We passed!

Graphic from N & W Associates

Life always includes both the good and the bad.  Yesterday was a great example of that.

I called the local department of public health (DPH) yesterday. A woman there said our 2567s (the written problems noted during the survey are put onto a government form called a 2567) weren't done being written up yet and we'd get them either today or Monday.  But she was kind enough to verify that we did pass the survey!

I couldn't stop praising God!

This means that as soon as I obtain the 2567, write a plan of correction (POC), and provide verification of those corrections, DPH will issue me what they call a 2567B. The lady I spoke with promised she'd even fax me a copy of the 2567B so that I could get it more quickly.  Once I have the 2567B we can contact CMS (centers for Medicare and Medicaid) and get paid for all our new admissions since November 15.  Wow-what a relief! I hate to even think about what would have happened if we had not passed...

I'd called the owner's son and told him and he told the owner (he's actually the owner as well). Later in the day the owner called me and I was thinking she was going to rejoice with me or perhaps even thank me.  The survey that we didn't pass came on my 4th day and the problem situation occurred back in August - so I was in no way at fault.  But I've worked hard together with everyone else, and by God's grace provided the leadership to get things fixed.

The owner has  4 other facilities. DPH is doing a survey at one other the others and it is going very terribly.  The owner was upset and distraught.  In my head I understand what stress this must be for her.  I know that this building I'm running lost a lot of money last year and then with this denial of payment for new admissions since November, it's made her short on cash.  It must be extremely stressful.  At the same time, I found it difficult yesterday when she was yelling at me on the phone.

She was talking, talking, talking about all the problems and then telling me how I need to reduce the number of licensed nurses are are running on the AM and PM shifts.  I reminded her that we are barely meeting the state required 3.2 nursing hours per patient per day and she told me that I needed to meet that requirement through C.N.A.s instead of licensed nurses.  I didn't even get into it with her that I think we need to keep the number of licensed nurses AND increase the numbers of C.N.A.s.  Instead of just meeting the required 3.2 we should be running at 3.6 - that's part of how we become a 5-star facility.  I didn't say it because I didn't think this was the time to tell her that.  The she started telling me how I need to get the census up.  I reminded her about the steady increase in the census every since I came, to which she countered that I need to have 30 Medicare. Her message was that you may think you're improving but it's not good enough. I let her know we are working together and it takes time.  I didn't even get into the fact that this building is a 2-star in a 5-star system and all the other issues.  I just said the truth - that I am doing everything I can to provide the leadership to make it better and it is getting better.

 I'm kind of mad at myself because I let her get to me. I felt hurt.  In my head I know that I work unto God and not the owner.  In my head I know that God has chosen to put His blessing and favor on me and that, by His grace and through a lot of hard work and strategizing, we are doing a great job at improving. In my head I know that it is "never enough" with these owners.  But it was 1:30PM and I hadn't had lunch.  It was Friday and I was tired from a hard week.  I was still struggling with cold symptoms.  I felt angry over top of sadness.  There were 2 checks I needed to cash for the facility so I went to lunch and then to the bank While out, I called and talked with John my husband.  I prayed.

By God's grace I strive to remain emotionally even.  I'm 57 and have my own hormonal issues so I'm reminding myself not to be so hard on myself for feeling upset.  I didn't act on those feelings or tell others at work about them.  Although I did mention to John our business office manager that I'd just gotten off the phone with the owner and instead of thanking me she was yelling at me. I tell him things because he wants to become an administrator and he'll have to deal with owners. I also told him that the truth is that we all did great with the survey and he and Kristine are doing a great job at increasing the census.

The owner is difficult.  I believe that this is where God has me now so I look to Him for the grace to be able to deal with her.  God has blessed me with favor with DPH on that re-survey and I am grateful.  I'm looking forward to what's going to happen in the coming days.