Nursing home considering web psychiatry

McCOOK, Nebraska -- Providing psychiatric care for geriatric patients can be difficult to do in rural areas, when the nearest psychiatrist can be more than 100 miles away.

That's where the Internet and webcams can make a huge difference. Hillcrest Nursing Home administrator Colina Nappa told the Board of Trustees at the regular meeting Tuesday morning of the opportunity of using telepsychiatry at the facility, where psychiatrists can communication and assess patients through video conferencing.

Behavior issues are not always due to Alzheimer's or dementia, Nappa clarified after the meeting. "There are many different reasons for issues and behaviors in the geriatric field," she said, that can lessen the quality of life for the resident. As an example, this could include a husband in a facility who recently lost his wife of 70 years and is depressed and lonely, she said.

Currently, residents at Hillcrest with behavior issues who need psychiatric care are taken to a psychiatrist in Beloit, Kansas, a three-hour drive.

Nappa provided the board with information from the company, "Encounter," a company that provides psychiatry via teleconferencing. The board appeared receptive to the idea and directed Nappa to check into another facility in Nebraska that uses telepsychiatry.

If used, the resident's insurance would be billed. Hillcrest would provide the private room and the company would supply the equipment.

In other action, Nappa updated the board on the financial report for September and said a $32,363,75 interest-only payment was paid on a $2.145 million bond. The bond was used for the recently-completed construction/renovation at the facility.

Payments are due twice a year, in October and April.

The financial report also showed total cash on hand at $382,761.85, with total Medicaid, Medicare and private pay revenue estimated at $78,824.44. About $299,801 in bills is estimated to be paid for the month.

Other business discussed at Tuesday's meeting included:

* the menu's at Hillcrest are under revision, to give the residents more options. The change will result in cost savings for the facility and alternative choices for residents who do not want the standard meal.

* the Quality Assurance Committee has met for the month and has come up with a plan of corrective action for deficiencies. The committee is comprised of representatives from each department, the medical doctor Dr Serbousek of McCook Community Hospital in McCook and a pharmacy consultant. Board of Trustee member Karen Kliment asked for copies of the minutes from those meetings be given to board members.

* Nappa and three other employees will attend a two-day dementia training in Lincoln. Participants will be nationally certified after training,

* current census: as of Tuesday, there were 87 residents, with one in hospice, eight in skilled nursing care, 40 state-paid and 36 privately-paid. The numbers are nearly identical to those in 2012, with 88 residents last year, 12 in skilled care, 42 state-paid and 36 privately-paid.

* the facility hired two nurses but is still in need of one full-time RN, two full-time LPNs and trained nursing aides. The year-to-date turnover rate is 24 percent, compared to 25 percent in August.

* the "Night on the Hill" fundraiser for the Hillcrest Foundation is set for Oct. 13. (An earlier version of this story listed an incorrect date.) Cookbooks, that include recipes of residents and staff, are also still available.