​When challenged to document their commitment to quality, this year’s winners of the American Health Care Association/National Center for Assisted Living National Quality Awards answered the call by digging into their quality practices; tracking their progress; and identifying activities, programs, systems, and processes that make their facilities extraordinary and enable them to thrive and grow. 

The 505 recipients this year were selected in three categories—Bronze, Silver, and Gold (previously Step I, Step II, and Step III, respectively).

Going For The Gold

Celebrating this year as the sole Gold recipient, and the first independently owned organization to receive the distinguished award, was Manchester Manor Health Care Center in Hartford, Conn. Administrator Mary Ellen Gaudette says, “I’ve been a nursing home administrator for 25 years, and this is the most exciting, rewarding honor I’ve ever received.” She adds, “Families, residents, and staff alike are so proud. One family member said that she can’t stop talking about it and bragging that her mother is at this home!”
Going for the Gold was Gaudette’s goal from the start. Her facility received the Bronze and Silver awards after only one try. It took Manchester two years to obtain the Gold, but it was well worth the effort. “We wanted to do this to advance the profession and to show the evidence of our organization’s dedication to quality,” she says. “The award shows that you stretch and improve constantly and never stop pursuing improvement, even after you achieve goals.”
How does a facility get from Bronze to Gold? “You go about it in small steps,” says Gaudette, adding, “As you get into the process and learn about the Baldrige criteria and how they work, the process becomes easier.”
Writing the Gold application was a huge task, she says, but she says that she had a slight edge. She served as a senior examiner, reviewing Silver applications, which allowed her to gain insight into the process, how it works, and what constitutes a successful

Telling The Facility’s Story

Gaudette, as well as other award recipients, stresses the importance of the application having a single voice. However, she says that this doesn’t mean that one person alone is involved in ensuring a successful application. “You must have the support from other people in the building. I had help with the writing, and I had help from others who enabled me to leave the building on occasion to focus on my writing.”
Whoever writes the application, Gaudette says, “you have to write it as a story—the story of your facility and the great things you do, as well as those for which you are striving. You start the story with the Bronze, then go into greater depth and involve more data collection in the Silver. With the Gold, you are pulling together all of your systems and the great things you’ve worked on, tying everything together and showing comparisons with others in the state and nation.”
Along the way, the facility enjoys many partnerships that make it successful, including relationships with other providers, vendors, staff, and volunteers. Staff involvement, in particular, is key. As Gaudette says, “As a facility, we honestly don’t make any decisions—including working on activities such as these Quality Awards—without staff input.”
However, the lack of one partnership has enhanced Manchester’s success—nursing staff agencies. “We have a summer incentive program designed to encourage staff to keep shifts covered. Staff can earn points for picking up extra hours. They then can cash these points in at summer’s end for gift certificates.”
The facility also has a winter incentive program in which staff with excellent attendance are eligibl'e for a drawing for a trip to Aruba or Disney World.
While winning facilities were proud of their work, many didn’t realize just how far they had come until they saw it
in black and white on their application. Many also appreciate the validation they received regarding the effectiveness of the processes and systems they have employed.
“Through the application process, we learned that the system we used to grade ourselves on our efforts to improve quality and safety works. We practice ‘plan, do, check, and act,’ and our quality assurance system has earned us distinction from our peers because of our consistently positive outcomes,” says Judy Dunman, administrator at St. Elizabeth’s Place in Jonesboro, Ark., 2010 Silver recipient.

Successful Facilities Share Qualities

Clearly, successful facilities share a passion for quality care. However, they also have other characteristic in common. For example, they all expressed a commitment to strategic planning.
“When I read the application criteria, I thought that it correlated with what we do every year—our strategic action plan that aims at providing exceptional care, developing our people, focusing on our customers, and achieving operational excellence,” says Troy Guntulis, executive director of Windsor Rehabilitation and Healthcare Center-Kindred in Connecticut, 2010 Silver recipient. “Every year, we develop 16 strategic plans in several core areas.” He adds, “This fits right into the application. The strategic planning fosters independent thinking, empowers people, and enables everyone to see themselves in the organization’s future.”

Facilities’ commitment to strategic planning often made the application process easier. As Brian Scheri, administrator at Mitchell-Hollingsworth Nursing and Rehabilitation Center, Florence, Ala., 2010 Silver recipient, says, “Without a plan, we wouldn’t even have been able to start.
“At our meetings, we had dry erase boards and just blurted out ideas. Then we looked at everything in terms of what fit into the spirit of the award. They made writing assignments and set a schedule for completion.”
The team started with a 40-page draft that they had to trim down to 18 pages. “We couldn’t have done that without planning, organization, and discipline,” Scheri adds.
Dunman adds, “Before you begin the application process, you have to know your strengths and weaknesses. You have to evaluate your systems, set expectations, and then raise your expectations.”
Facilities also share a knack for measuring outcomes and comparing results with other facilities statewide and nationwide. This isn’t always easy. As Renee Looker, executive director at Forestview Nursing Home of Wareham, in Massachusetts, 2010 Silver recipient, notes, her facility wanted to spotlight its Mind-Body-Spirit Program that offers free services such as aromatherapy, massage, Reiki, and music therapy.
“It was challenging to measure outcomes and compare results, because no one else was doing the same thing. So we approached it in terms of measurable issues such as [quality indicators] on pain and medication use,” she says.Facilities receiving Gold and Silver awards share the honor with staff, residents, and family members alike. At Gaudette’s facility, they built a special trophy case for the Silver Award with a light “that shines on it all the time. It’s there for everyone to see, and we point it out to visitors.” She adds, “We’ll go beyond this with the Gold Award.”
Brentwood Rehabilitation and Nursing Center in Yarmouth, Maine, celebrated “with a big barbeque for staff, residents, and families. We decorated with silver balloons—of course,” says Executive Director Dan Burns.
Lori Cooper, administrator at Silver recipient Stonebrook Healthcare Center in Concord, Calif., says, “This means a lot to the whole state, because we were the only facility in California to obtain the Silver Award. We’ll make up T-shirts for staff and highlight it on our Web site. We’ll have a big celebration in October.
“This is huge for us.”
Many award recipients said that residents and families were as proud as staff. As Looker says, “They take ownership. We won this for quality, and that means a lot to them.” Residents are proud to live in a home where their needs, concerns, health, and safety are paramount, and families feel good that their loved one is recieving the best possible care.
Most Silver and Bronze recipients are planning to pursue the next level. They are driven by pride and satisfaction. As Burns says, “The application validated the quality improvement process we have. It makes you look at the big picture, and we were able to document our successes. We discovered that we gave better customer service, which in turn made transitions of care easier. The opportunity to see how far we’ve come is priceless.”