The Green House. Project: An Innovative Non-Institutional Rehab Program. Real Home - PHYSICAL ENVIRONMENT. Meaningful Life - PHILOSOPHY OF CARE

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1 Slide 1 The Woodlands of John Knox Village Kandice Robinson krobinson@jkvfl.com The Green House Project The Green House Project: An Innovative Non-Institutional Rehab Program Slide 2 The Green House Model The Woodlands Life Care Community located in Pompano Beach, Florida 7 Story Mid rise Building 144 Skilled Nursing Certification 12 homes 4 Rehabilitation Homes 8 Long Term Care Homes Slide 3 The Green House Model Core Values Real Home - PHYSICAL ENVIRONMENT All areas of the organization are changed to fully embody Meaningful Life, Real Home and Empowered Staff. Each key aspect: physical environment, philosophy of care and organizational practices work in concert with one another to create the maximum benefit for the Elders and staff. Meaningful Life - PHILOSOPHY OF CARE Empowered Staff - ORGANIZATIONAL PRACTICES

2 Slide 4 Living Provides a home for people, with private room/baths, that harmonizes with the neighboring community Creates a real home environment with an open kitchen, great room, and easy access to the outdoors. Meets all federal and state licensing requirements Slide 5 Real Home Slide 6 Real Home

3 Slide 7 Real Home Slide 8 Slide 9

4 Slide 10 Real Home ALL Private Suites Real Rehab in a REAL HOME! Customized for ADL s Home cooked meals Motivating Convivium Slide 11 Meaningful Life! Slide 12 Meaningful Life Promoting dignity Welcoming Pet friendly space Pet Assisted Therapy Programs Full Service Spa Palm Bistro

5 Slide 13 The Art of Convivium Slide 14 Organizational Redesign Elders Rule House is staffed by Shahbazim Versatile workers with 140 hours of education Supported by a Clinical Team Empowered Staff Slide 15 Empowered Staff Nurses, Therapists and Shahbazim care for specific diagnosis o Ortho Home o Stroke Home o Cardio/ Pulmonary Home Shahbazim observe therapy sessions and actively participate in the healing process Therapy is on-going Independence is promoted Dedicated Staff

6 Slide 16 The Art of Not Floating! Dedicated Staff Decreased Readmission Rates Decreased Drug Errors Early Detection Deep Knowing Therapy Ongoing Slide 17 The Value of Deep Knowing Each Rehab Home has dedicated staff 1:1 Therapy Similar Diagnosis Reduction of Infection MD collaboration Developing rehab protocols based on shared goals and outcomes VIP Spine Surgery Collaboration Slide 18 Re-Inventing SNF Level of Rehab Intensive Rehab Units (IRU s) Offer: PT/OT 7 days a week 3 hours of therapy per day Daily MD Visits, with specialists on staff (Cardiology, Pulmonary, Infectious Disease) Shorter lengths of stay Skilled Nursing and Rehab: MD visits within 20 days of admission Therapy not available on weekends Long lengths of stay Medicare and Managed Care not approving IRU level of care Opportunity to model IRU level of Rehab

7 Slide 19 Functional Rehabilitation Slide 20 What is Functional Rehabilitation? This is your rehab. You decide. What s important to you? No institutional gym needed Ability to imitate not simulate, your everyday activities. Real Rehab in a Real Home Slide 21

8 Slide 22 Slide 23 Slide 24 Institutional vs. Functional

9 Slide 25 Institutional vs. Functional Slide 26 Slide 27 Going Home

10 Slide 28 Achieving Results Slide 29 What makes it better? PT/ OT/ Speech therapy provided 7 days a week Specialty homes (Ortho, COPD, ect.) Decreased infection Dedicated Staff Equipment needs are minimal. Direct caregivers involved in therapy Reinventing the Institutional Model of Gym Therapy Independence to promote dignity is our number one goal! TMC Rehab Consultant- 180 Skilled Nursing Facilities Nationally Slide Functional Outcomes - The Woodlands

11 Slide Functional Outcomes Nationally Slide National Hospital Readmission Rates at 30 days Slide Woodlands Hospital Readmission Rates at 30 days

12 Slide National Hospital Readmission Rates at 100 days Slide Woodlands Hospital Readmission Rates at 100 days Slide National Reintegration

13 Slide Reintegration from The Woodlands Slide National Average Cost Per Episode: $ 14, 805 Slide Cost Per Episode - The Woodlands $13, 012

14 2016 Trinity Health - Livonia, Mich. 42 Slide 40 TMC Reports: Highest Functional Outcomes Lower cost to CMS per episode Average LOS Nationally- 28 days 20 Days at The Woodlands Highest Reintegration Highest outcomes, lower costs, lower lengths of stay, lower hospital readmissions, highest reintegration to community Slide 41 TMC Metrics Nationally The Woodlands Functional Outcomes Cost to Medicare $14, 805 $13,012 ($1,793) Hospital Readmission 31% 12% Reintegration 53% 84% Length of Stay 28 days 20 days Slide 42 SNF Performance Network: BPCI Performance Represents all at-risk Holy Cross BPCI episodes discharged to the SNF performance network from Q Q based on February 2017 claims files. This chart does not account for case mix (ie: COPD v. LMJ). Q claims are not yet complete. Post-Acute % Eps w Episodes Cost/ Eps Avg LOS Per Diem Cost Provider Readmit CPA 32 $14, $ % FLL 70 $14, $ % John Knox 48 $9, $ % MO 29 $18, $ % MP 67 $16, $ % SJ 5 $7, $ % WM 26 $10, $ % WH 16 $8, $ %

15 2016 Trinity Health - Livonia, Mich Trinity Health - Livonia, Mich Slide 43 SNF Performance Network: BPCI Average Cost per Episode by Quarter All at-risk Holy Cross BPCI episodes discharged to the performance network from Q Q based on February 2017 claims files. Figures are not adjusted for case mix. Q3 claims not complete. $25,000 $20,000 SNF Cost $15,000 $10,000 $5,000 $0 Court at Palm Ft. John Knox Manor Oaks Manor Pines St. John's Whitehall Aire Lauderdale Boca Raton 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 Wilton Manors Slide 44 SNF Performance Network: BPCI Ortho Performance Represents all at-risk Holy Cross Orthopedic BPCI episodes discharged to the performance network from Q Q based on February 2017 claims files. Figures are not adjusted for case mix. Q3 claims not yet complete. Purple represents adjusted historic values Ortho LOS 20% 18% 16% 14% 90-Day Readmission 20 12% 15 10% % 6% 4% 2% 0% LOS LOS (Adj. Historic) Readmissions Readmissions (Adj. Historic) Slide 45 What Are People Saying? Physicians: Telling their patients we are the only place to go Small homes, with like diagnosis significantly decrease the risk of infection. Therapy is predominantly done in the rehab homes, decreased chance of cross contaminating shared therapy equipment. Discharge Planners: Finally a rehab choice that nourishes the mind, body and spirit. Calling us the Ritz Carlton of rehab! Not just because of the beautiful building, but because of the excellent care we are providing.

16 46 Slide 46 What Are Our Competitors Saying? Slide 47 Slide 48 Home is not a place, it s a feeling!