People making a difference.

Receiving due recognition may seem uncommon for many in long-term care. That's why Long-Term Living gave readers the opportunity, via our Web site (www.ltlmagazine.com), to nominate and vote for exceptional employees and leaders in the field today.

We received many nominations--and a few thousand votes--for the following people you decided are truly making a difference in the ranks of Administrators, DONs, CNAs, Ancillary Staff, and "Other" (including consultants, lobbyists, and friends of the industry). Whether they are managing staff, developing facility meal plans, or acting as the face and voice of an aging community, long-term care workers and advocates provide an important and valued service the world over. These stories are a mere snapshot of a few of these dedicated people and, hopefully, will inspire you to recognize and acknowledge good work when you see it.

Administrator Category

Jennifer Mikula

Palm Garden of Ocala

Ocala, Florida 

During a job interview, Jennifer Mikula once said to a prospective employee, "Where else can you go to work every day and get as many hugs as you want?" To some people this intimate recruiting technique may seem a bit presumptuous. Within the confines of Palm Garden of Ocala, however, it's just another example of the type of award-winning culture change administrator Mikula has personally instilled.

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A long-term care veteran, Mikula has 20 years professional experience in healthcare administration, including nearly 11 years at Florida's Palm Garden of Ocala, which she has helped to receive more than 20 awards--including Long-Term Livings 2008 OPTIMA award. Her culture change program, Empower with Choice, focuses on consistently addressing and upgrading dining, bathing, and activities--as well as the facility's language--with the ultimate goal of always providing choices to residents (known as 'community members' at Palm Garden).

"The initiative with this program was to inspire cultural transformation," Mikula says. "Our job here is to improve the resident's quality of life. We had a vision to deinstitutionalize the physical environment, and we started by designing day spas for pampering and relaxation. We serve restaurant-style dining vs. a feeding frenzy. And we created a fun zone, which is full of activities to stimulate the senses."

Also empowered by her program are Mikula's employees, who exist in a "leveled playing field" where they can make schedules and other decisions. "The staffing benefit is reducing employee turnover, because there's a lot of buy-in with the culture change movement," Mikula emphasizes. "They enjoy coming to work because they have a voice in the day-to-day assignments and workload."

After being nominated by several staff and residents for the People Making a Difference award, Mikula admits to feeling "blessed"--so much so that she has a sign above her door reading that exact word, right next to one that says, "Our residents do not live in our facilities, we work in their homes."

The inspiration for this "culture change journey" came about four years ago when Mikula visited a seminar on the topic. She returned to her home, sat around the table with her family, and decided it was her duty to write for a grant to help her begin this culture change transformation. The state of Florida cut her a check for $66,000 to jump-start her vision.

"But it's not about the money," Mikula reassures. "The will is more important than the way. There is no magic bullet. You can go out there and start with just changing the language in your building. You don't have to call them 'wings,' you could call them 'Cypress Lane' or 'Palmer Place.' You don't have to call them 'residents,' you can call them 'members,' 'guests' or 'elders.' It's the simple things you can start with. The time is right and it is the right thing to do, so have a true commitment and you can improve the quality of life for your nursing home residents."

Runners-Up

Candace Gautreaux

Regency Place Nursing and Rehabilitation

Baton Rouge, Louisiana 

Sister Anne Kull

Vincentian Home

Pittsburgh, Pennsylvania 

DON Category

Ida Sullivan, RN

Banks Jackson Commerce (BJC) Nursing Facility

Commerce, Georgia 

More than 30 years ago, Ida Sullivan began her healthcare career as a CNA in a hospital and nursing home, along with another job. Because of her love for her residents and dedication to healthcare she continued her pursuit of a healthcare career first as a licensed practical nurse, and then completed her studies for a BSN degree. Today, as director of nursing at BJC Nursing Home in Commerce, Georgia, she leads, teaches, and inspires her staff to provide the highest level of care for their residents.

