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Enhanced Care Services

Our enhanced level of care services are intended to meet the needs of residents in the mid-stages of their cognitive impairment(s), with advanced chronic health conditions, and/or require more complex care. Residents that meet the criteria for this level of care will receive services that have been approved by the Vermont Department of Disabilities, Aging, and Independent Living through a variance program that allows the facility to care for residents with nursing home level of care needs. 

24/7 Safety Monitoring and General Supervision

  • 24/7 access to secure recreational outdoor space.

  • 24/7 secured exterior doors to support a dignified approach to managing wandering and to prevent elopement related injuries.

  • A facility-wide security alarm system with 24/7 professional monitoring.

  • Access control technology that monitors exit door activity (in/out), secures exit doors, and sends alerts directly to staff when unauthorized door activity occurs.

  • Call alert system for residents with the cognitive capacity to utilize them.

  • Exterior motion sensing technology that allows safe and unrestricted outdoor activity.

  • High staff-to-resident ratio (8am to 8pm 3-4 staff-to-11 residents | 8pm - 8am 2 staff-to 11 residents).

  • Individual motion and pressure sensing technology to prevent falls for residents at high risk for fall related injuries.

  • Interior motion sensing technology that supports staff with wandering inside to reduce the common frustrations associated with disorientation.

  • Lift equipment that lifts residents who have fallen to avoid unnecessary assistance from an ambulance service, transfers to the hospital, and unexpected medical expenses.

  • Silent fall prevention technology that identifies unsafe activity/movements, alerts staff, and prevents falls without bothering residents with loud alarms that sound off in their room.

Medication Management

  • Assistance with self-administering medications, when appropriate.

  • Coordination with prescribing providers to ensure accurate dosing, administration parameters, and refill orders.

  • Coordination with prescribing providers to manage frequent changes to medications being used to manage behavioral health symptoms.

  • Complete medication administration.

  • Delivery and inventory management of medications and medical supplies.

  • Monitoring for adverse medication side effects, this includes a comprehensive antipsychotic drug monitoring program.

  • Monitoring medication efficacy, therapeutic doses, coordinating with prescribing provider about necessary changes to a medication.

  • Pharmacy services provided by Health Direct pharmacy in Williston, Vermont (deliveries daily).

  • Procurement of medications and medical supplies from the pharmacy.

  • Routine (as ordered) drug monitoring procedures (e.g., lab work, INR, etc.).

  • Routine (monthly) monitoring of medications by the primary care provider.

Nursing Services

  • 24/7 on-site nursing medication management, consultations, health assessments, and chronic care management.

  • Behavioral health nursing services offered by the primary care clinic that services our facility, and local mental health services.

  • Hospice and palliative care nursing services offered by non-affiliated providers.

  • Primary care triage nursing services offered by the primary care clinic that services our facility.

  • Rehabilitative nursing services offered by non-affiliated providers.

  • Wound care nursing services offered by non-affiliated providers.

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In addition, our Director of Nursing will also provide the following routine services for residents:

  • Coordination with medical and mental health providers.

  • Coordination with the Administrator and direct care staff to oversee the physical, mental, and psychosocial needs.

  • Monitoring the status of behavioral health conditions.

  • Monitoring the status of chronic health conditions.

  • Monitoring the clinical status of hospice and palliative care residents.

  • Overseeing the administration of medications and the training program for staff certified to manage medications.

  • Restorative care services.

  • Reviewing and monitoring health assessments and health status reports.

  • Reviewing and monitoring individualized health service and behavioral intervention plans.

  • Reviewing and monitoring medications, treatments, and procedures.

 

Our Director of Nursing provides all on-site nursing services routinely and as needed based on the individualized care needs of each resident. We do not have set time limits for nursing services to ensure that residents receive the appropriate level of nursing care.

Personal Care

  • Assistance with ambulation and mobility.

  • Assistance with activities of daily living.

  • Assistance with bathing.

  • Assistance with dressing.

  • Assistance with eating.

  • Assistance with grooming.

  • Assistance with maintaining a choice schedule and routine.

  • Assistance with managing urinary and bowel incontinence.

  • Assistance with oral hygiene.

  • Assistance with personal hygiene.

  • Assistance with toileting.

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Residents receiving enhanced care services will receive moderate-to-exstensive care assistance with all activities of daily living. 

Health and Wellness Services

  • 1:1 caregiver support to sit with residents in the emergency rooms when families are unavailable to ensure that residents feel safe and comfortable while in an unfamiliar environment. 

  • Agreements with local health providers (e.g., primary care, vision, and dental) clinics for whole-day blocks designated for the care of only our residents.

  • Agreement with the primary health clinic that services the facility to provide appointment blocks for our residents to get them assessed for acute health concerns to avoid unnecessary emergency room visits.

