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JOINT CONFERENCE COMMITTEE

LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER

June 24, 2009

INTEGRATED HOSPITAL REPORT

EMPLOYEES OF THE MONTH – APRIL TO JUNE

April 2009 – Steve South, CNA, O7

Steve was nominated by Unit 07 staff and residents because he exemplifies an extraordinary level of care and professionalism across cultures and he does so with a complex medical unit where nursing standards are very high. He is dependable, easy to work with, promotes teamwork and is well liked and trusted by residents.

May 2009, Nidia Abuanza, CNA, M5

Nidia demonstrates compassion and dedication when working with residents who have complex medical, nursing and challenging behavioral needs. Nidia has an enormous amount of respect for our residents and goes out of her way to make them feel comfortable. Being a bilingual employee, Nidia assists in promoting better communication between Spanish speaking residents, their families and staff. We congratulate Nedia for all her hard work and her commitment to LHH.

June 2009, James Zelaya-Wagner,

Psychiatric Clinical Social Worker Substance Abuse Treatment Services Team Member

Jim is a team player. He wants all to succeed so that residents benefit. Jim has excellent group process skills. These are evident when leading resident educational groups like Ash Kickers and other groups. His attention to the emotional tone of the group and his gentle way of attending to the needs of the group members and staying on task has rescued many meetings and has added to their productivity. Jim has been the leader of LHH’s efforts to improve smoking safety and to create smoking cessation programs on campus. His work with resident smokers is characterized by honesty, respect and creativity. Recognizing that some residents were falling in the smoking area, Jim worked with Operations Staff to have the smoking area repaved so that the surface was smooth for those who travel by wheelchair. In closing, Jim Zelaya-Wagner is a team player, an excellent teacher, an outstanding clinician, who is dedicated to the residents at Laguna Honda and to making LHH a safer place to work for its employees.

ANNOUNCEMENTS/INFORMATION

SFGH/LHH PACS Integration Project

The SFGH/LHH PACS Integration Project is an on going project is finally nearing completion. It was conceptualized in 2004 when LHH Radiology Department initially converted over to Digital Radiographic Images. The project took off again in 2008, spearheaded by Richard Hollingsworth Radiology Director at SFGH and RJ Merck SFGH Radiology Supervisor. They worked in collaboration with LHH Radiology Department and the IS and Billing Departments from SFGH and LHH.

Our first Digital Radiographic exams were transmitted successfully through the PACS system to the SFGH Radiology PACS this Thursday June 11th. The Radiology Technicians here at LHH were happy to report that within 30 minutes the Diagnostic Report was available to the requesting MD on the Lifetime Clinical Record. In the past SFGH radiologist would have to come over to LHH to read the images. The dictated reports would not be available for 1-2 days after the image was taken. LHH is scheduled to go Live and began transmitting all of the Digital Radiographic Images through the PACS to SFGH July 1st. This will allow Just In Time reading of all of are images and results available on the LCR within hours of the image being taken.

Health at Home

On June 16, we welcomed Health at Home to Laguna Honda. The staff are consolidating their operation from two other sites elsewhere in the city on Unit F5.

Cafeteria Composting

In keeping with the citywide waste reduction and diversion efforts, Laguna Honda is proud to announce that we are starting a cafeteria food composting program. In collaboration with our partners at Sunset Scavenger and the SF Department of the Environment, we will be adding new green composting bins to our recycling and trash disposal area in Moran Hall. We will use staff, volunteers, and signage to educate and encourage residents and staff to properly dispose of their food scraps, recyclables, and waste. Through adjustments to our current waste hauling processes, we anticipate that this new composting program will actually result in a net cost savings of approximately $15,000 in the first year of operations. Thus, this effort will preserve our precious natural resources as well as our critical financial resources.

Soda Free Summer

In support of the Health Commission's Resolution on Soda Free Summer 2009, Laguna Honda has discontinued sales of carbonated beverages in our cafeteria for the months of June, July, and August, 2009. After discussions regarding a Soda Free Summer with our Resident's Council, the Council voted to keep sodas in vending machines and the General Store.

The Laguna Honda Grapevine

In the interest of keeping you informed of news at Laguna Honda, I include copies of our newsletters dated since April 2009 (Attachment A).

