ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, April 28, 1996 TAG: 9604270015
SECTION: BUSINESS PAGE: 1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
In its fourth year, the Virginia Veterans Care Center in Roanoke appears to have grown up - almost.
Two new managers are in place. Andrew Vinson of Catawba became executive director in September, representing the board that oversees the state-owned facility. Last week, Bob Gerndt, a Botetourt County resident, took over as administrator for Diversified Health Services Inc., which manages the home.
Virginia Veterans Care Center, adjacent to the Veterans Affairs Medical Center in Salem, was built by the Department of Veterans Affairs and given to the state to operate.
It is Virginia's experiment in privatization and that has been part of its problems. It was slow to fill up its 240 beds after it opened on Veterans Day in November 1992, reaching capacity after an aggressive marketing campaign.
But residents outpaced the facility's ability to hire staff, and there was turnover of management for the state and the management company and even a squabble among the state-appointed board members.
Sen. Malfourd Trumbo, R-Fincastle, who was named to the board last year, described the center as no longer a new baby, but an infant "starting to squall."
The place was without an executive director for many months, which allowed a board member, Michael Fries of Botetourt County, to gain considerable power over the home's operations, and to use that power incorrectly, according to some of the residents.
After charges of verbal abuse of some residents, Fries was barred from the facility and asked to resign from the board.
At the same time, residents and their families complained loudly about inadequate staffing and bad food. The place that was to be a model for future nursing homes seemed anything but that.
After an inspection last August, the home was warned that if it didn't make changes it could lose its status to admit patients whose bills are paid by the federal Medicare/Medicaid programs. In October, during a surprise inspection, state officials found a number of deficiencies still existed, but enough had been corrected to bring the home into "substantial compliance."
Still, an administrator who arrived in February 1995 was asked to leave earlier this year. The administrator's "management style" didn't fit, said a Diversified official. |n n| Gerndt, who has worked in nursing homes since 1978, said he's undaunted by the Virginia Veterans center's past.
"This facility was envisioned as a premier facility," he said. "For any long-term care facility, that is a difficult goal."
Gerndt comes from a similar privatization project. For the past 61/2 years, he ran Lynchburg's city nursing home. For the past year, he worked with the private company that took over the city nursing home.
What he learned there should help him meet the challenges at the veterans center, Gerndt said.
He also said that he took the position only after he was convinced that the state board management and the private management company had "congruent goals."
They do, and improved food service and adequate staffing are tops among them, according to Vinson, the executive director.
Vinson said he came to the center last year with goals to improve patient care, dietary services and housekeeping.
Recently, he got Diversified to agree to a specific staffing level. Regulations require minimal staffing; Vinson wanted better. He particularly wanted to be sure the home was not short-staffed on the 11 p.m. to 7 a.m. shift which often didn't have enough workers when employees called in sick or didn't show up for work.
Diversified responded, too, by hiring a nurse in charge of improving quality. It also added a volunteer coordinator and a part-time admissions nurse.
Housekeeping was improved by shifting more staffers to weekend duty. Weekends are the home's busiest time because that's when residents have guests.
"We all understand better what the goal is," Vinson said.
Despite the problems, Virginia Veterans Care Center has been profitable. Reports to the state show that Diversified earned a net profit of $696,000 in 1995, which represented an almost 11 percent return on investment and was comparable to the nursing home industry average.
The food service problem has been the most difficult to turn around, and still isn't resolved, Vinson said last week.
Food service surveys still show little aggravations such as condiments not being put out for residents to use and wet dishes. Vinson had a food service quality improvement council of two residents and three wives of residents helping him work on the food problem.
The home was built without a full kitchen and instead used a system in which prepared food was cooked and then cooled and held to be reheated at mealtimes. It took three years to get a kitchen, so making it work right won't happen quickly, Vinson and Gerndt agreed.
They also have agreed to seek certification from the Joint Commission on the Accreditation of Healthcare Organizations, a national organization. The home's board will vote in June on whether to seek the citation. The process will take three years and require considerable effort but is considered an achievement of quality.
Vinson views it as an incentive to remain a quality facility.
"To lose the designation would be the kiss of death," he said.
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Despite the problems, Virginia Veterans Care Center has been profitable. Reports to the state show that Diversified earned a net profit of $696,000 in 1995, which represented an almost 11 percent return on investment and was comparable to the nursing home industry average.
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