Editor’s note: Senior housing, including assisted living, has become a staple for elderly care. This story, the fourth segment in ECM Publishers’ five-part series on elderly care and nursing homes, will look at Guardian Angels of Elk River, which has a long waiting list for long-term care. Guardian Angels also provides senior housing and a continuum of other health care services.
Nursing home care has evolved significantly in the last three decades. Just ask Dan Dixon, administrator of Guardian Angels of Elk River.
Dixon vividly remembers walking with his mother at the Knute Nelson senior health care facility in Alexandria.
“As a young adult, I was trying to help and this is how I got my start in senior health care,” Dixon said.
Nursing home care has become a multifaceted long-term care product, meaning that it includes skilled nursing care, assisted living and senior housing, he said.
Guardian Angels has been part of the Elk River community since it first became a skilled nursing care center in 1965 and serves approximately 2,500 area seniors each year.
Guardian Angels has 120 beds for skilled nursing. It logged 502 admissions last year, the average stay being 22 days. Dixon said the goal is to reduce that stay to 18-20 days.
As one of the larger employers in Sherburne County and Elk River with 420 employees, Guardian Angels provides a continuum of care, including transitional care, post-acute care, disease management and adult day care.
Guardian Angels reaches out in the community to also provide certified home care for 1,000 clients.
The challenge in recent years has been how to care for the graying in Minnesota, Dixon said. He said the elderly care approach has to be strategized around a network and system of care.
The pressure for senior living has been great in Minnesota, Dixon said.
Guardian Angels, a faith-based, not-for-profit senior care provider, offers long-term and short-term care, in addition to memory care, and Medicare home care from its care center facility in Elk River. It also offers assisted living; community services, including adult day care; senior dining; and senior housing.
Senior housing is available from Guardian Angels in Elk River, Zimmerman and Becker. In 2014, housing will be available in Coon Rapids with an $18 million facility and in Albertville with a $9 million development. The senior housing area has exploded with both assisted living and senior apartments.
Guardian Angels has 238 units. The senior housing menu includes: Guardian Angels by the Lake, 90 assisted living; Lake Orono twin homes, 20; Pullman Place Cooperative, 65; six HUD buildings including Riverview (24), Becker (21), Zimmerman (41), Guardian Oaks of Elk River (63); Angel Ridge of Elk River (53) and Evans Park of Elk River (36).
Autumn Glen Senior Living is coming to Coon Rapids with apartment units designed to accommodate seniors living independently, as well as those needing assisted living services of memory care.
The Autumn Glen building will feature spacious one- and two-bedroom apartments; underground parking; a library; a chapel; a guest suite; fitness room; country store; game room; beauty and barber shop; scheduled transportation; close proximity to doctors offices and Mercy Hospital; and health care staff availability 24 hours a day.
The other senior housing property is called Engel Haus of Albertville. The senior community plans to open in 2014.
Increased demands on the system
Guardian Angels currently has a seven-year waiting list for skilled nursing care needs.
The baby boomer explosion has had a major effect on the senior care delivery, Dixon said.
By 2020, there will be more elders turning 65 or older than the number of children in our school system, he said.
With the state and federal government underfunding elderly care, Dixon said, a reliance on increased technology has to be made to assure the senior population an opportunity to gray and age in place. He also believes there will be more demand for regional care, a direction Guardian Angels has pursued.
“We can’t build a new wing onto the skilled care facility because of the lack of funding and because of the costs,” Dixon said.
Because of underfunding, Guardian Angels’ skilled nursing Medicaid days is short funding by about $28 per resident per day. Medicaid days refers to the number of days that those who qualify for Medicaid, usually elderly, receive services from Guardian Angels. The shortage in revenue comes as a result of Medicaid not keeping pace with the cost of skilled nursing services. Medicaid will pay a portion of nursing home costs for beneficiaries who require skilled nursing or rehabilitation services.
Guardian Angels last year served 27,000 Medicaid days in its skilled nursing facility. The shortage of funding through Medicaid amounts to about $756,000, Dixon said.
“We must find other sources to cover the lack of funding, and much of it comes through Medicaid days,” Dixon said.
Admission days have grown from 100 per year to 502 per year currently and next year the total will be in the 600-700 range, he said.
