At the Greater Fayetteville Business Journal's Power Breakfast last month, the Fayetteville VA Medical Center Executive Director Dan Dücker touted the new Community Living Center “cottages” as the VA's contribution to the local long-term care demands. 

Dücker said a 2019 study projected a 70 percent growth in the region's demand for long-term care resources by 2029.
“VA has positioned itself to get out in front of the demand,” says Dücker. “We have a game plan to continue to grow on our campus here at Fayetteville.” 

The Community Living Center, located on the medical center campus at 2300 Ramsey Street, is currently under construction. Two cottages are open and occupied, with two more in the design phase. A proposed multi-story memory unit would complete the center. 

The VA also offers long-term care support for veterans via eight separate contracts with community facilities to allow patients to receive care if space isn't available at the VA. It's also looking at leasing property on the coast as another option, says Dr. Vijay Kumar Gorintala Subbanna, chief of geriatrics and long-term care.
Each cottage can house 12 veterans with a private room. The units were designed to have a more home-like feel, featuring less institution-style furnishings. The two open cottages are currently serving 23 patients. The memory unit building will serve 15 to 20 patients.
A HOLISTIC APPROACH

The CLC provides a skilled environment for veterans needing short-term and long-term care. Eligible veterans are those who need assistance with day-to-day living tasks or are nearing the end of their life.
SERVICES INCLUDE:
•24-hour skilled nursing care
•Restorative care
•Access to social work services
•Geriatric evaluation and management
•Respite Care
•Palliative Care and Hospice Care for end of life
Subbanna says the eligibility screening policy assesses patients on a case-by-case basis, considering their medical needs and circumstances. Spencer Dickens Jr., chief nurse for the CLC and geriatrics extended care, says a team of providers determines who is eligible for the cottages, and family input is welcomed as well.
The CLC, designed by Toland Mizell Molnar and built by Brigade Contractors and Harbor Services, sits on 5.5 acres and costs $18 million. The project began in 2016 and its completion is expected by 2027.
Dücker says completion of the third cottage is scheduled for the next year to 18 months.

STAFFING 

Between the heavy toll from COVID infections to the nationwide nursing shortage, long-term care facilities struggle to provide skilled short and long-term care for the elderly. The Fayetteville VA has managed to avoid this national trend, with a healthy staffing ratio and no COVID-related deaths at the CLC to date, according to Dickens.

The CLC cottages allowed veterans to be moved out of the VA hospital's third and fourth floors, away from patients with COVID, and into  their own facility.
“We think the cottages are much safer in this pandemic environment because we can isolate them from all the folks who might be sick,” says
Dücker. “We can control access to this space much easier.”
When visitations were closed due to widespread community infection, the cottage's one-level structure with wide windows in each room allowed families to visit safely. The VA also offered tablets for video chats. In-person visits are currently permitted.
“The pandemic has had an impact on veterans and their families, but we keep safety at the forefront,” says Dickens. “Our approach to providing the care for our veterans, providing service to those who've served, is a holistic approach to care for the mind, the body, and the spirit.”