Community Governed Nursing Homes Nova Scotia (CGO)

CONTENTS

What Makes Community Governed Nursing Homes Unique? Business Issues: Community governed organizations have unique challenges with trying to negotiate with lenders. Leveraging assets to develop programs that are not coming with guaranteed funding from the “department” are difficult at best to achieve. This significantly reduces the ability to finance investment programs and services due to a lack of capital. Governance Issues: Although there are numerous benefits to being governed by a community board, there are challenges around the time and process required in decision-making. This reduces the flexibility of these organizations to respond to change in an immediate fashion. Within the community governed sector there are differences in how boards

interact and influence their organizations. There is evidence that the risk tolerance for voluntary Boards is limited and therefore risky adventures designed to meet and respond to community needs is often restricted. Capacity: The insular nature of community governed organizations has resulted in numerous missed opportunities to share best practice, build capacity and expertise within all of our organizations. Innovative practices such as fractional employment and shared departments (i.e.: Shared HR, IT, Performance Excellence departments) have been

disregarded in favor of utilizing resources to replicate these services at each individual organization. Board best practice is also often not shared and the models of effective governance are missed opportunities for everyone to benefit from the journey of others. Community Involvement: Not only are community Governed organizations governed by volunteer community representatives they are also fundamental “places” where communities are heavily invested and have a stake. They are therefore dynamic homes with a strong community presence in volunteerism and partnerships.

Dion Mouland, Chair

Josie Ryan , Vice Chair

Arlene Morrison, Treasurer

Dion has worked in the NS health system for 25 years in an array of front line and management positions. He has served on several board including Community Health Promotion Network Atlantic, Metro Community Housing, Caregivers NS, continuing care council, and has been on the Board of HANS. He is a surveyor with Accreditation Canada and has been a part time professor at Dalhousie University for the past 7 years teaching in the health administration program. He has been the CEO of Ocean View Continuing Care for the past 11 years and thoroughly enjoys country life with his 3 canine friends.

Josie has worked at Northwood for 16 years and within the Long Term Care sector for over 25 years. As a Registered Nurse she has worked within Administration, Infection Control, and Occupational Health and currently is Executive Director responsible for Northwood’s In Care Living Program. Northwood is an accredited organization offering programs and services to 641 residents within two locations and within the community to over 6000 client throughout Nova Scotia. Josie is excited to have the opportunity to participate on the board helping CGO members influence the direction of Long Term Care in the province.

Arlene is Administrator of Alderwood Long Term Care Facility in Baddeck, NS, a position she has held for the past 14 years. Arlene is currently a member of CGO and CCANS and has served on Continuing Care Council, HANS Board of Directors and Health Care Human Resource Sector Council. Arlene graduated from Dalhousie University in 1982 with a Bachelor of Commerce degree. She also has a certificate in Project Management from St. Mary’s University. She has held various administrative positions with A.G. Bell Museum and the Village of Baddeck. Arlene is a proud mother of two and loves to sail, read, run and practice yoga.

Michael Archibald, Director

Lisa Smith, Director

Michael is the Administrator of the Maritime Odd Fellows Home in Pictou, NS, since 2012 having previously worked as a Manager at the IWK, and in research at Capital Health. Following 18 years in the private sector, Michael began working in the Healthcare sector after completing a Neuroscience degree at Dalhousie and an MBA at Saint Mary’s. Michael lives in Truro with his partner Christine, and three children.

Lisa’s experience in the health and community services sector spans over twenty-six years, encompassing two government departments, a district health authority and a sizable long term care facility (Glen Haven Manor – New Glasgow). Lisa holds a BBA, BSW and MPA. She is an active Rotarian and a member of the National Senior’s Council and Continuing Care Council. Lisa’s commitment to community is demonstrated by her countless volunteer connections to agencies serving seniors, children, mentally challenged and individuals in crisis. In her role as Administrator, Lisa ensures all elements of the organization remain committed to providing exceptional individualized quality, expecting the highest level of accountability to residents, families, staff and community. Serving on the Executive has been an enjoyable experience for Lisa and she is grateful to be associated with a society motivated toward “success through collective capacity”.

Sherry Keen, Director A Dalhousie nursing graduate, Sherry has worked in healthcare for the past 32 years, initially in Halifax, then in Ontario. Sherry worked in Public health and acute care/chronic care nursing in Hamilton Ontario. Sherry worked in a variety of leadership positions in chronic care in Ontario. Upon return to Nova Scotia she obtained her MSHA at Dalhousie and began her career in Long term care. For the past 12 years Sherry has worked at Windsor Elms Village in Falmouth. he has been involved with the CGO since its beginning and greatly values collaboration in building collective capacity in the non profit sector. She is a champion of the Eden Alternate philosophy, and has been successful in gaining Eden registry status for the Windsor Elms in April 2013. Sherry lives in Bedford with husband Bob and her 3 grown daughters.

Message From the Board Chair The infancy of any new initiative is a time of flux and change and often riddled with many successes and challenges. As we close the 3rd official year of the Community Governed Nursing Homes of Nova Scotia I am honoured to provide you this report that overviews some of the challenges for our organization but is largely reflective of terrifically positive work done by a tremendous group of energetic people, the members of the CGO Society.

