Cassie Alvine (Announcer):
Welcome to the Reimagining Rural Health Podcast series, brought to you by Sanford Health. In this series, we explore the challenges facing health care systems across the country from improving access to equitable care, building a sustainable workforce, and discovering innovative ways to deliver high quality, low cost services, and rural and underserved populations. Each episode examines how Sanford Health and other health systems are advancing care for the unique communities they serve.
Today, Nate Schema, Good Samaritan Society president and CEO leads a conversation on the challenges and the opportunities facing the long-term care industry. Joining Nate are Dana Bachmeier and Luke Wanous.
Nate Schema:
Hey all. My name is Nate Schema, and I'm the president and CEO of the Good Samaritan Society. We have the privilege of serving in more than 200 communities across the United States and are one of the largest not-for-profit providers of senior care and services in the nation. In 2019, we merged with Sanford Health, giving us the opportunity to provide care to people at every stage of life.
Today, I'm honored to be joined by Dana Bachmeier and Luke Wanous, who are administrators in two of our nursing homes in Sioux Falls, South Dakota. Luke and Dana are great up and coming leaders, wonderful people, and I'm excited for our conversation today. Dana, I want to start with you. Can you tell us a little bit about what you do and how you got here?
Dana Bachmeier:
Yeah. So, I am Dana Bachmeier, administrator for Good Samaritan Society - Sioux Falls Village. At the Village, we serve about 160 residents. Previously, I served as administrator of Good Samaritan Society -Miller in Miller, South Dakota, where we served 40 residents. I started in long-term care when I became a certified nurse assistant at Sanford Health Vermillion Care Center. I have also worked in the emergency department at Sanford Hospital as a patient care tech. And then my experience goes as far back as to volunteering on the postpartum floor of the hospital and volunteering as a baby rocker in the NICU (laugh). So, lots of long-term care experience.
I got my start with Good Samaritan Society as administrator in training at the Sioux Falls Center. I've experienced many areas of health care and I'm really drawn to senior care because of how rewarding it is.
Nate Schema:
Luke, after graduating from Augustana University, how about you?
Luke Wanous:
Love Augie! Love everything about it. So, I started off as administrator here within Good Samaritan Society in 2019 with Dana Bachmeier. We went through the administrator in training cohort together. I'm currently the administrator of Good Samaritan Sioux Falls Center facility, which serves about 75 residents here in Sioux Falls.
But when I started my training, I started off in Waukon, Iowa, which is a town of about 2,000 people. And we served a census or about 68 residents. The reason I really got into long-term care was to give back to the community. Both of my parents had cancer as I was growing up. And so that really impacted me. They're both fine today. They're both healthy and happy and I couldn't be more thankful to God, but I just wanted to give back into the community. And health care really spoke to me as a career choice.
Nate Schema:
I think I remember receiving the list of the ranking order of our administrators from 2019. And, you know, I'm proud to say that your name – it was in the top half. We'll just leave it at that Luke. (Laugh)
Luke Wanous:
Dana, I from day one, I knew she was number one, so I was very open about that. But I was just happy to be a part of that cohort with Dana, with Justin Jones. And so we continue to serve with Good Samaritan.
Nate Schema:
It's been an awesome class for us. You know, certainly a few things have changed since my time as an AIT back 17 years ago starting back in Mountain Lake, Minnesota. Still one of our proud and really awesome locations in southwest Minnesota. A lot's changed in the last 17 years besides the fact that we weren't wearing as many masks in the pre-pandemic areas. And we certainly went about the care maybe in a little different way.
In the days that I started we were still on paper charts, and it was before the days of PCC and doing all those different things. We had to actually do those rounds and pull out those quality audits and pencil them out ourselves. So, things have changed.
I'm certainly grateful that we're able to put the pandemic behind us and really looking forward to the future and just so grateful to have that all behind us. And now that we've moved past the crisis of the pandemic, Dana, what are you experiencing?
Dana Bachmeier:
I think you just aged yourself. (Laugh)
Nate Schema:
Fair, very fair!
Dana Bachmeier:
I think post-pandemic, we see a lot more joy – a lot more joy in our residents and our families just as we have visitors coming in the building, really enhancing that family-like environment that we aim to create. So that's something post-pandemic that's been amazing. There are still workforce challenges we still experience, and I believe health care industry-wide experiences those.
But senior care, we feel it, especially specifically when it comes to hiring registered nurses and licensed practical nurses, those RNs and LPNs. As an example, I have a position posted for an overnight registered nurse, and that's been open for 299 days. I looked today. So still feeling that. But we do our best with what we have and our residents deserve that best quality of life.
Nate Schema:
I hear from our peers across the industry right now that hiring's really challenging. You're certainly not alone. During the pandemic, and this is well documented on the Bureau of Labor Statistics, for anybody that wants to go out there and do a little data geeking out, there was over 200,000 health care workers lost. And the nursing home sector, specifically long-term care, no other part of the health care sector was affected quite like we were. And so, Dana, what would you say to a family member who is concerned about staffing levels in long-term care today?
