January 2007
19 of the 23 ORANJ CCRCs (82%) responded to the survey and it was clear from the completed questionnaires that most respondents took time to submit full and thoughtful answers. Two methods will be used to present the results. One is by the percentage of “Yes” and “No” answers but it is important to remember that percentages are somewhat misleading when the total number of responses is only 19. The second is a summary of comments which will “flesh out” the percent answers.Health Care Committee: %yes %no
- Does your facility have a Health Care Committee? 89 11
- Does your committee have a mission statement? 66 34
- Membership of your committee
- Professional Staff 64 36
- Health Care Administrator 93 7
- Medical Director 58 42
- Director of Nursing 86 14
- Other Personnel 91 9
Chair of the Health Care Committee is usually selected by appointment by the president of the Resident Council (84%). Resident Councils as a whole in three CCRCs appointed the chair of the Health Care Committee, the Executive Committee of the Resident Council in two CCRCs chose the chair, while three of the Health Care Committee chairs volunteered for the position.
Term limits varied between one and two years, and the usual practice was to permit a second one year term. The number of residents on the Health Care Committee varied from 5 to 18, with a median of 8 and the total membership of the Health Care Committee varied from 5 to 22 with a median of 11. Every Health Care Committee included some members who had a background in the health professions, the percentage ranging from 12% to 83% with a median of around 40%.
Medical Services On Site: %yes %no
- Temporary stays in long term care ordered by facility physician? 88 12
- Registered nurse on duty 24 hours per day to respond to medical emergencies? 89 11
- Does your facility provide these services?
- Annual physicals 53 47
- Routine screenings 63 37
- Blood pressure monitoring 95 5
- Wellness nurse checks 79 21
- Treatment of minor cuts 95
- Annual flu vaccinations 100 0
- Pneumonia vaccinations 95 5
- Physical rehabilitation therapy 100 0
- Intravenous procedures 89 11
- Visiting health care providers, e.g. dentist, podiatrist, ophthalmologist etc. 95 5
It is clear that most of us are living in a full service CCRC because medical care is available! The results show that almost all the responding facilities cover most of the items on the questionnaire check list, with only the two routine procedures, physicals and screenings, covered somewhat less often than the other items. One respondent noted that intravenous procedures are only done in the skilled nursing facility, and another pointed out that the annual physicals in his CCRC are not provided for those residents who are under the care of outside doctors.
Motorized/Electric Vehicle/Chair Policies: %yes %no
- Is the approval of your facility physician required for use of a vehicle? 47 53
- Is passing a driving test and licensing required? 67 33
- Is proof of insurance with minimum of personal liability required? 53 47
- Is periodic retesting required? 59 41
- Are there parking regulations? 76 24
One member noted that permission to use an electric chair had to come from the resident’s personal physician (as distinct from the facility physician), another added that retesting is mandatory every three years, and a third stated that electric chair parking is a distinct problem at his facility.
Medical Transportation for Scheduled Medical Appointments: %yes %no
- Does your facility provide medical transportation? 100 0
- Is there a charge for this service based on time/distance? 68 32
- Can arrangements be made for a staff member to accompany the resident? 64 36
- Is there a charge for this service? 63 37
- Do you have resident volunteer drivers who use their own cars? 27 73
Four respondents noted that medical transportation is free when within designated range, otherwise there is a charge. At one facility, there is a charge for medical transportation if the resident is not under the care of that facility’s resident doctors. Staff members from one of the responding facilities are permitted to accompany a resident to the hospital if that facility’s staff doctor requests such a service. There were a number of comments related to the use of volunteer drivers, the gist of which was that such transportation can only be permitted in an emergency.
Providing Information to the Community on Residents Admitted to the Hospital or Health Center: %yes %no
- Do you have a waiver system with residents’ signatures which permits release of such information? 63 37
- Is this information posted on a daily basis? 21 79
- Does your facility have a “buddy system”? 21 79
One facility noted that residents can submit names of other residents or relatives to whom information can be released, but a formal “buddy system” is not in place. Another wrote that there used to be a “buddy system” but that the plan had “petered out,” and a third said that information about residents who were in the hospital or in the health center was posted every three or four days.
Resident Volunteers: %yes %no
- Do you have resident volunteers providing services in your Health Center? 42 58
- Do you have a volunteer training program? 42 58
- What services do they perform?
About half of those responding indicated that residents played an important volunteer role in the Health Center. Ten of the respondents identified various duties performed by volunteers in their facilities, with most including companionship, assisting at meal times, making sure that patients had fresh water, transporting patients to activities and appointments (beauty salon, church services, library, etc.) helping with crafts (knitting, etc.) delivering and helping to write letters, and assisting with social programs (singalongs, bingo, etc.).
Prescription Drugs: %yes %no
- Do you have an on-site pharmacy? 16 84
- Does the pharmacy (on-site or off-site) bill residents? 83 17
- Who provides pre-packaged drugs in your Health Center? Respondents listed the pharmacy, if any, that their facility uses.
- Does the drug provider accept the residents’ health insurance coverage? Most respondents answered“Yes” to this question, with the caveat that their answer depended on the terms of the policy.
- How are unused packaged drugs handled? Seven noted that these drugs were returned for credit where applicable. Two said that their Health Center followed whatever procedure the NJ state law mandated. Two said that these drugs were discarded. One said that unused drugs were the property of the resident.
Medical Forms: %yes %no
- Does your facility have a form/procedure for a resident being admitted to a hospital? 84 16
- Does your facility have an emergency medical card for the residents to carry in their wallets? 32 63
- Does your facility require an advance medical directive? 62 48
- Does your facility have a magnetic refrigerator card for medical information? 84 16
- Does your facility have an electronic system for medical records? 27 73
A number of respondents who answered “Yes” to the first question added specific information about the kinds of information which the transfer form included (past history, diagnosis, medications, etc.). There was one response which noted that while his facility did not issue emergency medical cards, residents were urged to carry this kind of information when leaving the campus. Three respondents whose facilities do not require an advance medical directive added that the medical department urges such a directive be completed. Two respondents said that while their facilities do not have magnetic information cards, similar forms do exist and are completed by each resident. Five noted that while their facilities do not have electronic systems for medical records, they are in the process of implementing such a system in the near future.