pennsylvania DEPARTMENT OF MILITARY ANDI VETERANS AFFAIRS January 11, 2024  SOUTHEASTERN VETERANS' CENTER ADVISORY COUNCIL MEETING MINUTES  The Southeastern Veterans' Center Advisory Council met. January 11, 2024 at 10:00. AM ini the All- Purpose  Room of Coates Hall at the Southeastern Veterans' Center.  Advisory Council Members Participating: Barry Amole, Vietnam Veterans of America, President Mary Archey, Marine Corps League, Vice President- vial Microsoft TEAMS Richard Doherty, Military Officers Association of America Thomas Applebach, Lehigh County Office of Veterans' Affairs Kenneth Nadwodny, Catholic War Veterans Robert Richardson, Resident Representative The Hon. Tracy Pennycuick, PA: State Senate- vial Microsoft TEAMS Department of Military and Veterans' Affair/Southeastern Veterans' Center: Travis Davis, Executive Director, Long-Term Care - 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 tot the Commandant- -SEVC Linda Neiman, Veterans of Foreign Wars Auxiliary Dan Kuper, Personal Care Resident Excused Absence: Jeffrey Elliot, PA AMVETS  Visitors:  Doug Forsythe, Disabled American' Veterans Kenneth Schweitzer, American Legion, Secretary Thomas Brown, Veterans of Foreign Wars John Getz, Veterans of Foreign Wars VACANT, PAI House of Representatives MG MarkJ J.S Schindler, Adjutant General DMVA Maureen Weigl, BG (PA)- - DMVA Barbara Raymond, BVHI Director: = DMVA Mia Woods, Compliance and Ethics Officer- DMVA  Advisory Council Meeting. January 11,2024  Page 1of6    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 October 12, 2023, Meeting Minutes:  Amotion was made by Thomas Applebach and seconded by Richard Doherty to approve the minutes of the Advisory Council Meeting held on October 12, 2023. Motion carried, and minutes were approved as  written.  Report of the Medical Director:  Lauren Stenson, Director of Nursing, reported on behalf of Medical Director Dr. Violetta Berdichevskaya. We now have 2 full-time DMVA CRNPS working in the building, along with a contracted Physician. Our full- time Medical Director is expected to start in March. Since October, we have hired 61 RNs, 1LPN, and 10 CNA. We have been able to back down on agency staffing a little bit, which is nice because it is important to us We currently have one resident with the flu that is being treated in the facility, as well as one resident with the flu at the hospital, in stable condition. For Covid, we also have one positive resident being treated in the facility and one positive resident at the hospital, in stable condition. We do not currently have RSVi in Vaccine Update: We have 135 residents vaccinated for the flu and 81 residents have received the latest Covid booster. The Covid booster number is a little lower due to the outbreak that we had in October. The residents who had been positive needed to waiti to receive the vaccine. We: are: starting to administer those vaccines this week. We had a slight issue with the consents for the RSV vaccine, but we are working on getting the vaccines to those that want to receive it. Right now, we are at 62 residents vaccinated for RSV. We are continuing to offer vaccines to staff as well. We have had 4 vaccine clinics since October. Richard Doherty askedi if we are seeing an uptick inf flu numbers as compared to normal. Lauren stated that our numbers are about normal and that we, thankfully, have not had any flu outbreaks this year. Lauren stated that wel have been wearing masks since basically October, sO we: are doing our best to keepi it at bay. Jill Alwine, Admissions Coordinator, provided the council with an admissions update.. Jill reported that for the last quarter, the facility had an average of 211 residents, leaving us with 81 vacancies. Of those vacancies, 11 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 20 admissions. For 2023, we had a total of 76 admissions. Our waitlist is at 941 total applicants, 79 veterans and 15 non-veterans. The approximate waitlist times for skilled nursing and personal care are about 2-4 months. Our memory care unit is currentlya about a 20-24 month wait, duet toith being our smallest area. Jill also noted that we had set out some informational materials on the table if anyone would like to  tol have consistent staff that can anticipate our resident's needs.  thei facility.  Report of the Admissions and Marketing Coordinator:  take some to hand out.  Richard Doherty asked. Jill to repeat the waitlist numbers.  Advisory Council Meeting. January 11,2 2024  Page2 of6    Thomas Applebach asked if those numbers included memory care. Jill confirmed that it did. Thomas Applebach then asked if we were about at capacity and Jill replied that we were pretty much at capacity. He commented on the length of the waitlist time for memory care and asked if we are seeing an upward trend in memory care needs. Jill stated that we have seen an increase in people needing that level of care, Brian added that our memory care unit is a smaller 30- bed unit. He further explained that during our admission committee meetings, the team has been reviewing the incoming applications to see if we would be able to safely care for a veteran or a spouse on a different unit, rather than admitting them directly to memory care. Brian stated that we are also looking into updating our Wanderguard system in Coates Hall. This system is used to prevent ar resident thati is a possible elopement risk from accessing the elevators. This would also allow us to admit more residents that are a wandering risk to other units. Jill Alwine said that they also call applicants that are on the memory care waitlist to get an update and: see ift they still need that unit or if we may be able to admit them to a different floor. Lauren Stenson added that we also regularly review the needs of the residents on that floor to see if they still need the secured unit or if they could  and iti is across the whole industry.  