The final seven of this year’s 20 To Watch illustrate the best of long term and post-acute care.

In the third and final round of Provider’s inaugural 20 To Watch feature are two administrators, a director of health management, two chief executive officers, a dementia care program director, and an owner/administrator. For more information about each of the 20 outstanding individuals featured during the past three months, click here.
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Kay PeruskiKay Peruski

Courtney Manor
Bad Axe, Mich.
Kay Peruski feels very much at home in the long term care setting. “I treat Courtney Manor like it’s my home,” she says of the 112-bed skilled nursing center where she is administrator. “This is my hometown, with people I know; it’s very important to me.”
Home, indeed. Peruski has been at Courtney Manor for some 26 years. “Dedication and commitment are two words to accurately describe Kay,” says Dan Echler, regional director of operations for Ciena, the company that owns Courtney Manor. “Under Kay’s leadership, Courtney Manor received the Calvin H. Monfils Facility Excellence Award from the Health Care Association of Michigan in 2010 and a Bronze [National Quality] award from the American Health Care Association in 2011.”
Courtney Manor has also been recognized as one of the “Best in Bad Axe” by local business owners for the past five years in a row.
Peruski describes herself as “approachable” and customer-service oriented. “I let employees know my expectations. I want everyone to feel welcome and secure in leaving their loved one here. I’m always looking for a way to improve things and try something different.”
This approach has paid off for Peruski. When Ciena developed eight best practices for all of its homes to incorporate, six of those eight were ideas spawned at Courtney Manor.
Peruski is proud of her staff as well. “I get a lot of compliments on the staff on how friendly they are and how helpful they are. I always tell them, ‘You will not get into trouble for doing something for someone, but you will for not doing something [to help a resident or family member].’ They are very accommodating to families, especially at the end of life.”
What It Takes
Having worked with Peruski for 20 years, Echler says she turned around a facility through innovative ideas and outside-of-the-box thinking.
Leading a nursing center like Courtney Manor requires people and problem-solving skills, says Peruski. “You have to be able to deal with a family that is frustrated and sit down with them. I think that makes them feel confident that they’ve made the right choice. And you really have to be able to read people. And if you treat people right and take good care of them, all the rest comes. The staff, longevity, we’ve got a lot of staff who’ve been here for years. If you get the people part right, the rest of it will come.”
Peruski has passed on her passion about long term care to her two sons, both of whom work in nursing homes as well. “My younger son is an administrator at Ciena at Waterford, and my other son is an administrator in training.”
When asked what she would do if she couldn’t do her job, Peruski is at a loss.
“I couldn’t tell you what I would do. If I didn’t do this, I don’t know; it’s just my life now. This day-to-day contact, the things that I enjoy the most, spending time with families and residents, that part would be missing.”

