Comprehensive Healthcare Services at Brookhaven at Lexington
Brookhaven at Lexington offers extensive healthcare services through a dedicated team led by experienced senior management. Residents benefit from personalized care plans, weekly team meetings, and various contract types accommodating their needs. The facility provides a range of services, from transitional care to specialized programs, ensuring residents receive high-quality care tailored to their individual needs.
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Healthcare Services at Brookhaven at Lexington March 2024 1
Healthcare Team Senior Management Jim Freehling, President/CEO, Licensed Administrator Sue Kirkpatrick, EVP/COO, Licensed Administrator Gardenview and Andover Erin Finn, SVP/CFO Kim Pratt, VP/CHRO Cherie Noe, MD, Medical Director, Board Certified Geriatric & Internal Medicine Healthcare Directors, Social Services, Rehabilitation Services Christine Bouchard, LICSW, Director of Resident Health & Babson Assisted Care Josephine Cronin, RN, MBA, RACCT, Director of Resident Nursing Services Vanessa Vega, BSN, CDP, Director Andover Assisted Care Furtuna Risom, RN, Director of Nursing Services Marissa Gadacy, LICSW, Resident Health & Babson Ariane Loeb, MSW, LCSW, Andover & Gardenview Elena Halstrom, PhD, Rehab Coordinator, Select Rehabilitation
The Healthcare team meets weekly to discuss & facilitate resident care needs based on assessment tool & team input: Transitioning from hospital to temporary stay in Andover or Gardenview, or returning home Permanent transitions to Healthcare Residents anticipating surgery or on hospice/palliative care Residents at risk due to memory/isolation/mental health
Residence and Care Agreement (Contract Type) Residents of Brookhaven at Lexington enjoy one of the most comprehensive Healthcare Packages in any Continuing Care Retirement Community (CCRC) in the Country. Brookhaven is a Type A CCRC. 1. Extensive contracts: also called Type-A Contracts, provide residents with, lifetime access to independent living, assisted care and skilled nursing care with little or no increase in the monthly fee as the result of a need for a higher level of care. 2. Modified contracts: provide residents with a discounted rate for independent living and a limited period of assisted care or skilled nursing care. Should the resident need a higher level of care beyond that limited period, they pay a daily rate for their care. 3. Fee-for-service contracts: also called rental contracts, provide a lower monthly service fee for independent living residents, but charge a daily rate to residents needing assisted care and skilled nursing care services. 5
Residence and Care Agreement Section V. Health Care Services A. Covered Services 1. Health Center Services (Gardenview) 2. Assistance in Daily Living Program (Resident Health) 3. Assisted Care Units (Babson and Andover) 4. Emergency Response Services 6
Assistance in Daily Living Program Resident Health Services: 781-372-0104 Nursing services are available to independent Residents Monday through Friday, from 8:30AM to 9:00PM, and on Saturdays and Sundays from 8:00AM to 4:30PM. Brookhaven healthcare team oversees clinical services and interfaces with outside Physicians as needed. Aides: 7:00AM 9:00PM 7 days a week. Available to help with personal care, bathing, grooming, medication reminders and wheelchair rides. One hour of care: not a continuous hour and must be medically necessary and appropriate. 7
Covered Services Dietary Consultation Brookhaven has a consultant registered dietician available to meet with Residents for review of special dietary needs. An appointment with the dietician can be scheduled through Resident Health Services. Social Services A licensed social worker is available through Resident Health Services for various needs at no additional charge. Marissa Gadacy is available Weekdays. Tray Service The Community will provide tray service to Residents in the Independent Living Units during short-term illnesses when ordered by Resident Health Services. One meal per day will be covered by the Monthly Service Fee. Additional tray service meals will be charged to Resident based on the meal rate schedule and must be approved by the Nurse. Dinner trays should be ordered before 3:00PM. In order to maintain quality meal service for all Brookhaven Residents, please adhere to these cut-off times. Please call Ext. 2370 to place your request. 8
Daily Check-in Each apartment is equipped with a motion activated sensor that indicates movement in the apartment. Resident Health Staff will call or visit any apartment where motion is not recorded. Anytime a Resident leaves overnight an Away Notification Slip should be filled out on the Residents Only Web Site or at the Front Desk with accurate dates of departure and return as well as phone number. If Resident is planning on extending their stay or returning early, it is their responsibility to call the Front Desk with the change in date. 9
