pennsylvania DEPARTMENT OF MILITARY AND VETERANS AFFAIRS April 11, 2024  SOUTHEASTERN VETERANS' CENTER ADVISORY COUNCIL MEETING MINUTES  The Southeastern Veterans' Center Advisory Council met April 11, 2024 at 10:00 AM in 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 Kenneth Schweitzer, American Legion, Secretary Doug Forsythe, Disabled American Veterans Richard Doherty, Military Officers Association of America Thomas Applebach, Lehigh County Office of Veterans' Affairs Kenneth Nadwodny, Catholic War Veterans Robert Richardson, Resident Representative  Thel Honorable Tracy Pennycuick, PAState Senate- via Microsoft TEAMS Department of Military and Veterans' Affairs/Southeastern Veterans' Center:  Maureen Weigl, BG (PA)-DMVA Travis Davis, Executive Director, Long-Term Care-DMVA Barbara Raymond, BVH Director- - DMVA Michael Belcher, Veterans' Services Specialist- DMVA Michelle Copeland, Social Work Coordinator- DMVA Brian Gula, Commandant -S SEVC Mildred Butler-Coleman, Deputy Commandant- SEVC Dr. Sin Kei Yeung, Medical Director-S SEVC Lauren Stenson, Director of Nursing SEVC Jill Alwine, Admissions and Marketing Coordinator- -SEVC Sarah Klufas, Assistant to the Commandant SEVC Linda Neiman, Veterans of Foreign Wars Auxiliary Dan Kuper, Personal Care Resident The Honorable Katie Muth Nikki Whitlock, Chief of Staff, Senator Katie Muth's Office  Visitors:  Lisa Walters, Chief of Staff, Senator" Tracy Pennycuick's Office- via MicrosoftTEAMS  Terra Shaner, Geriatrics and Extended Care Services Business Manager, CVAMC- vial Microsoft TEAMS  Excused Absence: Jeffrey Elliot, PA AMVETS Thomas Brown, Veterans of Foreign Wars John Getz, Veterans of Foreign Wars  Thomas Coreau, Dauphin County Office ofV Veterans' Affairs The Honorable Dan Williams, PAI House of Representatives MG MarkJ.S Schindler, Adjutant General- DMVA Mia Woods, Compliance and Ethics Officer- DMVA  Advisory Council Meeting April 11, 2024  Page 1of8    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. Swearing in of Council Members: and sworn in by General Maureen Weigl.  Ken Schweitzer, American Legion, and Mary Archey, Marine Corps League, were re-appointed to the board  Review and Approval of. January 11, 2024, Meeting Minutes:  A motion was made by Ken Schweitzer and seconded by Mary Archey to approve the minutes of the Advisory Council Meeting held on. January11,2024. Motion carried, and minutes were approved as written. Dr. Sin Kei Yeung introduced herself and told the council about her educational background. Dr. Yeung completed her undergraduate degree at the University of Maryland, College Park and did her medical school training at Medical College of Virginia (now known as Virginia Commonwealth University, Medical College ofV Virginia). She also completed heri internal medicine training at UMDNJI in New Brunswick, NJ, and her Geriatric Fellowship at St. Vincent's in New' York. She has been practicing in the Delaware County area for about 14 years in various settings including outpatient, family practice, and nursing homes. Lauren Stenson, Director of Nursing, gave a medical update for the facility on behalf of Dr. Yeung. Over the past month, we have had a little bit of a Covid outbreak. We had at most 4 residents on our quarantine unit. We are currently clear of any Covid positive residents and are finishing up outbreak testing on one of our floors. So far, we have not had any more positives as a result of this outbreak testing. We are also on the tail end of a Norovirus outbreak. The facility did a wonderful job of identifying residents that were experiencing symptoms and created a protocol where we monitored residents and put them into contact Wea are working on consents for the 2023-2024 Covid vaccine. The nice thing about this one is that it comes ins single-dose vials, whereas before we had to closely coordinate distribution for 300 doses at a time. We are still providing flu, RSV, and the Fall Covid vaccines. The reason we are still providing the Fall Covid vaccine is because we had the outbreaki in October, and we were nota allowed to administer vaccines for 90 days after those residents tested positive. We are catching up on those vaccinations before we moveon.  Report of the Medical Director:  precautions to minimize the spread. We are watching 6 residents at the moment.  Report of the Admissions and Marketing Coordinator:  Jill Alwine, Admissions Coordinator, provided the council with an admissions update. Jill reported that our census as of March 31st was 219, which is the highest it has been since prior to Covid. Overall, our occupancy rate is 79 percent, 87 percent for skilled nursing and 72 percent for personal care. We had a total of 23 admissions over the last quarter. Our waitlist is at 1141 total applicants, 94 veterans and 20 non- veterans. The approximate waitlist times are 2-4 months for personal care, 3-6 months for our skilled nursing units, and our memory care unit is currently about a 2-year wait, due to it being our smallest unit. Jill also noted that we had set out some informational materials on the table if anyone would like to take  some.  