The Practical Use of Strategic Planning

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Minnesota Department of Veterans Affairs

MN Veterans Homes Strategic Plan 2008 – 2013

December 2009 Update

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Minnesota Veterans Home – Minneapolis

The Minnesota Veterans Home - Minneapolis was once known as the Old Soldiers Home. It was built in the late 1800’s for indigent Veterans of the Civil War. Founders of the Home intended for it to be peaceful, beautiful and comfortable community for the Minnesota Veterans who required care during their golden years. The Home sits high on bluffs overlooking the Mississippi River and near the picturesque Minnehaha Falls. In 1887, the Legislature authorized the establishment of a Soldiers Home as a reward to the brave and deserving.

The Minneapolis campus consists of 341 skilled nursing home beds and 161 licensed domiciliary beds; providing nursing care and related health and social

services to Veterans and their spouses who meet eligibility and admission requirements.

Location Highlights:

The Minneapolis Campus is close to various public transportation systems, libraries, colleges, shopping malls, city parks and various businesses that may offer work opportunities for domiciliary Residents. The Home has a close working relationship with the VA Medical Center in Minneapolis.

Minnesota Veterans Home – Hastings

In 1978, the Hastings State Hospital was converted into a domiciliary residence for Minnesota Veterans. At the time, it was licensed for 200 board and care beds.

Located 21 miles southeast of St. Paul on 128 beautiful wooded acres along the Vermillion River, The Minnesota Veterans Home – Hastings houses Residents in two separate buildings, each providing access to the campus and many amenities.

Resident Profile

The Veteran who would most benefit from living at The Minnesota Veterans Home – Hastings is someone in need of medication management, psychosocial support and personal care reminders, but not requiring skilled nursing-level care.

The current clientele of The Minnesota Veterans Home – Hastings have a variety of medical, mental and/or chemical health needs. The top admitting diagnoses are:

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• Alcohol/chemical/polysubstance dependency • Schizophrenia • Major depression disorder/depression • Diabetes

Fifty percent of admitting Veterans are homeless or at risk of being homeless and the Residents are prescribed an average of 11 medications each. The staff works with the Residents of the Minnesota Veterans Home – Hastings to address their significant and diverse needs while empowering the Veterans to make positive choices to achieve change in their own lives.

Minnesota Veterans Home – Silver Bay

In 1991, the Silver Bay Elementary School was converted into a skilled care facility for Minnesota Veterans. The Minnesota Veterans Home – Silver Bay is located on the scenic North Shore of Minnesota overlooking Lake Superior.

Our Home is licensed for 87 skilled care nursing beds. A 25 bed special care area has been created to meet the special programming needs of Residents with cognitive loss (dementia). Our special care area was designed using the

philosophy of creating a community. This care area has an activity kitchen, living room and dining room. The Home’s programs and services focus on helping Residents reach their highest level of independence.

In 2009 we started a large renovation project that will change our facility into 4 small households. Each household will have a small kitchen, living room, and dining room space for 20-23 residents. The goal is to enhance individuality and create family. We project to be completed with this project in 2011.

Location Highlights

Silver Bay offers all of the activities of Northern Minnesota. The community and surrounding area offer libraries, colleges, shopping, parks and various businesses that may offer work opportunities.

Minnesota Veterans Home – Luverne

Located on the prairie in Southwest Minnesota, the Minnesota Veterans Home - Luverne provides skilled nursing care for 85 Residents in a small town environment. Programs and services focus on providing person centered care based on a social model of care. The Home follows the Eden Philosophy model of culture change that seeks to address the loneliness, helplessness and

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boredom that can be a nursing home plague. Besides providing a huge array of both internal activities and outings, the Home actively promotes events where children of all ages are involved in the activities with Residents. Also, dogs, cats and birds are an integral part of the Home.

Once a Resident is admitted to the Home, an individualized plan of care is developed by the primary service providers that will address the Resident’s physical, psychosocial and spiritual needs. The goal of the plan is to promote as much Resident choice and independence as possible. The overall goal of the Home is to create and support an environment that provides a homelike atmosphere in a communal setting.

The Minnesota Veterans Home - Luverne has a 17-bed Alzheimer’s/dementia care unit. The entire 42- bed wing, which houses the Alzheimer’s/dementia unit, is focused on meeting the needs of those Residents that have cognitive loss. The other 43 bed wing is home to Residents that can initiate and participate in the social interactions provided in a more independent manner.

