks at all of the Healthcare Centers for the applicable fiscal year end. This is then
divided by the total inpatient days to determine the average nursing hours per patient day, by state and in total.
GA
NC
SC
Total
Go for the Gold
In 2007, UHS-Pruitt implemented the “Go for the Gold” program to encourage and reward our Healthcare
Centers that demonstrate outstanding achievement in the following quality indicators:
• Post-Acute Pain • High Risk Pressure Ulcers
• Customer Satisfaction • Quality Measure Ranking
• Physical Restraints
Winners will be determined by criteria at Gold, Silver and Bronze award levels. Winners at each award level receive
award plaques and money for a celebration of their achievement. More importantly, it was decided that each
employee in the winning Healthcare Centers receive a monetary award for their contribution to their Healthcare
Center’s success.
The 2008 “Go for the Gold” Winners were:
Gold Winners: UniHealth Post-Acute Care-Athens Heritage, North Carolina State Veterans Home-Fayetteville,
The Oaks at Limestone
Silver Winners: UniHealth Post-Acute Care-Fairburn, The Oaks of Carolina, Heritage Healthcare at The Pines
Bronze Winners: Heritage Healthcare of Greenville, Heritage Healthcare of Macon
14
Embracing Our Partners (Employees)
In 2002, UHS-Pruitt Corporation formed a
committee of leaders with a representative from
each of our service divisions. This committee
was charged with the responsibility to be
employee advocates. One of the first tasks the
Committed to Caring Committee completed was
to survey employees at every service location
on every shift, including all Healthcare Centers,
to determine what was important to them as
employees, caregivers, family members and other
life roles. From the data that was collected, the
UHS-Pruitt Mission statement was formed:
Our Family, Your Family, One Family;
Committed to Loving, Giving and Caring;
United in Making a Difference.
One of our innovative quality programs that occurs every year and promotes quality service delivery is our
Committed to Caring Challenge Program. This program empowers our partners to be creative and come up with
“out-of the-box” ideas.
After three days of intense judging by the Committed to Caring Committee, the location winners are announced
and recognized with prizes and rewards for each employee. Our FY08 winners are as follows:
•
The first place winner was a project sponsored by United Nutritional and United Medical of Norcross called
“Kids Coping with Grief.” The project provided grief-related story books, activity books, DVD’s, memory
boxes and a website to help children deal with grief.
•
The second place winner was Heritage Healthcare of Toccoa and UniChoice, for the project entitled “Forever
Young”. Volunteers at the center built a playground for the grandchildren of patients to use during their visits.
The visits enhanced the quality of time by allowing sons and daughters an opportunity to visit with their
parents while they watched the children on the playground. Often it provides direct interaction between the
patients and the children, as well as patients without visitors experiencing the joy of watching the children play
and laugh.
•
The third place winner was UniHealth SOURCE of Rome’s project named “A Girl’s Day to Play”. The team
provided a fence to a family’s backyard so that their autistic daughter could play safely outside. Prior to the
fence installation, the child was restricted to the confines of her house for fear of her wandering. Once the yard
was fenced, the team provided a sandbox and outside toys.
Since 2002, Committed to Caring Councils have been established in all locations to enhance employee awareness
of our quality culture. These C2C Councils solicited input from all employees. From that employee feedback, a new
Employee Recognition Program was developed and implemented throughout the organization.
Over the last five years, the Committed to Caring Committee also developed a Leadership Mirroring Program that
has seen over 40 organizational leaders mirror front line employees each quarter, to learn and understand what
our employees do on a daily basis. These are a few examples in which UHS-Pruitt opens the communication doors
between all levels of employees so that their voices are heard.
We value and respect each and every employee in our organization and are proud to say that our employees
15
have “their hearts in the right place”. As a result, UHS-Pruitt has replaced the term “employee” with “Partner”
to demonstrate that all employees, at every rank within the organization, are in partnership in providing quality
services to our customers.
