TUESDAY, APRIL 30, 2013 A special supplement to the AUSTIN DAILY HERALD

Teresa Stewart is the director of nursing at Grand Meadow Healthcare Center, where she hasworked in various roles since 1999. Matt Peterson/matt.peterson@austindailyherald.com

Director of nursingfeels right at home

Since 1999, Teresa Stewart has beena fixture at the GM Healthcare CenterBy Matt Petersonmatt.peterson@austindailyherald.com

Anybody who has spent time atGrand Meadow Healthcare Center haslikely seen Teresa Stewart.

The dedicated care professional hasworked there since 1999 and withinmonths becamea certified nurs-ing assistant.Now, she’s thedirector of nurs-ing.

While herincreasedresponsibilityover the yearshas meant moreadministrativework and timebehind a desk,Stewart still hasa passion for the one-on-one care. Sheneeds to get out of the office andmove.

“I don’t wear dress clothes to workvery often,” Stewart said Monday, cladin scrubs that matched her co-workers.

Grand Meadow Healthcare Centerprimarily serves elderly residents whohave been discharged from hospitals,need rehabilitation, need pain manage-ment or can no longer live at their ownhomes.

“Anything that is needed once theyare discharged from the hospital,”Stewart said.

The facility currently has 28 residentsand can house 43. Stewart can’tremember anywhere near how manyresidents she’s seen in 14 years, but shehas gotten to know plenty of them

quite well. Jokingand lightening themood, discoveringhow each personprefers a certain rou-tine or simply beingthere for someoneare all parts of thejob. After all, someof these residentssee Stewart and thenursing staff almostevery day. Thereneeds to be a com-fort level.

“We know ourresidents probably better than I knowmy parents,” Stewart said.

Clearly, Stewart’s supervisor saw herdedication and promoted Stewart todirector of nursing.

“She generally cares for the peopleshe works for,” said Megan Kleinsasser,executive director. “She knows the facil-ity inside and out.”

“We know ourresidents probablybetter than I know

my parents.”-Teresa Stewart

See STEWART, Page 3SL

Senior Living2-SL TUESDAY, APRIL 30, 2013 AUSTIN DAILY HERALD

MAY BRANSON MAY 9-12, 2013 $559MYRTLE BEACH & CHARLESTON, SC MAY 18-26, 2013 $1299NW CIRCLE & YELLOWSTONE NATIONAL PARK JUNE 13-28, 2013 $2249NASCAR - MICHIGAN SPEEDWAY JUNE 14-17, 2013 $529Sprint Cup & Nationwide RacesMACKINAC ISLAND, MI JUNE 21-23, 2013 $429CALGARY STAMPEDE & CANADIAN ROCKIES JULY 6-14, 2013 $1519CHICAGO, IL Gangster Tour JULY 19-21, 2013 $429SUMMERTIME ON THE MISSISSIPPI JULY 23-25, 2013 $449TRAINS IN THE COLORADO ROCKIES AUGUST 8-17, 2013 $1489MINNESOTA STATE FAIR - 1 Day Tour AUGUST 22 OR 24, 2013 $35CODY, WY & YELLOWSTONE NATIONAL PARK AUGUST 25-31, 2013 $999UTAH CANYON COUNTRY PARK TOUR SEPTEMBER 1-12, 2013 $2299SEPTEMBER BRANSON SEPTEMBER 5-8, 2013 $549MACKINAC ISLAND, MI SEPTEMBER 13-15, 2013 $429CHARLEY PRIDE SEPTEMBER 14, 2013 $99Crystal Grand Theater in Wisconsin DellsFALL MYSTERY TOUR SEPTEMBER 18-22, 2013 $699All New 5 Day Tour!NEW ENGLAND FALL COLOR TOUR SEPT. 28-OCT. 9, 2013 $1689HOSTFEST - MINOT, ND OCTOBER 2-5, 2013 $579ALBUQUERQUE, NM Balloon Fiesta OCTOBER 9-16, 2013 $1179AUTUMN IN THE SMOKY MOUNTAINS OCTOBER 14-19, 2013 $849WASHINGTON DC & GETTYSBURG OCTOBER 21-27, 2013 $1059CHRISTMAS BRANSON OCT. 31-NOV. 3, 2013 $549CHRISTMAS BRANSON NOVEMBER 7-10, 2013 $549CHRISTMAS BRANSON NOVEMBER 14-17, 2013 $549CHRISTMAS BRANSON NOVEMBER 21-24, 2013 $549HAWAII-MAUI & HONOLULU JANUARY 18-26, 2014 $3499Complete Package with AirFLORIDA - A Great 14 Day Winter Get-A-Way FEBRUARY 2-15, 2014 $2099DEEP SOUTH TEXAS MARCH 1-14, 2014 $2099NASCAR-KENTUCKY SPEEDWAY JUNE 26-29, 2014 $589Sprint Cup & Nationwide RacesALASKA - LAND & CRUISE JULY 19-30, 2014 Starting at $5199

THE PRICES ARE BASED ON DOUBLE OCCUPANCYAll of our Tours are Fully Escorted in

Deluxe Motorcoaches & Luggage Handling is included.For More Information or to Book A Tour, Call Today!

