Turnaround

Fixing McFarland nursing home

The County commissioner responsible for the McFarland Memorial Nursing home admits it has its share of challenges, but says overall care at the facility is good and getting better. Susan Turnbull points to improvements in resident care measures—the case-mix index(CMI) and resident satisfaction—as positive indicators of improving performance.

Turnbull has been under fire since December when it was revealed that the municipality was paying $600,000 for two contracted administrators for the home after it terminated the chief administrator and director of care late in 2014. Together, the departed staff members earned less than half this amount.

In October, a provincial inspection report was critical of certain procedures and process at the facility. Council balled the two issues together and then balked at Turnbull’s proposed solution.

Turnbull acknowledges the fact that there are issues at the home—some structural, some systemic—but she rejects the notion that they are outside the norm for a facility of this kind.

She says the building is showing its age, the hallways are too narrow and it is difficult to maintain. Keeping up with provincial requirements for documentation is also an ongoing challenge, but doesn’t reflect the quality of care the care residents receive in the home, according to Turnbull.

But it could impact McFarland’s provincial funding,which is why, during budget deliberations, Turnbull proposed creating a new Care Co-ordinator position to ensure documentation requirements were met—a key criticism made by provincial inspectors. Council rejected Turnbull’s recommendation, arguing that the high-priced contracted administrators could do this job.

The commissioner says council knew more than a year ago how much the County was paying St. Elizabeth’s for the interim administrator and director of care. She says council was fully briefed in a closed session in December 2014, including details on the length of the contract. Council authorized the contract that night. It should not have been a surprise a year later.

She praises the work of the contracted administrators assigned to McFarland and the responsiveness of St. Elizabeth Health Care.

With the sudden departure of the administrator and director of care, the municipality had to scramble to find people to fill these spots. Provincial regulations require that these positions are filled and onsite.

Calls to a handful other facilities and agencies failed to produce folks with the qualifications needed. St. Elizabeth, however, pulled two people from other assignments and had them in place at McFarland the following Tuesday.

“St. Elizabeth came to the plate,” said Turnbull. “When everyone else declined.”

She says the interim administrator and director of care have done a good job under trying circumstances, and have managed to improve McFarland’s overall quality of care.

“The challenge is keeping it there,” said Turnbull.

But the instability and upheaval has been difficult on staff. There remain some long-term challenges. Not the least of which is that the McFarland home must be thoroughly remodelled within the next ten years, according to province. This will require a major structural reconstruction— or perhaps a new building altogether.

Before that, however, the municipality must stabilize the administration of the facility. St. Elizabeth’s contract expires in June.

Last week, council agreed to recruit and hire a chief administrator and director of care. They hope to accomplish this prior to May to ensure a smooth transition. But it may not be easy to fill these positions.

Turnbull worries that it could be a challenge finding the right mix of qualifications, including a proven ability to improve quality, demonstrated ability to engage staff and good core skills.

She says these skills will be necessary to effect the quality improvement plan she wants to see shape this facility and it operations. There are no quick fixes— Turnbull expects this program will take five to seven years to be fully implemented.

In the meantime, Turnbull is committed to improving communication with residents, staff and council.

“Our staff care deeply about the people we care for,” said Turnbull. “That will never change.”