Controller Sandy Brock suggested the board approve the move from a 165 census budget to 170 in light of recent numbers. She said the census was already back to 171 as of Tuesday. Administrator Dennis Burtnett said the preferred goal would be to achieve a regular census of 175 or more.
Director of Nursing Sandra Lingo explained the census numbers are lower than normal, due to the palliative care the center has recently begun to offer.
“We’ve had a lot of residents [who] have teetered on palliative versus comfort. We kind of created a palliative program in the building where we take people in and kind of take care of them through their passing,” Lingo said. “... There is such a need for that in Cleveland. So many families these days can’t keep a loved one at home during that process, and they really need a place where they can see them cared for.”
Board member Lonnie Setlich pointed out the severe conditions of the Medicaid patients has increased recently. A reason for this are the “stiff” requirements listed by Medicare. Lingo explained it is more and more difficult for residents to gain Medicare’s approval to enter a nursing home facility.
The supposed stringent requirements could affect both the mortality rate of residents and the census of the center.
“It used to be if you scored a 3 on the PAE (Patient Admission Evaluation), you could come to the nursing home,” Lingo said. “Now it takes at least a 9.”
Burtnett said there has been a decline in census numbers in facilities across Tennessee due to the requirements and the CHOICES program.
Board member Bill Winters said he was most comfortable with the census number that is most productive for the staffing.
Lingo assured him the Patient Per Day staffing model the facility follows ensures a balanced staff-to-resident ratio.
“Your staffing changes daily, according to your census,” she said. “So, if I am at 160 today, I am only going to run the staff for 160. If I am 170 tomorrow, I am only running the staff for 170. That is a complete change from how the budget has worked in the past.”
She assured board members the documentation process by workers has also been made more efficient, through electronic devices attached to the walls in the hall. Staff report what happened with details instead of merely writing “transferred patient.” She said the more detailed process will also help in future surveys.