Confident Choices for Senior Living

1. Confident Choices for Senior Living Volunteer Reviewer Training

2. Your Role as a Site Reviewer Thank you for volunteering to be a Confident Choices site reviewer! In this role you will make an important contribution to Aging Services’ quality initiatives in senior housing. Aging Services’ Confident Choices for Senior Living program is designed to: • Improve the quality in HWS/AL settings by setting high standards for HWS providers and by identifying best practices that can be shared with other providers • Increase public trust and consumer confidence • Inform consumer decision-making

3. This Training Includes: • A brief review of the Confident Choices Application Requirements • The role of Aging Services staff, District Coordinators, and volunteer Site Reviewers • How to prepare for and conduct the Site Review • Some tips for Reviewers

4. Confident Choices Application Requirements The CORE requirements for applicants: • Must be a currently registered HWS establishment • Ethical Conduct: adoption of Aging Services’ Code of Ethics or national equivalent within past 2 years • Experienced Leadership: Housing Manager has at least 1 year of experience and completes at least 10 CEU’s annually • Consumer Satisfaction: resident and/or family satisfaction survey within last year • Consumer Information: process for welcoming and orienting new residents/families and a current handbook

5. Confident Choices Application Core Requirements • Regulatory Compliance & Emergency Preparedness • Operational response plan for weather and other emergencies • Employees and volunteers receive training on emergency response plans • Residents receive annual training (as appropriate) • Fire drills conducted in accord with State Fire Code • Conducts an annual non-fire emergency drill • Compliance with other applicable requirements

6. Confident Choices Application Core Requirements If the building offers a dementia care program or unit, • Must follow currently recognized dementia care standards, such as: 1) Adoption of Aging Services of Minnesota’s Guiding Principles for Dementia Care within past 2 years, OR 2) Adoption of the national Alzheimer’s guidelines or similar program • Must submit a copy of the 9 disclosures required by MN Statute 325F.72 (this provides more background information about the program for the reviewers)

7. Confident Choices Application Requirements • Must address at least 9 of 23 Elective Requirements divided among these categories: • Quality of Care & Services (at least 2 from this category) • Open, Effective Communication (both of these electives) • Resident Health, Wellness, and Life Enrichment (at least 2 from this category) • Employee Satisfaction and Development (at least 2 from this category) • Community Connectivity, Benevolence, and Innovation (at least 1 from this category)

8. Quality of Care & Services Electives Applicants must choose at least 2 of the following electives: • Clinical Performance Improvement Plans • Non-Clinical Performance Improvement Plans • Resident Transitions Coordination • Data Collection on Key Measures/Goals • Involvement of Residents/Families/Responsible Parties in Improvement Efforts

9. Open, Effective Communication Applicants must address both of these electives: • Resident/Family meetings or councils • Resident communication system

10. Resident Health, Wellness, and Life Enrichment Applicants must address at least 2 of these electives: • Resident education/learning • Referral systems/community integration • Resident socialization and recreation • Fitness/Wellness programs • Resident-centered technology • Resident care conferences

11. Employee Satisfaction & Development Applicants must address at least 2 of these electives: • Employee satisfaction survey • Employee education and training • New employee orientation • Employee recognition • Employee meetings • Exit interviews

12. Community Connectivity, Benevolence and Innovation Applicants must address at least one of the following: • Social accountability • Resident/employee benevolence • Innovation • Volunteers

13. Confident ChoicesApplication Process • Providers can check with staff to see if their Code of Ethics, Guiding Principles for Dementia Care are current (update required every 2 years) • Code of Ethics and Dementia Principles information is on www.agingservicesmn.org(under “Provider Resources, then “Quality Initiatives”) • HWS establishments can find the application and instructions on the Aging Services web site (or call staff) • Application fee must accompany application: • Aging Services members-initial fee $150; if not approved and re-apply within one year $100. Member renewal fee is $75. • Non-members – initial fee $300 and if not approved and re-apply within one year $250. Non-member renewal fee is $250.