Dana Bachmeier:
I would probably say quality of care is our number one priority at Good Samaritan Society and Sanford, when we can't hire on staff, we don't go without; we go to travel nursing staff to fill the gaps. We are a family, and all our staff, whether traveling staff or our own staff, are held to the same quality of care our residents deserve.
Nate Schema:
You know, the consequences of being short staffed is often the seniors have fewer options. It becomes an access issue. And I think about the upper Midwest where we have the privilege of serving. Sometimes people may have to go upwards of 30, 40 and 50 miles for care. You know, 70% of the residents we serve live in rural communities. So we are laser focused on ways we can protect seniors' rights to receive care as close to home. But Dana, what are you doing at the Sioux Falls Village to hire the people you need today?
Dana Bachmeier:
Long-term care is an incredibly rewarding career. So we take a variety of approaches to expose people to the opportunities that we have. We did a food truck hiring event earlier this summer where we had a food truck on-site. We did interviews, facility tours, and then offered free meals to applicants. So that was a creative way that we tried to get people in our doors.
We go as far as to recruit international nurses, and I'm happy to say in September we will have an international registered nurse joining our family at the Sioux Falls Village. So very excited about that.
And then another great benefit to both organizations hiring and to nurses applying is the Build Dakota Scholarship, which is kind of like a partnership between health care organizations in the state to pay for schooling for RNs and LPNs. It's just a really good pathway and it can lead to being debt free after college. So, who wouldn't want that?
And then Sanford and Good Samaritan Society also have several internal scholarships that we offer employees and then talk about certified nurse assistants for those who are not yet certified. Good Samaritan Society offers on-the-job training to get that certification. And CNA experience is really important to those looking to go into the nursing career, really any health care career. But it's also just a really good career in that it teaches valuable life lessons. And it's so rewarding.
Nate Schema:
You know, I often hear, well, if you just paid more, you'd have more workers. What I've often had to educate my family, friends, colleagues, it really is a bigger economic challenge than just that. When you have other industries and businesses, whether it's Jimmy John's, Qdoba, McDonald's, they're going to charge you and I more for a hamburger or a sandwich. We don't have that same luxury given that 50, 60, 70% of our reimbursement or our funding comes from the federal and/or state governments. So we don't have that same type of luxury just to pass along those costs to those we serve. Luke, anything you'd like to add about how you invest in your team members?
Luke Wanous:
Yeah, absolutely. Thank you. I think we just want to go above and beyond to just create a culture of care and family within the Sioux Falls Center. We take our team out to the Canaries game and we go on bowling nights – those little things outside of the facility that really draws a family-like environment. We bought T-shirts for the entire team and the slogan on the T-shirt is the nursing home team. We don't do average, we do awesome. And we really picked that because if you are dropping your family member off or your loved one at our facility, do you want average care or do you want just an awesome environment, awesome care, awesome people that care for your loved one? And that's what we really strive for here at the Sioux Falls Center. We have the entire organization also behind us.
We recently had a big event at our facility where individuals from the National Campus, I think Nate, you were there for a little bit, that came and served our team for doing such a great job in providing excellent care for our residents. And I couldn't feel more support from the National Campus and our entire organization. So I really appreciate that. But it really stems from that culture of family that Good Samaritan has.
Nate Schema:
I love that. And I think you feel that the minute you step into your building there, Luke, the culture, the hospitality, it's first class. You know, that's a great segue and I want to talk a little bit about resident well-being. I want to talk holistically about how we deliver an exceptional experience to our residents each and every time. And what those loved ones experience when they walk into your community.
Luke Wanous:
Yeah. So, the experience that they have when they walk into our community is a full on environment of servant leadership. The team really goes above and beyond for the residents being number one. I played football at Augustana University here in Sioux Falls and I reached out to my coach.
Nate Schema:
Well, “played” might be an overstretch but –
Luke Wanous:
I practiced a lot (laugh), I watched a lot of film pass ball calls on the sidelines. I was part of the team. And that's the thing is servant leadership. Although you aren't a starter, you still do everything that you could do for the success of your team. And so that just led me to go reach out to my coach, Coach Jerry Olszewski and ask for a number two jersey, which he graciously gave us. And so I have that hanging up in our facility. And just a symbolic reminder of the residents come first. We all are second. We're number two; they're number one. And it's going above and beyond for the sake of others before yourself. And that's what we really want to strive for at the Sioux Falls Center.
Nate Schema:
You Know what, Luke, I know you're not a dad yet, but I feel like those dad jokes are going to be right in your wheelhouse someday with these T-shirt sayings.
Luke Wanous:
Yeah, you know, I've been told that before, (laugh) especially with my college roommates, I was kind of the dad of the group, so I get it. I get it. It's a term of endearment for me, Nate (laugh).
Nate Schema:
Dana, I want to talk with you a little bit about innovation. What role do you see innovation playing in enhancing the resident experience?
Dana Bachmeier:
We are constantly seeking innovative ways to enhance the quality of life of our residents. I've seen firsthand how innovation and new ways of delivering care have impacted the experience of our residents in a very positive way.
A few examples we have at the Sioux Falls Village is our home hemodialysis in partner with Sanford Dialysis. We have a number of residents who are receiving dialysis services right down the hall from where they live. It's seamless.
