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Friends Care Community emerges from pandemic

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Correction: The article about Friends Care Community in the May 26 edition of the paper incorrectly said that the facility has had no cases of COVID-19 among its residents. While FCC had no cases among residents through the first 20 months of the pandemic, several patients tested positive with mild cases during the Omicron variant outbreak this past December and January, according to Executive Director Mike Montgomery. Also the facility’s board has 11 members, rather than 10 as stated in the article.

Yellow Springs Friends Care Community entered the calendar year of 2020 with significant plans for the facility’s campus on East Herman Street.

Leaders were looking toward expansions in both the assisted and independent living areas, with architectural renderings in hand for the assisted living structure and work crews clearing an undeveloped adjacent lot for the construction of 10 new independent living cottages.

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In addition, the results of a series of focus groups showed an ongoing shift in the desires and expectations of elders toward more whole-person care, further moving the facility from the primarily medical approach of a traditional nursing home to a setting that includes emotional, spiritual and social well-being as well.

Then the pandemic hit, the facility went into lockdown, and just getting through “week to week and day to day” became the staff’s focus, Executive Director Mike Montgomery said in a recent interview.

The pandemic isn’t over yet — Montgomery still submits daily reports to the Centers for Disease Control and Prevention — but the rhythms of life at Friends Care Community, or FCC, are beginning to return to pre-pandemic routines.

And with that return comes questions about what’s next for FCC. Do leaders pick up expansion plans where they left off more than two years ago? Did new factors arise during the pandemic — or as a result of it — that affect the facility’s future operations?

Those are questions that the 10-member board faces in the months ahead.

FCC’s operational needs are changing, Montgomery said, but the current direction isn’t fully clear, Montgomery said.

Pre-pandemic focus groups and surveys showed that aging Baby Boomers have different ideas from elders of the past about how they expect to spend the final years of their lives.

“They’re looking more for a home than an institution,” Montgomery said.

Social life is important, as is access to activities and events.

“They want transportation to plays, concerts, restaurants,” he said. “People want to be involved in the community. They want educational opportunities, volunteer opportunities.”

They want internet access and private rooms.

And as modern medicine improves their quality of life, elders are waiting longer to enter long-term care, Montgomery said.

Pandemic outcomes

Entering care was delayed even further during the pandemic, Montgomery said, citing several factors influencing that lag.

For one, more family members were at home — either working remotely or out of work due to the pandemic — and potentially available to care for elder family members there.

Also, the inability to visit loved ones amid the lockdown was another driving force in keeping or bringing them home if possible.

Montgomery said that five families removed elder relatives from FCC during the pandemic to care for them at home.

FCC’s rehab unit was also affected during the pandemic’s height, he said. As hospitals filled up with COVID-19 patients, many procedures that required rehab services afterward were put on hold, and consequently FCC had fewer referrals. At the same time, more providers offered physical therapy services in patients’ homes, eliminating the need to stay in a facility. The growth of in-home therapy, and its reduced cost, could have continuing consequences for facilities like FCC post-pandemic, but the full effect is yet to be known, Montgomery said.

In terms of long-term care, private rooms became even more important during the pandemic as FCC sought to protect patients from infection. While the elderly were among the most vulnerable to the coronavirus, Friends Care has not had a single positive case among its residents, an achievement of which they are proud.

Montgomery said that being able to keep residents physically separate was an important lesson for FCC to remember post-pandemic in terms of reducing contagion risks in other viral outbreaks that may arise.

The long-term care unit currently has 66 beds, 18 of which are in shared two-bed rooms.

Turning the remaining nine shared rooms into private accommodations is something the board will be considering, Montgomery said.

“Luckily we had enough space [to spread out],” he said.

Perhaps the biggest issue for FCC after two pandemic years is a shortage of staff.

“We have a great, great staff,” Montgomery said. “We want more of them.”

But with the pandemic, “people are nervous about working in nursing homes,” he added.

FCC currently has 82 employees on staff, 50 of whom are full time. Earlier this week, the facility had three job listings: for a part-time diet aide, a part-time licensed practical nurse and a full-time night-shift registered nurse. The rates of pay listed were $10.50 an hour for the diet aide, $24 an hour for the LPN position and $27.50 for the full-time RN. Full-time hires also receive a $1,500 signing bonus.

According to several online job listing sites, FCC falls on the higher end of nursing home employee pay. Montgomery said that the institution has tried to stay competitive while offering other perks as well, including coupons to area restaurants and tickets to such activities as Dragons baseball games.

The number of employees affects the number of patients the facility can house, Montgomery said, noting that the current ratio is one staff member to eight patients during the week and one to 10 or 11 on the weekend. The nursing ratio is one to 15, compared to the average nursing home ratio of one to 18, according to Montgomery.

As a nonprofit institution, FCC has more control in maintaining smaller patient to staff ratios, he said. “Our mission is to take care of the residents. … If we don’t have staff, we won’t fill the beds.”

The majority of hands-on care is provided by State Tested Nursing Assistants, or STNs, Montgomery said. The position requires 72 hours of training, and can offer a path to further nursing certification, but Montgomery said many see little future in the job, which pays between $10 and $18 an hour in Ohio, according to nursing care websites.

Montgomery said that the pandemic has left the FCC staff, including himself, exhausted. But they’re regrouping and anticipating new directions from the presiding board, most of whom are new to their positions since the beginning of the pandemic. After canceling their May meeting, first because of storm-related internet connectivity issues and then scheduling conflicts, they are next scheduled to meet on June 7.

“There are a lot of options, a lot of things to discuss,” Montgomery said.

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