P.O. Box 168, Pleasant Hill, TN 38578 931-277-3518 UPLANDSVILLAGE.COM April 19, 2018 Vincent Davis, State Survey Agency Director 665 Mainstream Drive, 2nd Floor Nashville, TN 37243 Dear Mr. Davis, On behalf of Uplands Village and Wharton Nursing Home, we appreciate the opportunity to submit this request for $33,720.00 to utilize civil monetary penalty funds. If approved, funds will enrich the quality of life of nursing home residents by establishing training focused on resident-centered care. We believe that every nursing home resident has the right to choice, dignity, respect, self-determination, and purposeful living, and want to empower our staff by giving them the tools, resources, and inspiration to make that happen for every resident. “Culture change” is the common name for a global initiative focused on transforming care, as we know it, for elders and other individuals living with different cognitive, developmental, psychological, and physical abilities. It advocates for a shift from institutional models of care to person-directed values and practices. Person-directed care is structured around the unique needs, preferences, and desires of each individual. Through this approach, decisions and actions around care honor the voices and choices of care recipients and those working most closely with them. The keystone of this proposed project is a comprehensive educational experience developed by The Eden Alternative ® entitled Certified Eden Associate Training. This 3-day training illustrates the importance of the particular well-being of each individual and qualifies nursing home employees to initiate the culture change journey in their organizations. Nursing home employees leave the training feeling empowered and inspired to customize care based on the needs of the individual. Uplands Village and Wharton Nursing Home are committed to maintaining and consistently revitalizing an awareness and application of the Eden Alternative principles. It requires being vigilant and prepared to bring new employees into the process. We are striving to certify at least 75% of our employees, and will hold four 3-day trainings on site in which participants will be immersed in what it means to give and receive dignified and respectful treatment. On behalf of Uplands Village and Wharton Nursing Home, thank you in advance for your review and consideration, resulting in final approval of this request. Sincerely, Louise Buckner, RN, LNHA, Uplands’ Director of Health Services EIN 62-0479194 Uplands Village/Wharton Nursing Home 1
20
Embed
The Eden Alternative Certified Eden Associate Training.€¦ · The Eden Alternative® entitled Certified Eden Associate Training. This 3-day training illustrates the importance of
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
P.O. Box 168, Pleasant Hill, TN 38578 931-277-3518
UPLANDSVILLAGE.COM
April 19, 2018
Vincent Davis, State Survey Agency Director
665 Mainstream Drive, 2nd Floor
Nashville, TN 37243
Dear Mr. Davis,
On behalf of Uplands Village and Wharton Nursing Home, we appreciate the opportunity to
submit this request for $33,720.00 to utilize civil monetary penalty funds. If approved, funds
will enrich the quality of life of nursing home residents by establishing training focused on
resident-centered care. We believe that every nursing home resident has the right to choice,
dignity, respect, self-determination, and purposeful living, and want to empower our staff by
giving them the tools, resources, and inspiration to make that happen for every resident.
“Culture change” is the common name for a global initiative focused on transforming care, as we
know it, for elders and other individuals living with different cognitive, developmental,
psychological, and physical abilities. It advocates for a shift from institutional models of care to
person-directed values and practices. Person-directed care is structured around the unique needs,
preferences, and desires of each individual. Through this approach, decisions and actions around
care honor the voices and choices of care recipients and those working most closely with them.
The keystone of this proposed project is a comprehensive educational experience developed by
The Eden Alternative® entitled Certified Eden Associate Training. This 3-day training illustrates
the importance of the particular well-being of each individual and qualifies nursing home
employees to initiate the culture change journey in their organizations. Nursing home employees
leave the training feeling empowered and inspired to customize care based on the needs of the
individual.
Uplands Village and Wharton Nursing Home are committed to maintaining and consistently
revitalizing an awareness and application of the Eden Alternative principles. It requires being
vigilant and prepared to bring new employees into the process. We are striving to certify at least
75% of our employees, and will hold four 3-day trainings on site in which participants will be
immersed in what it means to give and receive dignified and respectful treatment.
On behalf of Uplands Village and Wharton Nursing Home, thank you in advance for your review
and consideration, resulting in final approval of this request.
Sincerely,
Louise Buckner, RN, LNHA, Uplands’ Director of Health Services
Name of the Management Company: ___________________________________________________
Chain Affiliation (please specify) Name and Address of Parent Organization: __________________
Outstanding Civil Money Penalty? Yes No
Nursing Home Compare Star Rating: ______ (can be 1, 2, 3, 4 or 5 stars)
Date of Nursing Home Compare Rating: ____ /____ /_______ MM DD YYYY
Is the Nursing Home in Bankruptcy or Receivership? Yes No
If an organization is represented by various partners and stakeholders, please attach a list of the stakeholders in the appendix.