We understand that meeting customer expectations of quality requires all Partners to be competent and highly
skilled in their job duties. In an effort to meet those demands, our organization provides ongoing educational
opportunities through our United Clinical Education Department. The clinical educators within UHS-Pruitt
conduct ongoing regional classes in Pain Management, IV Therapy, Skin and Wound Care Programs, etc.
Within the past two years, each Healthcare Center was provided a computer terminal with internet access on
which all Partners can log on and receive on-line education and competency testing through our UHS-Pruitt
University and Care to Learn Programs. We are pleased to report in FY 08, over 36,000 on-line education programs
were taken by our partners!
We are an organization
that truly believes
that quality service is
a result of providing
opportunities
for growth and
advancement to our
Partners, allowing them
to shine like STARS!
Our organization continues to provide annual internal educational conferences to all
Administrators, Directors of Health Services, Dietary Managers, Activity and Social
Directors and Environmental and Maintenance Directors. However, the most exciting
educational opportunities are provided to our Healthcare Center Certified Nursing
Assistants (CNA). Three times a year, three different CNA’s from each Healthcare Center
are brought together for a three day conference that fosters and grows their care giving
skills through exciting educational classes, networking with peers and sharing of best
practices. Since 2002, more than 600 CNA’s have attended these conferences.
UHS-Pruitt has worked in conjunction with the Georgia Healthcare Association, the
Georgia Department of Labor and Griffin Technical College to create a career ladder.
This program allows nursing assistants to enroll in three online courses at Griffin
Technical College. In addition to their academic work, they have clinical competency
skills checklists that are administered by the nursing leadership at their center.
Completion of their academic work and their clinical on-the-job training enables them
to earn a CNA Advanced Practice certification. In recognition of this achievement,
UHS-Pruitt Corporation gives the graduates a raise in pay. The first five graduates were from The Oaks at Peake in
Macon, GA. The courses they took at Griffin Technical College will count toward the LPN program if the students
decide to pursue this step in the ladder. However, UHS-Pruitt is creating another step for those who do not
desire to become an LPN. We are currently developing a certification in three specialty areas: care preceptorship,
dementia, and restorative.
In 2005, UHS-Pruitt recognized the potential leaders within our organization. In an effort to retain valuable
partners who are able to continue our mission into the future, we developed and implemented a Leadership
STARS program. This intense program teaches and promotes effective leadership skills necessary to advance
within our organization. As a result, over 45 Partners have participated in the program. Building off the success
and strategies of the Leadership program, a Clinical STARS program was implemented in FY08 that focuses on
leadership skills specific to the clinical environment. We are an organization that truly believes that quality service
is a result of providing opportunities for growth and advancement to our Partners, allowing them to shine like
STARS!
Although the UHS-Pruitt Corporation Committed to Caring Committee and Council are enhancing a culture of
Partner appreciation, we recognize that our Partners need various avenues in which to communicate concerns
16
90%
Partner Survey HCC Average:
Response Rate
81%
80%
70%
60%
61%
53%
50%
40%
30%
20%
10%
0
Oct 06
OCT 07
JUL 08
Partner Survey HCC “Excellent” and “Good”:
Overall Satisfaction
63%
62%
62%
61%
60%
59%
60%
60%
Oct 06
OCT 07
JUL 08
in private and anonymously, if desired. Our organization provides all
Partners with information on reporting concerns through a toll-free hot
line. We also utilize My InnerView’s Employee Satisfaction Survey process
to obtain additional feedback from our Partners on an annual basis. This
data provides UHS-Pruitt and the Healthcare Centers with areas where
we are successful and areas where we need to improve, to attract and
maintain Partners that provide quality services to our customers.
