Confident Choices for Senior Living

1. Confident Choices for Senior Living Volunteer Reviewer Training June 10, 2010

2. Overview of the Training • Very brief review of the application requirements • Description of the review of the written application • Role of staff, district coordinators and volunteer reviewers • How to conduct the on-site review • Tips from experienced reviewers • Questions

3. Confident Choices Application Requirements Must meet the Core Requirements: • Adoption of Code of Ethics (or equivalent) within the past 2 years • Housing Manager has at least one year of experience and commitment to ongoing training • Resident (or Family) Satisfaction Survey within the past year • Current Resident Handbook and a process for welcoming/orienting new residents • Must comply with applicable codes/licensing requirements, have emergency plans, provide emergency information to residents, hold required fire drills, conduct at least 1 drill for weather or other emergencies at least annually • If applicable, adoption of Dementia Care Guidelines (or equivalent) within the past 2 years

4. 1) Quality of Care and Services—Applicants mustaddress at least 2 of the following electives: Clinical performance Improvement plans (evidence of regularly monitoring clinical outcomes) Non-clinical performance Improvement plans (evidence of regularly monitoring non-clinical services or outcomes, such as staff turnover, food satisfaction, completion of work orders, etc.) Systems or established relationships with other providers to assure coordinated transitions for residents Quality dashboard (progress toward meeting key measures/goals) Continuous Quality improvement process that involves residents and/or families Confident Choices Application RequirementsMust meet at least 9 of 23 Elective Requirements in 5 different categories

5. 2) Open, Effective Communication—applicants must address both of these electives: Resident/family meetings or councils are regularly scheduled System to regularly communicate with residents and/or families (newsletters, etc. Confident Choices Application Requirements

6. Confident Choices Application Requirements 3) Resident Health, Wellness and Life Enrichment—applicants must address at least 2 of these electives: • Resident Education and learning enrichment programs • System for integrating residents in the broader community (outside the building—as appropriate) and for referring residents to other service providers as needed • Opportunities for resident socialization and recreation within the building and involving external programs or groups as appropriate • Fitness/wellness programs and building takes active steps to encourage resident wellness (physical, mental, spiritual) • Resident-centered technology • Care conferences are scheduled regularly

7. Confident Choices Application Requirements 4) Staff Satisfaction and Development—applicants must address at least 2 of these electives: • Staff satisfaction survey within the last year with a response rate of at least 50% and an action plan to address any issues • Available ongoing education and training opportunities for staff beyond mandatory requirements • Formal staff orientation process • Program to address team building, staff recognition and staff morale • Regular staff meetings in which line staff are able to identify concerns • Exit interviews with departing staff to get feedback for improvement and increased staff morale

8. Confident Choices Application Requirements 5) Community Connectivity, Benevolence & Innovation—applicants must address at least 1 of these electives: • Social accountability programs to demonstrate commitment and investment in the larger community • Benevolence fund to assist residents or staff in need • Implementation of an innovative program, procedure or physical plant design • Use of volunteers to enhance services for residents.

9. Confident ChoicesApplication Process • Members can check with staff to see if their Code of Ethics, Guiding Principles for Dementia Care are current (update required every 2 years) • Code of Ethics and Dementia Principles information is on www.leadingagemn.org (under “Quality Initiatives”) • Members can request a Confident Choices application packet or can find the application and instructions on the web site • Application fee must be with submission: • LeadingAge Minnesota members-initial fee $150; if not approved and re-apply within one year $100. Member renewal fee is $75. • Non-members – initial fee $300 and if not approved and re-apply within one year $250. Non-member renewal fee is $250.

10. Review of the Written Application • Staff reviews the written application for completeness (no judgments are made on the quality of the statements): • Whether the core requirements have been met • Whether at least 9 elective requirements have been addressed • Staff will contact the applicant and hold the application if there is an oversight that is easily corrected • If requirements have not been met, staff will contact the applicant and provide technical assistance if they want to re-submit

11. Next Steps for Complete Applications • In districts with a coordinator, staff notifies the coordinator that an application is ready for review • Either District Coordinator or LeadingAge MN staff identifies 2 reviewers for the on-site review • Both the applicant and the reviewers are asked about any conflict of interest—applicants may request other reviewers if a conflict is identified • If no conflict of interest, staff sends the reviewers copies of the application and review forms. • The lead reviewer coordinates the site visit date with the applicant.

12. Important Roles • LeadingAge Staff—review applications for completeness, correspondence with applicants, questions • District Coordinators in Districts C and F (or LeadingAge staff) • Assign volunteer reviewers • Check for conflicts of interest • Help recruit new reviewers • Ambassador of Confident Choices program • Volunteer Reviewers • Review the written application and identify questions or programs to review on-site • Conduct site reviews • Complete review forms and make recommendations • Ambassador of Confident Choices program

13. Program Integrity Confidentiality Statement • Requirement for both District Coordinator and Volunteer Reviewers • Review and sign as part of the reviewer training Conflict of Interest Statement • Reviewers sign one for each building they will visit • Applicants are asked to indicate if they have a concern about an assigned reviewer • If conflict of interest is declared must be explained fully • Return statement to LeadingAge staff prior to the visit No Gifts (a drink and light snack may be accepted)

