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Former OAHCP President Tom Coble Speaks at International Conference in Shanghai

Ardmore Native Delivers Keynote Address on Long Term Care

Tom Coble, an Ardmore native and former president of the Oklahoma Association of Health Care Providers (OAHCP), visited Shanghai, China in October to speak at the 6th Annual Retirement Living World China conference. Coble is the current chairman of the American Health Care Association (AHCA) Board, which advocates for quality care and services for frail, elderly, and disabled Americans.

Coble participated in a panel discussion, Using Home Care as a Branding and Marketing Strategy for Market Development. Other panelists included Jun Sasaki, Managing Director at Yushoukai Medical Corporation, Tu Hsin Ning, President of Taiwan Home Service Strategic Alliance, and Glenn Lawless, Principal Strategy Advisor at Annecto Australia. The panel discussed how to market home care to attract potential consumers, integration of home care services to meet the requirements of different kinds of retirement communities, and optimization of home care service packages for effective branding.

Coble was also a featured keynote speaker at the conference, sharing his expertise on the role of the long term care center in population management within an aging society. He shared background on long term care in the United States and how health care financing and delivery systems are changing. Much of his presentation focused on a concept called Nursing Home Without Walls. According to a recent article in Provider magazine, Coble said, “It’s about integrating the medical model [long term care] with the social model [home- and community-based services]. What it comes down to is the care center becomes a place to serve both the residents in the center and the elderly in the community by offering services such as Meals on Wheels and wellness checks.”

Conference attendees included operators, developers, investors, technology vendors, consultants and many other professionals from around the globe – Europe, the United States, Canada, Japan, New Zealand, Australia, and more. The concept behind the event is based on the growing Chinese elderly population and the existing challenge to build and operate a successful, sustainable senior living environment for these residents. The conference brings together worldwide industry leaders each year to explore new market strategies and business growth opportunities, as well as discuss strategic actions to keep up with the industry expectations.

In addition to speaking at the conference, Coble visited four long term care communities and a rehabilitation center in Shanghai.

Coble’s passion for and expertise of long term care has made him a highly sought after speaker for events such as this. He speaks nationally to the investment community, insurance conferences, national trade associations and provider groups on important topics such as future payment models, population management and risk management. He has delivered expert testimony before committees of the U.S. Congress and the Oklahoma State Legislature. He represented AHCA at The White House Conference on Aging in 2015, which marked the 50th anniversary of Medicare and Medicaid.

A resident of Ardmore, Okla., Coble was elected to his second term as AHCA Board Chair at the 67th Annual AHCA Convention and Expo in Nashville last month. He has served on the AHCA Board of Governors since 2011 in various roles, including chairman of the AHCA Independent Owners Council and most recently as vice chair on AHCA’s Board of Governors. Coble has also served as president of the Oklahoma Association of Health Care Providers and has had several legislative appointments to health-related task forces, councils and state boards.

A version of this article originally appeared here on

KEPRO Phone Changes

Good Afternoon,

I am writing to let you know that over the last year, in compliance with our CMS contract, we have accepted forwarded calls from each state based QIO’s beneficiary appeal/quality of care (QOC) toll free number.  CMS requested that we implement this during the first year of the contract to help with the transition.


As of August 1, 2015 the calls to the state based QIOs toll free number for appeals and QOC concerns will no longer be forwarded to KEPRO.  Additionally, the toll free numbers that were in effect prior to August 1, 2014, the state based QIOs appeals/QOC concerns, will no longer work starting August 1, 2015.


Please keep in mind that this change only affects the state based QIO toll-free number that was used for beneficiary appeals, such as discharge, and Quality of Care concerns.   Some Area 3 states still work with the same state based QIO as they were awarded the QIN contract.  You need to touch base with your QIN concerning questions associated with other numbers they have in place. QIN-QIO in Oklahoma is TMF.

In order to prevent confusion and frustration I am asking for your assistance in spreading this information to your partners, members, stakeholders and anyone else that this change will affect.   With this change it is imperative all providers have KEPRO information on their forms.

KEPRO Area 3 toll-free number: 844-430-9504

If you have any questions please contact me.  You can also visit our website,, for additional information.

Nancy Jobe
Outreach Specialist
Rock Run Center
5700 Lombardo Center, Suite 100
Seven Hills, Ohio 44131
(216) 396-7537

Five Oklahoma Facilities Receive Bronze National Quality Award

Five facilities in Oklahoma are recipients of the 2015 Bronze – Commitment to Quality Award for their dedication to improving the lives of residents through quality care. The award is the first of three distinctions possible through the National Quality Award Program, presented by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL). The program honors centers across the nation that have demonstrated their commitment to improving quality care for seniors and individuals with disabilities.

Recipients from Oklahoma were:

  • Lakeland Manor, Ardmore
  • Whispering Oaks, Ardmore
  • Arbor Village Nursing and Rehabilitation Center, Sapulpa
  • Beadles Nursing Home, Alva
  • Meridian Healthcare, Comanche

"It is a great honor to have facilities in our state recognized by AHCA/NCAL with a National Quality Award," said Rebecca Moore, Executive Director of the Oklahoma Association of Health Care Providers. "Improving the lives of the residents and families we care for every day is what brings us joy. This award symbolizes the dedication and commitment our members have to the quality journey."

Implemented by AHCA/NCAL in 1996, the National Quality Award Program is centered on the core values and criteria of the Baldrige Performance Excellence Program. The program assists providers of long term and post-acute care services in achieving their performance excellence goals.

The program has three levels: Bronze, Silver, and Gold. Centers begin the quality improvement process at the Bronze level, where they develop an organizational profile with essential performance elements such as vision and mission statements and an assessment of customers’ expectations. Bronze applicants must also demonstrate their ability to implement a performance improvement system. Trained Examiners review each Bronze application to determine if the center has met the demands of the criteria. As a recipients of the Bronze - Commitment to Quality Award, all five facilities may now move forward in developing approaches and achieving performance levels that meet the criteria required for the Silver - Achievement in Quality Award.

"These facilities have demonstrated their commitment to providing quality care and I commend them for that," said the AHCA/NCAL National Quality Award Board of Overseers Chair Christine Boldt. "I encourage each and every one of them to continue their quality journey by striving for the Silver and Gold levels."

The awards are sponsored by AHCA/NCAL Associate Business Members My InnerView, by National Research Corporation and PointRight. My InnerView represents the true voice of nursing home and assisted living residents, families, and employees with the most insightful quality measurement solutions and satisfaction surveys in the healthcare continuum. PointRight is the recognized leader in data-driven analytics for health care and insurance. Oklahoma facilities were five of 545 centers to receive the Bronze level award. The award will be presented to the facility during AHCA/NCAL’s 66th Annual Convention and Exposition, October 4-7, 2015, in San Antonio, Texas.

June 2015 Legislative Wrap up from FKG

Issues Opposed by OAHCP

Many bills are filed each session that specifically targets nursing homes and how they operate. Legislation that are unfunded mandates are always issues we will oppose.

Here is a list of several of the bills filed this year that we opposed and they did not become law:

  • HB 1062 by Dustin Roberts, would require nursing homes to have an emergency power generator on site.
  • HB 1327 by Richard Morrissette, this bill was a long encompassing so called reform bill. The bill would have added many requirements onto nursing homes operators including a mandatory family counsel and a crash cart on site with medical resuscitation equipment. The bill required nursing facilities to hire a medical director and for them to be a physician. This director would have been listed on a statewide web site at the Department of Health. The bill changed the ownership requirements for nursing facility disclosure and for those ownership names to be hosted on a public web site and for disclosure to occur for any other business doing business with the facility. The bill increased nursing home staff levels. This would cost millions of dollars to staff with no funding. This bill was not heard on the House floor.
  • HB 1443 by Richard Morrissette, this bill would have expanded the Advantage Waiver program. This program which is already larger than any like program of its size in the country would be further expanded under this bill diverting crucial medical dollars away from high acuity level patients and spending that money on increases social needs of those staying in their homes.
  • SB 509, by Kim David, this bill was another nursing home generator requirement.

Managed Medicaid

Managed Medicaid has been a hot topic at the Capitol for the last two years. Last year an attempt was made to put the entire state Medicaid program under managed Medicaid. However, no provider groups were consulted when crafting this plan. Therefore, all provider groups including OAHCP opposed this effort. Because of the opposition the bill did not advance.

However, we knew the issue was not going away. Therefore, the leadership of OAHCP began meeting with the Hospital Association and with Blue Cross and Blue Shield of Oklahoma. Blue Cross had not been pushing the previous managed Medicaid effort and believed that a solution had to be a provider driven solution. Therefore, the three groups met all interim to see what common ground could be reached.

There were a few critical objectives for OAHCP. First, we knew this was an issue that many in the Legislature and Governor’s office were committed to doing. Secondly, the Medicaid budget is an unfunded mess. The growth that has occurred within that population has not been on the nursing home side. Almost all the growth has occurred because of more eligible Oklahomans enrolling in the program. This has caused OHCA’s budget to explode in recent years. We knew this was a bigger issue and we wanted to figure out how to be a part of finding a long-term solution to the budget issue.

Senator Kim David and Rep. Glenn Mulready introduced two bills on managed Medicaid. After doing their own research the Legislators determined the most politically feasible path was to limit the managed Medicaid to only the dual eligible population. Those individuals that are eligible for Medicaid and Medicare.

OAHCP also conducted research on dual eligible populations and concluded that one of the populations that were not being discussed was the Home and Community Based population. These are the individuals that stay at home and receive government assistance but also have the highest rate of going to the hospital and doctor. Nobody is managing this population so our suggestion was to include this population into the dual eligible debate.

After lots of discussion and push back HB 1566 is the bill that OAHCP supported. The bill includes the home and community based populations and also requires that the dual eligible managed Medicaid program would not include nursing homes initially. The bill states that nursing homes would be phased in a minimum of two years after implementation of the program. We estimate that this will be 2018 at the earliest.

The language leaves it to the Oklahoma Healthcare Authority to determine after two years if nursing homes will be included. If the evidence does not show savings or better outcomes there is a possibility that nursing homes would never be included. There is still a lot to learn from other states that have already done this. OHCA plans put together working groups and get input from providers and insurance companies to craft the best possible program.

Home and Community Based Programs

An area of focus for OAHCP this session was Home and Community Based Programs like Advantage Waiver. These are not required programs under federal law. Oklahoma elected to participate in this program in the early 90s. OAHCP called for a detailed review of why the program was created and whether or not it is still serving its purpose of saving money by diverting care away from costlier institutional care.