I am proud to say that the majority of community governed nursing homes are now members of the CGO. Of a total 42 eligible members, 31 are active paying contributors to our work. This past year our strategic directions have remained our pivotal focus and this report provides some of the details on the initiatives undertaken for members, by members. We’ve received positive accolades from the ministry, Board members of CGO, managers, and volunteers who have all benefited in some way from our work. As members are aware, one of our founding purposes was to promote capacity building and competence within the

community governed homes in Nova Scotia and I believe we are on a very positive road this past year to that commitment. We’ve organized and provided educational workshops on ethics, moved ahead with Provincial work to develop a quality framework for LTC, and started the very first Fellowship for LTC in partnership with Dalhousie University. We’ve remained committed to our advocacy agenda and to that end work to action members wish to garner some traction on the issue of heightened aggression in LTC homes has been positively received. Our members have heard many success stories at quarterly members meetings including the Coaching Program at Mountain Lea Lodge. The uniqueness of our organization remains in its structured approach to being truly driven for members, by members. Engaging everyone can be an arduous task but well worth the effort at the end of the day when people are part of change. As I end the Chair of the Board role in June my passing words to you are “do not follow where the path may lead. Go instead where there is no path and leave a trail”. Let’s continue to work together towards our vision “success through collective capacity”; I believe it will ensure those we are privileged to serve are the true beneficiaries of our work…..living well in a place they feel is their home.

Our Mission : To Support and Promote Community Governed Nursing Homes in Our Vision: Success through collective capacity

Nova Scotia

Governance Models / Board Recruitment & Evaluation / Ethics / Foundation The work in this strategic direction this past year has focused primarily on the delivery of educational sessions on ethics for member organizations. Sessions were held in Port Hawkesbury and Windsor and a total of 46 people attended. The evaluations were positive and members have expressed a desire to continue to provide these sessions in the upcoming fiscal year. The focus of the sessions has enabled a broad audience of participation and therefore folks from Board, management, volunteers, and front line staff have attended the sessions. One of the enhancements planned for the future is the ethics of Board decision making in allocating finances in an organization. All session participants are provided with a template of resources following the sessions which has included ethical frameworks as well as policies they are able to take back to their organizations and adapt to their own use. One of the challenges in this strategic direction is the lack of Board member engagement in the actual planning of the work. This coming year there are plans to start an active plan to engage Board members from around the Province by hosting a 1st “Stewardship Conversation” in the

fall of 2014. There is also a commitment to provide education this year on the governance and management of “Foundations”.

Strategic Direction Board Leader: Dion Mouland

Succession Planning / Leadership Models / Models of Care Succession planning is a systemic issue and there are very limited opportunities for new graduates and existing professionals to gain the necessary experiences for the effective operations of nursing homes in this province. The CGO group aims to develop and implement a model whereby graduating leaders can get exposure to this industry, particularly in rural areas. A fellowship is being planned for implementation over the next 2 years. As an initiative of the CGO the Health Administrative Fellowship (HAF) is designed to provide exceptional candidates, who have successfully completed a Masters level program with additional post-graduate training in a specific area within the health system. The Fellowship, in partnership with Dalhousie University Faculty of Health Professions, is a preceptor-directed post-graduate program with defined educational objects that are developed and measured for the specific area of study within the Health system. The fellowship is a 1-year program of post-graduate study that can be applied to a variety of settings including academic health centres, community health centres, government health agencies, and corporate health agencies. The Fellowship has become an increasingly sought after postgraduate training program, primarily attributable to the increasing demands for specialized expertise in an increasingly complex health system. Additionally, with an increasingly competitive healthcare secure job market, the experience gained through participation in a formal Fellowship

can provide a competitive advantage to the new health administrator. Benefits: Organization  Permits evaluation of potential candidates for future leadership positions  Exposing current management to interaction and exchange of ideas with postgraduates or new careerists

 Allowing opportunities for introduction of current academic theory and learning techniques

Fellow  Enhanced understanding of health systems through in depth, postgraduate training

 Enhanced skill development within the context of extended formal mentoring  Enhanced opportunity to learn about decision making at the highest governance, corporate, or executive levels  Enhanced

opportunity to develop mentoring relationships that can influence future professional development and career advancement

 Enhanced

opportunity to develop expertise in health administration making the Health Administration Fellow more marketable

Profession  Outstanding

future leaders and mentors in health administration who will enhance the network of highly skilled professionals that will be in increasing demand in the next 5-8 years.

Strategic Direction Board Leader: Lisa Smith

Electronic Capacity / Information Technology & Software Systems Technology is rapidly spreading across Long Term Care and many homes are investing in hardware and software to increase efficiencies. The first priority is advancing the CGO website to enhance communication and sharing between members. Over the next year, we will continue to collect information on capacities within members’ organizations. With numerous vendors vying for business, we will create opportunities for information seeking and discussions with user experiences throughout the membership. It is important to gather information from the Health Districts and Department of Health and Wellness on the direction the sector is pursuing and in advocating for funding to ensure Community Governed Organizations remain current within the Long Term Care Sector. The technology group is excited to work with you over the upcoming year!

