Annual Report of the & Hospital for Disabled Miners for the Fiscal Year July 1, 2005 thru June 30, 2006 by Gary Olson, Superintendent 1 The Arizona Pioneers’ Home and Hospital for Disabled Miners is provided for by law in the Arizona Revised Statutes, Articles 41-921 through 41-925, 41-941 and 41-942. The Home is an institution for aged and infirm pioneers, owned and operated by the State of Arizona in Prescott, Arizona. It is managed by a Superintendent who is appointed by, and under the supervision of, the Governor of the State. The Home is exempt from Arizona Department of Health Services Licensure. The total capacity is one hundred fifty-five residents. Due to renovation of plumbing in the previous two years, the census had been lowered to allow for vacant rooms to move residents while sections of the Home could be replumbed. With the completion of the plumbing, admissions were increased during this fiscal year to bring the census up to capacity. Of the 129 individuals living in the Home on June 30, 2006, 86 were living in personal care, 21 were living in intermediate care and 18 required skilled nursing care. Those living on the first and third floors in personal care are largely able to care for themselves and attend the Dining Room for their meals. Because of their advanced age they require varying degrees of nursing attention, particularly in the area of administration of medications. All of the residents in the second floor infirmaries require much more skilled care. The average age of the residents as of June 30, 2006, was 85, with the youngest being 68 years old, and the oldest 102 years old. There were 36 men and 93 women. The average population for the year was 130. There were 25 disabled miners living in the Home on June 30, 2006. Those residents not having disabled miner status were required by ARS 41-923 to pay for their care based on their ability to pay. A total of $913,396.56 was collected from these individuals and deposited into the General Fund. No expenditures during fiscal year 2006 were made from the General Fund. All costs to operate the Home were paid for from the Miners and State Charitable Funds. The average monthly cost of care per resident was $3,681.00. Total funds expended during the year amounted to $5,822,782.75 as follows: Salaries & Employee Related Expense Professional and Outside Services Travel Food Drugs, Medicines & Medical Supplies Other Operating Expense Capital Outlay $ 4,779,586.75 77,892.00 21,515.00 173,156.00 276,496.00 494,137.00 .00 2 Twenty-three residents expired during fiscal year 2006; nine residents were voluntarily discharged; and 30 individuals were admitted to the Home. Of the discharged individuals, one did not meet the criteria to remain at the Home, six chose other living arrangements, one was relocated to a facility that could better care for her dementia, and one passed away while at another facility for rehabilitation before returning to the Pioneers’ Home. Although there continues to be a waiting list for entry, the majority chose to decline offers of residency when contacted. Due to this, the Home’s vacant rooms were open immediately for those applying for admission without a wait. More than 90 applications for admission were mailed to individuals calling the Home to inquire about residency, not including all that were handed to visitors that came to the Home to get an application. A change to A.R.S. 41-923 took effect in August 2005, changing the residency requirement from 30 years to 50 years, and raising the age requirement from 65 years to 70 years. Those who would not meet these requirements were specifically contacted and advised that they would need to move in before the statute changed, in order to be grandfathered under the former statute, or forego moving in the Home until they again qualified. Four individuals accepted the invitation. Twenty-five percent of those on the waiting lists were removed in August because they no longer met the requirements for