possibly move somewhere else.  Report of the Deputy Adjutant General - General Maureen Weigl - DMVA:  General Weigl was unable to attend the meeting.  Report of the Executive Director, Long Term Care - Travis Davis - DMVA:  Travis Davis started by saying that he will be covering Barb Raymond's portion as well, since she could not Travis announced to the council that we are going to be launching a female veteran's magazine. He The Adjutant General was out to visit all 60 of our veterans homes this holiday with several guardsmen and women. Thel homes threw their annual holiday parties and Travis commented that the parties felt the most normal since the pandemic started. Lots of families and children came to visit with their loved ones. Survey Update: The Delaware Valley home just completed their Annual Department of Health survey and Federal VA survey. Both survey teams showed up during the same week, which also happened to be the week of Del Val's holiday parties. Despite all that was going on, the team did an excellent job handling everything. We also have. AnnualVA: surveys coming up in February for Gino Merli, Erie, and SEVC. Asoft today, we are at 1,094 residents across all 61 homes, thisi is an occupancy rate of about71 percent. The waitlist across the state is 252, including veterans and spouses. Our census number is slowly going up and There is not much newi from a legislative standpoint since our last meeting. Regarding the federal staffing minimum update that CMS proposed, we did submit our response to the Governor's office. We have not heard anything yet. CMS is currently reading through all of the responses submitted which, last we heard, was about 10,000. One the state side, nothing has really changed with the budget. We are looking for an increase in our Medicaid rate. As of right now the General Appropriations bill has made it out of the Senate, butitisn not out of the house. Travis deferredt to! Senator Pennycuicki to seei if she had any further comments.  be at the meeting.  mentioned that Senator Pennycuick has also assisted with this project.  our waitlist is slowly going down.  Advisory Council Meeting. January: 11, 2024  Page 3of6    Senator Pennycuick: stated that in the most recent fiscal code, we did an increase the Medicaid rates, but it isr not what was asked for. She further stated that they start the budget int the end of February, and will be looking toi increase that, just based on the fact that there are a lot of seniors in PA that rely on that care. Hopefully, there will be more money coming our way soon. Travis explained that one of the reasons why we need that Medicaid increase is that when the PAI Department of Health rolled out their 3-year staffing increase plan, funding was only there for years one and two. So, we need that funding to support year 3. Regarding 5-star ratings, Delaware Valley, Gino Merli, Southeastern and Southwestern Veteran homes are Wel have been doing reallywell filling vacancies across the homes, other than direct care workers. Asl Lauren mentioned, we have made progress with our clinical staff, RNS, LPNs, and CNAS. But that is still the big! bulk of what we need right now and that is still what is limiting us from being able to fill our beds. Right now, we have over 300 vacancies across the state. Another discipline that has been difficult for us is social services. Our VA regulations require social workers to have a master's degree. Other nursing homes and agencies in the state do not require this, but the compensation is pretty much the same. We are trying to fight this and find ways around this, because we are seeing a lot of turnover in social workers. Unfortunately, even when we try to look at using agency staffing to fill these positions, they do not have We have a new Commandant at Delaware Valley, Margo Coleman. She has been with the DMVA for at few years and has even worked in the private sector as a Nursing Home Administrator, as well. Construction wise: we have a lot of job order contracts going on for renovations and repairs to keep our facilities running; things such as HVACS, new dishwashers, new refrigerator equipment, roof leaks, etc. The Hollidaysburg new building project is about 20 percent complete. All the steel is completed and sO far, it We have active Covid, active Flu, and active RSV throughout the 6 homes. However, our numbers have been pretty good. Across all 6 homes, we have 8 residents with Covid, 8 residents with the flu, and 8 residents with RSV. Our numbers are fairly low compared to the general population, but we have seen a little bit of all three of these in all of our homes dating back to around Thanksgiving. We have the vaccinations available for our residents. Consent is somewhat challenging, but we are navigating the Richard Doherty commented on the number of vacancies across the state and asked if this was due to staffing issues. Travis replied that it was. Unfortunately, we are fighting with everyone else in the industry for the: same pool of staff that has been shrinking since the pandemic. We had al lot of people retire or leave the industry and we have not seen that pendulum. swing back as aggressively with direct care workers as it has with non-direct care works such as dietary, housekeeping, etc. Richard Doherty stated that his  all ranked as! 5-star facilities. Erie and Hollidaysburg are currently at 3-stars.  anyone to give us either.  looks great!  process to make sure we are getting vaccines to those that have requested them.  retirement community is having the same issue.  Report of the Director of Veterans' Homes - Barbara Raymond - DMVA:  Barbara Raymond was not able to attend the meeting.  