Strategic Direction Board Leader: Josie Ryan

Evidence Based Decision Making / Methodologies This society recognizes the importance of effective business planning and the long term sustainability of the continuing care sector. Although true business plans are not being asked of organizations, it is believed that

the sector should take the lead in develop a consistent and legitimate approach to business planning. Work continues to identify resources and tools which match member priorities identified in the past year for business planning and financial benchmarking activities. The development of benchmarks and indicators of performance are integral in making decisions that are based in evidence. A review of a recent member organization financial comparison report is underway to improve the comparative value to be used for benchmarking. A consistent approach by a large number of organizations would provide the valuable information in the management and performance of the sector. Complying with policy directives from the Department of Health and Wellness and agencies such as the Department of Labour and Advanced Education, the Department of Agriculture and the Office of the Fire Marshal can place unintended financial pressures on organizations. By working with the department more closely in the development of these polices these cost implications could be more accurately identified. Tools and resources to identify and measure the operational impact of policy changes are to be identified or developed as future work of this strategic direction.

Strategic Direction Board Leader: Michael Archibald

Quality and Risk Long Term Care organizations in Nova Scotia pride themselves on providing quality care to the senior population of this province. While some community governed organizations are further along on the journey of collecting and disseminating data than others, each organizations has an opportunity to learn and grow from what others are doing in the area of quality and risk. The CGO group endeavors to support all organizations in their goal of providing safe, effective care. Development of standards and criteria for risk and quality is a fundamental step in supporting organizations in this goal. The balanced scorecard has been identified as a possible tool that organizations can adopt to support their needs. This year has seen the implementation and piloting of a quality scorecard, starting first with clinical indicatorsthe purpose of this trial was two fold: 1. To identify common key indicators of priority for collective monitoring 2. To examine the burden of data collection of these indicators across the NS LTC non profit homes. The quality/ risk committee has seen strong sector engagement in this pilot, which currently involves over 10 facilities in data collection and analysis. This next year will continue the pilot with the addition of more

indicators as well as the development of a quality manual to support the process. Another priority this year will be the identification of other key risk areas that could be addressed by this committee as well, to further the capacity of our members.

Strategic Direction Board Leader: Sherry Keen

Advocacy / Political Awareness As with any truly member driven organization it is imperative that issues facing those members are represented collaboratively. To that end, the CGO developed an advocacy agenda in 2012 for its members that included issues that pertained to several areas of nursing homes operations and governance. That original agenda, including the following, will be reviewed and updates and deletions will be made depending on todays most pertinent issues. This work will happen in June 2014 and will be made available at AGM. Long term care funding formulas are different within the system and there is a need to ensure members are at the planning table when Government is tasked with any development in funding formulas that will impact providers. A consultative approach will be championed by the CGO for this work. Funding for risk and safety issues remains a concerns for members in the nursing home sector including impacts being seen with legislative and departmental policy changes. The diversity of care being seen in nursing homes creates unique acuity challenges and must be addressed. “A bed is a bed” philosophy needs to be recognized as outdated. Nursing homes are operated under an antiquated Homes for Special Care Act that needs consultative review and change. Standards of service delivery are different between outdated and older homes versus newer replacement and new builds. The plan for capital investment needs to be communicated to providers to ensure equality to all residents of Nova Scotia living in Nursing Homes. Providers are unable to support a smooth and efficient transition sometimes due to limited access to their wait list information. This must change and information needs to be communicated.

Strategic Direction Board Leader: Arlene Morrison

Society Objectives

 Provide Networking Opportunities for Governors of CGOs to learn and grow together in the provision of Long Term Nursing Home Care in Nova Scotia.  Provide opportunities for management and leadership of Nova Scotia’s CGOs to network with peers facing common situations.  Provide a Forum for organizations to explore building capacity among organizations of similar governance models.  Increase the competence and confidence of both Board and Management structures through the sharing of risk, quality, ethical, and financial management best practices.  To increase the understanding of the uniqueness of the community governed organization model and support similar organizations in how to operate efficiently and effectively.  Advocate for the residents and staff within the Nova Scotia nursing home system.

Statement of Operations Revenue Membership Fees Balance Forward Total Revenue

$20,825.00 $6,621.19 $27,446.19

Expenses Bank Charges Catering Honorariums Management & General Expenses Office supplies Professional Fees Travel Web Services Other - deposit correction Total Expenses Net Income

$45.84 $300.00 $2,800.00 $2,183.54 $18.27 $630.25 $1,715.46 $970.90 $100.00 $8,764.26 $18,681.93

The total year end results for the Society was a surplus of $18,681.93

For Membership or Other Information Contact: Dion Mouland, Board Chair or Chris Jones, Board Support Website: www.cgons.ca Email: [email protected] Mailing Address: P.O. Box 130, Eastern Passage, NS, B3G 1M4

Tel: (902) 465-6020 Ext 2135 or 2145