Mohammad Qazi and his team are creating a home-like atmosphere that is turning traditional perceptions of nursing homes upside down.

Most people regard nursing homes in a negative light—quite frankly as a stepping stone toward the inevitable. But Mohammad Qazi, president and CEO of Southfield, Mich.-based Ciena Healthcare Management, which owns and operates 30 skilled nursing and rehabilitation facilities across the state, is turning that perception on its head.

Mohammad Qazi, President and CEO

With 3,350 licensed beds, Ciena Healthcare Management is one of the largest privately owned operators of skilled nursing and rehabilitation facilities in Michigan. It provides rehabilitative services, including sub-acute care, ventilator care, infectious disease services, progressive wound care treatment, IV therapy, and respiratory care.

Traditionally, the organization has focused on acquiring existing facilities ranging in size from 50 to 200 beds, but to create the desired atmosphere, it is currently engaged in some major renovation projects. “Most skilled nursing facilities were built in the 1960s or early ’70s and have an institutional feel and look to them, so our strategy is to change that as much as possible,” said Qazi.

But there’s only so much you can do with a 40-year-old building, so Ciena Healthcare Management is now in the process of replacing one facility, and has just finished building two new ones. Regency on the Lake, located on a 7.4-acre plot in Fort Gratiot Township, opened in August 2006. The 54,524-square-foot, 108-bed building reflects a new design concept Qazi believes will revolutionize skilled nursing and rehabilitation services. Instead of grouping short-term rehab patients in with long-term skilled nursing patients, Regency on the Lake is separated into two distinct facilities with separate entrances, dining areas, and common spaces.

“For the short-term rehab patients who may be recovering from hip or knee replacement, sitting next to a disoriented 95-year-old dementia resident can be uncomfortable. It’s difficult for families as well,” said Qazi.

This is a relatively new problem for the nursing home industry as life expectancies continue to rise with the advent of medical technologies. Twenty years ago, Qazi explained, the majority of nursing home residents were in their late 60s and early 70s. Today, residents are split into two generations: the 60- to 70-year-olds who require rehabilitation after surgery or stroke, and seniors in their 80s and 90s suffering from dementia and other serious illnesses. “One group goes home, the other doesn’t, and the one that doesn’t is getting much sicker much later than the industry is accustomed to.”

In addition to changing the overall facility design, Ciena Healthcare Management has added amenities to its new facilities that aren’t typically found in skilled nursing centers. For example, recently opened 93-bed Royalton Manor in St. Joseph, Michigan, which also separates short- and long-term care residents, has a variety of gathering spaces, including an ice cream parlor, a family dining room, several sitting areas, and a children’s play room. The facility also encourages residents to stay active with two activity rooms, a chapel, a beauty shop, and a library. The blueprints for Fountain View of Monroe, a replacement facility currently under construction, has 80% to 90% private rooms, most of which are accompanied by private showers rather than the common shower areas found in many older facilities.

The décor at most of Ciena’s facilities is changing as well. Regency on the Lake, for instance, is decked with hardwood floors, plush furnishings, and warm, inviting colors. According to Qazi, creating a comfortable environment not only benefits residents, but families as well. “We find that the less institutionalized the setting, the more apt the younger generations are to visit their loved ones,” he said.

Good life, good food
To create a more positive experience, Ciena Healthcare Management is giving residents more choices, starting with food. The organization has moved away from meal-of-the-day-on-a-tray dining to buffet-style dining. “Now our residents can choose what, when, and how much they want to eat. They never had that option before,” Qazi said. “Just because you’re a resident in a nursing home doesn’t mean you don’t deserve choices.”

The concept was launched in the two new facilities last year and has been rolled out to all 30 facilities with great success. To go one step further, Ciena Healthcare Management is now in the process of hiring chefs to start offering made-to-order meals.

In addition, the organization is developing several out-of-the-box programs for residents, including music lessons in a handful of facilities and computer training courses to teach residents how to use the Internet for research and keeping in touch with loved ones.

Culture of excellence
For years, most nursing homes have been focused on compliance, Qazi explained, but for Ciena Healthcare Management, that’s not good enough. “In such a highly regulated industry, compliance is key, but we’re going a step further to create an environment of excellence where everything revolves around the needs of the resident,” he said. “Once you do that, everything falls in place.”

To make the journey from compliant to excellent, Ciena Healthcare Management puts extra emphasis on hiring the right staff and providing them with the appropriate education and support. The organization not only offers tuition reimbursement to local colleges and universities, but it has developed an ongoing inhouse training calendar. “We encourage employees to improve their skills and gain certifications, and we continue to send this message to administrators at each location so they can let their employees know these learning opportunities are available,” said Qazi.

One of the main drivers of Ciena Healthcare Management’s culture of excellence is empowerment. As a management service, it provides all 30 facilities with operations management; state and federal compliance consulting; Medicare, Medicaid, and managed care billing; financial management; vendor management; payroll services; HR and legal consulting; recruiting; internal auditing; and training and education programs. But Qazi doesn’t believe in looking over the shoulders of his administrators, instead letting them do what is best for each location.

“The management company has a role to play, but we let the facilities run their own show. We don’t believe in having a cookie-cutter approach. We want them to come up with solutions to their own problems and think locally,” said Qazi. But that doesn’t mean the folks at Ciena Healthcare Management don’t work as a team. In fact, administrators and company leaders meet regularly to share best practices.

Throughout all his years in the skilled nursing industry, Qazi finds a fundamental fault. “Unfortunately, when it comes to nursing homes, only bad news make it to the press, but a lot of good things happen. We want to highlight that a nursing home isn’t just a place to die. It’s a place to live.”