pennsylvania DEPARTMENT OF MILITARY ANDI VETERANS AFFAIRS October 12, 2023  SOUTHEASTERN VETERANS' CENTER ADVISORY COUNCIL MEETING MINUTES  The Southeastern Veterans' Center Advisory Council met October 12, 2023 at 10:00 AM via conference call. Virtual meeting was scheduled to take precautions during COVID-19 outbreak ati the facility.  Advisory Council Members Participating: Barry Amole, Vietnam Veterans of America, President Mary Archey, Marine Corps League, Vice President Kenneth Schweitzer, American Legion, Secretary Richard Doherty, Military Officers Association of America Thomas Applebach, Lehigh County Office of Veterans' Affairs Robert Richardson, Resident Representative Thomas Brown, Veterans of Foreign Wars  Department of Military and Veterans' Affair/Southeastern Veterans' Center: Richard Hamp, Special Assistant to the Deputy Adjutant General- DMVA  Barbara Raymond, BVH Director- -D DMVA Mike Hoover, Chief of Operations- DMVA Keith Mensch, Project Manager- DMVA Mia Woods, Compliance and Ethics Officer- DMVA James! Stafford, Veteran Service Specialist- DMVA Brian Gula, Commandant - SEVC Mildred Butler-Coleman, Deputy Commandant- SEVC Lauren Stenson, Director of Nursing SEVC Jill Alwine, Admissions and Marketing Coordinator-SEVC Sarah Klufas, Assistant to the Commandant-SEVC Ann Marie Grimes, Resident Representative Todd Rankin, Program Specialist, CVAMC  Visitors:  Terra! Shaner, Geriatrics and Extended Care Services Business Manager, CVAMC Beth Mazza, Representative from Senator Tracey PennyruicksOffice Gareth Orme, Representative from Senator Katie Muth's Office  Excused Absence: Jeffrey Elliot, PA. AMVETS Doug Forsythe, Disabled American' Veterans VACANT, PAI House of Representatives MG Mark. J. Schindler, Adjutant General DMVA Kenneth Nadwodny, Catholic War Veterans John Getz, Veterans of Foreign Wars The Hon. Tracy Pennycuick, PAS State! Senate Maureen Weigl, BG (PA)-DMVA Travis Davis, Executive Director, Long-Term Care- DMVA  Advisory Council Meeting October 12, 2023  Pagelof6    Call to Order:  The Advisory Council Meeting was called to order by Barry Amole at 10:00 AM. There was a moment of  silence, followed by the Pledge of Allegiance. Review and Approval of July 13, 2023, Meeting Minutes:  A motion was made by Thomas Brown and seconded by Richard Doherty to approve the minutes of the Advisory Council Meeting held on. July 13, 2023. Motion carried, and minutes were approved as written. Lauren Stenson, Director of Nursing, reported on behalf of Medical Director Dr. Violetta Berdichevskaya. We are currently experiencing an outbreak of Covid. We have 50 positive residents, 3 of which are in the hospital. Most are asymptomatic or only experiencing minor cold-like symptoms. We also have 8 positive staff members that are currently out of thei facility. We: are doing outbreak testing throughout the units, sO Most of the residents have received their flu shots that have consented. We also hosted a flu vaccine clinic for the staff yesterday. We are working on getting consents for the updated Covid vaccine and will be shortly sending out consents fori the RSV vaccine sO we can start administering both of those. Regarding staffing, we have 2 full-time CRNPS that are in the onboarding process and 1 full-time Staff Physician/ Medical Director that is also in the process of being hired. We created 12-hour shifts for RNs in the facility and are working on creating 10-hour shifts for CNAS. We are hoping by creating these flexible schedules that we will attract more candidates to the facility. We are still hopeful for a collaboration with the Reading Area Community College to become one of their clinical sites for their nursing program. Richard Doherty asked what the county Covid numbers looked like and ift the county as a whole is seeing an increase in numbers. Lauren responded that the county is seeing an increase in numbers, mostly duei to the time of year and how highly contagious this current strain is. People can test negative in the morning and  Report of the Medical Director:  we are picking up additional positives here and there.  test positive int the afternoon.  Report of the Admissions and Marketing Coordinator:  Jill Alwine, Admissions Coordinator, provided the council with an admissions update. Jill reported that for the last quarter, the facility had an average of 203 residents, leaving us with 89 vacancies. Of those vacancies, 21 are due to staffing issues, 36 are being reserved for quarantine, and 32 are because we changed our 3 and 4-bed rooms to 2-bed rooms for infection control purposes. Over this last quarter we have had 14 admissions, bringing out year-to-date to. 56 admissions. Our average occupancy rate has been 70 percent. Our waitlist currently includes 67 veterans and 11 spouses. The approximate waitlist times for skilled nursing and personal care are 4-6 months and 2-4 months, respectively. Our memory care unit is  currently about a 20-24 month wait, due to it being our smallest area. Report of the Deputy Adjutant General = General Maureen Weigl - DMVA:  Richard Hamp, Special Assistant to the Deputy Adjutant General, provided an update on behalf of General Weigl. Our budget year is going really well, and the homes have the resources that they need to provide  Advisory Council Meeting October 12, 2023  Page 2of6    good and effective care. Additionally, we. just got our summary of recoveries that the DMVA has been ablet to doi for our veterans throughout the Commonwealth and so far for our 2022-2023 result, we have recovered: al little over 970 million dollars in benefits for our veterans. Many oft these veterans live in our homes. We were at the top oft the list for all 54: states and territories, and we are very proud of that. Our  VSOs are working very hard to make sure we take care of our veterans. Report of the Executive Director, Long Term Care - Travis Davis -D DMVA: Travis Davis was unable to attend the meeting due to a scheduling conflict. Report of the Director of Veterans' Homes - Barbara Raymond - DMVA: tot the current Covid numbers, it was determined to be best to make the change.  