Randie Dale Duretz was named after a race horse, and by all accounts her parents must have been prescient.

The veteran director of activities at Luther Woods Nursing and Rehabilitation Center has a seemingly endless supply of energy and enthusiasm. She’ll often arrive at work during the 5 a.m. hour and not depart until after 6 p.m. She owns 133 costumes, which she wears to work to celebrate every little holiday or occurrence.

In the past, she’s roller skated by residents’ rooms, trying to get them to participate in activities.

“My goodness, I don’t think the woman ever sleeps,” says John Thomas, an occupational therapist at the Hatboro, PA, nursing home.

“She is one of a kind,” adds longtime Administrator Lynn McLaughlin, recalling one recent instance when Duretz had all of the residents wearing pink tutus to celebrate breast cancer awareness.

While Duretz’s boundless energy was inherited at birth, her desire to work in eldercare came much later on. She grew up in a “hopping neighborhood” of Winfield, PA, with two younger brothers (who are also “go-getters”) and was treated “like a princess” by her mother, a homemaker who dabbled in talent management, and father, who was in the photo-finishing business.

She went to commercial arts school in the early 1970s, looking to become a professional greeting card artist. But she had a change of heart after visiting her grandparents at a nursing home. Seeing Bubby and Zeda parked in front of a window each time, with little to keep them entertained, she decided to go back to school with an eye toward nursing home care.

After working in photography with her father and for Philadelphia City Council member James Tayoun, Duretz landed her first nursing home job in 1985 as an activities assistant. She  directed activities for nine years, followed by several years of jumping from one facility to the next, helping with openings. After a break for a few years, she made her way back to Luther Woods in 2011, where she’s been ever since.

“Our activities department was never the same, so I recruited her to come back,” says McLaughlin, the home’s administrator for more than 30 years.

Duretz has implemented numerous programs over the years. One of her favorites is “Brush Stroke,” which has residents using household items, such as credit cards, to paint pictures. She’s also brought her love for boat excursions to the residence by hosting week-long “cruises,” where residents get to visit different ports throughout the facility to play games and sample different cuisines. “I feel like I’m a cruise director on land, but the ship’s always in a calm mood,” says Duretz, who’s been on 13 real cruises herself.

Earlier this year, the National Association of Activity Professionals recognized Duretz as its Professional of the Year.

Duretz — happily divorced since 1985, she says — likes to spend time with her boyfriend of 14 years, Michael Cohn, and 4-year-old black cat, Melley. She has a special affinity for animals and has often lent her spare time to doing voluntary pet therapy work after hours. She also has a special place in her heart for another animal — her beloved Philadelphia Eagles football team.

The “Energizer Bunny,” as her co-workers call her, said she has no interest in hanging up her activities director hat anytime soon.

“Nope. Not right now,” she says. “I’ve still got lots to do. Endless energy and so much still up my sleeve.”

Resume

1971

Earns a two-year certificate from a community arts school

1985

Lands first nursing home job as activities assistant at Ashton Hall Nursing & Rehab Center in Philadelphia

1988

Earns director of activities license from the National Certification Council for Activity Professionals

1990

Joins Luther Woods for the first time as director of activities and volunteers

1999

Leaves to help open the RidgeCrest assisted living facility, followed by several stints at other providers

2000

Earns personal care home administrator license

2011

Rejoins Luther Woods as director of activities and volunteers

2018

Recognized as the National Association of Activity Professionals’ “Professional of the Year”

2018

Publishes, with two co-authors, “168 Hour Caregiving Work Week: Activity and Behavior Interventions for Low-Functioning Individuals”

Rather, the Many Healthcare and Rehabilitation Center, in Many, LA, has been welcoming cats and dogs to its quarters to help bring a little friskiness into residents’ lives. The nursing home recently partnered with the local animal shelter to create a new program called the “Animal House Club.” 