14. Staff Review of the Application • Staff reviews the written application for completeness (no judgments are made on the quality of the statements or programs): • Have all the core requirements been met? • Has the applicant addressed at least 9 elective requirements? • Staff will contact the applicant and hold the application if there is an oversight that is easily corrected • If requirements have not been met, staff will contact the applicant and provide technical assistance if they want to re-submit

15. If the application is complete: • Either Staff (or an Aging Services member serving as a coordinator in Districts C and F) will identify two interested reviewers. • Staff will check with both the applicant and the reviewers about any known conflict of interest concerns – applicants may request other reviewers if a conflict is identified. • If there are no conflicts of interest, staff sends the reviewers a copy of the application, review sheets, an expense form and other information.

16. Important Roles • Aging Services staff – reviews applications for completeness, corresponds with applicants, answers questions, identifies two reviewers for each application • District Coordinators in District C and F assist in identifying and assigning volunteer Reviewers. They also help recruit new Reviewers and act as “ambassadors” of Confident Choices • We always try to schedule a first-time reviewer with an experienced reviewer • Volunteer Site Reviewers – • review application and identify items for further review on-site • conduct site reviews • complete review forms with recommendations and return to staff • Act as ambassadors of Confident Choices

17. Program Integrity Confidentiality Statement – one time only • Requirement for Volunteer Reviewers • Review and sign as part of the reviewer training • Return signed statement to Aging Services staff Conflict of Interest Statement – one for each site • Reviewers sign one for each building they will visit • Applicants are asked to indicate if they have a concern about an assigned reviewer • If conflict of interest is declared, the conflict must be explained fully • Return statement to Aging Services staff prior to the visit

18. Preparation for the Site Visit • Reviewers send their conflict of interest forms prior to the visit to Aging Services staff • Review the application prior to site visit • Identify documents or programs you want to review on-site • Note any questions you have • Review the application review form. • The review form will help guide your review of the application contents and the common areas/physical plant when you are on-site • It can be helpful if one of the reviewers leads the conversation while the other reviewer takes notes. Work this out ahead of time—new reviewers might want to be the note-taker.

19. Scheduling the Visit • Lead reviewer schedules the visit with the applicant and coordinates date/time with second reviewer--. • Let the applicant know if there are documents you want to look at when you are on-site • If possible, try to schedule your on-site review for times when activities are going on in the building and residents are present. • Plan on about an hour for your visit • If several buildings on a campus have applied, Aging Services will ask the reviewers to do the visits at the same time, so you may need to allow extra time. • In campus situations, the policies and programs are usually similar in all the senior housing buildings so the review of several buildings usually doesn’t take a lot of extra time.

20. During the Site Visit • During visit, reviewers verify information on the application • Ask to see documentation as appropriate • Tour the common areas and grounds/parking lots if possible given the weather. • One or both reviewers take notes on observations on the review sheets, identifying any best practices • Program Integrity • No Gifts – We ask that reviewers politely refuse any gifts (mugs or other giveaways) or meals, but you can accept a drink and light snack

21. At the End of the Site Visit • Applicants will ask you whether they “passed.” Tell them: “We need to finish our review forms and submit them to Aging Services of Minnesota. Aging Services of Minnesota will contact you with the results very soon.” • Thank the building manager and other staff for the tour and their time, and go off site to review your notes and come to a joint recommendation. • Aging Services will send a letter to the applicant with the decision or will follow up with a phone call or email if there are any issues.

22. Final Steps for the Reviewers After leaving the HWS establishment: • The two reviewers compare notes and observations • Compile notes on a single review sheet, along with your recommendation whether the establishment should receive the Confident Choices designation • Identify any best practices • Identify any concerns that Aging Services staff should relay to the provider • Please write legibly!! • Send the completed review form with recommendations to Aging Services staff • Discard/shred your copies of the application • Send Aging Services staff your expense form

23. If the Reviewers’ Recommendation is “Yes” the Site Should Receive the Confident Choices Designation • Staff will prepare a letter notifying the applicant that the building has received the Confident Choices for Senior Living designation • Successful applicants will receive a marketing packet and plaque. • Staff will follow up with the applicant to ask permission to share any best practices the reviewers have identified

24. If the Recommendation is “No” • If, after the site visit, you honestly feel as though this applicant does not deserve the Confident Choices designation, contact Aging Services staff right away and discuss your concerns and observations. • In consultation with other staff, staff will make the final determination on how to proceed. • One possibility might be a second site visit by different reviewers for a second opinion. • Or, the applicant might be asked to submit additional information or to re-apply • If the applicant is unsuccessful, staff will communicate that to the applicant and will offer technical assistance.

