June 1, 2009 |

Just one more question

Like the great TV detective Columbo, Long-Term Living columnist Gary Tetz (Funny You Should Ask) always has one more question. In this bimonthly feature, he talks with long-term care leaders about anything that pops into his mind. He’s as surprised as you are that they’ll speak to him, and apologizes in advance for whatever inanity he might blurt out in the pressure of the moment.

As we stand together on the brink of economic apocalypse, I wondered how a good nursing home administrator keeps people focused. So I asked one of my undercover long-term care informants/moles who I should talk to, and she suggested Lori Cooper.

Lori has been at Stonebrook Healthcare Center since 1992, and has served as administrator since 1999. She holds a Masters degree in Public Administration/Health Services Administration from the University of San Francisco, and serves on the public advocacy committee for the California Association of Health Facilities (CAHF).

Her only ground rule was that I make her look witty, and “not like I have a big ‘ol foot in my mouth.” I reluctantly agreed.

Hi, Lori. Is this still a good time to talk?

Yes. I was just updating my home flood insurance policy, and it was making me crazy. Maybe I’m a little bitter. Let’s write about that!

You’re in Concord. That’s near San Francisco, right?

A little bit east, yes.

If I recall, you have a lot of windmills down there.

That’s a different part of town.

So your facility is not powered by wind?

It is not.

Except when the politicians drop by.

That’s true!

Well, thanks again for calling me back. You had no idea who I was. Weren’t you afraid?

No, but now I am.

I could have been anybody. A regulator, an attorney. You had no way to know.

True, you can never know.

As an administrator, what is the phone call you most dread when you’re paged overhead?

Well, I would most dread being paged overhead. We don’t do that.

Good answer. It was a trick question.

The call I would hate the worst would be if somebody eloped. That wouldn’t be good. I don’t dread the state coming in. They don’t worry me too much.

Why is that? That’s not normal.

Maybe not. But they’re just doing their job, and we’re doing ours too. I have confidence in our staff and the way we run our building.

That’s a very admirable attitude. How do you manage to maintain such cheerfulness?

Well, I just love what I do. Truly, I do. I have good owners and a good staff, and we’ve all been here a long time. I’ve been administrator for ten years, but I’ve been in the building for 17, so that helps. I think administrators who do a lot of job hopping don’t have that comfort level.

So it’s not just an act? You’re not inwardly a seething ball of rage?

No. I’m really not. Unless you want to go back to that flood insurance we were talking about earlier. I can be sarcastic, though.

So you actually enjoy your job. After ten years you don’t feel like you’re just waiting for parole?

I enjoy it. I really do.

What’s the worst part of being a long-term care administrator in California right now?

Oh my god.

That bad, huh?

You worry about the reimbursement and how you’re going to care for your building full of medical residents if the state goes bankrupt. Things like that.

What’s your secret for coping with that sort of stress?

I think it’s laughter. I laugh things off, though maybe you can’t tell that from our conversation so far.

These are difficult times for everyone. What’s the key to being an effective leader?

Well, I listen to my employees. I know them all by name, and I know a lot about what’s going on with them. As a building, we try to be understanding and make accommodations when we can. You have to be constantly there for your staff, and do things to keep them going.

Like what?

We’ve done all kinds of things here. If somebody says something nice about someone on a resident satisfaction survey, I’ll go down and tell everybody what a wonderful job they’ve done and give them a little award. Each year we do a campaign, the last one was called “Get your game on,” and it was just a way to keep people motivated and excited about doing their daily job.

It’s fun here. People smile a lot. It’s not a downer to go to work, and I think you have to keep it that way. We laugh together, we cry together sometimes. But mainly we’re laughing.

What’s the most inspirational thing you’ve ever said in a staff meeting?

Ice cream man!

Ice cream comma man?

No, we have the actual ice cream man come here, you know, with the bell ringing. Other than that, I’m not one for big inspirational speeches.

So nothing you’ve said is ever going to be etched on a marble wall?

