When it came to hiring the next community mentor/administrator of The Neighbors of Dunn County, the nursing home’s oversight committee was unanimous in their choice.
Carmen Flunker, 23, not only brings enthusiasm and experience to the state-of-the-art facility, she brings a unique history and perspective to the job she began on July 2.
“I grew up in nursing homes,” she said, noting that her mother herself was a nursing home administrator who later became a professor. And with both parents working, she spent a a lot of time with her grandparents growing up. Her 98-year-old grandmother lives in the senior apartments at Chippewa Manor in Chippewa Falls.
“We lived in Eau Claire, so she took care of my brother and I,” Flunker said. “I grew up with an elderly population. ... It kind of runs in the family, I guess.”
In 2017, she graduated from University of Wisconsin-Eau Claire with a bachelor’s degree in health care administration. She served as an assistant administrative intern at a nursing home in Wheaton, Ill. After earning her degree, she worked as the administrator in a Black River Falls nursing home for eight months. On July 2, Flunker began her new position at The Neighbors.
The hiring committee told her they were looking for someone who is energetic, willing to be involved with the staff and residents and who has a strong business sense.
“I personally don’t like sitting in my office,” Flunker said. “I would much prefer being out where the action happens and seeing the actual day-to-day operation which is hard to manage without being actually in it.”
The way she sees the job’s main goal as providing residents with the highest quality of care. But Flunker recognizes that The Neighbors also needs to be a sustainable business. And the ultimate aim needs to a between the two.
Been there, done that
Among the most powerful aspects that drew her to the nursing home profession is what she can learn from the elderly population she help to serve.
“They’ve been there, they’ve done that kind of thing. And obviously they made it work,” Flunker observes. “Their experiences, their lives, they know what happened, they learned from it as well. They have all the great stories to tell you. It’s just great to spend time with them — and I think they’ve earned the quality that we provide here and that I want to provide. They’ve earned our efforts to take care of them in the last years of their lives.”
Flunker is delighted to be able to do just that in the kind of setting that honors that effort. Describing The Neighbors as “breathtaking”, she said it’s unlike the traditional x-shaped building most comes to expect.
“There’s nothing wrong with that, but it’s great to walk into a place that’s friendly, just the atmosphere of the building itself is inviting,” Flunker said about her first visit. “It doesn’t feel like you’re going into a nursing home which has a negative connotation and stigma. I think it’s great for our residents that it’s definitely homelike, especially with the neighborhood and households. That’s the new model.”
Flunker predicts that while the quality of care is of utmost importance, the wave of the future includes the kind of pleasing aesthetics of The Neighbors add that to the likelihood that residents are more apt to adjust to their new environment.
“It’s so friendly and warm and welcoming,” she added. “It’s a place to live ... for people to be comfortable, have their own space and just be happy and not feel like a nursing home. There are great nursing homes that have the old model and that do great things for people who need care. It’s just very nice to be able to offer a little bit more.”
Whether the style is traditional or cutting edge, Flunker said the biggest challenge all nursing homes face is the census, or keeping the facility full.
“There’s tons of healthcare providers and people have so many options. Even outside of nursing homes, there’s home heathcare ... assisted living ... swing beds,” Flunker explained, pointing out that increasing the census is among the goals with which she’s been charged.
Several years ago, a CliftonLarsonAllen study was commissioned to improve the revenue outlook at The Neighbors. Among the recommendations was to convert one of the three neighborhood dwellings into an assisted living facility. Opened in 2013, The Neighbors of Dunn County offers 137 beds in three buildings, each one housing three separate units of 13 to 16 single-occupancy rooms, each with its own full bathroom.
While it’s a viable option that’s still on the radar for the future, Flunker said as of now, the facility will remained focused on its nursing home mission. In early August, the census was 117, with a goal of reaching the 120s: “Previously it had been a lot lower. We’re still working to improve that, too.”
The Medicaid reimbursement rate is also a big stumbling block that will require legislative changes to improve.
“There was a small 2 percent change, but we haven’t seen the benefits of that because that goes directly off of your case mix index,” Flunker said, noting that the requirements are very specific. “Each resident is assigned a reimbursement rate based on all sorts of factors — their medication, their level of care. It basically determines how much the state see their worth, or how much they should reimburse us for them.”
In addition to Medicaid usually which makes up the majority, other methods of payment include private pay, Medicare, Medicare Advantage plans, or like-Medicare — private insurance plans that operate on the same style as Medicare A.
Staffing is also an industry-wide issue. “There just aren’t enough people,” Flunker said. “Jobs like CNAs and nurses who work in a nursing home is becoming a stepping stone ... You’re a CNA for a year, then you get your LPN, then you’re here for another year, then you get your RN — and you go to a hospital.”
While staffing at The Neighbors is relatively stable, “We are always open to new applications, new people. Fortunately, we’re not in a dire crisis for staff; we are managing. But it is a crisis across the industry as a whole.”
While the work is satisfying, Flunker added, “There’s a difference between the people who do it as a job and those who do it as a profession.”
Coming full circle
Flunker was born in Menomonie and actually lived in the backyard of The Neighbors on Plum Tree Circle until she was 5 when the family moved to Eau Claire.
“It’s a little like a homecoming,” she said. “I love the area. I’m excited to be back.”
She’s looking forward to moving into the new home she closed on a couple of weeks ago and returning to her roots as a city and Dunn County resident.
After just over three months on the job, County Manager Paul Miller said Flunker is doing well. “There’s a great deal that has to be learned about any facility, but she’s jumped in with both feet on the deep end. She’s on the floor a lot, getting to know staff, residents, residents’ families, the broader community. I think the most important thing is that she’s infused the place with new energy, new focus.”
Miller said the oversight committee has been very pleased with Flunker’s work so far as well as how hard she works and how quickly she’s gotten on top of the issues: “The expertise she already possessed that she brought to the table and the efforts that she’s made to learn the facility, the people and making steps toward improvements.”