We also have a model of care that ensures care is coming to our facility. It isn't always easy for our residents to go to appointments, therefore we have physicians in our facility almost every day seeing our residents, dental services coming to our facility and podiatry services. Most of these services are made possible by our Great Plains Medicare Advantage Program. So things like physician services are possible for facilities in Sioux Falls, but also those rural facilities like Miller and Tyndall and De Smet. It goes everywhere throughout the state. These services are truly a game changer in both urban and rural communities because our hot, humid summers, which we're experiencing now, and our cold winters, it makes traveling difficult.
As I think about Sanford and Good Samaritan society, I think we excel in bringing quality care through innovation to not only Sioux Falls, but our rural communities as well.
Nate Schema:
It's great that you bring up these innovative opportunities made possible by our partnership with Sanford Health. When we came together with Sanford in 2019 for this very purpose, it really was about how do we reimagine care? What does the integrated health care model really look like and how has it lived out? So it's super exciting to see this vision come to life through your programs at the Sioux Falls Village. And here you describe the many ways that our residents are benefiting from all the ways that you're serving there, here in Sioux Falls.
Luke, are there any other ways that you've seen our partnership simplify the health care experience for the residents and families you serve?
Luke Wanous:
Oh, absolutely. I think our partnership with you on the Sanford Health Network is just so vital for the overall resident experience. We have open communication and dialogue with the Sanford Medical Center weekly to go through what our residents need what their patient experience is like and how we can better improve as an overall structure and organization. And I really appreciate that partnership because it's, like I said, the open dialogue is just vital for the overall experience for the residents and patients that we serve.
I'm glad that Dana was able to touch on our Great Plains Medicare Advantage plan. I think that the whole point of that is to provide as much care and service to the residents in-house as possible, to keep them in their home, to avoid the hospitalizations, provide additional services such as podiatry. So we have a podiatrist that comes into the facility and works on our residents’ feet monthly. We also have senior dental that comes out to our facility and works on our residents’ teeth cleaning. Those are some of the services that we can provide here in-house.
And really it just shows the overarching goal of Good Samaritan and Sanford is to treat the resident at their home and in the nursing home setting. And that's what I really appreciate about the whole environment that we serve. And so, Nate, I think Dana and I have talked a lot today. So what excites you the most about the future?
Nate Schema:
It's a little bit of everything that we've been talking about today. In some ways I reflect back on where we've been the last four years, and the whole pandemic threw a bit of a wrench in things. And in some ways it felt like we took a bit of a detour because we were on the path, we were doing all the things that we wanted to do as an integrated health system, and then we kind of had to throw that playbook out the window and rebuild the new COVID playbook.
So I think what's been really fun and exciting for me to think about is, let's get back and rebuild that foundation, get back to those innovations that first and foremost are best for our patients, our residents, and think about how we solve the workforce challenges that we talked about earlier, augment that with the virtual care technology, infuse that with new and exciting ways that we can deliver care.
So I think it's all of it. I don't know that there's one single thing that I can say that's going to be a game changer, but it's the collective of being an integrated health system, seamlessly transitioning patients across that care continuum and really delivering health care at the right place and at the right time. The other thing that I would call out is, you know, as I sit down and talk to two young dynamic leaders, I can't help but to be excited about the future of health care looks like. And I think it's in great hands.
I think the foundation is still being written, and yet I am so confident that the future of our health care system, the future of our integrated health system, is going to be well taken care of with the talents of two leaders that I'm in front of here today. Luke, you might not have played a whole lot on the football field, but I am confident you are going to make an impact in this organization (laugh).
Dana Bachmeier:
I love that. Nate, what advice do you have for someone who’s loved one may need senior care?
Nate Schema:
When I think back to the reason why I got into this business to begin with, I can't help but to bring up my four grandparents that were a part of my journey almost the entire way. Up until a year ago, I had all four of my grandparents. I remember growing up and going down the dusty gravel road in Grandpa's blue Ford and him telling me to “get over, you're going to drive” at 11 years old. I remember going to feed the cows. I remember going to the creek and catching those frogs and toads.
And so I think about what we do in a very personal way and how we do it.
And so I think it's just really important that we always remember why and the generation that we're serving, and they really laid the foundation by which we're able to enjoy all that we've come to enjoy here in the United States, and certainly here at the Good Samaritan Society for the past a hundred-plus years.
So, I think it goes beyond just meeting their physical needs. And I think that's the special thing we're able to do here at Sanford Health and the Good Samaritan Society. We're able to meet all of their needs, their mind, body, and soul, and bring all of us to work. At Good Samaritan, our work is more than just a job; it's a calling. So I'm really just excited about how we continue to build upon this integrated health system and imagine and reimagine what future looks like moving forward. Dana, Luke, thank you so much for joining me in this conversation. Thank you for everything you do for your team members and the residents that you serve.
Cassie Alvine (Announcer):
You've been listening to “Reimagining Rural Health,” a podcast series brought to you by Sanford Health. Hear more episodes in this series or other Sanford Health Series on Apple, Spotify, and news.sanfordhealth.org.
