Nursing is the largest department at the nursing facility because care is so individualized and provided around the clock. Licensed professionals including registered nurses and licensed practical nurses coordinate the care administered and supervise certified staff as they assist individuals. Certified staff include certified medication aides, certified rehabilitation aides, and certified nursing assistants. In coordination, these nursing staff members work closely with the individuals served, their families, and other health care professionals.
After a thorough comprehensive assessment of baseline functioning of each individual, a care plan is formulated with the assistance of other departments and of course the individual served. This directs the services required and desired by the individual. Medications and treatments are administered daily by nursing staff and rehabilitation assistance is provided as planned. The individual is assisted with all types of ADLs (activities of daily living) including dressing, grooming, mobility, toileting, and eating according to the plan. It is impossible to always have the best outcomes, but through assessment and planning, the goal of the nursing staff is to reduce falls, prevent pressure ulcers as possible, maintain each individual’s safety, minimize unplanned weight loss, reduce pain, and improve or maintain overall functioning.
The nursing department strives to administer the highest quality of nursing care. Extensive professional nursing education is provided to make certain nurses are incorporating the latest advances into daily practice. Care pathways and professional communication contribute to quality through use of national protocols such as Advancing Excellence and INTERACT. The award-winning nursing staff has received multiple grants to apply new interventions and because of longevity, advances and positive change are lasting.
Some of the additional services offered by the nursing department include; dementia care, diabetes management, wound care, hospice services, palliative care, IV therapy, pain management, individualized education, tube feedings, and tracheostomy care.
The Business Office at the facility assists individuals and their families in many ways. Office staff file for Medicare, Medicaid and private insurance benefits. They assure that all necessary paperwork is complete and accurate. Office staff will assist individuals with banking as requested. They will also assist individuals in arranging services such as cable television, newspaper subscriptions, and mail. Any time there is a change in an individual’s payment source, the Business Office will help transfer information as necessary. The Business Office will even assure that residents receive emails.
The Dietary Department establishes and maintains quality standards for meeting the nutritional needs of the individuals served while observing and honoring tastes and preferences. The nutritional program is based on an assessment of the nutritional needs of each individual and must be in accordance with the physician’s order. On a daily basis, every effort is made to promote dining independence for the individuals served and to promote an atmosphere which will enhance all meals. Three nourishing and attractive meals and snacks are provided on a daily basis. There are multiple options at each meal enabling individuals to select a menu most appealing to them. The nutritional status of each individual served is reviewed periodically by a licensed dietician. At all times, the Dietary Department focuses places an emphasis on palatability and a high quality dining experience.
In addition, there are many special occasions enhanced with involvement from the Dietary Department. Many activities include food or drink to celebrate special events. Each individual’s birthday is recognized with special table decorations, a birthday plate, and a personal cupcake. Realizing that individuals love to socialize with their friends and families, there are several events annually where these special people are included in meal sharing such as picnics, the Christmas party, steak nights, and Mother’s and Father’s Day celebrations.
Should individuals require assistance with meals, nursing staff stand ready to provide help as needed to promote dining with dignity. Seasonal and home grown food is also regularly enjoyed.
Chautauqua Guest Homes’ activity programs exist to enhance the quality of life of individuals served through development and matching of activities to needs, capabilities, and interests of these individuals. The activity offerings are continuously changing as facility populations change. Friends and families are encouraged to participate at any time.
A fairly recent advancement now used on a frequent basis is the addition of technology to facility programming. Facilities are equipped with Wifi and there are typically laptops and e-readers for individual use. Current events and any type of programming is easily accomplished through technology. Even Bingo is improved through a software program. Evening activities have been enhanced also.
More traditional programs at the facilities include daily exercise and routine Tai Chi classes, birthday parties, holiday celebrations, outings, music, spa days (manicures, pedicures), traditional and electronic games, and religious ceremonies. Also on a monthly basis, Resident/Tenant Council is convened to remind individuals of their rights and to also allow an opportunity to bring up issues or requested items.
This department ensures that the Chautauqua environments remain clean and sanitary through daily housekeeping service and laundry processing. Laundry and housekeeping are provided within the facility and also for individual rooms/units. Both personal and facility laundry is processed off-site and then delivered following processing. Both result in lessening the chance of infections within the facility and a more comfortable clean living area.
The Maintenance Department is responsible for proactively assuring safe working conditions within and even outside of the entire facility including equipment and supplies. Maintenance also assures that the facility meets or exceeds all Emergency Rules and Regulations including fire protection. Logs assure that necessary and important aspects of facility safety are regularly monitored. Water temperatures are measured, emergency lighting is checked, door alarms are tested, and fire sprinkler systems are examined routinely. These are only a few of the many items that are tested to assure that they are functioning as required. A preventive maintenance program minimizes breakdowns during use resulting in fewer negative outcomes. Maintenance also is responsible for snow removal during the Iowa winters and grounds upkeep during nice weather. Both resident equipment and facility equipment are routinely examined. The maintenance staff is even responsible for assuring that there are no prohibited items such as electrical extension cords, cheater plugs, or door jammers in use within the building.
At Chautauqua Guest Homes, therapies include occupational therapy (OT), physical therapy (PT), and speech therapy (ST). In the long term care setting, OT, PT, and ST help individuals adapt to illness, injury, or disability. The job of “living” may mean learning to live with a new health challenge by completing daily tasks in a different manner. These tasks can include walking, getting up and down from a chair or bed, and regaining strength and balance to perform activities of daily living. Activities of daily living include dressing, grooming, hygiene, toileting, and feeding. They may also include re-learning care of belongings, clothing, home, medication management, cooking, and even driving. OT, PT, and ST may use real or simulated tasks as well as specialized exercise with or without adaptive equipment to meet an individual’s goals.
In addition to the departments as detailed above, there are several standing committees that contribute to promoting the professional standards of care within the facility.
Probably the most important of these is the Quality Assurance Performance Improvement (QAPI) Committee. This committee includes representatives of all three Chautauqua facilities, the Medical Director, Dr. David Schweier, the consultant pharmacist from Martin Health, and staff members from multiple departments. This committee maintains routine statistics that are monitored for negative changes or trends and also special study areas to either improve overall performance or address issues of concern.
Established policies and procedures are rotated and reviewed through this committee to assure they are current and correct. This committee allows the entire Chautauqua establishment the opportunity to look at itself honestly and improve wherever possible. Statistics are compared against national benchmarks to search and evaluate our performance. The QAPI committee meets at least quarterly or whenever there are areas of concern that need to be addressed immediately.
Other standing committees include the Safety Committee which is charged with monitoring unplanned incidents that can impact the safety of the individuals served and the Skin Committee who monitor any skin issues until resolution. Other committees meet as needed and special projects are frequently initiated to otherwise improve.
Of special interest to the individuals served, care plan conferences are scheduled weekly and all individuals are assessed at least quarterly or whenever there is a significant change in condition. Individuals served are encouraged to attend and participate in their care conference to direct Chautauqua in methods to best achieve mutual goals. Medicare meetings are also held weekly to review the progress of individuals receiving Medicare coverage with nursing and/or therapy involvement. And all Chautauqua Department Heads have an open door policy and prefer that areas of concern be discussed immediately so problem solving can begin as soon as possible.