Annual Department Reports 2013

Published: May 16th, 2013







The Pastoral Care Program at United Living Community during 2012:

1.  Visiting residents at the nursing home, Park Place Assisted Living, Park Place Apartments, and the hospital.  Meeting with members of residents’ families.

2.  Conducting services of worship, mostly at the nursing home, including weekly chapel services, memorial services for deceased residents, and services on holy days.

3.  Leading weekly Bible studies at the nursing home, Park Place Assisted Living, and Park Place Apartments.

4.  Visiting each classroom at theChildDevelopmentCenterweekly to read, sing, or play with the children.  Eating lunch twice weekly with the preschool children.

5.  Coordinating the local presentations of the Hospice Foundation of America’s national “Living with Grief” and “New Perspectives” conferences.

6.  Participating in programs and organizations in the church and community.

7.  Participating in the organizational, administrative, social, and educational activities of United Living Community.  Meeting with members of the staff about their concerns.

8.  Representatives of many churches visiting, conducting services, leading devotions, and administering Holy Communion for residents of United Living Community.



The application for licensure for Assisted Living has been sent in.  We are now awaiting acceptance.  The apartments are all occupied at this time.  We had two transfers to ULC in March along with two admits in March.  We have a waiting list for the apartments as well.

We have been engaged in activities with the CDC.  The residents recently made cookies for the children for snack time.  This activity was very well received.  We will begin indoor planting this week with the CDC.  The residents are very much looking forward to the gardening activity.  We have put on hold our outings due to the weather.  We do believe Spring is out there somewhere.  One of our new admits is an artist, he has been doing painting & drawing activities with the children.  The children really enjoy the time he spends with them. 

The painting & carpeting is completed at PPA with the exception of a few areas where the baseboard carpeting needs to be completed.  It all looks great together.  We have started Spring cleaning as well in all areas, the apartments, storage spaces, utility room, Solarium.

The residents have remained healthy & happy. 



I will start with my quote from last year:  It takes a team to play together. Each person has an important position to play.  If they do not play together the outcome may not be a win. Winning is not everything as we learn in life but playing together is a victory. 

You need a coach or leader to guide you through the game. Our victory will be measured by providing the best quality of care and life for all our customers and to be A.L.I.V.E.

I have looked through last year’s annual report and realized I had under estimated the construction project.  It has affected many important things here at the ULC.   One issue has been the intergenerational concept. One major issue has been getting through the building with the kids.  It is hard to bring the little kids over and same bringing the residents down to the kids. I have to say it has been nearly impossible during construction with generations and weather concerns. 

We have held generations, but mostly for the Toddler 3 and Preschool age groups. As soon as construction is finished we hope generations will be back in full force. We will also start up the baby lover’s activity again.  I do know residents like the kids to visit their rooms so we have added signs on their doors that states "Welcome to My Home".  The sign is to alert teachers, kids, and parents to come in and visit.  Looking into the future, I would like to start up the "STAR" program again, visit the school systems, have some 1st grade classes come and read to the residents monthly, involve high school students with reading to residents or have them help activities.  I have a goal of meeting with those in the school systems to move up and beyond the intergenerational concept we have in place already.  Again it will take a TEAM effort to move this forward.

We continue to have a strong base of volunteers that come and help entertain each month. We thank our volunteers every day  because without them, we would not be able to do all that we do.

The neighborhood concept has brought on a learning experience. When construction is done we will have 4 nursing homes to run.  The activity staff are trying hard to do small group activities in each neighborhood, and they are also trying to keep up with about 10 or more 1 to 1 visits a day in each neighborhood, along with keeping up the intergenerational concept, pet cares, and the large groups that are offered to all neighborhoods.  The positive with the smaller groups is it is a better quality of life and programming of activities that they are choosing. The neighborhood concept still continues to grow and working on leaders with the neighborhood concept or coaches to help them grow.

