- Associated Press - Friday, April 18, 2014

TOPEKA, Kan. (AP) - Nursing homes traditionally have run more like hospitals than homes, but a growing number around Topeka are changing business as usual.

The Kansas Department for Aging and Disability Services is asking more facilities to join the Promoting Excellent Alternatives in Kansas Nursing Homes program, commonly known as PEAK. Nursing homes that want to join this year have until April 30 to apply.

KDADS Secretary Shawn Sullivan said the idea of more homelike settings began to gain traction in the 1990s, but Kansas didn’t have a program to recognize facilities that went in that direction until 2002. Only five to 10 facilities received the PEAK award each year until 2011, when KDADS revamped the program to focus on a quality improvement process.

Participating facilities have to show progress in four areas: giving residents more choice about their routines; streamline processes so staff can make decisions more easily; providing a homelike physical environment; and providing activities that support a meaningful life. As of last week, 189 of the state’s 330 nursing homes were in some stage of the process, Sullivan said.

Leanna Chaffee, administrator of Brewster Health Center, said the home got the PEAK award three times and is now at the top level as a “mentor” home for facilities that are new to the program. The key isn’t always setting up the right policies but creating a culture that puts residents at the center.

In a traditional nursing home model, staff members have one specialty, such as serving food or acting as a nursing assistant, and would serve most or all residents in that capacity. In the new “universal” model, staff are assigned to a small group of residents and take care of most of their residents’ needs, Chaffee said.

A group of residents is called a “neighborhood” instead a unit, and staff are encouraged to get to know their residents personally, Chaffee said.

“They have four or five people we call their family,” she said.

Desiree Johnson, co-director of nursing at Aldersgate Village, said residents already could personalize their rooms, and they will be able to decorate their shared hallways as they see fit.

The facility still is in the process of changing, Johnson said, but residents no longer have scheduled times when they must get up, go to sleep, eat their meals or shower. That can give staff some challenges, she said, but some residents like the ability to change up their schedules.

“It’s (about) how the resident wants it,” she said. “It’s not (about) how it works best for us.”

Laura Richardson, administrator for McCrite Plaza Health Center, said the home is still in the early stages of the PEAK program, but they have changed food service to be more like a restaurant than a traditional nursing home. Residents can come in any time between 7 a.m. and 7 p.m., she said, and order whatever they want off the menu.

They also assign the same staff to a group of residents so they get to know each other, Richardson said. If staff members know a resident well, they can tell if something is wrong, even if the resident can’t verbalize the problem, she said.

“If I’m always there with these eight people, I’m going to get to know their preferences better,” she said.

There are five levels, depending on how many of the goals a facility has met, Sullivan said, and financial incentives to go with them. Level 1 facilities get an extra 50 cents added to each resident’s daily rate, while level 5 ones get an extra $4. Kansas State University’s Center on Aging does training related to the program and evaluates how well facilities have met their goals, he said.

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