This article is sponsored by The Joint Commission. In this Voices interview, Senior Housing News sits down with Sheila Bogen, Executive Director at The Selfhelp Home, to learn how and why The Selfhelp Home decided to pursue accreditation with The Joint Commission, which it received in September 2021, making it the first senior living community to do so. She explains how her organization prepared for this process and what they expect to see in the future as a result of the new accreditation.
Senior Housing News: What career experiences do you most draw from in your current role?
Sheila Bogen: I recall my earliest hospitality experience back in England, working in my family’s luxurious hotel on the southeast coast of England, in a gorgeous, little town called Bournemouth. When I married and moved to America after a few years of child-raising, I entered the senior market. I’ve always enjoyed being around seniors, working with them, and hoping to be one. I was able to realize my dream. My working life here in the United States, both in skilled, for-profit nursing homes, and also in not-for-profit CCRCs.
This has provided a lot of learning-on-the-job experience. I bring all of it to The Selfhelp Home every day.
What conditions in the senior housing industry right now necessitate more external oversight?
Bogen: People who are moving into assisted living look like the people that I admitted 25, 30 years ago into skilled nursing home beds. These are people who have to move into assisted living because of their declining health. Because of this, we were very interested in what The Joint Commission had to offer. Even though every state has different rules and regulations about what can go on in assisted living, there’s no federally mandated guidebook like there is in skilled nursing.
When The Joint Commission opened up their services for accreditation in assisted living, we were very excited. It levels the playing field. People say, “I understand I lived in my house as long as I can. Now, I have to move on into a facility.” It’s imperative for us to concentrate both on healthcare and hospitality.
What were your organization’s key struggles and the strategies that you took to overcome them?
Bogen: The big thing is Coronavirus. Things were humming along very nicely until this terrible plague struck. Our biggest challenges today are number one, census recovery. How do we go about reestablishing Selfhelp Home within our senior communities as a safe place to move into?
Joint Commission accreditation elevated our reputation as a quality provider. If there’s a standard they can actually put their finger on to say, “Well, that’s a Joint Commission facility,” it’s more attractive because they know the conditions will be much better than in other places.
The other part of the equation is attracting staff. COVID resulted in a tremendous number of layoffs, and some of those people are reluctant to go back in the field. Some of them are scared. Some of them still have young kids at home. That’s another reason we went for Joint Commission accreditation. I think people want to work for quality organizations.
Why did Selfhelp Home feel it was important to pursue Joint Commission now?
Bogen: We believe that our residents deserve the best, and we will go all the way to make sure we can give them the best. Achieving Joint Commission accreditation demonstrates this. It shows that we actually are the best.
Additionally, we wanted to be the first senior housing organization in the nation to receive the accreditation. We like to do things ahead of the curve, and if I can stand out today in October 2021 and say, “I have been accredited by the Joint Commission, not only in my skilled nursing, not only in my subacute rehab departments but also in my assisted living department,” then I’m way ahead of everybody as well.
How did your organization go about preparing for accreditation?
Bogen: I called my team together and said, “What do you think about going for accreditation in assisted living?” To tell you the truth, they said, “Wow, what a great idea.” They were enthusiastic from the get-go, absolutely. We were very fortunate that we got accreditation in our other departments because a lot of the work was already done. For example, emergency preparedness to the layman in the street means you have a flashlight if the electricity goes out. We have three 4-inch binders that we deal with for emergencies and that applies both sides of the coin — assisted living and skilled nursing.
We didn’t have to recreate that particular portion of the program. The majority of work fell on the assisted living team. They had to make sure that every “i” was dotted according to the standards, and they’re pretty high of The Joint Commission. We had to make sure all of our medications, services and the resident plans of care were reviewed as a formal, interactive and continual exercise in assisted living.
It was just fine-tuned for The Joint Commission survey. We were fortunate to be able to work with a company we used when we applied for our Joint Commission accreditation for our skilled nursing unit. The company is called Achieve Accreditation, and we would not have been able to do this without them. They did a gap analysis for us to show where we are and where we need to be for Joint Commission standards. We were already doing a tremendous amount of things that The Joint Commission asked for.
The other thing we had going for us, which helped us tremendously with getting our accreditation, is that for years we’ve had our own holistic care meeting. The interdisciplinary team meets once a month and discusses whether a resident has declined in health, whether their ADLs are still in the right place, whether they’re participating in activities and eating properly. It tells us a great deal.
What do you hope will come next for Selfhelp Home now that you are accredited?
Bogen: We hope we will have a pickup in census in the Selfhelp assisted living department. We hope that we can attract quality staff from the outside, even if they haven’t worked in health care. Anyone who can be hospitable and polite should come and see me because we can teach you the other part. The other thing that we hope will come out of this is the establishment of our own home care company. We would like to have our own staff, our own training, our own oversight of this part of our work so that we know that the people who are coming in are first class and well-trained.
It also helps continue the full continuum of care that we offer here. We offer outpatient therapy, respite therapy. This would just be another add-on to the full continuum that we already offer.
What is your advice to your industry partners such as providers, nonprofit CCRCs and other homes like yours?
Bogen: My advice to them is make sure you have a strong, committed team to get this going, including the support of the executive director. If your team is wishy-washy, and you’ve got people saying, “I’m not going to do that. I can never do that,” you’re not going to succeed. We’re very fortunate to have the full support of our board, including the health initiatives committee members, who were very supportive in getting accredited.
The other advice is, don’t go for accreditation alone. When you’re doing it for the first time, go with a company that can help you. We recommend Achieve Accreditation because we’ve worked with them. They’re a national company and we found them to be transparent and absolutely helpful. Their quality of care was excellent.
Coming into this year, no one knew fully what to expect in the senior living industry. What has been the biggest surprise, and what impact do you think that surprise will have on the industry in 2022?
Bogen: There are a couple of things. First of all, coming into this year, we have seen a slight uptake in admissions, which is, of course, great. We’ve also seen somewhat of a shift away from institutionalizing healthcare. Originally, nursing homes started based on the model of a hospital as a nursing station, and everything that happens goes on in that nursing station. We’ve moved away from that, and there are more and more people embracing person-centered care. We also see on a physical level plans to create more private rooms for our skilled patients.
Everybody has their own private apartment here at Selfhelp. Not only that, if somebody moves into Selfhelp as an independent resident, as they move through the continuum into the levels of assisted living, they do not have to move out of their original apartments unless they want to. The thought of moving is just awful for most people. That is a tremendous advantage. The people in the industry are starting to talk about the spaces that we provide for our seniors in a much more holistic way.
Editor’s note: This interview has been edited for length and clarity.
The team at The Joint Commission offers unmatched resources and learning opportunities for ongoing quality improvement efforts for the duration of the accreditation period. To learn more about why Joint Commission accreditation is right for your organization, visit jointcommission.org/alc.