Jeffrey PhilbrickJeffrey Philbrick

Colonial Poplin Nursing and Rehabilitation Facility and
Poplin Way Assisted Living
Fremont, N.H.
Long term care is a family affair for Jeffrey Philbrick. His first job was as a cook at his parents’ rest home at the age of 15. “I held one title or another part-time since then, working during school breaks,” says Philbrick. “I started working full-time after college, in 1989, as the assistant administrator of Colonial Poplin, the family-owned and -operated skilled nursing facility. I took over as the administrator after my father’s death in 1996, and as co-owner with my brother after our mother passed away in 2002.”
The family business, in fact, reaches back three generations: “My maternal grandfather opened one of the old-fashioned rest homes in the early ’70s where he and his wife lived and cared for about 10 elderly people. My parents bought that from them in 1979 and ran it for four years before they built and opened Colonial Poplin,” says Philbrick.
Philbrick recalls he was always helping out around the grounds, mowing, shoveling, or plowing, as well as filling in shifts in dietary or activities. And although he flirted with the idea of moving to New York City, he realized that his calling was back in New Hampshire.
Philbrick credits his mother with instilling in him the importance of treating residents with reverence.
“Her strongest lessons to me revolved around how important it was to treat people as individuals and with respect. That people—residents, family, and staff—not money, were the foundation of a strong, rewarding business.”
Natalie Gaudet, administrator at Poplin Way Assisted Living, lauds Philbrick for his foresight and ability to recognize the needs of the elders in the community. “In 2002, Jeff added an assisted living community, and since its inception, it has maintained an occupancy rate of over 98 percent, has met or exceeded its budgeted profit margin, and has achieved deficiency-free state surveys,” she says.
“The underlying formula for success has been Jeff’s devotion both to the residents and his staff. He has implemented both employee wellness and incentive programs, making the employees vested in the company and in the seniors they serve.”
As a leader, Philbrick respects his staff and encourages them to respect themselves and each other. “I believe firmly in leading by example and not asking others to do what I am unwilling to do myself,” he says. “I listen closely to what my staff have to say; offer advice, insight, and direction where needed; and then trust my staff to stay on task and succeed.”
Both communities have come a long way in the past decade, says Philbrick. When his mother passed away 11 years ago, Colonial Poplin had a staff of 35. “Today, Colonial Poplin and Poplin Way have a combined staff of 135. Such growth required a lot of hiring, and not all of our hires were the best. Over time, by clarifying our expectations of the staff and working hand-in-hand with management and frontline-level employees, we have forged an excellent, caring, dedicated professional staff,” he says.
“As the owner, my family name is inextricably linked with everything that goes on in my [centers],” Philbrick says. “I sleep soundly at night knowing that I can trust my staff to do what is best for the residents at all times. That affords a level of security that has value no dollar sign can define.”

Natalie ZeleznikarNatalie Zeleznikar

Chief Operating Officer 
Five Star Living
Duluth, Minn.
Having been a nursing home administrator for a number of years, Natalize Zeleznikar knew her way around long term care. But when her grandmother needed 24-hour assistance, Zeleznikar realized that there was nothing in the area to accommodate her, and her parents had promised her she would never be in a nursing home.
“I grew up on a farm where my great-grandparents, taking care of them and helping them, was very much part of our lives. From nine years old and up, I was exposed to that. My parents took care of their parents on the farm. But it wasn’t feasible for my parents to do this for my grandmother. She had become bedbound, and my only other option was to have her stay in her apartment and hire 24-hour care.”
So Zeleznikar came up with a solution: She would build a new home. And build she did. Within six months, Zeleznikar had built a 10-bed assisted living community, much like a “miniature Keystone Bluff” (the nursing home where she worked at the time).
"We took the best of Keystone but created a small home,” she says. “Grandma had all of her belongings with her, and we recreated her room the same way it was in her apartment. We integrated the best of smaller setting nursing homes so that it feels like home.”
Zeleznikar borrowed from the Green House and Household models to create the home for her grandmother and nine other residents. She also picked sites that enable residents to see outdoors. The homes (there are now 10) are small in size with a great room and fireplace in the center. “We let seniors bring their pets with them. That’s been really important to families and residents,” says Zeleznikar. “We also have a high staffing ratio in each home.”
“My goal is to give people a great ending. They’ve had their life, so I want give them a calm atmosphere that’s not overstimulating. Many homes are designed for memory care and dementia. But half have dementia and half have other needs and are eligible for nursing homes. I designed a building to handle them on their worst days, not just their best days. And having fewer people under one roof creates a more intimate setting.”
The building was filled in one day, according to Zeleznikar.
Zeleznikar’s dedication to creating a caring atmosphere for residents has won praise from staff. “She may be an owner of the company but you would never know it when she shows up on site at one of our facilities,” says co-worker Brenda Marshall. “She can be found doing residents’ hair, playing the piano, or holding a dying person’s hand so they don’t have to be alone in the last chapter of their life. She sets an amazing example for others to follow.”
Marshall notes that when she thinks of all the Five Star employees who do a great job, “the most dedicated, and the person who continually goes above and beyond, is Natalie.”
One example of this is an activity program Zeleznikar developed recently. “She wanted to honor our seniors and developed a traveling suitcase program with themes such as weddings, patriotism, and back to school. She filled those suitcases with items from the past to match the themes. The 25 suitcases are moved from facility to facility within the company.
Marshall also gives kudos to Zeleznikar for making the corporate office a “support service” office to let all staff know they are available to them at any time.
“Natalie has answered her phone at many hockey games, meeting breaks, family gatherings, and at all hours of the day,” Marshall says.

