Residents and their families were treated to tours around the 184-bed Cheektowaga, NY, facility — fully decked out with holiday lights and decorations — courtesy of a horse-and-carriage team brought in from nearby Banner Farm.

“I thought it would be wonderful for the families and the residents to get together during the holidays,” said Rhonda Gorman, activity director at Garden Gate. “A lot of times we do a tree lighting or something like that, but this time we thought it would be nice to do something different.” 

She was inspired to organize a carriage ride activity after the success of festive fall hayrides earlier in the year. 

The event — which Gorman is calling “Country Christmas” — drew quite a crowd. Gorman estimated between 50 and 75 residents, family members and staff came to hang out with the horses.

Residents who were physically able were whisked away on the carriage ride, but even those who weren’t able to access the ride itself got to participate in the highlight of the event.

Even more than the holiday spirit-boosting ride, the horses were clearly the star of the show. The team showed up early and stayed late, Gorman said, ensuring that everyone got to spend time with and even pet the enormous Clydesdales. 

“It really adds a wonderful quality of life for the residents to get outside in the wintertime and see horses and be with their families,” Gorman said. “It’s something that we strive for with our staff.”

The Banner Farm Clydesdales don’t only go out for Christmas events, but the horse breed has become synonymous with Christmas ever since it was featured in an iconic series of holiday Budweiser ads. 

This is the first time that Garden Gate has run the carriage ride event, but it will not be the last.

“This will definitely be an annual tradition,” Gorman stated.

And the holiday season is just getting started for Garden Gate’s residents, as the facility has more Christmas events lined up, including three days of lunch and gifts with Santa later this week.

A free coffee shop now runs twice a week at the Le Mars, IA, nursing home, attracting regulars for homemade fancy lattes and good company. 

Residents have been meeting for coffee with Emily Toering, the facility’s activities director, every Tuesday and Friday since late May, with no plans to stop any time soon. 

Toering set up the “shop” with nothing but a single portable burner, a pot and a mason jar for hand-frothing milk for lattes. A pair of residents usually help Toering prepare drinks for everyone who shows up.

But more than the coffee, residents love the chance to socialize, do devotions together, and form deeper bonds than they could at other activities with less social downtime.

“You can do bingo and crafts and all that, but when you’re doing those you really don’t get time to talk and get to know each other very well,” Toering said. “I listen to my residents and I love to see them socializing with each other.”

She was inspired to try the coffee shop activity after a coffee truck was brought in for the 83 staff and 60 residents of the Le Mars facility. She noticed that residents were curious about the truck, but most had decided the price of the specialty drinks was too steep. She suspected the residents might be interested in a more affordable option.

To keep the cafe experience as real as possible, the shop has a printed menu, updated seasonally, with resident-favorite drinks often topped with whipped cream and spices. The most popular drink this month is the Peppermint Mocha.

Families and community members recently donated 35 ceramic mugs to the pop-up cafe after residents expressed that would make the experience even more cozy. 

More than 20 residents have become regulars at the cafe, which has become an institution at the facility. In December, they decided on a new name for the cafe — Coffee Delight, named for the new sense of social connectedness residents have found there. 

Cora, a 66-year-old resident at Good Samaritan, summed it up simply.

“We all need to talk to somebody to open up our hearts and feel like we are wanted and needed around here,” Cora said. 

Toering agreed that the social routine and the ability for some residents to help out with the coffee making helps those who attend feel a greater sense of community and purpose. She recommended that other nursing homes try a similar approach to social activities if they’re in a rut.

For more stories of nursing homes embracing the brighter side of life, see McKnight’s coverage of Disney being inducted into a facility’s centenarian Clubhouse.

PHCC launched the annual Adopt-a-Resident program in 2019 — going beyond the facility’s usual family gift-giving tradition and asking the local community to pitch in with donations for residents so that all of them could be included.

The results have been beyond expectations.

“This program was started to make sure that everyone gets something for Christmas,” explained Emily Mounts, director of social services at PHCC. “It’s kind of expanded into that they get a lot for Christmas.” 

Since its launch, the Adopt-a-Resident program has picked up steam in the 120-bed facility’s Princeton, West Virginia community. Churches, schools, Boy Scout and Girl Scout groups, and local radio stations have all contributed to make sure Christmas is a big deal at PHCC. 

Gifts rolling in include everything from candy and snacks, to clothes, activity books, room decorations, warm clothes and blankets, magazines, scented lotions and jewelry.

Residents will open their gifts at this year’s Christmas party — always PHCC’s biggest event of the year, according to Mounts. 

