Homestead Village Enhanced Senior Living: A LIFE PLAN COMMUNITY

Life Plan Community has been chosen, after a multi year effort, to replace Continuing Care Retirement Community (CCRC) as the primary description of communities for older adults.  For most people, their first question would be, "Why change?"  That is a good question.  The best way to answer it is to first look at history and then look at the present.

Communities for older adults have been labeled with various terms over the past hundred years that today seem unbelievable.  "Asylum" was probably the most heinous label.  Of course when asylum was the popular term, residents were referred to as inmates; so the terminology was offensive from all aspects.  "Homes for the Aged" was  used regularly replaced by "Convalescent Home" and "Nursing Home."  When these terms were no longer acceptable, new, modern terminology took their place.  The modern terms were cool and very business like.  "Skilled Nursing Facility" and "Rehabilitation and Skilled Nursing Center" are two of the more popular terms that are still in use today.  The term facility is ubiquitous.  It appears in the news and even in regulations. It is often the term used to describe a community by its own residents and employees.  Facility is the opposite of home.  No one calls the home they grew up in a facility.  The most basic definition of facility is space or equipment necessary for doing something.  It is a very functional term; but does not describe the key reason we create communities for elders:  caring, compassion, love and fellowship.  Center has a similar connotation.
Back in the seventies and eighties, as retirement communities began to appear across the country, the term continuing care retirement community became popular and has come to define the type of living arrangement that offers multiple levels of care in one location.  Even the accreditation is named Continuing Care Accreditation (CARF-CCAC).  This terminology has served well for the past three decades or more; but its shortcomings have begun to appear.  As the new generation of elders approach the decision to move to a community, they have expressed displeasure with the term, CCRC.  Two of the four words elicit negative feedback.  Care and Retirement are both unpopular with the boomers.Even continuing is institutional sounding.
Leaders in the"Life Plan Community" field recognized this problem and began a deliberate effort to identify new terminology that best describes what we offer.  After two years of hard work including market testing, the term "Life Plan Community" has been chosen.  It was announced at the annual LeadingAge conference in Boston in November. The public relations information included with the announcement includes the tag line, "It's my life; it's my plan; it's my life plan community!"  Use of the term in place of CCRC is voluntary; but it offers a new and fresh take on what communities such as Homestead Village offer those who choose to make us their home.
Homestead Village will embrace Life Plan Community and do its part to facilitate the transformation in language and thought.

Church of the Apostle's Rader Park

Homestead Village is blessed to be located in an idyllic location, close to every major attraction and thoroughfare, yet tucked into beautiful neighborhoods.  One amenity that we often take for granted is Rader Park.  According to Church of the Apostles’ website,

“Rader Park is an outdoor ministry of Church of the Apostles that encompasses over 20 acres of our campus. Over the years it’s been developed with an eye toward stewardship of the earth and faithful ecological practices. Improvements include:

• Over 100 trees have been planted in the last few years including memorial trees to honor members who have passed away. There are stands of evergreens planted as boundary trees to hide a busy road. The memorial trees have created an aleé of hardwoods leading to a group of evergreens planted to create an enclosed campfire area used for intergenerational campout.
• Other natural features include a pond stocked with fish which is home to frogs and a snapping turtle or two.
• Church members have worked together to build walking trails and gazebos at strategic places for rest and viewing the scenery.
• A large pavilion was completed in 2007 and is used for outdoor worship services and church picnics. Playground equipment for the children is available in this area.
• A butterfly garden was developed to encourage all sorts of beneficial insects.
  
