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From NaCCRA Lifeline Newsletter Issue 2, 2023

Representing CCRC (Life Plan) Residents Nationwide Since 1992. Written by Jack Cumming – Carlsbad By the Sea

Walk into most skilled nursing facilities, and the sense of institutionalization strikes one. Even now, many rooms are shared, usually with a stranger. The most visible feature is a nurses’ station with 24 hour bright workroom illumination.

This clinical appearance (and fragrance) is not new. It’s been part of skilled nursing facilities from the beginning. Most CCRCs have a skilled nursing facility on site as the last stage in the care progressions associated with CCRC living. Lately, there has been progress toward producing something better.

Consider Bill Thomas, MD, and his wife, Jude. Bill is an idealist. He graduated from Harvard Medical School in 1986, planning to be an emergency room physician. But, early on, a part-time position as the medical director of a small rural nursing home led him to want to improve the lives of geriatric patients. Since then, he has advocated humanizing skilled nursing facilities. To that end, he originated the concept of the Green House Project and the Eden Alternative, an educational organization.

That evolution is adversely impacted by a reimbursement and regulatory structure, making it increasingly difficult for CCRCs to maintain skilled nursing facilities without losses affecting the overall quality of life.

Some CCRCs have abruptly closed their skilled nursing facilities without warning, causing consternation among CCRC residents. Others have consulted with their residents and have developed mutual understandings that are beginning to bear fruit. What Episcopal Communities and Services, a California provider, is initiating at its Covington community is a good example of what such a new approach can look like. The Covington is a taxexempt CCRC in affluent Orange County.

The Covington website (https://www.ecsforseniors.org/blog/care suites-at-the-covington/), used here with permission, describes what this forwardthinking CCRC does to make stays (or living) under skilled nursing facility conditions more palatable. The following is a quote from the website:

In April, The Covington proudly opened five Care Suites. These customized suites offer 24-hour nursing care and recovery care to residents returning from a stay in the hospital.

“We knew there was a need for short-term, round-the clock access to support,” says Cash Benton, Executive Director of The Covington, “so we designed the Care Suites, specifically for those needing a place to recover before returning to their homes.”

The Suites have a range of exceptional features. The beds can be adjusted to any height and have specially selected, hypoallergenic mattresses designed for those spending more time in bed. The bathrooms are freshly updated with extra wide shower entrances. The living areas can accommodate Physical and Occupational Therapy sessions and have a lift chair for ease of use.

There is a microwave, a complete set of dishes, and a fridge stocked with snacks to welcome visiting friends and family. The in-suite dining room table allows residents to eat in their room or dine with other residents in one of The Covington’s three restaurants. In addition, the 60-inch TVs enable residents to watch their favorite shows, follow exercise programs, communicate with family, and more.

In addition to the thoughtful amenities, each resident in a Care Suite has access to round-the-clock nursing care if needed and has a dedicated Team Member available at all hours. A nurse practitioner admits the resident to the Care Suite and follows up throughout their stay to ensure that their care is consistent and monitored. “The average stay is about two weeks,” Cash says.

CCRC residents may want to check with the management where they live to see if a similarly welcoming alternative to the traditional skilled nursing facility experience is underway in their CCRC. John Knox Village in Pompano Beach, Florida, as one example, has long worked with the Green House Project to give its residents the best experience possible.

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