Cedarbrook Nursing Homes Management Report & Quality Improvements

Cedarbrook Nursing Homes Management Report April 11, 2018

2 The Cedarbrook Team John Kristel, MBA, MPT Samuel Miranda, Jr., MS, RN, NEA- BC Ronald J. Petula, CPA Joseph Shadid, MBA, MSN, RN, NHA Steve Breidigan, CPA, MBA President & CEO Senior VP, Finance, and Chief Financial Officer Administrator, Cedarbrook Chief Financial Officer, Cedarbrook Senior VP of Patient Care and Chief Nursing Officier

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4 Quality Clinical Improvements Implemented Abaqis Quality Assurance system Aligned both campuses as St. Luke s Preferred Providers Practiced antibiotic stewardship Implemented legionella water testing Improved wound care via two certified wound nurses and bed/mattress capital plan

5 Quality Clinical Improvements Became a restraint-free facility Reduced use of psychotropic meds by an additional 8.7% Improved rehab equipment pressure mapping system Improved clinical equipment vital sign monitors

6 Quality Maintained 5-Star Overall Improved to 4-Star Quality measure, despite complex population and new regulations Increasing technology focus via: Relias learning management Point Click Care improvements Maintenance care work order system

7 Service Comfort & Care Improvements Renovated family room in Allentown Built satellite rehab gym and dementia sensory room in Allentown Improved kitchen equipment at both campuses Began renovations of the Fountain Hill lobby

8 Service Implemented new prayer groups at both campuses Built a new chapel in Fountain Hill Improved collaborative faith services (between campuses)

9 Service Implemented Bundle Program at both campuses Developed and implemented an in-house patient and resident satisfaction survey Enhanced therapeutic recreation such as fishing outings and touch screen computers

10 Finance Financial Improvements Increased facility occupancy from 92.69% to 93.67% from 2015 to 2017 (Medicaid increased from 88.79% to 89.52%) PA state-wide occupancy rate was 89.39% in 2015-2016 fiscal report Medicare resident days increased 16.7% over 2016 Managed operational expenses to 3.3% under budget Increased Case Mix Index (CMI) from .88 to 1.00

11 Finance Financial Achievements Reduced Medicare bad debt write off by $54,000 ($180,000 reduction in 2016) while Medicare resident days increased Reduced the number of Medicaid pending days outstanding during 2017 by 300 (1,000 day decrease in 2016) and reduced the number of residents with cases pending Hired experienced billing staff to fill vacant positions, improving customer service and technical skills within the department Assisted County with evaluation of facility building options and operational planning

12 People Educational Enhancements Implemented Relias learning management system throughout Cedarbrook Enhanced Social Services with dynamic new director Certified DON and both ADONs Certified Dementia Risk Manager Implemented successful security service during the last 6 months Introduced multi-disciplinary rounding

13 Growth Admissions Improvements Continued partnerships and collaborations with other skilled nursing facilities Current/Recent aesthetic projects include parking lot at FH, lobby at FH and repainting resident rooms at both campuses Implemented best practices with regard to dementia care and short-term rehab

14 Next Steps Concentrate on quality of care with a focus on bundled payments and the ACO model as well as serve our residents through the Valley s major health systems Remain clinically and cost competitive by offering the highest quality at the lowest cost Continue to prepare for Community Health Choice implementation, which the state has already delayed one year (for our region).

15 Next Steps Facilities Improvements Short-term: Transform Gift Shop/smoking area to a resident Caf , auditorium renovation at Allentown, implement dietary menu software Long-term: Work with County Administration and the Board to construct the new Wing at the Allentown campus in a manner that is of the highest quality for our deserving citizens at the best cost to the taxpayer

Implemented quality assurance Improved wound care Became restraint free Maintained 5-Star overall rating Improved to 4-Star Quality measure Increased educational opportunities Certified wound care nurses Instituted multi-disciplinary rounding Renovated social spaces Enhanced faith based services Built satellite rehab gym and dementia sensory room Implemented satisfaction surveys Implemented best practices with regard to dementia care Implemented aesthetic projects to increase admissions Managed operational expenses to 3.% under budget Increased Case Mix Index Reduced bad debt and Medicaid pending days 16

17 Questions?