Assisted-living facility in Duluth Heights draws state’s notice for quality care
When Jeanine Ryan took a job at McCarthy Manor, an independent assisted-living facility in Duluth Heights, she imagined a very short stay.
Ryan, who had studied journalism and psychology at the University of Minnesota Duluth, had been taking classes at a Bible school in Seattle. She came back in 1991, needing a job to tide her over for a couple of months.
“Quick job, yeah,” said Ryan, now assistant administrator in her 25th year at McCarthy. “But John is the most amazing boss.”
That would be John Hansen, who with his wife, Anne, purchased the three-story brick building from St. Louis County in 1987.
The circa-1920 building, constructed as Arlington Home and originally — and briefly — used as a home for people then referred to as “wayward women,” sits amid 10 acres of farmland and meadow. It’s across Arlington Avenue from Chris Jensen Health & Rehabilitation Center, also formerly owned by the county. Together, they once formed the “county farm,” a complex designed for the poor.
The building could best be described as unassuming. It’s a word that also could be applied to its owner, whose aw-shucks manner and easy laugh mesh with his casual sweater over long-sleeved shirt and small second-floor office, its walls covered with Father’s Day cards and pictures from fishing trips.
Yet, the for-profit, 32-bed facility he directs could be said to be, if not one in a million, at least one in 215. That’s the number of such facilities that underwent “comprehensive surveys” by Minnesota Department of Health personnel in 2015, according to program manager Josh Berg. The number that received perfect, deficiency-free results: One. McCarthy Manor.
“I thought: Wow. That’s the first time I think I’ve seen that or noticed it,” said Nancy Hintsa, a social services supervisor for St. Louis County.
The state agency also took note.
“Staff specifically reached out and talked to the owner directly to commend them on and reinforce the high quality of services that they were providing,” said Scott Smith, a health department spokesman.
The state’s standards are high and uncompromising.
“They’re pretty nitpicky,” Hansen said. “They really look at things closely.”
Yet the error-free report is not so unusual for McCarthy Manor. It has been inspected three times since the state went to a more rigorous survey a decade ago, Hansen said, and has yet to be found with a deficiency.
But the latest perfect mark, formalized in a letter to Hansen from the health department’s Jeri Cummins last Jan. 27, was achieved after a particularly formidable effort.
Leaders in the staff of about 25 people had essentially spent all of 2014 reworking its policy manual to match revisions mandated by the state, Hansen said.
“We went through the new rules basically line by line,” said Jennifer Linge, a registered nurse at the facility for the past 5½ years.
“And we just worked on it, and literally we probably got done with it … Dec. 31,” Hansen said.
‘We were very ready’
It’s somewhat of an inside joke among the McCarthy Manor staff that if a fancy car pulls into the parking lot, it’s probably state inspectors, Hansen said.
On Jan. 6 of last year, with the new procedures barely in place, it was them.
“We were very ready,” Hansen said. “I didn’t have a mini-heart attack when I saw them, but it was like, oh man, talk about not having any time to relax a little bit.”
But it was OK, Ryan said.
“It was kind of a relief for them to come through, so we could see what we were doing right and what we were doing wrong,” she said. “They were very encouraging, and they were very pleased with what they had seen.”
But McCarthy Manor’s qualities can’t all be measured, said Hintsa, who has worked with aging and disability home and community-based services for 16 of her 28 years with the county.
“(Hansen) got an award for compliance,” Hintsa said. “I would give him the award for: How can we be your family and normalize your life?”
Mark Gunderson, 67, a resident for more than four years, said he has found that to be the case.
“The food’s good; the staff are nice,” the polite Walker, Minn., native said. “The administrator, John Hansen, is very approachable. You can come to his office and talk to him if you want to.”
There’s testimony to that when Hansen comes back from a vacation and the conference room adjacent to his office quickly fills with people eager to talk to him, Ryan said.
Fishing with the CEO
The word “family” frequently comes up when one talks with McCarthy Manor staff.
“A lot of the residents don’t have family, so we’re kind of their family,” Ryan said.
Added Linge: “Everyone that works here cares for the residents. It’s not just a job; it’s not just a paycheck. … It makes me feel good to come to work.”
The family feel sometimes includes fishing trips. Hansen himself has joined residents on fishing excursions, although he said increasing paperwork has prevented him from doing so in recent years.
Residents’ families notice, Hintsa said.
“Families share with us … how meaningful it was for them to know their dad went fishing,” she said.