Our objective this session was for the Legislature to examine these programs and make sure they are serving their intended purpose. Our findings indicate that Oklahoma is spending more on this program than most states and that two factors are most troubling.

First, the Advantage Waiver program does not use the same assessment tool as nursing homes to determine eligibility for their program. The program is intended to keep those that otherwise would be in a nursing homes in a home care setting if they can be cared for in a cheaper more efficient manner. However, examination of Advantage shows that screening for the program is lax and it is has grown to be larger than nursing homes. More patients are taken care of in the Advantage Waiver program than is currently being cared for in nursing homes. Many of the patients are receiving services that are not considered "medically necessary."

Secondly, the program is administered at the Department of Human Services. Whereas, nursing homes are administered at the Oklahoma Health Care Authority. Those that run the program at DHS have an inherit bias to grow their program. This creates two agencies competing for scarce budgetary resources.

The concern we have raised is that when one agency is not determining eligibility for placement of the elderly then it is impossible to properly place those patients and do it in a needs based manner. Our findings show that because of these two factors DHS has grown Advantage Waiver beyond its intended purpose. The impact of this is that critical Medicaid dollars are being diverted from medical care for nursing homes, hospitals and doctors and instead Oklahoma is fully funding those elderly on the healthy end of the acuity spectrum. The elderly population would be better served if one agency were in charge of placement. Even further a third party entity ideally would determine placement so that it was done solely on a needs basis.


Once again Oklahoma faced a budget shortfall. There are many factors for this but bottom line is that dollars that are available to be appropriated by the Legislature was officially $611 million less than they had the previous year. At the same time the Medicaid agency grew by over $100 million from last year. Therefore, going into session the state had $611 million less to spend but for OHCA to provide the same services it did last session they needed in excess of $100 million in new dollars. As you can see this creates quite a budgetary program for those providers that are reliant on Medicaid dollars.

Last session nursing homes faced the same budget shortfall as this year. We were able to convince leadership that nursing home rates needed to be protected. Our rates are some of the lowest in the country and leadership agreed to hold nursing homes harmless while all other providers received a rate cut. This session that looked to be very difficult to do because of how deep the cuts at OHCA had gone.

During session Congress reauthorized the CHIP program, which meant more federal dollars where available to the Medicaid agency. This cut the shortfall at OHCA to between $60 and $70 million. Therefore, OHCA announced a round of proposed cuts that totaled $40 million. Included in this was a reduction for nursing home deductible for Medicare from 100% to 75%. These proposed cuts were dependent on OHCA receiving an appropriation from the Legislature of a little more than $20 million. This was ambitious considering most agencies were facing cuts instead of increases.

OHCA, fought hard to get as much money as possible appropriated to the Medicaid program. In the end, OHCA was appropriated $18 million in new dollars. This was the largest amount of money appropriated to any agency in the state. This was in light of the circumstances a great victory for providers. OHCA has not officially adopted their budget but our hope is that no additional cuts beyond the Medicare copay will be instituted.

News and information from the American Healthcare Association

2015 Progress Update Solid Results Yet Challenges Remain

We entered 2015 with two major reimbursement objectives. The first was to avoid being a pay-for in any temporary doc fix. The second was to achieve a clean SNF payment rule for 2016. We exceeded our expectations on the first and met the second. In addition to securing a permanent doc fix and the stability that legislation brings to the sector, we also successfully inserted therapy review language that eases the regulatory burden on our members and makes sense for patients.

On the quality front, our major objective was to seamlessly launch the next installment of the Quality Initiative. Through your collective hard work in achieving the objectives of the original Quality Initiative, we worked with CMS, set a solid expansion, and rolled out an even more impressive set of goals for the next five years. You have moved the needle so much that MedPAC and CMS officials have publicly acknowledged that care in facilities is improving. We will now take this progress to even greater heights.

There has also been good news on the assisted living front. Our long-standing goal of avoiding federal regulation is in good shape. We've redoubled our lobbying efforts and believe that the dynamics that would lead to federal regulation are not in place. We will continue to work hard to keep any consideration of top-down regulation in check. Additionally, we have successfully launched the Senior Living Executive Council (SLEC) - a panel that mirrors the Council for Post-Acute Care (CPAC) on the skilled nursing side. The SLEC provides larger companies a forum to make policy and political suggestions to the NCAL Board. The effort is off to a terrific start, with 17 companies currently participating. We also successfully launched the next phase of the Quality Initiative for assisted living, which focuses on hospital readmissions, antipsychotics, staff stability and customer satisfaction. Furthermore, LTC Trend Tracker??? was expanded to include AL data for the new Turnover and Retention Upload.

Yet, challenges remain. Any thought that the permanent doc fix meant that we were in the clear on the Hill was dashed by major trade legislation known as Trade Promotion Authority (TPA). In fact, we had no time to celebrate our wins for the year. Just one day after Congress completed work on the doc fix, congressional staff thought it would be a good idea to make us a pay-for in the trade bill. We have succeeded in squashing that effort, but episodes like that signal that we can never rest.

In this memo, I am going to first step back and discuss our biggest struggle. Then I'll walk through the remaining policy challenges for this year and next. Finally, I'll outline some options for you to help.


As an entrepreneur and former governor, I have belonged to and worked with scores of trade associations. Some may have been in the room when policy is deliberated, but most have not. I've noticed that the boards and members of almost all trade association believe that their organization is uniquely relevant and at the nexus of policy discussions. They are wrong.

The truth is that most trade associations do not have a seat at the table. It's a matter of simple math. There are 7,000 trades associations in the U.S. There are 15,000 registered lobbyists in DC alone. Roughly 10,000 of those 15,000 would tell you that they are the Speaker's best friend, but that of course is not possible. Assuming the Speaker works 250 days a year, and decides to meet with two associations each day (which realistically he cannot); it would take 14 years for the Speaker to meet with each group! It would take him 30 years to meet with each lobbyist! The reality is that I doubt there are more than 500 trade associations that are truly moving the needle in the Federal City.

So the question is: How do we make a difference? First, the Board has allowed me to bring my leadership approach to the organization. That approach is simple. I believe that for any organization to reach its optimum performance it needs to be driven by a mission and measured by metrics. The goal in our work is easy because the work you do is so important. Together the Board and our staff created the mission of "Improving Lives by Delivering Solutions for Quality Care." That statement drives our staff, drives me, and provides the context for every decision we make.

We measure ourselves by metrics as opposed to anecdotes or adjectives. While many associations strive to adjectives, we strive to specific policy or empirical objectives. It's hard to aspire to an empty superlative. But it is easy to evaluate if the goals are specific and defined. The Board sets objective goals, we hold ourselves accountable to them, and we measure everything we can along the way. In short, we are running AHCA/NCAL in the same way that you are running your business.

In this town, that is a big advantage. Most associations understand the importance of mission. Few understand the importance of metrics and the power of measurement and accountability.

We use that process to win in two areas. The first is that we have to provide policy solutions. We take solid policy alternatives to the Hill, to CMS, and to the think tanks. Frankly, Washington is starved for credible, substantive initiatives, and by providing them, we make ourselves relevant. More importantly, we create the template for policy, rather than waiting for bad policy to be thrust upon us that we then try to change.

But being right on policy is not enough. It should be, but it's not. In this town we also have to be strong politically and strong with our lobbying efforts. All 7,000 trade associations believe they are right on policy, but not all 7,000 can be heard. Only those that understand they need to marry great policy with deep political efforts truly have a chance to get to the table.

All of that means that we are essentially two enterprises: 1) a policy shop comprised of Quality, Research and Reimbursement divisions; and 2) a political and lobbying shop. Collectively, the aim is to improve lives by providing solutions for quality care and that drives everything we do.


Let's begin with the Hill. AHCA was able to remove the Medicare cut from the trade bill, but the entire episode is a preview of what we face for the remainder of the year. Some congressional staff, and probably a few members, believe that now that the doc fix is over, all provider pay-fors are available for everything else. The reasoning is that when the annual doc patch loomed, Congress would resist using health care offsets for anything other than the SGR because they knew it was impending. With that ritual out of the way, we are now fair game for everything else.

I don't want to overstate this risk, but I also don't want to understate it. It is real enough that the Senate initially paid for TPA with a quarter of one percent cut to all providers for the last half of 2024. It's serious enough that staffers are telling us we need to carefully follow the Highway Bill, the debt ceiling and budget debates. But, we were able to put together a coalition of providers, then get fortunate on the House dynamics, and the cut was pulled from the trade bill.

My belief is that we are not as vulnerable as we were when the doc fix threat existed, but we are also not in the clear. As a result, we will remain diligent. For example, we thought that after the doc fix, we might be in a position to pare back some of our outside lobbying team. We've decided against that, and so our lineup of consultants remains. In fact, we've added Kyle Simmons to our roster. Kyle was Senate Majority Leader Mitch McConnell's chief of staff for 15 years and has been a terrific addition. Further, we have decided that because the risk remains, our political activity must be just as strong, and so our schedule of events and commitments will actually increase.

Our organizational goal calls for no cuts. Despite these new risks, I believe we will succeed in achieving that goal.

With CMS we are now focused on the 2017 SNF payment rule. We learned the hard way back in 2011 that you can't wait for a bad rule to come out to respond. We now work a year in advance to give us the best chance for a clean rule. Most of that work is done by outside volunteers, and we have a retreat set for September to lay out the plan of action. I'll have more clarity by then of the likelihood of a clean 2017 rule and will report at that time. We know that CMS continues to have concerns surrounding therapy utilization and is on a path to characteristic-based payments. But it is too early to predict if the agency will use the 2017 rule to mandate those changes.

I believe our biggest challenge may not be the Hill or CMS, but instead changes taking place to post-acute payments in the market. Part A Medicare, as a percentage of payments, continues to decline. Managed care, ACOs, and "duals" projects are replacing our traditional form of payment. All these alternatives have in common a reduced length of stay and narrower networks. AHCA has devoted resources and developed educational and advocacy materials intended to mitigate the effects of these changes. In addition, we have initiated dialogues with the CMS Medicare Advantage and Medicaid Managed Care teams to address these issues, as well as many others.

My concern is that we can win every issue on the Hill and at CMS, but if we wake up one day and don't have any Part A left - replaced instead with payments that cut length of stay in half - we are in real trouble.

