WHO IS MAKING IT MATTER

The Generative Power of Appreciation

Shout-out from Georgianne Hewett, Vice President for Advancement

I want to share something that happened today. Michelle Munk asked me if we could post the National Teammate Appreciation Day post from social media on Touchtown. She said residents were asking about what was going on and it would help them be informed. I told her I would. I downloaded the post, formatted it for Touchtown and loaded it for all three residential communities. Here’s what happened at IL (and maybe elsewhere, too): Residents have been thanking teammates all day long. One resident came up to Jacob and said, “We appreciate the food.” Jacob asked to what food he was specifically referring. The resident said, “All the food, every day.” Residents would also stop by the You Make It Matter booth and ask about it. When I explained, they would say, “I try to let teammates know how much we appreciate them every day.” I thanked them for doing that and told them how much their words mattered to teammates. Several residents emphasized how lucky they feel to live here. They also LOVED the posters with the pictures of teammates and residents. Several asked who did them and I told them HR and Marketing. I hope you will consider leaving those up for several days.

Maintenance Teammates

Shout-outs from Residents

Mimi Boney: She was set to have guests arrive to stay at her apartment when the day before their arrival, her guest shower stopped working, and the toilet seat went “berserk.” Nancy Day arranged for the maintenance crew to come and fix her shower, and give her a brand new toilet seat all before her guests arrived.

Lydia Rivas: She had a sound in her closet for months and each time the maintenance team would come, the sound would not be there. But they agreed to have an outside company come in to take a look at her AC and they were able to find and repair the problem for good.

Pat Shumaker: Recognizes that the maintenance team is down one member and they must feel overwhelmed, but they never show that they are overwhelmed. Always smile and work to resolve the work orders placed.

Frances Symank: She had an issue with her patio and she thought it would take the maintenance team some time to come to address her work order, but she left to run an errand and when she returned, she found Nancy Day there sweeping off her porch.

Karen White, PAS

Shout-out from Brittany Washington, LVN, PAS, Clinical Supervisor at Home and Community Based Services

The first week of February was a tough one, and I would like to shine a light on Miss Karen White in the PAS Dept. She was very gracious to her Wesleyan family and helped out tremendously during the ice storm. She was able to make sure all PAS patients in the Wesleyan community were seen and did not miss any medications. We want her to know how lucky we are to have her and what a great teammate she is. She is joyous and such a gem.

The Home Health Team

Shout-out from Bethany Sisneroz, President and CEO

Congratulations to Mamie, Sarah, Brittany and the Home Health/PAS Teams on a zero-deficiency survey!

The results of this week’s survey spans 2019-present, so it was no easy feat to finish with no deficiencies cited.

The Wesleyan appreciates your attention to detail, your dedication to quality outcomes and the loving way you
work to fulfill our mission.

GREAT JOB TEAM!

Nancy and the Landscaping Crew

Shout-out from Gail Massad, Independent Living Resident

Dear Nancy — Happy Friday!!! Bob and I want to thank you for the quick response to our work order!!! The landscaping crew did a great job trimming the giant tree behind our cottage which was hanging over the walking path. They also trimmed the yaupon holly bushes which needed attention — and we enjoy looking at them from our porch. Many thanks! We appreciate you. Have a great weekend.

NUTRITION SPOTLIGHT

Skills and Creativity Shine in Pureed Meals Program

Always seeking ways to improve the lives of our residents, the dedicated dining staff at The Wesleyan Skilled Nursing recently had a chef in to train them on pureed food, so they can make our offerings more appetizing for our residents who require that preparation. We are proud to report that the chef revealed that The Wesleyan already had a program better than many he sees; however, we also had areas where we could improve.

Taking the education to heart, staff have begun applying their new skills, resulting in better appearance — and taste — in our pureed food offerings.

YOUR HEALTH & NUTRITION MATTERS

Superfood – Legumes!

Beans, beans, a magical fruit! The more you eat, the more you…enjoy them!?! I think we all know the rhyme, but here is where you will find the reason. Legumes are a family of foods that include beans, peas, lentils, soybeans and peanuts. Usually they are served up as a side dish or snack, but they have many other uses. Here are a few fun things to know about why you should have legumes in your diet.