The accommodations in the old building might pale compared to those of gleaming, newly built facilities. The facility has both single-occupancy and double-occupancy rooms, Hansen said, and no two are alike. To an outsider, they seem small.
But for many families and residents, that’s secondary, Hintsa said.
“Care, commitment, quality of service are paramount,” she said. The accommodations fall somewhere down their consumer list.”
‘Like a little farm’
The setting is another matter. In winter, the solid, old building and its surroundings look stately in new-fallen snow. In the summer, it’s surrounded by flowers, lawn and trees, a vegetable garden, a large raspberry plot and 25 apple trees that Hansen planted 25 years ago.
He leaves some apples on the trees at harvest time for the sake of deer, he said.
Gunderson said he spots deer outside McCarthy Manor every couple of weeks.
Bear and fox also are seen from time to time, and at least one marten, Hansen said. There was an unconfirmed sighting of a wolf.
“The whole feeling here for me, it’s kind of like a little farm,” Hansen said.
That’s appropriate for Hansen. He was raised in Crookston, Minn., the son of an accountant whose real love was his hobby farm. Hansen got a degree in agricultural economics and had a career as an agricultural banker in North Dakota. But he and his wife sought a move to her hometown of Duluth.
Her family had owned a few board-and-lodging places, so the listing of a county-owned boarding house for sale didn’t seem like such a reach. It was 1987, and Duluth’s economy was in the dumps.
“We were the only bidder,” Hansen said, laughing. “That’s what I heard later.”
Didn’t he have to be an optimist to invest in Duluth then?
“That or just didn’t know any better,” Hansen said. “I was only 26, so I thought: Hey, we’ll come to Duluth. It probably seems like it was a little daunting, but at that time it was exciting.”
‘Pretty run down’
But the transition from county-owned to privately owned didn’t work for the facility’s employees, who would no longer have their benefits as union members. They all quit on the day Hansen took over.
Fortunately, Hansen said, McCarthy Manor had only 10 residents at the time. He had help from his wife’s family, and it was easier to find new staff members then than now. The vacancies also gave the new owners the chance to embark on remodeling.
“(It) was pretty run down,” he said. “The roof leaked. Half the windows were broken — not half the windows, but, you know, a lot of little broken windows. No carpet. White walls.”
Now, the place is elegantly decorated with paneling, wallpaper, fresh paint, carpeting and hardwood floors. It’s filled to capacity, or nearly so. When Hansen was interviewed, it also was fully staffed — unusual at a time when some facilities are offering hiring bonuses to nurses.
But Hansen isn’t complacent about that. He did start a bonus system last summer for employees who refer someone else who is hired.
“I would say we’re really pretty stable, but we’re always looking for —” He paused. “Do you know anybody?”
‘Above and beyond’
Depending on the level of care needed, residents are housed for $2,000 to $4,000 a month, he said. That includes private-pay residents and those with waivers provided by the state.
But sometimes it’s not clear where the money will come from, Hintsa said.
“They’ve gone above and beyond with certain clients,” she said. “They’ve taken them when they weren’t sure if they had a payment source and what that source would be.”
When asked about that, Hansen confirmed it. “We’ve gotten burned a few times doing that,” he said.
But it’s usually not a problem, he said, and county personnel are good to work with when it comes to placing residents.
At 55, Hansen said he has no plans to do anything else. He likes the size and location of his assisted-living home. It’s not for everyone, he realizes, but it’s ideal for some.
“We definitely appeal to a certain type of person that doesn’t want to be downtown, likes this feeling that we have here,” Hansen said. “And not so much all the asphalt and tall buildings.”
McCarthy Manor also accepts people who aren’t easy to place, who may not have much support from family, Hintsa said.
“Sometimes, they are very challenging people that have a lot of barriers, a lot of issues,” she said. “When they accept someone, they really commit to the individual, to improving their life, their health.”
And then she added: “Having a perfect survey by the state, I think that is a big feat.”
SIDEBAR: What the state looks for
The specifics of a Minnesota Department of Health survey of what it calls home-care providers are spelled out by Minnesota statute.
The survey “shall be conducted without advance notice,” the law stipulates, and the survey team has authority to talk with residents without notice to the provider. They also can talk to residents’ family members, with the residents’ approval.
The health department’s “guide to the survey process” notes that “observations of care and services provided to clients will be made throughout the survey,” including medication administration and other tasks.
Documents such as policies and procedures, marketing materials, client records and personnel records must be produced for the surveyors to review.
Surveyors look for such things as reports of maltreatment, implementing the “home care bill of rights,” competency of unlicensed personnel and infection control.