Consulate Health Care, a national leader in post-acute care, is forging the way to improved patient outcomes and interdisciplinary collaboration. As the sixth largest provider in the U.S., and the largest in the State of Florida, that is no small feat.
Joseph D. Conte, president and chief executive officer, originally founded Tandem Health Care in 1997, with one center in Cheswick, PA. Under Conte’s leadership in 2006, Tandem grew into Consulate Health Care with seventy-eight centers in six states. Today, Consulate encompasses more than two hundred centers in twenty-one states, offering services ranging from comprehensive post-acute care and rehabilitation (including physical, occupational and speech/language therapies) to long-term skilled nursing, Alzheimer’s and dementia care.
Meeting the needs of patients and residents is a top priority. Whether they are long-term residents or short-term patients recovering from surgery and planning to return home, Consulate is staffed by a professional team of registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs) and rehabilitation therapists; team members also vital to patient care include social services, food services, housekeeping, engineering, admissions and administrative support staff. Each care center also has a Medical Director and attending physicians of the patients’ choice.
Short-term Care and Rehabilitation
Consulate Health Care offers services for patients recovering from surgery or illness who no longer require a hospital stay — but who aren’t quite strong enough to return home safely and independently. Rehabilitation programs provided in-house at each center help patients rebuild the strength and mobility they need in order to return home. Licensed therapists provide physical, occupational and speech / language therapy for a wide range of illnesses and injuries (such as orthopedic surgery, stroke or heart disease).
- Physical therapy promotes mobility and functional ability, with the goal of assisting patients in returning to their highest level of functioning. Each patient is evaluated on admission and a personalized treatment plan is developed. Physical therapy may include exercise, gait training, range of motion therapy, balance, falls prevention and pain management.
- Occupational therapy helps patients return to the activities of daily living; that is, the skills necessary for independent living. In occupational therapy, patients are not only assessed for their abilities, their normal environments are also evaluated in case modifications are necessary. Patients practice everyday skills such as dressing, bathing and eating; they also participate in memory, coordination and balance activities.
- Speech and language therapy assists patients with written and verbal communication or swallowing. (Modalities such as the VitalStim are used to improve swallowing skills). Speech therapists also help patients with memory, reasoning skills and oral muscle strength.
Long-term, Skilled Nursing Care
Skilled nursing care is provided around the clock, and specialty services are tailored to meet the needs of each patient:
- Cardiac, pulmonary and post-stroke care
- Oncology care
- Wound care
- Palliative care
- Tracheostomy care
- Pain management
- Orthopedic care
- Nutritional services – when special diets are prescribed (such as low-sodium, low-fat or liquid)
Many Consulate centers also offer Alzheimer’s and dementia / memory care programs. These focus not only on patients, but also on their family members. Alzheimer’s can be an overwhelming disease with both physical and emotional struggles for all involved. Consulate’s goal is to preserve the dignity of each resident, and with family participation, care plans are developed that address comfort, abilities and activities of daily living. Care is provided by specially trained team members who assist with everyday basics such as personal hygiene, showering and bathing, assistance with eating, continence management and mobility.
Respite care is also available for families caring for loved ones at home. Consulate accepts patients on a temporary basis so that families and caregivers may experience some relief and rest.
Consulate also works with various hospice organizations for medical, emotional and spiritual support for patients in the last stages of a terminal illness.
For residents who do not require specialized care, Consulate also features comfortable and secure assisted and independent living locations, as either apartments or single family homes. Amenities include landscaped grounds, housekeeping services and transportation.
Serving the Needs of the Community
To achieve quality patient care, safety and satisfaction across the board, Conte and his senior management team recognize three fundamental ingredients: engaged employees, cutting-edge technology and multi-disciplinary collaboration. “To enhance our mission of ‘providing service with our hearts and hands’, we have implemented new employee programs and invested in our infrastructure,” he explains.
Care and Collaboration Start with Employee Engagement
Employee engagement can be challenging, admits Conte, especially on such a large scale and with recent corporate mergers and acquisitions. New employees from these mergers take time to engage and build a loyalty to their new company. “We are a large family,” he says, “and we want our caregivers to treat our patients and residents like family. I know that the best care is delivered when team members are engaged with each other and the company.”
Chief Administrative Officer Veronique Keller agrees. “Each person on the team, even those who provide indirect care, need to understand their unique role and how we all connect,” she says. “Patients benefit most when we are all engaged in their plan of care. Together we truly make a difference.”
How Do You Engage a Workforce in Over 200 Facilities?
According to Conte, the first valuable step is recognition. “We recognize our employees when they demonstrate our core values– compassion, honesty, respect, integrity and passion,” he explains, “and that begins with education.” For the past 2 years, Consulate has offered more focused educational programs to employees that promote positive working relationships and better communication between departments. As a result, subsequent employee surveys have reported gains in employee engagement levels.
Emerging Technology Promotes Seamless, Secure Communication
Consulate is also on the cutting edge of improved clinical coordination and communication tools. According to Chief Information Officer Mark Crandall, Consulate’s chief objective is to provide physicians, nurses and therapists with easily accessible and secure patient information. Advancing technology is making that goal a reality.
“We are using technology to furnish patient data right at the bedside, right at your fingertips,” Crandall says. “We have invested in the infrastructure necessary to provide a highly efficient electronic health record (EHR) platform, and we are preparing to employ telehealth and point of care devices in our care centers.”