Only a Few Seats Left on Some Tours!

Email: glenn@glennsmotorcoachtours.com

Machines help hospitalscombat ‘superbugs’Associated Press

NEW YORK — Theysweep. They swab. Theysterilize. And still thegerms persist.

In U.S. hospitals, an esti-mated 1 in 20 patients pickup infections they didn’thave when they arrived,some caused by dangerous‘superbugs’ that are hard totreat.

The rise of these super-bugs, along with increasedpressure from the govern-ment and insurers, is driv-ing hospitals to try all sortsof new approaches to stoptheir spread:

Machines that resemble“Star Wars” robots andemit ultraviolet light orhydrogen peroxide vapors.Germ-resistant copper bedrails, call buttons and IVpoles. Antimicrobiallinens, curtains and wallpaint.

While these productscan help get a room clean,their true impact is stilldebatable. There is nowide-ly-accepted evidence thatthese inventions have pre-vented infections or deaths.

Meanwhile, insurers arepushing hospitals to do abetter job and the govern-ment’s Medicare programhas moved to stop payingbills for certain infectionscaught in the hospital.

“We’re seeing a culturechange” in hospitals, saidJennie Mayfield, whotracks infections at Barnes-Jewish Hospital in St.Louis.

Those hospital infec-tions are tied to an estimat-ed 100,000 deaths each yearand add as much as $30 bil-lion a year inmedical costs,according to the Centersfor Disease Control andPrevention. The agencylast month sounded analarm about a “nightmarebacteria” resistant to oneclass of antibiotics. Thatkind is still rare but itshowed up last year in atleast 200 hospitals.

Hospitals started paying

attention to infection con-trol in the late 1880s, whenmounting evidence showedunsanitary conditionswere hurting patients.Hospital hygiene has beena concern ever since,with arenewed emphasis trig-gered by the emergence adecade ago of a nastystrain of intestinal bugcalled Clostridium difficile,or C-diff.

The diarrhea-causing C-diff is now linked to 14,000U.S. deaths annually. That’sbeen the catalyst for thegrowing focus on infectioncontrol, said Mayfield, whois also president-elect ofthe Association forProfessionals in InfectionControl and Epidemiology.

C-diff is easier to treatthan some other hospitalsuperbugs, likemethicillin-resistant staph, or MRSA,but it’s particularly diffi-cult to clean away. Alcohol-based hand sanitizers don’twork and C-diff can persiston hospital room surfacesfor days. The CDC recom-mends hospital staff cleantheir hands rigorouslywith soap and water — orbetter yet, wear gloves. Androoms should be cleanedintensivelywith bleach, theCDC says.

Michael Claes developeda bad case of C-diff whilehewas a kidney patient lastfall at New York City’sLenoxHill Hospital. He andhis doctor believe hecaught it at the hospital.Claes praised his overallcare, but felt the hospital’s

room cleaning and infec-tion control was less thanperfect.

“I would use the word‘perfunctory,’” he said.

Lenox Hill spokes-womanAnn Silverman dis-puted that characteriza-tion, noting hospital work-ers are making efforts thatpatients often can’t see, likeusing hand cleansers dis-pensers in hallways. Sheticked off a list of measureused to prevent the spreadof germs, ranging fromeducating patients’ familymembers to isolation andother protective steps witheach C-diff patient.

The hospital’s C-diffinfection rate is lower thanthe state average, she said.

Westchester MedicalCenter, a 643-bedhospital inthe suburbs of New YorkCity has also been hit bycases of C-diff and theother superbugs.

Complicating matters isthe fact that larger propor-tions of hospital patientstoday are sicker and moresusceptible to the ravagesof infections, said Dr.Marisa Montecalvo, a con-tagious diseases specialistat Westchester.

There’s a growing recog-nition that it’s not only sur-gical knives and operatingrooms that need a thoroughcleaning but also spots likebed rails and even televi-sion remote controls, shesaid. Now there’s moreattention to making sure“that all the nooks andcrannies are clean, and thatit’s done in as perfect amanner as can be done,”Montecalvo said.

Enter companies likeXenex Healthcare Services,a San Antonio companythat makes a portable,$125,000 machine that’srolled into rooms to zap C-diff and other bacteria andviruses dead with ultravio-let light. Xenex has sold orleased devices tomore than100 U.S. hospitals, includ-ing Westchester MedicalCenter.