Advisory Council Meeting April 11, 2024  Page: 2 of8    Thomas Applebach asked if we were still holding a certain number of beds vacant. Jill confirmed that we currently have a unit of 36 beds that is closed partly due to staffing issues and also to reserve a space if we need to quarantine Covid positive residents. We also have about 32 beds that are vacant because we changed our 3 and 4-bed rooms to 2-bed rooms for infection control purposes. And finally, we have 5 beds that we have out of service due to a behavioral concern with the roommate, sO we are not able them at this time. In total, that is 73 beds that we cannot fill at this current time.  to pair  Thomas Applebach asked a follow up question wondering if the beds that are offline are included in the authorized beds' number. Travis Davis replied that 'authorized beds' reflects all of our licensed beds,  including those that are offline. Jill clarified that we have 219 beds filled and 73 vacant. Report of the Deputy Adjutant General = General Maureen Weigl - DMVA: for all the support that their organizations give our veterans every day.  General Weigl started by thanking all the board members for serving on our Advisory Council as well as Senator Muth and the TAG visited SEVC and played Bingo with the residents. They took turns Bingo numbers and talking with the residents. Senator Muth also brought candy and flowers to calling give  out away.  The event was a big success, and all the residents had a lot of fun.  Upcoming events: May 30th will be the TAG's Fishing Derby. We are looking forward to taking veterans to fish with the TAG. On. June 10th, Senator Pennycuick's office is hosting a Women Veterans event. You go to Senator Pennycuick's website and nominate some female veterans to be recognized during the event at the capital.. June 12th is Women Veterans Day. The Governor will also be holding a ceremony where he will be recognizing female veterans. You can go on his website to nominate people to be recognized, as well. At Temple University over Memorial Day weekend, the Military Basketball Association will be holding an event. The Military Basketball Association is al basketball league that is made up of active-duty service members and veterans. The event is open to the public and it is like their version of NCAA tournament. We are going to try and get some veterans there. If any of your organizations would an like to: set up tables or attend the event, reach out to the Military Basketball Association. We have been doing really well with the PACT. Act. Pennsylvania is in the top 5th on processing claims and benefits since the PACT Act came out. We have over: 1 billion dollars' worth of money coming into the Commonwealth because of those increased claims and benefits. More things have opened since March 5th. Now. if you served anywhere, anytime and were exposed toi toxins, you can get VA up healthcare. September 4th-6th, we are going to have our first ever Veteran Conference in Pittsburgh, are all welcome to attend. We are. going to bring in the Federal Government, state agencies, local you: as well as private partnerships to talk about behavioral health and mental health. We willl have government, a committee talking about homelessness and housing security and also one to talk about employment and Lastly, if any of yours groups would like to send care packages to some of the troops we have deployed,  can  Day  Please keep pushing it and have your service organizations push it.  education. We will put more information out once we have an agenda.  please let us know.  Report of the Executive Director, Long Term Care - Travis Davis = DMVA:  Travis Davis started by providing a survey update. Since our last meeting, the VA has conducted annual surveys at 3 of our facilities; Gino Merli, Erie, and Southeastern. Also, the Department of Human Services  Advisory Council Meeting April 11, 2024  Page 3of8    conducted their annual surveys at Hollidaysburg and Erie. So far, so good with all of those surveys. We had a but Department in after hours and were here until about midnight. Brian, Lauren, and the team did a great  of Health complaint survey here at Southeastern. Brian will go more in depth on specifics, these things do happen in our industry, but the team responded well, and we thank with Infection Prevention and respiratory iliness across the homes. Barb Raymond will  they Unfortunately, came job. them for all their hard work. We are doing well  give an update on the numbers, but overall, everything is going well.  Weh have had al lot of key personnel moves. Firstly, thank you and welcome to Dr. Yeung. We: are very excited to have her on board. She brings with her a wealth of knowledge and experience with the geriatric population and nursing homes. Brian and Dr. Yeung are going to be interviewing some nurse practitioners this week and next week. Also, Southeastern is going to bel hiring a new Director of Nursing because Lauren will be coming up to headquarters. She will be working mostly on the eastern side of the state, helping the homes with things like policies, education, on site trainings, etc. We are really excited to have support Lauren in this new role. Luke Hughes is our new Facility Administrative Officer. Luke has been with the DMVA for about 7-8 years and was one of our Construction Project Managers. Now he is going to oversee all the construction and facility maintenance for all the homes across the state. We also have an offer out toac candidate to fill our vacant Commandant position at the Southwestern Veterans' Center. Rich Adams, the longtime Commandant