Riffe says nursing home care always evolving
Nursing homes have changed in the 34 years since Gary Riffe started as administrator at Eventide at Hi-Acres, and he expects more changes ahead after he retires Sept. 27.By: Kari Lucin, The Jamestown Sun
- Riffe and Panchot
Nursing homes have changed in the 34 years since Gary Riffe started as administrator at Eventide at Hi-Acres, and he expects more changes ahead after he retires Sept. 27.
One thing, however, remains the same.
“We are given a wonderful privilege in being trusted to care for people,” Riffe said. “We become that surrogate family, and that’s a huge honor.”
Riffe’s replacement, Doug Panchot, started Sept. 19.
“Long-term care, as with any health industry, is always evolving, always changing,” Panchot said. “So it’s just trying to stay on the cusp of that.”
Panchot said he will spend the first part of his tenure at Eventide evaluating current operations, getting to know the staff and getting to know the system.
Riffe’s retirement party for residents and staff will be from 2 to 3 p.m. Sept. 27 at Eventide. The public is invited to a retirement party from 5:30 to 8 p.m. Thursday at Quality Inn and Suites.
Changing times
Before he started at Hi-Acres in Jamestown, he served as administrator at nursing homes in Alcester, S.D., and Livingston, Mont. Prior to that, he worked in accounting, sold mobile homes for a time and worked for a jeweler.
Riffe went into long-term care because of the people involved, from the customers — residents and families — to the staff.
Long-term care has changed since Hi-Acres opened 49 years ago, and even during Riffe’s tenure.
People used to go to the nursing home and stay there for long periods of time, perhaps until death. Now, many people stay in long-term care just long enough to get rehabilitation after an injury or illness, and some of them are repeat customers. About 40 percent of the residents of Eventide discharge and go home, or to assisted living.
“On the other spectrum of care, in the past ... we didn’t get people as sick as we do now,” Riffe said, adding many of the residents Eventide gets now would have stayed in the hospital to receive care there. Now hospitals can’t accept them — the costs are too high. Long-term care can more efficiently provide that service, Riffe said.
Even the physical elements of long-term care facilities have changed. Private rooms are the trend, and facilities are actively attempting to become as homelike as possible.
Rehab centers and secure facilities for dementia patients are being built to assist in treating people with those particular needs.
Eventide built its 16-bed dementia wing in 1997, and it was designed to encourage residents to make their own decisions.
The facility’s existing rehabilitation center will become more important, Riffe said, and future efforts will likely focus on promoting it.
Because patients often require so much more care than they once did, nursing home staffing has changed, too, both in raw numbers and in qualifications.
Raw staffing numbers have more than doubled. In 1977, Hi-Acres had 104 beds and 80 staff members, meaning there was .77 staff for each patient. Now there are 142 beds and 225 employees — 1.58 staff for each patient.
In 1977, there were only a few registered or licensed practical nurses at Hi-Acres. In 2011, there are four unit managers, all registered nurses, plus five wing managers who are registered nurses. There are also LPNs in some of the wings and trained medication aides.
Employees are also more highly trained than ever before, which is a necessity when so many patients need far more care than they once did. Certified nursing assistants are trained to be medication aides, for example.
“There’s constant training while you’re here,” Riffe said. “Every month, there’s training.”
The “caring” element in long-term care has remained a constant, however.
“I can teach you to make a bed, and teach you how to feed (a person), but if you just do it mechanically it’s no fun — no fun for you or for the resident,” Riffe said, comparing it to an assembly line. “And you can’t do that.”
Regulating care
Long-term care facilities have become more regulated than ever before. Staff already keeps a Minimum Data Set on all patients, which include their patient histories, physicians’ orders and medical data. All that information is sent to state and federal officials.
As of Oct. 1, the MDS will be revised to include social and behavioral background information.
“We’ve always (kept track of) it, but they want a system they can come in and check,” Riffe said.
At least 10 positions have been added to cope with the paperwork.
Long-term care expenses and costs have skyrocketed, too. In 1977, Riffe’s budget was just a few hundred thousand dollars. The budget for 2011 is expected to reach $11 million.
As options for assisted living and home care have increased, nursing homes have become just one choice of many — and people sometimes think differently about long-term care than the other choices.
“Nobody fusses if they have to go to the hospital,” Riffe said, but people feel differently about nursing homes. “That means I’m older, I cannot take care of myself, and we don’t want to think that way.”
Assisted living can be accepted more easily, Riffe said, but as more and more care is provided by assisted-living facilities, they too are likely to become more regulated.
He also sees providing dialysis as a possibility for long-term care facilities in the future.
“(Long-term care) is an exciting profession to get into,” Riffe said.
Sun reporter Kari Lucin can be reached at 701-952-8453 or by email at klucin@jamestownsun.com
Tags: local news, news, riffe, health
RSS Feeds