The Board agrees with this concern and is acting. Chairman Len Russ appointed the payment reform task force, which has now been at it for over a year. Part of its work has been a plan that would place us in charge of the Part A payment by creating a SNF episode that we would control. This plan is deep in the development stage, but not yet ready for the Hill. Significant time and money are being spent to get it ready. With respect to Part A, AHCA has now beefed up its reimbursement division to assist members and states to best position themselves as the market changes. This work has ranged from providing toolkits to members who are in managed care markets, to hosting seminars and webinars on how members themselves can take on risk.

Finally, there are opportunities. We believe this will be the year that we get the Veterans Affairs (VA) legislation passed. This will provide veterans with the option of using our members' facilities. It will also clarify myriad rules that relate to taking care of this important population. We believe that passage will increase our members' volume and more important, provide high-quality care options that our nation's heroes deserve.

We are also still pushing for relief on observations stays. It's increasingly the case that Medicare recipients leave hospitals thinking they have a rehab benefit - only to learn that they do not. Congress wants to act. The issue is the cost. We want it fixed, Congress wants it fixed, but we need the Congressional Budget Office to outline the cost. We believe a report is forthcoming and may pave the way to solve this problem.


I'm pleased to report that the organization is also having a good year. One metric we look at is membership. We are at record membership both with AHCA and NCAL.

I'm also pleased to report that we continue to exceed our goals relating to employee satisfaction. We set out this year to have our progress validated by a third party, and just last week, The Washington Post named AHCA/NCAL as one of the top employers in the greater Metro DC area. We achieved that status by competing with over 1,900 who applied and had their employees independently surveyed. We ended up as the 16th rated small employer and #1 among trade associations.


Not only are there 7,000 trade associations in town, there are many that are much larger and have more resources than we do. Our operating budget is $34 million. The American Hospital Association is over $100 million. PhRMA and the American Medical Association are over $200 million each.

But we have a much larger footprint than our $34 million because of the generous donation of millions of dollars in time that we receive from you. Through our committees and Board our outside members donate tens of thousands of hours each year to help us achieve our goals.

Here are five ways that we could use your help right now:

Embrace Quality Initiative 2.0. Go to this link and it will outline the goals of this new initiative. These are the CMS focus areas, and your continued pledge to work on them will help us meet our goals and position you for changes taking place in payments.

Participate in the Quality Awards. This link will get you started. Over 3,000 buildings have now received this Baldridge-based recognition. It will make your buildings better and can differentiate you from competitors.

Come to the Annual Convention. This year it's in San Antonio from October 4-7 and we need you there.

Get involved with your member of Congress either by coming to DC and we will set up Hill visits or by touring your member of Congress or Senator through one of your buildings. Go to this link and we will set this up for you and make it easy.

Participate in our political activity. We have an amazing lineup of high-level political events throughout the year. You are invited to them and have the unique experience of spending time with our nation's leaders, usually in a pretty small, intimate setting. Please contact Jennifer Hahs for more information.


Our success really is a journey. We are at a point where the first half of 2015 has gone well, but this is not the end. We have to finish 2015 off strong and then accelerate heading into 2016 and beyond.

I hope you feel that we have built a solid platform for you here in Washington. Our team is talented and passionate. We are thankful every day that we don't have an ordinary job. We get to spend every day looking for solutions to improve lives. Thank you for supporting and encouraging that passion.

Mark Parkinson

Oklahoman Tom Coble Elected Vice Chair of the American Health Care Association

Tom Coble (center), pictured in June of 2014, with AHCA Chairman Leonard Russ (left) and AHCA President & CEO Governor Mark Parkinson when Coble received the Joe Warner Patient Advocacy Award. The Joe Warner Patient Advocacy Award honors AHCA/NCAL members who have worked diligently to educate Members of Congress about the needs of long term care patients and residents, and who have worked to advance quality care in long term and post-acute care facilities.

Providers in the nation’s largest long term and post-acute care advocacy groups earlier in the month formally chose the leaders they hope will take them "on offense" for the next year. The Oklahoma Association of Health Care Providers (OAHCP) is pleased to announce that President of the Board Tom Coble was chosen for the position of Vice Chair of the American Health Care Association (AHCA). Delegates elected Coble at the 65th American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Annual Convention & Expo.

Tom Coble is the founder and CEO of Elmbrook Management Company, which owns and operates seven long term care and assisted living communities in southern Oklahoma. He also is the founder of HealthCare Management Company of Oklahoma. He currently serves as Chairman of the American Health Care Association Independent Owners Council and also serves as President of the Oklahoma Association of Health Care Providers. Coble has had several legislative appointments to health-related task forces, councils and state boards, including the Medicaid Reform Task Force, Governor’s Task Force on Medicaid, Medical Liability Task Force, the Oklahoma Continuum of Care Legislative Task Force, the Continuum of Care and Assisted Living Standards Council and the Oklahoma State Board of Examiners for Nursing Home Administrators.

Gaining recognition as a leading expert and spokesman in the field of long term care, Coble has delivered expert testimony before committees of the US Congress and the Oklahoma State Legislature. In addition, he is a frequent guest speaker on behalf of the provider community at different events and forums over the years. Coble’s work and dedication to the field have brought him national recognition and honors with him receiving the first ever Steve Chies Future Leader Award in 2013 and the Joe Warner Patient Advocacy Award in 2014.

A resident of Ardmore, Coble has a Bachelor of Science degree from Southeastern Oklahoma State University, Masters of Business Administration from Oklahoma City University. He is a licensed Nursing Home Administrator receiving his Nursing Home Administration Certification from the University of Oklahoma. Prior to entering the long term care industry in 1993 Tom spent over 15 years working in the oil and gas industry.

"AHCA is honored to work with this distinguished panel of leaders," said Mark Parkinson, AHCA/NCAL President and CEO, when asked about the election. "Their dedication, diversity and knowledge will be invaluable as we continue to address our unique challenges and find concrete solutions that will benefit long term and post-acute care."

According to Rebecca Moore, the Executive Director for the Oklahoma Association of Health Care Providers, Coble is a passionate provider and advocate for our vulnerable loved ones. "Tom’s mother is in a long term care facility in Oklahoma so he makes it his mission to ensure all residents get the same good care as her," Moore said. She went on to add that, "It is truly rewarding to see someone serving nationally that can help showcase the high level of care that’s provided in Oklahoma."

OAHCP Elects Executive Committee at Annual Retreat

Pictured (left to right): Scott Pilgrim, Secretary; Mark Lietzke, Treasurer; Tandie Hastings, Vice President; Tom Coble, President

The Oklahoma Association of Health Care Providers (OAHCP) named their 2015 Executive Committee. Tom Coble of Ardmore, and current American Health Care Association Vice-Chair, was selected as returning President of the Board for the coming year.

"We have a good group of officers who understand long term care. They are on the front lines every day taking care of residents and their families," stated Rebecca Moore, Executive Director of OAHCP.

The remaining members of the executive committee included Tandie Hastings, CEO Companion Health Services of Guthrie, Board Vice-President; Mark Lietzke, CEO Image Health Care of Tulsa, Treasurer; and Scott Pilgrim, President & CEO of the Diakonos Group of Tulsa, Secretary.

Members of the OAHCP executive committee are elected annually by current members of the OAHCP Board during the OAHCP Fall Retreat Meeting.

Important Information Regarding the Centers for Medicare & Medicaid Services (CMS) Quality Improvement Organization (QIO) Program changes to providers

KEPRO is the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) under contract with the Centers for Medicare & Medicaid Services (CMS) in the state of Oklahoma. Providers’ QIO contact for medicare discharge appeals and quality of care concerns is KEPRO. Please be aware that "Notice of Medicare Non-Coverage" forms and any other internal or external documents or resources that list the incumbent QIO’s information need to be updated with KEPRO’s contact information, which can be found at The fax numbers for sending medical records are also available on the website.

In order to participate in the Medicare program, certain providers are required under federal law to have a Memorandum of Agreement (MOA) with a QIO. MOAs outline the QIO’s and provider’s responsibilities during the review process. As of August 1, 2014, providers in Oklahoma need to have an MOA with KEPRO. For more information, or to download the MOA, please visit

In the event you are having difficulty contacting KEPRO’s toll-free numbers, please notify your telephone support staff. The 844 and 855 prefixes are new toll-free dialing exchanges and may not be set up in your organization’s phone system. Providers may also use the local telephone numbers when contacting KEPRO.

KEPRO’s Outreach Specialists offer educational programs and resources to inform providers and Medicare beneficiaries of the free services they offer. To request a presentation, please email

Carol's Corner: MDS 3.0 Q&A

Hello again from Carol’s Corner! We hope to get these articles to your MDS Coordinator in the nursing or administration department. Hopefully this will support their work by providing answers to sometimes confusing questions. Please help us by directing this article to that person. Also, let them know if they have any other pressing questions they can send them to the e-mail on this newsletter.


With the changes to the MDS 3.0 that came out October 1, 2014 there have been many questions concerning what dates do I populate Section A1600. Entry Date, A1900. Admission Date(Date this episode of care in this facility began), and A2400B. Start Date of Most Recent Medicare Stay. This has been a common theme question from my clients since October 1st of this year.


A1600 Entry Date

Code 1: admission/entry when one of the follow occurs:

  1. Resident has never been admitted to this facility before; OR
  2. Resident has been in this facility previously AND was discharged "Return NOT anticipated." OR
  3. Resident has been in this facility previously AND was discharged return anticipated AND the resident DID NOT return within 30 DAYS from the discharge date.

(You can see that all of these 3 items above correspond to when the resident would be determined a "new" resident according to the RAI Manual’s definitions and explanations.)

Code 2: re-entry: when all 3 of the following occurred prior to this entry or the first day of their return; the resident was:

  1. Admitted to this facility; AND
  2. Discharge "return anticipated" AND
  3. Returned to this facility within 30 days of discharge

(But by coding them with a 2 this would mean that the resident has not been gone long enough for them to be determined a new resident therefor they are "just returning" and it is a RE-ENTRY.)

A1900 Admission Date

To document the date this episode of care in this facility began.

  • Enter the date this episode of care in this facility began. Use the format: Month-Day- Year: XX-XX-XXXX. For example, October 13, 2010, would be entered as 10-13-2010.
  • The Admission Date may be the same as the Entry Date (A1600) for the entire stay (i.e., if the resident is never discharged).

(You can see that A1600 and A1900 "might" be the same date. If this resident is either a brand new resident to your facility (he/she) has never lived at your facility before or because they have been gone long enough to warrant treating them as a new admission or when they left you didn’t think they would return and completed a discharge assessment that was "Return NOT Anticipated".)