The activity department won an award for their red carpet theory. I have put together a theory that everyone must feel they have walked the red carpet. When a resident is new the activity staff meet with the resident to find out what would make them feel special we also have this theory with our birthdays.  We ask the residents what they want for their birthday to make them feel special. The staff have done a great job with follow up on the red carpet theory and it has been a great success. It does help enhance and empower the residents if they are new or if it is their birthday it helps recognize each individual. I do a QA study on this so the red carpet theory is followed through with each resident. This is not a task done alone the TEAM has been very successful on the follow through.

The Joy Ranch outing was a huge 24-7 outing and a very successful one.  The SDSU walking club is a success and we also have 3 ladies that do water aerobics.   We will continue to strive to provide quality outings continue to use BATA.  Once the weather gets nice we will start with our outdoor outings like the fishing outing. We can't wait to have trolley rides again and to start up our intergenerational gardening projects along with our outdoor walking clubs. I have tried to base more outings on resident request from resident council meeting like going to Volga Valley to eat.  It is always nice to get around the community and spread our name.

I am always proud of those that work in activities. I thank Jen, Bobbie, Diane, Deb for all their hard work. I know we do have many staff that fill in for activity staff and I thank them for working with us to better the residents lives. I do know I lost Evelyn Fee this year due to budget issues, but she is still volunteering at the United Living Community. She has brought and still brings so much to our home. We are lucky to have Evelyn on our side. God bless her for all her years of service, donations, and time. Words alone can't express enough thanks.

We all really have many goals and tasks we want to follow up on to make life meaningful for our residents. I am hoping to start up the Haunted House again this year and would really like to host some type of Grandparents Celebration for the community. We have many goals on equipment to make our house exciting and useful and bring meaning to all their lives.  I know the memory care staff will need more training and each neighborhood will run on such different levels.  There will need to be lots of education, education, and education.

I think to summarize my report the construction has put a damper on things, but once it is all done and residents are in their right rooms and neighborhoods things will be run more smooth with education and hands on assistance.  It will be a learning process in each neighborhood. We can only continue to warm the soil and grow together through the process of change.



It continued to be a busy and exciting year at the United Living Community.  We welcomed 63 new residents to ULC over the year.  We had two residents come for respite care.   We discharged twenty-four residents either back home or to other facilities.  We were saddened by the death of thirty-nine residents.  We had several people use our adult day care program throughout the year.  Some come on a very regular basis and some come just occasionally. 

The staff continues to be reminded about resident rights and dignity on a yearly basis.   It is mandatory to have this in-service yearly.  The staff is able to do this in-service online.   

Family council was held two times during the year.  These meetings tend to be held in conjunction with other family events happening in the facility as well as the annual meeting.  We appreciate the families that attend these meetings and like to hear the comments that you have.

We have surveys that we continue to do with residents and/or families.  We appreciate the comments and feedback that we get on these.  It really helps us to see what we are doing well at and what areas we need to improve in.   

We continue to use Deer Oaks Behavior Health Services to provide counseling services for our residents.  We have one person from Deer Oaks that comes 2 days a week to see residents.  It is very nice to have her here a couple times a week for those residents that need her services.  She is also available by phone if needed in between her visits. 

The Med D open enrollment period was October 15, 2012-December 7, 2012.   Omnicare was very helpful in helping residents find new plans if needed.   If you ever have a question on Med D please be sure to let us know.

We continue to do investigations and reporting of any possible abuse or neglect issues that may occur in the facility.  There are several rules and regulations we must follow as well as reporting guidelines.  If we do suspect abuse or neglect we do need to report this to the state and local ombudsman, the Department of Health, and police department if needed. 

We have three hospice agencies that are available to provide services to our residents that are facing end of life issues.  We have the Brookings Hospice, Compassionate Care Hospice from Sioux Falls, as well as Aseracare from Sioux Falls.  This is a wonderful service to have available to those residents and families that need it. 

Thanks to everyone who helped to make the holidays a joyous and special time for our residents and staff.  Thank you to the staff who participated in the “angel” project this year.  The residents look forward to all of the extra “goodies” and events that go along with the holidays. 

We continue to be busy with the remodeling project.  We have had to move many residents to different rooms during this time.  We appreciate the understanding and patience of our residents and families.  We know that change is not always easy.  The rooms look very nice once they are updated. 