It started when resident Valerie Gold found a wounded dog on the side of the road and brought her back to the facility, naming her Tula. Some of the residents then decided to start the club, which includes a play area for pets in a courtyard. Wanting to help more, they started making blankets for pets at the Sabine Humane Society, crafting more than 100.

The program was recognized by the Pioneer Network in September with a Community Commitment Award for its contributions to the eldercare field. “It’s very therapeutic, especially for me,” Glad said.

June Bolton, dietary manager for Many, said programs like this require a shift from the typical mindset. Many Healthcare became pet friendly years ago, allowing residents to bring their own critters.

“It’s beneficial because their lives don’t end here. This allows them to stay involved in the community,” she told McKnight’s. “This is their home and that’s how you have to look at it. ”

But earning those stripes hasn’t been easy.

Many dynamics have led to building relationships. The Affordable Care Act elevated discussions around the continuum of care, prompting skilled nursing leaders to seek their rightful place at the collaboration table.

Common objectives in many of these partnerships are raising quality and lowering rehospitalizations.

For nursing homes, the stakes are high.

“Lowering rehospitalization rates has been key for market share,” says Cheryl Field, chief product officer for Prime Care Technologies. “Post-acute care providers want to be in these collaboratives and networks because they like being on that preferred provider referral list.”

Maria Arellano, RN, American HealthTech clinical product manager, says the objectives of these partnerships center around sharing and transparency. And each party needs to benefit for them to be successful.

Other motivators are at play.

“While quality is the obvious goal, the underlying driver that gets overlooked is cost,” says Jason Jones, chief technology officer for SimpleLTC. “Cost and quality go hand in hand, and carefully choosing and nurturing partnerships is critical to both. The question providers should ask is: ‘What’s the highest amount of quality we can deliver for each dollar spent?’”

Nursing homes and hospitals both understand they need to deliver better outcomes.

“Under the new [Patient-Driven Payment Model], key and timely information about the patient’s clinical characteristics will be vital to the SNF’s success,” adds Arellano.

Payers also need to see a good return on their reimbursement dollars.

“While items like rehospitalization penalties played a role in establishing initial partnerships, the future is geared toward value-based care, including total episodic costs, quality and patient experience,” says Steve Herron, senior director and solution executive for post-acute care at Cerner Corp. “This will require a massive shift within our industry to start considering patient care across the continuum and not episodically within our silo.”

Data at the core

The biggest motivator of all may be data. Lots of it. And it’s quickly becoming the most important currency of all.

“Essentially, hospitals have begun narrowing their network of referral partners, and as a result, they choose partners based on more scrutinized criteria — and data is at the heart of those choices,” says BJ Boyle, vice president, general manager of post-acute insights for PointClickCare. “The sharing of data, for many healthcare providers, has become a non-negotiable prerequisite.

“LTPAC providers need to go on the offensive by arming themselves with data, making strategic decisions to put them in the best position, and aligning themselves with the innovative partners and vendors that can help them thrive, not just survive, in this world,” Boyle says.

“Preventing readmissions, coordinating care for recovering patients and managing those with serious chronic conditions are all key objectives for both accountable care organization [ACOs] and long-term care providers,” observes David Carter, licensed nursing home administrator and vice president, advisory services, and LTPAC business and clinical operations analyst for Stratus Interoperable. “But neither of them is likely to survive the transition to value without the ability to exchange vast amounts of information electronically.

“What’s in play now is developing ways to work more closely together with the right technology to make that happen,” notes Carter.

Adds Dawn Iddings, senior vice president/general manager, homecare, for Netsmart: “Having access to real-time clinical information at the time of discharge to prevent rehospitalization is vital, but just as important is the availability of that information to conduct medication reconciliation and ensure data integration during the most vulnerable transition of care: between the hospital and post-acute care.”

Partners everywhere

Information technology linkages are as varied as ever, depending heavily on the sophistication of the nursing home’s infrastructure, as well as its appetite for expense and sharing data, say observers.