“This is a very great time for us. We really love the resident Christmas party — we talk about it all year long. We try to set aside a date well ahead of schedule and put that out in our newsletter to families so they can save the date too,” said Mounts. 

“We put a lot of effort into making sure this is something memorable for them.” 

Residents can expect to have presents delivered by Santa, whose arrival will be announced via loudspeaker. 

Christmas may not come to an end on the 25th, either. The program has grown so much that the community’s generosity spills over into helping residents throughout the coming year.

According to Mounts, any leftover gifts and monetary donations are held onto and used for residents who need help with quality-of-life issues like repairing damaged glasses or for newly admitted residents who might not have all the warm clothes and comfort items they need.

As they gear up for this year’s Christmas party, it’s a special time for staff and residents at PHCC. Mounts is confident that this year’s celebration will be another success.

“This is something that’s very special to [our residents], and that’s our main focus — making sure that they have a great Christmas,” Mounts said. “And with all the support that we’re getting, I’m 100% sure that they will.”

For more stories of nursing homes embracing the holiday spirit, see McKnight’s coverage of a facility’s special Veterans’ Day ceremony.

The nursing home held a ceremony and dinner Nov. 10 to celebrate the lives and dedicated service of its veteran residents — 19 of whom attended the event. 

Many of the veterans wore hats or other regalia reflecting their service branch. Those present had served in World War II, the Korean War, the Vietnam War and the Cuban missile crisis.

“These gentlemen did so much for this country and so much for each one of us as individual citizens of the United States,” said Donald Kirsch, CEO of Welty Cooperation, which owns the 192-bed facility, who delivered remarks at the event.  “It’s just a very emotional evening. Not only for me, but all of our staff.”

The ceremony took place in Good Shepherd’s chapel, where residents and their families were welcomed by an honor guard of nearby Moundsville residents and veterans. The honor guard raised the US flag and showed residents and their families how to properly fold the flag and the significance of that process. They also played “Taps” to close the ceremony. 

“There was not a dry eye in our chapel,” Kirsch told McKnight’s Long-Term Care News. 

Local musicians also took part, playing patriotic songs such as “God Bless America,” “The Caissons Go Rolling Along” and “The Star Spangled Banner.”

Veteran residents and their families were treated to a dinner after the ceremony, with food provided by Good Shepherd’s staff chefs.

Good Shepherd also made sure that the veterans and their families had some mementos to remember the occasion. 

“We had a professional photographer there to take a picture of each veteran with their family,” Kirsch explained. “We do that without cost and we provide each veteran and each family member of each veteran with a photograph.”

Good Shepherd has been holding this event for the past 12 years — though the COVID-19 pandemic forced leaders to put the tradition on hold for two of those years. 

“We realized that we had several veterans in our facility and we thought that it would be a perfect idea to recognize and honor them for their service to our country,” Kirsch told McKnight’s.

“It means quite a bit,” Army veteran Jack Blazier told local news at the event. “I didn’t do that much in the service. I appreciate them. Y’know, I’m just an average guy, I thought.”

A team of staff workers put together their annual trunk-or-treat event in the facility parking lot with help from residents and neighbors. Their goal was to provide a safe and fun trick-or-treating activity for local kids while connecting Hallmark Healthcare to the people around it.

It was a whole-community effort, explained Carol Williams, CEO and administrator at Hallmark Healthcare. Staff members dressed up and decorated their cars with elaborate Halloween displays while residents packed candy bags, helped with pumpkin painting activities and passed out candy to local kids. 

Hallmark Healthcare’s neighbors also took part, donating candy to fill the kids’ trunk-or-treat bags. 

“Anytime you have the opportunity to invite the community in, it’s a good thing,” Williams told McKnight’s, “because we’re a part of the community so it makes sense for the community to know who we are, who our residents are, who our staff are.”

The event had more to offer than just Halloween candy — the lineup of free snacks included hotdogs, popcorn and s’mores, with hot chocolate and apple cider to drink. Attendees also enjoyed a costume contest, pumpkin carving and painting, dancing and a “ring” toss using a witch’s hat. Contest winners received prize ribbons and “boo baskets” filled with candy.

The event had more to offer than just Halloween candy — the lineup of free snacks included hotdogs, popcorn and s’mores, with hot chocolate and apple cider to drink. Attendees also enjoyed a costume contest, pumpkin carving and painting, dancing and a “ring” toss using a witch’s hat. Contest winners received prize ribbons and “boo baskets” filled with candy.

