Elder Care Funding Proposal: A Private Sector Comprehensive Solution

Initiative To Develop and Implement Services and Products That Provide The Following Solutions For The Senior Housing And Care Industry and Aging Citizens Business Model that Returns Measurable Consumer Satisfaction and is Profitable Professional Elder Care Giver Training Family Care Giver Training - International Innovative Technology that Facilitates and Supports the Business Model Proprietary Plan Prepared for Professional Care Resources, Inc. Submitted by ZephyrWest, Inc. Patent Solely Owned and Developed by BlueZephyrTM, Inc.

The Long-Term Care Solution
A Private Sector Initiative to be Funded by The Elder LifeCare Foundation

Professional Care Resources, Inc. (PCR) is committed to enhancing the quality of life of elders in the broad continuum of eldercare living arrangements. The first corporate focus is on the skilled nursing facilities in the United States. National studies have indicated that the incidence of clinical depression in these facilities is 60 percent; and generalized anxiety approaches 50 percent. One merely has to walk through a skilled nursing facility to gain a sense of the emptiness and hopelessness among the resident population. And one merely has to look at the books to gain a sense of the financial crisis.

There are five targeted areas that have a direct bearing on the emotional, spiritual, and physical well being among elders, and on the financial health of the care facility.

I. Corporate Culture Change

The first targeted area will include achieving a major corporate culture change. Presently, skilled nursing facilities have been developed with the assumption they are medical centers and therefore must be staffed and operated as such. This means the "culture" of the skilled nursing facility is based upon the medical hierarchy. The physician has all the knowledge and power and this knowledge and power diminishes as one goes down the "chain of command" in the facility. The person at the end of this chain is the patient; who has little, if any, knowledge about his treatment and little or no power to affect his course of treatment.

This type of culture engenders the depression and anxiety found so often in these facilities. It also engenders a second problem directly affecting the quality of life of residents - elevated turnover rates among those employees having the most daily interaction with the residents. Some eldercare facilities have a turnover rate among the Certified Nursing Aides (CNAs) of 400 percent, a cost of approximately $15,000 per turnover.

We believe a change in the corporate culture of skilled nursing facilities will significantly alleviate both of these problems. We will change the corporate culture from the "medical model" to a resident centered model. In this model the knowledge and power bases are inverted. The resident and or his family, up to the level of their understanding and function, are responsible for his treatment. He is the captain of his own treatment team. This corporate culture change empowers the resident to begin acting effectively on the environment rather than having the environment acting on him. Additionally, this culture change empowers the CNAs in a similar manner.

II. Performance Management

The second facet of the corporate culture change is accomplished through the introjection of a Performance Management program. In a Performance Management program, the entire staff is trained in achieving desired behavioral and attitudinal outcomes through the implementation of behavioral techniques. Behavioral techniques are present in all skilled nursing facilities; however, they have been implemented unconsciously and elicit behaviors and attitudes which are counter productive to achieving quality of life goals. Therefore, PCR will contract with an internationally renowned firm to bring about the desired corporate culture change.

III. Curriculum Enrichment

PCR knows that by increasing the knowledge base of all members of the treatment and administrative staff in the facility, the quality of care will be increased for the residents of that facility. Therefore, the third targeted area is the upgrading of the Knowledge Base in facilities. In order to accomplish this goal PCR is contracting with a variety of eldercare leaders across the United States to develop curricular enrichment modules for all eight levels of career opportunities found in facilities across the country. The most comprehensive curricular module will be for the CNAs in the facility. We believe it is critical to raise the level of functioning of the persons who have the greatest contact and the greatest daily impact on the resident. Some of these curricular modules will be developed by:

- Institute on Aging, Health Sciences Center, Temple University
- School of Nursing, Medical School, Holy Family University
- Institute on Aging, Health Sciences Center, University of Florida

The Information Division of PCR will translate these curricular units into a distance-learning format. The Chief Information Officer of PCR has extensive experience in developing these kinds of materials. He formerly held a similar position with Sylvan Learning Centers.

The curricular materials will be presented to employees in a web-based format. The employees will first take "leveling" type web based courses. Thereafter, PCR will offer continuing education materials to maintain the employee's currency in clinical areas, preventing and reducing risk factors, legal issues, maintenance of the corporate culture, and maintaining the Performance Management Program.

In summary, by elevating the knowledge and function of the person with the direct daily interaction with the resident, you increase employee satisfaction and reduce the costs associated with high turnover.

Reduction of risk is very important in the skilled nursing facility for two reasons. First, by reducing the risk in the facility the risk of harm to the resident is reduced. These areas of harm occur as a result of many factors - skin breakdown, falls, infections, physical and emotional abuse, medication errors, and others.

A second major benefit of risk reduction derives from reducing litigation directed toward the facility and its employees. By achieving a reduction in these factors PCR directly affects the contribution margin of the facility as well as prevents a fragmentation of the facility's efforts and attention resulting in a heightened quality of care for the resident. In this important area of Risk Reduction, PCR is fortunate in having, as a product development partner, CNA Insurance Company. CNA Insurance is the largest underwriter of skilled nursing facilities around the world. As a result of PCR's working with this product development partner, PCR facilities will develop up-to-date knowledge, skills, and techniques in reducing risk.

IV. Certification of Excellence

A fourth targeted area of intervention by PCR is the certification of both the facility and the facility's employees. PCR certification will indicate the facility and the professional and treatment personnel in the facility have achieved a level of excellence and, through re-certification and continuing educational experiences, have maintained this level of excellence.

V. Community Outreach

The fifth targeted area is directed toward providing eldercare answers and solutions to a variety of persons interacting with the elderly in our communities. PCR's Outreach Program will consist of three web sites. These sites will be for the elderly where ever they might be along the broad continuum of living arrangements, the eldercare provider whether a family member or a person in an eldercare program or facility, and the professional and treatment staff members in a variety of facilities.

These career opportunity levels are Certified Nursing Aide, Licensed Vocational Nurse I and II or Licensed Practical Nurse I and II, Registered Nurse I and II, Administrative Nurse, Activity Therapist, Social Services Worker, Case Planner, and Administrator.