#1SEMPER GINIA TYRA Board of Veterans Services New Veterans Care Center Presentation December 17, 2020 Thurraya Kent John Bell Dan Helmer#2GINIA What do they do, how many there are, and who gets in? LTCF for veterans; four levels of care Virginia's veterans care centers deliver four levels. of care to Virginia's veterans: 1. 2. Skilled nursing Alzheimer's/memory Rehabilitation All 50 states have them • 157 state veterans homes (SVHS) All 50 states and Puerto Rico • CA, TX = 8 SVH each; FL, MO, and OK = 7 each First SVH established 1864 (Connecticut) • Federal operating supplement - 1888 3. 4. Assisted Living (domiciliary) - Roanoke only . Virginia has two and is building two more • • • • Federal construction grants - 1930 More planned: 12 new construction and 8 bed replacement projects on USDVA FFY20 priority list Eligibility requirements vary by state Residency (current, minimum number of years, etc.) Character of military service (honorable discharge, other than dishonorable, etc.) Veteran has medical need for level of care provided SVH can provide level of care the Veteran needs Period of service (all periods, wartime, etc.) Means test (ability/non-ability to pay) Non-veteran (spouse, Gold Star family member) 1. 2. Virginia Veterans Care Center, Roanoke (1992) Sitter & Barfoot Veterans Care Center, Richmond (2007) . 3. Jones & Cabacoy Veterans Care Center, Virginia Beach (2022) • 4. Puller Veterans Care Center, Vint Hill, Fauquier County (2022)#3RGINIA New Veterans Care Centers - Overview and Timeline Jones & Cabacoy Veterans Care Center ● • 25 acres donated by the City of Virginia Beach Named for two Virginia heroes: o Col William A. Jones, III, USAF, MOH recipient, Vietnam ○ SSgt Christopher Cabacoy, U.S. Army, Killed in action, Afghanistan, 2010. Virginia Beach native Puller Veterans Care Center ● 30 acres donated by Vint Hill EDA and Vint Hill Village (Fauquier County) • Named for three Virginia heroes/public servants: o Lt General Lewis B. (Chesty) Puller o Lewis B. Puller, Jr. o Linda T. (Toddy) Puller Event/Milestone State funding committed Land donated Design complete VA awards matching grant Contract signed with CM Construction started Month -8 (hiring starts) Construction complete Month 1 (1st residents admitted) Month 3 ("regular" cycle of admissions begins") Month 17 (target for full occupancy) Month 20 (target breakeven) Puller VCC 2015/16 J&C VCC 2015/16 2016 2016 March 2019 March 2019 December 2019 December 2019 March 2020 March 2020 March 2020 July 2021 January 2022 March 2022 March 2020 December 2021 June 2022 August 2022 June 2022 November 2022 August 2023 January 2024 November 2023 April 2024#4RGINIA PER' D Puller VCC - Birdseye View - Design Wiley | Wilson + orcutt | winslow www.dvs.virginia.gov#5RGINIA Puller VCC - Birdseye View - October 24, 2019 www.dvs.virginia.gov 5#6RGINIA Puller VCC - Birdseye View - September 2, 2020 PER www.dvs.virginia.gov#7RGINIA PER D Puller VCC - Birdseye View - September 2, 2020 www.dvs.virginia.gov 7#8GINIA SEMPER TYRA Puller VCC - Birdseye View - December 10, 2020 8#9RGINIA PER D Household Interior Wiley Wilson + Orcutt | winslow 6#10RGINIA PER D Resident Courtyard Wiley Wilson + orcutt winslow 10 10#11GINIA SEMPER TYRA J&C VCC - night pour - December 10, 2020 CAPITAL CONCRETE Pella 11#12IRGINIA Staffing, Census, and Funding: Basis/Assumptions SEMPER TY Staffing: • . 24/7/365 operations - three shifts/day, plus M-F employees "Whole Person" approach to care - blends medical care with recreational, therapeutic, and social opportunities that contribute to overall physical and mental health/well being Operate the care centers as symbols of the Commonwealth's commitment to her veterans Hire/train/retain a team dedicated to delivering exceptional, personalized care Households are basic unit of direct care delivery. Direct care staffing in multiples of 8 (ex. 1 CNA for 8 residents, 1 LPN for 16 residents, etc.) Census • Admissions will average 2/week (or 8/month) until full occupancy (assumes that there will have to be some weeks with 3 admissions/week to make up for losses. . Target 95% or greater occupancy Revenue: • 55% of residents will be Medicaid; 30% will be VA SCD (i.e. residents who have 70-100% service-connected disability rating; 10% will be private pay (mainly asset drawdown prior to Medicaid qualification); and 5% will be Medicare. . Proposed change in GOV Introduced budget will help revenues 12#13IRGINIA Start-up funding and initial operating funds Basis/Assumptions SEMPER First staff hired in Month -8 • First residents admitted in Month 1 • Full census (95% or better) will be reached around Month 17 • Revenues catch up 2 months later (Month 19) . DVS VCCs operate on a reimbursement basis At the end of the month, DVS bills payer source (Medicaid, Medicare, etc.) • 30-60 days later, receive reimbursement check • Working capital advance (from state treasury) authorized: will cover start-up to break even · Funding for equipment replacement (ex. - wheelchairs, lifts, etc.) and "routine • New buildings - should require no major capital/maintenance reserve projects for 4-5 years maintenance" (ex- carpet replacement) will be needed sooner 13#1435 30 25 20 15 10 5 SEMPER GINIA TYRA . Hiring Begins Eight Months Prior to Opening First Hire is the Administrator • Next are Director of Nursing, HR Director, Finance Director, Facilities Manager, and Admissions Director Number of Hires, by Month - Puller Veterans Care Center 33 19 0 1 Jul-21 Aug-21 0 Sep-21 3 Oct-21 Nov-21 Dec-21 8 7 2 Jan-22 NOTE: Jones & Cabacoy VCC hiring: shift five months to the right Feb-22 Mar-22 Apr-22 May-22 8 19 11 11 6 || Jun-22 Jul-22 11 10 9 6 6 6 Aug-22 Sep-22 13 13 11 7 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23 Apr-23 May-23 14#15250 200 150 100 50 0 SEMPER GINIA TYRA • Staff Levels plateau in Month 15; Census in Month 17/18 Staff must be hired/trained before residents are admitted • Admissions will look like a "stair step” pattern: 10 new admissions and 2 discharges per month until target census (95%) occupancy is reached in Month 17 Staffing Levels and Average Census Jul-21 Sep-21 Nov-21 Jan-22 Mar-22 May-22 -Staffing Levels - Puller -Average Census - Puller Jul-22 Sep-22 Nov-22 Jan-23 Mar-23 -Staffing Levels - J&C May-23 Jul-23 Sep-23 Nov-23 Jan-24 Mar-24 Average Census - J&C 15 May-24#16SEMPER GINIA TYRA QUESTIONS/COMMENTS? 16