I think the most important thing I say is how much I appreciate what they’re doing, and that doesn’t necessarily come as a big speech in front of everybody. Sometimes it’s just one on one, hearing it from me.

You’re a former music therapist. If you had to soothe your staff by singing a song, what would it be?

“You Light Up My Life.”

What if you needed to soothe them with a song written since 1977?

Maybe I don’t know any.

Do you ever just wander through the building strumming your guitar?

I’ve been known to play the piano in the building, but not so much the guitar lately.

It seems like you need a more mobile instrument.

Maybe I need one of those accordion things with the cymbal and the drum.

And a harmonica in a holster in front of your mouth, and a monkey on your shoulder?

Yeah! That would be great. Where do you get one of those?

Good question. I play the accordion, by the way.

Oh do you?

Maybe you and I could be a roving team, like Wallace and Davis in White Christmas.

I think that’s a grand idea.

That’s the first sarcastic thing you’ve said.

Well, I’ll turn it up a notch.

Now you know, Lori, I’ve been spending some time lately on Nursing Home Compare….

Oh, here we go, I’m bitter about that too, you know.

I see that you’re a four-star facility. What happened? Why not five?

(Excitedly) I’m back to four? I had been a three! Am I really back to four?

I’m pretty sure you’re a four.

When I went to three, I was a bitter, bitter woman.

Did you immediately blame the Russian judge?

It must have been the Russian judge! But here’s my soapbox-it’s a flawed system. (Sound of keyboard clicking) Oh, I sure hope…I’m looking it up right now, you know.

So that’s good news if I’m right?

It will cheer up my whole day.

Nobody has ever been cheered by my phone call.

Well, this might be a first. (Keeps trying to find her facility on Nursing Home Compare) There it is. Okay, let me see. Find a nursing home…Stonebrook….Oh, I hope I’m back to four….

See, you’re just doing what all your prospects are doing.

I am! And you know, the interesting thing is… (with great excitement) OH, I’M BACK TO FOUR!!!! That is so good! Now I don’t hate the system anymore! (Then seriously) But let me tell you, it really is skewed, even if I’m a four again. Look, it gives me two stars for staffing, but I have more staff than anybody in town.

I know, I was going to talk to you about that.

It’s ridiculous, honestly. I have a lot of staff. I have so many they get in the way sometimes.

Do you feel like you’re in high school and just got called in to talk to your parents about your report card?

That’s exactly what it feels like.

You’ve got some explaining to do, young lady.

I do! But that’s the point. I can’t explain it. It’s just skewed. The problem with this system is that people [consumers] look at it but don’t really understand it. They think, “I’ll only send my loved one to a five-star facility.” But it’s very misleading. My building has been three and four stars, and we provide excellent care. But that five-star building might have six people to a room and not have enough census for the quality measures that automatically get put up there [on Nursing Home Compare]. It’s crazy, and it stinks.

But people love simplistic rating systems.

Yeah, I know. But you have to have one you can trust. It’s a good idea in theory, but I don’t think it’s quite there yet.

I’m told you just admitted a special resident to your building.

Yes, I brought my daddy in. I’ve been here a long time and I think we have a wonderful facility. But having him here has really opened my eyes. It’s something that would be good for every administrator to do. Being an active part of the healthcare delivery system as a consumer instead of a provider is a different story. It really makes you think.

What’s changed in your building now that your dad is there?

There are definitely changes on the horizon. I thought we did a good job of making sure people could live as close to normal lives as possible, but there’s still room to grow. Obviously we want to do well for everyone, but now that it’s my dad, it’s even more personal.

(phone rings in the background)

Do you need to get that?

No, it’s just my insurance agent telling me I have to pay $1,543 for my flood insurance, just because I have a creek in my backyard. Isn’t that ridiculous? It makes me sick.

Maybe that’s not a creek. Maybe you just have a broken pipe under the sink.

No, I live in a 100-year flood zone.

Most floods don’t last that long.

True.

To send your comments to the editor, please e-mail mhrehocik@iadvanceseniorcare.com.