1. Track 4.02 Commercial Marketplace and Nursing Home Transformation – Following Consumer Demand June 15, 2007 12:15 PM 1

2. Daniel H. Wilt Vice President Information Technology Erickson Retirement Communities 2

3. Erickson, a developer and manager of campuses for middle- income people over age 62, current supports more than 19,000 residents at 18 campuses in 9 states (Maryland, Virginia, Pennsylvania, Michigan, New Jersey, Massachusetts, Texas, Colorado, Illinois). Each campus is supported by Erickson Health SM, the nation’s largest and most completely integrated wellness and health care system and has independent living apartments, assisted living and nursing home facilities with climate-controlled walkways providing access to all campus amenities including multiple restaurants, convenience markets, on-site medical center, bank branches, hair salons, barber shops and interfaith pastoral staff.

4. Erickson Health SM Integrated Wellness Care Delivery Model –Primary Care Providers –Skilled Nursing and Assisted Living –Home Health –Rehab –EMS –Care Coordination –Mental Health and Wellness Erickson Advantage SM –Medicare Advantage Demonstration Project Health Information Exchange (HIE) Participation Personal Health Records (PHR)

5. Current Skilled Nursing Product

6. Current Assisted Living Product

7. Where we’re heading to, More Assisted Living Product

8. Why More Assisted Living? Cognitive impaired – i.e. dementia continuing to increase Benefit from enhanced daily programming Increased and better screening tools to get the right resources for residents Resident needs and guardian feedback Enhanced Service offering Decreased institutional setting Opportunities for transition from IL, AL, SNF

9. Moving towards the Household Model  Program is designed for a smaller living environment supported by household staff  Household Staff includes Household Nurses and Household Associates  Household Associates provide nursing, programming, housekeeping, and dining support to the residents

10. Functional Activity Based Programming Functional Activity Based programs are individually designed to address: The needs of the resident Personal preferences Behavioral status Life long history Strengths and capabilities Cognitive challenges of each individual Functional capacity as determined by selected screening tools Individual Program Plan

11. Program Highlights Activities based on cognitive assessment 5 meal plan & 24 hour snack availability Custom Interiors Life skill activities Resident preferences: morning/ evening bath or shower, early or late riser, activities of choice

12. Life Skill Activities

13. Current Dining Experience

14. Participatory Dining Experience

16. Technology that Supports the Operations 16

17. SNF Technology Adoption Model StageLevels of EMR Adoption 9Resident Access to Personal Health Records 8Medical record fully electronic: Care Delivery Organization able to contribute to EHR as a by product of EMR. Clinical analysis of data driving resident outcomes. 7Closed loop medication administration (eMAR integrated with CPOE and pharmacy to maximize point of care safety processes) 6Clinical and Business Processes restructure for enhanced workflow and automated clinical support 5Ancillary: Electronic documentation from Rehab, Labs, X-Rays, and Clinical Reports 4Physician Documentation (Protocols, outcomes, variance and compliance alerts) 3Order Entry and Electronic Administration Entry (Medications and Treatments) Clinical Decision Support System (error checking within than order entry, i.e. drug-drug, drug-food, drug-lab conflicts) 2Clinical Documentation (vital signs, assessments, interdisciplinary notes, care plan charting, and, flow sheets), 1Point of Care Documentation (Activities of Daily Living and Care Delivery Services) 0MDS and Care Planning

18. How is technology changing the environment? Care Plans Assessments Orders: Medications and Treatments Medication Administration Records Activities of Daily Living Labs 18

19. How is technology changing the environment? Wireless Laptops Point of Care Documentation Paper reduction Universal Access to Information 19

20. Personal Health Records Resident Access to medical information: Medications, Problems, Labs, etc. Portable to any place Improved quality of information because of their ability access the information 20

21. External Integration Linking with Hospitals and Specialists Building a more complete clinical picture 21

22. Electronic Prescribing Improving communication Reducing transcription errors Reducing duplicative work for staff 22

23. Thank You 23