A2400B Medicare Stay: Start date of most recent Medicare Stay

Code the date of day 1 of this Medicare stay if A2400A is coded 1, yes. (A2400A asks "Has the Resident Had a Medicare-covered Stay since the Most Recent Entry?")

(So, if the resident is in your facility using their Medicare Part A benefit (Regular Medicare or Conventional Medicare NOT Medicare Advantage) This means that payment is being made for their stay in your facility by Medicare Part A then you would enter the date that this resident entered or re-entered your facility using Month, Date, and Year. I read an answer on the AANAC website once that said: "To correctly code this item, look at the Entry Date at A1600 and ask the question, "Did a Part A stay start on that date or any day thereafter? If the answer is YES, then enter the date that the Part A Stay "started".)

(For every assessment completed while your billing office is billing Medicare Part A for that resident there should be a "start date" in A2400B.)

Hope this helps your coding dilemma’s and helps your Holiday Season be more enjoyable. From my office to yours…Happy Holidays!


Carol Smith, BSN, RN, RAC-T, a member of BKD National Health Care Group, provides nurse-consulting services for skilled nursing facilities. Carol is a registered nurse with more than 35 years of experience in the senior services industry in a variety of administrative and clinical positions, including director of nursing, executive director of a CCRC, MDS coordinator, nurse consultant, administrator, staff development coordinator and Medicare nurse specialist.

Thank you for your interest in Carol’s Corner. Please let us know if you have a question or questions that you need an answer to. Submit questions to: Sean Rose, Director of Communications at CARE Oklahoma at

Anxiously Awaiting a Birthday Song, the Story of Oklahoma Almost Centenarian Ralph Russell

Ralph Russell is a man with a tune. Now a resident of the Share Convalescent Home in Alva, the 99-year-old loves a good gospel melody.

In late September, Keith Dobbs, President and CEO of the Coalition of Advocates for Responsible Eldercare, visited with Russell…and ended up singing a duet of Amazing Grace with the almost centenarian.

"He said he wanted to sing a song with me, so what do you do? You can’t turn him down," commented Dobbs on his statewide tour to meet all the hundred-plus-year-olds.

Russell is just a month away from turning 100 on November 11 and he has another tune in mind -- Happy Birthday! He said he knows his daughter-in-law Joy Russell is planning a big celebration with a chocolate cake.

"I’m gonna make it," said Russell in reference to reaching the high note of being a centenarian.

A retired lumberjack, railroad worker, farmer and an active baseball player, Russell contributes his longevity to staying active and busy. "There isn’t anything that takes the place of hard work. Keep your nose to the grindstone," is Russell’s advice to the younger generations.

His work ethic continues as his great granddaughter, Alyssa Inman, is an LPN at Share Convalescent Home, and takes care of his three days a week.

"There’s just something special about this man," shared Dobbs. "You only have to be in his presence for a few minutes and you are blessed."

Dobbs thinks it is his strong commitment to his faith and his family.

Ralph Russell (left) and Great Grandaughter and caretaker Alyssa Inman (right) speak with CARE Oklahoma. Russell, a former leader of his church choir, is celebrated his 100th birthday on November 6thand received 100 birthday cards thanks to the work of CARE Oklahoma.

"I lead music for over 60 years at my church," stated Russell. The country Morningstar Baptist Church still stands on the family property in nearby Waynoka.

"He does love to sing. He breaks into song with the least encouragement," said Russell’s son Sheldon, a noted author who lives on the family farm in rural Waynoka.

Russell has two sons with lots of grandchildren and great grandchildren. His late wife Violet and a daughter are still special memories for him as he reflects upon his life story. "Yes, Violet could fry chicken. Not everyone can fry chicken, you know," said Russell.

Rita Goodrich, administrator at Share Convalescent Home, stated that "Ralph Russell is a good man. We are honored to get to enjoy him here with us every day."

"I keep remembering a line from Amazing Grace that says how sweet the sound," commented Dobbs. "I just can’t get that sweet sound off my mind of an almost 100 year old man singing praises and sharing cheer."

Latest Press Releases

Two press releases regarding OAHCP were recently published. Click the titles below to view each press release.

September 2014 President's Message

Dear Colleague:

We are absolutely pleased that nursing homes and ICF-IIDs Medicaid rates were not cut and the decision to not reimburse therapeutic leave days was reversed. However, despite our best efforts, it is disappointing that the recommendation to cut "hospital leave" days was accepted.

We understand the need to balance budgets during times of revenue shortfall. We also appreciate that the Oklahoma Health Care Authority had little or no control over a shortfall created by a reduction in Oklahoma's FMAP and growth in the Sooner Care program. There is no silver bullet or easy choice for the Oklahoma Health Care Authority to make in balancing its budget while insuring quality and access to its programs. This is a decision that we will most assuredly be focusing our efforts on in the future.

You and our other colleagues in health care have made an impact with state leaders regarding our industry's concerns and requests. This session was, for the most part, a resounding success largely due to your efforts and we cannot thank you enough. I am deeply appreciative of your contributions of time, energy, and advocacy to such a worthy cause on behalf of our profession. Your work and efforts help us all as a profession continue to advance in many ways, but in this way, and for this effort we are especially thankful.

Be sure to "Like" our Facebook page and CARE Oklahoma's Facebook page to keep up to date on our activities and efforts.

I look forward to working with you in the future to show our state leaders how we are the solution and want to be involved in the process to make its outcomes better for the loved ones we are entrusted to take care of.

Thankfully and Respectfully,

Tom C. Coble
President of the Board
Oklahoma Association of Health Care Providers

September 2014 Executive Director's Corner

Hello Everyone:

Hope you have had a great summer and wonderful restful vacations. As summer ends and September begins we start focusing on football (GO POKES), Legislative races for November, along with Thanksgiving and then Christmas. The next few months will go by fast before you know it we will be ringing in 2015.

This fall the Legislature will conduct three Interim Studies on Nursing Facilities. You can find out particulars at the following website: We will represent our membership at these meetings. Interim studies often lead to new legislation for the coming year so we will be involved to analyze the impact on any new legislation that would affect our profession.

Some of you may have already heard that CMS has not renewed its contract with Oklahoma Foundation for Medical Quality and has awarded Oklahoma's contract to TMF Health Quality Institute – the Texas QIO. You can find more info regarding TMF at You can join the TMF- Quality Improvement Network at to get updates and valuable information to improve the quality of care for your residents. TMF will be joining us at our Fall Fair and our upcoming Owners Meeting in November. CMS's main focus on this new contract will be on re-hospitalization's.

Hope to see you at our Fall Fair in Tulsa.

Rebecca Moore
OAHCP Executive Director

CARE Oklahoma chooses COMS Interactive

Coalition of Advocates for Responsible Eldercare (CARE Oklahoma) has announced a partnership with COMS Interactive.

The two organizations signed a Gold Level Partnership agreement, which establishes COMS as a CARE Preferred Partner. CARE offers a limited number of Preferred Partnerships.

The agreement means a push for clinical management software to go into the state's facilities, including COMS Disease Management software, Daylight IQTM.

"COMS provides progressive leadership and innovation required to elevate care for the elderly and frail to the next level," commented Keith Dobbs, president and CEO of CARE Oklahoma. "They have demonstrated quality enhancements in facilities throughout the US, and we are anxious for them to provide assistance to Oklahoma care providers."

In other COMS news, Americana Corporation announced a strategic partnership Tuesday. The partnership supports an interface between Americana Corporation's AmeraCare products/services and Daylight IQ.

"Partnering with COMS is natural extension of our business model," noted Bryan Hood, principal, Americana Corporation. "The interfacing of Daylight IQTM with our AmeraCare products and services represents another example of our dedication in providing integrated solutions, and we are excited to provide this additional integration to our customers."


Working on Your Behalf with State and Federal Elected Officials!

OAHCP and CARE have been busy coordinating with state and elected officials for visits to member facilities to keep our leaders informed and educated about long term care in Oklahoma!

Several leaders in the long term care profession met with Governor Mary Fallin over lunch recently. Governor Fallin shared that she started her first job during high school at a nursing home in Tecumseh.

"Dad said you needed a job…and he got me one at a nursing home," Governor Fallin shared.

Governor Fallin worked at the facility during the summer and started back to school in the fall. Little did she know that several years later, she'd have a relationship with that same facility, Sunset Estates, as it was the caregiver facility for both her mother and grandmother.

With leaders in the long term care profession, Governor Fallin fielded questions and comments from leaders in the long-term care profession. She expressed her continued interest in the Medicaid program in Oklahoma and how that is the payer source for a great number of residents in long term care facilities.

Both of Governor Fallin's parents served as mayor for Tecumseh. During that time, her family became good friends with the late Herman Hackett, a grandfather in Oklahoma's long term care. Herman's widow, Gail Hackett, currently from Enid, attended the luncheon along with two of the Hackett's children. The Hackett family operates Greenbrier Village, a long-term care community in Enid.

Congressman James Lankford visited Guthrie Wednesday morning as he spoke with citizens during a "meet and greet" inside Golden Age Nursing Home.

Lankford, who won the Republican Party nomination in June for the U.S. Senate, primarily spoke and fielded questions on health care. He said there are going to be tougher days ahead, but said not to lose hope.

Lankford went on to say that the Affordable Care Act "Obamacare" creates new issues every month and needs to completely go away. However, he did say the system before Obamacare was not working either.

"Decisions need to be made locally," Lankford said to the gallery of an estimated 100 people.

Lankford will be challenged from Democrat Connie Johnson in November to fill the seat being vacated by Sen. Tom Coburn.

Centenarian of the Month


Vivian Haddox has several aliases and titles of endearment. To some, she's the Dumpling Queen, to others, she's either Granny or Prayer Warrior. Recently a new honor and corresponding title was conferred to her as last January, Vivian earned the title of an Oklahoma Centenarian.

On January 17, she celebrated her 100th birthday surrounded by a host of family and friends. In this instance, host is used to highlight every sense of the word, due to the fact that Vivian celebrated with her nine children, 23 grandchildren, 48 great grandchildren, and over 20 great great grandchildren.

Haddox lived alone until age 92, and for the last eight years she's lived at the Claremore Nursing Home, a member of the Oklahoma Association of Health Care Providers, where at least one family member comes to visit her every single day of the year.

"We just love her and it seems there's a gathering of us with her every evening," commented Haddox's youngest child, Treila Andrews. "Laughing, singing, playing music, telling stories."