Supporting an eco-friendly “paper light” environment, Consulate’s EHR promotes seamless and accessible communication among caregivers — from the patient’s original physician encounter through the hospital admission and skilled nursing stay — and beyond. The telehealth system allows remote practitioners to assess and observe patients through a live video feed. Peripherals, such as blood pressure readings, as well as the EHR, are real-time and can be read concurrently.
“With thousands of caregivers employed by Consulate and an extended network of physicians, our utmost concern is granting secure access to authenticated devices at the patient’s bedside,” reports Crandall. In addition to the computers on wheels (COWs), physicians and nurse practitioners will soon have the ability to utilize their approved mobile devices (iPhones, iPads, Android tablets, etc.) at the patient’s bedside. “We are working internally and with our chosen software partners to ensure that we can quickly and securely on-board the wireless devices that deliver actionable data and electronic health records right to where the data is needed to give the best care possible at the bedside,” Crandall says. “We must have an easy workflow that is user-friendly and secure.”
With these innovations, automating data collection and analysis, physicians and nurses are saving time and have the ability to provide more hands-on care. The innovative technology and advanced communication tools improve efficiency, accuracy and safety – and, most importantly, patient care.
“We can do so much more at the bedside now than we could ten years ago,” affirms Crandall. “There will be no more searching for charts, no more deciphering numbers and letters. Everything is in one place, right at the bedside. Our caregivers can better focus on quality patient encounters, and that truly reflects our mission.”
Enhancing Patient-Centered Care Through Increased Patient-Provider Relationships
As Chief Administrative Officer, Veronique Keller guides Consulate through the dynamic health care environment following the enactment of the Affordable Care Act (ACA) and ensuing payments and delivery systems reforms aimed at reducing the growth of health care costs. Consistent communication and interdisciplinary collaboration are essential. “The more we collaborate with each other – and the more we communicate with our residents and families – the better the outcome. The Affordable Care Act is encouraging us to break down our traditional silos,” says Keller, who is also a trained physical therapist.
New programs now implemented at Consulate illustrate their commitment to “breaking down the silos” and enhancing the patient-centered experience. The Journey Home program is a patient-centered planning initiative that is initiated at the time of admission. Patients complete a rehabilitation history describing prior levels of function, and they provide feedback about their home setting, loved ones and rehabilitation goals. Family members are encouraged to be as involved as possible. When returning home to independent living is no longer a possibility, long term options at Consulate are discussed.
Another role that is being introduced is that of customer service liaison, who greets every new resident, delivers a welcome gift, and invites each resident and their loved ones to a care management meeting. This meeting involves a multi-disciplinary team composed of the attending physician, clinical services, case management, rehabilitation, pharmacy and the facility’s executive director. Physical / emotional needs and expectations are reviewed, and the care plan process is discussed – including prescribed durable medical equipment (DME) and medications, follow-up appointments, home health and community service needs.
Patient education is also crucial, particularly for patients with chronic disease. Brochures explaining disease management protocols — for illnesses such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and diabetes — are distributed. Compliance is encouraged, with an emphasis on hospital readmission prevention.
Preventing falls is another important component to each patient’s care plan. Patients are reminded to ask for help if assistance is needed for getting in / out of bed; using assistive devices (such as a walker or wheelchair), toileting or navigating the hallways. The Consulate care team meets regularly to assess environmental hazards or staff training needed to enhance the safety of residents and employees alike.
A new program under development is the “Nurse Navigator.” A nurse navigator will go to the patient’s home to encourage medication and disease management compliance. The nurse navigator will place follow-up phone calls and assist in scheduling subsequent physician appointments, among other services.
Physician-Provider Relationship and Enhanced Patient Experience
According to Keller, programs such as “Journey Home” and care plan meetings encourage interdisciplinary collaboration and improve patient experience which is associated with improved health outcomes.
“We want to have a true interdisciplinary team, and we welcome our physicians to lead that charge,” she says. “We encourage our physicians to be active and involved in helping us excel with our patient care programs.”
Consulate Health Care Receives Prestigious Awards
Conte’s efforts are to have the Consulate team committed to engagement and excellence — this is evidenced by dedicated employee ambassadors, technology and infrastructure advancements and patient-centric programs and collaborative efforts. As recognition for these innovative initiatives, Consulate Health Care recently received two distinguished awards.
Earlier this year, the American Health Care Association and National Center for Assisted Living (AHCA / NCAL) recognized fifteen Consulate Health Care centers as recipients of the Bronze Commitment to Quality Award. This national award, bestowed through the National Quality Award program, honors facilities for their commitment to quality care for their residents, and seniors and individuals with disabilities.
In September 2014, for a second consecutive year, the Orlando Business Journal ranked Consulate Health Care #1 in the Golden 100 Top 10 Privately-held Companies. Consulate was
recognized for successfully merging organizations “culturally, operationally and financially.”
Prescription for Success
Since 2006, Consulate Health Care has been a national leader among skilled nursing centers for the highest standards in patient care and innovation. “In today’s changing health care environment, we
believe that, more than ever, enhancing the patient experience will lead to better health outcomes for those entrusted to our care,” concludes Keller.
That is the prescription for success.
By Ann Alexander