Elizabeth DavisElizabeth Davis

Bright Side Manor Assisted Living
Teaneck, N.J.
Affordable assisted living is Elizabeth Davis’ mantra. After working as a social worker in New York City in supportive housing for elders, Davis saw many seniors who didn’t need a nursing home but couldn’t afford to live independently.
“We would have nowhere to send them,” Davis says. “We also made home visits, and some boarding homes were substandard. The physician I worked with at the time and I decided to buy a property that already met all of the life safety codes in place, and we found Bright Side Manor.”
At the time, it was a “rundown” 50-bed residential health care facility that needed a lot of work, says Davis. “It was a nice community, and we felt it had great potential. The owners were very committed to selling to people who would not force the existing residents to leave—so we took over a management contract with the commitment to buy it when we had the funds.”
In 1990, Davis and her colleague took over the operations of Bright Side and applied for nonprofit status with the Internal Revenue Service.
“We had very little capital and knew we would have to work hard and fast at cultivating community support,” Davis says. “We got grants and volunteers to help paint and decorate. We also began raising the bar in terms of staffing.”
Eventually, the state assisted living regulations were in place, and Bright Side was approved as an assisted living community, which meant that they could get reimbursed under Medicaid. However, raising money and getting approval for a major construction project was long and hard, Davis notes. In the end, they completed a $5 million construction project, all while the residents stayed there.
“We now have a very committed board of directors. It’s been a labor of love. Half of the residents are here under Medicaid, and anyone can come in under Medicaid. Our private rate is consistent with Medicaid. It’s challenging, but somehow or other we do it.”
Davis recognizes her “incredibly dedicated staff” for maintaining the mission and keeping things together. “We know each other, and we all have lot of fun together. We get support from churches, synagogues; it’s a very rich environment. Anyone can come here—money is never a factor,” she says.
“In addition to her daily work of running a state-licensed health care facility, Davis continually seeks new and creative ways to ensure that seniors have options,” says co-worker Erika Kao. “She has developed a program that allows her to use a government grant to ‘subsidize’ residents whose incomes are too high to qualify for Medicaid but too low to pay Bright Side’s lowest rate, which is sometimes half of what one might pay in a traditional assisted living facility. She meets with elected officials to push for the Medically Needy Program to pay for not just nursing home and home care, but also assisted living, because there are many older adults who can’t stay at home but who don’t need to be in a nursing home.”
If that weren’t impressive enough, Bright Side has become a placement field site for Columbia University School of Social Work. “During a time when the number of social workers committed to the aging population appears to be shrinking—despite that the population is growing—Davis has devoted her entire career to this underserved population,” says Kao. “I never dreamed this career would take me down the path it has taken me. I think that social workers—as we face ongoing economic challenges—will find ways to create the programs to address the needs and solve the problem,” Davis says.