The acute side long ago invested heavily, and it shows.

“Referral sources, ACOs and integrated care networks have built technology frameworks and will partner with providers who have the technology to share critical resident data with the end goal of reducing rehospitalizations and improving care,” says Matt Mello, director of sales for CareWorx.

Nursing homes often are still playing catch-up.

Says Carter: “Some providers find themselves building out costly internal data operations and are still confused as to how to make it all work. Often, there is lack of the right incentives to make investments in data-sharing agreements and the interoperable interfaces necessary for success.”

Many find it necessary to outsource the task of data presentation and migration to predictive analytics services and other partial solutions to bridge the information sharing gap, he adds.

PharMerica has engaged with many post-acute providers in recent years in efforts to improve transitions of care. The transfer from hospital to SNF is a particularly thorny one that is still plagued by data quality issues, says Suresh Vishnubhatla, executive vice president of long-term care operations for PharMerica.

“In our experience exploring the care transitions from one care setting to another, we found the information was not completely reliable,” he says. “It’s like having a really expensive flat panel TV and great cable service, but nothing works because the cable signal is always down.”

Meanwhile, the goalposts keep moving.

While nursing homes are having to deal with more and more clinically complex residents, hospitals and other entities are calling upon them to engage in shared risk arrangements where payments will be based on minimizing expenses in a network with other venues of care, says Herron.

“These networks are not built from handshakes and gift baskets, but from analysis of hard data around cost, quality and experience,” he adds. “Proving that your organization is interoperable is not enough. You need to be able to demonstrate how you are taking advantage of interoperability to provide more accurate, timely, error-free care to residents.” 

Providers should understand that “now more than ever they are competing for hospital referrals based on quality,” says Thomas Martin, director of post-acute data analytics, CarePort Health.

“How that quality is being measured is shifting from measures that capture patients in your care setting to those that occur after the patient leaves your care setting,” Martin says.

Best practices

Most experts would agree that the long-term care industry is ready to bring significant value to these kinds of collaborations. They’ve invested heavily to ensure the quality of their data is as good as the care they provide.

Jones says one of SimpleLTC’s large skilled nursing customers uses risk stratification starting on the day of admission.

“They use predictive quality data and resident frailty indexing to maximize quality, which helps them attract and keep the best partners,” Jones says. “This helps them deliver top quality and control costs throughout the care process.”

One indisputable tool every nursing home needs is an electronic health records system, experts agree.

“Implementing a market-leading EHR with integrated analytics, decision support and care coordination tools are the key to driving enhanced outcomes,” says John Damgaard, president and CEO of MatrixCare. “This helps them deliver quality care efficiently by providing the data they need to identify and drive out any cost efficiencies or care practices that aren’t contributing to a successful outcome.”

He adds that these tools can give acute providers a window into the personal health record of their patient to track the senior’s recovery progress “even after they are discharged to post-acute care facility or home care.”

Post-acute care providers that look to acute care as a source for referrals can leverage this technology to examine the types of referrals that do best within their facility, Damgaard says. Nursing homes that are only now investing in EHR technology are finding they bear little resemblance to first-generation systems.

“EHRs that just modify outdated, paper-based workflows won’t cut it,” Damgaard adds. “You can’t implement decision support based on decades-old, paper-based workflows and expect to compete with those leveraging decision support that draws on machine-learning and other new technologies. You just won’t be able to get your cost and your outcomes where they need to be. You’ll be left in the last century.”

But they also can carry germs, including surface-clinging bacteria that can live for weeks if not properly treated.

That’s one reason Linked-Senior is proactive about offering handling and cleaning advice to its clients even after getting out of the device-supply business.

“Technology, the more mobile it is, the more likely it is to keep people active and engaged,” says LinkedSenior founder Charles de Vilmorin. “But any device that is in a common area, any screen that’s going to be touched, it needs protection.”