Advisory Council Meeting. January 11, 2024  Page 4of6    Report of the Commandant - Brian Gula-SEVC:  team from headquarters to be here at  Brian Gula started by saying that we are expecting our compliance  a 'mock survey' tool  the end of the month to complete our Facility' Performance Assessment. This is essentially  review the facility'so compliance with federal and state regulations. It isa great learning  where they for us to identify any area to annual surveys for the year. Since last meeting, we did  that we may need to work on to prep us for our Annual VA and Department of  1st to review skilled nursing and February 6th-8 gth  Health survey. They will be here. January 30th. February  review us beforec our  review Personal Care. The compliance team tries to time it that they come in to  clear and are  certified with our 2023 VA survey. We were in the plan of  fully  with the Federal VA. Our 2024 Annual  corrections phase last meeting, but we are now backi in compliance  VAs survey will most likely bei in February.  mentioned  TAG was out to visit the facility in December. The residents always love that participated in the Friend of a Veteran program. We had an overwhelming  As Travis  earlier,  seeing him and the men: and women in uniform. amount of donations this year. The Volunteer  Thank you to everyone extra every resident needed.  Office  a set up 'Holiday  Bazaar' in Tilghman Hall with all the  that  donations and resident were able to 'shop' for some free brand-new items. We are grateful  was able to receive a Christmas gift and also got to pick out some extra items that they  to and admissions, along with the nursing staff, for completing 76 admissions this  Brian offered props Jill all but! 51 beds on that unit.  that was empty due to staffing and were able to fill  past year. We reopened one of our units this past year  During 2023, we filled al lot of key positions, including our Quality Assurance department and many administrative positions. Our concentration for 20241 ist to work on implementing some processes  nursing  and  with using our Quality Assurance team to really evaluate our  toi improve our care services, along  current processes and procedures and see where we have room for improvement. Report of the Deputy Commandant- Mildred Butler-Coleman- SEVC: Mildred Butler-Coleman stated that we are almost ready to close up our boiler project. system is almost online. In at few weeks, we: should be able to fullyt transfer  We have been  our hot water heating system from our facility' heating system, sO we will not have  working on separating to shut the heat off when we are fixing new ones.  the water and vice versa. Everything willi finally be separate. The  from the old boilers to the  Sot far, the Coates Hall building is much betteri in terms of consistent heat and air conditioning.  an  to increase the speed of ouri internet for office staff. The building  We are working on getting upgrade  their computers.  will have an increased bandwidth so that staff can operate a little more efficiently at  what it will not do is allow everyone to get Netflix and other streaming services at this time. been installed for the upgrade and mapped out. Verizon will then come backi in and  However, The hardware has  between them. Once this is complete, then we  using our mapping, install the boxes and doing the wiring  the 9-5  will need to test the network to see how much it can take to make sure it willl hold up during  hours when there is the most demand. We are looking into updating paging  our  system in the buildings. Currently the systems are not linked, sO  We had a company come in and  if you need to page someone, you must page both buildings separately.  Page5of6  Advisory Council Meeting January 11, 2024    give us an estimate on one combined system, along with fixing some issues in areas where hear the pages. We are, just waiting on pricing to: see what we are going to do and how fast you can not As Brian mentioned, we are looking to update our Wanderguard system so that if a resident is thani ini the secured memory care unit. Thomas Applebach asked if the system is able to manor, track rather  we can doi it. an resident's  elopement risk, they can not access any oft the elevators in either  some residents that might be somewhat  building. Then we can look into having  cognitively impaired on normal floors in a safe  locationsi if anyone were to get out of the building. Mildred stated that the a resident exited out of, buti it is not like a GPS that can track.  system can tell you what door  and we have received a quote from them  someone. Berkshire is our preferred vendor  on the update.  We wanted to thank all of the volunteers that came in and helped us with all oft the  hosted for the residents. We would not have been able to do it with out and Holiday events we  everyone's hard work and dedication! Comments from the Council:  you we really appreciate  Thomas Applebach thanked everyone fort their hard work. the Bazaar and the veterans really enjoyed the event,  Ken Nadwodny stated that he had volunteered here during the holidays and was also  them  here yesterday for  comparing  to kids in a candy store.  Old Business: Nothing to Report. New Business: Good of the Council: Nothing to Report.  Mildred thanked Thomas Applebach for the donations that he brought from the collection.  Time and Date for the next Meeting:  With no further business to discuss, a motion was made to end the meeting. Motion carried. The regular meeting oft the Advisory Council will be held on April 11, 2024, at 10:00a.m.  next  Approved:  Himt Selt Kenneth Schweitzer,Secretary Minutes submitted by: Sarah Klufas  Advisory Council Meeting January 11,2024  Page 6of6