Long Term Care staff awarded for excellent quality of care

At the Alaska Hospital and Health Care Association (AHHA) conference in Girdwood last month, Petersburg Medical Center Long Term Care received the top award of Excellence in Quality for the 2023 Nursing Home Quality Awards.

The Alaska Nursing Home Quality Achievement Award was bestowed to PMC by Mountain Pacific, a nonprofit corporation that oversees the quality of care for Medicare and Medicaid members through federal and state contracts, as a Gold Pan award for the quality of care delivered to patients in long term care.

Present PMC staff members did not know they would receive the award at the conference, but reported feeling excited and pleased that the care and commitment of the Long Term Care team had gained this recognition. Chief Nursing Officer Jennifer Bryner and PMC CEO Phil Hofstetter accepted the award on behalf of the PMC team.

"The nursing staff really deserves the credit, you know," Hofstetter told the Pilot. "It's the nurses, it's the CNAs taking care every single night, day, weekend, that really should get the recognition for an award like that. They do all the hard work ... A long term care CNA is one of the most challenging positions."

LTC Activities Coordinator Alice Neidiffer told the Pilot that on a given day, there is one nurse staffed in long term care, two CNAs -certified nursing assistants- staffed, and two activities assistants, counting herself as one. Two of the three in the activities department are also CNAs, meaning they are properly equipped to "jump in and help out ... so really, you've got five people working the floor for 14 residents," which she said is relatively unheard of in other long term care facilities.

"You know, when I think about the quality of care our residents are receiving, one thing that really comes to mind is ... we have a phenomenal staff to resident ratio here."

Neidiffer said, from her perspective, "you're going to see better care when you have that increased one-on-one time with your residents."

"We get to know each of their individual preferences, what their needs are. All the way up from, like, administration's involvement, they get to know our residents. The physicians know. Our residents, the nurses, the CNAs, the activities, the dietary team, the rehab team - they know what our residents like, they know what our residents need, they know ... cultural things about our residents that play a role in the quality of care they get," she explained. "And part of that, we see just because we're in a small town and a lot of these people are local, and we've known them throughout our life spans. But we have a really great staff here that works incredibly hard."

"It's wonderful that we were recognized ... I'm happy that long term care was recognized. The quality of care is fantastic in our facility, in our long term care residents, you know," Hofstetter continued. "And a lot of that has to do with people from the community taking care of residents. It's a strong point."

Neidiffer told the Pilot that LTC is always looking for more members of the community to visit or volunteer. Her primary goal is not to just "get a ton of volunteers" into LTC, but is rather about making an effort to slowly get the community back into long term care - especially in the wake of lifting COVID restrictions.

LTC shut down a lot during COVID times, she told the Pilot. Now that restrictions have lifted and opened things back up, Neidiffer is "trying to get that community presence built back up," because it is important for the wellbeing of residents in long term care.

A call is out for more people to attend "little events that we have..." like visiting for trick or treating on Halloween "...to try and get our long term care residents more familiar with the community and, vice versa, our community more familiar with who we have in long term care."

Neidiffer said there are "tons of volunteer opportunities" at LTC, suited for any degree of responsibility.

"We can help get you certified to drive our van so that you can take the residents on van rides around town ... [or] something less committal, like coming in to play music or to share stories with the residents, coming in to run game night, little things like that," she said.

Attending one of the weekly activities - like Friday morning bingo, manicure Mondays in the LTC salon, or scrabble on Wednesday afternoons, to name just a few - "gives the community an opportunity to start to meet our residents - start to understand what long term care currently looks like."

During the summertime, beams of sunlight shine through the expansive windows of the beloved solarium where LTC residents enjoy spending time gardening. The plants do really well, and to their benefit, so do the gardeners.

"It's an easy place for a lot of our residents to garden, which they all really enjoy," explained Neidiffer.

People could look out the window while eating at the dining table set up there, and staff could have their meetings in the space as well.

Being a generally cooler space in comparison to the rest of LTC, Neidiffer said the solarium has "been a nice place for people to work out," and an exercise bike called a New Step was located out there for residents to use.

"It's hard to fully capture the calming or soothing potential of the solarium in its current state with the guys working on it and it's all torn apart and whatnot. But truthfully, the solarium has so much potential to be just like a nice calm place, especially when we have all the plants in it ... it can be a great place. But, we don't have a solarium right now."

On Aug. 17, black mold and rot was discovered in the solarium.

Hofstetter explained that the many windows of the solarium had some seals where water slowly leaked in.

The sheetrock's waterlogged or rotten appearance was brought to attention while cleaning the space a few months ago. "And then as we looked at it closer, we asked facilities to come in and take a look, and we recognized there may be some mold," he said.

The space was consequently sealed off from use.

"We shut everything down in that area..." said Hofstetter.

"We had to cut our gardening season a little bit short," said Neidiffer.

"...Closed it off, and then had somebody locally assess the location of the mold and we needed to get it fixed," he said. "They're doing that right now."

Bob Olsen and his crew are working on the project and are replacing the seals to prevent problematic leakage from repeating. Hofstetter said they redid and replaced the structure with wood and are "renovating that whole area... it's almost done, actually. They did a really good job. There's a couple of areas we noticed that there's still some leaks, so he's gonna work on that."

In the 1960s, the Long Term Care facility was the oldest part of the building; old equipment remains post-renovation, like the wheel-and-pulley mechanical elevator that is still operational and hauling food up and down for LTC.

"We've had to make a couple little renovation-type things," Neidiffer said in regards to how the LTC facility has had to adapt in lack of the solarium. "For starters, we had to move our exercise bike into like one of our living spaces for the residents." The exercise bike resides beside two recliners in front of the television in a common use area, "because we just don't have any other space for it at this time."

Two to three bookcases that LTC had in the solarium were lost when the issues in the solarium were beginning to be uncovered. Rot that had accumulated in the solarium's structure from years of water leakage, had taken to the bookcases as well.

"Not only do we not have that space now - now we don't have that space to store things," said Neidiffer. From big things like the exercise bike and extra dining table, to small things like books, games and puzzles, "We lost a lot of storage when we lost the solarium."

She said they have had to make-do and try to "disperse things appropriately" by moving some of those smaller items into the very small LTC resident hair salon, or in the old-shower-room-turned back storage closet - or even Neidiffers office, which is "even more storage now than it was, you know, beforehand."

Neidiffer took a moment to look at the challenge from a different angle.

"It's given a great opportunity to thin things out where things aren't so much needed," she said, but added, "It's hard to get rid of anything as it is for anyone... you never know what can be applicable in the future."

Overall, "things are getting pretty cramped" in the Long Term Care facility. Right now, there are 14 residents in long term care, "and it's not a big space to begin with." The rooms are small, and losing the solarium has tightened the area of LTC that was once "a bit of a more open space."

"We're just trying to navigate that," Neidiffer said.

"It's so small. It's so small," said Hofstetter. He raised the point that the extremely limited space that LTC currently has to work under begs the need for a new hospital facility.

"You're at the end of your life, and you're at your most vulnerable, and you're living in our residence, and you're only living at 200 square feet."

"It's challenged with funding and challenged with space, and the ... aging facility ... just makes it that much more difficult," said Hofstetter.

But while the long term care facility leaves much to be desired and is in some ways in dire condition, the quality of care the patients receive - as highlighted by last month's statewide excellence recognition - goes a long way to make up for it.