Important Documents Vial of Life MOLST (Medical Orders for Life-Sustaining Treatment) HCP (Health Care Proxy) Funeral Home Insurance Coverage: Brookhaven requires Medicare/Medex. Other insurance may not cover all pharmacies or Brookhaven Nursing Center. To ensure your important documents are up-to-date, please schedule an appointment with Resident Health for a review. 10
Wellness Program Brookhaven provides an active, ongoing Wellness Program to encourage and support health and a sense of wellbeing. An array of programs, encompassing all the dimensions of wellness, offer residents many opportunities for both individual and community pursuits. Physical wellness opportunities include the Fitness Center, pool, and classes. Esthetician, Massage Therapist and Personal Trainers are also available for a fee. Other programs include Heart Healthy menu choices, and health and medication counseling. Watch the monthly calendars and weekly bulletins for special wellness events, exercise programs, and group meeting times. Nature Path Recommend a cell phone if walking alone. Tick prevention: Light clothing, hat, tuck pants in socks, and spray clothing with Deep Woods Off. (Green Top Can) 11
Assistance In Daily Living Program Non-Covered Services If Resident becomes in need of additional assistance with tasks of daily living ( Supplemental Assistance in Daily Living services) such as bathing, dressing or personal caregiver services in excess of the one hour per day of such assistance provided by the Community as described in Article V, Section A, 2, the Community will assist the Resident in identifying an appropriate agency to be engaged by the Resident at the Resident s expense to provide such services. All arrangements must be approved in advance in writing by the CEO. 12
Assistance In Daily Living Program Non-Covered Services (continued) The agency must agree to policies and procedures established by the Community. The Community reserves the right to make determinations with regard to Resident s ability to continue to occupy the Living Unit in a safe and healthy manner. The Community may require that Resident obtain Supplemental Assistance in Daily Living services as a condition of continuing to occupy the Living Unit if it determines that such services are necessary to assure the health, safety and well-being of Resident or others. The Community may, in its sole discretion, decline to approve a proposed arrangement for Supplemental Assistance in Daily Living services if it determines that, for any reason, the arrangement is not consistent with the health, safety and well-being of Resident or others. Driving: Evaluation by Independent Driving School 13
Personal Wellness Coordinator Services The Personal Wellness Coordinator provides individualized support services that assist a Resident to live as fully and independently as possible and to remain connected to his or her community, friends and family. The Personal Wellness Coordinator works one-on-one with Residents and families to design a wellness plan that addresses the specific needs and goals of the Resident. The Wellness Plan is revised as frequently as needed in response to Resident and family input or to address a life change or new challenge. Residents have flourished under this proactive, individualized approach. Often reliance on outside private care is reduced or eliminated. To schedule a meeting to discuss engaging these services please contact the Resident Health Department. There is a nominal charge for these services that will be reviewed with you during your meeting. 14
Laboratory A laboratory technician is currently on site Monday and Thursday 7:30am to 9:30am. Scheduled lab days may change based on the tech s availability. Medicare is billed for these services as appropriate. Medical Equipment and Medical Supplies Resident Health Services can assist you with a physician s order in ordering medical equipment and medical supplies. The vendor bills Medicare directly, or the Resident if not covered by Medicare insurance. Needle Disposal: If you use needles in your own medical care, Resident Health will accept the needles for disposal only if they are in a Sharps Container. Containers can be purchased in the store. 15
Medical Transportation Residents in need of help with off-site medical transportation should call Resident Health. Charges may apply for these services. Options include Lexpress, LexConnect, FISH and other various private escort services. Pharmacy Pharmacy assistance with medication may be available through Resident Health. The Resident or Resident s private insurance will be billed. Pharmacy pickup is available Monday through Friday, between the hours of 8:30AM and 4:00PM in the Resident Health Department. Prescriptions from OSCO Pharmacy must be called in by 2pm for same day delivery. Osco delivers blister packs each Tuesday. The convenience of blister pack is no ordering needed. 16
