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Barton shuffles to take new patients

by Linda Hiller

Without much warning, Barton Skilled Nursing at Virginia Creek had to shift into high gear last month.

The facility had been open for less than five months with six patients, when Valley Meadows Sub-Acute Care Center in the Gardnerville Ranchos closed Dec. 10, leaving its residents scrambling to find another place to call home.

“Things got so hectic so fast,” said Administrator Esther Vanbaren. “Initially, we’d planned to build our Medicare short-term patients first, and then go to the long-term residents. But with Valley Meadows closing, we went from six to 20 patients immediately. The nurses were understanding of the situation, and pulled a lot of overtime over the holidays. They deserve a lot of the credit for our being able to admit those Valley Meadows patients, because we didn’t have the time to add all the staff we needed on that short notice. Everyone worked hard.”

n Still growing. Today, there are 31 residents at Barton Skilled Nursing at Virginia Creek, but Vanbaren said there wouldn’t have been any if they hadn’t passed the Nov. 30 surprise survey by the Nevada Bureau of Licensure and Certification. The survey was a three-day, top-to-bottom look at the facility by department officials, a routine occurrence for new facilities as they establish their existence.

“They interviewed residents, family members, looked at our records, books, policies and procedures,” Vanbaren said. “It’s a very thorough examination. I don’t worry about the surveys, though, because if you do what you are supposed to do, then when the examiners come, there is nothing to hide.”

The formal certification was recorded Dec. 3, one week before the 14 patients from Valley Meadows needed to come on board. It is crucial to receive this certification to be able to legally bill for Medicare and Medicaid patients, she explained.

“The timing was right, because these people needed a place to go,” Vanbaren said. “Now that we’ve got that experience under our belt, we hope to be at full capacity, which would be 60 patients, by summer.”

n Patient advocate. Vanbaren, 45, is a registered nurse, and has worked in skilled nursing facilities for a decade. Her first job, in Natick, Mass., was as a nursing assistant in a nursing home. She learned things there – mostly what not to do – that she still thinks of today as she administers the 60-room care center just north of Summerville at Virginia Creek.

“I remember, we got in trouble for changing the sheets too often,” she said. “I think they said we could only change them twice a day, but if a patient needed clean sheets, I changed them. Here, we don’t have any rules like that – we want our residents as comfortable as possible.”

Barton’s facility is owned separately from Summerville, but they do cooperate, sharing the kitchen, for example.

n Staff advocate, too. Esther and her husband Richard live at Lake Tahoe and have three children ranging in age from 16 to 28. She was director of nursing at Barton Skilled Nursing and Rehabilitation Center at South Lake Tahoe and still works there 10 percent of her work week. She passed the national exam by the Board of Examiners for Long Term Care Administrator last year, and since opening the Carson Valley facility, her work emphasis has shifted to here.

Bringing in qualified staff quickly was the primary challenge Vanbaren faced after learning of the needed beds last month. The facility is equipped to offer occupational, physical and speech therapy, short-term rehabilitation and long-term care. Right now, there are approximately 50 employees, including Betsy Dorrance, the director of nursing.

“Betsy is a very remarkable, very caring person,” Vanbaren said. “She really watches out for everyone.”

Barbara Adams is the activity director, with a busy program, including field trips, already on board, Vanbaren said. Nancy Rojas is the medical records clerk. She worked at Valley Meadows (formerly Cottonwood Care Center) for several years.

Cheryl Osborne is the charge nurse for the facility. She came directly from Valley Meadows, as did approximately one dozen other staff members, Vanbaren said.

“It has been kind of nice, because many of our Valley Meadows patients miss their old home and to have people here who worked there and who are familiar faces makes it easier on them in their transition,” she said. “Many times, people who work in these types of facilities become like family to patients, especially if the patients have no family nearby.”

n Making difficult choices. Vanbaren said turning down difficult patients, or individuals she feels would be disruptive to the people already living and working there, is one of the hardest parts of her job.

“We are a living community inside these walls,” she said. “And since we become like family, we have to make sure everyone can fit in without too much difficulty. Most of the time we can find a way to make it work, but sometimes we have to suggest an alternative facility.”

Turning down patients because there aren’t enough nurses is another difficult situation for an administrator, Vanbaren said.

“After what happened in December, I made a vow that we wouldn’t take any more patients unless I knew we had enough nurses to handle them,” she said. “I don’t want to make the nurses go over hours again, and it’s not fair to the patients, either. We just want to do the best job we can.”

Vanbaren said a grand opening celebration for Barton Skilled Nursing at Virginia Creek will be held this spring. For more information, call 782-7846.