The Eden Alternative is moving its headquarters from Texas to Rochester, NY. Kudos to new Eden CEO Christopher Perna. And double kudos to the Rochester Biz Journal for posting an in depth report on Eden’s move and central role in the culture change movement:
The Eden Alternative plans to move its headquarters from Texas to Rochester.
The internationally active non-profit offers an array of consulting, training and support services to adult care facilities. The Eden Alternative focuses on making nursing homes, assisted-living facilities and other adult-care facilities more home-like and less institutional.
Some 200 U.S. nursing homes, including two in Rochester, are affiliated with the non-profit. Scores more across the country and several locally have adopted its trademarked systems. The organization also has a foothold in Canada, where eight nursing homes in Saskatchewan, Nova Scotia, British Columbia and Alberta are Eden Alternative affiliates.
The headquarters relocation comes six months after former MedAmerica Inc. president Christopher Perna became Eden Alternative CEO.
A Pittsford resident, Perna accepted the post in June. He has worked out of a home office since then, dealing remotely with the organization’s headquarters staff in Wimberley, Texas, and in several other locations around the country.
The rest of the organization’s seven-person staff will continue to work in various locations. Perna plans to hire a local office manager.
The Eden Alternative was founded in the early 1990s by William Thomas M.D., an Ithaca-based geriatrician who still serves as its chairman. A globe-hopping lecturer and advocate for radical re-engineering of adult homes, Thomas has authored a half-dozen books with titles such as “What Are Old People For?” and “How Elders Will Save the World.”
Proponents see the roughly $1 million organization as a force that could revolutionize the way adult care is delivered.
Perna proposed a move of the Eden Alternative headquarters to the Rochester area to the organization’s board and won approval for the relocation in November. The official move is slated to take place early next year. He plans at that time to shift the headquarters operation from his home to leased space in Brighton.
Locally, St. John’s Home and the Rochester Presbyterian Home are certified Eden Alternative affiliates. Facilities that have trained staff in Eden Alternative methods include Unity Health System’s recently opened cottage-style skilled-nursing facility in Greece, the Kirkhaven nursing home in Rochester and the Fairport Baptist Homes.
Geriatrician Allen Power M.D. is Eden Alternative mentor at St. John’s Home. Application of Eden Alternative principles to the 475-bed skilled-nursing facility has vastly improved residents’ quality of life and made the staff happier, he said.
Eden Alternative principles stress free choice for residents and cast aides and other caregiving personnel in roles that can seem more like companions than supervisors. Turning skilled-nursing facilities from hospital-like institutions into homey residences requires a 180-degree culture shift for aides and administrators, Power said.
Since implementing the methods, St. John’s Home has seen a steep decline in its staff turnover rate, he said. Over some seven years the rate has plummeted from 30 percent to 8.5 percent.
Power credits a flattening of the organization’s management structure for the improvement. In keeping with Thomas’ Eden Alternative principles, he said, much of the day-to-day decision-making has moved to frontline personnel. Entrusted with more responsibility, aides are more satisfied with their jobs and less likely to quit.
After sending its skilled-nursing staff to St. John’s Home for Eden Alternative training, Unity moved long-term residents out of a 120-bed skilled-nursing facility attached to Unity Hospital into four new 20-bed cottages on the health system’s 162-acre Greece campus.
The new cottages feature cozy, communal living and dining areas in which staff and residents mingle. There are no central nursing stations or other institutional hallmarks. The physical layout largely conforms to a Greenhouse model, a nursing home design developed by Eden Alternative founder Thomas.
The cottages’ physical layout is important, said Sandra MacWilliam, executive vice president in charge of Unity’s Center for Aging and Continuing Care. But the culture shift Power describes is as important and perhaps more so. In the new order, residents are not, for example, herded into a dining area for meals.
“If someone is used to sleeping in, they can do that, get up at 10 and enjoy their coffee and bagel,” MacWilliam said.
In addition to being trained to accommodate residents, certified nursing aides working in the cottages not only see residents take medication but also help with housekeeping and cooking chores as might a relative caring for an elderly parent.
Despite a 15 percent boost in pay for taking on extra duties and Eden Alternative training, not all Unity aides were comfortable with their new roles, MacWilliam said. Some asked to be transferred to the system’s more traditional long-term care facilities.
And some residents’ family members have had trouble adjusting. Visitors, unsure of how to find or speak to staff members, are sometimes flummoxed to see there is no nursing station.
Still, MacWilliam sees the culture shift as an unqualified success, and residents’ attitudes have unmistakably changed for the better.
“People who used to take meals in their rooms are out and about,” she said. “They’re socializing. And we’re talking in some cases about people with serious conditions.”
State Department of Health inspectors, who so far have given the new cottages high marks, have been impressed by the facility, MacWilliam said.
While residents’ quality of life has improved exponentially, operating costs have not gone up, MacWilliam noted. Because a housekeeping staff is largely no longer needed, costs of staffing the operation have declined slightly. The drop is not enough to materially affect the facility’s budget. Still, MacWilliam sees fees Unity paid for the Eden Alternative training as a bargain.
Training programs account for the biggest share of the Eden Alternative’s revenues, Perna said. Certified training affiliates such as St. John’s Home split fees with the Eden Alternative. The non-profit also generates income from Web-based training and from a conference it holds every other year.
Perna hopes to realize a 15 percent boost in training revenues. It is a dual-purpose goal. More training would help swell the organization’s coffers and help spread the word.
Currently, Eden Alternative facilities are spread unevenly. Some states have few or none, while others have many. With 31 Eden Alternative certified nursing homes, Michigan has the highest count. Pennsylvania has 12; New York has three. Illinois, Missouri, Nevada and Delaware have none.
The Eden Alternative became a force in Michigan because the organization got state regulators on board, Perna said. Once the state backed the program, nursing home operators were quicker to adopt it.
In New York, Perna hopes to work with the Rochester-based Finger Lakes Health Systems Agency, which has the ear of state Department of Health officials. Nationally, he is cultivating contacts with for-profit and non-profit nursing home trade groups.
The headquarters move also will bring to a local fulfillment firm, Panther Graphics, the Eden Alternative’s production and mailings of pamphlets, brochures and training materials.
Power of St. John’s Home sees the Eden Alternative’s headquarters move as a boon that could boost the movement’s profile locally.
“It’s great for Rochester,” Power said. “This has always been an area where culture change has taken place. But until now, the Eden Alternative has taken a back seat. With his business background, I think Chris Perna can really move things forward.”