Inspection reports for Cordova Community Med Ltc have shown slight improvements since 2021, but Director of Nursing Olivia Moreno said nursing home employees are still working to ensure care for their residents.
The issues cited in the December 2023 Department of Health & Human Services Centers for Medicare & Medicaid (CMS) Services report — which denoted failing categories — included medication security, food prep and safety, hygiene, and the labeling of drugs and biologicals. The report is standard and usually conducted every 12-15 months, and was a result of surveying and observing long term care staff.
Moreno said hospitals and care providers can always expect to see something they should improve upon outlined in these reports, and that they are useful because the report can shape the quality project for the year — giving areas of improvement the provider team can focus on. Moreno joined the community medical center in December 2023 — right before the most recent report came out.
The December 2023 report cited deficiencies that could cause “potential of minimal harm” to the “potential for more than minimal harm,” and included a citation for violating federal standards for protecting residents from the spread of infections.
Moreno said most of the issues were easily addressed, primarily through additional training and educating. For example, one deficiency cited was that some medications were not properly locked away. Moreno explained that it’s a matter of making sure things are properly locked and not just locked. It comes down to having the correct policy in place and following it “to a T” every time, she said.
Dr. Hannah Sanders, the CEO of Cordova Community Medical Center, told The Cordova Times that the long-term care unit currently holds a five star CMS rating. She also emphasized that data can be skewed because of the hospital’s small size.
“Our hospital does not generate enough data for a CMS star rating,” she said via email. “Our (long term care) unit’s rating is based on the limited number of categories that we have sufficient data for and can be skewed by minor changes, a single event or patient illness.”
Cordova Community Medical Center’s (CCMC) long term care unit has 10 certified beds and eight residents. Moreno said the center has a “great” nurse-to-resident ratio, with three nurses who live in town all year and one traveling nurse, and there isn’t much turnover in staff for long term care. She said turnover in healthcare can be especially hard, especially in leadership roles as there are a lot of pieces to manage. Moreno said the center’s staff is “always going above and beyond.”
Last summer the CCMC received the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) 2023 Bronze – Commitment to Quality Award. The Bronze Award is the first of three progressive levels of recognition from the AHCA/NCAL National Quality Award Program, and the program highlights organizations that meet rigorous standards of performance when it comes to improving the lives of both staff and residents in long term care. Moreno said Daniella Rossi, the former director of nursing at CCMC, did a lot of the work to improve long term care’s score over the past few years. Right now, Moreno said the staff is working toward achieving ANCA/NCAL’s Silver – Achievement in Quality award, and then will move on to focusing on the Gold – Excellence in Quality award. The path to the Silver award includes policy checks — like making sure the center is equitable in its hiring process and that the language is inclusive.
“We get a lot of good feedback from families and residents,” Moreno said.
Moreno said some of the deficiencies cited in last year’s report came as a result of the challenge of operating a hospital in rural Alaska. The guidelines the long-term care unit must follow are set at the federal level, and also apply to nursing homes that are much larger than the care unit in Cordova.
In the December 2023 report, food quality and food freshness were cited as deficiencies — some examples included kale with yellowing leaves and cantaloupes with brown spots — but Moreno said food preparation and storage can be difficult in rural Alaska, which doesn’t have access to the freshest produce.
While the center is fully staffed “for the most part,” CCMC can “feel the pinch” if someone gets sick or something else comes up unexpectedly. Moreno said the center doesn’t have a deep pool of nurses to rely on, but can fill gaps ahead of time with traveling nurses. It’s also a challenge if a new or traveling nurse comes to “rural, rainy Alaska” and decides living and working here isn’t for them. Moreno said the center’s goal is to have permanent staff staffing every position.
Last year, nurses at CCMC taught a certified nursing assistant course through the Prince William Sound Community College (PWSCC), and hope to be able to provide that course again this year. Clinical hours would be available at CCMC long-term care, and some financial assistance will be available. Moreno said she hopes there are some high school students who will be interested in taking this course. Anyone interested can reach out to her at [email protected] or Alyssa Kleissler at PWSCC at [email protected].
Moreno also said CCMC is looking for volunteers to help engage with and brighten the days of residents. While the center has enough staff to take care of the residents, she said, volunteers bring in diversity, new ideas, and positive energy. Volunteering can include helping the residents socialize and reading to residents. Locals interested in volunteering can reach out to CCMC at [email protected] for more information about applying to be a volunteer.
She said that it’s important to the team at CCMC that long term residents are comfortable, have fun things to do, and are treated like it is their home, because for these residents “it is their home.”
This story was corrected on Sept. 4 to clarify the findings of the Centers for Medicare & Medicaid Services report from December 2023. It was also updated to include a statement from Hannah Sanders.