Tablets can seem like a lifesaver if they help residents feel less lonely during building-wide isolation periods. Such devices also are increasingly pushing into patient rooms for activities such as music therapy or memory exercises.

Meanwhile, point-of-care workstations with electronic health records access or medication management tablets often roll down shared hallways and into and out of patient rooms. Other handheld electronics — ranging from nurse call pagers to smartphone cameras used for pressure wound monitoring to residents’ own phones and tablets — are inescapable in modern nursing homes.

Danger may be lurking on every stylus, keypad or touchscreen.

“We know from numerous clinical studies across the globe that healthcare workers’ mobile handheld devices are frequently contaminated with healthcare-associated pathogens,” says Rosie Lyles, M.D., director of clinical affairs for Medline. “Mobile phones, which we often carry in our pocket and hold with clean or dirty hands, can lead to potential risks, such as noise, distractions, loss of concentration, data safety, disturbance of patient privacy, and transfer of microorganisms possibly leading to nosocomial infections.”

Healthcare-associated infections remain a leading, high-cost problem for providers, and hand-washing compliance rates are less than ideal. Handheld phones, Lyles points out, are rarely cleaned after handling and may transmit microorganisms after contact with a patient to become the source of bacterial cross-contamination.

It’s clear someone needs to take responsibility for mobile device disinfection as part of an overall infection control plan, including monitoring where the items roam.

“This type of equipment is patient care equipment and needs to be considered in a facility’s protocol,” says Joan Hebden, RN, infection prevention consultant for APIC Consulting. “In light of a high prevalence of pathogenic bacteria in long-term care settings, it is something that should not be overlooked.”

Policy needed

Hebden said mobile electronic devices should be addressed in policy as would any other reusable equipment — such as IV poles, wheelchairs or blood pressure cuffs — or any electronic device mounted in a resident’s room.

A single contaminated device could allow the flu, C. diff, MRSA or worse to fly through a facility.

“Alarmingly, there are quite a number of papers that have found gram-negative bacteria are highly prevalent, and they are shown to live a long time on surfaces,” Hebden says. “Anyone who touches it, their hands become contaminated. Then you have the issue of contact transmission occurring.”

Among the device-lurking dangers nursing homes should be concerned about: cipro-resistant Acinetobacter, a pathogen commonly associated with healthcare-acquired infections.

This time of year, prospective clients are more likely to raise the question of how to safely sanitize electronics because flu is top of mind, de Vilmorin says.

But establishing a policy that sets cleaning expectations, assigns responsibility and monitors for compliance can help keep devices from contributing to disease outbreak year round.

Every few months, it seems, a new study reveals a different weak spot in the industry’s infection control procedures. Past studies have hit on stethoscopes, blood pressure cuffs, chalkboard frames, and the markers and erasers used on whiteboards.

“I’m not sure people are surprised by it or that they don’t have time to address it,” says Nick Haralambis, RN, senior healthcare product manager for HD Supply. “It’s been drilled into our heads that everything is dirty. It’s just a matter of diligence.”

Haralambis recommends the Centers for Disease Control and Prevention’s Clean Hands Count for Safe Healthcare campaign. It’s a reminder that proper handling of all other equipment begins with consistent, thorough hand-washing efforts.

Like the frequently missed nooks and crannies of our hands, Haralambis says providers should monitor the cleanliness of high-touch but low visibility items.

“Siderails on beds, head and footboards, medical carts, lifts and even wheelchairs and geri chairs: These are things that are touched time and time again, but are they ever cleaned?” he asks.

Talking back to dirt

Manufacturers can suggest treatment solutions that protect investment in devices, whether that means using slightly more expensive impregnated wipes or stocking up on protective sleeves.

Some steps are more effective than others. Hebden says keyboard covers, though easily wiped down, quickly fell out of favor because they reduce users’ tactile sensation. Likewise, antimicrobial coatings may not provide the protection technology pros think they do.