Barbara Raymond started by stating apologizing that we are unfortunately back to a virtual form, but due Across the 6 homes, our 3 eastern homes have had some significant outbreaks. As Lauren mentioned, we currently have an outbreak at SEVC. We recently just recovered from an outbreak at our Delaware Valley facility, and our Gino. J. Merli facility in Scranton is undergoing an outbreak much like the one at SEVC. The west- side homes only have one or two positives. However, the typical pattern is that it starts int the much larger areas and pushes across the state. Our hospitals across the state are quite full of Covid- positive people. Our positive numbers for staff are not too bad. We currently only have 25 staff members that are We are offering the Covid vaccine across all 61 homes for residents and staff. The CDCi is recommending that you wait 3-4 months after you have had Covid to get the vaccine, so we are timing that out with our homes and the outbreaks. The vaccine that is available for Covid ist treating the most recent strain, XBB. Thankfully for the most part, our residents tend to be asymptomatic or only have minor cold symptoms. Flu vaccines are also being offered ati the homes with adequate participation. RSV vaccines are also available at our homes for our residents. It is up to the medical provider to determine what they would Five out of our sixi facilities, including SEVC, were noted to be in Newsweek's top nursing homes in Pennsylvania. Newsweek looks ati things like surveys, staffing numbers, and quality measures to Recent surveys have taken place at our Gino Merli facility, Hollidaysburg, and SEVC. Brian will, go into more detail about SEVC. Deficiencies were minori items that we are working continuously to improve. The DOH and' VAI look at every aspect of operations for thel home and deficiencies can be as little as a calendar Admissions are going very well at SEVC and Delaware Valley; their waiting lists are quite robust still. Some of the other facilities are: a little bit lower prior to pre-pandemic levels, but we are actively marketing our homes at events to help grow those waitlists. We did have an admissions-hold at our 3 facilities that are experiencing outbreaks. As Delaware Valley recovers from their outbreak, we will continue to admit at  positive across the homes.  consider to be 'high risk' to be eligible for the vaccine.  determine their rankings.  not being posted or food temperatures not being up to a resident's liking, etc.  that facility.  Advisory Council Meeting October 12, 2023  Page 3 of6    Five of our six facilities are 5-star rated through the Nursing Home Compare website. They are. similar to Newsweek in their ranking andi thei things they! look ati to determine these rankings. The other facility is We are actively preparing for our upcoming holiday visits from the Adjutant General. Our residents always Nothing new from a staffing standpoint; the nursing department continues to be a challenge for us across the homes. We are actively participating inj job fairs and marketing events to help improve this. We are however easily providing the level of care that our residents need. Our staffing ratios tend to be higher than the private sector. So, even though we are not at the level that we would like to be at, we are still Construction wise: we are actively building our new building for our Hollidaysburg facility. This  rated at a 4-star. We are very proud of our homes.  love seeing him and the troops coming in in uniform and they really enjoy the visit.  well above the state minimums and private sector.  construction will last at few years, but we are excited to see the outcome.  Two of our projects that we are working on ati the homes are getting funding for our residents from the PACT Act, as well as the Catastrophic IIness Act. Our revenue team is actively working with the Federal VA Beth Mazza asked Barbara to clarify who did the! 5-star rated survey fori five of our six homes. Barbara said that it was Centers of Medicare and Medicaid Services through Nursing Home Compare.  toi increase our resident's month-to month monetary revenue.  Report of the Commandant - Brian Gula-SEVC:  Brian Gula started by saying that we have received all of our regulatory annual surveys for 2023. Lifesafety conducted their survey in August. There were 9 deficiencies that were cited, all minor issues. We deem this to be a successful survey as we did not receive any deficiencies where actual harm or potential harm to the residents was determined. The Department of Health was here at the end of August to conduct their survey and we received 5 deficiencies, again, no deficiencies with actual harm or potential harm to residents. We have developed a plan of corrections and the DOH is due back any time after October 18th to review our plan of corrections and put us backi in compliance. Lifesafety was out on September 26th, reviewed all deficient areas, and put us backi in compliance for those. Earlier this year we had our Federal VA survey. We