Using The Resident Expectations Survey to Improve Life at Homestead Village

As mentioned previously, the 2011 Resident Expectation Survey was very positive.  Summarizing, overall satisfaction came in at 98.54% and satisfaction increased or stayed the same in 18 of the 23 areas surveyed.  While the numerical ratings for each question in the satisfaction survey are both  interesting and beneficial to benchmark the satisfaction scores versus previous surveys, the comments are the the very best source of information for quality improvement. 

Each of the 23 questions in the bi-annual expectation survey includes space for comments and many residents took advantage of the opportunity to provide feedback.  For 2011, the comments spanned 44 pages and totaled over 1100 separate points of feedback.  Well over half of the comments were positive regarding services and quality of staff members; but the constructive criticism contains many illuminating statements and good ideas.

Each Department Leader reviews the comments pertaining to their department, identifying comments that are positive as well as those that raise concerns.  For each concern, an appropriate action is determined.  For concerns that span more than one department, a quality improvement task force is developed to address the shortcoming.

Some examples of comments follow: 

Question 17 covered the quality of staff exhibiting friendliness, helpfulness, competency and cheer.  That category scored 99.64% satisfied, a .01% improvement over 2009.  20 of the 23 comments were positive.  The three concerns related to staff not being friendly at all times.  The clearest example was the comment that "some staff look the other way when I encounter them in the hallway."  These comments will be used as customer service examples in employee training and new employee orientation.

Question 16 relates to the timeliness and quality of communication between administration and residents. This question scored 98.55%, a .85% increase in satisfaction over 2009.  Ten of the nineteen comments were positive.  Of the nine concerns, some related to HVTV (Channel 95), one related to timeliness of notices, and one stated that long term goals are not clear.  Channel 95 improvements are ongoing and the timeliness of notices and long term goal issues will be examined for ways to improve both.

This level of detail is applied to all comments so that we can continue to improve the quality of our services and better fulfill our mission!

Satisfaction - a Homestead Village Tradition!

Our biannual satisfaction survey was conducted in Spring 2011 and the results once again prove that Homestead Village residents are very happy with their community and their decision to make Homestead their home.

Fickes House Dining Room is a reflection
of Homestead quality.

Of the 22 aspects of quality of life surveyed, 13 scored above 98%, 17, above 95% and 2 scored 100% satisfaction.  That compares to the 2009 survey in which 9 areas scored above 98% and 15 above 95%.

The two services that scored 100% satisfaction were Transportation and Snow Removal.  Of special note is our Environmental Services Department goal to remove all snow from each resident's path - including the snow between resident cars parked outside and even the snow ON each resident's car!

As important as the high scores are in measuring satisfaction, we especially treasure the comments.  Our residents' countless ideas and feedback will serve us well in continuing to make Homestead Village the best place to live and to work.

Why Homestead Village Needs To Grow

Townstead is the exciting new 60 apartment edition to Homestead Village.  Some residents have asked, is it really necessary to build 60 more apartments.  They like Homestead Village just the way it is and do not want it to grow any bigger.  Their question is, "Why do we need to build more apartments?"  Here's the answer.

What is too big?
Often existing residents don't like the idea of new living units because it means more people and more crowds.  In reality Townstead will be beneficial in this area.  The sixty apartments will further improve our financial position and reduce each resident's individual portion of the administrative overhead.  Most of the first floor renovations and additions and part of the second floor will be  dedicated to wonderful new common space.  In reality, the new Homestead Village will feature improved activity and dining space as well as a much larger library, chapel and other meeting rooms.

Even though we are blessed with more than sixty acres in the best location in Lancaster, Homestead Village will never grow too big...Future growth at our Rohrerstown location will be limited to incremental increases, meaning Homestead Village will always be a medium sized senior living community.


New Apartments bring Needed New Amenities
Common space costs plenty.  Many communities spend tens of millions of dollars to add important amenities. It is not financially prudent to invest millions in non-revenue producing amenities without adding some additional revenue producing living units.  Townstead gives us the best of both worlds.

Growth meets a Need
Homestead Village has grown many times over the past 25 years.  The addition of seventy additional apartments in 1989, the completion of the cottages in the late eighties, the development of Villa Court in the nineties followed by the completion of The Mews in the last decade has given hundreds of seniors the opportunity to live at Homestead Village who otherwise would not have had that opportunity.  Today, our priority list stakeholders who want to live in a two bedroom apartment are unable to make Homestead Village their home, due to the acute shortage.  Townstead will add fifty additional two bedroom apartments, alleviating the long wait.

Townstead is the best and brightest future for Homestead Village!

Managing your Medicare Benefit

Since 1965 seniors have benefited from a great health insurance program known as Medicare.  Designed specifically for the needs of seniors, Medicare has played an important role in improving the lives of older adults.  Over the decades, numerous changes have occurred to the Medicare program and a number of innovations have been tried.  Here is a short description of what you need to know about your Medicare benefit.