Ask whether products making antimicrobial claims contain E.Coli– and MRSA-killing copper, such as MicroGuard. The company’s copper alloys have shown a 99.9% kill rate against six infection-causing bacteria, including MRSA and VRE.

Rugged tablets designed for healthcare often feature an anti-microbial housing that lasts longer than coatings. Other touchscreens made for healthcare settings are designed to stand up to antimicrobial cleaners.

During outbreaks, de Vilmorin also has seen his long-term care clients opt for disposable sleeves, such as the iBarrier, that completely seal a tablet to limit germ transmission while in use by a resident. The sleeve is replaced each time the device is used.

Gloves also can be part of the solution when touching most screens — but only if employees remember to change them.

Timed out

Another important question is when to clean. Mobile devices carried by clinical staff — or those shared over a whole day by multiple shifts — may be easy to miss.

Cleaning responsibility, frequency and monitoring duties all should be determined by a team that ideally includes environmental services, clinical staff and the building’s infection preventionist, Hebden advises.

Creating a catalog, checking it often for lapses and monitoring with ATP or fluorescent light testing can help ensure efficacy.

No matter the product, operators need to be sure active ingredients address any known viral or bacterial culprits, and follow the appropriate application time to ensure a complete kill. Vendors such as HD Supply and Clorox provide clients with kill times for various products, and they can help develop comprehensive standard operating practices.

While terminal room cleanings provide a good opportunity for thorough sanitation, the presence of long-term patients, some of whom may not leave their room for long periods, is a challenge in skilled nursing.

Clorox Healthcare recently announced its Total 360 System, which delivers an electrostatic spray throughout a patient room and can be safely used with some electronics, according to internal testing.

“Electronics are tricky. The water in most disinfectants can be too much for them,” says Katherine Velez, Ph.D., Clorox senior scientist. “But the Total 360 creates a thin, even coating on surfaces.”

Users shouldn’t apply the spray directly to a monitor or other screens, but can stand up to four feet away and use a gentle sweeping motion over an entire room. The negative charge in the spray will make it seek out surfaces “like a target missile.”

“You get the assurance that you’re covering everything, even anything that’s oddly shaped,” Velez says.

Clorox also has introduced a new alcohol-free wipe, the Versa-
Sure, that is compatible with a broad array of hard, non-porous surfaces because it doesn’t leave corrosive residue. Still, the manufacturer suggests checking with individual electronic makers to see if products are compatible.

Cleaning mobile health devices with alcohol or bleach-based wipes would reduce pathogens, Lyle says, but those same disinfectants or abrasive materials may destroy screens.

She suggests facilities develop an iPBundle, first advanced by Mary Lou Manning at Jefferson College of Nursing in 2013, that promotes infection prevention and recognizes the need to preserve electronic resources meant for resident and clinical use.

Part of it must be the word itself, and its negative associations. To rise is to be powerful; to fall is to fail. Perhaps that’s why Brene Brown wrote “Rising Strong,” not “Falling Helpless.”

In a nursing home, “Fall!” is one of the most feared warning exclamations in the lexicon, just behind “Surveyors!” “Plaintiff attorney!” and “Rabid squirrel loose in the activity room!”

As a profession, fall is also when the night-sweat anxieties of an impending new and unpredictable year make increasingly regular visitations.

So it’s no wonder we’re uneasy. Certainly those falling leaves in autumnal months are pretty, but we know their transformation is fueled by decay and death — not exactly an encouraging metaphor.

In “Let Your Life Speak,” Parker Palmer reflects on the seasons, and reminds us that even life’s most unwelcome changes produce the fertile ground in which something new and beautiful can grow. Through the brutal biological necessity of fall and winter, “the conditions for rebirth are being created.”

Case in point: Out in my garden, while I’ve been ruing the sad demise of a once-beautiful milkweed plant, it opened those dry, ugly pods and scattered seeds via tiny white parachutes, any of which might someday sustain a monarch butterfly.

