Grant Application Entries

Presbyterian Homes & Services of Kentucky

1030 Alta Vista Rd
Lousiville, Kentucky 40205
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Hattie Wagner

Grant Request ($ Amount)

$8,000.00

Project Title

Bringing the World to Our Residents with Innovative Technology: $8K Request to Purchase the iN2L (It’s Never Too Late) Mobile 50 System

Project Begin Date

11/01/2020

Project End Date

10/31/2021

Name

Hattie Wagner

President

CEO

Date

08/11/2020

PROJECT DESCRIPTION AND BUDGET

1. Describe the proposal in a detailed narrative of services and benefits it will provide in improving standards of living and opportunities, meeting social purposes or responding to needs.

Presbyterian Homes and Services of Kentucky (PHSK) respectfully request $8,000 to invest in IN2L (It’s Never Too Late) innovative technology that is empirically shown to improve quality of life for older adults and people with neurological disorders, especially those with dementia (iN2L, 2020). After consultations with iN2l, we selected the Mobile 50 System. Each system is $11,659. To accommodate our dementia patients, we need three systems.

Three systems accommodate 300 residents in these locations:

• Louisville Campus
• Rose Anna Hughes Home
• Westminster Terrace

By utilizing iN2L person-based, adaptive computer systems, our residents stay engaged through thousands of computer-based experiences, and life enrichment activities. To deliver a person-centered experience, and to meet the specific needs of residents, staff and the residents’ families, iN2L Mobile 50 systems include the following content:

Health & Wellness

• Exercise videos
• Cognitive & therapy
• Fall prevention & strengthening videos
• Scientifically designed brain training games delivered by the HAPPYneuron™ brain fitness program with content developed by iN2L’s certified therapy staff

Stay Connected Applications

• Access to Internet & Skype video calling application to keep residents connected to family and friends

Engagement Content

• Allows residents to stay engaged through thousands of computer based experiences & activities
o Games, puzzles, virtual travel applications, spiritual, history & reminiscence content

myiN2L.com

• Web-based tool helps family members partner in the care of loved ones by giving them ability to customize their iN2L user button
o Select specific applications within the system, upload pictures & videos
o Create digital biographies (My Story) for each resident

My Story

• Person-centered experience
• Helps family & caregivers set up a snapshot of the person’s life—interests, accomplishments, preferences, pictures & music

Staff Training

• Tools for staff engagement & empowerment
• Paraprofessional Healthcare Institute curriculums for direct-care workers on providing personal care services to older adults, peer mentoring, adult abuse & neglect prevention
• Best FriendsTM
o Positive Approach to Brain ChangeTM by Teepa Snow & Cognitive Pathway by Vertis Therapy for dementia care
o Physician Orders for Life-Sustaining Treatment for end of life care

Centers for Medicare and Medicare Services (CMS) Content

• Access to the Medicare, CMS & Kentucky Cabinet for Health & Family Services websites
• Identity theft Web tips information
• Introduction to Hand in Hand Toolkit

iN2L’s content reaches a range of function levels and interests to help engage long-term care community residents resulting in a better quality of life and better general health.

Perceived results are data driven. Mather Lifeways Institute on Aging evaluated iN2L. Results proved participants to be more energetic, demonstrated higher activity and social engagement levels, and expressed more positive emotions (iN2L, 2020). We expect the same results.

iN2L will assist us in achieving an additional objective—reaching more residents than is currently possible with five full time activities personnel. With the technology, we provide more personalized life-enriching activities than ever before. By training our activities staff, our community takes an inclusive approach to caring for our residents. This allows staff to interact with residents in meaningful ways. These interactions result in our residents living their lives as fully as possible.

2. Attach your Project Budget.

08.28.20.PB_.PHSK.pdf

3. Provide a narrative that clearly defines how Kentucky Social Welfare Foundation funds will be used and accounted for in relation to the Narrative above. Provide the start dates and timelines for tasks.

To purchase three iN2L Mobile 50 Systems, we need to raise approximately $35,000, as each system cost $11,659. Three systems will accommodate up to 300 of our residents. We have identified numerous foundations to raise the money and have one application pending with the Truist Foundation. Your $8,000 investment will be used alongside other foundation grants to pay for these new technologies.