100,000Estimated number ofdeaths tied to hospitalinfections each year.

$30 MillionEstimated annual

medical cost added byhospital infections.

By the numbers

Nursing home week begins May 12 and runs through May 18. Grand Meadow Healthcare Center will host a list of activities with local support during that time.

Stewart has continu-ously advanced hercareer since the day shestarted. She attendedRiverland CommunityCollege, became a CNA,got her Assisted LivingFacilities certification,became an LPN, an RNand most recently direc-tor of nursing in 2011.Over time, she hasbecome a problemsolver, whether thatmeans training, comingto work while on call orlearning the needs ofnew residents.Yet Stewart and her

co-workers are always

looking for ways to maketheir facility more effi-cient, so residents canreceive more serviceswhere in some casesthey’d have to go backto a hospital. One recentchange included switch-ing from paper logbooksto touchscreen comput-ers.“The goal is to catch

things before they getout of control,” Stewartsaid.Of course, with any

career, challenges arise.Stewart is used to that.“The first week, that’s

where you see the chal-lenging parts of learningthem or what they like,”

Stewart said about serv-ing newcomers.

Still, things workthemselves out. Soon

enough, everybody feelsat home.

“It feels like a hugefamily,” Stewart said.

Senior LivingA special supplement to the AUSTIN DAILY HERALD TUESDAY, APRIL 30, 2013 3-SL

DOORS

LAWNCARE

LAWN CARE

PAWN SHOP

PAWN

SHOP

RON’S

• Gold• Silver• Jewelry• Diamonds• TVs• Stereos• Tools• Coins• Sports Equipment• Digital Cameras• Guns• Musical Instruments• Appliances

Tues-Fri 10-6 • Sat 10-2

2203 4th St NWAustin, MN

437-1301

BUY • SELL • LOAN • PAWNLAWN CARE

LAWN CARE

GUTTERS

IRRIGATION

LAWN CARELAWN CARE

LAWN CARELAWN AERATION • POWER RAKING

MOWING & EDGINGSPRING & FALL CLEANUP

DAVE DONAHUEPh: 507-567-2689Cell: 507-438-3975Brownsdale, MN

Dave’s

HARDWARE LAWN CARE

Teresa Stewart works at her desk Monday morning at the Grand Meadow Healthcare Center, where she does a little bit ofeverything.

Stewart:‘It feels likea huge family’From Page 1

VA withholds disabilityclaims executives’ bonusesAssociated Press

WASHINGTON — TheDepartment of VeteransAffairs is withholdingbonuses for senior officialswho oversee disabilityclaims, citing a failure tomeet performance goals forreducing a sizable backlogin claims processing.The backlog has

increased dramaticallyover the past three years,and the department hascome under intense criti-cism from veterans groupsand members of Congresswho have asked PresidentBarack Obama to try tospeed the process.VA spokesman Josh

Taylor said Monday thesavings would be used tohelp reduce the backlog.He didn’t provide specifics,

nor could he say howmanypeople would be affected orhow much the savingswould be. The withhold-ings apply only to execu-tives of the VeteransBenefits Administration,which is part of the VA.“We remain confident

that VBA senior executivesare dedicated to ournation’s veterans, and theywill continue to lead ourdrive toward VA’s goal:eliminating the claimsbacklog in 2015,” Taylorsaid.In all, records show the

VA paid its senior execu-tives a total of $2.8 millionin bonuses in fiscal year2011. Among the VBAbonuses, three staff mem-bers received the top pay-ment of $23,091 each.The amount of the

bonuses was firstreported by the Centerfor InvestigativeReporting.The number of dis-

ability claims pendingfor longer than 125 daysjumped from less than200,000 to nearly 500,000in fiscal 2011.“How does the depart-

ment expect to turnthings around when it isrewarding employeesand managers for fallingbehind?” said Rep. JeffMiller, the Republicanchairman of the HouseCommittee on Veterans’Affairs.The VA and other fed-

eral departments rou-tinely give bonuses toSenior Executive Serviceworkers and other non-political employees.

By Roni Caryn RabinKaiser Health News

Betsy Gabay saw arotating cast of at least 14doctors when she was hos-pitalized at New YorkHospital Queens foralmost four weeks lastyear for a flare-up of ulcer-ative colitis. But the per-son she creditswith savingher life is a spry, persistent75-year-old with a vestedinterest — her mother.

Alarmed by her daugh-ter’s rapid deteriorationand then by her abrupt dis-charge from the hospital,Gabay’s mother contacteda physician friend who gother daughter admitted toMount Sinai MedicalCenter in Manhattan.

