By Janis Siegel, JTNews Correspondent
Despite Washington state’s 5 percent cut to the Caroline Kline Galland Home’s budget, the Jewish nursing home remains the No. 1 ranked nursing home in the state when it comes to delivering high-quality, long-term care for the elderly and disabled who call it home.
According to a first-time study of nursing homes in six states conducted by the Centers for Medicare and Medicaid Services (CMS), the Kline Galland Home in the Seward Park neighborhood received the best ratings in the six categories that were studied. Joshua Gortler, executive director of the Kline Galland Home for the past 32 years, says that since the home opened in 1914, care there has always been rated in the top 5 percent in the state.
In the study, the CMS looked at 40 Seattle-area long-term care institutions and evaluated them based on six criteria. They assessed the number of residents who needed increased help with daily activities, had one or more bedsores, lost 5 percent or more of their body weight in one month, had to be in physical restraints on a daily basis, had certain types of infections over the past year and had very bad pain at any time or had moderate pain each day for seven days or more.
Typically, the CMS contracts with the state to conduct inspections. The health department or the department of human services usually inspects local nursing homes in Washington state. State inspection teams look at deficiencies that may exist in the quality of care, resident assessments, resident rights, and nutrition and diet.
Gortler feels that when looking for a home in which to place your loved one, there are additional aspects to consider. “The state uses a Minimum Data Set or an MDS using six criteria,” Gortler said. ” It’s uniform and it’s measurable. I think all of those criteria are factors that one can take into consideration when choosing a nursing home, but I would use these as an indicator.
In addition to the government’s inspection criteria, Gortler added his own checklist to that of the federal study and state’s checklist.
“So, what do you look for?” asked Gortler. “Some of the things you might look at are: What is the ratio of staff to residents? What is the longevity of the staff? What is their job satisfaction and are they overloaded? Do they get a sense that their job is important? What kind of environment is it? What kind of rehabilitation program does it have? What are the activities and who provides these activities? How much privacy and public spaces do they provide? What is the level of training of the social workers? Who are the volunteers there? What kind of medical program does it have? What kind of mental health services do they provide? What kind of commitment to [staff] training do they have? And, does it have dental and podiatric services?”
The Kline Galland Home offers six medical programs, including physical and occupational therapy, dental, podiatric and psychiatric services and optometry. Gortler says that the reason the Kline Galland occupies the top spot out of all the nursing homes rated in Seattle is because the study shows that they excel in services and in care.
“We have a vision and a philosophy”, said Gortler. “We give close to 40 percent more hours of care to our clients. We also have a dedicated staff that has been here a long time. We only assign six patients [to a staff member] per shift. If they have to take care of 15 people per shift, they can get very discouraged. We pay a little bit better and we give our staff continuing education benefits. All of our social workers must be master’s-prepared.”
Gortler believes that the atmosphere of respect and support that is provided to both the employed and volunteer caregivers at the home ultimately contributes to the well-being of the residents. He says the philosophy at Kline Galland is to work toward improved health for the residents.
But in a financial environment where the federal Medicaid program awards more money to nursing homes whose residents are more ill, the Kline Galland Home must innovate their funding methods so that they do not have to let that unfortunate fact of administrative life change their approach to health care and service.
“The way the state operates is that they give you more money the sicker you are”, Gortler said. “Each day, when we reflect improvement, the state says, “˜We’re going to give you less money today.’ The question is: Do we accept decline as a matter of fact or do we try to prevent it as much as possible?” Because Medicaid subsidizes 70 percent of the residents at Kline Galland, the home’s board of directors is looking to protect their bottom line from a disproportionate dependency on the state’s budget.
They are looking toward a future plan for financial support that is a partnership between the government, the community and the family.
“We’re not supported by the [Jewish] Federation”, Gortler said, “but we’re very nicely supported by the Jewish community. Those who want to support Kline Galland can set up a charitable remainder trust, an endowment or a bequest or they can give a direct gift or a lifetime gift. I’m looking for $28 million. We’re at a stage of developing a major endowment to ensure that this institution is very well endowed.”