Background

The Nathaniel Witherell (Witherell) is a nonprofit short-term rehabilitation and skilled nursing center located on 24 acres two miles from downtown Greenwich, Connecticut, and has served the community since 1903. Witherell is owned and operated by the Town of Greenwich and is the only municipally owned nursing home in Connecticut. Witherell has placed in the top 13 percent of all nursing homes in the United States to be named a Top Nursing Home in Connecticut by U.S. News & World Report.

Witherell’s 202-bed facility includes a state-of-theart rehab center and 46 rehab beds. The facility has undergone major infrastructure improvements and renovations and continues to improve the living spaces.
Witherell places their staff as a top priority and, in 2019, they partnered with the Health Dimensions Group (HDG) Workforce Solutions team to assist with recruiting a solid interim licensed nursing home administrator (NHA). In 2018, HDG completed a comprehensive assessment of Witherell’s operational challenges and opportunities. Therefore, HDG understood Witherell’s critical need for securing a talented interim NHA that could stabilize operations during recruitment for a permanent NHA. HDG secured the interim NHA and provided supportive consulting services during the interim’s tenure spanning three and a half months. HDG’s experience enabled us to make an immediate impact in steadying the center to facilitate a successful transition to a permanent administrator.

“HDG provided us with an excellent interim nursing home administrator, who was working when COVID-19 struck. Working in tandem with HDG, the facility treated 55 out of 175 patients for COVID-19. Their efforts were herculean and kept the nursing home running without any citations from the State Department of Public Health. I could not have asked for a better partner than HDG during this extremely difficult time.”

Larry Simon, Chairman, The Nathaniel Witherell Board, Town of Greenwich

Resources & Services

HDG placed a fully qualified and vetted health care professional as the interim nursing home administrator (NHA) and continued to oversee this professional during the duration of the engagement to promote ongoing client satisfaction. HDG’s approach to securing interim and permanent leaders is depicted to the right. HDG’s multi-discipline consulting and operations team provided ongoing support and resources for the interim NHA through weekly telephonic meetings and emails, supplemented by individual meetings to resolve specific time-sensitive issues. Key areas of support offered include:

  • Operations and clinical oversight, as well as advisory support during the director of nursing absence, such as regulatory and documentation compliance, infection control, risk management, and staffing.
  • COVID-19 management assistance.
  • Accounting and finance assistance with cost reporting and financial reporting and management.
  • Communications, including media monitoring and messaging advice.
  • Marketing to develop and stabilize census.
  • Clinical reimbursement minimum data set (MDS) and audit best practices.
  • Human resources, including employee onboarding and orientation, attendance compliance, corrective actions, and performance improvement.

Tools & Deliverables

HDG was able to use our experience in recruiting, retaining, and engaging team members at our own communities, as well as our understanding of the challenges in finding qualified and dependable team members, to aid in our search. By listening to Witherell’s needs, drawing from our own personal and professional connections, and applying bestpractice human resources strategies and industry knowledge, HDG was able to make the best placement possible for the interim NHA. As part of our strategic and operational consulting support, HDG provided tools and process recommendations that assisted the interim NHA in successfully leading Witherell to regain its status as a 5-star rated nursing home. Some of these areas include:

  • Infection control policy manual and forms to aid in regulatory compliance.
  • Deficiency correction plans and educational materials to improve survey management.
  • Talking points, website statements, letters, and sample communication plans to effectively respond to residents, families, staff, and media regarding COVID-19.
  • COVID-19 task force and plan development and implementation, including securing personal protective equipment (PPE); infection control; COVID-19 isolation procedures; state and federal agency updates; compliance with numerous state inspections and a heavy reporting burden during the height of the COVID-19 pandemic in Connecticut; staffing; and education, as well as communication.
  • Creation of roles with detailed tasks for MDS department staff to achieve greater efficiency in completing MDSs timely and accurately.
  • MDS and therapy invoice audit processes to optimize reimbursement and improve revenue.
  • Employee onboarding process and educational materials rooted in long-term care compliance training materials and focused on overall employee experience and engagement.
  • Staff performance improvement plans (PIP) to develop employees and reduce turnover.
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