Keeping our Skilled Nursing Patients Safe is our Number One Priority!

With the news of the COVID-19 pandemic, Cynthia Bush, RN, Director of the Skilled Nursing Facility (SNF) at Mountains Community Hospital, immediately closed their doors to nonessential staff and visitors at the beginning of March.

“The only visitors allowed,” she said, “are for compassionate care situations such as end-of-life.”
The residents, she noted, have been staying in their rooms, as mandated by the California Department
of Public Health, so they can’t engage in any communal dining or group activities. If the residents
venture out on their own to the solarium, they are wearing masks. Should anyone wish to go for a walk,
Cheri Altmeyer, Activities Director, will take him or her outside, one by one.

Cheri has also been coming up with creative ways to keep the residents entertained. They have been
doing arts and crafts projects like painting birdhouses. They have also been playing bingo, their favorite
game, from their rooms. Sandals Church recently donated five tablets for the residents to use for video
communications with their families or to watch movies and play games. “The residents have been
frustrated,” Bush said, “as none of them are sick, so they are having a hard time understanding why they
must maintain social distancing. Cheri is working wonders, keeping them occupied!”

In talking about MCH’s response to COVID-19, CEO Charlie Harrison noted that all the SNF residents are
healthy. “It’s imperative for us to protect the residents,” he said. “It’s easier to do because they are in
their own wing.”

That MCH cares for and about its long-term residents is evident in the recent five-star rating the Skilled
Nursing Facility received for the second year in a row from the Centers for Medicare and Medicaid
Services. In addition, the SNF was named to the list of America’s Best Nursing Homes. The nurses who
care for the residents, Bush said, know them so well “they can anticipate their needs and they know
everything about them, including how they take their coffee in the morning.”

The SNF is inspected every year by a federal agency and every other year by the state. Bush works
closely with Ashley Altmeyer, Nursing Clinical Coordinator, who oversees the nursing staff and
coordinates the residents’ care. Ashley was quick to give credit where it is due. “Our five-star rating is
directly related to the care the nursing staff gives. The CNAs anticipate the residents’ needs and develop
relationships with them.”

Some of the residents have been referred to the SNF by their physician. For others, the family has been
trying to care for them at home and now understands the patient needs care 24 hours a day. Still others
have been in another facility and the family would like to transfer them closer to home. “You can’t just
walk in and get a bed,” Bush said. “You have to show you need skilled nursing 24/7.” Cynthia Bush and a
team comprised of Ashley Altmeyer, a physical therapist and a social worker, interview the patient and
the family to see if the patient will be a good fit for the SNF. “We have to see if we are able to provide
for their needs,” Bush said, noting, for example, that they cannot accommodate ventilators in the SNF.
“We look at their overall health conditions – some people are too healthy,” Bush said. “And the patient
has to be covered by Medi-Cal,” which reimburses the facility for the bed. Medicare covers medications
and lab work.

In addition, Bush said, they talk to the potential resident about what their expectations are and their
current struggles. “We schedule a roundtable meeting with the full disciplinary team,” she noted, “to
get a broad understanding of what they require before admission.” Dr. Walter Maier heads up the team
as the SNF’s Medical Director. He does monthly rounds and is kept abreast of any changes in their
conditions by Ashley Altmeyer.

Under more normal conditions, the goal of the SNF staff is to help the residents have as normal a life as
possible. “We want to make sure their life is outside the four walls of their rooms,” Bush said. The
activity van, equipped to accommodate wheelchairs, enables residents of all levels of mobility to enjoy
outings to nearby stores, parks, museums, restaurants and other areas they have an interest
in. Spiritual services are also available upon request. Hortencia’s has invited the residents to enjoy lunch
there at no cost to them. “They are definitely an active bunch,” Bush said. “At a lot of skilled nursing
facilities,” Bush said, “you don’t see the residents involved. Ours are up and out of bed at least a couple
of times a day.”

In addition to playing bingo, the residents have also enjoyed yoga with Polly Sauer. We are fortunate to
have community members who volunteer their time and expertise for classes on yoga, cooking,
and storytelling. We even have a professionally trained singer who shares an afternoon of playing and
singing show tunes and musical hits, that our residents sing along to. Since the Solarium was renovated
last year by local resident and interior designer, Grania Murray, the residents have enjoyed spending
time there too.

The SNF keeps an interest list of potential residents. Many are folks who are currently doing well at
home, where their families want to care for them as long as possible. Bush said they ask the family
about the patient’s needs, what they feel they might not be able to provide. They also ask about the
patient’s diagnosis; diabetes, COPD, MS and Parkinson’s disease are the big qualifiers as they are
progressive diseases. “The patient will eventually be more dependent on care,” Bush said.

As a patient is admitted to the SNF, the staff works hard to match that person up with the right
roommate. “We’ve gotten pretty good at it,” Bush said. “They take a liking to each other. We look at
their personalities and interests.” In fact, she added, “they get protective of each other. One will tell a
nurse that the roommate isn’t feeling well.”

When visiting is allowed, many family members come to dine with their loved ones. Some bring in
doughnuts. Others take the resident’s laundry home. And, when the COVID-19 restrictions are lifted,
residents will once again be able to leave the facility for up to seven days to visit with family. “That gives
them the ability to go home for the holidays,” Bush said. “They’re always happy to come back. We want
our residents to be able to do as much as they can while we maintain their quality of life and
independence. We want them to keep their dignity,” Bush said.

The Skilled Nursing Facility can accommodate 20 residents at a time and there is typically always a
waiting list. Contact Ashley Altmeyer, Unit Supervisor, at (909) 436-3016 to get more information or
schedule a tour.