About the Legume

• Beans are one of the oldest cultivated crops in the word, dating back at least 7,500 years.
• Legumes are all seeds that are protected by the pods (legumes).
• Legumes form the second largest family in the plant kingdom.
• There are approximately 13,000 types of Legumes.
• Most plants get nitrogen through the soil for growth. Legumes pull nitrogen out of the air and can replenish nitrogen in the soil instead of taking it.

Fun Facts

• In Asia, dried beans are ground into flour and used for baking.
• Lima beans, when being eaten by caterpillars, will release a substance that attracts wasps that will kill said caterpillars.
• The tallest bean plant is recorded at 45 feet, 3 inches tall.
• North Dakota produces 1/3 of the U.S.’ bean products.
• Ancient Greeks used to use beans to draw for the elections of local officials.

Nutritional Facts

• Legumes are extremely low in fat, and practically free of saturated fat.
• They are cholesterol free.
• They contain protein, fiber, B vitamins, iron, calcium and potassium.
• Legumes are a good substitute for meats for protein consumption.
• They can be good for dieting as they have a high fiber/low calorie balance.

OTHER PERSPECTIVES MATTER

What We Each Bring to the Table

by Jacob Butler, Director of Dining Services, IL

Food is my art, and I take it seriously. That’s why it’s sometimes hard when a resident criticizes our food offerings. For all of us in Food Service, comments or complaints can hurt sometimes, and bring you down when you really tried to do well. So how do we deal with it?

There are two things I always try to remember in this situation: Everyone has an opinion they are entitled to, and we must recognize and respect what every individual “brings to the table” in terms of their past experiences with food and how that influences their taste.

I grew up cooking with my grandmother. My Nannie was the greatest cook ever if you ask me, and she could do no wrong. I learned to love and respect food. She taught me the power that food has in bringing us together. I bring that with me whenever I am cooking; I carry the ideals that my Nannie instilled in me and draw on those when I am having a dining experience.

Many of our Food Service teammates have similar experiences and memories that influence their opinions on food. Respecting what each other brings to the table, the richness of our combined experiences makes us a successful team.

It is only natural, then, that our diners draw on their ideas and experiences when having a dining experience with us. It’s what influences how they feel and what they say about our efforts, and what THEY bring to the table.

So what does this have to do with managing comments, criticisms or complaints?

We can change our perspective by understanding our diners’ perspectives regarding food. Understand how their upbringing, cooking experience and relationship with food can have a great impact on their expectations — just like it does on ours. They are going to refer to their memories of how they, their mother or father, husband or wife would cook. They remember the smell and taste of mom’s cooking, or what it was like to cook for themselves. They will judge our food against theirs, and generally believe theirs is better…and that is okay. That is what they bring to their table.

It’s something we all do — embracing the present with the integrated memories and experiences of our past. Reducing the sting of daily “constructive criticisms” can be as simple as understanding that we all bring something to the table.

What do YOU bring to the table in YOUR position?

Here are some examples of how residents’ experiences with food have shaped their taste.

Nancy

Nancy started cooking when she was young. She joined 4H and began developing her skills as a baker. She started to excel and compete in 4H. As she aged, she never lost her love for baking.  

Karen

Karen didn’t cook much growing up. She did spend some time working in a soda shop, running the fountain and making sweet treats. She isn’t necessarily particular about food, other than the fact that she has a special diet she needs to follow. 

Louise 

Louise never really cooked much growing up. She never really had a huge interest and, when she married, relied on her husband to be the chef of the family. After he passed, she had to learn to cook for herself. She likes to research trends to better understand what it is we do.

Rosemary 

Rosemary has a long-standing belief that “food is love.” This was something that her family believed and they always made it a point to be joined together for a meal. She was raised cooking and believes that the love you put into the food will reflect in the taste.  

Katie 

Katie likes to eat and isn’t picky. She grew up with a mom who couldn’t cook and a dad who couldn’t taste. It was the worst of both worlds, and she is happy for what she gets.  