We utilize the satisfaction survey in correlation to the turnover of our
Partners. Our organization has recently begun collecting and analyzing
statistical employee turnover data. Our formula for calculating the data
is identical to the turnover formula utilized by the Quality Partners of
Rhode Island and the Quality Improvement Organizations. The formula
is the total number of terminated employees each month for the last 12
months added together and divided by the total active employees at the
end of each of the past 12 months. This produces a 12 month rolling
average turnover factor. UHS-Pruitt believes a decline in turnover will
result because of the myriad of programs aimed at partner recruitment,
retention and satisfaction.
Great Jobs, Great Money, Partner Referral Program:
Our organization is striving to continue to build a Committed to Caring
culture that will attract and retain quality Partners (employees) who
deliver care and service to our customers. In 2007, UHS-Pruitt developed
a formal Partner recruiting program with the addition of professional
recruiters joining the UHS-Pruitt family. As part of our recruitment
efforts, the “Great Jobs, Great Money, Partner Referral Program” has
shown valuable results in recruiting Partners. This program capitalizes
on research that indicates that job applicants who are referred by existing
employees within the organization have higher retention rates than
employees hired through traditional recruiting methods. UHS-Pruitt
is proud to announce that in FY08, The Good to Great Partner Referral
Program has paid $223,114 to 684 Partners as a result of recommending
their friends and family to our organization!
17
Refining Quality through Resource Linkages
We look forward to the challenges that lie ahead in the long-term care environment. We strive to preserve the
Committed to Caring spirit within our organization while enduring change to continue to improve our quality
programs and practices. Our organization continues to look for practical approaches to quality driven by
sometimes idealistic external demands.
We understand that as an organization we cannot stand alone in our endeavors to meet our customers’
expectations of quality. Therefore, we have established collaborative partnerships that link us with other industry
stakeholders to sustain efficient, quality services. Through these linkages, our Healthcare Centers cultivate quality,
frequently setting best practice examples for others in our industry.
CMS-Quality Improvement Organization Partnerships:
Under the direction of the Centers for Medicare and Medicaid (CMS), the Quality Improvement Organization
Programs consist of a national network of 53 QIO’s in each state. The QIO’s work with consumers and providers to
refine care delivery systems to make sure patients get the right care at the right time. The program also safeguards
the integrity of the Medicare Trust Fund by ensuring that payment is made only for medically necessary services.
The program assists providers in transforming quality to make healthcare safe, effective, patient-centered, timely,
efficient and equitable.
UHS-Pruitt had numerous Healthcare Centers that participated in CMS-QIO Intensive Participant Groups during
CMS’s 7th and 8th Scopes of Work. We are excited to continue our relationship with the QIOs during the 9th
Scope of Work beginning in the fall of 2008.
Trade Associations:
We encourage our Partners at all levels to join and become active participants within various national and state
trade associations. Many of our organizational leaders hold committee positions and/or have seats in elected offices
within these trade associations. Some of the trade associations we are proud to participate in are:
•
•
•
•
•
•
•
•
•
•
•
•
•
American Health Care Association
The Alliance For Quality Nursing Home Care
Georgia Health Care Association
South Carolina Health Care Association
North Carolina Health Care Facilities Association
Florida Health Care Association
Georgia Long Term Care Nurses, Activities and Social Services Association
National Association of Directors of Nursing Administration in Long Term Care
American Association of Legal Nurse Consultants
Healthcare Compliance Association
American College of Healthcare Administrators
American Association of Nurse Assessment Coordinators
American Health Lawyers Association
Quality Award Winners:
The American Health Care Association’s National Quality Award Program is a prestigious honor awarded to
nursing homes, assisted living facilities and residential care facilities that meet the criteria for quality. The awards