The skilled nursing facility didn’t take exact attendance numbers, but estimated that more than 100 local kids made it to the trunk-or-treat event. Around 25 residents were involved in the festivities, too, as well as a committee of 13 staff members. Some families were repeat visitors to the annual event.

“Residents enjoy seeing all the kids and the costumes — that’s what they enjoy more than anything,” Williams explained, noting how meaningful intergenerational social events are to residents and to the community. 

Staff and residents were excited about putting on the spooky event. “Once this time of the year arrives, everyone is ready for what we consider the kickoff to the holiday season.” Williams said. 

Hallmark Healthcare isn’t finished with the festive spirit for the year either. 

“We’re doing a tour of trees coming up in December,” said Williams.

This isn’t McKnight’s only feel-good Halloween story this year. We also covered a program uniting prison, nursing homes over pumpkins

However, on June 19, Davis received plenty of attention — when she was given the keys to a new 2023 Chevrolet Blazer. She had entered and won the “Lean on Me” contest hosted by Crest Healthcare Consulting, the organization providing operational support for Cedar Ridge and other skilled nursing facilities around Illinois. 

The contest, open to over 1,000 workers from 13 different skilled nursing facilities, was a demonstration of employee appreciation. Part-time and full-time employees were encouraged to answer the essay prompt, “Who do you lean on, and who leans on you?” Once contestants emailed their essays in, their names were entered into a random drawing. Employees had 30 days to send in their submissions.

In order to increase contest participation and excitement, Cedar Ridge advertised through flyers around the facility, reminders during morning huddles, and even one-on-one conversations with each employee.

There were no word limits and no writing requirements, everyone was simply encouraged to dig deep and drop their name in the hat. Davis wrote the winning entry:

“I worked so hard as a Certified Nursing Assistant, caring and helping those that can’t do for themselves. I did it with no problems; even on our bad days, we still made it work. I got an unexpected promotion to Human Resources and I couldn’t be happier with my new position. I lean on my staff and they lean on me, too. Not just because I handle the money, but because I care. They know they can ask me for help at any time no matter what it is. And yes, I will still get on the floor as a Certified Nursing Assistant: no questions asked!!!!!” 

Davis certainly spoke from the heart without any expectation of the surprise she would ultimately take for a drive. Ashley Huels, director of business development for Cedar Ridge, says Davis was “crying and jumping for joy” once she learned she was the lucky winner. Davis’ Cedar Ridge colleagues got to share this momentous event with her as she was announced winner on a Zoom call with all contestants on June 14. 

Huels says that the contest, which was hosted for the first time this year, was more than just a generous giveaway. She explained the importance of recognizing the people you rely on during the work day and says that employee appreciation is possible even at facilities where an expensive prize may not be feasible. 

“Anything that you can do to show the employees that they’re appreciated, whether it’s small or big, it goes a long way,” Huels observed.

Although Davis ultimately opted for the $15,000 cash-out option instead of the 36-month paid car lease, she took her hot new ride for a spin after receiving the car keys from Crest President Shully Lichtman. 

Davis was all smiles as colleagues cheered her on, proving once again those we “lean on” to be priceless.

In the fall of 2018, resident Emily Ryan was recovering from a hip injury at The Buckingham. She noticed that many of her fellow residents lacked visitors and appeared isolated and dejected. She knew something had to be done to help patients reconnect with others, so she decided to take matters into her own hands. Enter, The Smile Squad. 

Due to COVID-19 setbacks, The Smile Squad officially launched at the start of this year. What initially began as a group of five volunteers has now grown into a dedicated crew of 20 Buckingham independent living residents. Every day, two squad members visit each room located on the community’s two skilled nursing floors. During their visits, volunteers may play games with patients, gift them with helpful items, or simply provide a listening ear. 

“We get them to think about their memories and their past. It really does seem to cheer them up,” said Ryan.

Ryan and her partner visit up to 25 rooms when they volunteer, spending around 10 minutes in each room. Skilled nursing residents appreciate having someone pay attention to their wants and needs, especially a peer. Ryan told McKnight’s that orchestrating this program has required little to no expense and that the true purpose of the Smile Squad is to forge relationships between all types of Buckingham residents.  

Jeanette Mitchell, the Manager of Lifestyle at The Buckingham, has been working with Ryan for the past five years to help The Smile Squad come to fruition. 

She described the happy moment when Ryan proposed the idea to her: “I felt like this would do a lot of justice to the residents in regards to making them feel welcome and loved.” 