Connie 

Connie grew up cooking with mom. Her mother was a great cook who also raised her to eat everything on her plate. We will often hear Connie asking for only a little of this or that because of the waste-not mentality. She also is a firm believer in eating with your eyes first — what looks attractive should taste great. Color scheme shares just as much importance as taste in her world.  

Carolyn 

Carolyn grew up with parents who ran a grocery store. She was surrounded by food daily while helping her parents. This was both a blessing and a curse, as they would eat a lot of the items that were not selling to prevent any waste. She had the opportunity to try a lot of different food because of this. 

Pat 

Pat has been cooking since she was 10 years old. She started young and has a command of her home kitchen. She enjoys being able to have someone cook for her, but is well versed in the ways of the kitchen.

Steve 

Steve grew up a farm boy, raised on fresh food and dairy. His dad didn’t believe in mechanical milking, so Steve had to do it manually. He understands he has options and will go wherever his tastes take him that day. Most of the time he is happy with a bowl of beans and cornbread.

Kathleen 

Kathleen had to teach herself how to cook. Her mother went to work, which left her holding the pot and spoon. She will never claim to be a good cook, but does enjoy good food.

MATTERS YOU MAY HAVE MISSED

HOW I MAKE IT MATTER

Una sonrisa hace la diferencia

A Smile Makes the Difference

Maria Alvarado, Housekeeping Lead, IL-West

Maria believes her work for the residents of IL-West third floor is important to their daily lives, and she comes every day ready to give them her best! “Llegar a trabajar lista para dar a los residentes el mejor servicio,” she says. In return they give her their trust and appreciation.

For Maria, speaking English as a second language has not been a barrier to communicating with the 48 residents she serves monthly. Actions and attitude break through any language limitations in making connections. Residents are always thankful for her work, and in response, Maria projects a positive attitude: “Siempre ten una actitud positiva.”

A 25-year Georgetown resident, Maria lives with her husband and one of two children. A friend recommended working at a senior community to Maria; three years later she believes it was the right fit, saying she enjoys her work environment and appreciates the work, “aprecia el trabajo.”

When asked for any advice she would offer a new teammate to help them be successful, Maria said, “a smile makes the difference, una sonrisa hace la diferencia, always be happy, siempre se feliz!”

YOUR BENEFITS MATTER

MEDICAL BENEFITS

Q: What insurance do we have for medical benefits?

Imagine 360 and the Multiplan^® network of providers

 Q: When my doctor asks what medical insurance I have, what do I tell them?

Let them know your insurance is covered through the Multiplan^® network of Imagine 360.

 Q: My doctor has never heard of this insurance before, what do I tell them?

You can tell your doctor that it’s new to you, too! Our insurance is unique and is often referred to as a “boutique insurance plan” — sort of like your local coffee shop is compared to Starbucks or McDonald’s.

• Make sure your doctor or medical facility (urgent care, walk-in clinic) is “in-network” before you make an appointment.
• Let your doctor know that our insurance plan falls under the Multiplan^® network of providers.

 Q: How do I know if my doctor is “in-network”?

You can check the network of providers to see if your doctor is in-network.

• If you are enrolled in the Modified Essential plan:

                        – Go to Multiplan.com

                        – Select PHCS

                        – Select Specific Services

                        – Search for a provider (doctor or medical facility) near you

• If you are enrolled in the Value Advantage or Enhanced Advantage plan:

                        – Go to Multiplan.com

                        – Select Multiplan

                        – Select Practitioner & Ancillary

                        – Search for a provider (doctor or medical facility) near you

Q: How do I find a doctor that takes our insurance?

It depends on what plan you are enrolled in. Depending on the plan you selected when you enrolled in benefits, you can search a network of providers to find a doctor or medical office near you.

• If you are enrolled in the Modified Essential plan:

                        – Go to Multiplan.com

                        – Select PHCS

                        – Select Specific Services

                        – Search for a provider (doctor or medical facility) near you

• If you are enrolled in the Value Advantage or Enhanced Advantage plan:

                        – Go to Multiplan.com

                        – Select Multiplan

                        – Select Practitioner & Ancillary

                        – Search for a provider (doctor or medical facility) near you

Q: Do I need to bring my benefits ID card with me when I go to a doctor appointment?

