What makes small-town nursing homes tick?

In this episode, Matt Holsen with Sanford Health News talks with Cassie Greene, senior director, Good Samaritan, and Joe Bartolo, administrator, Good Samaritan Society - Algona, Iowa.

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Transcript

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Matt Holsen:

What is the most important factor for keeping small town nursing homes open and accessible?

Cassie Greene:

The community. Having the community involvement and the community buy-in.

Alan Helgeson (announcer):

“Reimagining Rural Health” a podcast series brought to you by Sanford Health. In this series, we explore the challenges facing health care systems across the country from improving access to equitable care, building a sustainable workforce, and discovering innovative ways to deliver high-quality, low-cost services in rural and underserved populations.

Each episode examines how Sanford Health and other health systems are advancing care for the unique communities they serve.

In this episode, Matt Holsen with Sanford Health News talks with Cassie Greene, senior director, Good Samaritan, and Joe Bartolo, administrator, Good Samaritan Society - Algona, Iowa.

Matt Holsen (host):

One of my favorite things to do is to go visit and cover stories in nursing homes in small communities. And so if you could just introduce yourself for us, tell us where you're from and your connections to long-term care and small communities. Joe, we'll start with you.

Joe Bartolo (guest):

So, my name is Joe Bartolo. I'm the administrator in Algona, Iowa, at the Good Sam location there. I've been there for going on 24 years in about every role in the nursing field and now as the administrator. So, I've got a pretty good history there.

Matt Holsen:

And tell us about Algona.

Joe Bartolo:

So, Algona is a smaller town, about 6,000 people. We've got two nursing homes, we've got two assisted livings, obviously one of the nursing homes, the assisted livings, and a senior living on our campus. So, we're fairly large compared to our competitors.

Matt Holsen:

And Cassie, you're a former administrator in Auburn, Nebraska, is that right?

Cassie Greene (guest):

Yeah, so I am just transitioning out of the administrator role from Auburn, Nebraska. I've been there for a total of 15 years. I started there as a social worker. We have a nursing home, and assisted living, and home health in Auburn, and we are the only senior care provider.

Matt Holsen:

How big is a town like Auburn?

Cassie Greene:

Auburn is 3,500 people, so not quite small enough to just be one, but we are holding our own.

Matt Holsen:

What do you think is unique about small-town nursing homes?

Cassie Greene:

We are so blessed to be a small-town nursing home. We have the support from our community, from our churches, from the surrounding communities, from our schools. Everybody is one, and everybody is holding each other up to make sure that we succeed.

Matt Holsen:

Joe, what would you add to that?

Joe Bartolo:

I'd probably say the same. You know, we really rely on the community. I think the investment of our staff that are from the small communities is probably a little bit better than when you see your larger communities, your urban areas. I don't know if they're as committed as they are with us because of that connection.

Matt Holsen:

Yeah, you guys are pillars of the community, I would assume. Joe, why do you think it's important to connect nursing home residents with members of the community?

Joe Bartolo:

Well, you know, the residents at the nursing home were, for the most part, pretty big members of the community at one point. And so, you know, to allow them to continue to have that connection, whether we take them out or bring people in, I think is vital for their well-being, for their spiritual, their mental and their physical well-being. So, you know, a lot of the service groups that they were a part of are still thriving, and to help out a little bit, maybe in a different capacity, I think is really important.

Matt Holsen:

I want to ask you both about what roles volunteers play. Joe, I've been to your location; we covered your basketball team coming in and that intergenerational, you know, activity. Talk a little bit about what role volunteers play.

Joe Bartolo:

Yeah, volunteers are important to us. You know, obviously in this day and age, staffing crunch sometimes is difficult. So, if you get volunteers to come help, like in our case when we had that volunteer of the year, do coffee for a couple hours; it, you know, takes a load off of the staff to have some of those residents packed into the dining room while he's right serving them. Or if it's someone just coming in to help wheel people to and from, getting church services set up, it's really important. It takes a load off of the staff for sure.

Matt Holsen:

Cassie, how valuable do you find volunteers, or how do they play a role in your long-term?

Cassie Greene:

Yeah, I would echo what Joe just said. Volunteers are critical in our building. We have students from the Auburn High School that come in and do crafts with our residents, or even accompany us to a lunch bunch at a local restaurant, or go bowling with them. So, it really is just keeping that connection to the community there and allowing them to have a both life in and out of the center.

Matt Holsen:

When you think about events and activities, what are the top ones that your residents enjoy the most?

Cassie Greene:

Yeah, my residents really enjoy when those FFA (Future Farmers of America) students come in, or those FBLA (Future Business Leaders of America) students come in, or even the art students. When they are getting to touch hands with them, and to get to tell their stories, and get to just love on somebody.

