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"It's a Privilege to Work Here"

Healthwin's dedication to top-notch care has helped them achieve three consecutive deficiency-free surveys

By Laura Kuhn

Healthwin, located in South Bend, Indiana, has been around for more than 100 years, but it didn't always have a waiting list of CNAs eager to work there. Over the years, Healthwin has had its ups and downs, but in 2001, the combination of poor reputation, quality of care issues and a multitude of financial problems had the facility on the verge of bankruptcy. Fortunately, the board of directors made the decision to bring in new management to try to prevent facility closure.

Healthwin's renaissance isn't a Cinderella story, but rather one of hard work and perseverance. The new management company, Pillar Management Group, espoused a business model based on carefully balancing three principles:

  1. Employee environments: Good employees render good care
  2. Quality of service: The non-negotiable objective of the organization
  3. Stewardship: Financial outcomes will happen if the first two tenets are followed
During the early 2000s, Healthwin's staff had to work very hard to transform the organization. Slowly but surely, things started to turn around. Dawn Long, Healthwin's Director of Nursing, joined the team in 2006, the same year the facility dedicated itself to a "residents first" way of thinking. Before coming to Healthwin, Long spent seven years as a DON at a corporate facility. "The first six months I was here, I didn't make any decisions," she recalled. "My ADONs and I were instructed to get to know the staff. I just sat back, watched and learned."

Small changes make a big difference

The facility made a conscious decision to focus on customer service-based issues. For example, in 2006, Healthwin switched to restaurant-style dining. When residents make their way to the dining room at Healthwin, a hostess greets them and escorts them to an open table. Servers then take their orders and bring them the food they selected. Although providing this level of service comes with a higher price tag, Long says the residents' satisfaction is worth it.

Healthwin also set out to create a "family atmosphere" in the building. Residents' families can eat for free at the facility, and snacks are placed throughout the building for the staff to enjoy. There are also a number of dogs and birds who now call Healthwin home and provide comfort and companionship to residents. Each spring, Healthwin hosts a prom for its residents. High school and college student volunteers come into the facility and do makeovers on the residents and a local Macy's donates dresses for the ladies to wear. At the facility's annual summer and Christmas parties, it's not unusual for Healthwin to host 650 guests in the building or its sprawling adjacent garden. "In the early 2000s, the atmosphere at Healthwin was very subdued," Long said. "But gradually the culture in the building began to change. Now the residents look forward to activities and their meals."

Personalized service resonates with residents and families

Another successful service-oriented program that Healthwin implemented is the resident orientation luncheon at which department heads, family members and the new resident all gather and enjoy lunch together. During the meal, Healthwin staff review the resident's chart and lab results and explain how often a doctor will come to visit. They also review the facility's rules, such as what the family can bring into the facility, and give them an idea of what to expect. Family members are given Healthwin managers' cell phone numbers and are encouraged to call them any time they have questions or concerns.

"It's like a first care plan," Long said. "Most residents are scared when they come in, and some families have no idea what's going on. This makes them feel like they have a voice."

"It's a privilege to work here"

"We've gone from a culture of not listening to management to now it's a privilege to work here," Long said. "It's that recipe of people that creates a successful team. The administrator works side by side with us, and a lot of employees have been here for 20-plus years. A lot of people love this place we even have nurses who have their parents here."

In addition to emphasizing teamwork, Healthwin works very hard to have well-trained staff. New staff nurses who have already worked in long-term care still receive two weeks of orientation, including mock admissions, mock procedures and competency testing. New graduates and hospital nurses are treated like they're brand new to the field and receive four weeks of orientation one week with the staff educator and three weeks with a nurse preceptor. Even CNAs are competency tested and given preceptors to work with. New CNAs quickly learn that there are three things they must have on them at all times a gait belt, a report sheet on their residents and their name tag.

Staff members also undergo sensitivity training so that they better understand the challenges that residents face. During training, staff eat thickened food, do role playing with social service personnel and sit on something wet to get an idea of what it's like to be incontinent. This extensive training ensures that staff members are both well prepared and compassionate.

Secrets to survey success

"A lot of places treat surveyors badly they feel like they're an annoyance," Long said. "Here, we embrace the survey process and treat the surveyors with respect." This, in addition to a lot of hard work in every aspect of the care process, has contributed to Healthwin's last three surveys being deficiency free.

"The key is to never get cocky and to keep working hard," Long said. "We always know where we have to improve. We work hard every day." Long also acknowledges that Healthwin isn't perfect, and management recognizes that staff members will make mistakes. "We just ask that they tell us about it, and tell us the truth," she said.

Healthwin also routinely conducts its own internal surveys. Residents and families, as well as employees, complete surveys to help management identify Healthwin's strengths and weaknesses. The results are made available to participants and action plans are developed for areas that need improvement.

"We're at an advantage because our residents and family members know that management wants their input and that resident choice is important," Long said. "If you never talk to residents or families, they feel like their only voice is to talk to surveyors."

An eye to the future

Healthwin is currently planning extensive renovations that will result in the facility having predominately private rooms in addition to some new private Medicare suites. At the end of the day, Long says the secrets to Healthwin's success are trust and teamwork: "I think that when your management company allows you to do what you do, that's the key. So many DONs have good ideas, but they're seldom given the chance to express their ideas and follow through on things." Through hard work and dedication to their residents, Healthwin is fulfilling its mission "to enhance and assist those we serve to achieve their desired physical, mental and spiritual potential and to rebuild, through compassionate care, purposeful and meaningful lives."

To learn more about Healthwin, visit their website at www.healthwin.org.