are determined at three distinct levels with the quality criteria reflecting the Malcolm Baldridge National Quality
Award. UHS-Pruitt is proud to have the following Healthcare Centers bestowed this award:
18
Step I Award Winners:
• Georgia War Veterans Home
• Heritage Healthcare of Ashburn • Heritage Healthcare of Athens
• Heritage Healthcare of Blue Ridge • Heritage Healthcare at Crestwood • Heritage Healthcare of Elkin
• Heritage Healthcare of Farmville • Heritage Healthcare of Forsyth
• Heritage Healthcare of Fort Oglethorpe
• Heritage Healthcare of Lilburn
• Heritage Healthcare at Shepherd Hills • Heritage Healthcare at Spring Valley
• Heritage Healthcare of Toccoa
• Heritage Healthcare of Toomsboro
• Heritage Healthcare of Valdosta
• The Oaks at Scenic View
• UniHealth Post-Acute Care-Athens Heritage
• UniHealth Post-Acute Care-Fairburn
• UniHealth Post-Acute Care-Santa Rosa
We are pleased to announce the following Step I Quality Award winners for 2008:
• Heritage Healthcare of Franklin
• Heritage Healthcare of Grandview
• Heritage Healthcare at Holly Hill
• Heritage Healthcare at Lakehaven
• Heritage Healthcare at Sunrise
• Heritage Healthcare of The Pines
• Magnolia Manor
• The Oaks at Peake
• UniHealth Post-Acute Care-Columbia
Step II Award Winners:
• Georgia War Veterans Home • Heritage Healthcare of Toccoa
Georgia Quality Award Winners:
Georgia Health Care Association in partnership with the Quality Improvement Organization established a
Quality Award program in 2008 that recognizes Georgia nursing centers that have demonstrated a commitment to
continuous quality improvement. We are proud to recognize the following centers as winners of the first annual
Georgia Quality Award:
• Heritage Healthcare of Athens
• Heritage Healthcare of Forsyth
• Heritage Healthcare at Shepherd Hills
• The Oaks at Scenic View
Alliance for Quality Nursing Home Care:
UHS-Pruitt is a member of the Alliance. This group is made up of long-term care companies that share a desire to
provide quality services to our nation’s elderly and frail populations. Leaders within our organization participate in
the Alliance’s committees that support building quality linkages with other industry stakeholders.
Membership in the Alliance also allows UHS-Pruitt to participate in data analysis that our organization utilizes in
comparing ourselves with other industry leaders, as well as providing us with another set of quality measures that
we can utilize in our performance improvement activities.
19
Recognizing Our Future Opportunities
UHS-Pruitt recognizes that only through a process of self-analysis and utilizing quantifiable data, will we be able to
identify our opportunities for improvement. These opportunities have been assessed to determine the relationship
of importance to our Strategic Plan, Mission and Vision.
Each year we take a critical look backward to what we said we would strive to accomplish. We assess each
opportunity to determine whether or not our anticipated results were met and why. We determine if goals and
plans were realistic and relevant to the changing demands of the industry. In 2008, the following opportunities
reflect the outcomes of our self-critical assessment. We are optimistic that these opportunities will continue to
enhance the quality of care and services we provide to those we serve.
Customer Satisfaction:
UHS-Pruitt Corporation understands that caring for patients means
not only ensuring their physical needs are addressed, but also their
spiritual needs. In 2008 we initiated our Spiritual Care Program
within our Healthcare Centers. This program follows the cycle of a
patient’s life in the health care community and contains suggestions for
rituals and programs to enhance the spiritual care offered along this
journey. The program is easily adapted to the particular culture of an
individual health care center. The rituals and program suggestions are
a beginning point for partners, patients and community members to
form meaningful connections with one another. The program focuses
on the following three areas:
1. “Hello”- Ways we welcome new patients to our Healthcare Centers
2. “Day-to-Day”- Sustained care that respects a patient’s preferences
and existing spiritual expressions
3. “Good-bye”- Ways we extend good-byes with dignity and respect
The Spiritual Care Program is supported in each Healthcare Center
with a designated Regional Chaplain. Our Regional Chaplains are also
available to provide spiritual resources to assist our Partners in times of
need.
