New superintendent leading the way at historic Arizona Pioneers' Home
PRESCOTT - Ted Ihrman took over as interim superintendent of the historic Arizona Pioneers' Home in late October 2009 with the goal of maintaining the level of high-quality health services for its residents.
Ihrman kept his pledge, and on March 28, after nearly two years of tireless efforts, Gov. Jan Brewer named him the acting superintendent for the state- operated and state-financed continuing care retirement home at 300 S. McCormick St. near downtown.
The complex, which opened its doors a century ago, provides services to qualified longtime residents who either live there independently or who require assisted living.
"In my travels, I have not encountered another facility that provides the care that this facility does," Ihrman said from his office at the home earlier this month. "There are areas we can make improvement in as far as the nursing or medical care. But, really, we're about at as high a level as can be reasonably achieved."
State statute defines the qualifications for admission into the home, which currently has 102 residents, although it can accommodate as many as 155. To qualify as a resident, an individual must have lived in Arizona for 50 years or more at the time of entry, among other criteria.
In addition to medical care, food and housekeeping/laundry services, the complex offers its residents recreation therapy and leisure activities, such as bowling, pool, crafts, bingo and dancing.
Ihrman said the Pioneers' Home remains a necessity in the 21st century because of the increasingly high cost of medical care. Although the complex's aesthetics are below average when compared to modern assisted living homes, the care and companionship residents receive from staffers outweighs most any other factor, Ihrman added.
"I hope that (the home) continues pretty much as it is into the future," Ihrman said. "It serves a purpose and definitely fills a need for longtime residents."
Some assisted living homes charge residents $4,000-$6,000 a month. At the Pioneers' Home, the state pays a share of the cost for each resident based on that person's monthly income. Clients give their income to the state, which is deposited into Arizona's General Fund. In turn, each person gets a $200-per-month spending allowance.
"As opposed to most skilled nursing facilities, which we frequently are referred to, people come here generally with the expectation that this is their last residence," Ihrman said. "A very significant portion of the people living here would be unable to afford housing anywhere else."
Pioneers and miners have different criteria for admission. For example, the home's miners can be admitted without having to move into independent living quarters. But when a pioneer arrives, that person must first go through a trial period during which he or she is completely independent, Ihrman said, before progressing through the system.
"During that trial period, they're responsible for taking care of themselves," he said. "We will assist with medication administration, if needed, and the nurses will monitor their health. But, basically, we're not going to intervene as long as they're OK."
Ihrman, a longtime nurse and Yavapai County resident, was the home's director of nursing for nearly two years before his promotion to superintendent. In his previous position, he hired nurses and nurses' assistants, handled the department's budget and medications, and kept the home in compliance with state regulations.
"I've had a pretty broad experience in various aspects of healthcare - hospital-based, behavioral health, assisted living and skilled nursing, as well as correctional in-home health," Ihrman said.
Now, Ihrman is in charge of the whole complex, with his main focus being the budget. He oversees the home's eight departments, including a 98-person staff, and fills in for department heads when necessary.
In these times of tight budgets, Ihrman said one of his top priorities is keeping the home's finances in order without impeding on quality of care.
Director of Nursing Barbara Jimenez said the three-floor complex has 60 staffers in its nursing department, including 30 licensed and registered nurses working in four separate units on three different shifts.
They are responsible for the health and welfare of all residents, administering medications and documenting the progression of clients' medical care, among other duties.
Veteran nurse Jeanne Lopez said the home has one aide per five to eight clients and two nurses per 25 residents to ensure improved safety and continuity of care. Jimenez added that it's important to have a big staff because of the home's large-capacity rooms.
"That way, we can provide the care and the supervision that they need," Jimenez said.
In addition, the home operates two medical transportation buses that take clients to and from doctor's appointments Mondays through Fridays. Physical therapy is also available at the complex, although some patients venture into the city for that service as well as hospice care.
Sixty percent of the home's staff is involved in direct nursing care, Ihrman said. Most of the complex's clients generally have some kind of cardiac condition, such as hypertension or chronic obstructive pulmonary disease, he added, and the nurses monitor those individuals.
Dr. David Duncan, the home's medical director, serves as a Medicare provider. He visits the home on Mondays, while nurse practitioner Terry Barns drops by on Thursdays.
"The choice is left to the residents as to who they want to have as their medical provider, but most of them choose Dr. Duncan," Ihrman said. "It's handy for the residents, who we don't have to transport to outside medical appointments as much."