For facilities interested in creating their own such squad, Mitchell recommends staff members take a more hands-off approach and allow the volunteers to “have more involvement.” She says staff members can still provide guidance through giving volunteers a list of things they can and cannot ask per HIPAA. All members of The Buckingham’s Smile Squad undergo minimal training to ensure volunteers know how to appropriately speak with skilled nursing residents. 

Ryan shared a story about one skilled nursing resident from the Ukraine who was unable to communicate with nursing staff. Fortunately, a member of The Smile Squad spoke Ukrainian and offered to help make the patient feel more at ease. This simple interaction transformed one’s patient experience in an indelible way.

“There is something very special about peer-to-peer connection,” said Shannon Schmidt, The Buckingham’s Director of Lifestyle. “When you get someone there because they want to be there, it is something special.” 

A number of members of The Smile Squad have been in skilled nursing at one point so they see quite clearly the importance in having visitors. And the benefits go both ways, according to Ryan. 

“I’m so grateful that I’ve met some of the people that I’ve met… The bottom line for life (is), ‘If you’re not contributing, what’s the point?’”

Most 15-year-olds spend their free time playing video games or watching television. For Ruby Chitsey, however, it’s an age when time is of the essence and she chooses to spend hers at a local nursing home. 

Chitsey is the CEO and founder of Three Wishes for Ruby’s Residents, an Arkansas-based nonprofit dedicated to granting small wishes to long-term care residents. As if one kid managing a nonprofit weren’t impressive enough, Chitsey is supported by six other young altruists comprising the organization’s “Kid Board.” 

She and her fellow kids collaborate with nursing staff across the US to grant residents’ wishes. They have fulfilled more than 40,000 wishes. Some of the items residents popularly request are clothes, favorite candy, pet food and blankets. Although most items cost less than $10, no wish is too big or too small. Three Wishes is financially supported by private donors who cover operating costs and overhead, according to the Three Wishes website.

Chitsey started Three Wishes when she was only 10 years old. After spending time at the nursing home her mother worked at, Chitsey developed a connection with the senior residents. Fast forward five years and Chitsey’s mother, Amanda, serves as the president of Three Wishes to help her daughter and the rest of the “Kid Board.”

Chitsey has been recognized globally for her humanitarian work. She was named a top 20 finalist for Time magazine’s “2022 Kid of the Year.” 

To add to her list of accolades, Chitsey was most recently presented with the 2023 Spirit of NADONA Award at the 36th annual National Association of Directors of Nursing Administration (NADONA) conference in Orlando, FL. The award is presented to an individual who gives back to the senior community and works toward providing residents a better quality of life. NADONA President Robin Arnicar presented Chitsey with the award. 

“Unfortunately, sometimes in healthcare we get so busy trying to take care of the physical and the safety needs of people, we forget about psychosocial well being, love and belonging,” said Arnicar. “She [Ruby] is just fulfilling an unmet need.” 

When NADONA board members stumbled upon a video of Chitsey, they knew they had found their next Spirit award recipient. She is the first person not affiliated with NADONA to be given this award. “Ruby was kind of a unicorn for us” said Arnicar. 

Like a unicorn in its truest form, Ruby Chitsey is one of a kind. “Kindness Is My Hobby” is her mantra  — and the title of her recent children’s book on how youth can get involved in charity. 

We can all learn a thing or two from Chitsey. Arnicar suggests nursing leaders should consider their policies on allowing children within their facilities. She encourages programming that forms intergenerational connections between residents and youth. Some ways to facilitate this include allowing staff to bring their children to work and scheduling activities with nearby daycare centers. 

“Talk to your programming staff to see how many children related programs they have and be intentional about bringing children into the nursing homes,” Arnicar added. 

As for Ruby, she continues to make her mark on our world. 

“We need more people like Ruby,” Arnicar says, describing her as “vibrant.” “She truly is humble and doing it for the right reasons. She’s making an impact.”

On any given day, a long-term care provider can safely figure he or she will be on the receiving end of a wary eye, or giving one out.

Sad but true, no debate there. By anybody.

That’s why reasons for a straight-on smiles are so deeply appreciated. I’m glad to note that you can always find them in the McKnight’s “The Brighter Side” feature. This weekly bon mot from skilled nursing’s front lines is without fail a grin-inducer. 

Sometimes the result is a wide, cheeks-raising smile and sometimes it’s a more subtle nod of satisfaction. Think of it like the equivalent of that final, bright bit that ends many nightly newscasts.

I know by every Thursday morning I’m more than ready for it in our Daily Update newsletter — and the numbers show you are too. Among its endearing qualities is how providers can learn a few operational details from peers about how to produce or manage a joyful event or circumstance.