Andrews shared that her mother, in addition to having a strong family, has a strong church family. It's so strong that the Westside Holiness Church, at the corner of Highway 88 and Lowery Road in Claremore, conducts a church service at the facility each Sunday afternoon at 2 p.m. Pastor Darrell Meadow shared that she's one of the church "originals".

Brother Meadows stated, "She's a very faithful lady. She's got the Lord in her heart."

For the last 57 years, Haddox has been, as described by some, a silent leader at the church. "If the doors were open, she was there," her daughter said.

A tumble in the hospital several years ago and a bout with dementia now has Haddox spending a great amount of her day in a wheelchair where she cares for her companion, a baby doll usually dressed in a matching dress.

"That baby has a variety of names," shared Don Haddox, her third eldest son, "Momma calls the baby by a different child's name. Whoever is on her mind that day."

Despite her failing memory, Haddox has one constant thing on her mind. Encouraging people to pray. "She says that to the other residents and employees. Pray. Pray. Have you prayed today?" Andrews continued.

Haddox sings a special nursery rhyme to her baby doll that goes something like, "I love you little. I love you big. I love you like a little pig."

Keith Dobbs, the President and CEO of the Coalition of Advocates for Responsible Eldercare, recently had the opportunity to visit with Haddox on his statewide tour of long term care facilities where he's interviewing centenarians.

"I found Mrs. Haddox to be a sweetheart. She's definitely loved by her family and the family at Claremore Nursing Home."

Visiting over 250 facilities so far, Dobbs stated that you can tell this centenarian is loved by the way the staff is spoiling her. Haddox loves watermelon and the dietary team goes out of the way to get her watermelon most every day.

"I know they special order it just for Momma in the winter time when they are out of season," her daughter stated.

Andrews said she came to visit her mother one day and she was in the kitchen helping make oatmeal cookies since that's one of her favorites.

"I'll have to stop and think of her actual name," said Nathan Raith, administrator at Claremore Nursing Home. "We've called her our Granny so long that we forget she has another name."

Dobbs shared that it's great to see the bond between residents, their family, and the caregivers at any facility but especially this facility. "She retired from cleaning houses and taking in ironing to raise her family. Now roles have reversed and she has someone taking care of her every need."

"It's been a good experience to have Momma at Claremore Nursing Home. They have been very good to her," concluded Haddox's daughter.

As Dobbs was winding up the interview with Haddox, her daughter, son, and son-in-law Gary Andrews, the 100-year-old said her signature line, "You leave my car out there."

Don Haddox chuckled that his mother has said that same thing for many years as they are leaving her…whether at her previous home or her home at the Claremore Nursing Home. While she's never had a driver's license, she always had a car and has driven all over eastern Oklahoma.

When asking her family about the backstory, Dobbs learned, "She just likes the security of knowing she has a car waiting for her outside just in case she ever needs it."

Hello from Carol's Corner with Answers to SNF Provider Questions.

I frequently have providers stop me and ask "why don't we offer a blog or question/answer forum for the skilled nursing facility providers across Oklahoma"? This has been a dream of mine for a long time to be able to provide a "quick reference" to common questions. CARE has provided this wonderful opportunity for you to send in your questions to this newsletter. They will route these questions to me and I will gather these questions and respond to the most commonly asked questions. For this first Carol's Corner I have selected frequently asked questions that end up on my desk:

Question: I am confused about the CMS memo that went out to the MAO (Medicare Advantage Organizations) concerning the need for the Admission HIPPs code being on the MAO bill that is submitted to Medicare or CMS. Does this mean I as the MDS Coordinator in the SNF need to complete an Admission Assessment even when the patient/resident does not stay in our building for 14 days?

Answer: This CMS memo was sent to all MAO, PACE organizations, Cost Plans, and certain Demonstrations on May 23, 2014. CMS is requiring that the MAO include the HIPPS code from the Admission Assessment completed by the provider to be included on the MAO bill being submitted by the MAO to CMS. This is a "separate" requirement from CMS to the Medicare Advantage Organization. The MAO should be instructing each facility that is caring for their client (MAO's client) their particular requirements. Some Medicare Advantage Organizations pay the SNF by the five-day assessment, unless this "agreement" has been changed between the MAO and the SNF provider this would remain in effect. Ask questions of the MAO specifically which assessments they require to be completed by the SNF. Remember only OBRA assessments are submitted the QIES ASAP.

Question: I have been told so many contrary things that I do not know what is correct and what is not concerning whether or not a patient/resident can use their Medicare Part A and Hospice Services at the same time in a SNF. I have actually had Hospice representatives tell me that I cannot use them at the same time. Is this true?

Answer: Let me first say that it is not true that Medicare Part A and Hospice services cannot be used at the same time in a skilled nursing facility. They can be used at the same time. Now, let us discuss this situation further. While a person/resident uses their Medicare Part A benefits in a SNF it cannot be for the terminal condition that they are using their Hospice benefit. The hospice benefit is to provide "palliative care" and manage the symptoms for this care. So let's take an example, say a patient/resident has terminal colon cancer and utilizing their hospice benefit for this condition. While they are ambulating to the dining room one day they fall and break their hip. They elect to have an ORIF completed at the hospital and return to the SNF a few days later. If they have Medicare Part A eligibility, they had their three midnight qualifying stay in acute and have days remaining in their benefit period, the physician agreed to a skilled level of care and certification that patient/resident could utilize their Medicare Part A benefit for the rehabilitation from the ORIF and still maintain their use of their Hospice benefit. This is one example of when services for Medicare Part A and hospice benefits could be used simultaneously.

Carol Smith, BSN, RN, RAC-T, a member of BKD National Health Care Group, provides nurse-consulting services for skilled nursing facilities. Carol is a registered nurse with more than 35 years of experience in the senior services industry in a variety of administrative and clinical positions, including director of nursing, executive director of a CCRC, MDS coordinator, nurse consultant, administrator, staff development coordinator and Medicare nurse specialist.

Thank you for your interest in Carol's Corner. Please let us know if you have a question or questions that you need an answer to. Submit questions to: Sean Rose, Director of Communications at CARE Oklahoma at

Put On Your Oxygen Mask First: Self-Care for Caregivers

By Kris Bryant

If you have traveled by airplane you are familiar with the safety spiel recited at the beginning of each flight, "In the event of a decompression, an oxygen mask will automatically appear in front of you. To start the flow of oxygen, pull the mask towards you. Place it firmly over your nose and mouth, secure the elastic band behind your head, and breathe normally. Although the bag does not inflate, oxygen is flowing to the mask. If you are travelling with a child or someone who requires assistance, secure your mask on first, and then assist the other person." In the long (and oftentimes turbulent) flight of caring for our parents and grandparents as older adults, we sometimes forget this important principle: Caring for ourselves allows us to continue caring for others. Here are a few ways to do this in everyday life:

  1. Manage Personal Stress. Make a list of stressors and focus on the ones you can do something about. Find ways to accept what you cannot change. Learn to say no to new responsibilities.
  2. Give Yourself a Break. It’s okay to ask for help from trusted family and friends every once in a while. Make a list of ways that others can help you or your loved one. Be clear about your needs and the importance of your request. To help you relax, find ways to soothe your five senses.
  3. Communicate with the Treatment Team. It’s important to stay in close communication with your loved one’s team of physicians, therapists, and nurses. Ask questions about how treatment is going. Share your concerns about your loved one’s diagnosis, prognosis, and general well-being. This can give you and the person you are caring for a sense of empowerment.
  4. Stay Active. Exercise promotes physical, mental, and emotional health. Taking walks with your loved one can be a great way to care for each other’s needs while strengthening your emotional bond.
  5. Listen to Your Emotions. Take a moment to pause throughout your day to check-in with your feelings. Journal your thoughts, emotions, questions, struggles, and joys throughout the day. Our emotions serve the purpose of telling us when something is wrong or out of whack in our lives.

May you "continue to breathe normally" and have the strength to care for yourself and your loved one to the utmost. Adapted from

Kris Bryant, MA, LPC

Kris Bryant is a Licensed Professional Counselor in private practice in Midtown Oklahoma City. Kris brings to his work more than seven years of experience in a community mental health setting where he learned the art and science of therapy, how to help people from all walks of life, and the value of community engagement. Kris was appointed by Governor Mary Fallin to the Oklahoma Suicide Prevention Council in 2013 and is a member of the Wellness Now Mental Health Workgroup for Oklahoma County.

Resident Profile: Centenarians Lend Comic Relief

"Vera Farmer told me a secret," shared Keith Dobbs, the president and CEO of CARE.

"I'm a 103 but don't tell anyone. It's just our little secret," smiled Farmer as she was visiting with Dobbs at her home at Sequoyah Manor in Sallisaw.

One of the caregivers at Sequoyah Manor commented that Farmer doesn't look a day over 80.

Farmer attributes her longevity to "being ornery."

Farmer's cousin and closest relative, Tommy Taylor, a life-time resident of Sallisaw, said that she once chuckled about the reason for her longevity "was because she never had kids."

Dobbs noted that several of the centenarians that's he's interviewed across Oklahoma have either never married or never had children.

"There just might be something to Vera's age us!" laughed Dobbs. He is traveling the state interviewing and photographing centenarians and was contacted by Debbie Sanders, the administrator at Sequoyah Manor about Farmer's recent birthday.

Sanders vividly recalls Farmer's birthday, which was October 21. Sanders said that she went to wish Farmer a happy 103rd birthday and found Farmer sitting at the door to her room. "It was all decorated by the staff and there were balloons on Ms. Farmer's chair."

"I said, do you know whose birthday is today?"

Farmer response, "No."

"I said, it's your 103rd birthday."

Farmer paused and said, "[Shoot] fire. How'd that happen?"

With quick wit and dry humor, Farmer doesn't miss a beat, according to Dobbs. He told her the story of interviewing a 101-year-old resident in Chandler one warm day this past summer. The centenarian asked him if he wanted to go skinning dipping with her.

Farmer said straight-faced, "Well, did you go?"

Dobbs asked her what her plans were for Christmas. She commented, "I'm not going anywhere. I like it right here."

She did confide that she'd like some new socks and a box of chocolate-covered cherries for Christmas. Stephanie Chuculate, the certified nurse aide and certified medication aide who was caring for Farmer on the morning of the interview, stated, "She likes her warm socks."

Dobbs, a native of Sallisaw and a graduate of Sallisaw High School, promised Farmer that he'd be there next October to help her celebrate her 104th birthday.

"I'll see you then. Don't be late," concluded Farmer.

