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Pushing for innovation amid heavy regulation

Donna Grosstephan, director of nursing at the Highlands at Brighton, believed it was the start of a new era when Cindi Barry took the job of administrator there in 2005.

  "If there were any doubts, she made it clear the day she took a sledgehammer to a wall in the facility’s lobby because it was dingy," Grosstephan wrote in a letter of support.

  Barry said she wanted an "open air" look, and Grosstephan says she knew they were in for some changes.

  Barry did more than renovate the 145-bed skilled nursing facility. She has more than doubled the number of new admissions in five years at the Highlands at Brighton, an affiliate of the University of Rochester Medical Center, and created a model of transitional care that includes the development of discharge plans for all residents.

  "Barry’s creativity, intelligence, dedication and drive have had a profound impact on the Highlands at Brighton and, subsequently, on health care in the Rochester community-particularly for its senior population," wrote Bradford Berk M.D., vice president for health sciences and URMC CEO, in his nomination form.

  Barry, who has worked in the field of nursing home administration for more than 20 years, says the most rewarding part of her job has been the opportunity to see her vision for the facility become a reality.

  "When I first toured the Highlands at Brighton in 2005, I was impressed with the potential for growth in the variety and types of services provided and the impact we could have on the Rochester community," Barry says. "I have been fortunate to have assembled an impressive team of professionals, and together we have pushed the limits and changed the perception of what can be accomplished in a nursing home setting."

  She says the facility’s transitional care model, which has been developed and fine-tuned over the last five years, has allowed a majority of those admitted to return to the community and to great independence. 

  "From my perspective, we are the model of the future in post-acute and skilled nursing services," she says.

  Barry’s greatest challenge has been the regulatory environment and inadequate reimbursement from third-party payers for the complex care that the Highlands at Brighton provides.

  "As we continue to evolve and seek to find innovative ways to assist individuals transitioning from an acute hospitalization back home or to a more independent level of care, the onerous regulations often impede our progress," Barry says. "The layers of regulation originally designed for traditional nursing homes restrict our ability to try new, innovative strategies."

  Additionally, the complex care the Highlands at Brighton provides to some 500 people each year often is not recognized in the reimbursement methodology for Medicaid and managed-care insurers, she says. Although the facility has developed the skills and processes to provide for a wide array of care needs, it must sometimes turn away an individual because of the cost of providing services.

  The facility is tackling the challenges by building relationships with regulatory agencies and advocating with insurers, regulators and industry associations.

  Steven Goldstein, URMC vice president and president and CEO of Strong Memorial Hospital and Highland Hospital, wrote in a letter of support that Barry has positioned the Highlands at Brighton for continued success.

  "When the landscape has changed and health care delivery looks entirely different than it does today, thanks to Cindi’s leadership, the Highlands will remain relevant, valid and valuable for its ability to change and contribute to the needs of the community," Goldstein wrote.              

3/18/11 (c) 2011 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or e-mail [email protected].

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