  • Continuous close health monitoring of chronic medical and mental health conditions.

  • Coordination with mental health provides, services, and local programs.

  • On-site behavioral health services offered by the primary care clinic that services our facility.

  • On-site hospice and palliative care services offered by non-afflicted providers.

  • On-site wound care services offered by non-affiliated providers.

  • On-site oral hygiene evaluation and services offered by non-affiliated providers.

  • On-site physical therapy and rehabilitation services offered by non-affiliated providers.

  • On-site podiatry nursing evaluations and services.

  • On-site vaccination clinics offered by the primary care clinic that services our facility.

  • On-site phlebotomy services (e.g., INR, blood work, medication monitoring, etc.) offered by the primary care clinic that services our facility.

  • On-site infection prevention and monitoring services (e.g., UTIs, URIs, etc.) offered by the primary care clinic that services our facility.

  • Post-injury restorative and rehabilitation services offered by non-affiliated providers.

  • Preventative care and procedures offered by the primary care clinic that services our facility.

  • Routine (monthly) on-site primary care services and acute health monitoring offered by the primary care clinic that services our facility.

  • Transportation to vision and dental appointments with 1:1 support staff when necessary.

  • Transportation with 1:1 support from staff (when necessary) to/from scheduled medical appointments, emergency rooms, health clinics, etc.

Behavioral Management

  • Comprehensive non-pharmacological training programs for management and staff to address behavioral and personality challenges to reduce the need for medication.

  • Comprehensive monitoring program for medications being used to treat behavioral symptoms.

  • Coordination with mental health and behavioral health services, providers, agencies, and primary care providers.

  • Designated calm spaces to reduce the distress and disturbance of disruptive behavioral symptoms, and to provide residents with a private space that protects their dignity while they experience a difficult time that others may not understand.

  • Individualized 1:1 supportive care and behavioral intervention strategies, when necessary, to manage challenging behavioral symptoms that can be difficult to redirect using traditional approaches.

  • Individualized behavioral intervention and modification programs to mitigate the distressing implications of behavioral and personality challenges.

  • Risk management training for management and staff to understand the unique safety challenges associated with dementia care living environments.

  • Specialized group and independent activities to provide daily opportunities for residents with challenging personalities and behaviors.

  • Specialized training for management and staff to support them with identifying underlying potential causes of negative behavioral and personality changes.

  • Supportive care and health services to identify, manage, and improve behavioral and personality challenges commonly associated with progressive cognitive impairment(s) such as apathy, aggression, agitation, depression, irritability, psychomotor agitation, delusions, hallucinations, sleep pattern changes, and changes in appetite.

  • Therapeutic activity programs to support residents with maintaining low-stimuli, therapeutic activities throughout the day to reduce the occurrence of challenging behaviors.

  • essentialALZ  - Alzheimer’s Association dementia care training and certification is required for management and direct care staff to ensure research proven communication strategies, care approaches, and behavioral intervention strategies.

Activities and Social Recreation

  • Animal assisted therapy.

  • Assistance and encouragement with daily recreational activities.

  • Assistance and encouragement with participation in daily socialization.

  • Assistance with obtaining and participating in independent activities.

  • Life enrichment programs.

  • On-site cosmetology services.

  • Routine visits from family pets, young children, and babies.

  • Scheduled transportation with 1:1 staff assistance.

  • Transportation to/from community events.

  • Visit the activities and lifestyle page for more information regarding activity offerings.

Case Management

  • Assistance with gaining access to needed medical, social, and other health-related services.

  • Assistance with clinical care coordination to facilitate effective communications between health providers to achieve optimal health outcomes.

  • Assistance with participation in community mental health programs.

  • Assistance with accessing medical, dental, visual, and mental health services.

  • Assistance with maintaining Vermont long-term care Medicaid eligibility.

  • Assistance with applying for Vermont long-term care Medicaid.

  • Assistance with managing Medicaid benefits.

  • Assistance with obtaining, reviewing, and managing records.

  • Assistance with sending and receiving mail and packages.

  • Assistance with coordinating with social services agencies.

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The Administrator will additionally support residents and their families with additional case management related tasks upon request by either the resident or their family

Hospice and Palliative Care Services

  • 24/7 nursing support by phone to help with changes in clinical status.

  • Coordination of available community services and end of life planning.

  • Emotional and spiritual support for residents and their families.

  • End-of-life medication management.

  • Managed care services to allow residents to receive comprehensive end-of-life care at the facility.

  • Pain and comfort management.

  • Social services and care coordination.

  • Triage nursing and medical interventions to avoid hospitalization.

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Hospice and palliative care services are provided in conjunction with local hospice care agencies and providers. 

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