You know, just this week we had the local art club come in, and they built birdhouses with our students. So, really, it's just having that connection and being able to see life throughout and, you know, getting to share their story with a child who might not know them or talk to them without coming in and being connected by us.

Matt Holsen:

When our team, Sanford Health News, comes into a lot of locations in small communities, the farm time always comes up, right? Joe, what would you add to this?

Joe Bartolo:

Yeah, I would say when schools come in, I think they really enjoy the choir groups, when the speech groups come and do their practices before they go to their competition. Sports groups, prom, homecoming, you know, they see them in their dresses.

They were obviously a student at one point, and they were in the choir, they were in the speech, they were on the basketball team, the softball team, football team, whatever it may be. So, you know, it just maybe takes them back to a place in time and puts a smile on their face.

Matt Holsen:

Yeah. And we're talking about, you know, the community being engaged. What can that do for a resident’s well-being?

Cassie Greene:

Oh, it's huge. I would say that our success comes from our community being engaged. Our community supports us in everything we do. We have pastors, we have ministers. I mean, it doesn't stop. We have everybody in the building, the mayor is in the building, he comes in and visits, you know, somebody who was a longtime mayor before him. We have a lunch bunch that is within our building for those individuals who cannot go outside of the building. And our communities, they show up; we put our ask out, and they are there.

You know, one of the, I think, unique things about Auburn and a small community is the amount of visitors that we have within our building. There is not a day that goes by that I do not see up to 20 visitors in that building. And it's not necessarily just family members; it is people from the community coming to see how we are doing and what they can do to help us.

Matt Holsen:

And this is not something that bothers staff, right? This is something that is a huge help to staff, or how would you phrase that, Joe?

Joe Bartolo:

Yeah, it's — I think it's welcomed. Like I said, especially sometimes if you have a family or a service group come in for a resident who's maybe struggling and you're spending some extra TLC time with that resident, and you've got some visitors or people from the community that come and talk to them, obviously it helps relieve the staff a little bit. But it does change that mental well-being, maybe picks them up a little bit, and their day’s certainly better. So, I think there's a lot of perks to it.

Matt Holsen:

Do you recall a specific experience from a community or volunteer event that made a lasting impact on you?

Joe Bartolo:

I think for me, on a personal level, with the basketball team when they come in, you know, I've got my three families: I've got my family, I've got my work family, and the basketball family, which is —

Matt Holsen:

Yeah, explain that a little bit real fast.

Joe Bartolo:

Yeah, so life is busy with the five kids, with my wife and I, and then obviously, you go to work, and there's a lot of stuff that we do on a day-to-day basis at work. And then, you know, after school a lot during the basketball season, I'm coaching them, and so my time is fairly occupied with that. So, when I can have those group of girls come in and do the activities and things, that's pretty significant to me anyways. That, like I said, two huge parts of my life connected together.

Matt Holsen:

And your residents become real big fans of your basketball team, too.

Joe Bartolo:

They do, yeah.

Matt Holsen:

I saw that in person.

Joe Bartolo:

Certainly follow everything that we do — and we've got a couple girls that work for us, so it makes it even more special.

Matt Holsen:

Yeah. Helps in recruiting as well.

Joe Bartolo:

Yep.

Matt Holsen:

Is there an experience that made a lasting impact for you?

Cassie Greene:

Yeah, I would say just when we bring in the students, you know, my children go to Auburn public schools, and so when I see my kids come in the building and it's not necessarily because I'm forcing them to come or I'm asking them to come with me and they're just walking in and they're happy and they're meeting up with somebody that I'm not asking them to do, that just really warms my heart and lets me know that there is hope for our future.

Matt Holsen:

Cassie, your former center in Auburn was recently featured in a docuseries highlighting the heroes of long-term care. What did the series focus on in Auburn, and why did you think it was important to be part of it?

Cassie Greene:

Yeah, so Nebraska Health Care Association and Peter Murphy Lewis came up with this initiative to go and document seven nursing homes, and we happened to be one of the lucky ones in Nebraska. They chose a different theme in each nursing home, and ours was culture of the community.

And I felt that it was important because our community really is unique. We have everybody in that building, and I felt like it was our way to shine and to show like there are ways, like that Joe's center does as well, is to bring those kiddos in and let that intergenerational mix, let those old hands touch those young hands, and just watch the magic happen and let them see their lives and their memories shine through. And so I thought it was really important for my staff and my residents just to be part of something so special, and it was one of the best experiences we have ever had.