We will wait and purchase the iN2L systems when we are notified of grant awards. Based on what we know about your giving timeline, we project it will take (at least) 90 days to receive confirmation of an award; therefore, our expected timeline is as follows:

November 2, 2020: Kentucky Social Welfare Foundation (KYSWF) and the Truist Foundation approves our grant requests
November 3, 2020: PHSK notifies iN2L of award and orders three (3) Mobile 50 systems.
November 9, 2020: Equipment is delivered and installed.
November 10 – 13, 2020: PHSK works with iN2L to be trained on the systems.
November 16, 2020: PHSK conducts a small pilot study using ten (10) residents to experiment with the systems and gauge satisfaction levels with using the technology.
December 1, 2020: iN2L is ready and available for all residents to use.
October 31, 2020: PHSK sends our investors an evaluation of the program.

AGENCY DESCRIPTION

4. Describe your agency’s service area with regard to population, cultural, racial and ethnic makeup.

Since 1947, Presbyterian Homes and Services of Kentucky (PHSK) has created thoughtful services and care options for seniors throughout Kentucky. Headquartered in Louisville, we provide skilled nursing, therapy and rehabilitation, assisted living, and personal care services at our four nurturing communities-Louisville, Elizabethtown, and Pikeville-across the Commonwealth of Kentucky. An interdisciplinary team of dedicated staff members work together to advance our common mission to provide the highest quality of compassionate care and assistance to adults in every stage of life.

In our family of communities, we honor relationship as we serve with compassion, strive for excellence, respect diversity, protect dignity, and promote justice. Recognizing the privilege of service, we wholeheartedly affirm the gifts and wisdom of age, even as we recognize and address the special challenges that also come with aging. Fostering authentic relationship between our residents and our dedicated employees, specialized medical professionals, family members, vendors, and volunteers, we connect people to people.

Our primary mission is to provide care for vulnerable seniors, which encompasses the high percentage of low-income seniors who call one of our communities home. As they age in place, generally their need increases.

Typically, 234 people served by PHSK are Medicaid recipients and 14 are charity care recipients (services provided free of charge). Across all of our senior housing, a majority of PHSK’s residents have incomes below the median income for the community in which they reside. Last year, 51% of our resident stays were those unable to support full cost of care. Over 30% of senior renters in Louisville pay more than half their income in rent (up more than 10% since 2005; the largest increase of any metro area in America).

Currently, 45% of our residents receive subsidized care and Medicaid benefits. In America, the average income from social security of people aged 65 and older is only $1,500 per month, with 23 million seniors living in poverty (Good Samaritan Society, 2020). According to WelfareInfo.org (2019), seniors in Kentucky (between 75 and 84 years old have a poverty rate of 12.3%. Seniors over 85 in Kentucky are at a rate of 14.1%. These data represent our target population.

5. Indicate total number of paid staff and total number of volunteers.

The total number of staff is 266 and 191 of them are full-time employees. We have approximately 100 volunteers.

6. List the goals and objectives of your agency.

Occupancy rate is the best tool to evaluate success of our communities. Our goal is to have our communities at full occupancy with a waiting list. This program will draw seniors who otherwise would not receive this level of care or connection in personal homes.
Another measure of success is improvement over time the high level of participation in the program. One of our partners in this endeavor is the Trager Institute, will be able to expand their services to a larger population and boost the positive outcomes of our residents. Trager’s Flourish Index measures how well a customized care coordination plan improves an individual’s health. For residents entering one of our communities, a baseline score is established and follow-up assessments are conducted every six months. This measurement allows us to access the impact of the services provided, adjust the care plan as needed and track an individual’s changing health status, connecting them with greater support services as needed. The Flourish Index was designed with input from primary care physicians, mental health specialists, and geriatricians.

The index measures 59 quality of care indicators across six determinants of health: biological, psychological, individual health behaviors, health services, environmental, and social. This assessment includes a physiological assessment (blood pressure, BMI, A1C, cholesterol levels), a test of self-efficacy that measures how well an individual can manage a chronic disease; and a behavioral assessment that measures behavioral risk factors and a mental health assessment, including the UCLA loneliness scale.

As we implement the Flourish model, we track these outcomes:

Number of assessments completed/month
Number of health problems reduced or managed/month
Number of physical therapy sessions/month
Number of daily living needs met/month
Number of hours of counseling provided/month
Number of group therapy sessions held/month
Number of transportation services provided/month
Number of seniors in stable housing/year

Another measure of success is overall healthcare costs. Research suggests that coordinated care improves an individual’s health and reduces healthcare utilization and the associated costs, according to a study by the Institute of Medicine. Through this program, we are able to incorporate a larger network of providers to improve outcomes efficiently and therefore reduce costs of care.