Restorative Therapies Restorative therapies include physical, occupational and speech therapies. There are several vetted options available to Residents including: BI/Lahey Home Care, Care Tenders & Mass General Brigham Home Care Provide therapy services covered by Medicare Part A benefit and some Medicare Advantage plans. Homebound status is required to qualify. Need for services is determined in advance and authorized via a physician s order. Select Rehabilitation and Metrowest Mobile PT Network (PT services only) Provide therapy services covered by Medicare Part B, some Medicare Advantage/other insurance plans. A therapy screen may be performed prior to the physician s order to determine need for services. Private pay option if not covered by Medicare Julie Binkewicz, PT Private Pay Physical Therapy 17
Health Care Provider Office Hours Brookhaven provides office space for several healthcare providers, including Primary Care Physicians, Audiologist, Dentist, Ophthalmologist, Podiatrists and Nurse Practitioner. These services are billed to your insurance directly, or to the Resident if not covered by insurance. Please contact the Resident Health Department to schedule appointments. Health Groups within Brookhaven: Beth Israel Lahey Health Dr. Cherie Noe - Medical Director Dr. Diane McMullin Sarah Lay, GNP, ANP If you would like to switch to a physician above call the Resident Health Department. 18
Psychiatric Services Psychiatric and psychological services are available onsite, through outside vendors. Resident Health can assist in the referral process. These services are billed directly to the Resident s insurance or the resident, if not covered by insurance. Psychiatrist: Dr. Bruce Kaster - Every other week Psychologist: We are currently looking for a full-time in-person therapist. For those needing psychotherapy interventions immediately, contact Social Worker, Marissa Gadacy, for a list of therapy providers that will conduct virtual therapy sessions. Hospice Care: Home, Assisted Care, Gardenview 19
Primary Care Physician (PCP) Outside of Brookhaven When you are ill: If you have an outside Physician, the Resident Health nurse can perform an assessment and either the Resident or Resident Health Nurse can confer with your Physician. There is no onsite Physician. Nurses are on call for emergencies 24 hours a day, 7 days a week. 20
Other Physician Services: Podiatrist: Dr. Kaplan - 2x month Dr. Boudreau - 2x month Ophthalmologist: Dr. Umlas, Lexington Eye Associates - Approx. every 8 weeks Audiology: Dr. Melanie Marple, Audiology & Hearing Solutions every other week on Thursday 21
Assisted Care Units at Brookhaven BABSON AT BRANDEIS ASSISTED CARE The Babson assisted care unit is for residents who require some assistance and supervision with activities of daily living. The living units consist of private studios and one-bedroom apartments. The common areas include the country kitchen, living room, TV room and patios available for resident dining and recreation. Residents will bring their own furniture. Babson is staffed 24 hours per day, 7 days a week. Daily support services include specialized activities and fitness programs, medication monitoring, three meals a day, daily housekeeping, and laundry services at no additional cost to residents. Please note that Medicare does not pay for assisted care room and board but may pay for Medicare approved ancillary services such as rehabilitation therapies. Upon permanent placement in Babson, the resident will continue to pay the monthly service fee for his/her last-occupied living apartment, as adjusted from time to time. 22
Assisted Care Units at Brookhaven ANDOVER ASSISTED CARE Andover Assisted Care provides an alternative to skilled nursing for Residents with age related chronic conditions, with or without Dementia, and the need for assistance with Activities of Daily Living (ADLs) Physical Layout 30 apartments located on the 3rd and 4th floor of the Andover Building 15 apartments, both private studios and one-bedroom apartments, on each floor Common Areas include: Living/Dining Area with an electric fireplace Activity Room Screened in Balcony 23
Andover Assisted Care Temporary Short-Term Resident Admissions Typical Short-term Resident Admissions may include: Debilitating illnesses Orthopedic surgery Illness or surgery requiring rehabilitation therapies 2 days/week and/or skilled nursing care Temporary transfers may bring small furnishings and accessories if desired Smart TVs with streaming capabilities can be provided to Residents on temporary stays 24