14. The On-site Review • Reviewers send LeadingAge staff their conflict of interest forms prior to the visit • Prepare by reviewing application prior to site visit—identify documents or programs you want to review on-site • Lead reviewer schedules visit with the applicant and asks the applicant to have identified documents available for review. • During visit, reviewers verify information on the application • Ask to see documentation as appropriate • Tour the common areas, grounds (if possible) and parking lots. • Complete review forms with recommendations • Identify any best practices

15. Confident Choices On-Site Review • Purpose of the on-site visit • Verify what the provider submitted in the application • Ensure validity and integrity in this process • Key question: “Does the Confident Choices designation belong on this building?” • NOT intended to be • Prescriptive: we aren’t there to tell them how to do “it,” just that they are doing “it” • A “survey” in the sense that we have come to know it

16. Key Points to Remember • Focus on common areas • You don’t need to go into resident apartments—but it’s often hard to avoid politely • Be friendly to residents, family members and staff, but do not interview them • Don’t just focus on what you might see, but also what is done about it – for example, spills on floor

17. Key Points • Keep local standards in mind – what is appropriate for the Twin Cities may not be appropriate for a small community in greater MN (and vice versa) • Keep resident population and customer requirements in mind • This is intended to be a collaborative process; work with the housing director, ask questions • End result is a “yes” or a “no,” not a score or statement of deficiencies

18. Key Points • Remember that you are not a consultant and to check for your biases – just because you wouldn’t do “it” that way, doesn’t mean it is wrong • Visit estimated to be an hour in length, may be two hours if building/campus is large • Each HWS building must apply separately, but visits to several buildings on a campus or buildings that share common policies and programs may be coordinated and streamlined. Talk to LeadingAge staff if you have questions about a visit to multiple building sites.

19. At the End of the Site Visit • Reviewers should tell the applicant that LeadingAge Minnesota will notify them whether they will receive the Confident Choices designation. • Reviewers should go off-site to complete the review form together, including a recommendation on whether the applicant should be a Confident Choices designee. • Include notes on any best practices • Positive comments will be shared with the applicant • Make sure notes are legible! • The lead reviewer sends the completed full review form with all the reviewers’ comments to LeadingAge staff. • Reviewers send LeadingAge Minnesota their expense statements (we coverage mileage and meals)

20. If the Recommendation is “Yes” • LeadingAge staff will prepare a letter notifying the applicant that the building has received the Confident Choices designation • Successful applicants will receive a marketing packet and plaque with a “slider” indicating the time period for their designation. • LeadingAge staff will follow up with the applicant on any best practices the reviewers have identified

21. If the Recommendation is “No” • If, after the site visit, you honestly feel as though this applicant does not deserve the Confident Choices designation, contact LeadingAge staff right away and discuss your concerns and observations. • In consultation with the District Coordinator (if any) and other members, LeadingAge staff will make the final determination on how to proceed. One possibility might be a second site visit. • If the applicant is unsuccessful, staff will communicate that to the applicant and will offer technical assistance.

22. Tips for Reviewers • Providers are proud of their buildings and will want to give you the “marketing” tour, but watch your time and stick to things on the application that you need to verify • Ask to actually SEE key documents or related materials that support the information on the written application (cue the applicant ahead of time re: what documents you will want to review). But watch your time—you don’t need to examine everything. • Ask questions to see if a program described in the application is actually up and running. Don’t give the applicant credit for things they are planning to do in the future. The application needs to be judged on what is currently being done.

23. Tips for Reviewers • It can be helpful if one of the reviewers leads the conversation while the other reviewer takes notes. Work this out ahead of time—new reviewers might want to be the note-taker. • Keep the conversation friendly—this is not a survey. To help your conversation along, use leading phrases like: • “Tell me about your . . .” • “What have you done with your survey results?” • Remind applicants that you are not judging the QUALITY of their program or process, just verifying what they described in their application. • Try to schedule your on-site review for times when activities are going on in the building and residents are present.

24. Tips for Reviewers • If, for your own information apart from the CC review process, you want to ask more detailed questions about a program, say, “I’m curious, this has nothing to do with the CC review, but can I ask you. . .” • If you are offered some sort of gift or souvenir from the establishment, please nicely tell the applicant of the Confident Choices “no gifts” policy for volunteer reviewers to protect the integrity of the program--but, feel free to accept a drink and a light snack. • Applicants will ask you whether they “passed.” Tell them: “We need to finish our review forms and submit them to LeadingAge Minnesota. LeadingAge Minnesota will contact you with the results very soon.”

25. Why Be a Volunteer Reviewer? Our reviewers noted the following benefits they’ve personally found from doing site visits: • You get great ideas to take back to your own community • You’re inspired to look at your own practices differently • Just expanding your knowledge about senior communities is helpful • It’s great being exposed to so much “good news” • Networking--Getting to know your peers is always a benefit • It’s a great opportunity to develop a relationship with your reviewer partner

26. Before your first site visit: • Sign the confidentiality statement and return it to LeadingAge staff • Sign a conflict of interest statement for the site you will review; return statement to LeadingAge staff • Review written application prior to site visit • Complete the final review form off-site with your partner and send completed form to LeadingAge staff. Note: Whenever possible, we hope to partner new reviewers with an experienced reviewer.

27. Documents and Forms to Review • Roles/responsibilities of District Coordinators and Volunteer Reviewers • Confidentiality Statement • Conflict of Interest Statement • Application Review form • Checklist with tips • Reviewer expense form

28. Questions??? Feel free to contact Mary Youle at myoule@leadingagemn.org or 651.645.4545