By use of the special software, iN2L, the quality of life is improved for the residents by reducing loneliness, boredom, psychotropic drug use – under normal conditions but are even are greater likelihood of occurrence due to the restrictions imposed to protect them from exposure to COVID-19.

REASONS FOR REQUESTING GRANT

7. Describe why this project is needed and how it implements the purpose of the Kentucky Social Welfare Foundation.

Based on your past giving, we know you make investments in new projects that build capacity for nonprofits and take them to the next level of effectiveness and efficiency. Our iN2L project not only builds capacity for our nonprofit, but it will improve standards of living and opportunity among a poor, sick, vulnerable population – low-income seniors living with neurological disorders.

The impact iN2L will have on our residents is undeniable. We know this because comparable organizations have used these innovative technologies to improve quality of life for older adults and people with neurological disorders. In addition to the study mentioned earlier that was conducted by Mather Lifeways Institute on Aging, Presbyterian SeniorCare Network (PSCN) serves as another example. Using iN2L technologies, PSCN conducted a study that showed the technologies increase engagement, satisfaction, physical performance, and team efficiencies (Childress, 2019, Leading Age).

Based on empirical data, we believe implementing the system will be beneficial for residents and for staff with positive, measurable outcomes in three areas.

Increased resident engagement and satisfaction with care: Based on the studies conducted by Mather Lifeways Institute on Aging and PSCN, the addition of iN2L systems significantly boosted therapist resources without occupying a lot of space within the clinic. The systems allowed therapists to create a rehabilitation experience that is centered on who the resident is as an individual and what is meaningful to her or him. It brought joy, laughter, and lightheartedness into the rehab clinic.

Improved physical performance: Therapists have used the system in several ways to improve residents’ physical performance. Teams use the system to promote a productive therapeutic atmosphere, playing music that everyone in the clinic enjoys or pulling up a beach scene on a snowy winter day. Therapists have also used the system to divert attention from the physical challenge of their therapy activities, using trivia or games.

The rehab module programming directly addresses physical and functional impairments. Therapists used the video camera for biofeedback on postural alignment. In a person demonstrating visual neglect, the movement patterns of visual targets were manipulated to increase visual tracking toward a certain direction. Videos “walked” a resident through a house with multiple safety hazards to assess their environmental safety awareness.

Increased staff efficiencies: Using motorized and adjustable components, therapists quickly customize the system’s physical setup to fit the resident’s needs, while the rehab module allows quick access to relevant programs to provide targeted intervention. Therapists now can provide activities that span a variety of interests without having to physically locate, retrieve, and return equipment.

8. How did you identify the need that is addressed by the proposed project?

Our staff, employees, and volunteers have close relationships with our residents; therefore, we have ample opportunities to observe day-to-day behaviors of our residents and engage in meaningful conversations with our seniors. We care about our residents, and we work to ensure they are as happy and healthy as possible. This said, when we observe a person’s health declining because of a neurological disease, such as dementia, we do not sit back and watch and do nothing. We take action.

We found iN2L technologies through the Thrive Center in Louisville, KY. After we took a tour of the Center and learned about the benefits of iN2L, we knew we had to raise money to invest in these technologies. Investing in iN2L is the same as investing in our residents. Everyone deserves to continue living a full life as they age—one with joy, purpose, and meaningful connections. iN2L brings people together, connecting seniors with what interests and fulfills them and enabling them to share conversations, experiences, learning, and fun with each other, their caregivers, and family members.

Forward-thinking communities are using iN2L to solve problems associated with caring for older residents with neurological diseases. Two-thirds of community leaders believe engagement technology is extremely or very important, according to a recent survey conducted by iN2L. Yet, barely more than half say they engage residents extremely or very well today, and 60 percent rely on the activity department to drive engagement-focused programming. This siloed approach to the engagement model has become outdated, and we can relate to this. The need for a technology that keeps our residents engaged is long overdue.

9. Does any other organization in your community serve this need?

There are others who offer affordable housing for seniors, but the uniqueness of PHSK is the community-based service piece we offer through collaborative partnership. There is one similar organization, Nazareth Home, that recently partnered with iN2L to execute a groundbreaking palliative care program called Connected Affirmation Project (CAP). The CAP program is the first of its kind in the U.S. and affirms the life of elders by utilizing iN2L technology to help tell their life-stories and create a legacy keepsake for families.

