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Seward City Council Work Session <br /> July 24, 2017 <br /> Seward Mountain Haven <br /> Operational Consideration—Increasing Census <br /> Situation: The census at Seward Mountain Haven (SMH) has declined over the last several years. <br /> Recent efforts have increased the rate of admissions, but overall census has remained steady at an <br /> average daily census of 26. Management continues exploring improvement of services and alternative <br /> models of operating the facility to improve census. <br /> Background: SMH is licensed for 40 long term care (LTC) beds, also known as nursing home beds and <br /> is Alaska's only LTC facility using the Green House Project model of care. The census was at a high of <br /> 38 in 2012, but has since slowly decreased and has not been above 34 since November of 2014. <br /> Focused efforts to improve outreach and the admission process has resulted in 17 new elders since <br /> September 2016, however,due to increased discharges, our net census has only increased by 2 during <br /> this period. Achieving a high census helps ensure that we provide excellent care to as many elders as <br /> possible, helps ensure financial viability to continue our mission, and helps meet debt service <br /> obligations for the construction of SMH. <br /> Assessment: Evaluating referral information,especially reasons for declining referrals, provides <br /> information towards how we might increase census. Based on 2017 referrals,the top reasons for <br /> declining referrals were: <br /> Reason for declining referral %of total declinations <br /> Could not meet elder's medical needs 46% (89 of 197 referrals) <br /> Elder did not meet nursing home level of care 23% (46 of 197 referrals) <br /> Could not meet elder's behavioral/psychiatric needs 11% (22 of 197 referrals) <br /> In reviewing the specific medical and behavioral health needs of these declined referrals,we are <br /> working towards implementing services that would increase the types of elders that can be cared for <br /> at SMH. To date,we have added wound care services, IV therapy services and have become a center <br /> of excellence for memory care and continue to look at other services. <br /> In regards to those referrals that did not meet nursing home level of care, adding assisted living could <br /> provide a home to a portion of those referrals and meet a need currently underserved in the <br /> community. This would require new licensing and further evaluation of its operating and financial <br /> impact. <br /> Recommendation: Continue to evaluate and add additional medical and behavioral health services <br /> that broaden SMH services and increase the number of nursing home referrals we can accept. Further <br /> evaluate assisted living as a new service, separate from nursing home care. <br />