This week’s installment is a perfect example.

Maple Knoll Village on the north side of Cincinnati is capitalizing on Bengals-mania. The local NFL franchise’s first Super Bowl appearance in 34 years is going to be celebrated with proper abandon.

Sunday evening when the NFL’s championship game is played, the black and orange will be in abundance and the Joe Burrow jerseys will be out in force. A bar and local food specialties (perhaps chili and Graeter’s ice cream, anyone?) will punctuate the happy gathering.

Facility leaders could have settled for encouraging residents to keep watching postseason  games on their own or with family members. But no. They took the tiger by the tail and said, “Let’s party!” To make it work, they’ll be hosting a fest in an auditorium area that allows for social distancing, safe cohorting and other confidence builders.

Some 125 people in the 141-bed facility have said they’re attending, organizers told us earlier this week. Having fun with math, that could mean something like an 88% conversion rate. But that’s nothing, really.

Yes, this crew knows how to have fun and observe best caregiving practices while respecting one another. As of the first of the year, COVID vaccination rates were 97.9% for residents and an extremely impressive 95.6% for staff — both far above state and national averages.

With roots reaching back 173 years and ties to the University of Cincinnati (whose football team incidentally made it to the final four itself this season), Maple Knoll definitely has earned its Bengal (party) stripes. 

And in a way, so have we. What a pleasure it was to read about this longstanding CIncinnati institution’s creativity and can-do spirit. Actually, there are uplifting stories like this every week in long-term care. You’ll find them in The Brighter Side, of course.

Not all of these cheerful chapters might dangle the prospect of a Super Bowl celebration out there. But they are all champions nonetheless. I invite you to join the winning ways and drop us a line about worthy “Brighter Side” topics. 

We’ll count on it happening with a smile. Just like they’ll be wearing all over Maple Knoll on Sunday — even before the right team wins.

James M. Berklan is McKnight’s Long-Term Care News Executive Editor.

Opinions expressed in McKnight’s columns are not necessarily those of McKnight’s.

Both of Ruby Kate Chitsey’s parents work in long-term care and she’s been a frequent visitor to nursing homes during childhood. But seeing the elderly barely scraping by on a monthly Medicaid allowance of $40, she couldn’t just sit on the sideline watching them suffer.

“It kind of put me to realize that that’s not a lot for them and that they deserve more,” she told a local TV station.

Last May, she grabbed an old notebook and started chatting with residents at the Harrison Rehabilitation and Health Care Center, in Harrison, AR, where her father is the medical director. Her mother, Amanda Milford Chitsey, 50, is also a geriatric nurse practitioner and owns her own company that provides clinical services to several SNFs. Ruby Kate asked everyone she could what three things they wanted most in the world.  

“She is a typical 11-year-old child, but she sees things that others can’t see, as far as other people’s pain,” Amanda told McKnight’s. “Other kids could walk through a room and just not see other people’s plight, but that’s not Ruby.”

Amanda Chitsey expected Ruby to unearth outlandish requests — airplanes, millions of dollars. But they were surprisingly all grounded and realistic, whether it was a box of McDonald’s French fries, food for a pet, or a new pair of shoes.

“The answers were stunning. It made me cry because I had had some of these residents for 18 years,” she said, pointing specifically to a man who wanted a pair of pants that fit. “It really brought me to my knees because I had never noticed it. She broke a barrier that I was never able to break because this generation is so proud.”

Cathy Abatangle, the administrator at the Harrison Rehabilitation, says Ruby has a magical effect on the facility’s residents.

“She’s a very special little girl,” Abatangle told McKnight’s. “It just lights up their faces. They’re so happy to see her, and she connects with them in a different way than adults do.”

The mother-daughter duo decided to spread the effort to all five nursing homes where she provides services, and Ruby Kate ended up speaking with dozens of residents about their desires. The two set about helping to fulfill their wish lists, launching a Facebook group called “Three Wishes for Ruby’s Residents” and a GoFundMe page to help pay for the endeavor. As of Tuesday night, it had raised more than $50,000 and counting.

The campaign has drawn national attention, getting featured on CNN Tuesday and grabbing Ruby Kate a “kid hero” award from the fundraising website. Amanda Chitsey believes her daughter may have started a “movement” and they’re thinking of launching a nationwide organization to help more seniors across the country.

“I didn’t expect this, but I would love to start a nonprofit, given all the money we’re receiving and the national attention that she’s getting now,” Amanda Chitsey told McKnight’s. “I’m overwhelmed at this point, but I think there are enough people in every state who are in the same predicament as the ones that we see every week.”