What’s going on with nursing home plans?

Aug. 13--La Junta Health Service District directors meet the second and fourth Wednesdays at 1 p.m. at Inspiration Field

The La Junta Health Service District is completely different from the City of La Junta. It is financed by a one percent sales tax, which will be reduced to .5 percent upon completion of the facility. The board meets twice a month and has made considerable progress toward their goal. At Wednesday's meeting, one director, Diane Fowler, was out of town. Present were Dr. Paul Yoder, former Mayor Lynn Horner, Janet Hill (the financial brain and the treasurer) and Johnnie DeLeon (whom one must admit knows a lot about running a business related to public health). Fowler is a registered nurse.

They have been visiting nursing homes in the area and out of the area but still in Colorado. They did not like the institutional model with the long corridors, double occupancy and feeling of a hospital. The model the group liked best was the Green House Project in Akron, Colorado. It consists of cottages holding no more than ten or twelve occupants with linking outdoor space between each two cottages, built in a cluster.

The board put out a request for purchase for land which is reachable by public utilities of the City of La Junta, in the city or in close proximity. They received eight bids. Three of them would have been acceptable if the owners could have put them together in one purchase, but this did not work out. The land they decided to purchase was Lloyd and Darlene Labrier's land, on the west side of South San Juan Ave. between the Air Force housing and Prairie View Church. They purchased the 35 acres fronting on San Juan, of the 80 acres in the parcel, for $50,000. While negotiations were going on, the Labriers had another offer for the whole 80 acres, but Horner said they wanted the land to go for the nursing home, so they saved it for the Health District. Purchase date was July 26, closing date is tentatively set for September 26.

The money from the sales tax has been coming in pretty steadily at a little over $70,000 a month, resulting in a balance of $310,678.04 after travel expenses. Hill suggested investing in a mutual fund specifically designed for public money, complying with all rules and regulations. Money can be taken in and out of these funds without penalty. The board looked favorably on the idea, after the initial land purchase has been made, a supplemental bookkeeper hired, and office space acquired. Eight good applicants for bookkeeper have been forwarded to the Board from WorkForce. The top three or four applicants will be interviewed.

A teleconference was conducted on Wednesday describing the physical setup of the Green House Model. The cottages contain ten or twelve single occupancy rooms. Meals are served at a large table, with tables nearby where the staff eats. It consists of a collaborative model, certified nursing assistants, in this model called a Shahbasim, multi-tasking, working out a pattern of duties that is rotational: client care, cleaning, cooking, laundry being some of the basics. The cottages are paired, with green space in between fenced for outdoor space that is secure. One certified nurse serves two cottages. The medical director is a medical doctor. A guide, who is selected by organizational skills and facilitating personality, helps the people communicate and work as a team. A sage, who is a volunteer from the community, also helps with problem-solving. A print-out of the instructional power point will be available to all the board members after Wednesday afternoon, and board members will have a copy they will share with the general public.

The three general principles are a meaningful life, a real home and an empowered staff which works together. The rooms are single occupancy.

One question presented by Hill from interviews with potential clients and nursing home occupants was, "What about married couples who want to be together?" The answer from the facilitator, Claire Lucas, was that different facilities work it out in different ways, but each person has a room. Married couples may designate one room their bedroom and the other a sitting room, with adjoining door. Another question from the people who are now in the long-term nursing section of the hospital had to do with their wanting to all eat together. Since there is an upper floor and a lower floor, Horner said he doubts there are many more than twelve people at a time, anyhow. Lucas suggested the existing people could be grouped with their friends in the cottages. In any case, they will be asked with whom they want to eat and socialize. The present group at the hospital is down to 31, since the hospital is not admitting new medicaid patients to the nursing floors.

She asked if the present workers at the hospital will be asked to transfer to the new nursing facility, and most will be, to maintain the home-like atmosphere of the facility. Lucas also said it will help to alleviate anxiety of the staff, also, and help with the transition. The current deadline for the hospital nursing home's closure is March 31, 2020, which means there is no time to lose in getting started on the new facility.

Another aspect of this plan is the addition of a short-term rehabilitation cottage. The cottage itself, with daily routines, seems to substitute very well for a big gym, said Lucas. What people in rehabilitation facilities need, anyhow, is coping mechanisms for dealing with daily life when they go home. This has been a very successful aspect of the Green House plan, with the number needing re-hospitalization dropping from 18.6 percent to 9.6 percent.. Length of stay in Green House facility is 19.2 days, compared with 28 days in conventional rehab centers. Lucas suggests a separate cottage for rehab patients who are returning to their own homes.

Due to the number of considerations for expenses of construction and operation, Horner and Hill will be working next week to get the approximate numbers ready for the financial feasibility step in two weeks. Working with the Green House Model, highly favored with government entities and funders, will help get the project under way more quickly. Horner hopes to break ground in the spring.

___

(c)2018 La Junta Tribune-Democrat, Colo

Visit La Junta Tribune-Democrat, Colo at www.lajuntatribunedemocrat.com

Distributed by Tribune Content Agency, LLC.