Yes. It will make your appointment check-in go quicker, as most providers or physician offices
need to take a photocopy of your benefits ID card. If your provider or physician’s office has questions about your insurance, have them call the phone number on the back of your benefits ID card that is listed under Information for Providers:

 Q: How do I get a new medical benefits ID card if I need one?

• Go to miBenefits.imagine360.com and log into your account.
• On the dashboard page of your account, there is a place for you to Order a new ID card or View your ID card.
• If you would like to print your ID card, select View then Download.

Q: What is “Member Services”?

Member Services is a group of customer service agents who can help you answer questions about your medical benefits, insurance coverage, deductibles and billing. You can reach out to Member Services by calling 1.800.903.4360 Monday through Thursday from 7 a.m. to 9 p.m. CST and Friday from 7 a.m. to 7 p.m. CST.

 Q: When should I call Member Services?

You can call Member Services (800.903.4360) whenever you have questions about your benefit coverages, when you want to know if your doctor or provider is covered by our insurance plan, or if you have questions about any bills you receive related to your medical benefits.

 Q: What if I don’t want to go into a doctor’s office but need some medical questions answered?

• You can schedule a telemedicine or virtual visit with a doctor through United Concierge Medicine (UCM) Digital Health. This is a benefit offering that you have when you enroll in medical benefits.
• You can access this benefit by calling UCM at 844.484.7362 or visiting their website at goseesam.com.
• The first time you visit the website, you will need to create an account by clicking on the Create an Account button. It will guide you through a verification process using your email address and telephone number.

 Q: What is UCM Digital Health?

• UCM stands for United Concierge Medicine and provides full service, 24/7 access to board-certified, emergency medicine trained providers who can diagnose, treat or triage all your healthcare needs virtually by app, website or phone. This is a free service available to you when you enroll in medical benefits.
• You can access this benefit by calling UCM at 844.484.7362 or visiting their website at goseesam.com.
• The first time you visit the website, you will need to create an account by clicking on the Create an Account button. It will guide you through a verification process using your email address and telephone number.

 Q: Do I have the option to see a provider virtually? Or do I have a telemedicine benefit?

• Yes. You can visit a provider virtually through UCM Digital Health. This virtual service is a free service available to you when you enroll in medical benefits, and you have 24/7 access to use this service at no cost to you.
• You can access this virtual health service by calling UCM at 844.484.7362 or visiting their website at goseesam.com.
• The first time you visit the website, you will need to create an account by clicking on the Create an Account button. It will guide you through a verification process using your email address and telephone number.

 Q: How do I get my prescriptions filled?

• Let your doctor or pharmacist know that you have pharmacy benefits through Elixir.
• The information needed by your pharmacist to fill your prescription is located on the back of your benefit ID card, under Pharmacy Plan:

Q: What is miBenefits and do I really need to sign up for it?

miBenefits is a website portal hosted by Imagine 360 for you to access and manage your medical benefit information easily with a click of a button. Through the miBenefits portal you can create your online account, which will give you login information and a password to access all of your benefit information and claim information.

Q: What do I do when I get an Explanation of Benefits (EOB) in the mail?

• An Explanation of Benefits, or EOB, is a statement from your health plan to let you know how a claim was processed. It shows information about services received, the provider seen and the date of service. Your EOB is not a bill.
• When you receive an EOB in the mail, be sure to review all of the information and make note of the Patient Responsibility section of the EOB statement. The Patient Responsibility section will inform you of the amount you will be responsible for paying and that will be billed to you by the provider.
• When you receive a bill in the mail from your provider, you will need to review the EOB statement to ensure that the amount on your bill matches the amount in the Patient Responsibility section of the EOB.
• If the amount you are billed does not match the amount shown under the Patient Responsibility section of the EOB, then you will need to reach
  out to Member Services (800.903.4360) to have them resolve the discrepancy on your behalf.

 Q: What do I do if I get a bill in the mail from my doctor’s office?

