Nursing centers face more challenges

    I am determined, however, to look back this time next year with a sense of pride. Starting off the new year in a new role as chair of the state’s largest association of skilled nursing and rehabilitation facilities has left me a little daunted yet excited about the possibilities that lie ahead and never surer of my convictions. Collectively, my associates in 24-hour long-term care, approximately 9,000 of us in total, have our work cut out for us in the months ahead and failure is not an option.
    Nearly 9,000 of Rhode Island’s most sick, frail and injured citizens rely on the care provided in 85 skilled nursing centers throughout the state. For many, Rhode Island Health Care Association (RIHCA) facilities are places of transition between hospital and home, and for others the facilities are a place to call home for months or even years. Our services are critical for those needing rehabilitation, recuperation and convalescence following an illness or injury. The facilities are also valued by hundreds of families that are unable to provide the care to loved ones with dementia, post acute care needs or multiple medical conditions. The numbers of people depending on Rhode Island’s long-term care facilities are too vast to allow goals to be cast off with a casual maybe next year attitude.
    While 2010 was a year of transition in health care as Washington ramped up to usher in health care reform, 2011 promises more significant changes as newly elected officials begin their roles in public life. Last year, the Rhode Island Department of Human Services (DHS) put the wheels in motion for a vast retooling of the state’s long-term care reimbursement system. The quality of care of thousands of Rhode Islanders depends on the ability of our policy makers to understand a complex and ever changing system and anticipate the best way to efficiently deliver quality health care to the aged and chronically ill. With several state departments under new leadership, including the DHS and Department of Elderly Affairs, it will be a mission that comes with a steep learning curve.
    The state’s skilled nursing community is small but open, and personnel from each of RIHCA’s facilities would welcome the opportunity to help educate those unfamiliar with long-term care as to what it is we do and what our residents need.  Our part in crafting the health care system of the future relies on communicating regularly and effectively with those who set its wheels in motion.  As chair of RIHCA, that is resolution No. 1 in 2011.
    Beyond that, I believe the fundamental lesson to be shared in the coming year was most eloquently relayed by Dr. Bill Thomas, an internationally renowned geriatrician who recently spoke in Providence. Dr. Thomas pioneered the culture change movement in nursing homes, a movement aimed at making long-term care facilities less institutional and more focused on the people they care for. Culture change, he says, is about changing the balance of power in skilled nursing residences to give the elders we care for as much decision making ability as possible because everyone, even those with diminished physical and cognitive abilities, deserve to have their preferences heard. He reminds us all -- providers, policy makers, friends, and families -- that we have an important role to play in delivering a life worth living to those who place their trust in us. Keeping residents’ needs front and center while we work collaboratively to deliver quality health care is a most worthy goal and one that I am proud to promote in 2011 and all the years ahead. Have a happy and healthy new year.

    Joan M. Woods is chair of the Rhode Island Health Care Association (RIHCA), a non-profit association comprised of about two-thirds of Rhode Island’s skilled nursing and rehabilitation facilities. She is also executive administrator of Grand Islander Center Genesis HealthCare in Middletown and winner of the 2010 RIHCA Distinguished Administrator Award.