UHS-Pruitt continues to meet the needs and expectations of our customer base. We are becoming keenly aware
that to meet them, our partners must be trained and knowledgeable in customer service skills as they relate to the
type of patients for which they are caring. In an effort to gain this understanding and to better equip the staff with
these skills, we are implementing the following:
•
In-depth, Focused Training: Centers are evaluated by leaders both in the center and in the organization as to
needs related to customer service training. After this evaluation, training is given for a short period of time,
focusing on a few areas of need versus an overview of customer service as provided in the Partner Orientation
or Annual In-service. Areas considered include professionalism, effective communication, business
interactions, customer preferences, co-worker conflict, and so on.
UHS-Pruitt also believes that methods used to obtain more knowledge about our customer base is vital to excellent
customer service. To that end, we are putting into practice the following:
•
Family/Patient Focus Groups: Small groups of family and patients will be brought together with center and
20
organization leadership to discuss methods to improve programs within the center. This is not a “family
council” but a group of people with common care requirements (e.g. short-term rehabilitation) that are able
to articulate their evaluation of the service, reasons for choosing the center, providing strategic direction, and
expectations.
•
Improved Discharged Patient Response: Currently our response rate for those patients that are discharged
from our Healthcare Centers is between 17% and 20%. This is consistent with the national response rate for
this type of survey. However, we believe that in order to improve, we need a response rate that will make our
data more statistically relevant. This will allow us to make far more informed decisions related to customer
satisfaction. We will begin instituting a process, whereby discharge surveys will be provided to patients
and families upon discharge instead of though mailings later in the month after discharge. We believe we
will capture a larger proportion of our discharged patients and be able to improve our customer satisfaction
initiatives.
•
Detailed Green Sweep: We believe that it is important that we provide an environment that is very pleasing
and aesthetically comforting. Our current “Green Sweep” looks at the Healthcare Centers as a whole and
begins to scratch the surface related to customer environmental needs. Nevertheless, UHS-Pruitt would like to
go beyond this. We are beginning to develop a more detailed program that will help the leaders in the center
to identify those areas that are of particular concern to our patients and families. This will consolidate many
aspects of environmental care and provide a road map to improving those “little things” within the center.
Quality Programs:
UHS-Pruitt understands that our business focuses on the delivery of care and services to our patients. This
encompasses a coordinated effort between clinical and operational actions and responsibilities. Both must
work in unison to provide our patients with overall quality care and services and are reflected in the following
opportunities:
•
Clinical Goals: UHS-Pruitt has established the following clinical goals to measure the changes in the clinical
services provided to our patients. These goals are measured utilizing “real-time” data through our LTCQ
software, which collects and analyzes Minimum Data Set (MDS) patient assessment data. This allows our
organization to respond timely to clinical findings related to the clinical goals listed below and others not listed
but monitored:
1. High Risk Pressure Ulcers: 14% 2. Physical Restraints: 4% 3. Post-Acute Pain: 13%
4. Low-Risk Pressure Ulcers: 2.4%
Although our organization continues to be higher than the national average on high-risk pressure ulcers, we
recognize that due to the MDS coding requirements, this indicator also captures those patients admitted to our
Healthcare Centers with existing pressure ulcers. Last year, we added the goal of incontinence to identify what
influence that indicator had on high-risk pressure ulcers. After focusing on and reviewing our incontinence
programs, we are below the national average on low-risk incontinence. With that being said, UHS-Pruitt
continues to focus on our pressure ulcer programs. However, we have replaced last year’s incontinence goal
with low-risk pressure ulcers for FY09. We feel this would give us a more accurate picture of our pressure
ulcer prevention programs.
UHS-Pruitt is proud to report that we continue to fall below the national averages on physical restraints and
post-acute pain. Not only do these goals remain as national Advancing Excellence Campaign goals, but as
outlined in our strategic plan, we are continuing to acquire centers with less than optimal quality programs. By
21
maintaining a focus on these goals, we are able to determine, through new acquisitions, if our physical restraint
and pain programs are effective in promoting quality services.
