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How Arma Health and Rehab won NRC Health’s Excellence in Action Award

Arma Health and Rehab isn’t a big skilled-nursing facility. Situated in a small town in Kansas, it hosts 45 residents at peak capacity. But this little nursing community is operated by some very ambitious people.

The dedicated efforts from Arma’s staff and administrators have given it a reputation for excellence. In fact, the community boasts some of the highest resident satisfaction and employee engagement in the nation. That’s why Arma received NRC Health’s 2018 Excellence in Action Award.

Earning the award is far from easy. To qualify, communities have to conduct both customer and workforce satisfaction surveys, and achieve a response rate of at least 30%. After receiving responses, they must rank in the top 10% of positive responses to two questions, one directed to residents and one directed to employees: “Would you recommend this facility to other residents?” and “Would you recommend this facility as a place to work?”

Arma’s staff members have managed to build an outstanding workplace culture that both sustains resident satisfaction and keeps employees enthusiastic. Jen White, Arma’s Director of Nursing, sat down with NRC Health to explain how they did it.

Professional outreach

First, Jen explained Arma’s situation prior to her arrival.

“Three years ago the building was under different management, and they didn’t necessarily have an outstanding reputation in the community,” she said. So when she—and Arma’s new administrator, Jenifer Morey—were brought aboard, Jen believed it was crucial to inform the community that things had changed. With Mission Health Communities now managing the building, the focus became providing the Mission Experience of quality, person-centered care at all times.

“In long-term care, you build relationships with hospitals and clinicians in the area,” Jen said. “You have to show them that you can take care of their patients. Once they see you do that, there’s that trust, and they feel good about sending residents to you.”

This was not easy in Arma, where there are several competing communities just a short drive away. Jen and her team had to work hard to assert Arma’s place in the mix.

“It was an educating process to get these other facilities to trust us,” Jen said. “We hosted open-houses, made a lot of phone calls, met with social workers. We got the word out that the building was under new management with Mission Health.”

Successfully reaching out to area hospitals was a large part of Arma’s rising census numbers. Before they deliberately engaged with area clinicians, the organization’s occupancy hovered around 20. But by building a robust referral pipeline, numbers soon swelled to 40, and from there to 45—Arma’s peak capacity.

Engaging the staff

At first, this increasing population was a major challenge for Arma’s team.

“We went from 22 to 40 residents in just a couple months,” Jen explained. “That’s a huge jump in the workload, and it took some people by surprise. But it was important that we keep our standards high while all these new residents were coming in.”

To thrive under these conditions, Jen said that her focus was on building a positive working culture. She and other leaders took a variety of measures to keep that culture healthy.

“We have lots of events to help the staff feel celebrated: potlucks, raffles and drawings, things like that,” she said. “We also have a Star Board that gives employees a chance to say nice things about their coworkers.”

But even more important, she noted, was leading by example. Living by Mission Health’s CARES values (Character, Attitude, Respect, Excellence, and Service) means that every employee, at every level, should exhibit those qualities. “Earning [staff] respect matters so much,” Jen said. “You can’t just assume it’s going to come. You have to get your hands dirty, work the floor, pick up shifts when you can. You have to show them that you don’t expect anything of them that you wouldn’t do yourself.”

The staff responded to Jen’s willingness to roll up her sleeves. Staff turnover rates dropped significantly under her leadership, and the majority of staff members reported that they’d recommend Arma as a place to work.

Better resident care

Improved staff morale can make a world of difference. But Jen and her team weren’t content with stopping there. They also made some other important changes to elevate Arma’s state of care.

First of these was a new medical director. “We brought on a new medical director who was in the area, in Pittsburg [a larger town nearby],” Jen said. “He has a nurse practitioner who’s on call and willing to come in anytime, whom we now have a direct line with. It’s a big improvement on accessibility to primary care, which is a huge benefit to our residents.”

Having regular visits from advanced clinicians made for a much healthier resident population at Arma. Further changes, based on resident feedback, also made them happier. For instance, shortly after Jen arrived, residents were telling staff that they wanted more flexible mealtimes. Jen and her team implemented open dining, which allowed residents to eat when it suited their schedule.

As the resident population grew, Jen also made a point of refining the welcome process. “When we give tours now, we’re very conscientious of the interaction,” she said. “We’re open to them, letting them know what we do, showing them that we’re not just a hospital. That reduces a lot of the anxiety you can see from new residents.”

These changes helped residents feel more much comfortable in their stays—and got them recommending Arma to their friends and families.

Trust is an honor

Those recommendations speak to the immense goodwill Jen and her team have built at Arma. Through their commitment to the Mission Experience, they have created a culture of caring that inspires loyalty from residents and employees alike. A skilled-nursing facility can ask for no greater distinction.

It’s NRC Health’s honor to highlight their achievements, among those of the other skilled-nursing facilities that earned the Excellence in Action Awards in 2018. Their work is an inspiring example of the way senior care ought to be done.

The full list of recipients can be found here.