Otterbein Homes: Comfort in Mind - Health Executive - RedCoat Publishing - Inside Healthcare

After years of practice running continuing care retirement communities (CCRC), Ohio’s Otterbein Homes is switching gears. With an aging population and changing expectations, Otterbein is rolling out a new model. According to Donald Gilmore, Otterbein’s president and CEO, change was inevitable.

Donald Gilmore, President and CEO

“People living in long-term care and their caregivers suffer because nursing homes are configured like an institution. We want to change that and liberate both elders and their caregivers,” Gilmore said. “We are creating homes for people and high quality jobs for the people who serve them.”

Otterbein Homes has almost a century of experience in the field. The first Otterbein community, near Lebanon, Ohio, served both children and seniors from 1912 until 1963. During the 1960s, Otterbein was a leader in the development of modern nursing communities. Since then, four more Otterbein nursing communities opened around Ohio. But once again times have changed, and now Otterbein is leading another revolution in elder care.

Recently, Otterbein launched a new brand of nursing communities. Avalon by Otterbein is described as a small house model of care. The first Avalon community opened last year, and five more will open by 2009. Once every planned project is completed, Otterbein and Avalon by Otterbein will serve 300 nursing home residents.

The Avalon project, led by Jill Hreben, the senior VP of strategic planning, was designed and implemented with the help of Dr. Jude Rabig, a gerontologist who is a pioneering force behind the small house model. Gilmore said research indicates baby boomers are rejecting the traditional model of nursing home care for themselves and their parents. The Avalon communities are designed to provide the privacy, autonomy, and dignity this generation values so highly.

“Avalon is being built with the future in mind. The drive toward control and choice in medical and health matters began in long-term care with a wave of people flocking to assisted living,” said Gilmore. “We are convinced people will choose a home over an institution when given a choice. Avalon provides that option.”

Avalon is designed to be a place where the best communal aspects of a home harmonize with parts that promote privacy and individuality. Each community has five houses with 10 people in each house. The heart of each house is the hearth. It includes an open kitchen, a dining room with a large table where family style meals are served, and a living room with a fireplace. Each person has a private room and private bath with a shower. There is also a separate spa-like bathing room. The design includes a small office, which serves as a space for private meetings, and a work area for the clinical support team members, complete with advanced technology such as an electronic medical record.

Otterbein was able to get this initiative up and running because its board was able to purchase land for multiple projects up front. In addition, by building new facilities within counties it already serves, Otterbein could redistribute bed licenses. Gilmore said the original Lebanon facility had a license for 356 beds, far too many in today’s environment. Since modern seniors prefer to relocate closer to home, this was a win-win for Otterbein. It also opened up employment opportunities by redistributing the workforce.

Culture change
According to Gilmore, implementation had many challenges. The regulatory hurdles were worked through with the cooperation and support of the state. Internal teams from every department worked collaboratively to adapt Otterbein’s practices and to create a working financial model.

Each Avalon project costs about $8 million to build, and the new model is financially untested because it is so different. There isn’t the critical mass associated with a 100-bed nursing home, and there is a higher ratio of state tested nursing assistants than in the traditional model. But Gilmore said by removing the non-productive overhead of a traditional department structure from the equation and streamlining operations, the model is proving viable.

“There are skeptics who criticize the financial feasibility of the operation, but after a few months we are already seeing better margins than at our current nursing homes, while continuing to serve a high level of individuals who are Medicaid recipients,” said Gilmore.

Residents aren’t the only ones who have to adapt to the Avalon method. Nurses and other staffers underwent extensive instruction in the nuances of Avalon care delivery methods. Otterbein was able to learn from the experience of the Green House project, a similar initiative with its first homes in Mississippi. Through regular visits and access to experts, Otterbein was better prepared to begin the transition once Avalon homes were up and running.

Although the Avalon program is the wave of Otterbein’s future, the five original Otterbein homes have also been updated to keep up with the times. Otterbein communities have moved to empower residents, where simple changes like open dining hours with point of service delivery can go a long way. Though there may come a time when future renovations to Otterbein buildings may make them more like Avalon, the combined strength of the Otterbein and Avalon brands gives Gilmore and his team the opportunity to lead the evolution of the industry in Ohio.

“We won’t be satisfied until we’ve replaced our traditional model, even on our CCRC campuses,” said Gilmore. “We started this off-campus deliberately so we could perfect it without the confusion of the way we always have done things, and we think the Avalon method is the answer.”

< Previous Story		Next Story >

CURRENT ISSUE

CATEGORIES

HEALTH SOLUTIONS