Thank you to all of the residents, families, volunteers, and employees that make working at ULC something special.  If you have any questions or concerns please let us know.  



It has been about 3 weeks that I have been acting D.O.N.  These are the impressions I have had about this last year.

  • Nursing continues to monitor infections acquired in facility and hospital acquired.
  • Many of the facilities policy and procedures were updated
  • Increased our thoroughness with the admissions process including having a sole nurse completing all admissions
  • Changes in staff with new staff coming in.  New D.O.N. starting in      May 2013
  • New software Point Click Care is replacing Accucare for all nursing needs
  • Staff education incorporating on-line education called health care academy
  • Holding random CNA and Nurse meetings
  • Beginning the neighborhood idea with our own changes d/t current staffing
  • Utilizing a C.N.A. supervisor to increase communication and implementation of new procedures
  • Developed a multitude of policies addressing areas of immediate need (e.g.)
    • Wound policy and procedures
    • Medication administration and documentation, PRN documentation
    • Hospice policy and care planning
  • Opened up our Hospice service opportunities to include Aseracare, Compassionate Care and Brookings Hospice     
  • Continue to contract with outside counseling services for resident through Deer Oaks
  • Focus on improvement of daily communication with stand up meetings daily
  • Looking forward to electronic charting for C.N.A.’s through point click care
  • Established utilizing 3 MDS nurses
  • Re started the use of pocket care plans for C.N.A use and to increase better communication for resident centered care
  • Partnered with Omnicare to decrease our hospital readmissions with residents who have a diagnosis of CHF
  • Through Quality Assurance staff identified areas of concern and developed policies and procedures to counter act these areas
    • Weight loss – focus on dependent and cued residents
    • Pressure Ulcers – “Red Circle program, Puppy program and Green sheets”
    • Call light response – “Visual Monitoring”
  • Decreased antipsychotic medication use in facility
  • Working on a wound care protocol



Community Partnership Development:

Parent Involvement:

  • Developmental Checklists on every child has been completed.  These checklists provided a basis for the Parent Teacher Conferences that were completed as of April 16, 2013. Checklists and conferences are held twice each year.
  • Parent Satisfaction Surveys have been offered to all parents attending conferences.  The form we initially selected is somewhat lengthy and the return on them has been low.  We are in the process of creating a more parent friendly survey using a combination of several formats. 
  • A group of parents have been involved in the planning of the Intergenerational Garden.  Volunteers are building garden containers and filling them with soil, parents have donated seeds and will also be donating plants.
  • Parent suggestions we are exploring:  Offering a noon time yoga class; creating a CDC Facebook page; and parent volunteer work days.

Community Involvement:

  • Field trip by preschool children, their teachers and parents is being arranged to GAP, the next child care step for those entering Kindergarten.  We will continue to build on developing relationships with community partners and seeking other partners in this process.


  • Due to building construction, most generation activities had to be placed on hold.  Currently, only 3, 4, and 5 year olds are participating.  The ULC Activities Director, the PPA/PPAL Manager and the CDC Director are working on long range planning (which will also bring teaching staff to the planning team).  Activities will be in full force by mid-May.
  • Gardening:  seed planting, watching the seeds sprout, watering the plants in our indoor mini-greenhouse is preparation for our outdoor gardens being planned.  We’ll be looking at ways to expand this project in the future years.  This year’s anticipated outcome is a Harvest Festival (food from our gardens).  By year three, we have a vision of the residents helping teach parents about food preservation.


  • We are experiencing some technical glitches in our goal of transmitting information to parents’ electronically.  The Director’s Parent Newsletter (issued monthly since December 2012) is now available on the


  • A center-wide calendar will be available on the website and will include generational activities and garden progress.  Our goal for this calendar is June 2013.
  • When a child has been in the program for 2 weeks, the parents are receiving an email welcoming them to our “community” and encouraging them to keep in contact via the best means for them.