“Autumn reminds me that my daily dyings are necessary precursors to new life,” Palmer says. In other words, the falls make the springs possible, the failures fertilize the triumphs.

Maybe the autumnal demise of long-familiar systems and processes across the long-term care spectrum will reanimate our profession, and enrich the lives of those we serve.

Rising from fall in the warmth of spring, we’ll be better than ever before.

Things I Think is written by Gary Tetz, a national Silver Medalist and regional Gold Medal winner in Humor Writing in the 2014 American Society of Business Publication Editors (ASBPE) awards program.

Minnix, of course, is the former president and CEO of Leading-
Age. He led it for 15 years and has spent more than four decades in the business.

Now, the Georgia native has put his valuable insights between the covers of his first book, “Hallowed Ground: Stories of Successful Aging.” May it be the first of many. Minnix freely unloads humor and wisdom about some of life’s stickiest subjects.

(Full disclosure: When the author approached me about a year ago to read some “rough” thoughts he had assembled for a possible book, I jumped at the chance and have encouraged him since.)

This is the self-help, inspirational stuff that made people like motivational speaker Leo Buscaglia famous. Genuine as the day is long, it is not a book for the professional caregiver, nor the family caregiver. It is a feast for the human soul.

Above all, it is Larry in full candor. Sometimes shockingly so. Not one to simply discuss others’ challenges or shortcomings, he lays bare his own personal weaknesses and family flaws.

We get the full background on relatives such as nosy cousin Johnnie Mae, ornery great-grandmother Ma Dennis (who had three sets of twins), an emotionally detached father and dozens more. This includes the eldest surviving family member so many LeadingAge followers came to know through the years, Cousin Bubba.

Throughout, there are lessons. He takes us through his early years at Wesley Woods in Atlanta, where he led an innovative community offering long-term supports and services. He addresses the value of attitude, intimacy, dying and death, caregiving, retirement and “those places” people go when they can’t live on their own any more.

He estimates nearly 100 different people figure into stories in the book. They all become part of Larry’s family. Many serve as exemplars, all the better to explore successful (and unsuccessful) aspects of aging.

This is an engaging examination of life that will get you reflecting on your own, and likely acquiring some new goals along the way.

Welcome to Larry’s world. Pick up a copy and raise yourself to “Hallowed Ground.” (Now available at http://larryminnix.wpengine.com/ and online via booksellers such as Amazon.)

To refresh your memory, here’s what President Trump had to say last December:

“Instead of eliminating two old regulations for every new regulation, we have eliminated 22,” Trump noted. He then went on to announce more cuts would be on the way.

And here’s what Centers for Medicare & Medicaid Services Administrator Seema Verma had to say:

“The changes we’re proposing will dramatically reduce the amount of time and resources that healthcare facilities have to spend on CMS-mandated compliance activities that do not improve the quality of care.”

To be sure, the overall effort to ease restrictions is in full force. The government is aiming to trim about $686.6 million from deregulation by the end of 2018, according to published reports.

Everyone, it seems, has less red tape to deal with as a result. Except, apparently, skilled care operators.

As we reported earlier, the federal government released new quality-of-care data, along with a firm admonishment that the sector needs to do better.

This follows a CMS proposal that mandates civil money penalties against skilled nursing home staff who fail to report “reasonable suspicion” of crimes.

Another recent report suggested nursing homes are piling on gobs of unnecessary therapy services, and implied some action should be taken to curb the abusive practice. (For what it’s worth, the American Health Care Association blasted both the report and the data it rests on.)

Of course, all of this is mere prologue to the big event. The Patient-Driven Payment Model is on the horizon.

Most notably, this new framework will remove therapy minutes as the basis of Medicare payments. The new standard will be resident classifications and anticipated resource needs.

Think this new approach might fuel provider confusion, accusations of gamesmanship, or calls for follow-up rules? Yep, me too.