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"When I decided to become an LPN, I had to do some of my training in the nursing home environment. During my first year as an LPN, I realized that this is where I wanted to be," Sullivan says. But Ida Sullivan didn't stop there. Her next goal was to become a registered nurse. "I pursued that degree because any time I tried to change anything at the nursing home I was told 'Go get your RN and maybe you'll be able to do something about it.'"

But being an RN wasn't enough for Sullivan. "I still couldn't accomplish everything I wanted, so I became an administrator." She then worked for a company as director of nursing that gave her the opportunity to work with and train caregivers in four states. "I keep working for change in how our elders are cared for," she states.

Part of that change is going where you're needed. Two years ago, a BJC Nursing Home administrator needed an experienced DON. Because they had worked well together at another company in the past, she asked Sullivan if she was interested in the job. Even though she was an administrator, Sullivan was happy to get back into action on the nursing floor. "Even when I was an administrator," she explains, "I couldn't stay in the office. I was always helping out on the floor because I felt that's where I should be."

Sullivan teaches new DONs and CNAs that the nursing home is the residents' home and that staff are invited visitors. "Therefore, we must listen to them and respect them. We are invited to take care of them," she explains. "You'll be surprised at what you can learn from your residents; you may be also surprised at who you are talking to," she says. "I've taken care of published authors, doctors, and even a descendent of Werner von Braun, the rocket scientist and champion of space exploration," she explains. Sullivan remarks that talking with and learning about your residents gives you a great sense of history.

As she looks to the future of long-term care, Sullivan sees challenges ahead with staffing, reimbursement, and caring for needy elders, but she hopes that geriatric care becomes an attractive, rewarding career opportunity for future CNAs and nurses. Sullivan hopes to see long-term care flourish in the future.

Runner-Up

Christa Little-Fawn, RN

Rifle State Nursing Home

Rifle, Colorado 

CNA Category

Cynthia Walker, CNA

Hawthorne Village Retirement Community

Ocala, Florida

No one is ever stranded or late for an appointment because Cynthia Walker is in charge. Because of her reputation of efficiency, Walker was invited to join the transportation/appointment office to help handle its growing workload. "Families will let Cynthia know that their loved one has an appointment and she makes sure that the resident gets there safely and efficiently," says Director of Nursing Sheryl Creech. Although Hawthorne Village has a medical director, at times a resident needs special services. That's when Walker, who has worked at Hawthorne Village for three years, can locate services from an outside physician. "There's a lot of documentation and communication with families, residents, and medical offices involved," says Walker. Because of her efficiency and attention to detail, Walker has established exceptional working relationships with area physicians, hospitals, dialysis centers, and clinics. As Creech states in her nomination, "The outstanding communication between all parties involved has enhanced outcomes and satisfaction immeasurably." As a result of her efforts, not only do residents keep appointments as scheduled, but the facility has benefited in reduced transportation expenditures.

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In addition to these responsibilities, Walker continues to make a difference through cheerfully performing her CNA duties, by volunteering at facility events, and enjoying a great rapport with residents, staff, and families. Creech remarks that when the announcement was made that Walker was the lead vote-getter on the loudspeaker, the whole building--staff, residents, visitors--got excited about this well-deserved honor for Walker. "She's a big favorite around here and everyone wants the best for her," Creech adds.

Runners-Up

Viola Bradshaw

Daughters of Israel

West Orange, New Jersey

Tomeka Stewart

Sherwood Manor Nursing and Rehabilitation

Baton Rouge, Louisiana

Ancillary Staff Category

Vicki Carlson, RD

Benefis Extended Care and Rehabilitation Center

Great Falls, Montana 

Something as complex as improving resident quality of life can be a daunting request for individual staff members, but Registered Dietitian Vicki Carlson embraces culture change with a simplified approach, much like a short order cook.