Matt Holsen:

It was really interesting to watch, and thanks for being a part of that. Joe, you're not only a leader at Good Samaritan in Algona, and we've discussed this already, but you also have an active leadership role in the community. Tell us about that, and why that's important you think? You mentioned you've recruited a few folks from your basketball team. I assume you do more in the community than the basketball team too.

Joe Bartolo:

Yeah. Yeah.

Matt Holsen:

But why is that important?

Joe Bartolo:

I think it's really important. Cassie said it, that intergenerational mix, you know, I think everybody that's probably been in the field as long as we have had some sort of connection early to the nursing home. Likewise for me as a child with my grandma, as the activity director at the local nursing home going down there, you kind of feel you have a love for what long-term care is.

And so if we can get those kids in there and get them involved, I think it certainly helps with the recruitment. It helps them understand that, you know, the generations that came before them and the impact they made, whether it's on the community or schools, whatever it was, I think it's vital.

Matt Holsen:

Especially in a small community and rural areas, nursing homes are often what the only health care provider in the community. How does this affect the way your community members see you?

Cassie Greene:

Yeah, you know, in Auburn, like I said, we are the only senior care provider. So, we, again, have the assisted living, the skilled nursing, and the home health. But we actually are on top of a hill. So, the nursing home is on top of the only hill in Auburn, and we call it the Health Care Hub. So, across the street is the hospital, down the hill is the dentist, the pharmacy, and the health clinic. So, you can come to the nursing home, and it's like a one-stop shop. Everybody comes in and out, and it’s really easy access to get the care that you need.

Joe Bartolo:

Yeah, I would say for us, we've got a lot of really great nursing homes in our area, but we are the only one that has the full continuum of care, I would say, with the senior living, assisted living, skilled nursing, all on the same campus, and then we do the outpatient as well. So, I think that sets us apart. I think that's an advantage for people to look at where if they come into senior living, you know, they probably know, eventually down the road, they're probably going to have to go to assisted and then to us.

And in a lot of cases, you know, people come to us and they're not quite ready to go home. At the nursing home, we can transition them down to one of those lower level of care, and I think that's a big deal, to give them more of their independence back, or we can send them home, and they can come back and do outpatient while they live at home.

Matt Holsen:

What is the most important factor for keeping small-town nursing homes open and accessible?

Cassie Greene:

The community. Having the community involvement and the community buy-in. I am so blessed to be able to say that our facility is agency-free and that … come(s) from the excellent buy-in from my community. Everybody that works at the Auburn facilities, they're local. So, our local community really has invested in us and has continued to keep us agency-free through this staffing crisis that everybody is experiencing. And it truly would not be possible without our community support.

Joe Bartolo:

I would say the same thing. We recently, in the last six months, have gone agency-free, and I think it's a lot of our local workers coming back to the workforce and making them feel at home. The community's invested in us; we're also invested in them. Chamber ambassadors, what we do with the schools. And I always challenge our leadership staff to get involved in a local service group so we can show that we're out there and we want to be a part of it.

Matt Holsen:

What advice do you have for someone who might be intimidated about going into a nursing home?

Cassie Greene:

I would tell them to take the chance. Go meet with the social worker, go meet with the administrator, the director of nursing, job shadow. It doesn't hurt to go in and just take a walk through a building, see how the culture is within that building, and really just take the chance. Some of the best stories and memories that I have are from being in a nursing home and getting to see those residents and their families on a daily basis. And, you know, they have great stories, and it really is a humbling experience.

Matt Holsen:

What is the best thing community members can do to support their local long-term care centers?

Joe Bartolo:

I think come into the centers, walk around, see what's going on, listen to what's going on, you know, attend some of our events that we put on.

I think maybe from a government standpoint, as far as the reimbursement goes, getting educated on where our downfalls are. When we have our local town halls or when we have those senators come into town, to attend those and listen because at some point, somebody in your family's going to be affected by it, and I think you can help by being a branch or another voice for us.

Cassie Greene:

Yeah, definitely advocation, you know, advocate for us. When you hear the news, sometimes it's a one-side story and it doesn't always fit all nursing homes. So, before you take the buy-in of what is being told, come and talk to us and take a walk around the building and figure it out for yourself.

When those senators and legislation is making bills for us, they have the best intentions. But sometimes, until you’re boots on the ground, you don't know what is actually going on within a building.

Matt Holsen:

I want to thank you both for your time and for all you do in our rural Good Samaritan communities. Thanks for being with us.

Joe Bartolo:

Yep, thank you very much.

Cassie Greene:

Thank you.

Alan Helgeson:

You’ve been listening to “Reimagining Rural Health,” a podcast series brought to you by Sanford Health. Hear more episodes in this series or other Sanford Health series wherever you get your podcasts and at news.sanfordhealth.org.