25. Confident Choices On-Site Review • Purpose of the on-site visit • Verify what the provider submitted in the application • Ensure validity and integrity in this process • Key question: “Does the Confident Choices designation belong on this building?” • NOT intended to be • Prescriptive: we aren’t there to tell them how to do “it,” just that they are doing “it” • A “survey” in the sense that we have come to know it

26. Key Points to Remember • Focus on common areas • You don’t need to go into resident apartments—but it’s often hard to avoid politely • Be friendly to residents, family members and staff, but do not interview them • Don’t just focus on what you might see, but also what is done about it – for example, spills on floor

27. Key Points to Remember • Keep local standards in mind – what is appropriate in the Twin Cities may not be appropriate for a very small rural community (and vice versa) • Keep the resident population and customer needs and expectations in mind • This is intended to be a collaborative process; work with the housing director, ask questions • End result is a “yes” or a “no,” not a score or statement of deficiencies

28. Key Points to Remember • Remember that you are not a consultant and to check for your biases – just because you wouldn’t do “it” that way, doesn’t mean it is wrong • Visit should take about an hour, may be two hours if building/campus is large • Each HWS building must apply separately, but visits to several buildings on a campus or buildings that share common policies and programs may be coordinated and streamlined. Talk to staff if you have questions about a visit to multiple building sites.

29. Tips for Reviewers • Ask to actually SEE key documents or related materials that support the information on the written application (cue the applicant ahead of time re: what documents you will want to review). But be careful of your time—you don’t need to examine everything. • Ask questions to see if a program described in the application is actually up and running. Don’t give the applicant credit for things they are planning to do in the future. The application needs to reflect what is currently available.

30. Tips for Reviewers • Keep the conversation friendly—this is not a survey. To help your conversation along, use leading phrases like: • “Tell me about your . . .” • “What have you done with your satisfaction survey results?” • Remind applicants that you are not judging the QUALITY of their program or process, just verifying what they described in their application. • Providers are proud of their buildings and will want to give you the “marketing” tour, but watch your time and stick to things on the application that you need to verify

31. Tips for Reviewers • If, for your own information apart from the CC review process, you want to ask more detailed questions about a program, say, “I’m curious, this has nothing to do with the CC review, but can I ask you. . .” • If you are offered some sort of gift or souvenir from the establishment, please nicely tell the applicant of the Confident Choices “no gifts” policy for volunteer reviewers to protect the integrity of the program--but, feel free to accept a drink and a light snack. • Applicants will ask you whether they “passed.” Tell them: “We need to finish our review forms and submit them to Aging Services of Minnesota. Aging Services of Minnesota will contact you with the results very soon.”

32. Summary for Reviewers: • Sign the confidentiality statement and return it to Aging Services staff before your first site visit • Sign a conflict of interest statement for each site you will review; return statement to Aging Services staff • Review the written application prior to site visit • Complete the final review form off-site with your partner and send completed form with your recommendation to Aging Services staff.

33. Why Be a Volunteer Reviewer? Our reviewers noted the following benefits they’ve personally found from doing site visits: • You get great ideas to take back to your own community • You’re inspired to look at your own practices differently • Just expanding your knowledge about senior communities is helpful • It’s great being exposed to so much “good news” • Networking--Getting to know your peer community is always a benefit • It’s a great opportunity to develop a relationship with your reviewer partner

34. Peer Reviews are the Essential Part of the Confident Choices Program Aging Services’ Confident Choices program depends on volunteers like you. In appreciation for your time and expertise, Aging Services: • Covers your mileage and meal expenses incurred while doing a review • Sends volunteer reviewers a $25 coupon for each review completed. This coupon can be used toward the cost of an Aging Services educational program.

35. Questions??? Feel free to contact Mary Youle at myoule@agingservicesmn.org or 651-645-4545