Interview with Vernon Zeger

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ocated in Ocala, Florida, Ocala Health and Rehabilitation Center (OHRC) is a 180-bed nursing home with a 46-bed dementia wing. OHRC is owned and operated by Northport Health Services (NHS). Based out of Tuscaloosa, Alabama, NHS has nursing homes in Florida, Alabama, Arkansas, and Missouri. OHRC has 193 employees. Vernon Zeger, NHA, is the administrator and is responsible for the overall financial and day-to-day operations. Following, Vernon answers some of our questions about his facility.

Vernon Zeger (left), Administrator, and Dr. Eladio Dieguez (right), Medical Director, of Ocala Health and Rehabilitation Center in Ocala, Florida

       Does your facility have a wound care team and a skin care team?
       Vernon: We have a skin care team made up of nurses, as well as a skin subcommittee, which includes dietary staff (to address nutritional intake to promote wound healing) and a wound care nurse who monitors the healing process and takes measurements of the wounds.
       Who handles your procedure scheduling?
       Vernon: Our medical director or his ARNP is in the building weekly to see residents. Logbooks are at every wing for the physicians that visit. Sections are labeled for nursing, social services, etc., so that follow up can be done by that department to ensure paperwork is completed in a timely manner.
       How is inventory managed in your facility? Who handles the purchasing of equipment and supplies?
       Vernon: Nursing inventory is managed by a central supply clerk who is responsible for making sure the appropriate nursing supplies are ordered and checks the wings daily to make sure nursing staff have the appropriate supplies. Each department head is responsible for making sure supplies are in stock. Some departments have checklists they use weekly from which to order accordingly, while other departments keep logbooks in which an employee can make a note that it is time to reorder when a supply is running low.
       Has your facility recently expanded in size and patient volume? Will it be expanding in the near future?
       Vernon: Our facility was built in 1976 as a 120-bed skilled nursing facility, and in 1981, a 60-bed dementia wing was built. As needs changed, so did the size of the wing. The wing was reduced to 46 beds in 2000, and there are plans to reduce it to 22 beds. NHS gained ownership of OHRC as well as four other facilities in Florida in 1999. OHRC has invested time in upgrading the facility with artwork, furniture, and medical equipment to provide better quality care and make the facility more home like.
       What measures has your facility implemented in order to cut or contain costs and improve efficiency?
       Vernon: To control costs, we have spend-down binders for each department. Within the binder is the individual department's budget. Every time a department head orders a product, the amount is deducted from their spend-down sheet. In addition, we use washable briefs, which saves on buying disposable, and scanners located on each wing are utilized to keep track of supplies used by the nursing staff. Double checks are done weekly by the central supply clerk to make sure that routine supplies are being charged. Dietary staff orders prethickened liquids to maintain consistency and cut down on labor hours.
       Does your facility have an outpatient program?
       Vernon: An outpatient program is in progress and should be in place by mid-June.
       How are new employees oriented and trained at your facility?
       Vernon: Employees go through an all-day orientation process where they go over policy, procedures, and facility ideals. At that time, every department head introduces his or herself and inservices on their department. Nursing staff members are oriented on different shifts and wings so they get a feel of how each wing is different. Employees are also cross-trained.
       What are your strategies for retaining and motivating staff?
       Vernon: Food is a big way of motivating staff. We have pizza on different shifts and doughnuts in the morning. We do games, such as questionnaires. If you answer all the questions (regarding state survey issues) correctly, your name is placed in a drawing to win a gift certificate. We have a credit program as well. When staff members go above and beyond (show positive attitudes, demonstrate teamwork, or help out in other departments), they get a green paper worth one credit. Once they collect 10, they bring the papers to the business office and trade them in for a Walmart gift card. Quarterly barbecues, massages, and facility raffles are other ways we motivate our staff and show our appreciation.
       What continuing education opportunities are provided to staff members?
       Vernon: Monthly, we have a staff developer who schedules a variety of inservices, some state mandated. Staff members are able to attend inservices and receive CEUs that are needed for their licensure. We also invite local agencies, such as the Alzheimer's Association, and local doctors to lecture on subjects pertinent to our staff.
       How is staff competency evaluated?
       Vernon: Staff members are evaluated after 90 days and annually based on work performance.
       Does your facility utilize any alternative therapy?
       Vernon: The only alternative therapy our facility utilizes is massage therapy to stimulate muscles as well as relieve tension.
       What quality assurance (QA) measures are practiced at your facility?
       Vernon: We have a QA meeting monthly, and we have a safety committee as well. The team consists of line staff, the medical director and codirector, myself, the director of nurses, as well as other department managers. We also have other subcommittees that meet weekly to address weight loss, psychotropics, and restraints.
       What makes your facility unique?
       Vernon: We have a weekly VIP Luncheon where we invite residents from each wing to have a meal with the social services department and a select department head. During these luncheons, the residents get to voice issues and praise the facility.
       We also do weekly compliance rounds during which all department heads count off by 3s (because we have 3 wings), and we check rooms for cleanliness, nursing issues, any repairs needed, etc. This is great for preventative maintenance and to catch issues before they become problems. The wing that looks the best each week wins a prize.
       Additionally, we have a weekend manager program so that a manager is available to address issues and to help assure smooth operation seven days a week. A department head works four hours each day (Saturday and Sunday), and he or she gets to take a day off during the following week. It rotates, so they have to work a weekend only one time every 12 weeks in our building.

ECPN will spotlight an administrator or director of nursing from a long-term care facility, acute care facility, or home care agency in every issue. Please contact Renee Olszewski by phone at (800) 237-7285, extension 209, or by e-mail at rolszewski@hmpcommunications.com for a questionnaire.