submitted our corrective action plan for that. All has been accepted, except one that is still pending due to al billing issue that we have to wait for the end of the cycle. Once this is happens, we should be cleared and placed back in compliance. The most recent survey' was on October 5th, with DHS who inspects our personal care unit. The results of that are: still pending. The surveyor was thoroughly impressed on the care that the residents are receiving, Regarding our CMS 5-star rating: as of April, we reported that we were a 3-stari facility. Upon the refresh in. July, we did achieve the top 5-star rating. We continue to monitor that and maintain the! 5-star ranking. The next refresh is due in October. Our pre-calculation is that we may see a drop to a 4-star, but we are only 11 points away from maintaining the 5-star and are confident we will be able to do: SO.  environmental services, nursing care, and administrative services.  Advisory Council Meeting October 12, 2023  Page4of6    To reiterate what Barb said about the Newsweek rankings, there were 11,000 nursing homes nationwide that they identified as top performing. Out of those 11,000, they selected 475 to be deemed the 'best nursing homes. They ranked 29 nursing homes from the 475 that are in Pennsylvania, and SEVC ranked  13th in the state.  Report of the Deputy Commandant- Mildred Butler-Coleman- SEVC:  Mildred Butler-Coleman stated that we are in the midst of having 2 new boilers installed into Coates Hall. We have been working on separating our hot water heating system from our facility! heating system. When the building was first built, they were intergraded. We are now: separating them so1 that we have better control over the system and do not have to worry about an issue with one: system interfering the We are working on getting an upgrade to increase the speed of our internet for office staff. The building will have an increased bandwidth so that staff can operate al little more efficiently at their computers. The hardware has been installed for the upgrade and we are waiting on next steps from Verizon. We had a new sidewalk poured ini front of Coates Hall and around the flagpole ini the circle to make it Our residents are using telehealth visits for psychology and psychiatry services, along with other specialties on occasion. Some of the residents like it since they do not have the inconvenience of having We installed a security gate on Brown Drive to help prevent unauthorized vehicles from coming onto the property. Staffa are able to swipe their badge to gain access. Security will also be able to monitor the gates  operations of the other.  safer for residents and staff to navigate.  to travel to and from appointments.  via a camera and even open the gates to allow vehicles in.  Comments from the Council:  Ken Schweitzer asked Barry Amole if the Legion is going to distribute finances around Christmas time like they had done in the past. Barry Amole confirmed that they will, and it is scheduled for December 7th at 10AM. Brian Gula assured Barry that he will make sure the volunteer coordinator, Tara Vaszily, has the date on her calendar. Barry said that the State Commander and the State President of the Auxiliary tour every Mary Archey asked about the Wi-Fil upgrade andi ifi it was going to be building wide. Mildred Butler-Coleman clarified that it is not going to be Wi-Fi for residents to use for their personal devices. It is an increase in bandwidth to increase speed for administration for their laptops and devices. Barb: stated that Mike Hoover can explain a little more on the subject. Barry Amole stated that currently they pay for Comcast for the residents, so he mentioned if there would be an upgrade sO that the residents can use the Wi-Fi, that they could use the money elsewhere. Mike Hoover stated that he has been working with all the homes to get what is referred to as a 'guest Wi-Fi or commercial Wi-Fi that will allow the residents access. Once that project is complete, we could probably drop the other services that are currently being paid for by the organizations. Things were delayed due to waiting on the hardware to arrive. One of our homes is currently testing the community Wi-Fi. Out of the gates, we need to test the available bandwidth that we currently  home. It was cancelled the past few years, sO hopefully we can make it work this year.  Advisory Council Meeting October 12, 2023  Page 5of6    have to see at what point the bandwidth slows down. We do not have a current timeline, but Verizon is  currently working on installing hardware and we are, just waiting on next steps.  Old Business: Nothing to Report. New Business:  Mia Woods provided a compliance update to the council. Mia started out by saying that the team has resolved an open issue regarding running exclusion checks for targeted licensed staff. We now havea credentialing process for checking those exclusions. We are. still in the process of doing contract reviews andi for SEVC we are currently working with the clinical staff and Commandant to do some investigations about provisions of medical services. Once that is resolved, we will report back to you.  Good of the Council: Nothing to Report.  Time and Date for the next Meeting:  With noi further business to discuss, a motion was made to endi the meeting. Motion carried. The next regular meeting oft the Advisory Council will be held on January 11, 2024, at 10:00a a.m.  Approved:  Schweitzer, Secretary  EALms  Minutes submitted by: Sarah Klufas  Advisory Council Meeting October 12, 2023  Page 6of6