Landis Homes – Lititz PA ( Lancaster county)
Monday 13/8/12 – Eva Bering Vice President Operations
Campus set on 100 acres – 70% Mennonite residents with significant number of
Mennonite staff who wear traditional clothing.
Beds: 680
Service provision:
 CCRC
 Independent living – 500 cottages and apartments
 Personal Care - 124 Beds
 Assisted Living - 44 Beds
 Skilled nursing care (including secure dementia units 2x13 bed units) – 103
licensed beds - Average length of stay less than 1 year.
Staff – 540 Employees
 Good retention and culture to nurture the needs of others, Christian orientation
 17% Turnover
 Staff drawn from 16 countries – language issues
 RN – Registered Nurse
 LPN – Licensed Practice Nurse
 PCA – Nursing aid
Legislative ratio: 2.7 hours per resident per day
Ratio : 4 hours per resident per day for hands on care staff.
Client Type :
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70% Mennonite
2/3 female 1/3 male
50% private residents - $367 per day
40% Medicade
10% Medicare - Aged insurance products
Occupancy rate:
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Skilled nursing: 98%
Personal care : 97%
Cottages and apartments – 91%
Local Competition:
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Landis is the largest CCRC in the Lancaster County
Competition 2 miles away
In mode for merger and acquisitions
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Funding and costs:
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Long term care funded through MediCade around $204 per resident per day
and the expense of the service is $340, the difference is subsides by
fundraising activities and other operational sources.
Medicare A – Pays $205 - $600 per day dependent on assessed needs –
Average payment is $500 per day.
Payment established via a Minimum Data Set (MDS)Assessment – a 31 page
document that has to be completed multiple times throughout their stay.
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Medicare pays for residents up to 100 days, the amount will be determined by
the minimum data set and the needs of the resident. If the resident is remaining
in the facility post the 100days then they will be able to apply for MediCade.
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Limited support for Disadvantaged residents within the centre as they cannot
afford to support those that do not have MediCade
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Personal Care - No subsidies resident pays for everything. No entry fee but a
daily rate. Average age of residents mid 80’s. Cover meals, therapy, laundry
and activities.
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Most residents have insurance cover.
Medicare D – Pays for drugs – most people join up for this.
Medicare C – Managed Care Plan – requires pre authorisation and certification
to provide these. 23% of Private residents are on Medicare C.
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Residents can gift $12000 per annum but Medicade have a “5 year look back”
(Deeming)
Independent Villages:
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Apartments – approx 12 per building – 1100 – 1600 sq feet
Smaller Unites $80 - $100K plus monthly fees (lease)
New Units - $200K - $230K upfront – Monthly fees of between $1100 – $1500
per month
Average length of stay – 10 years
Safety checks once a year
Ageing in place as much as possible
No legislation but insurance requirements
Residential Environmental:
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Very long wide corridors.
Wide doors into the bed rooms
Pod like structure in new areas
All areas corridors and rooms were carpeted
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Mostly single rooms – rooms appeared to be large and spacious with own or
share bathrooms
Some rooms with connected foyer and bathrooms
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Skilled area: Small dining rooms, small lounge areas, points of interest such as
the train set, use of memory shelves outside of each room, garden areas, use
of non alarm technique to reduce noise in the centre – use of fall mats
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Dementia units – carpeted, secure, single rooms and ensuites, for ambulant
and non ambulant – central area for dining and activities, Small garden outside
area
Lots of natural light and wide windows with views
Individual room air conditioning
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Admission process:
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Full financial review of residents’ assets This information will be reviewed on
the basis that the resident can pay the advanced payment and skill nursing for
2 years approximately: $300K – $400K.
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Completing of the application for residency
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No clinical admission for independent living is completed during this time
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The total amount is:
o Initial amount is approximately $150K - based on the square metre of the
accommodation
o Monthly payment – approximately $900- $1100 per month
o Skilled Nursing - $320 per day
Review of resident finances is completed annually or at any time if concerns
regarding ability to pay, and at least 3 yearly.
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Clinical:
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Use of Care Tracker for documentation
Use of electronic management system for medications and sachet system
Quality system:
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Survey for skilled nursing service completed unannounced annually with 3
assessors 4 days - Department of Health – audit the skilled care
- 9 grades of compliance – varying scope and severity if found wanting.
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Personal care service – 3 day audit - Office of long term living and Department
of public Welfare – Assisted Living and Personal Care
PLUS
 Office of ageing – 1 day audit
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UMR ( Utilization Management Review) 1 day quarterly reconciliation of billing
and claiming
Quarterly and annual benchmarking data is completed for state and national
comparison
Food safety reviews completed 6 monthly
Department of Insurance – Every 5 years
Voluntary quality program – 5 year survey
Office of Ageing – Day care – licence arrangements
Lifestyle/ Diversional therapy:
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No requirement for all staff to be qualified
7 days program
9am – 7pm
Usual Activities.
Learning and development:
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requirement for all staff to complete the following hours per year:
o RN – 30 hours
o Aids- 20 hours
o Administrators – 48 hours.
Key initiatives and challenges:
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Challenges associated with changes in funding – Likely decrease.
Resident wake when they want to wake
Breakfast is made to order – 7 days a week 730- 10am and then serve to order
for lunch and dinner.
Dakim – brain training program for residents
Communal dining room for staff, families can access meals together
ATM available
Architecture and Planning:
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Traditional planning - Corridors with res rooms either side
Long corridors with minimal access to external light apart from common rooms
Well finished
Very wide corridors
Rooms good size similar to Australian facilities
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Interesting sitting nooks…including model train set-up
Dementia unit small but not connected well to other parts of the facility.
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Nice visual connection through staff office base.
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