• If you receive a bill in the mail from your doctor’s office or other provider, be sure to check your Explanation of Benefits (EOB) statement to ensure that the amount you owe your doctor or provider matches the amount in the Patient Responsibility section of the EOB.
• If the amount on the bill matches the amount on the EOB statement, you will need to pay the bill according to the terms of the bill.
• If the amount on the bill does not match the amount on the EOB statement, you will need to reach out to Member Services (800.903.4360) to have them resolve the discrepancy on your behalf.

 Q: If my doctor wants me to have lab work completed as part of my visit, what lab company should I choose?

Quest Diagnostics is the preferred lab partner of the medical benefits.

 Q: Does my benefit plan cover wellness exams or preventative appointments?

Yes! If you are enrolled in any of the medical benefit plans — Modified Essential, Value Advantage or Enhanced Advantage — you can go to a wellness check-up or wellness exam and it will be 100% covered by insurance.

DENTAL AND VISION BENEFITS

Q: What insurance do I have for dental and vision?

Insurance coverage for dental and vision benefits is through Mutual of Omaha.

 Q: Do I need a benefits ID card to go to the dentist or to an eye appointment?

• You will receive a card from Mutual of Omaha for your dental benefits. Your dental benefits ID card will look different than your medical benefits ID card.
• You do not need a card to go to the eye doctor. Just let your eye doctor know that you have vision benefits through Mutual of Omaha.
• You can view your vision benefits online at mutualofomaha.com/vision.

 Q: When my dentist asks what dental insurance I have, what do I tell them?

You can tell your dentist that your dental coverage or dental benefits are through Mutual of Omaha.

 Q: When my eye doctor asks what vision insurance I have, what do I tell them?

You can tell your eye doctor that your vision coverage or vision benefits are through Mutual of Omaha. Your vision benefits through Mutual of Omaha utilize the EyeMed network of providers.

 Q: What is EyeMed and how is it different from our vision benefits through Mutual of Omaha?

• Vision benefit coverage or insurance is through Mutual of Omaha.
• EyeMed is a partner of Mutual of Omaha and is the network of eye doctors that Mutual of Omaha’s vision benefits utilize.
• You can view your vision benefits online at mutualofomaha.com/vision.

KEY HEALTH BENEFIT TERMS AND DEFINITIONS

Providers 

The doctors or medical facilities you go to for healthcare (doctor’s offices, clinics, urgent care, labs, etc.)

Provider Network 

The list of medical facilities, providers and suppliers that the health plan or insurance carrier has contracted with to provide healthcare services

Insurance Plan or Health Plan 

A plan offered by an employer that provides health coverage to employees and their families. LeadingAge Texas Health Plan, Inc. (HPI) is the insurance plan or health plan for The Wesleyan.

TPA (Third Party Administrator) 

The group that processes all of the medical claims/bills that come through when you use your insurance. Imagine 360 is the current TPA for the health plan.

 Member Services 

A customer service group that helps employees and providers answer questions about the benefit plan and insurance coverage including how to find providers, what the benefit plan covers, and any billing questions or issues

 Deductible 

The amount you pay for covered healthcare services before the insurance plan begins to pay

 Copay 

A fixed amount you pay for a covered healthcare service, usually paid at the time you receive the service. The copay amount can vary by the type of covered healthcare service.

 In-Network 

A designated list of healthcare providers, medical facilities and suppliers (doctors, dentists, urgent care centers, etc.) with whom the health insurance provider has negotiated special rates

 Out-of-Network 

Healthcare providers, medical facilities and suppliers that are not in the health plan’s network. The cost of services provided by out-of-network providers is much higher for you. Additional deductibles and higher coinsurance will apply.

 Out-of-Pocket Maximum 

The maximum amount you and your family pay for eligible expenses or covered services each benefit plan year. Once your expenses reach the out-of-pocket maximum, the health plan pays benefits at 100% of eligible expenses for the remainder of the year. Your annual deductible is included
in your out-of-pocket maximum.

Coinsurance 

The percentage of costs of a covered healthcare service you pay after you’ve paid your deductible. For example, 80% coinsurance means the plan covers 80% of the cost of service after a deductible is met. You will be responsible for the remaining 20% of the cost.