Social Security Amendments of 1972
Signed into law by President Nixon, the key change brought about by this amendment made Medicare available to anyone who had paid into Social Security for a short period of time and then became disabled, after a two year waiting period.  This is the first of many changes that weakened Medicare financially.

Catastrophic Medicare Act of 1988  
The first sweeping change that occurred with Medicare was the passing of the Catastrophic Medicare Legislation in the late eighties.  While the name implied an improvement in Medicare benefits, it actually resulted in a catastrophic financial impact, resulting in its repeal just one year later - one of the only instances of the Federal Government recognizing its error and addressing it in a timely manner.

Medicare Modernization Act of 2003
The next major change to Medicare was the Medicare Modernization Act, adding a prescription drug program to Medicare.  While the act improved access to drugs, the complexity of the program makes it very difficult for most seniors to utilize it fully and the unfunded cost has actually further destabilized the Medicare program.

Medicare HMOs and Advantage Programs
As part of the Balanced Budget Act of 1997, the Medicare Choice program was established.  These programs are either HMOs or PPOs that bundle Medicare services into a cost effective program. The programs often entice older adults to leave their traditional Medicare plans with the promise of lower monthly premiums and enhanced prescription drug benefits; but the shortcomings of the plan are revealed when residents need it most.  Some plans only contract with certain providers for services such as long term care, often forcing retirement community residents to use a different nursing home for rehabilitation.  Many plans only approve very short stays before cutting the Medicare benefit, putting the burden on the resident or their advocate to fight for the benefits that by rights they should already have.  While these programs promise to save enrollees money, they often fall short of expectations when real medical needs arise.  For this reason, Homestead Village believes traditional Medicare is the best choice for retirement community residents.

Patient Care Protection and Affordability Act (PCPAA)
The PCPAA, also known as Health Care Reform, makes fundamental changes to the program, including the reduction of nearly $500 billion dollars from the program over the next ten years.  While politicians promise older Americans that their health insurance will not be harmed, many of these cuts threaten the quality of care and even access to medical care.  The PCPAA earmarks nearly $148 billion in cuts to hospitals, nearly $40 billion in cuts to home health care, $15 billion in cuts to nursing homes and nearly $7 billion in cuts to hospice.  The Medicare Advantage Plans are scheduled to receive $132 billion of cuts over the next ten years.  Already, the federal government has announced an 11% cut for nursing home residents in 2011 - even in the face of rising expenses.  This will result in severe pressure on providers to maintain quality in an extremely challenging fiscal environment.

With the difficult financial challenges that both state and federal governments face, the pressure on Medicare will only increase over the next decade.  The PCPAA actually uses reductions in Medicare to help fund uninsured Americans.  This will most likely result in some form of rationing similar to what seniors in countries such as Canada face where medical care is rationed based on the age of the patient and the funding available.  If Medicare is going to remain a high quality health insurance program for seniors, then some tough decisions will need to be made by our leaders in Washington.  While there are some cost savings from the implementation of electronic record keeping and fraud reduction, fundamental changes need to occur with the program (along with all of Social Security), including age restrictions as well as premiums based on both income and the real cost of health care.  Washington's unwillingness to address this political hot potato will end up jeopardizing the program.

If you have any questions about your Medicare benefits, please check out www.medicare.gov.  It is a great source of information.  Homestead Village's staff will also help you find answers to your Medicare questions.

How do Levels of Care & Aging in Place coexist?



Inviting Fickes House Kitchen

 At Homestead Village, we offer you the best of both worlds!  The traditional Continuing Care Retirement Community (CCRC) was designed to move residents (customers) through the levels of care based on the communities' pre-established care guidelines.  This model is very efficient; but puts the retirement community in the position of dictating to its customers when and where they have to live.  That is not desirable to most residents.
Homestead Village continues to offer all of the traditional CCRC levels of care plus we have added additional services such as Homecare and Memory Support Personal Care to further improve our mission to enhance the independence and dignity of each person served.  Our vision is to create an aging in place, home-like environment for our residents, filled with companionship and great care.

Homestead Village is a traditional CCRC
Independent or Residential Living:
Offering the widest variety of housing options from cozy, very competitively priced studio apartments up to 3 bedroom, 3 bath, 2 car garage villas, Homestead Village has your perfect home in one of its 165 cottages and villas and 112 apartments.

Personal Care (formerly referred to as Assisted Living):
In Pennsylvania, the name Assisted Living was chosen by the Department of Welfare for a new level of care that costs significantly more money to license and as of this date offers no compelling reason to pursue licensure.  Only a handful of retirement communities in Pennsylvania currently offer this new assisted living service.  Basically Assisted Living refers to a licensed level of care that permits residents with more care needs to remain at that level rather than move to skilled nursing.  Homestead Village continues to offer Personal Care Licensed Services in our apartments.  It is called Supportive Services at Homestead Village.  Homestead's unique personal care service allows you to live in any of our apartments and receive personal care services at a very reasonable price - much lower in studio and one bedroom apartments and very competitively priced even in our largest two bedroom special end apartments!