If your facility is home to a centenarian or colorful resident, let us know so we can recognize them! Contact us by email or phone, 405-524-8388 ext. 117.

Facility Profile: State Senator AJ Griffin visits Golden Age Nursing Home

A visit to Golden Age Nursing Home was like returning to old stomping grounds for Oklahoma Senator AJ Griffin, R-20.

"I have been down every one of these halls," Griffin said to the group that gathered at Golden Age Nursing Home Tuesday, November 26th, to discuss Oklahoma's long-term health care system.

Once upon a time, before Griffin served in the state senate, she brought the 8th grade classes she taught to local nursing facilities each month to interact with Guthrie seniors.

Griffin sees great value in young people interacting with seniors, as she was also instrumental helping develop an inter-generational preschool at Willow Creek Health Care facility also in Guthrie.

As a friend of the Chappell family who owns Golden Age Nursing Home, Griffin says she supports these kind of family-owned care systems.

"These are friends and neighbors caring for friends and neighbors," Griffin said to the various facility owners, administrators, staff and advocates who attended the event.

Among the topics discussed was the State's budget forecast, Medicaid rates and potential effects of the Affordable Care Act in Oklahoma.

This time of discussion with Senator Griffin was very meaningful. Please let us know if you would be willing to hold a similar event with your local legislator at your facility. OAHCP and CARE can make it happen!

Who is your local legislator? Do you know?

To easily find the local legislators for you or you facility, here are a few easy steps:

  1. Go to CARE's Legislative Action Center,
  2. Click on the green "Elected Officials" Tab
  3. Enter your facilities zip code and press "GO"
  4. Enter your facilities address (if promoted) and press "GO"
  5. DONE! Your Representatives' pictures will appear. Simply click on their photos to find their bios and contact information.
  6. ALSO, while you're there, under the green "home" tab of the Legislative Action Center, click the "Join Our Network" link to sign up for important email updates on legislative issues pertaining to our profession.

Contact OAHCP or CARE for a full list of legislators with contact information, sorted by facility.

Facilities reaching excellence

In Oklahoma, 31 facilities received an overall 5-star rating for December. Congratulations all! The following OAHCP member facilities received this top rating:

  • Baptist Village of Oklahoma City
  • Boyce Manor Nursing Home
  • Glenhaven Retirement Village
  • Grace Living Center-El Reno
  • Grace Living Center-Jenks
  • Grace Living Center-Mangum
  • Gregston Nursing Home, Inc.
  • McAlester Regional Hospital, SNF
  • Memorial Nursing Center
  • Mitchell Manor Convalescent Home LLC
  • Plantation Village Nursing Center
  • Rainbow Health Care Community and Rainbow Assisted
  • South Park East
  • Southern Oaks Care Center
  • Stilwell Nursing Home, LLC
  • Stroud Health Care Center South
  • The Gardens
  • Walnut Grove Living Center

Election of New Board

New elected positions:
President: Tom Coble, Elmbrook Management
Vice President: Greg Guymon, Nowata Nursing Center
Secretary: Scott Pilgrim, Diakonos Group, LLC
Treasurer: Mark Lietzke, Image Health Care

Many of our members were honored at AHCA

Ninety Oklahoma nursing centers were honored as part of AHCA's Quality Initiative Recognition Program. This program recognizes nursing centers that meet at least one of the four AHCA Quality Initiative Goals, (1) Safely reduce hospital readmissions by 15%, (2) Increase staff stability by 15%, (3) Increase customer satisfaction to 90%, (4) Safely reduce the off-label use of antipsychotics by 15%. Sixteen of those nursing facilities were recognized for meeting two goals. The most widespread achievement in our state was the reduced antipsychotic category. Facilities receiving honors are:

Beadles Nursing Home Cedar Crest Manor Chandler Nursing Center
Choctaw Nation Nursing Home Cimarron Pointe Care Center Claremore Nursing Home, Inc
Fort Gibson Nursing Home Glennwood Healthcare, Inc Grace Living Center-Northeast O K C
Heritage Village Nursing Center, Llc Manorcare Health Services-Northwest Parkhill North Nursing Home
Quail Ridge Living Center, Inc Shawn Manor Nursing Home Southern Hills Rehabilitation Center
Wood Manor Nursing Center Ada Care Center Ambassador Manor Nursing Center
Antlers Manor, Llc Artesian Home Ballard Nursing Center
Baptist Village Of Hugo Broadway Manor Nursing Home Broken Arrow Nursing Home, Inc
Broken Bow Nursing Home Calera Manor, Llc Cedarcrest Care Center
Cherokee County Nursing Center Colonial Manor Nursing Home, Inc Colonial Park Healthcare Center
Companions Specialized Care Center Country Club Care Eastgate Village Retirement Center
Elmbrook Home Fairfax Manor Glenhaven Retirement Village
Golden Age Nursing Home Of Guthrie, Llc Grace Living Center-Clinton Grace Living Center-Edmond
Grace Living Center-Mangum Grace Living Center-Muskogee Grace Living Center-Norman
Grace Living Center-Northwest O K C Grace Living Center-Southwest O K C Grace Living Center-Tahlequah University Northwest
Grace Living Center-Wildewood Grace Living Center-Wilshire & Broadway Green Country Care Center
Greenbrier Nursing Home Gregston Nursing Home, Inc. Harrah Nursing Center
Highland Park Manor Hillcrest Healthcare Homestead Of Hugo
Jan Frances Care Center Lakeland Manor, Inc Medicalodges Dewey
Medi-Home Of Arkoma, Inc. Mitchell Manor Convalescent Home Llc Montevista Rehabilitation And Skilled Care
Mooreland Heritage Manor Nowata Nursing Center Parkland Manor Living Center
Ponca City Nursing & Rehabilitation Center Ranchwood Nursing Center Rolling Hills Care Center
Seminole Care And Rehabilitation Center Sequoyah East Nursing Center, Llc Sequoyah Pointe Living Center
Shanoan Springs Nursing And Rehabilitation Shawnee Colonial Estates Nursing Home Southern Oaks Care Center
Spiro Nursing Home, Inc. St Ann's Home Stilwell Nursing Home, Llc
Stroud Health Care Center South Talihina Manor, Llc The Cottage Extended Care
The Gardens The Lakes The Wolfe Living Center At Summit Ridge
Tuscany Village Nursing Center Village Health Care Center Wellington Hills Living & Rehabilitation Center
Westhaven Nursing Home Wewoka Healthcare Center Whispering Oaks
Willow Creek Health Care Windsor Hills Nursing Center Woodland Hills Nursing Center


OKLAHOMA CITY - It was a busy and rewarding October for Ardmore citizen, Tom Coble, the owner of Elmbrook Management Company, as he received a national award and was elected to leadership roles in both national and Oklahoma-based long term care associations.

Coble was honored with the first ever Steve Chies Future Leader Award in mid-October during the 2013 annual convention for the American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) held in Phoenix. Coble received the award as a "Future Leader" in the organization who has gone above and beyond as a member.

"It is an honor any time you receive recognition from your professional peers. As a long term care provider in Oklahoma, my central goal is to ensure that the residents in my facilities receive the best possible care and age with the utmost dignity," said Coble. "Staying active within AHCA and the long term care profession goes hand-in-hand with that mission."

"Tom has long been a leader in the long term and post-acute care field and has worked tirelessly to push quality initiatives both in our centers and on Capitol Hill," said Mark Parkinson, President and CEO of AHCA/NCAL. "His example is one that our Future Leaders can and should emulate."

Coble was selected by a committee consisting of Steve Chies, founder of the Future Leaders program, and representatives from AHCA/NCAL leadership because he is a Future Leader who has demonstrated the following over at least a three year period; involvement in AHCA/NCAL committees; consistent contributions to the organization's government relations activities; participation and leadership at the state level; active engagement in national and statewide advocacy and grassroots efforts.

During AHCA's annual convention, Coble was also elected as a member of the AHCA Board of Governors for the organization's 2013-2014 term. AHCA's Board of Governors is elected by the association's governing body, the Council of States.

In addition to Coble's appointment to AHCA's national board, the Oklahoma Association of Health Care Providers (OAHCP) elected Coble on October 16 as President of the association's Board of Directors. OAHCP is Oklahoma's statewide professional association that promotes improved long term care quality by offering continuing education to both care-givers and administrators and by advocating at the state capitol on behalf of Oklahoma's long term care profession.

"I take pride in the responsibility I've been given in serving on both AHCA's Board of Governors and chairing the OAHCP Board of Directors," said Coble.

Coble is the founder and CEO of Elmbrook Management Company (EMC), that owns and operates six skilled nursing facilities and an assisted living facility in southern Oklahoma. He also founded the Health Care Management Company of Oklahoma (HMC), which uses integrated healthcare delivery systems to administer long term care. Coble is a graduate of AHCA/NCAL's Future Leaders Class of 2008. He was recently reelected to AHCA's Board of Governors as the Independent Owner Representative.

FACILITY PROFILE: Beadles Nursing Home Celebrate Hawaiian Style

You could feel "Aloha nui loa" at the 32nd Annual Hawaiian Luau at the Beadles Nursing Home on October 2. Those are the Hawaiian words for "very much love" which was shared among tropical music, festive foods, paradise decorations, and the coronation of a new queen.

Patty Clements was crowned as the 2013 Hawaiian Luau Queen, an honored position of loyalty elected by her fellow residents. Clements will reign as queen throughout the year until the 2014 Luau. She has resided at Beadles for the past nine years.

"The Beadles Nursing Home has been doing this special event since 1980 for our residents, their families, employees, medical staff, and community friends," commented Administrator Adam Jordan, missing only one year when a multi-week sprinkler system installation was in progress during that time of the year.

Jordan, other administrative team members Barbara Hiett, Marietta Lynch, Dayna Jordan, and most front-line employees were equally as festive in tropical clothing and leis.

Many residents wore a lei during the Luau which is a wreath of flowers usually draped around the neck as a symbol of affection.

Alva Mayor Arden Chaffee was part of the big celebration.

"The Luau is a high day in Alva," shared Mayor Chaffee, "This is the best food in town."

Mayor Chaffee, physicians, other area medical providers, residents' family and community members especially appreciated the roasted pig, tropical fruit, special Polynesian-influenced rice, and coconut cake.

"This is my favorite time of year," shared one resident. "I love the festivities right here at my home."

CENTENARIAN PROFILE: Mittie Dailey's 107th Birthday

The voices of a daughter, granddaughters, friends and Mittie Dailey singing "What a friend we have in Jesus" echoed the halls of Heritage Villa Nursing Center Tuesday, October 1st, during Dailey's 107th birthday party.