Vivan BookerVivian Booker

Director of Health Management 
Mt. St. Francis Nursing Center
As 10 wildfires raged across Colorado last summer, nursing homes and assisted living facilities were forced to escape the flames via evacuation. Leading residents and staff through the crisis at Mt. St. Francis Nursing Center was Vivian Booker, director of health management.
“She made sure her staff had everyone prepared for evacuation as the residents were dispersed to 10 facilities,” says colleague David Skipper, Colorado Health Care Association. “She followed every resident to each facility, spending nights without sleep while making sure that they were being integrated into the receiving facilities as best as possible. She wanted to be certain that all were safe.
“She followed up with families to reassure them their loved ones were well cared for and not in harm’s way.”
But Booker is more modest about her role. “The real story should be about the long term care community instead of someone who just happens to have a higher title. This is really an inspiring story of communities that exist everywhere in this country. People who care about who they serve and what they do, people who don’t always get the recognition they deserve.”
Instead of talking about herself, Booker insists that the focus should be on the administrator and employees who had “so much courage, determination, and heart when evacuating out residents under a very stressful situation.”
“Many received the mandatory alert to evacuate their homes at the same time we learned of the immediate evacuation,” says Booker.
“Those employees didn’t leave, and employee titles disappeared that night—business office, housekeeping, culinary, and others didn’t leave.” Instead, says Booker, they pushed wheelchairs, held hands, and maintained a sense of calm and support by just being there.
Booker, who also serves as chair of the Colorado Health Care Association Quality Initiatives and Leadership Committee, “is the unassuming individual that provided quality leadership and determination at a moment’s notice and provided guidance and continuity throughout the crisis,” says Skipper.
“Employees in receiving centers prepared beds and food to shelter our residents and welcomed us into their homes. Many of their employees also had mandatory evacuation notices, and in the days following, our residents and employees would be spread in a 100-mile radius not knowing if they still had a home, whether they would still have a job or be paid for any of their work,” says Booker.
“Some employees traveled 60 miles round trip to assure their residents would have a known caregiver. They gave each other hope and strength to persevere, care for their residents, and show a familiar face. They built new friendships, adapted to new environments, and became part of a family in the other locations. All our employees in all departments went to these centers each and every day to not interrupt routines and to help the other centers’ employees meet our needs and those of their own residents.”
“Booker had enough foresight to call upon the resources of the entire long term care community and coordinated the disbursement of the residents with their needs in mind,” Skipper says. “Once the residents could return to their facility, she was faced with the daunting task of making the facility safe and ready for their return.”
In her debriefing with residents, one resident said it all, Booker recalls: “She said, ‘We woke up in a different place but you were all still there! You were always with us.’ This is the long term care community in Colorado who really deserves this recognition.

Heather LemoineHeather Lemoine, RN

RN Program Director
Bridges Memory Care
EPOCH Assisted Living at Melbourne
Pittsfield, Mass.
After 10 years as the registered nurse (RN) program director for a dementia care program, Heather Lemoine is still excited about her job. “I like it very much,” she says. “I enjoy helping people. I think in some ways I was destined to go into this field of practice in nursing because my own mother was diagnosed with the disease, and I’m a family caregiver now as well.”
Lemoine’s co-workers are more than happy to have her with them. “Heather’s compassion for EPOCH residents is endless. Despite her role as a busy RN, she will always take the time to help or explain something to residents when the need arises,” says Elane McNabb, director of community relations.
“Sometimes when she is answering questions for a tour, residents come up to her and say they need something. Rather than shrugging them off and saying she’ll help them later, Heather puts an arm around their shoulders and helps them find someone who can help,” McNabb says.
“Heather has helped grow our Bridges program into a top-notch program that provides the best, most compassionate care available for those with memory-related illnesses. In Berkshire County, Bridges at Melbourne is well-known and respected. Often when I tell people I work at Melbourne, they say that it’s such a great place and that their relative was in the Bridges program and received amazing care.
Then they’ll ask if Heather still works there, because Heather was a big part of providing their loved one with a warm, welcoming home and the care they needed and deserved.”
EPOCH Assisted Living at Melbourne is a community that prides itself on promoting each resident’s independence with “personal care packages” that are tailored to meet the individual needs of the residents. McNabb credits Lemoine with maintaining the community’s excellent reputation.
“For many adult children, placing a parent with dementia or memory impairment into a senior living community is scary,” says McNabb. “Some, at least initially, even view memory care programs like Bridges as horrible, dark, dreary places. When they walk into Melbourne, they feel they’re giving their parents the death sentence. But when they meet Heather, the fear subsides. She takes the time to sit down with families, explain the program, and answer all of their questions. After talking to Heather, people realize that there is hope for their parents to maintain a quality of life and dignity through an obscure journey. They come to trust that Bridges is a quality program with caring, compassionate staff members who will provide their parents with a safe, comfortable home.”
Lemoine believes that being helpful and fair, and her efforts to help staff “as much as I can,” are the reasons for her nomination to 20 To Watch. But those would be understatements, according to McNabb. “Her love and devotion to our residents is unmistakable and is a positive influence on all those who work and live here. Watching her interact so patiently and warmly with the residents is very reassuring to everyone, including me. I’d want my own mom to live here.
“Heather demonstrates tireless compassion and an innate ability to radiate hope and love to families and their loved ones who are dealing with this difficult life transition. In addition, her staff clearly appreciate her responsiveness, clear direction, and leadership qualities, which shows in their work.

