Senior Housing and Assisted Living

The obvious increase of crime rate everywhere is now making everyone ensure the security of themselves and their loved ones against any possible harm that might happen. Because of that, everyone has to know what they have to know especially when it comes to someone who may seem to be a threat to their security. Well, thanks to the freedom of information act because that can now be realized by using those important details that it has made available to the public. California Arrest Records is one of those stored records that you can check on for whatever concern nowadays.

Usually, people search for these documents to conduct a background check on an individual. Employers normally do this especially in choosing from the long queue of applicants who will be the best person to hire considering his having a clear record. Not only to a job applicant, but employers can also do the search to further strengthen the grounds for promotion of a certain present employee. Apart from those employers, an intimate partner of someone can also check on the other party’s credibility first prior to giving any type of commitment.

Obtaining the information on California Criminal Records through the government offices can be harder than doing it through the comfort of your own computer. That is because searching through the government means that you have to deal with a lot of paperwork to be completed and submitted to them before you will receive the desired result. For that, the process is expected to be inconvenient, not to mention the amount of time that it needs. That is why for those who can’t wait for long, searching through this means won’t be a great idea, but going online will make a difference.

With the aid of those commercial record providers over the Internet, you can now obtain the information that you desire in a more convenient way by paying just a little amount of money. Provided that you have the required fee plus those relevant details about the arrest that might be helpful to your search, the process is guaranteed to run smoothly and quickly. This one is truly favorable to you because it offers great results and immediacy of the entire process. It only requires a split minutes of your time; so you don’t have to worry over having a busy day ahead.

One of the best ways that you can do to gain assurance of your safety and security is to search for Criminal Records Free To Public. You should be truly happy because you’re now given the right to have full access and use of these important files. With the existence of various sites online, you still have to remember that some of them are tricky sites; they can’t provide you what you need. Because of that, it’s now your call to pick the best record provider that you’ll trust to give you back the worth of your money.

On the other hand, if you don’t want to pay for this information, then there are free searches available for you as well. Since their service is provided without any cost at all, you must expect a certain level of difference with the kind of service that they can provide from the service that those fee-based providers can give. Thus, it is often advisable to pay for the service especially if you’re dealing with reasons which are more than just mere curiosity. Therefore, think of your reason for conducting the search and the effect of that inaccurate information that you’ll be getting prior to making the decision as to how you should do the process.

Let us help you learn the facts about State of California Criminal Records before you pick your Criminal Records California online.

By Doug Fullaway, President & COO, Vigilan

In a previous article, we explored the staffing in assisted living based on ratios versus staffing based on acuity. Ratios are the most commonly used, but it is also clear there is a tendency to overstaff and in all cases, ratios ignore the actual changes in acuity for an individual resident. Staffing based on acuity is preferred, but not widely used as it seems to be too difficult to implement. Let’s look at one method that can be used to develop an easy-to-use acuity staffing tool.

The first step is to build a spreadsheet with a column for each service you are offering and a row for each resident. For bathing you could look at your own assessment document and you might add the following columns: Independent, Provide Reminders Only, Partial Assistance, Full Assistance.

Enter a row just above all of the resident’s names that says, “Standard Time.” In that row enter a standard time. But where do you get that time? Start with an estimate. You know a great deal already and these times can be revised as you learn over time. And be consistent in the way you set the times. For example, hours per week or hours per month is a reasonably simple way to think about the services. Full bathing assistance might be 30 minutes per bath and delivered twice each week so one hour per week could be a good place to start with a standard time for bathing.

Now fill in the cells for each service that a resident receives services. Your spreadsheet is filled out and ready for some simple analysis.

Add totals at the end of each row and each column. You will see the acuity as measured in hours for each resident. Does this comparison across the residents seem reasonable? Does it seem correct that Martha takes twice the time as most other residents? Is John really only taking three hours a week for all of the services you provide? If not, perhaps you need to start adjusting the time for that resident. If the standard time for full bathing assistance is one hour per week and you know John is just difficult and requires more time, then perhaps the cell for his bathing needs to say 1.5 hours.

Now look at the totals for each column. You will likely see the amount of time for medication management for each resident is about six hours per month and is the largest single time for any service. If this is not the case, then perhaps you are doing some work that does not show up on the assessment. For example, does the nurse provide a monthly review of the medications? And does it take about 20 minutes for each resident? Time to add a column to reflect the time the nurse is actually putting into the work for that review.

Build a summary for each job skill of the total time for the period. Caregivers deliver the care for many of the columns.

You will probably end up with something that looks like this.

As residents move in, add a row. As they move out, remove a row. As you update an assessment for a resident, update the cells for that resident. You can gather the caregivers who take care of Mary Albright and have a discussion to see that all services being delivered are documented. You can also ask how long it takes to do the job for each service for Mary.

You can also make the standard times more accurate by actually measuring how long it’s taking for that service for about 30 observations and then take an average time. Adjust the time upward by 20% to allow for lunch breaks, taking time to talk with residents, filling out reports, etc.

You should see several benefits from your use of an acuity-based staffing approach. You will better understand where your staff time really goes. You will adjust your staffing based on changes in census AND based on the change in care you are delivering to each resident. (Ratios just don’t do this!) And our analysis shows you will have enough staff, but not too much, which should save you money.