"It's your birthday Gran," several guests kept reminding Dailey.

Dailey has an impressive legacy of six children, one of which is still living, 19 grandchildren, 48 great-grandchildren, 24 great-great grandchildren and three great-great-great grandchildren. However, no matter what your relationship is to Dailey, she is a grandma to all. As Heritage Villa staff and other friends came in to wish Dailey a happy birthday, everyone lovingly called her "Gran".

Dressed up with a pink jeweled plastic tiara on her head, Dailey ruled the room as queen for the day as her granddaughter Renee Paul said. Dailey is known for her quick wit and even at 107-years-old, she kept the whole room laughing during her party.

Dailey hasn't let her age stop her from much. She waited until age 65 to get her driver's license, preferring to walk until then. On her 104th birthday, Dailey's family helped her to fulfill her wish to ride a horse one more time.

Dailey was born in Boles Community Indian Territory and moved to Bartlesville with her husband, Lindsey Dailey, in 1967. Heritage Villa Nursing Center has been Dailey's home for the last seven years.

Bristow Centenarian: Once a Teacher, Always a Teacher
By Keith Dobbs

Centenarian Carolyn Foster looks at a 1961 annual from Bristow Public Schools at her home in the Rainbow Health Care Communities in Bristow. Pictured on the left is Lori Glisson, an employee of Rainbow and descendent of several of Foster's students.

Carolyn Foster loves a good classroom, and says she's living in one every day.

"I love living in the nursing home," beamed 100-year-old Carolyn Foster. As a resident of Rainbow Health Care Communities in Bristow, she has students all around her.

Carolyn says that she thoroughly enjoys the stimulus of having so many people around to visit with and share stories with. "If I lived at home, I'd be alone all day."

"We spoil each other," she continued. "I love these girls who take care of me. I listen to what's going on in their lives, and they take good care of me."

A retired high school English teacher, Carolyn loves to tell stories about her students and their success stories. While teaching at the Bristow Public Schools, she'd even take students on foreign field trips to London during their spring breaks.

"I love English and couldn't have taught anything else but English," claimed Foster.

She became a teacher while her late husband, Arthur Foster, was away serving in World War II. Carolyn thought she'd start out as a substitute teacher but ended up as a favorite teacher instead.

Many of the employees at Rainbow are descendants of Carolyn's students. "Several of my relatives had Mrs. Foster for their teacher and they loved her," shared Lori Glisson, medical records coordinator at Rainbow Health Care Communities which is part of the Oklahoma Association of Health Care Providers, the long-term professional association for Oklahoma.

The staff who care for Carolyn say they had a hard time giving her enough books when she first arrived almost four years ago. "She read nonstop," continued Glisson.

Possessing both a quick and a sly wit, when asked a question that she doesn't want to answer Carolyn says, "Honey, do you know how old I am?"

Foster's 101st birthday is in December – less than six months away. "I don't want to plan my birthday party. I just want it to grow," she said. Spoken like a true teacher!

Keith Dobbs is president and CEO of the Coalition of Advocates for Responsible Eldercare (CARE Oklahoma). He writes about centenarians who live in long-term care facilities across Oklahoma.

Mangum Centenarians Thriving at Grace Living Center
By Keith Dobbs

Peer pressure is prevalent among the centenarians at Grace Living Center-Mangum. This long-term care facility currently has three residents that are over 100 years old and several more right behind them.

The youngest centenarian, Maurine Beekley, is 102 but will turn 103 on October 24. She's feisty and religiously follows politics in the news. Other centenarians have a hard time keeping up with her as she has a valid driver's license. On her 102nd birthday, her nephew took her to the DMV to get it renewed.

Lovingly nicknamed "Taro" by eight brothers, Sarah Morrison is 102 and her birthday is September 12.

"It's all about hard work," shared Ms. Morrison. "I chopped cotton and rode a cultivator."

Ms. Morrison has been a resident at Grace Living Center for over ten years. "These people are my family and friends. I just love it here."

Yet another centenarian, Doris Ueckert is 104 and walks all over the facility. "I've got to be able to walk down to the dining room and get the fried chicken and creamed potatoes," she joked as she described that as being her favorite meal at the center. A retired housewife, Ms. Ueckert says she enjoys lots of eating and sleeping.

"These ladies set the tone for a great place," commented Trista Smith, Grace's administrator. "I look forward to them being part of my life every day when I come to work."

Grace Living Center-Mangum, where these centenarians call "home", is part of the Oklahoma Association of Health Care Providers, the professional association for long-term care in Oklahoma.

Incidentally, all three women enjoyed long, loving marriages but never had children.

Keith Dobbs is president and CEO of the Coalition of Advocates for Responsible Eldercare (CARE Oklahoma). He writes about centenarians who live in long-term care facilities across Oklahoma.

Arbor Village provides school supplies to children of employees

Jessica Henson, Breanna Henson and Sandra Kay
Jessica Henson, Breanna Henson and Sandra Kay
Jerold Hodges, Andrea Hodges, Leanna Taylor and Sandra Kay
Sapulpa High School Senior Jerold Hodges (center) with his mother Andrea Hodges and younger sister, Leanna Taylor, age 3, as he gets presented with his school supplies by Sandra Kay, administrator at Arbor Village in Sapulpa.

It's back to school at Arbor Village in Sapulpa. The long-term care and post-acute rehabilitation center, serving the Greater Tulsa Metro area, purchased and distributed school supplies for the children of their employees. At a pizza party on August 8 with residents, staff, and children, Administrator Sandra Kay distributed backpacks along with the specific school supplies needed for over 30 children.

Pictured left to right are Jessica Henson, a licensed practical nurse at Arbor Village; Sandra Kay, administrator; and Jessica's daughter Breanna, a third grader at Kellyville Public Schools. Jessica has five children, ranging from first grade to ninth grade, who received their school supplies from Arbor Village before starting school.

"It's just important to be part of the whole family for us at Arbor Village. Our employees, their children, our residents and their families, we are all one big family," commented Sandra Kay.

Arbor Village is part of the Oklahoma Association of Health Care Providers, the professional association for long-term care in Oklahoma.

Centenarian: Noble man reflects back on 102 years
By Keith Dobbs

Fred Scott
Centenarian Fred Scott with Keith Dobbs and Connie Guinn

Fred Scott is a noble man — literally and figuratively.

The 102-year-old resident of the Noble Health Center is modest about his personal and professional accomplishments. After only a few minutes in his presence, you'll know he's a prince.

With a sharp mind and an incredible memory, Fred recalls a lifetime of love, caring, and sharing. He even spells out the word "love" to make sure he's understood and the word gets the appropriate respect it deserves.

Fred loved his late wife, Lula. During the last three years of their 67 years of marriage, Fred expressed his love with continual home care for Lula in her paralyzed state.

"He'd turn her every two hours and cooked and cleaned. That house was spotless," said his youngest daughter, Carrie Black.

Simultaneously, Fred also was the caregiver for a blind aunt who lived two doors down.

When asked why, Fred's standard answer is, "That's what love does."

"If Lula and I wanted to go somewhere, I'd just pick her up and put her in the car."

Until last year, Fred was still living in his own home and tooling around town in his Oldsmobile Cutlass. Most of his driving was to church, where he taught Sunday school and served as a deacon for more than 70 years.

"I led the singing, too," Fred said.

Fred provided the transportation to church for two of his widowed neighbors until his daughter took his keys away.

"That car ran like a top. I don't know why she took the keys away," he said with a smile. "I've never been arrested."

Many of church members and choir members visit Fred daily at his home in the Noble Health Center, a part of the Oklahoma Association of Health Care Providers.

"He gets an average of three to four visits a day," his daughter said.

Fred's noble approach to life is what attracts people to him. He started working the team of horses at age 12 and continued with hard work throughout his lifetime — farming 160 acres with corn, oats, wheat and alfalfa.

Fred's mid-life career was serving as the butcher at the University of Oklahoma, a position he had for 20 years.

"Every Monday morning, we got 20 head of cattle," Fred recalled. "We had to feed the football players."

Fred said during his time as butcher, they served 5,000 meals a day at OU.

At age 65, Fred learned to water ski, got his real estate license and served as tax assessor for Marshall County, a position he had for 10 years.

"Lula was out fishing 200 days a year, so I had to keep busy. I didn't buy her a boat, or she would have fished 365 days a year. She wouldn't have come in out of the rain and cold."

An avid gardener, Fred's story has been featured in Guideposts and Virtue magazines and on television numerous times. At one time, he supplied vegetables from his garden to Legend's Restaurant in Norman.

"When you have 210 tomatoes plants, you can produce a bunch of tomatoes," he said.

Fred has enjoyed sharing his labors of love with his three children, four grandchildren and three great-grandchildren.

"I hope I've taught them how to grow l-o-v-e and how to work."

On June 30, Fred celebrated his 102nd birthday by going to church, enjoying a party with more than 200 guests, and then going to visit the sick and frail in the hospital.

Because he's lived in Franklin (which is two miles south of Hollywood), Madill, Norman and now in Noble, Fred has friends around Oklahoma who love his quick wit, charming personality and Christian faith.

As a retired businessman and active citizen, he's always able to work some advice into his conversation. One of his quotes is, "I'm in sales, not management. God's in management."

As the president and CEO of the Coalition of Advocates for Responsible Eldercare in Oklahoma, Keith Dobbs loves honoring our state's centenarians.

Centenarian: A Good Word for Seminole's Lucy Hill
By Keith Dobbs

Lucy Hill
Lucy Hill

Lucy Hill is a lady of few words. At almost 101, she's heard them all and used most of the words in the English language as she retired after 40 years of teaching both elementary and high school.

Soft spoken and writing out many of her responses in cursive, Lucy remembers getting excited about going fishing with her late husband Buck, a marriage of over 60 years.

"I cleaned them and cooked them," Lucy shared.

Moving to Seminole County in the early 1920's after being born in Texas, Lucy continues to enjoy a full life. "Even as a teacher, she was still able to work in some fishing along with some sewing and baking," recalls her son Sam.

In addition to Sam, Lucy has another son, Bill. The two have provided her with two grandchildren and two great grandchildren. One of Lucy's good memories was about having a collie named Banner. Lucy says that Denver, Colorado, is still a favorite city to visit.

"Cranberries are my favorite food," said Lucy. And she likes Christmas and the color pink.