By then, Gabay, 50, hada blood clot in her lung anda serious bacterial infec-tion, C. difficile. She alsoneeded to have her dis-eased colon removed,according to the doctors atMount Sinai. Had theproblems been left unad-dressed, any one of themmight have killed her.

Coordinated care istouted as the key to betterand more cost-effectivecare, and is being encour-aged with financialrewards and penaltiesunder the 2010 federalhealth care overhaul, aswell as by private insur-ers. But experts say thecommunication failuresthat landed Gabay in arehab center, rather thanin surgery, remain dis-

turbingly common.“Nobody is responsible

for coordinating care,”said Dr. Lucian Leape, aHarvard health policyanalyst and a nationallyrecognized patient safetyleader. “That’s the dirtylittle secret about healthcare.”

Advocates for hospitalpatients and their fami-lies say confusion aboutwho is managing apatient’s care — and lackof coordination amongthose caregivers — areendemic, contributing tothe estimated 44,000 to98,000 deaths from med-ical errors each year.

A landmark report bythe Institute of Medicinein 1999 cited the fragment-ed health-care system andpatients’ reliance on mul-tiple providers as a leadingcause of medicalmistakes.Leape, who helped authorthat report, says therehave been improvementssince, but “we have notdone enough.”

Subsequent studiessuggest the toll may beeven higher than theInstitute of Medicine esti-mated. A 2010 federalreport projected that15,000 Medicare patientsevery month suffered suchserious harm in the hospi-tal that it contributed totheir deaths.

Gabay experiencedsuch shortcomings first-hand. During her 26 daysin theQueens hospital, she

said doctors would dorounds and “I couldn’t tellone name from the next. Ididn’t know whether itwas the gastroenterolo-gist, or the nutritionist, orthe physical therapist.”

When she was dis-charged to a rehab center,she was suffering fromacute abdominal pain andbloody diarrhea, and wastoo weak to get out of bed.

“I thought I was beingsent there to die,” saidGabay, who made a com-plete recovery once shewas treated atMount Sinaifor the infection and bloodclot and her colon wasremoved. Officials at NewYork Hospital Queensdeclined numerousrequests for comment, cit-ing patient confidentiality.

A new set ofdoctors

Patients such as Gabayare often surprised to dis-cover that the primary-care physician with whomthey have an ongoing rela-tionship isn’t the doctoroverseeing their hospitalcare and is unlikely to beinformed about theirprogress.

Instead, hospitals havestaff doctors called hospi-talists who are supposed tomanage a patient’s care,coordinating the variousspecialists, managingmedications and thenoverseeing the transitionback home.

“I see my job as an

orchestra conductorpulling it all together,”said Robert M. Wachter,chief of hospital service atUCSF Medical Center inSan Francisco, who coinedthe term “hospitalist” in1996. “I may only spend afew minutes in the[patient’s] room, but theother subspecialists arecommunicating to me, andI’ll integrate it so we givethe patient one uniformmessage.”

But that system is vul-nerable to breakdowns.Patients and family mem-bers meet hospitalists,along with many othermedical specialists, whenthey’re in crisis. Evenwhen hospitalists explain

their role, patients may betoo overwhelmed – or ill,medicated, or disoriented— to absorb the informa-tion. As a result, they oftendon’t distinguish the hos-pitalist from the dozens ofother caregivers they see.

“Unless the patient has

written it down, they willsay, ‘Someone was here,but I don’t remember whatthey said,’” said IleneCorina, founder ofPULSE, a nonprofit organ-ization in New York thatworks to improve patientsafety.

Senior Living4-SL TUESDAY, APRIL 30, 2013 A special supplement to the AUSTIN DAILY HERALD

STORAGE

• Vehicles• Materials for Contractors• Household Goods

3 Sizes: 10x7, 10x10, 10x20

Concrete Floors,Security Lighting

Manager on site24 Hours

FLOORING

FLOORING

TOWING

HOUSING

GOLF

Expires 6/30/2013

20 MILE2013 MEMBERSHIPSingle . . . . . .$350Couple . . . . .$450Family . . . . . .$550

Additional discounts availablefor groups of 10 or more

signing up together.

PRIVATE CART STORAGEAVAILABLE

FLOORING

CONCRETEPAINT HOME IMPROVEMENT

CreativeHardwood Floors

Installation • Sanding • RefinishingSales of Oak • Maple • Cherry • Walnut &

Exotic Woods in Strip & Parquet StylesJim Brogan • Tony Horsman • Trent Rutledge3532 Highway 63 South • Rochester, MN 55904

507-280-6282

RECYCLING

CONSTRUCTION

ASPHALT

AUTOMOTIVE

Health care’s ‘dirty little secret’:No one may be coordinating care