• Bee hives have been added and the church produces its own honey known as Sweet Success.
• In the summer of 2012, an acre and a half was plowed and a vegetable garden was planted. Members planted, weeded, harvested and sold vegetables on the property to clients and employees of our campus partner non-profit organizations. Over two tons of vegetables were donated to local residential missions and some of the produce was frozen for use in homemade soup made and sold in the church during the winter.
• Summer programming in the park is a very active part of our church. Center city school children arrive in May for field trips and benefit from the science and ecology they learn through stream studies, planting vegetables, fishing in the pond, and studying bugs living in the dirt. A Wacky Wednesday literacy program for toddlers and young children is held every summer with adult story readers. Organizations including our own Apostles Preschool, and various other non- profit agencies, use the park for their summer camps that last anywhere from a week to a month. 
• On Sunday evenings in the summer, intergenerational programs focusing on nature and ecology occur every two weeks and bring a large crowd of member families and neighbors alike. The evenings always end with ice cream, sometimes from our own soft ice cream machine.

Rader Park is an important part of our church mission of Sharing Christ’s Love with All People. Many people say they feel closer to God in nature and Rader Park fills that spiritual need for many. Come see our park and enjoy everything it has to offer.”

Church of the Apostles has graciously made Rader Park available for the enjoyment and well being of the Homestead Community.  We are indebted to them for enhancing our environment and surroundings with beauty and opportunities for exercise, picnicking, gardening and public service.  Over forty years ago, Nevin Shellenberger had a vision for his church to be surrounded by ministries that the church could support and lead.  With the help of like-minded individuals such as Glen Rader, Bob Williams, Richard Geiger, Al Alspach and others, Nevin's dream has become a reality.  Rader Park is an important part of that incredible legacy.

How Does Charitable Care Work at Homestead Village?

Many residents have asked the question, "How does Homestead Village provides charitable care?"  It is a key part of our mission and our non-profit, charitable status.  Charitable care starts with the generosity of others.  Homestead Village is able to provide charitable care because our generous and caring stakeholders have contributed to our endowment.  That endowment provides the additional revenue needed to cover the cost of the charitable care.  Another key to  providing charitable care is careful budgeting and operations.  Knowing that we have a commitment to provide charitable care, we are careful with our resources.  The final piece of the charitable puzzle is ensuring that the need for charity does not exceed our ability to provide it. That means appropriate screen of new residents in all levels of care to ensure that they can pay for their services most of their life.

 Most residents of Homestead Village (and most other retirement communities) pay for their services with their own funds.  Other non-charitable sources of payment are long-term care insurance and Medicare.  Medicare has many forms and primarily pays for the first 30-100 days of care in a nursing home as well as for medications, therapy, physician services and other ancillary services.  Long-term care insurance pays in most licensed areas of care, including nursing care, personal care and home care when a recipient meets the medical requirements of the plan.

For most of us, if we live long enough, we might outlast our assets.  It doesn't help that as we get older, we require additional assistance which costs more money.  The end result for many people is the inability to pay their full bill.  When this occurs, we ask the resident to write a letter detailing the situation and provide a full accounting of their financial situation, including all assets, income, expenses and debts. Homestead Village's CFO, Brent Messner, then makes a determination as to the amount of charitable financial assistance necessary to meet the full bill.  The resident continues to pay as much as they can afford.  That is how charitable care is provided in residential living and personal care.  

In the nursing home, charitable care is governed by the Medicaid program.  Medicaid requires in most cases, a recipient to spend down most of their assets.  Exceptions are made for the spouse in the community and residents can often keep their homes; but the Department of Human Services is likely to put a lean on the home to recoup Medicaid payments.  Residents applying for Medicaid must provide their financial information to the county assistance office, which makes the determination as to how much of the nursing home bill will be paid by the Commonwealth and how much will be the responsibility of the resident.