Lucy plans to celebrate her 101st birthday on August 12 at the Seminole Care and Rehabilitation Center surrounded by her family and friends.

"We love Lucy," commented Helen Frye, the administrator at Seminole Care and Rehabilitation Center. The facility is a member of the Oklahoma Association of Health Care Providers (OAHCP) - a statewide organization working to benefit nursing home residents, their families, nursing home providers and anyone else interested in quality long-term healthcare.

As the president and CEO of the Coalition of Advocates for Responsible Eldercare in Oklahoma, Keith Dobbs loves honoring our state's centenarians.

Six Oklahoma Professionals Win National Awards

Cynthia Lester
Best Attitude: Cynthia Lester from Southbrook Healthcare in Ardmore
Robert Keeton
Rookie of the Year Award: Robert Keeton from Maple Lawn Manor in Hydro
Brenda Tallon
Professional Appearance Award: Brenda Tallon of Meridian Nursing Home in Comanche
Charlotte Cummins
Resident Family Service Award: Charlotte Cummins of Medicalodge of Dewey in Dewey
Karrie Patton
Resident Service Commitment Award: Karrie Patton of Gregston Nursing & Rehab in Marlow
Tammy Bicking
Humanitarian Award: Tammy Bicking of Gregston Nursing & Rehab in Marlow

The National Association of Health Care Assistants (NAHCA), a partner organization with the Oklahoma Association of Health Care Providers, recently honored six Oklahoma long-term care professionals during their national conference.

The six national honorees from Oklahoma are: Cynthia Lester from Southbrook Healthcare in Ardmore, Best Attitude; Robert Keeton from Maple Lawn Manor in Hydro, Rookie of the Year Award; Brenda Tallon of Meridian Nursing Home in Comanche, Professional Appearance Award; Charlotte Cummins of Medicalodge of Dewey in Dewey, Resident Family Service Award; Karrie Patton of Gregston Nursing & Rehab in Marlow, Resident Service Commitment Award; and Tammy Bicking of Gregston Nursing & Rehab in Marlow, Humanitarian Award.

"We are proud to have six of the national professionals working in our great state of Oklahoma," commented Rebecca Moore, executive director of OAHCP. "Oklahoma employees are always among the top to be recognized each year."

The 19th annual "Key to Quality" Awards Banquet was held in Oklahoma City on June 20th. NAHCA is a professional association representing caregivers and long term-care facilities in the United States. The association has over 600 member facilities and over 36,000 individual members. OAHCP works in tandem with NAHCA to benefit nursing home residents, their families, nursing home providers and anyone else interested in quality long-term healthcare.

BABY RUTH: Stroud Centenarian Continues to Share Sweetness
By Keith Dobbs

Ruth Halsted
Ruth Halsted, a 105-year-old resident at the Stroud Health Care Center, who is lovingly nicknamed Baby Ruth.

At the Stroud Health Care Center, the name Baby Ruth means much more than merely an American candy bar. Baby Ruth is the loving nickname for Ruth Halsted, a 105-year-old resident, who's sweeter than any candy bar.

Baby Ruth, sometimes called Little Ruth, earned her nickname in part for her stature. At the time of her greatest height, she was nearly five feet tall. Years later, she says, "I'm shrinking."

A professional bookkeeper from Washington D.C., Ruth retired to her hometown of Stroud with her late husband Harry. Ruth's baby sister Mariam, age 93, also lives at the Stroud Health Care Center with her husband John Horn, 96.

"Our parents gave all of us girls Bible names," shared Ruth as she spoke of sisters Mariam, Esther and Naomi. Active in the First United Methodist Church of Stroud, having faith has always been a vital part of life for Ruth. "She's always been a hard worker in the church. If we ever needed help, Little Ruth would always hold up her hand," reflects Edna Arnold, director of hospitality at First United Methodist of Stroud, who visits Ruth frequently.

"My advice, work hard and save your money," commented Ruth. She's incorporated that philosophy into everything she does including touching the lives of those around her.

"She's my inspiration," stated Shelly Frakes, a certified nursing assistant who cares for Ruth at the Stroud Health Care Center. Ruth has been a resident of the health care center for the last 13 years.

Soft spoken, Ruth tells of seeing the first car that came to Stroud. "We had horse and buggies in those days so we all went up to the road to see the first car in the area."

She also reflects on the many Fourth of July celebrations during her childhood in Stroud. "We'd make a picnic and go up to the grove."

"I loved the lemonade, watermelon and pie supper at Fourth of July," Ruth said.

For other holidays and special occasions, Ruth said she was famous for her pecan pies with hand-picked pecans split in half. For her next birthday in February 2014, Ruth wants a lemon meringue pie. "That is one of my favorites."

Ruth may appear to be reserved but she has lots of spunk. She still has plans to write a book, teach a class on commercial business, and continue her volunteer work.

The Stroud Health Care Center proudly serves residents like Ruth Halstead every day and is also a proud member of the Oklahoma Association of Health Care Providers (OAHCP) - a statewide organization working to benefit nursing home residents, their families, nursing home providers and anyone else interested in quality long-term healthcare.

As the president and CEO of the Coalition of Advocates for Responsible Eldercare in Oklahoma, Keith Dobbs loves honoring our state's centenarians.

Chandler Centenarian Celebrates Life - Every Single Day
By Keith Dobbs

Hortense Ninness
Hortense Ninness - Photo by Carrie McCuistion, Activities Director at Chandler Nursing Center

Hortense Ninness just might have invented the word "spicy." At almost 101, she sports red hair and a spit-fire personality. When I recently sat down with Hortense to talk about her life story, I mentioned the summer's day was going to be a scorching 100 degrees. With a quick wit, Hortense replied, "Let's go skinny dipping."

During Hortense's lifetime, she's seen the invention of the pressure cooker, gas stove, electricity, television, microwave, computer and cell phone. She has even added buying a computer to her bucket list before her 101 birthday on July 23.

"If I have a computer, I might be able to find me a boyfriend," she joked.

Don't put it past her either. She recently got the idea that she wanted to move home to her family homestead which is four miles southeast of Davenport, OK in Lincoln County. She said she "didn't want to live in the nursing home with all those old folks." The family homestead was claimed by her grandfather, Israel Royer, during the run of 1889. It was a home her family shared with Keo Kuk, a chief of the Sac and Fox tribe, and it's a place that holds many fond memories for Hortense.

Ever the woman to put thought to action, the idea to go home nearly landed Hortense in jail. During a recent outing with her 80-plus-year-old-son, Romeyn Ninness, Hortense decided that day's agenda was moving home to the family farm. While discussing the finer points of the idea with her son, passing motorists witnessed Hortense and Romeyn's roadside exchange and called the authorities.

Hortense told me how she explained to the police officer that she "wasn't going to have anything to do with this nonsense" and then she proceeded to get in the driver's seat of the police car to drive off. Cooler heads prevailed and convinced Hortense that best course of action that afternoon was to head back to the Chandler Nursing Center, after all. Since 2011, Hortense has lived at the center in Chandler where her enthusiasm entertains both fellow residents and facility staff.

A retired seamstress, Hortense still enjoys quilting and sewing. One of her dearest friends is her Singer sewing machine that she purchased in 1933 and used during the depression. "It had the little screwdriver in the lid of the box. I love that machine," said Hortense.

"I've made house dresses, silk dresses, and I could sew you up a suit right now," said Hortense while grinning.

Now a centenarian, Hortense does small mending projects at the Chandler Nursing Home that she describes as "torn pillow cases and buttons." Although, one of the staff members confided that Hortense is secretly working on a quilt now.

Hortense credits her longevity to "not doing the stupid stuff."

"I don't drink alcohol. I've never tasted whiskey. I just eat right and the good Lord takes care of me."

Growing up, Hortense reflects that her mama told her to eat everything from the big family garden. "We didn't have asparagus back then so I really like to eat it now."

Hortense Ninness with Keith Dobbs
Hortense Ninness with Keith Dobbs, president and CEO of the Coalition of Advocates for Responsible Eldercare in Oklahoma - Photo by Carrie McCuistion, Activities Director at Chandler Nursing Center

Hortense's father was fondly nicknamed the "Sweet Potato King" because he raised and sold sweet potatoes across Lincoln County.

"I still eat all my green beans. They give me roughage in my tummy. More roughage, the healthier you can be."

While not a big fan of sweets, Hortense does claim to be sweet on John Wayne and Art Linkletter. "I think I outlived them both." She also outlived her husband of 77 years, Clarence, and her sister-in-law Vesta Hodge Royer who passed away two weeks ago at the Chandler Nursing Center after living to over 100 years of age herself. Hortense outlived two of her children but still has two sons, Romeyn and Marathon Jack; whose names are a reflection of her creativity and flare.

Also an artist, Hortense has artwork on display at the North Slope country rock schoolhouse that she attended through the sixth grade. The country schoolhouse has since closed but the structure still stands with Hortense's rendition of an early United States president etched in stone on the south end of the building.

"I want to be just like her when I grow up," shared Sheila Greenfield, the director of nursing at Chandler Nursing Center, who is 20 years away from retirement herself.

"She is an inspiration to a lot of us," stated David Rising, owner of the Chandler Nursing Center and a board member with the Oklahoma Association of Health Care Providers and CARE, a coalition of advocates for responsible eldercare. "She just makes you want to go make a difference."

Before striking off to find her copy of the Baptist Messenger, a publication of the Baptist faith that is hosting an age longevity contest, Hortense waved and shared her parting advice, "just enjoy life."

As the president and CEO of the Coalition of Advocates for Responsible Eldercare in Oklahoma, Keith Dobbs loves honoring our state's centenarians.


OHCWC Website Lauched

The Oklahoma Health Care Workforce Center launched a new permanent Web site at The Web site will be a valuable resource to all health care providers. Oklahoma is expected to have a shortage of more than 3,000 nurses, 500 lab technicians, 400 physical therapists, 300 surgical technologists and 200 occupational therapists by 2012.

In addition, Oklahoma hospitals have the greatest need for clinical employees including the following fields: nurses, respiratory therapists, imaging technologists, pharmacists, medical and laboratory technologists, physical and occupational therapists and scrub/surgical technicians.

With these startling statistics, the primary goals of the OHCWC are:

  • Ensuring Oklahoma's education and training systems have the resources and support necessary to produce the number of health care workers needed;
  • Increasing the job satisfaction and retention rates of current health care workers;
  • Improving awareness among young people and adults available opportunities in health care, therefore, increasing the number of individuals entering a health career.

Click here to see the OHCWC Website →