Andover Assisted Care Permanent Resident Admissions Planned with the Resident, their families & the IDC The Resident continues to pay the monthly services fee for his/her last occupied living apartment, as adjusted from time to time All units have electric beds Residents can customize their apartment to their liking Due to the residential configuration of the Andover units, Residents/Families must work with providers (Verizon/Comcast) for phone and cable.All units are phone and cable ready 25
Andover Assisted Care Andover Assisted Care also offers specific supports for Residents with dementia and memory deficits including: RN, Certified Dementia Practitioner Unit Director Direct Care Staff with Annual Dementia Training Relatively high Staff-to-Resident ratios with consistent Staff Assignments Anti-wandering systems/security safeguards Daily therapeutic recreational programming & activities 26
Emergency Call System An emergency call system is installed in the Living Units and common rooms and bathrooms throughout the community. A trained Responder, typically a Nurse is available to respond to emergency medical situations 24 hours a day. When you activate the emergency call system, a Nurse will call your apartment, and follow up with a visit as indicated. Most times, the responder will be accompanied by a Staff Member from Administration, Resident Health and/or Maintenance/Security. The Nurse will bring your Vial of Life which lists your important medical and emergency information. If the Nurse calls 911, Security/Maintenance will direct the EMTs to your location. A personal help button (PHB) is a portable emergency pendant or watch. When pressed, the pendant/watch will activate the emergency call system and indicate your location anywhere within the building, including your apartment, the corridors & stairwells, and common rooms. These devices can be ordered through Resident Health Services for an additional charge. The PHB does not cover outside areas including the Nature Path. Residents walking outside should carry a cell phone. 27
Gardenview Nursing Center Services Gardenview Nursing Center is licensed by the Commonwealth of Massachusetts, for skilled nursing care and rehabilitation services. It is located on level one of the Commons. The living units consist of semi-private and private bedrooms with shared or private bathrooms. The Nursing Center is available for both short and long-term admissions. Short-term admissions include: recovery from debilitating illness, surgery, or orthopedic surgery requiring rehabilitation therapies and/or skilled nursing care. A typical short-term stay is 1 to 2 weeks. Long-term admissions include: nursing care for chronic illnesses, assistance with activities of daily living and cognitive support. Residents admitted for short-term rehabilitation support will be assessed by our IDC team for needed services and goals. Residents are typically discharged from therapy services a few days before discharge to the living unit. A Discharge Planning Meeting with the Resident and IDC team occurs prior to discharge to ensure a smooth transition. 28
Frequently Asked Questions Who pays for Gardenview Services? Gardenview is Medicare-certified. Skilled nursing care and rehabilitation services are typically paid for by Medicare during a short-term stay. Upon permanent placement in Gardenview, the resident will pay the monthly service fee for his/her last-occupied living unit. Routine nursing care is covered by your Residence and Care Agreement at no additional cost with the exception of pre-existing conditions. If the permanent placement is due to the pre-existing condition diagnosis documented in his/her contract, Residents will pay the per-diem rate for one year and thereafter pay the monthly service fee. 29
What Services are available in Gardenview? Nursing services Social services Activity programs Three meals per day Dietician services Housekeeping & flat linen services Pharmacy, medication & consultation Physician Services (BI/Lahey Doctors Group) Laboratory Radiology Hospice 30
Non-Covered Services: Private Aides and Companions Gardenview has a more consistent staffing ratio than most nursing centers. If a resident wishes to supplement their care by using private nursing assistants or companions, Residents should consult the Social Worker for a list of Brookhaven approved agencies. Contract staff providing one to one care or companionship must meet all Federal long-term care training and orientation requirements of Gardenview prior to working in Gardenview. The cost of private aides, companions, and other private contractors is at the resident s expense. 31
Non-Covered Services: Transportation In some limited cases, Medicare may cover ambulance services. Most transportation services to outside appointments are at the Resident s expense. What Services are not provided in Gardenview Gardenview provides most Skilled Nursing Services, but does not provide: Intravenous Therapy Ventilator Care Dialysis Care 32