Safety & Security:

  • On April 9, I participated in an on-line training presented by SDSU Family Resource Network:  Responding to Emergencies: Is Your Program Ready? 
    • The information from this training, along with a toolkit for developing emergency plans for vulnerable populations will be used in refining our policies and procedures.  Our goal is to bring parents to the table to be part of this planning process.
    • Our center will be participating in the National Weather Service (NWS) statewide tornado drill conducted at 10am on Wednesday, April 24, 2013.



It has now been two full years since I accepted the position as Director of Environmental Services.  My duties include overssign the laundry, housekeeping and maintenance departments her at ULC.  I also work closely with the new construction project taking place at the ULC.

Now it’s time to write my annual report.

In 2012, my laundry staff washed 5,581 loads of laundry.  This is a total of 261,225 pounds of laundry.  We have two commercial sized washing machines both machines have a computerized feed on them.  The staff programs the washer for each load according to the type of laundry being done at that time.  The computerized system properly dispenses the correct amounts of chemicals and cleaning detergents for each load to properly ensure a clean load each time.  Hillyard Chemical Company supplies us with the proper chemicals that we use in our laundry area.  While using their chemicals, they also supply a monthly technical checkup.  This is to ensure both machines and chemicals are performing as required for clean laundry.

The housekeeping staff uses Hillyard products as well.  The products are used for cleaning assignments to be done as expected.  They are used to maintain daily cleaning of the rooms, lobbies and throughout the ULC campus for a safe and clean environment.  I follow up behind my housekeepers with a weekly inspection.  This inspection is to follow the regulations implemented by the state.  I thoroughly inspect one room in each of the five wings.  The rooms are inspected from floor to ceiling, including the bathrooms, under the beds and also the light fixtures.

The maintenance staff and I stay very busy with service requests from the entire campus of ULC.  We have hours covered from 5:00am – 7:30pm during the weekdays.  I am available for the on call maintenance for the evenings as needed.  Our maintenance staff has a rotating schedule to cover the weekend.  Last year we answered over 5,000 service requests.  We also do the lawn services which include mowing in the summer and snow removal in the winter.

ULC is a large campus!  There is a wide spread of ages from infants to elders.  When working with a big facility and dealing with the different ages, a large array of issues from big to small occur.  The days are never boring.  Sometimes we meet those challenges, and some we find we cannot handle.

Maintenance department also pitches in with many of the activities for the residents.  Some of these activities include trout fishing at Indian Hills Ponds, trolley rides throughout town and pontoon rides on Lake Campbell.  I, myself really enjoy instructing the Men of Wood woodworking classes which we do two times a month.  You can look around the campus and see some of the work the men of wood have completed.  Some of these projects include large wooden flower planters of different sizes, wooden benches and personal shelves in their rooms.  It is great to see all the smiles once we get all the men together and they get to do something different for one hour.

Fire drills are done each month by the maintenance department.  Each month a different shift is chosen for the drill, by doing the different shifts, all staff is well educated in the procedures needed to be done in case of a real emergency.  These drills are very important!  Our staff does well on the drills without many issues.  I am confident, if ULC did have a fire, the staff would handle the situation as expected.

Over the past two years, I set goals and expectations for myself, I feel that all has gone well!  There have been some challenges, but none that couldn’t be handled.  This is due to the teamwork of the ULC staff and volunteers as well.  I am pleased with my staff, as well as the entire staff at ULC.  Everyone works well together. 

I am looking forward to 2013.  The new changes and the final stages of the construction project are scheduled to be done around September.  I myself, as well as others, are very excited for the completion of the building project.  I want to thank everyone for an enjoyable two years!



The past year has been filled with change and restructure of the Dietary department. The Dietary Specialists are now working more closely with neighborhood residents in the smaller kitchenettes and the remodel has brought to us a calm home like environment. Although we do continue to move around a lot, the residents are beginning to feel at home in their neighborhood living areas. With our growing campus, our department was effected greatly by the remodel. We now provide Dietary Specialists in each neighborhood and staff the kitchen with a cook and assistant.

