Pioneer Place drives to top rankings in quality care

Lexie Browning, RN supervisor at Pioneer Place, check on information at the Vale compound. (Malheur Enterprise/Pat Caldwell)

By Pat Caldwell
The Enterprise

The elderly woman was dying. As her last days of life slipped away at a care home in Idaho, she wanted to see her daughter – who wasn’t coming.

A young certified nursing assistant stepped in.

Nilda Kelly, now a registered nurse at Pioneer Place in Vale, visited the woman daily. The delirious woman, racked by Parkinson’s, mistook Kelly for her daughter. Kelly didn’t flinch, acting the part of the daughter, talking to the woman through her final days.

“Just sitting there, just being able to provide her that care at the end of life, it hooked me,” Kelly said. “That totally changed everything.”

Fast-forward more than a dozen years and Kelly is now the director of nursing services at Pioneer Place, one of the key members of a team that has helped the local care facility earn top nationwide honors.

Pioneer Place recently captured a five-star rating from Medicare and was recognized by HealthInsight, a federal quality improvement nonprofit committed to improving health care in Oregon and elsewhere. HealthInsight lauded Pioneer Place for successfully meeting national goals in quality of care and reducing both the length of time a patient stays and hospital re-admissions.

Pioneer Place also has been honored as a “Center of Excellence” by the St. Alphonsus Medical System. The facility was also ranked fourth – out of 135 Oregon nursing homes – in achieving quality measures.

HealthInsight ranked the facility fourth out of 135 Oregon nursing homes in achieving quality measures. Inspectors review all aspects of a facility’s nursing care services.

For example, the inspectors review the staffing of a facility, its safety procedures and equipment and the quality of care. Then each facility is rated from one star to the highest, five stars.

The inspection is detailed, said Tom Hathaway, Pioneer Place administrator.

“They look for fire code violations. They look for broken electrical outlets. They look for residents that have nutrition issues that are not being addressed. They look at nursing documentation. They look at everything,” he said.

Pioneer Place’s recent accolades represent a lot of hard work and commitment, Hathaway said.

“There are not many facilities in Oregon that have a five-star rating,” he said.

Hathaway said when he took over as administrator, Pioneer Place held a two-star rating from Medicare. He wanted to change that.

“Over the past two years my nursing management team and I have worked hard to not only improve the quality of care but the quality of food, housekeeping services, quality of environmental safety and facility maintenance,” he said.

Today Pioneer Place is noted for offering a continuum of care, providing assisted living, skilled nursing and rehabilitation services in one location. In addition to a range of therapies available, the facilities offers respite care and full nursing services. The assisted living offerings include medication management, meals, housekeeping and personal services as well as activities.

Hathaway pointed to his staff as the key to the facility’s recent success, especially the work of Kelly.

“She has been incredible in training the nurses to understand the purpose and helping change the philosophy of care to one that is person-centered,” Hathaway said.

Kelly said the recent success of the facility rests squarely with the staff.

“It was two years of hard work, of the staff working as a team and a matter of following systems,” Kelly said.

Hathaway said when he hired Kelly he made his expectations clear.

“When Nilda took over the director of nursing position, when I interviewed her, I told her that was a goal for me, to make sure that she had the training and her nurses and caregivers had the training to raise us up from the two-star rating because two stars is below average,” he said.

Hathaway said Kelly immediately tackled an array of challenges and achieved success by building on an already strong foundation.

“She enhanced what we had,” Hathaway said.

Nurse Lexi Browning, of Willowcreek, was on the staff when Hathaway and Kelly took over and said there was a certain degree of worry that comes with change.

“We had a fear of the unknown. Anytime something new happens you can’t help but be nervous,” Browning said.

Browning said, though, that within short period it was evident the new leadership was focused on success in a measured way. The new management mechanisms Hathaway and Kelly designed cut down on anxiety, Browning said.

“I don’t have the stress now. I don’t leave feeling like I didn’t get done what I needed to get done,” Browning said.

Browning said she keeps her focus on her job and how to get better as a professional, even going so far as to keep a journal near her bed at night so if she awakens and has an idea for her facility, she can write it down.   

“I think the big difference is the teamwork and structure we have now,” Browning said.

Hathaway said his recipe for success was a simple one.

“Basically, my philosophy is to hire the best people I can find to help me do what needs to be done. It is just a matter of learning how to provide the best care possible and documenting what works,” Hathaway said.