at that facility, retired about a week ago. He was in the industry for over 4 decades. We hope to give an announcement in the next few weeks about who the replacement is. Right now, Barry Lowen is helping out as an Interim Commandant until we fill this position. We have a new Grievance Coordinator for headquarters, Michelle Copeland. Michelle is going to work with our headquarters' team and all of our Grievance officers and Social workers in all 6 homes. She is replacing Margo Coleman, who is the new Commandant at our Delaware Valley' Veterans' Home. We are excited to have Michelle on board. Finally, we initiated a formal internship program this year for graduate students looking to get into long-term care. It gives 2 students from across the state the opportunity to work for us forayear, get paid and gain experiencei in long-term care either at our headquartersor: at one of our homes. We have 2 students this year that are the first to go through this program. We have had students in the past intern for us, but it was never formalized. We have an intern that is going to be doing an Administrator in Training program in Scranton under one of our Commandants and we have another that is going to work at headquarters and help our Project Management team and our Business Operations team. We are really  excited to get this project underway and going forward, this will be an annual project.  5-star  Delaware Valley, Gino Merli, and Southeastern are all ranked as 5-star facilities.  Regarding Veterans' ratings, Center Southwestern currently at 3-stars.  ranked as a 4-star  and Erie and Hollidaysburg are  is currently  facility  Nothing has really changed regarding recruitment and retention. This still remains our biggest challenge with over 300 vacancies across the state. We are continuing with our recruitment programs, such as' Walk- in Wednesdays. We are filling a lot of disciplines other than direct-care workers, but our biggest needs are Yesterday, we had a Governance meeting. We have 2 meetings each year per Federal requirements. It isa good time for us to review all new policies, establish a charter, review all of our quality metrics, etc. Wego over all surveys in terms of resident and family satisfaction. Then, we bring those recommendations and  still RNS, LPNS, and CNAS.  thei information to the DAG, VA, and Adjutant General.  Page 40 of8  Advisory Council Meeting April 11, 2024    We continue tos see our census acrosst the state slowly climb and we: are: The biggest change over the last 6 months is that we are able to fill our seeing beds a little our homes, Southeastern Veterans Center still remains month wait to get ina and now we are: seeing people get in within at few weeks. Thomas Applebach was curious to know why we are filling beds faster. Travis Davis able to leverage some agency staffing to help supplement the staff that  our waitlist  go down as well. bit quicker in some of ago it was about a 6-9 responded that we: are at bed our current keeping them  little slower to get into here.  a popular home in terms of our waitlist, sO iti is a  However, for example, in Scranton about 6-12 months  beds. Also, Barb and the nursing admin team has  we have currently to fill more  spent al lot oft time at the facilities  management and making sure we are efficiently utilizing our labor resources withi the looking beds that They have done a great job with expanding the number of beds that we are able to fill with wel have.  complement of staff. Another thing that we are: seeing is there are: some  not quite ready to come in when we call  people on our wait lists that are  them, sO we move on to the next applicant, while  on the list.  Report of the Director of Veterans' Homes = Barbara Raymond - DMVA: Barbara Raymond started by giving an update on Covid positives at the homes. We any Covid positive residents or staff at any of our homes. The homes had winter months, but nothing major. We also have no influenza sO we are very pleased with that. Our RSV vaccine  thankfully do not have some minor outbreaks over the going climb; they did not, al little over 50 percent does recommend annual RSV but we are anticipating that to at Southeastern Veterans' Home and our  mild this  We  or RSV at the homes. Flu season was our residents is  year. were a little anxious to: see if any of those numbers were across the 61 homes. We expect that number toi increase if the CDC and FDA vaccinations. As of now, they have not made that recommendation, happen in the future. We did have a Norovirus outbreak here keeping it under control and no one needed IVI hydration.  to  pretty  with  acceptance  Delaware  Valley' Veterans Home. The homes did a great job from an infection prevention  at standpoint  From a staffing standpoint, we have been busy. We seem to be having a small upticki in RNs biggest struggle right now is recruiting nursing aides. Some things we have done through the door is offering training courses in the homes themselves assist with various job duties. They cannot do hands-on  applying. Our  to get more nursing aides as well as partnering with schools bring trainees in, and they  throughout the Commonwealth. We  have a Training CNA position, where we  assist the  care, such as bathing and feeding, but  can  nursing staff with other various tasks. We encourage them to go to school, we for they their  schooling, and we also pay them to go to school. We have had some success, but it is still pay  get these individuals on board.  