 There are a number of challenging scenarios related to planning for health care later in life.  One of the first is Long Term Care Insurance.  Long Term Care Insurance is a complicated purchase and it is difficult to know when to purchase it and how much coverage to buy.  A financial planner can help determine the specific policy and values to purchase, depending on your age and physical condition when you apply.  The second difficult decision is whether to listen to the many schemes about shielding assets.  The temptation is great but there are two problems.  One is the five year look back that the Department of Human Services employs and second is the ethical question.  Any money that is transferred within five years of application for Medicaid will be disqualified and that money will be required to be spent toward care prior to approval for Medicaid.  The ethical issue is simple. Why should the rest of society, and in the case of the Apostles Center, the rest of Homestead Village pay for your care if you have the financial resources to pay for it yourself.  The Federal Government is nearly $19 trillion dollars in debt.  Every state is struggling to balance its budget and Homestead Village loses money on each resident on Medicaid.  Thus all other residents have to pay more money each time a resident qualifies for Medicaid.  Lawyers offer many other schemes to shield money and help individuals with means qualify for Medicaid sooner.  While these schemes are usually legal, each elicits many ethical issues.

Resident Expectation Survey Points to High Satisfaction Levels

Every two years for over a decade, Homestead Village has asked our residents to participate in a satisfaction survey.  The survey has two components.  The first is the numerical scoring in 22 categories.  The second and much larger part of the survey is the comments that are solicited within each question and overall.

Fortunately Homestead Village Residents are a little happier than this group!

Numerical Scores
Every category improved from 2013!  Overall Satisfaction improved 14% from 2.83 to 3.22  The average of all scores in all categories improved 13% to 3.11  Both scores average in the Strongly Satisfied category.

The lowest scoring categories were quality of food provided by dining and care in the Apostles Center for Care.  Both garnered 2.5.    Quality of food improved 11%  from 2013 while care in the Apostles Center remained constant.  Please remember that a 2.5 is between satisfied and strongly satisfied; so while it is the lowest score, it is still a positive score!    

The service areas that recorded the highest levels of increased satisfaction were:
Upkeep and Repair of Buildings:   19%
Care in the Infirmary:  21%
Appearance of Grounds and Landscaping:  22%
Housekeeping Services in the Common Areas:  26%

As has been the case, the two areas of service with the highest overall scores were Staff Friendliness and Helpfulness and Transportation.  Both scored a 3.6.  Runner up was Snow Removal with 3.5.

Comments
Hundreds of comments were submitted with the survey.  They include criticisms, praise and suggestions.  All of the comments have been scrutinized by the leaders of Homestead Village and will be shared with the Board of Directors. The comments will be grouped according to popularity, cost effectiveness and strategic planning. Those deemed to improve Homestead Village's quality service and can be implemented within our budget parameters will be pursued immediately.  Others will help to shape our ongoing strategic plan and be placed on the wish list for future years.

This systematic feedback from residents is critical to ensure the highest quality service for the residents of Homestead Village.  Your participation is greatly appreciated.

Homestead Village Home Care Making A Difference

Homestead Village's mission is to enhance the independence and dignity of each person we serve.   We fulfill this mission every day throughout Homestead Village, providing assistance to those who need or desire such services.  In the Apostle Center we provide five star staffing every day.  Our staffing is just as strong in our memory support areas, including both nursing and life enrichment.  We delight in serving supportive services residents in their apartments, allowing them to enjoy their home as long as possible.

The last piece of our caring puzzle is our home care agency.  Homestead Village Home Care provides housekeeping, laundry, dining services and nursing in our cottages, Villa Court and The Mews.  Homestead Village Home Care also serves the surrounding community, providing assistance to older adults in nearby neighborhoods.  Our home care is led by a team of dedicated and capable individuals.  Homestead's Executive Director, Carol Carter, oversees the Home Care Agency.  Home Care has been the special project of Carol Carter who created the agency and has overseen its growth since the beginning. The day to day operations are handled by Catherine "Kit" Reese.  Kit joined the Homestead Village team last year and supervises, hires and schedules the home care team members.  Kit has over 25 years of home care experience and comments that she has never worked in a more friendly environment.  She enjoys getting to know the residents and has been surprised by how interested the residents were in her.  Of course a key home care team member is our Homestead Village MVP, Kathy Bartels, who is featured in this issue.  Carol,  Kit and Kathy, as well as are many other fine home care team members, embody the mission and vision of Homestead Village.  Our goal and desire is to bring professional, quality and timely service to your home if and when you need it.