Minnesota Veterans Home - Fergus Falls

The Minnesota Veterans Home – Fergus Falls is an 85-bed skilled nursing care facility and is Minnesota’s newest Veterans Home. It opened March 30, 1998, has reached capacity in little over a year, and has developed a solid reputation as demonstrated by long waiting lists. Accompanying the new building are new design ideas. A highlight is the Main Street—a hallway designed like an old town Main Street, with many of the rooms finished to the period 1930 to 1940. Along the Main Street are a barber shop, general store,

library, family inn and clinical exam rooms.

Unique to the facility is its Community Base Outpatient Clinic (CBOC). The clinic is established under a shared use agreement with the Veterans Administration and is the first VA Nurse Practitioner Nursing Home based clinic in the nation. This distinctively provides on-site medical review of eligible Veterans for access to care within the Veterans Administration system.

The Home has also introduced a new concept of nursing care with the innovative Nursing Universal Worker position. This nursing approach increases the accountability of nursing personnel and expands their sphere of influence over the care of the Residents. Primary Focus Nursing – a system developed by their leadership, has won state acclaim through the “Excellence in Practice” award from Aging Services of Minnesota.

As of the first quarter of 2011 the facility will be adding 21 beds for a Special Care Unit, bringing the total capacity to 106 beds. Additionally added is expanded space for dining, activities, a hospice suite, and new space for the Community Based Outpatient Clinic.

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Veterans Homes Program Goals and Objectives

Goal #1:

The Veterans Homes Program will provide high quality care and services.

Objectives:

A. Completed (see list on last page) B. The Veterans Homes Administrators will develop and initiate a person

centered/directed care philosophy by September 1, 2010. C. The Senior Director of Veterans Health Care will evaluate behavioral health concerns

and identify resources available by October 1, 2010

Goal #2:

The Veterans Homes Program will develop a community relations plan to increase awareness and support of the Minnesota Veterans Homes.

Objectives:

A. Completed (see list on last page) B. Completed (see list on last page)

Goal #3:

The Veterans Homes Program will ensure fiscal integrity.

Objectives:

A. Completed (see list on last page) B. The Business Managers and the Financial Officer will identify and recommend options to

enhance financial performance by July 1 of each year. C. Completed (see list on last page) D. The Senior Director of Veterans Health Care will coordinate with the Senior Director of

the Veterans Services to work with the Homes to optimize Veterans benefits and report status annually on July 1.

E. The Veterans Homes Administrators and Directors of Nursing will evaluate current pharmacy services and options and make recommendations for future pharmacy services by March 1, 2010.

F. Completed (see list on last page)

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Goal #4:

The Veterans Homes Program will develop a comprehensive plan to address human resource needs.

Objectives:

A. The Staff Development Directors, along with the Senior Director of Veterans Health Care will identify and implement core training standards by July 1, 2011.

B. The Human Resource Directors will develop facility programs to recruit and retain excellent employees by July 1, 2010.

Goal #5:

The Veterans Homes Program will develop a comprehensive risk management program.

Objectives:

A. The Senior Director of Veterans Health Care will coordinate a risk management analysis by July 1, 2012.

B. The Senior Director of Veterans Health Care will coordinate a disaster plan for the Veterans Homes by July 1, 2011.

Goal #6: The Veterans Homes Program will maximize information technology tools. Objectives:

A. The Veterans Homes Administrators, in conjunction with Information Technology staff will identify the technology needs of the Veterans Homes on March 1 annually.

B. The Directors of Nursing, in conjunction with the Director of Quality Services will fully implement the standardized electronic medical record according to level of care by July 1, 2012.

C. The Facilities Program Director in conjunction with the Director of IT and the Physical Plant Managers from each Home will fully implement a standardized Archibus system by July 1, 2012.

D. The Veterans Homes Administrators, in conjunction with the Director of IT will incrementally implement Health Insurance Portability Accountability Act (HIPAA) privacy and security rules to the Homes by October 1, 2010.

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List of Completed Objectives as of December 2009

Goal 1, Objective A: The Director of Quality Services for the Central Office will develop and implement a quality improvement plan by October 1, 2009. Goal 2, Objective A: The Legislative Director will develop continuous awareness of legislative issues through training and communications by January 1, 2009. Goal 2, Objective B: The Volunteer Coordinators and the Communications Director will develop a marketing campaign by January 1, 2010. Goal 3, Objective A: The Deputy Commissioner of Veterans Health Care will conduct a feasibility study on Centers for Medicare and Medicaid Services by September 1, 2009. Goal 3, Objective C: The Veterans Homes Administrators will develop a project management system to streamline the use of program funding based on Veterans Homes priorities by July 1, 2009. Goal 3, Objective F: The Deputy Commissioner of Veterans Health Care and the Senior Director of Veterans Health Care will conduct a feasibility study on future program development by September 1, 2009.