•
Direct Care Staff Additions: Last year UHS-Pruitt continued to respond to the patient acuity demands as we
transition into post-acute service delivery. We are pleased to announce that many of our Healthcare Centers
received additional direct care staff positions such as Registered Nurses, Treatment Nurses, Certified Nursing
Assistants, Transportation Nurses and Housekeepers. These positions were added to identified days and shifts
where patient care could continue to be enhanced.
As we continue to transition in the post-acute environment, our patients are requiring higher skilled services.
Understanding the therapy needs of our patients, UHS-Pruitt Corporation developed a new program in 2008
called “UniStep”. The UniStep Fitness program is a strength building program especially designed for the frail
and elderly. Our post-acute care centers and skilled nursing centers will incorporate the UniStep program into
their existing therapy and restorative programs in an effort to allow the patients to achieve optimal outcomes.
The program is a unique system that is safe, clinically controlled and supervised and consists of strengthening,
balance training, gait training, and cardiovascular training via the use of state-of-the-art Nautilus™ and
Biodex™ equipment. In addition to the UniStep fitness program, all or our Post-Acute Centers will use the
UniStep Pathway. Each patient will have an individual pathway that outlines the optimal sequencing and
timing of interventions as a “road map” through the recovery process. The goal of the pathway is to improve
quality of care, increase patient satisfaction, reduce risk of hospital readmission and develop cohesive teams of
healthcare professionals. In 2008, the UniStep program was initiated in nine or our Healthcare Centers with
plans to add more centers in 2009.
•
A Paperless Enterprise: UHS-Pruitt Corporation has adopted the concept of an electronic documentation
environment utilizing modern technologies and software to organize, store, locate and retrieve data. The
electronic charting software we utilize will aid us in providing a better quality of service to our patients, as we
will have easy and fast access to relevant data. There are three electronic programs we are introducing in our
Healthcare Centers to facilitate this endeavor: Smart Charting, Electronic Medication Administration Record
(EMAR), and Electronic Administration Treatment Record (ETAR).
•
Smart Charting is a data collection and reporting system utilized by our Certified Nursing Assistants
to document patient Activities of Daily Living (ADLs), and the daily care given to the patients. The
nursing staff monitors and verifies the documentation, and capitalizes on the data to generate reports.
This is valuable for formulating informed decisions about care planning, quality improvement, trends
in resident status, staffing assignments, and staff performance. We presently have 14 Healthcare
Centers utilizing this system.
•
EMAR is an innovative program designed to automate and coordinate, in real time, the entire drugdispensing process. American Healthtech is working in tandem with United Pharmacy Services’
software to integrate the process. It has the ability to provide automated alerts for drug allergies,
adverse interactions and incorrect dosage. We are in the first phase of software integration.
•
ETAR is the documentation program for wound and other treatments provided to our patients.
Creams, ointments and other pharmacy prescribed applications will integrate with the ETAR to assure
correct, efficient records of the patient care. We are in the first phase of software integration.
We are optimistic that through our electronic charting programs, our direct care Partners will have more
time to spend at the patient’s bedside. A paperless environment allows us to utilize our resources towards
the goal of delivering quality patient care, increased time with the patient, quality documentation and
efficient medical record organization, security and retrieval.
22
•
Electronic Patient Call Response System: Last year, we reported that UHS-Pruitt piloted an electronic
patient call response system that showed favorable results in monitoring patient calls. This system allows the
Healthcare Center a method for identifying patient call needs on an escalated response level and run data
reports specific to call response times, unit calls and patient specific calls. We are pleased to announce that
the pilot electronic call response system showed highly favorable outcomes. As a result, our organization is
currently installing or planning to install the system in nine Healthcare Centers. These Healthcare Centers
will be able to utilize the information for individual patient care planning, identify adjustments for staffing, etc.