Part of the nautical landscape for 50 years, the long-term care and rehab community has been given a sparkling $2.5 million makeover by owner/operator Marquis Health Services, which purchased the property in 2015.

Jennifer Hertzog, vice president of marketing and business development, says that at the time of the acquisition, the building desperately needed a facelift.

“It was a tired, sleepy little nursing home that hadn’t been renovated in 20 to 30 years,” she said. “It sits in a prime location across from a 500-bed hospital in a nice shore community, so it was highly attractive from an acquisition perspective, but we knew it would take extensive investment in renovation.”

In her initial walkthrough of the property, Hertzog said it was like entering a bygone era, “with wallpaper that looked like it was from the fifties. It was tired, dated and depressing. It needed a full-scale renovation.”

Enter Jonathan Rhoades, who headed up the physical improvements initiative and oversaw the 18-month project, including construction of post-acute rehab suites, a new therapy gym, dining room, public spaces and elevators, along with outdoor enhancements, landscaping upgrades and a resurfaced parking lot.

“This is a full-scale renovation of a complete long-term care environment,” notes Rhoades, a representative with the Marquis Facilities Construction Division. “Because the property was challenged spatially, our mission was to open it up. And because it is near the shore, we also focused on making it fit within the local landscape.”

From a decorative perspective, that meant adding touches to connect the community with the sea, Hertzog says.

“We’ve infused a palette of modern paint colors reminiscent of the shore — notably blues, pinks and yellows,” she says. “The artwork, window treatments and bedding are all designed to connect with the area. Even the floor pattern has a boardwalk look.”

The two-story, 40,000-square-foot, 110-bed skilled nursing and rehab community has been reshaped to maximize clinical services, Hertzog says. She notes the rehab gym is set up to simulate real-life situations.

Infrastructure upgrades enabled new oxygen piping systems to be installed, giving the community the ability to diversify its clinical offerings. Close proximity to Hackensack Meridian Health’s Jersey Shore University Medical Center affords Coral Harbor direct access to short-term rehab and post-acute patients for the community’s specialty cardiac and pulmonary rehab programs.

Other clinical services include a chronic kidney disease management program for routine nephrology oversight and consultative visits as well as an onsite community support group and disease-specific education.

1) Cleanability is important for slowing decline.

Ask any designer or seasoned facility housekeeping manager what the most important thing to look for in new furnishings — beauty won’t be highest on the list. Cleanability is.

Buyers today would be wise to choose products that repel germs and dirt not only to avoid cross-contamination, but also to lessen cleaning needs.

Experts also say to consider replaceable components, like seat cushions or window treatments.

“Your housekeeping staff knows how time-consuming it can be to replace traditional curtains in resident rooms,” observes Jim McLain, general manager, construction specialties, for Eldercare Interiors. “Today, easily removable curtain systems, unique track solutions, and even disposable curtains for high-contamination areas are all making it easier than ever to keep privacy curtains clean and free from potentially dangerous pathogens.”

2) Durability and safety go hand in hand.

Durability typically works in tandem with safety. Experts say products that don’t easily peel or show physical damage are likely to be more easily maintained and cleaned. Examples include acrylic polyresin materials in hard surfaces, non-fabric lamp shades that repel dust, and impervious fabrics such as vinyl and leather that don’t harbor moisture and odors.

Of course, the level of resident acuity is a huge factor, according to Jamie Thorn, national sales manager for Forbo Flooring.

Facility operators often overlook critical safety issues for slippery surfaces such as vinyl planks. So-called “transition strips” connecting areas between carpeting and wood, for example, also can create opportunities for falls, Thorn says.

Adds Mark Huxta, director of sales, healthcare, for Ecore, the key to selecting the right surface is choosing one that absorbs impact while safely redistributing energy.

Other considerations: minimizing volatile organic compounds to ensure cleaner air, avoiding casters on tapered legs and choosing chair arm heights that don’t squish seniors’ forearms under tables, says Melinda P. Ávila-Torio, senior associate and project manager for THW Design Interiors.