Staffing has been adjusted because of the four-year funding freeze. With Medicaid days, rural Minnesota is tight and hurting, Dixon said.
The moratorium on private pay has to be lifted and the Minnesota Legislature has to step up, according to Dixon.
Dixon, a veteran of 33 years in the senior health care industry, said he does not have funding to continue with various senior housing projects. Because of what he calls “mischief in Washington,” it is not known whether funding from the U.S. Department of Housing and Urban Development will continue to be available through the 202 program and other programs.
“We’re Minnesotans and will not put our seniors out on the street. We will care for them and try to reassure them, in the uncertainty we have, that we will care for them and allow them to enjoy life in Minnesota,” Dixon said.
Changing with the times
Guardian Angels was originally founded and sponsored by Holy Trinity Episcopal Church of Elk River in 1962. Three years later in 1965, it opened its door to those needing senior health care. Dixon said the Rev. Richard Grein “raised his hand at a community meeting” and committed to helping start a nursing home. It was an ecumenical movement.
The growth of Guardian Angels is represented by its 14 different mailing addresses. Corporate headquarters were moved last December to a building formerly housing a pizza store and an auto supply business in Elk River.
Care changes have been many in the past decade, Dixon said, with accountable care mandates and with hospitals reducing the length of stay of patients and moving them to transitional care, which Guardian Angels offers.
Guardian Angels offers chronic disease management led by a professional nursing staff. Rehabilitation personnel work with patients who need help with their knees, hips, heart, chronic obstructive pulmonary disease, lung issues and diabetes.
Dixon said seniors choose Guardian Angels because of the “marvelous quality of staffing and care” provided in this service area in the region. He said this type of care is sought by seniors and their families. He said repeat business often comes from the patient or extended family that needs extended care.
For every patient who comes into transitional care, four to five other patients are trying to gain access to that bed.
With the seven-year waiting list for long-term care, Guardian Angels will not be able to grow fast enough to change its crowded conditions, Dixon said. He said it is very important for seniors everywhere to select the type of health care system with which they wish to age.
The job of care
He said Guardian Angels has been blessed with longevity and the quality of employees.
“Our main goal is to be the employer of choice in this service area,” he said.
More employees will be needed, however, and with the new housing additions in Coon Rapids and Albertville 160 more employees will be required to meet the needs of 160 residents. A large corps of volunteers also helps with care and activity programming and brings the community into the doorways of Guardian Angels.
Workers at Guardian Angels take special training to be certified for nursing and assisted living jobs. Dixon said Guardian Angels tries to hire employees after they have gained experience in the field. He said Guardian Angels works closely with Anoka Technical College in recruiting employees.
“We just are not able to build brick and mortar fast enough to serve the population and also to recognize that a good share of society is going to want to age in their homes,” Dixon said. The trend line in Sherburne County is for a 41 percent growth rate, he said.
Dixon said the state has to focus its attention on the need for regional, skilled senior care facilities, and not every community in Minnesota will have a full array of assisted living, adult day care and home- and community-based services.
Technology advances hold the key to meeting the growth in elderly care, Dixon said. He gives these examples:
• Automatic medicine dispensing.
• Motion sensor technology.
• Triage care by television – A nurse will work with a patient at home with use of a transmitter in the kitchen. The nurse, via television, will check in with the resident in the morning and then go through procedures including blood pressure readings and weighing of the resident.
Dixon said Guardian Angels and other senior health care providers are working with Philips Senior Living Solutions in utilizing a motion sensor that serves as an electronic neighbor to pick up patterns of a senior’s daily living habits. If the pattern changes, it can be addressed, Dixon said.
Technology can lessen treatment time of a patient and can keep a patient in more stable health, Dixon said. Technology obviously is only as good as compliance from the patient, he said.
In dispensing medicine automatically, multiple doses can be regulated by an alarm feature that has an audible voice. If the voice alarm is not heeded, a telephone alert is made. These procedures are monitored by home health nurses.
This new technology and a caring attitude by caregivers and the community can result in seniors feeling valued and recognized as a valuable part of society, Dixon said.
Next in the series: Part 5 – The Homestead, in Anoka, is a 120-bed rehabilitation and living center, with 59 apartment units. It provides a mix of independent and assisted living.
Howard Lestrud is at