Medicare Rehospitalizations:
The patients we admit are at a much higher acuity level, requiring more intense services, than ever before. UHSPruitt recognizes that these patients desire to return back to their previous home or community living situation,
when they are able. As our organization continues to take a look at the quality of services our Healthcare
Centers provide, we feel a good method that would assist us in measuring the quality of services provided to our
short-term, high-acuity patients would be to look at the number of patients who discharge home (or back to
the community) instead of discharging to a hospital. The below graph measures our total percent of Medicare
patients, admitted under the top six high-acuity diagnoses, that were discharged from the Healthcare Centers to
the hospital. This data tells us that we are having fewer patients discharging to the hospital and more patients
discharging home or to another community living situation. In late 2008 UHS-Pruitt began focusing on how to
utilize this data to improve the care delivered to our patients. We plan to continue to scrutinize this information
so that we may continue the trend of returning patients back to their homes after discharge from our Healthcare
Centers.
Medicare Rehospitalizations
Jan 08 - Jun 08
% Improvement
26
.7
25
.0
26
2
23
.8
24
.
22
.5
.0
23
.4
17
.
4
.1
17
Non
Rehab
Rehab
2
4.
Rehab
Non
Rehab
HIP FRACTURE
23
Rehab
Non
Rehab
Heart Failure
Rehab
0
-4
.8
-1
.2
1.
2
3.
2
3.
5
4.
2
5.
3
6.
7
8.
6
9.
4
12
.1
12
.2
13
.9
15
.
5
16
17
.7
.1
18
.2
19
19
.2
.6
20
.9
16
% Patients Discharged to Hospital
During Medicare A Stay
26
.0
.6
28
.
29
9
.2
29
.8
31
.9
31
.8
Oct 06 - Sep 07
pneumonia
Non
Rehab
COPD
Rehab
Non
Rehab
UTI
Rehab
Non
Rehab
CVA
Rehab
TOTAL
KNEE
Partner Satisfaction and Retention:
The success of our Healthcare Centers is determined by the hands and hearts of our Partners. We appreciate their
loyalty to their patients and our organization. UHS-Pruitt wanted to express our gratitude to our nursing aides
who are on the front lines in providing quality services to our customers. In 2008 we were proud to have our
first annual “Guiding Light Care Giver of the Year Award”. This program recognized aides that are true leaders in
their field. Nominations, meeting specific criteria, were received from administrators and managers within our
Healthcare Centers, Veterans Homes, Hospice, Home Care, Rehab and Pharmacy divisions. During our annual
May Leadership Conference, the top ten finalists and their families attended a special luncheon in their honor in
which each received $1,000. In addition, our first place winner received $5,000, our second place winner received
$3,000 and our third place winner received another $1,000.
Although our organization was unsure how this award program would be received by our partners, we were
overwhelmed by the response and the nominations. All who attended the award luncheon were humbled to tears
watching the touching videos of each of the finalists who told his/her story of devotion to caring for others. We at
UHS-Pruitt knew on that day that we would continue our “Guiding Light Care Giver Award” program so that we
may give something back to those who give so much!
UHS-Pruitt is proud to announce the winners of our first annual “Guiding Light Care Giver Award”:
First Place Winner: Carrie McLellan, Heritage Healthcare at The Pines
Second Place Winner: Mary Joyce Luffman, United Rehab-Heritage Healthcare of Elkin
Third Place Winner: Lalmani Persuad, Heritage Healthcare of Lilburn
Our organization developed a wide variety of Partner programs since 2006 and 2007. We will continue to monitor
for success of the following programs in efforts to meet, recruit and maintain high-quality Partners:
•
In This Together: This program builds on the concept that a culture of respect among supervisors and workers
is essential for employee retention. The video, “In This Together”, along with the organization’s policies on antiharassment, communication, etc., has been used to educate all Partners on expected and respectful Partner to
Partner interactions. This program is being incorporated into our New Partner Orientation Program.