CENSUS REPORT

Below are the Nursing Unit Census Daily Averages for April and May 2009.

|Nursing Unit Census Daily Average |

|SNF Census |April 2009 |May 2009 |

|Beds Occupied: |764.83 |758.74 |

|Beds Held: |4.5 |5.87 |

|TOTAL SNF Census: |769.33 |764.61 |

| | | |

|Acute Census: |capacity (16) | |

|M7 Acute Census: |0.77 |1.58 |

|L4 Acute Census: |0.4 |0.13 |

|TOTAL PAID BEDS: |770.5 |766.32 |

STAFFING REPORT

The hospital staff vacancy rate reported this month is 4.03%. This is up slightly from the last reported rate in April 2009, which was 3.58%.

REGULATORY UPDATE

The U.S. Department of Justice (DOJ) will be back at Laguna Honda from August 31 to September 4 to check on the implementation of the settlement agreement San Francisco and the federal government entered into in June 2008. DOJ lawyers will be accompanied by consultants in nursing, psychiatry, medicine and community placement.

TARGETED CASE MANAGEMENT

The TCM report for April 2009 and May 2009 for LHH discharges is attached (Attachment B). The following are the overall number of monthly discharges for April 2009 and May 2009:

|CATEGORIES |APRIL 2009 |MAY 2009 |

| |Discharges |Discharges |

| | | |

|Rehabilitation |4 |6 |

|Respite |0 |0 |

|TCM |2 |2 |

|LHH |2 |3 |

|AMA |0 |0 |

|AWOL |4 |4 |

|Positive Care |3 |3 |

|TOTAL |15 |18 |

COMMUNICATIONS REPORT

The intention of the communications program is to help build a collaborative and innovative organization by providing reliable, accessible and constructive information. The following is an update on some of the new projects that we have developed and implemented through this program.

Resident Communication

Two new resident communication tools are now in place.

1) Residents have begun receiving information about hospital operations in the monthly resident newsletter, the Insider. A new Insider column produced as a collaborative effort by Resident Council members and the Communications Department covers staffing, transition, and other operational matters. The idea for the column was suggested by outgoing Resident Council president Paul Hendrickson.

2) Residents also receive information specific to the transition in community meetings on the units. The Education Council publishes a monthly bulletin for the activity therapists to use during the community meetings that contains answers to resident questions about the move. The bulletin ensures consistency in transition-related information.

Ambassadors Program

This month the hospital will launch a new initiative to build its internal communications infrastructure. The program will gather together mostly non-managerial staff from each department to serve as ambassadors for the new Laguna Honda to their colleagues throughout the hospital.

The ambassadors will meet monthly to plan for the move and help set goals for a renewed organization. They will be experts in the features of the new facility and in the hospital’s strategic plan for FY 09-10. They will be responsible for reporting at departmental staff meetings on information about the new buildings and the transition.

The program is intended to engage day-to-day staff in transition planning – not only in logistics, but also in the re-visioning of the organization as it embraces the changes that lie before it. It adds a person-to-person dimension to an integrated communications program that includes the staff newsletter and the new web site.

QUALITY OF CARE REPORT

2009 Annual State Licensing & Certification (L & C) Survey

For the third consecutive year, LHH passed the California Department of Health Services annual L & C survey on the first attempt with no substandard quality of care findings and zero error on their medication pass. L & C surveyors conducted their review of skilled nursing facility and general acute care services beginning May 26 through June 3, 2009. There were altogether 16 surveyors comprising of 11 nurses, 2 pharmacists, 1 dietitian and 1 physician. The surveyors who were present during last year’s survey commented that they observed further significant improvements at LHH since their last visit. This achievement is a reflection of the staff's commitment to consistent high quality of care and services they that provide to the most vulnerable residents of San Francisco. There is an extra sense of pride for the work that we do, not only in delivering resident care and services, but in successfully stepping up as a team to the challenges presented by the L & C surveyors.

SATS Anniversary

We would like to wish Laguna Honda’s Substance Abuse Treatment Services (SATS) program a Happy Anniversary. SATS will celebrate ten years of service on June 24. The program is an integral part of our mission to achieve the highest quality of care, quality of life, and level of independence for Laguna Honda residents. Congratulations to the SATS staff, and best wishes for another decade of excellence.

Respectfully Submitted,

Mivic Hirose

Executive Administrator

Laguna Hospital & Rehabilitation Center[pic]

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