Tim DressmanTim Dressman

Chief Executive Officer (CEO)
St. Leonard Senior Living
Centerville, Ohio
Like many who work in the profession, Tim Dressman’s devotion to it is rooted in his upbringing. “My dad told my brothers and me we were getting jobs in the nursing home, so we all worked in the same nursing home when we were young,” says Dressman. “Today, all my other brothers are in community service in one way or another.”
Dressman, whose first job in that nursing home was as an elevator operator at 13 years of age, has held onto that lesson through every job he’s had. As a Navy man, he earned his degree in health care administration and then worked in a hospital as an auditor. After auditing a nursing home, he wondered if he could run it better than the administrator could.
“So I got a nursing home license and was placed at a nursing home where I stayed for 11 years,” says Dressman. “It’s one of those jobs where you walk in and you know you were meant to be there.” Nursing home administration is not a job that you go to from eight to four and then leave, he says. “It’s truly a vocation. You have to love what you do.”
“Tim has a quest for knowledge and a strong desire to improve processes and performance with knowledge, mentoring, and innovation,” says Debra Stewart, director of wellness at St. Leonard. “Tim’s spirit of innovation is what captures the attention of his employees, because they know that he will lead from a pivotal point and allow others to succeed on their own merit.” In the 12 years that Dressman has served as CEO of St. Leonard, he has implemented a number of innovative programs, including a behavior-based ergonomic dementia care program and a wellness initiative.
Dressman also has taken advantage of local universities to garner interns and other fruitful partnerships. In addition, he teaches other individuals interested in becoming long term care administrators at a local college, Stewart notes.
“The awards that Tim has won are too numerous to count, but the awards that he has written to nominate his employees are even more,” she says.
Dressman enjoys his job immensely, but what he enjoys most is seeing employees and co-workers succeed. “I like to see all of our employees succeed and try to give them the credit they deserve,” he says. “I have a lot of great employees who give me a lot of great ideas. They all have great ideas, and if you listen they can open doors for you to new ways of doing things.”
Among Dressman’s standout leadership qualities are humility, the ability to listen, a humble approach “that you don’t stand above the rest of your people and that we are all equal partners in providing care to our residents and others.”
Dressman also prides himself in being open-minded. “I thank my dad for giving me the gift of being able to talk to all kinds of people of all socioeconomic levels,” he says. “He made us appreciate everyone as people.”
Dressman also is grateful for his work with the American College of Health Care Administrators, the professional organization for long term care administrators.
As Stewart puts it: “Tim is a confident leader, who also projects a positive ‘can do’ spirit toward the various teams at St. Leonard. He has a quest for knowledge and a strong desire to improve processes and performance with knowledge, mentoring, and innovation.”