Springtime at Homestead Village - so much to see and do.

We experience beautiful seasons in Lancaster County and there is endless beauty around Homestead Village in April and May.

Homestead Staff running in  Dorwart Park
and the Lancaster County Conservancy

A short trip in any direction opens up a host of scenic opportunities.
To the north is Noel Dorwart Park (Mr. Dorwart was a beloved member of the Homestead Village community) and the Lancaster County Conservancy. Together they form a delightful place to hike, run, walk your dog or just enjoy nature. Our employee Couch to 5K participants have spent hours running the trails in these parks and it is a favorite destination!  To our east is Conestoga House and gardens, the beautiful homes along Marietta Avenue, Franklin & Marshall College, Buchanan Park, the North Museum and all of historic downtown Lancaster.  There are an endless number of places to explore, hike and visit.

Franklin and Marshall College

Conestoga House and Gardens

Historic Lime Spring Farm

Directly to our west is historic Lime Spring Farm and its beautiful buildings, currently being re purposed as a small village hub with recreation facilities, restaurants, walking paths and a Bed and Breakfast.

Finally directly south is our own
Rader Park, a ministry of Church of the Apostles, Rader Park has picnic areas, walking trails, a stocked pond, a scenic creek, organic gardens, and many recreational and educational activities,

Downtown Lancaster

Homestead Village is truly located in the center of a very active and vibrant area to live, work and play.

Rader Park

Rader Park

Plow and Pineapple Evokes Heritage and Delicious, Nutritious Dining.

by Susan Doyle and Douglas Motter

In colonial times, The White Swan Hotel stood at the southeast corner of the square in the heart of Lancaster City.  When few were literate and news came by word-of-mouth, the hotel, marked with the image of a white swan, was a public house where travelers could find hospitality and locals could stop to catch up on the latest news.  Other Lancaster taverns, identified by signs hanging overhead from decorative brackets, included The Golden Lamb, The Conestoga Wagon, The Bunch of Grapes, and more.

Today, businesses continue to use symbols - or logos - that come to represent their organizations. Early in the history of Homestead Village, our logo was a stylized horse-drawn plow.  Long-time residents will remember the history that led to using that image.  Over 38 years ago, when Church of the Apostles broke ground for a new church building, congregants themselves pulled an antique plow through the earth.  That plow, donated by former Homestead Village resident, the late Martha Stoner, still stands in front of the church. 

The plow became our first logo in honor of the church’s role in the founding of Homestead Village. However, those who were unfamiliar with the farm-based heritage of our community had difficulty recognizing the image of the plow.  Since Homestead Village came to be recognized for its warm and friendly atmosphere, the pineapple - known as a symbol of welcome and hospitality - was incorporated into the logo, alternating with the plow in a stylish banner or border.  As the personality of Homestead Village evolved, so did its logo, with the pineapple today solely representing “enhanced senior living.” 

Plow and Pineapple has been chosen as the new name for our dining room by the organization’s leadership team, after a contest in which the Homestead Village community submitted dozens of names.  While there were many excellent suggestions, Plow and Pineapple met the unique criteria we desired.  The plow suggests the earth from which our food derives, as the pineapple symbolizes the bounty of our dining room.  The contributor of the name wishes to remain anonymous with the reminder that the space will always be where we come together for good food and good fellowship. 

In addition to honoring our past and present, the Plow & Pineapple also pays homage to the quality food we serve.  Fresh fruits and vegetables abound and wherever possible, they are sourced from our local farms.  Our new name reflects our promise to provide great food every day – farm fresh; natural; focused on health and wellness.

Plow and Pineapple will be represented with two distinct works of art.  The first will be the “pub” sign hanging outside the dining room.  It features the actual Homestead Village logos used throughout the decades.  The second artwork is a more artistic take on the name.  It will hang on the formal wall, inviting all to enter and enjoy a great dining experience.

Both versions capture the unique history of Homestead Village and unique dining opportunities our community offers.