NOTE: The entity or nursing home which requests CMP funding is accountable and responsible for all CMP funds entrusted to it. If a change in ownership occurs after CMP funds are granted or during the course of the project completion, the project leader shall notify CMS and the State Agency within five calendar days. The new ownership shall be disclosed as well as information regarding how the project shall be completed. A written letter regarding the change in ownership and its impact on the CMP Grant application award shall be sent to CMS and the State Agency.
Part III: Project Category
Please place an “X” by the project category for which you are seeking CMP funding.
Direct Improvement to Quality of Care
Resident or Family Councils
Culture Change/Quality of Life
Consumer Information
Transition Preparation
8
Uplands Village/Wharton Nursing Home 4
POLICY 03
Object
Line-item
Reference
EXPENSE OBJECT LINE-ITEM CATEGORY 1
(detail schedule(s) attached as applicable)GRANT CONTRACT
GRANTEE
PARTICIPATION TOTAL PROJECT
1 Salaries2$20,196.00 $20,196.00
2 Benefits & Taxes$0.00 $1,552.00 $1,552.00
4, 15 Professional Fee/ Grant & Award 2 $4,000.00 $0.00 $4,000.00
16 Specific Assistance To Individuals2$0.00 $0.00 $0.00
17 Depreciation 2 $0.00 $0.00 $0.00
18 Other Non-Personnel 2 $29,350.00 $515.00 $29,865.00
20 Capital Purchase 2 $0.00 $0.00 $0.00
22 Indirect Cost (% and method)$0.00 $0.00 $0.00
24 In-Kind Expense$0.00 $0.00 $0.00
25 GRAND TOTAL$33,720.00 $22,263.00 $55,983.00
ATTACHMENT 2
GRANT BUDGET
(BUDGET PAGE 1)
2 Applicable detail follows this page if line-item is funded.
1 Each expense object line-item shall be defined by the Department of Finance and Administration Policy 03, Uniform Reporting Requirements and Cost Allocation Plans for Subrecipients of Federal and State Grant Monies, Appendix A. (posted on the Internet at: https://www.tn.gov/assets/entities/finance/attachments/policy3.pdf).
Uplands Village/Wharton and Welness Homes
APPLICABLE PERIOD: The grant budget line-item amounts below shall be applicable only to expense incurred during the period
beginning DATE, and ending DATE.
Uplands Village/Wharton Nursing Home 6
Uplands Village
SALARIES AMOUNT
Uplands Village will incur the cost of all salaries, including the on-staff Eden Educator and replacement staff to cover staff in training
51 x 16.5 x 24 hrs. + 1551.73 (Longetivity, if applicable) $21,747.70
ROUNDED TOTAL $21,748.00
AMOUNT
$4,000.00
ROUNDED TOTAL $4,000.00
AMOUNT
$0.00
ROUNDED TOTAL $0.00
AMOUNT
$0.00
ROUNDED TOTAL $0.00
AMOUNT
$0.00
ROUNDED TOTAL $0.00
AMOUNT
$0.00
ROUNDED TOTAL $0.00
AMOUNT
$29,720.00
ROUNDED TOTAL $29,720.00
AMOUNT
$0.00
ROUNDED TOTAL $0.00
No request
SPECIFIC, DESCRIPTIVE, DETAIL (REPEAT ROW AS NECESSARY)
No request
This request is for all supplies, textbooks, meals and snacks, and certification with the Eden Alternative for 74 participants
No request
CAPITAL PURCHASE
OTHER NON-PERSONNEL
DEPRECIATION
SPECIFIC ASSISTANCE TO INDIVIDUALS
INTEREST
TRAVEL/ CONFERENCES & MEETINGS
PROFESSIONAL FEE/ GRANT & AWARD
ATTACHMENT 2 (continued)
GRANT BUDGET LINE-ITEM DETAIL
(BUDGET PAGE 2)
The cost for the third-party evaluator is $4000.00
No request
Uplands Village/Wharton Nursing Home 7
Funding
The proposed budget for this project is Attachment 2. We are requesting grant assistance for
training of 50 direct care staff, 16 ancillary staff (including administration), and 8
residents/elders and family members.
Training evaluation journals are $5 each x 74 = $370.
The Total for Supplies is $370.
The cost for the third party evaluator is $4,000.