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Carlson, who works at the Benefis Extended Care and Rehabilitation Center in Great Falls, Montana was the inspiration behind a recent pancake breakfast. While the facility's kitchen space has been temporarily squeezed by a remodeling project, the shortage of grills had residents complaining, "We haven't had a pancake in three months!" Carlson says she became frustrated that she could not attend to each resident's need for the fluffy breakfast food.

"I was talking to my husband about it and the next thing I know he had purchased in bulk some pancake mix and syrup, and he told me to hold this breakfast," Carlson recalls. "All of our staff came and pitched in." Setting up in the facility's large activity room, Carlson took to the griddle and flipped fresh pancakes onto resident plates or had them delivered to individual suites. Residents who are regularly fussy eaters gobbled up second servings. Even one dementia resident, who requires assistance with every meal, instinctively picked up the syrup bottle and dressed her pancakes.

For some facilities, this may seem like an isolated event, and that these residents were only treated because of a special circumstance. However, Carlson's co-worker Becky Pugh, social services program coordinator at Benefis, assures that's not the case.

"These are little things that make a huge difference and touch our hearts, and it wouldn't have happened without Vicki Carlson here," Pugh says. By instituting a restaurant-style menu with different entrees each day, Carlson has helped residents gain some sense of control in life by choosing their own meals, which is why Pugh says she nominated Carlson for this recognition.

In years past, food was served off the steam table in each dining hall, and residents really had no choice, Carlson says. Now, residents and staff talk to her daily about food preferences, especially the woman who requests a personal meeting with Carlson whenever she does not receive her 'baked' potato chips.

"It's all about the residents and their quality of life and getting to where they feel this isn't an institution," Carlson says. "It would be so easy to just stay in your office, because you can get your work done that way. But residents like to see people who are upbeat and have an energetic atmosphere about them. You have to have a desire to help people be happy in their living situation."

Runners-Up

Carole Schultz

Cedar Falls Lutheran Home

Cedar Falls, lowa

Kathie Vice

Auburn Memorial Hospital

Auburn, New York 

"Other" Category

Stephen A. Moses

Center for Long-Term Care Reform

Seattle, Washington 

Stephen A. Moses, president and co-founder of the Center for Long-Term Care Reform, has been a one-person public relations campaign to save Medicaid as a long-term care safety net for the country's most needy. He says this can be achieved by educating the public on the need for long-term care insurance for people not requiring public assistance. Moses drew national attention when he began the National Long-Term Care Consciousness Tour in 2008--a 35,000-mile journey across the country pulling a 16-foot Air-stream trailer, dubbed "The Silver Bullet," to call attention to the need for long-term care insurance. Moses spoke to anyone who would listen. He has been interviewed by countless local television stations, newspaper reporters, magazine editors, and radio talk-show hosts; done podcasts; and appeared as a speaker at state capitols and for insurance groups, financial professionals, national associations, and the general public. He also gets the word out through his LTC Bullet e-mailed to his supporters. Without long-term care insurance, Medicaid will collapse as a financing source, he says.

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"There are two things currently supporting Medicaid that are going to rapidly disappear. One is Social Security. Thirteen percent of the revenue that goes to nursing homes comes through Social Security. People in nursing homes on Medicaid have to contribute their income. Since Social Security is the primary source of income for the elderly, I call this Social Security spend-through instead of spend-down," Moses says. The other factor is Medicare's $85 trillion unfunded liability. "Medicare can't go on propping up Medicaid to fund long-term care," Moses says.

The Long-Term Care Consciousness Tour ended this year, but Moses will continue his quest to bring to light the benefits and necessity of long-term care insurance. "I'm not marketing long-term care insurance," Moses says. "But it's the only solution I've got for this problem."

There aren't many people who are as passionate about a cause as Moses is about saving Medicaid for those who cannot afford long-term care insurance. "My primary motivation is to save Medicaid as a safety net for the poor."

Runners-Up

James "Skip" Gregory

Bureau Chief, Office of Plans and Construction

Florida Agency for Health Care Administration

LuMarie Polivka-West

Senior Vice President

Florida Health Care Association