Memory Care Across The Healthcare Continuum Nursing care with consistent staff assignments. Andover and Gardenview have Door Alerts and Wanderguard capabilities. Babson main doors can be alarmed. Personal calendar management and transportation to in-community appointments. Mobility assistance & daily seated exercise program. Daily therapeutic recreational programming and activities. Family and Resident support through Social Services. In-house Physician and Nurse Practitioner option. Hospice Care support. Supplemental private care is available at the Resident expense. 33
Memory Care - Healthcare Units Social & Recreational Programs Group programs are selected based on residents ability to participate and cognitive abilities. One-to-one engagement/programming can only be supported with private help. Programs are scheduled around the most optimal times for residents: late mornings, after lunch and before/after dinner, to ensure a high level of participation. Care staff invite, encourage and transport residents to programs both on and off the units. Healthcare residents may choose to decline programs. Program participation is impacted by a resident s current cognitive state and stamina (advanced age). Programs include a variety of brain games, crafts, and social gatherings around food, music and facilitated reminiscing. 34
Memory Care - Healthcare Units Social & Recreational Programs Music is a powerful way to enrich the lives of people living with dementia. In addition to its ability to make connections, studies have shown that music may help reduce agitation and improve behavioral issues. A variety of musicians, including Steve Gintz, MA, MT-BC, a board-certified music therapist and mental health counselor, and Dan Hart, a retired psychologist and musician with over 30 years of experience, provide both interactive and passive music listening opportunities. Resident are encouraged to maintain their ties to the greater community by participating in dining and programs when interested and appropriate. Transportation, when needed is provided by unit staff. 35
Staff Training - Healthcare Units Direct care staff are either Licensed Nurses or Certified Nursing Assistants. All staff are required to complete a 4-hour annual Dementia Training in addition to other required topic (see below). Residents seeking information on dementia: https://www.alz.org/help- support In addition, both Nurses and CNA s complete annual licensure & certification competencies in addition to requirements below: HIPAA/Corporate Compliance Infection Control/COVID Management Fire Safety/OSHA CPR/AED Meal Management/Choke Safety/Heimlich Fall Prevention/Elopement Body Mechanics/Safe Mechanical Lift Operations . . . 36
Visitors Healthcare Units There are no restrictions on Family or Friend visiting times with the exception of Gardenview (below). Family/Friends are asked to pause visitation during any needed personal care for the resident. Visitation is not encouraged during meals unless arrangements have been made to dine with residents. If its your first time visiting, check with the Nurse if you are unsure whether you should schedule a visit directly with the resident or with the staff on behalf of resident. Please observe signage for any required COVID (screening, masking, etc.) /other contact precautions, and appropriate entry door. Gardenview Non-Family suggested visiting hours for short- term residents 2P-4P. 37
Brookhavens Quality Committee Brookhaven has had a Board Quality Committee since its inception. Its Charge is to develop and oversee policies and practices designed to assure achievement and maintenance of high standards of professional and ethical practice, and regulatory standards for general and healthcare operations. The Quality Committee meets quarterly. Its membership includes Senior Management, Department Directors, and Trustees among which are 3 Physicians, 2 Nursing Home Administrators, 2 Registered Nurses, a Certified Dementia Practitioner & a Social Worker. Reporting covers Corporate Compliance, Human Resources, Nursing Center, Andover, Resident Health/Babson, Plant Operations, Dining Services, & Resident Incident Reports. All reports follow the same format that ensures corrective actions identified and taken are followed through to resolution. 38
Brookhavens Quality Committee Types of information reported: results of DPH Healthcare Quality & Life Safety Surveys, other periodic surveys, and associated plans of correction, results of preventative maintenance & scheduled inspections, data tracking, and selected quality improvement performance initiatives. Examples of healthcare data tracking include: medication errors, falls, skin injury, & infections. Staff report on interventions and actions put in place to improve quality & reverse negative trends. The Quality Committee reports up to the full Board of Trustees. 39
Questions? 40