admission. The residents of the Home have a monthly meeting (Residents Council) with management of the Home to address all concerns and quality of life issues. This creates accountability to the primary customer --- the resident. Customer service remains a high priority. Residents and families repeatedly expressed gratitude for the care provided in the Home. Superintendent Gary Olson was appointed one month prior to the beginning of the 2006 fiscal year. In his first year, the following represents some of the more significant items of progress that transpired through the combined commitment, dedication and enthusiasm of everyone who works and lives at the Arizona Pioneers’ Home. • • Established consistency in fairness of treatment to employees and support to Department Heads 6/05 Managed John Miller exhumation issues 6/05—7/06 3 • • • • • • • • • • • • • • • • • • • • • • • • • • • • Clean up of hallways (removal of unnecessary equipment, etc.)—improvement of hallway egress 7/05 Establishment of monthly Safety Meetings 7/05 Return to Cable TV pursuant to resident request 8/05 Elimination of non-essential equipment 8/05—ongoing Enhanced Risk Management efforts—trained nursing staff in use of mechanical lifts and transfer protocols—reduced incidents and costs associated with injuries 9/05 Revisited use of Medicare benefits in an outside Nursing Facility for residents requiring rehabilitation after a qualifying hospital stay 9/05 Revision of Fire/Disaster Plan 10/05—staff trained Implementation of HIPAA Policies and Procedures 10/05—staff trained—agreements with Business Associates—employee confidentiality agreements Complete Revision and completion of Business Continuity Plan 10/05 Elimination of non-essential jobs through attrition 10/05—ongoing Enhanced efforts in review of vendor bills to avoid inaccurate bills—this was primarily effective in Pharmacy services by identifying third party pay sources and offset of APH expense 11/05 Renegotiated lower contracted medication costs with Pharmacy 11/05 Implementation of Abuse Prevention Program 12/05—staff trained Joined Arizona Health Care Association and established online long term care health care training for all staff 12/05 Redesigned Employee Appreciation Committee to include individuals from all departments 12/05 Installation of 3 new, professional, exterior signs (including the purchase of National Registry Historic Building Plaque) 1/06 Upgrade of 2 stairways to wood finish 1/06 Initiation of workplace violence policy 3/06 Elimination of 3 rogue vehicles to Property Surplus 3/06 Implementation of Medicare Part D coverage for residents (resulted in a $10,000 decrease in medication expenses in the first month) 3/06 Storage area clean up 4/06 Enhanced training for employees via consultants in Medical Records (7/05), Finance (8/05), Social Services (1/06), Psychologist (3/06), and Long Term Care MDS Assessment/Care Plan (4/06) Facilitation of new supervisory guidelines for consistency in how the agency addresses things as a whole 4/06 Cleaned out records room to align with retention schedule 4/06 Established/implemented (new) Employee Orientation 4/06 Revised Admission Assessment policies/procedures 4/06 Established ISA with ADOA fleet management to make all of our vehicles legal per statute and not have any more rogue vehicles 4/06 Implemented a new financial management system which includes monthly budget management and financial tracking 5/06 4 • • • • • • • • • • • Initiated redesign and upgrade of Arizona Pioneers’ Home Website 5/06 (www.azph.gov) Response/completion/correction to Risk Management in reference to 15 outstanding Performance Evaluations Assessment deficiencies—implementation thereof 6/05-6/06 In process of upgrading of hallways throughout the building—new paint, pictures (residents involved). In process of altering contract timeframes for doctors, pharmacy, and food to coincide with the fiscal year (residents involved in evaluation process). In process of revising Pioneers’ Home and Cemetery Management policies. In process of enhancing paging system in home per resident request. In process of establishing in-house laundry services and eliminate outsourcing of same. In process of establishing an in-house Certified Nursing Assistant training program to certify all current individuals in said position, and train future hires, as necessary. In process of developing an outreach power point presentation of the Arizona Pioneers’ Home to take on the road to each county at least once a year. In process of enhancing the Quality Assurance/Quality Improvement Committee for maintaining a high level of quality care systems and protocols, as well as identifying areas for improvement to continually enhance the services provided. Continually in process of identifying cost savings opportunities, while enhancing facility appearance, care and services. 5 Population of the Home as of June 30, 2006, was 129. Distribution by county was as follows: County Apache Cochise Coconino Gila Graham # 2 2 0 1 2 County Greenlee La Paz Maricopa Mohave Navajo # 0 0 19 2 2 County Pima Pinal Santa Cruz Yavapai Yuma # 3 2 0 88 3 Note: Of those from Yavapai County, many resided in other parts of the state previously and retired to Yavapai County prior to their admission to the Pioneers’ Home. Population Movement – FY2006 COUNTY Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma TOTALS NEW 2 0 0 1 1 0 0 6 1 0 2 0 0 17 0 30 DECEASED 0 0 0 0 0 0 0 4 1 0 0 0 0 18 0 23 6 READMITTED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LEFT 0 0 0 0 0 0 0 4 0 0 0 0 0 5 0 9 Distribution of Population by Age 90 & Over 90 6 91 6 92 1 93 3 94 4 95 0 96 4 97 1 98 2 99 0 100 0 101 1 102 1 80-89 80 81 82 83 84 85 86 87 88 89 70-79 4 6 11 9 10 6 7 7 8 11 70 71 72 73 74 75 76 77 78 79 TOTAL POPULATION: 129 Average Age: 85 Youngest Resident: 68 Oldest Resident: 102 7 60-69 1 1 2 1 1 2 3 2 4 3 60 61 62 63 64 65 66 67 68 69 0 0 0 0 0 0 0 0 1 0 ARIZONA PIONEERS’ HOME LIST OF RESIDENTS as of JUNE 30, 2006 AINAIRE, Laverne EDSON, Myrtle ALLEN, Opal FARIS, Joseph ALVIS, Clara FERGUSON, Dave ALVIS, Glenn FISK, Dorothy BETTS, Ruth FLETCHER, Jewel BLACK, Leonard FLOWERS, James BOSCH, Mary Frances GARDNER, Ivy Ray BRADSHAW, Ellen GIERTZ, Maggie BROWN, Juanita GILES, Geraldine BURTON, Mildred HAGENMAIER, Virginia BUSTAMANTE, Ernest HALLETT, Lois BUTRUM, Helen HARDT, Grace CHESLEY, Delbert HARMON, Joy CHURCHWELL, Courtney HARSHMAN, Gerald CLARK-GARDNER, Betty HASTINGS, Claudia CLARKSON, Mabel HECKETHORN, Frances CLOW, Lerene HENDERSON, Esther COOPER, Kenneth HERNANDEZ, Enrique COX, Audrey HETTLER, Mary Alice CREIGHTON, Grace HUGGINS, Hazel CUBITTO, Georgia HUGGINS, Joseph DENNY, Dixie HUNT, Dora DENSMORE, Helen JARREL, Florise DESPAIN, Wendell JARREL, Leota DODSON, Samuel JIRON, Matilde EARL, Andrew JOHNSON, Aileen ECKHART, Doris JOHNSON, Lucile ECKHOLDT, Julia JONES, Gladys 8 KISSEL, Keith PRESTON, Ruth KISSEL, Wilma RANKIN, Mary Lou KNABE, Mary REDDEL, Phyllis LACEY, Exie Maurine RENDON, Delia LAJOIE, Albani RITTER, Curtis LAJOIE, Lorraine RITTER, Nora LARSON, Vivian ROBERTS, Ward LAUX, Theresa ROBITAILLE, Vesta LEISCH, Flo RODARTE, Domingo LETHEM, Burnadean ROMNEY, Pearl LITTLE, Helen ROSS, Pearl MANZ, Helen ROSS, Wilma “Sandi” MARTIN, Maurice SCHILLIGER, Virginia MARTIN, Sadie SCHNOSE, Hilda MARTIN, Verna SHRODER, Stewart MARTINEZ, Greg SKOV, Nanette McCAULEY, Agnes Ione SMITH, Ada McCROSSEN, Mary SMITH, Grace McNULTY, Donald SMITHART, James MEDINA, Candelario SMITHART, Willie MERSEREAU, Vida SOWELL, Larry MILLS, Edna STUBBLEFIELD, Audrey MORRISTON, Lena STUBBLEFIELD, Wilson “Bud” MUNCY, Viola SUEVER, Anna NAFARRATE, Juan SYRKEL, Virginia PANCRAZIO, Anita TENNEY, Alaire PATRICK, Lea TENNEY, Lyman PATTON, Edna TERRIN, Anna PATTON, Fred THACKER, Loyd PAYNE, Betty THACKER, Robbie PETERS, Esther THIMSEN, Vernon 9 VAWSER, Virginia WARREN, Edna VINCI, Mario WEEMS, Hazel VINCI, Virla WHITE, Sam WALKER, Kenneth WHITE, Stella WALKER, Verna WILLIAMS, Mary WALTERS, Orma 10