With Supportive Services, our residents have both independent living and personal care levels of care AND aging in place in one - at a very cost effective price.  This is truly an example of enhanced senior living!

Personal Care Memory Support - Gelhard House at Westvue:
One of our four new households under development is Gelhard House at Westvue, a dedicated, secure memory support personal care home for residents with Alzheimer's and other memory loss ailments who can no longer live safely or comfortably at home.  Gelhard House features private bedrooms for fourteen residents; some of the rooms include sitting areas and all feature full baths. 

DEFINITION - At Homestead Village, a Household is defined as a group living arrangement centered around the comforts of home, including a living room, dining room and kitchen.  A Household can be at any level of care and we currently feature both skilled nursing and personal care memory support households at Homestead Village. 

Skilled Nursing Care - Fickes House and Radcliffe House:
The old, institutional style of skilled nursing is on its way out at Homestead Village, replaced by the household environments and  our person centered care approach.  The skilled nursing households still feature RNs, LPNs and Certified Nursing Assistants as well as Physical Therapists, Occupational Therapists and Speech Language Pathologists, working together to enhance each resident's independence and dignity in a beautiful, homelike atmosphere.  The number of available private rooms have skyrocketed from four up to twenty!  Once again our skilled nursing households feature the best of both worlds and are just one more reason why at Homestead Village, your receive enhanced senior living.

Skilled Nursing Memory Support - Young House:
Young House is currently under development and will feature a secure and pleasant household for up to fifteen non-ambulatory residents with Alzheimer's Disease or other memory issues.

Homestead Village Home Care:
Our newest service also contributes to the vision of aging in place through the provision of companions, certified nursing assistants and LPNs in your cottage, Villa Court villa or Mews villa, helping you stay in your own home.  Available in as little as fifteen minute increments, our home care service provides you with enhanced options, enhanced care and, of course, enhanced senior living!

Charting the Changes for the Better



Fickes House Kitchen and Dining Room

 Change is a neccesity of life.  It is a key step in improving quality of service; plus it keeps life interesting.  In fact no change is equal to stagnation.  Homestead Village has been changing dramatically over the past several years.  Those changes have all been designed to improve our delivery of quality care; but perhpas the changes have been so numerous and widespread that we need to take stock and review how enhanced living at Homestead Village is delivered.  So, for the next few months, that will be the focus of my articles.  Hopefully, they will be both helpful and informative, explaining how the various services of Homestead Village fit together to create the finest senior living experience.   The topics will be:

 - How do Levels of Care and Aging in Place coexist?

 - Insurance options - How to choose?
 - What makes the Homestead Village model superior?
 - A Homestead Village Glossary

Leading The Way In Comfort & Care



Fickes House Living Room - only made possible by
your generous gifts to the capital campaign!

 Our capital campaign has been a tremendous success, raising over $3.2 million and fast approaching the goal set by the Board of Directors of Homestead Village when they authorized it.  Achieving this success during one of the worst economic periods in recent history is a testimony to the dedication and caring of Homestead Village's stakeholders.

Yet, the work is not complete and we need the assistance of our whole community to finish the campaign.  Will you consider your response to the need?  What is the need?  First and foremost, while the campaign has reached the $3.2 million mark, many of the gifts have been bequests and will not be available for many years.  The final cost of the project will be approximately $4 million so there is still a shortfall between the actual cash available and the total cost of the project.  The results, so far, speak for themselves.  The new living environments exceed our expectations with soaring ceilings, beautiful finishes and comfortable nooks for private conversations.  The kitchens and dining rooms serve delicious made to order food and provide great cooking activity space. The new laundries allow personal laundry to remain in the house and be individually washed.  Finally, the showers in every resident room greatly improve the bathing process for residents and staff.  Recently the Fickes House spa was completed with its beautiful wood floors, ceramic tile walls and state of the art whirlpool tub. Fickes House feels like a fine home.

The Fickes House Living Room, Dining Room
and Kitchen create a spacious, elegant home!

In preparation for our housewarming, Paul Risk Associates and its subcontractors and busy turning the old bathing room into Radcliffe House's living room.  It is fascinating to see the old tiled showers give way to a new picture window and window seat.  The final five rooms are being remodeled and very soon phase one of the renovation will be complete!

Everyone is invited to the housewarming on July 27th.  As part of the celebration we have put together a housewarming gift registry.  You do not need to bring a housewarming gift to attend this celebration - we want everyone at Homestead Village to see and enjoy the remarkable transformation that has taken place!