a challenge to lots planning of fun always the week of Flag Day.  We are gearing up for State Veterans' Home week in June. All of the homes are activities, one of which includes a dunk tank. Veterans' Home week is Our revenue team is doing an awesome job with the Cleland-Dole Act to dollars for our veterans, getting our service connection numbers and the Federal VA therefore decreasing the amount that the  lower  medication costs for our residents. They are also doing a fantastic job with help the PACT catastrophic illness  Act; getting revenue  up getting that prevailing rate from  resident has to pay.  Construction update: we are on track with our Hollidaysburg facility. The building is  nice. We are hoping to have it complete by 2025, but we will see howt the winter starting to look very  homes have had drainage issues in their main kitchens. interruptions being made to food: service, Advisory Council Meeting April 11, 2024  goes. Several of the  Thankfully repairs were able to be made without  Page 50 of8    Report of the Commandant- - Brian Gula-SEVC: knowledge and experience from not only a physician  started  that we are extremely excited to have Dr. Yeung with us. She has lots of  Brian Gula  by saying  standpoint but from al long- term care standpoint.  board. She is  We are very excited for the quality of care that we will be able to provide with her on  currently holding down the fort solely. We are int the process of recruiting 2 full-time nurse practitioners  her. The  closed last Thursday. We had 11 applicants which resulted in 6 interviews  to assist  posting  scheduled for this week and next week.  We had our Federal VA surveyi in February. The survey team was here for a week and surveyed our skilled nursing unit and personal care unit. Overall, it was a pretty successful survey. We received 4 deficiencies, 2 ofwhich were in regard to a sharing agreement which is out of our hands as itis al headquarters level issue. We also received a deficiency due to a pharmacy invoicing issue and one minor patient care deficiency due to a nurse not complying properly with our hand washing policy during med pass. In  have provided  education on the policy to that nurse as well as to the rest of the nursing  response, we  staff as a refresher and will audit to make sure the nursing staffi is compliant.  We did have the Department of Health out for a complaint survey. The surveyor came in right before 6pm and she was here until midnight. They received a concern in regard to the quality of care pertaining to  residents. Lauren and her Assistant Directors of Nursing sat down with the surveyor and went  about 20  all  residents. There was only 1 deficiency found throughout their review. effects to the resident. We did what we had to do, but we did not  through information for 20 plus documented. There were no adverse areoccurrence ini the future. The window for our anticipation of that survey. As Travis mentioned,  of treatment, but we did not have it  We had a resident who was a new: admit. We had put in place a plan  sO that we do not have  have it documented. Again, we will provide some education and do some auditing,  annual  of Health survey is slowly approaching. We will enter that  Department  assurance team and other departments ready in  window around May/June. We will be getting our quality  we are currently  rated as a 5-star facility. We have 5 stars in our quality measures, 3 We have some prediction tools that we use to calculate our score  are  for our next quarterly refresh have a nice cushion should we see a  stars in our surveys, and 5 stars in our staffing measures. We predicting and our score is only going to go up on the nextrefresh, sO we will  that we will maintain our 5-star status.  decrease.  We have a Spring Job Fair coming up in May. We utilize the. ADHC: since it has its own parking and has been successful in getting us Social Workers, Nurse Practitioners, and Nursing Administration  We have seen some success with these job fairs in the past, but  entrance. It usually works out very nicely.  need. Recruitment assistance  as Travis and Barb stated earlier, our direct-care workers are our biggest  They contact us and we let them know what our needs are, then they will hone-in on schools  positions.  and career fairs to help us fill those needs.  Report of the Deputy Commandant- Mildred Butler-Coleman- SEVC: Mildred Butler-Coleman stated that, since our last meeting, we received all new  tables and chairs for our  Room. We also had the room painted to freshen up the space and give it a more modern feel. that we have been working on for the past 2 years is finally complete. The next thing on project switch over from heating to air conditioning since the weather is getting nicer. Today and  All-Purpose boiler Our the agenda is to  Page 6of8  Advisory Council Meeting April 11, 2024    tomorrow our contractors will be here to switch us over from heating to air conditioning, The month of April is always al little wonky since we can have both 30-40-degree days and 70-degree days. We: are looking into having our contractor Fitch Electronics update our overhead paging system in the buildings. Currently, if you wish to page someone, you must