About the Author:

Doug Fullaway is president and COO of Vigilan, a provider of software for senior living management, and has over 30 years of management experience. In 2002, Doug entered the senior market by joining the executive staff of Vigilan and is the proud owner of several senior communities.  Prior to Vigilan, Doug held positions in distribution, manufacturing, customer support, sales, and general management in the U.S., Europe and Asia.  Doug earned his undergraduate degree in industrial engineering from Oregon State University, served as an infantry officer in the US Marine Corps and graduated from the Harvard Business School.  In his spare time he loves to snow ski, fly a Cessna and go fly-fishing. He can be reached at dougf@vigilan.com.

Can you afford to get older?  According to a new Harris Poll, most people are not confident that we as a country are prepared to handle the costs generated by an aging population as Baby Boomers grow older.  The findings of the survey suggest that many people are aware of the challenges yet are willing to consider possibilities on addressing solutions such as encouraging people to work longer and to increase the age of eligibility for Social Security and Medicare.  Unsurprisingly, raising taxes or cutting benefits are much less acceptable. However, raising taxes is less unpopular than cutting benefits.

Surveying 2,576 adults online, Harris Interactive found the public is split on whether we will be able to afford the cost of many more old people (33%). According to Harris, 38% said will not be able to do so or 29% are not sure. More younger people (47% of Echo Boomers) and 51% of Gen Xers (aged 34-45) than older people think we will not be able to afford it.

Other results from the survey found:

• A 47% plurality of adults – but less than a majority – thinks that it is a good thing that life expectancy is increasing and that there are likely to be many more old people. Older people are much more likely than younger people to believe this; 58% of people over 65 think this but only 35% of “Echo Boomers” aged 18-33. While only 20% of adults think this is a bad thing, fully 34% are not sure.
• When confronted with a list of five possible ways of addressing the future cost of Social Security and Medicare, a third (35%) of adults say they don’t favor any of them. Possibly they do not believe the underlying premise that there is a problem. By far the most people (47%) believe we should “encourage people over 65 to work.” The next most acceptable option would be to increase the age of eligibility for Social Security and Medicare (30%). Only 21% think we should raise taxes while very few people (9%) think we should reduce Medicare or Social Security benefits.
• When told that “most economists think it is inevitable that we will have to do one or more of these things, whether we like it or not” and asked to pick two, the same pattern emerges. Fully 61% favor encouraging more older people to work, and 46% favor increase the age of eligibility. Almost a third (31%) choose increased taxes while very few favor cutting benefits for Social Security (10%) or Medicare (12%).
• A large 68% to 16% majority (with 15% unsure) believes “we as a society are not adequately prepared to spend more years caring for our aging parents than for our children.”
• A 50% to 26% plurality of those aged 18-64 believe that “our health care system, as it is now,” will not be able to handle the large number of older people who are likely to have chronic medical conditions such as heart disease, diabetes and arthritis.
• When told that “many economists think that, to pay for Social Security and Medicare . . . many more people should retire later and continue working after 65,” a large 64% to 25% majority of those under 65 agrees with this.

“These findings are interesting and important,” said Dr. Robert Butler, the president of the International Longevity Institute. “It is good to see public support for people working later in their lives. This would not only reduce the economic problems addressed in the survey; research shows that people with purpose and who have something to get up for in the morning live longer and better lives. There is also evidence that increased longevity creates new wealth.”

Most People Believe that We Are Not Prepared for Increase in Longevity and Number of Old People

The Ensign Group, Inc. (Nasdaq: ENSG), the parent company of the Ensign(TM) group of skilled nursing, rehabilitative care services, home health, hospice care and assisted living companies, recently reported record results for the first quarter of 2010.  The Ensign Group separately announced the acquisition of two Texas skilled nursing facilities and the operating assets of Horizon Home Health and Hospice, a home health and hospice agency based in Meridian, Idaho.

Financial Highlights Include:

• Adjusted earnings were a record $0.45 per diluted share, up 15.4% over the first quarter of 2009;
• Total revenue was a record $154.2 million, up 18.3% on a consolidated basis;

• Same-store skilled mix increased by 363 basis points to 54.0%;
• The company’s same-store skilled revenue increased by 12.4%, notwithstanding the negative impact of Medicare’s 1.1% net market basket decrease, which took effect on October 1, 2009;
• Consolidated EBITDAR climbed 19.4% to $25.2 million, with consolidated EBITDAR margins of 16.4%; and
• Net income rose 18.0% to $9.3 million for the quarter.

The Ensign Group also announced the acquisition of four long-term care facilities and a home health and hospice business in three separate transactions between January 1, 2010 and May 1, 2010. The real estate and operations were purchased with cash, and include:

• In Idaho, Emmett Care & Rehabilitation Center, a 72-bed skilled nursing facility in Emmett, and Parke View Rehabilitation & Care Center, an 86-bed skilled nursing facility in Burley, on January 1, 2010;
• In Texas, Heritage Gardens Healthcare Center, a 140-bed skilled nursing facility in Carrollton, Texas, and Silver Springs Healthcare Center, a 144-bed skilled nursing facility in Houston, Texas, on May 1, 2010.
• And in Idaho, Horizon Home Health and Hospice, a home health and hospice agency based in Meridian, Idaho, also on May 1, 2010.

A new low-tech elder monitoring service called FineThanx recently made its debut that utilizes only the existing phone system at home.  The system calls twice a day find out how an aging loved one is doing and reports the response or lack thereof in either case.  The automated phone service checks in with seniors once or twice a day.  If no one answers, or if a client needs assistance, the system immediately calls a "care circle" of people who can seek care for the client.  If the client is fine, the system sends reassuring e-mail messages to the client’s families, friends or health care professionals.  FineThanx charges $34.95 a month for the service and offers a seven-day free trial period.