Owner-operators should never overlook safety attributes when choosing furnishings. “Sometimes, the greater costs of ownership come when a piece of furnishing fails or leads to an infection,” Thorn adds. “Understand the liabilities that come along with not taking care of furnishings and other elements in the physical space.”

3) Emphasize staying power at every turn.

One way to extend the lifespan of expensive furnishings is choosing appropriately sized items. As Ávila-Torio advises, for example, go into the showroom with average resident seating dimensions and a general idea on the types of assistive devices they use to get around. Don’t be afraid have residents test chairs. Ensure that products don’t require harsh chemicals and cleaning methods. Sketch out floor plans, including widths of corridors and other pathways, where new furnishings will go, she adds.

All too often, busy staff and cognitively challenged residents overlook how their actions can cause needless damage and premature wear on things like wood tables and finely appointed chairs and sofas.

Some would be surprised to learn how infrequently buyers inquire about reupholstering options, says Christy Evangelista, marketing communications specialist for Open Road Furnishings. Furniture that can be re-covered is considerably less expensive to own in the long run. Evangelista also encourages acquiring metal seating (or at least chairs with metal legs) in high traffic areas. A quick look at furnishings today reveals some very un-institutional looking metal components.

Many vendors like Ecore offer so-called “performance layers” on hard surfaces to preserve the item’s beauty and durability, which, according to Huxta, significantly reduces maintenance and cleaning costs.

4) Consider routine, not frequent, maintenance.

Good quality furnishings and other physical elements require routine maintenance that ensures hygiene and cleanliness, aesthetics and structural integrity without costing a great deal in time and money.

Properly trained housekeeping and maintenance staff can go far in ensuring longevity, but attrition and turnover can impede that.

“A lot of folks may be left worrying about how to easily clean a floor rather than clean it correctly,” Thorn observes.

Huxta and Evangelista both espouse the value of furnishings that can be cleaned easily and effectively with the simplest of solutions — often just warm water and mild soap will do, for example. But everyone advises closely following manufacturers’ recommended cleaning methods. 

Mistakes to avoid

—Choosing beauty over brawn. Well-built furnishings that are safe and easy to clean and maintain trump aesthetics every time.
—Exposing expensive furnishings to unnecessary abuse. Furnishings will take a pounding from wheelchairs, canes and walkers. Simple communication and planning will go far.
—Overlooking safety. Too often, buyers forget to ask questions about potential
hazards that could lead to injury and liability risks.

Residents will be able to have more engagement through the program, said Nick Patel, president of Asbury Group Integrated Technologies, a full-service IT firm managing the pilot.

“We did extensive due diligence and were excited to hit the ground floor with this voice-integrated technology and social media platform,” he told McKnight’s. “We looked at the market segment. We knew Asbury Methodist were very tech savvy. What we found is the vast majority of residents had smartphones: They were a fully connected group.”

Patel describes the program as a “bold step forward” and said that residents and family members want to connect with the platform. Amazon is “leading the charge to educate voice providers to really create integrated technology,” he said. The system’s pilot was to go live in November with a larger rollout coming soon afterward.

In a demonstration at the LeadingAge convention in October, residents could be seen saying, “Alexa, ask Connected Living what’s on the menu today.” Residents  using the program also can hear a company calendar of events.

Sodexo and Connected Living have been in a relationship for about 18 months, and sought to integrate some of the platforms, said CEO of Seniors, Sodexo North America, Joe Cuticelli.

“Everyone should know that this kind of tech is the new norm,” he told McKnight’s. “It’s fairly seamless because of the infrastructure. It’s applicable at every level of care.”

Connected Living has a suite of technology functions, while Sodexo has long relationships and services at many senior living locations. The personal assistant aspect also reflects increased consumer demand: In 2018, one in six US adults, around 39 million, will have a voice-activated smart speaker, one survey estimated.