10. If so, what distinguishes your agency’s services from others?

We stand out. Our culture makes us different from other organizations. We are built upon the concept of community. A community built of residents, families, staff, employees, volunteers, and supporters—all interwoven in a tapestry of relationships, all driven by the same mission to care for our seniors. Our five communities are as unique as their geographic location, but with the same standard of care. Our residents can obtain these services under one roof: Respite Care, Personal Care, Apartments or Rooms with Meals, Housekeeping, Laundry, Social Activities, Assistance with Activities of Daily Living, Medication Management, and Medical Assistance.

PROJECT FOLLOW UP

11. Describe how you will measure outcomes of this proposal.

Quantitative and qualitative data are collected through formative program evaluations. For the iN2L project, we have the following goals in place, and each one is measurable.

• Improve resident/family satisfaction survey scores to 80% or above.
• Develop benchmarks for communications with resident/family members.
• Provide meaningful activities for residents
• Research, benchmark, and develop operational programs and performance indicators to improve outcomes.
• Research, modify, and expand services in existing PHSK communities consistent with the needs of the community.
• Increase community engagement, education, and outreach, including churches and advocacy, our donor base, and volunteers.
• Staff observations of residents’ behaviors before and after using iN2L will be documented (qualitative data)
• Amount of grant funding secured
• Number of new/current investors in the project
• Number of residents served
o Goal is to serve 300
• Number of activities staff trained and engaged
o Goal is to train and keep five engaged

12. After the grant funds are expended, describe how you will assure continuation of grant-funded services or equipment maintenance.

Once the iN2L systems are purchased, that is a one-time fee, and the only costs involved to sustain the equipment are minimal annual fees. We will learn more about those when iN2L installs and provides us with training on the Mobile 50 systems. We plan to pay these fees with earned income, which is explained more below, and with other grants and private donations.

Our track record shows success, growth, and sustainability. A best practice in sustainability is establishing multiple, dependable revenue streams. We have several reliable revenue streams that ensure sustainability, and those include:

• Medicaid Reimbursements
• Private Donations
• Grants
• Fundraising
• Board of Directors Commitments

Over the last two years, about 47% of PHSK's net nursing facilities services and ancillary services revenues were derived from services to patients in the Kentucky Medicaid program. In addition, just over 30% of net nursing facilities services and ancillary services revenues was derived from services to Medicare beneficiaries. Medicare Advantage plans are starting to include benefits such as transportation and meals after surgery. Our integrated model of care allows us to help residents take advantage of these benefits and potentially get reimbursements for providing the services, which is another strategy for long-term sustainability.

We are in the early stages of raising money for the iN2L systems, so no funds have been secured. However, we are applying to numerous foundations to help offset costs with the technologies and to raise funds for sustaining the iN2L systems and paying a percentage of the salaries for our activities staff. We apply for more than we need to cushion our organization against rejection. This has always been a best practice in securing grant dollars. Typically, we would not have to apply for funds to pay for these technologies, but with the COVID-19 revenue losses, we must rely on philanthropic support.

Kentucky Social Welfare Foundation $8,000
The Kings Daughters & Sons Foundation $10,000
Whippoorwill Family Foundation $10,000
Taylor Family Foundation $20,000
Truist Foundation $35,000

FINANCIAL INFORMATION

13. Attach your AGENCY BUDGET showing all financial resources.

08.28.20.AB_.PHSK.pdf

14. What fees or charges are made by the organization for its services?

The fees charged for services varies including daily care, rent, room and board, supplies, etc. These services are billed and payers are private insurance, Medicare, Medicaid.

15. What percent of the organization’s budget is used for fund-raising?

1%

16. What percent of the organization’s budget is used for administrative costs?

48%

17. If applicant has received prior grants from the Kentucky Social Welfare Foundation, provide dates, amounts, purposes and outcomes.

We have not received a grant from the Kentucky Social Welfare Foundation.

18. Attach your IRS 501(c)(3) tax designation letter.

08.28.20.501.PHSK.pdf

19. Attach your 990 or 990-PF federal tax return.

08.28.20.990.PHSK.pdf

Entry ID476

Entry DateAugust 11, 2020