The Dietary Specialists and I have been working on streamlining the process of food distribution as it is now more of an intensive task. We are fortunate to have been able to purchase a “Cambro eclectic hot holding unit” which will allow us to keep foods warm while walking the long distance between neighborhoods. This piece of equipment has also provided additional hot storage in preparation of food service making our food distribution system more effective and efficient.

Despite the rising food costs, given the past drought, and increase in the amount of food prepared to accommodate each neighborhood, we have managed to maintain the cost within the budget very well. Moving forward we plan to develop a late night snack menu that may be available to the evening Dietary Specialists so that residents may have more of a variety of choices at that time. We continue to strive to prepare foods from scratch as much as possible and are working on food presentation in which residents may have a very enjoyable dining experience… just like home.   As always, it is the goal of the ULC dietary department to provide great tasting nutritious meals that will intrigue our resident’s appetite.

The Dietary department has had the opportunity to do some catering both on and off the ULC campus. We have had multiple luncheons and events each month and have provided meals to Habitat for Humanity volunteers while they complete their important work. We very much enjoy working with the community in planning and providing these events. Each of us have learned a lot in providing these events and are hoping to continue to improve our service and presentation.

Looking into the future we are excited for the remodel to come to completion. The residents are feeling at home in the updated facility and will be pleased to have it all to themselves and relax in their neighborhood.



The past year has been busy.  Since January, we have been using Rehab Optima for all therapy documentation and assistance in planning/coordinating minutes for MDS purposes.  The program has a lot of potential that unfortunately I haven’t had the time to fully take advantage of.  But, it has a large reports section that is much more efficient in tracking our Med A, Med B and outpatient therapies.  As can be seen in the table below, we’re trending more and more therapy all the time.  The table shows how many residents were billed each month.  Right now we do have 8 people on Med A so we’re above our goal of 10% census.  This may be a little deceiving because some stays may have only been a few days.  Again, with the new Rehab Optima system I can track average length of stay as well.  Next year I’ll try to have a really impressive report ready for you!



Med A

Med B

April 2013 (as off 4/22/13)



March 2013



February 2013



January 2013



December 2012



November 2012

11 (2 Humana)


October 2012

12 (2 Humana)


September 2012

7 (2 Humana)


August 2012

13 (2 Humana)


July 2012



June 2012



May 2012




Pressure sores continue to be an issue.  I will be working with the financial department on a 3-year plan for buying and replacing wheelchair cushions.  A wheelchair cushion has a life expectancy of 6-12 months.  To say the least, ours are too old!  The problem becomes that they no longer provide the pressure relief they were designed for.  To be pressure relieving, the resident must have 2 inches of support before the wheelchair or seating system.  Unfortunately insurance companies will not pay for these in the long-term care setting, so we need to formulate a plan and rotation to provide adequate protection for our residents.

In the recent survey, we had two deficiencies that I will be helping in the plan of correction.  During orientation, I will provide more in depth and visual training on how to appropriately use our mechanical lifts.  Surveys are always a time to learn and review our current policies so we will implementing more auditing of staff using the equipment and maintenance will have a cleaning schedule for the lifts.  The other deficiency had to do with a walk-to-dine program not being done.  I have implemented an audit for this of which education will be a part of.  I thankJackie Clarkin the nursing department in her assistance with audits and education of our floor staff to ensure we’re providing the best care possible.



The Assisted Living has remained full.  We have two moves coming up at the end of April but the vacated rooms have already been rented.  Our waiting list continues to grow.

We had a Resident Council Meeting that was very well received.  We covered many areas especially food concerns.  The new chef from ULC came & listened to their concerns & will help the DLC’s implement these changes.  We have had a family of a current resident donate a new cat to the facility which has gone very well.  The new cat is very friendly & the residents enjoy the interaction with her.  They have also been enjoying a lot of musical entertainment.  There has been discussion with some residents in regard to some possible outings.  We will expand on this topic when the weather warms up.

We did some converting of supplies to the dishwashing system which will be more cost effective for the facility along with new towel holders. 

We have had a very healthy winter at PPAL.  We are all looking forward to the nice weather to come.