•
Supervisor Training: “Keeping the Good Ones”. Training stresses the importance of building relationships
with partners and acknowledging good work when it happens. The program was developed and is presented
by the UHS-Pruitt Chaplains. In the last fiscal year, they have made over forty presentations. The goal for
2009 is to make presentations in 100% of the business units.
•
Encouraging Feedback: One of the hallmarks of great leaders is that they go out of their way to “hear what
they don’t want to hear”. In that vein, UHS-Pruitt produced a video of our CEO making a special appeal for all
Partners to complete the employee satisfaction survey from My InnerView. The intent of the message from the
CEO is to increase the response rate of the surveys and to have honest and forthright feedback without fear of
retribution. Because of our focus on encouraging feedback, we had an outstanding response rate of 82% in the
partner satisfaction survey, conducted in July 2008 by members of the HR and Operations teams. This is more
than 30% higher than an average response rates nationwide.
•
Pay 4 Performance Incentive Program: Our organization recognizes the current labor pool shortages
of Administrators and Directors of Health Services. This labor pool shortage provides industry-wide
opportunities for enhancing competitive recruitment and retention packages. UHS-Pruitt has implemented a
Pay 4 Performance Incentive bonus program for all Healthcare Center Administrators and Directors of Health
Services. This program allows financial incentives to be paid to these Partners when they meet established
quality, case mix and employee and customer satisfaction goals. This incentive program allows our Partners
who support our organization’s Mission, Vision and Commitment to Caring philosophy to be recognized and
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rewarded for their work ethic.
A new program that was implemented in 2007 was the establishment of the “Good to Great” Committee. This
committee consists of Healthcare Center Partners whose work is influenced by the policy decisions made by the
organization’s leadership. In an effort by the UHS-Pruitt leadership to make an informed policy decision that will
have significant impact in the care of our patients, the Good to Great Committee is challenged to pilot and test
the potential policy and make recommendations to the organization’s leadership prior to release of a new policy.
In 2008, the Good to Great Committee took on the challenges of addressing the “drill-down” specifics that were
identified as having a direct impact in our customer satisfaction surveys results. The committee focused efforts on
measures to prevent lost and wrinkled patient laundry items. The measures being reviewed include using steamers
to prevent wrinkled clothing and individual patient laundry bags.
UHS-Pruitt supports a not-for-profit foundation called The United Hospice Foundation. An initiative of this
foundation launched this year entitled “Pruitt Cares” provides assistance to caregivers experiencing hardship due
to a medical emergency or natural disaster. Since its inception, “Pruitt Cares” has provided help to over 125 people
and/or families.
Our Family, Your Family, One Family,
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Conclusion
UHS-Pruitt Corporation is proud to publish our third annual Quality Report. The “Pathway to
Greatness” for our Healthcare Centers, as described in this document, allows all stakeholders to
envision our organization’s Mission, Vision and Committed to Caring philosophy. We understand
that our success is reflected in quantifiable data measurements that support the quality care and
services we provide. We believe in promoting and leading the long-term care industry in being
transparent, in an effort to gain the trust of and strengthen relationships with our stakeholders.
UHS-Pruitt believes that quality is exemplified in all our business functions and relationships. This
belief allows to compliment, support, and enhance one another. The end result, using evidencebased data, is our ability to reflect the quality care and services we provide to our customers.
UHS-Pruitt is Committed to Caring.
Committed to Loving, Giving and Caring.
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1626 Jeurgens Court
Norcross, GA 30093
770-279-6200
Fax: 770-925-4619
UHS-Pruitt is one part of a larger organization comprised of companies that provide health care and related products and services. This
document was prepared by UHS-Pruitt on behalf of those companies based on their collective accomplishments and dedication to their
customers. For purposes herein, the name “UHS-Pruitt” is used to identify the group as a whole and should not be construed to impute liability
to UHS-Pruitt Corporation or as an alter ego or agent of any other company. Each company has adapted and ratified on its own behalf all
information contained herein.