The Total for Professional Fee/ Grant & Award is $4,000.
The first of four Certified Eden Associate Training events will include an educator from The
Eden Alternative, assisted by Uplands Village’s Certified Eden Educator. This event is $495 per
person plus $60 for meals. $555 per staff person x 21 people = $11,655. The Eden Alternative
offers a special rate for Elders and their family members of $100 per person. We added $60 each
for meals. $160 per Elder/family member x 2 = $320. In addition, we added $20 a day for meals
3 days for the 2 Eden Educators and 1 support staff = $180. The first event totals $12,155.
The three remaining Certified Eden Associate Training events will be conducted by Uplands
Village’s Certified Eden Educator. These events are $299 per person plus $60 for meals. $359
per staff member x 45 = $16,155. $160 per Elder/Family Member x 6 = $920. In addition, we
added $20 a day for meals for 3 days for the Eden Educator and 1 support staff = $120. The
remaining 3 events total $17,195.
The Total for Training is $29,350.
As the grantee, we are covering the cost of training for at least 1 board member totaling $515.
Uplands Village will absorb the salaries of additional staff necessary to cover the shifts of
training participants as well as the on-staff Eden Educator. This totals $21,748
Total Grantee Participation is $22,263.
Total Request: $33,720
Total Grantee Participation: $22,263
Total Project: $55,983
Uplands Village/Wharton Nursing Home 8
Job Descriptions for Key Personnel
Lisa Norris, R.N, is a certified Eden Educator and the Project Coordinator for Uplands Village.
She will attend, assist, and/or teach all four proposed trainings as well as make all necessary
preparations. She will coordinate with the Eden Educator from the Eden Home Office, and
working with Human Resources and Staffing Managers, Resident Councils, and Volunteer
Organizations to identify participants in the Eden Alternative training. Lisa will also be
responsible for all training reports to the Eden Home Office and grant reports required.
Meredith Martin, Education Coordinator for The Eden Alternative, will be responsible for
conducting the first proposed Certified Eden Alternative Training 3-day session according to the
standards of the Eden organization, send required materials back to Eden Home Office (EHO),
and provide feedback to the EHO post training. She will work with Lisa Norris to help Lisa
refresh her Educator skills.
George Chitiyo, Ph.D., Associate Professor, Educational Research and Evaluation, will
coordinate evaluations of the proposed project goals including pre- and post-training tests,
verifying establishment of on-going contact and discussion between trained associates and within
the organization, conducting focus groups to evaluate post training staff attitudes and practices
toward care and aging, and presenting a written report. Dr. Chitiyo earned his B.S. and M.S.
degrees from the University of Zimbabwe and his Ph.D. from Tennessee Technological
University. He has authored or co-authored numerous articles in such publication as the Journal
of Pediatric Nursing and Jamba: Journal of Disaster Risk Studies as well as presented papers on
evaluation and assessment at professional conferences. Dr. Chitiyo also developed the Patient
“Lightening-Up” Rating Scale (PLRS) Alzheimer’s patients’ response to therapy (December,
2016) and developed instruments to assess the effectiveness of a peer mentoring program among
minority students at Tennessee Tech University, 2013-2015.
Biographical Sketch for Currently Employed Key Personnel
Lisa J. Norris, RN, and Uplands Village’s Certified Eden Educator, received her Associate
Degree in Applied Science in Nursing in 2000 from Roane State Community College in
Tennessee. She was licensed as a registered nurse in 2000 (License # 129220). She worked as a
Skilled Unit Coordinator of a 53 Bed Unit at Life Care Center of Sparta, TN, before joining the
nursing administrative staff at Uplands Village. Since 2003, Lisa has worked as Uplands’
M.D.S. Coordinator, the Director of Nursing at Wharton Nursing Home, Director of Home
Health Services for the independent elders in the retirement community, and Culture
Change/Staff Development Coordinator. She became a Certified Eden Educator in 2012. Lisa
also holds Basic Life Support certifications in CPR and Emergency First Aid Instruction (2010)
and Facility Supervision (2002) from the Tennessee Health Care Association.
Lisa earned a Certificate of Achievement in Reframing Dementia: An Eden Alternative
Perspective in 2017, and successfully completed Dementia Beyond Drugs: Changing the
Culture of Care with Dr. Allen Power in 2013.
Uplands Village/Wharton Nursing Home 9
Involved Organizations
Uplands Village George Chitiyo, Ph.D.
Lisa Norris, RN, Eden Educator Independent Consultant
P. O. Box 168 Associate Professor, Education Research &