page both buildings separately. We are hoping to make the system more convenient and effective by combining the two systems sO you can page both buildings at the: same time. We are waiting on quotes to find out what the cost would be to make that switch. While we were waiting, we were able to have them fix the speakers in our chapel so that the We are working on a project to have our Coates Hall elevators lock, SO ifa a resident that is a wander risk gets on the elevator, they won't be able to go anywhere. We haven't had an issue with this, but we want to ensure we are doing everything we can to keep our residents safe. Although we haven't had any As Barb mentioned, our facility was one of the ones that had drain issues in the kitchen. After years, it has finally been fixed. There was some inconvenience for the dietary staff themselves, but the issue did not disrupt our food service or inconvenience residents.. Another big-ticket item that wej just had approved is that our walk-in refrigerator and freezer in the main kitchen need to be replaced. The contractor needs to come in and take out all thei inner workings and replace them. The work willl be: starting on Monday. This isaz 200,000-dollar project. The refrigerator and freezer are original to the Tilghman Hall building. We currently have 3 live-fish aquariums throughout the facility, 1in each lobby and 1 on our memory care unit. We have been leasing these aquariums and have had a contract for the last 5-6 years. We have decided to try something different and are getting virtual aquariums instead. We willl have TVs dedicated tot these aquariums' where you can change the 'fishscape' to see different ecosystems and different fish. We have 2 of these aquariums already set up and once we see how things go, we may add a 3rd to the We have 3 large TVs that were donated byt the Veteran Bowlers Association. These were used to upgrade some oft the TVs int the CLCTV rooms for the residents that have visual impairments and struggled to see The newest events that we have been having for our residents are food trucks. Organizations can donate money for us to have food trucks come out and residents can eat free, and staff have the option to We have 2 students that will be recognized at our Volunteer. Appreciation Luncheon on April 24thf for earning the Presidential award for volunteering 100 hours throughout the school year. We would like to thank you and your organizations for everything that you do to improve the quality of Nikki Whitlock stated that Senator Muth's office can provide certificates for the: students winning the Presidential awards. Sarah Klufas will forward the names of the students for the recognition.  residents can hear the services better.  elopement issues, we want to prevent them from possibly happening.  memory care unit. The contract fori the live-fish aquariums ends, June of 2024.  the other TVs.  purchase lunch. It is nice to provide some options for staff and residents.  lifet for our residents.  Advisory Council Meeting April 11, 2024  Page7of8    Comments from the Council:  Thomas Applebach asked if we would provide an agenda or schedule of the events happening each day of Veterans' Home Week. Mildred stated that we are still in the planning phase, but once everything is Senator Pennycuick provided a quick update on some of the bills that are of interest in the Veteran community. On Tuesday, the Korean Valor Act, Senate Bill 973, was passed out of the Veterans' Affairs Committee, and it will be considered on the floor of the Senate in the upcoming session at the end of April. The Korean Valor Act mirrors the federal Korean Valor Act that recognizes Vietnam War veterans that fought for the Korean Armed Forces alongside U.S Forces and are now American Citizens. Additionally, we have Senate Bill 194 that eliminates federal VA aid and attendance from being considered for any state programs. Currently your help is needed with Senate Bill 1145, which is the Veterans Sharks Bill to protect veterans against 'Claim Sharks'. It was scheduled to run but there is an organization that is pushing hard to allow the payment for consultation on claims and got the bill shut down. If anyone in the room would like to call Senator Muth or Senator Mastriano and show your support of the bill, that would be very much appreciated. We are going to hold a public hearing to help educate more members on what the challenge Thomas Applebach stated that these 'claim sharks' and 'pension poachers' are really good at working their wayaround the law and wanted tol knowi ifthe! bill currently! hasany' 'teeth' to go aftert these people. Senator Pennycuick stated that the bill has some 'teeth' to it. She would like it to be much stricter, but for now itis  finalized, we can send something out to the council members.  is with these organizations that charge to do a veterans' claim.  acceptable. Old Business: Nothing to Report. New Business: Nothing to Report. Good of the Council: Nothing to Report.  Time and Date for the next Meeting:  With no further business to discuss, a motion was made to end the meeting. Motion carried. The next  regular meeting of the Advisory Council will be held on. July 11, 2024, at 10:00 a.m.  Approved:  Pnt Selu Kenneth Schweitzer, Secretary Minutes submitted by: Sarah Klufas  Advisory Council Meeting April1 11,2024  Page 8of8