click the image to view excerpts from
   an interview with Robyn Stone (2:16)"COLLAGE actually embraces all of the principles of quality first that AAHSA has put out there over the past five years. It focuses on an evidence-base, collecting good information, using good data to make better decisions, and gathering data and sharing data across organizations so that people really understand where they are improving and where they still need to do the work. There is no way to get to quality without engaging in the kind of work that COLLAGE allows organizations to do."

Robyn Stone, Executive Director, Institute for the Future of Aging Services (IFAS) and Senior Vice President of Research, AAHSA, Washington, DC

   click the image to view excerpts from
   an interview with Tom Slemmer (3:00)"We think this tool is very special in terms of its ability to get at unmet needs, to assess them in a way that people can understand and really help them to live more successful....We really think that COLLAGE is going to be an instrument that allows us to provide that linkage between health care and housing in a way that really makes a big difference in seniors lives....We’re looking at not just affordable senior housing, we’re looking at using this in church settings, we’re actually talking to a suburban city government about the possibility of using it with some of their home-bound seniors, we’re talking to housing authorities about possibly using it. What we think is that having low income seniors in affordable senior housing stay there is a really big deal for the government in terms of cost and it’s a really big deal for the residents. They all want to stay in their own home and we think COLLAGE is going to give us the tools to help them stay in housing, get their unmet needs met. There are some incredible stories coming out of our experience of using COLLAGE ..."

Tom Slemmer, President and CEO, National Church Residences, Columbus, OH

"Data from the COLLAGE assessments validates the trends I'm seeing as we interview our residents. The data will serve as concrete evidence to show my administrator and team the need for a redistribution of resources and staffing. I'm excited to be able to develop targeted programs and resources that will best meet the needs that we've uncovered....My hat is off to you. COLLAGE is an incredible product with a dedicated team of professionals supporting it."

Kathryn Kelly, Wellness Coach, Orchard Cove, Canton, MA

"What we found with COLLAGE, and I think we're just beginning as the uptake is increasing within our organization, is in the area of the efficiencies that it creates. It has standardized a very critical function for us that is the assessment, the data gathering, and the ability to turn that into good decisions. We've gone from an organization that just in our home care agency had 18 different assessment tools that we were using to now one....I think organizations like ours really can suffer from their own past successes and kind of read our own press releases and think we’re doing great. When in reality, we’ve got a long way to go. Our ability to really capture data and use that data instead of just good opinion to make great decisions and implement those decisions is something that COLLAGE has really helped us to move to and we begin to see that then in the outcomes that we get....I think one of the intangible elements that COLLAGE has brought to our organization is the transforming of the individual clinicians – the nurses, the social workers, dieticians, the folks that are using this tool – you can almost see moments of light bulbs going off. They're able to really kind of dialogue now with folks instead of just making decisions for people.They become new effective professionals and it’s exciting."

David Gehm, President and CEO, Lutheran Homes of Michigan, Saginaw, MI

"COLLAGE gives us a data-driven capability to look at the things that we’ve been doing for a long period of time and hone in on what we’re doing well, what might need to be adjusted that we could be doing a little better, and help us prioritize. We can look at 20 different things that someone 80 years old can be doing to enhance their life. The COLLAGE data helps us to look at things from the standpoint of what are our highest priorities?...People at 80 years old have some type of chronic ailment. Our ability to manage that chronic ailment in a manner that maintains their independence requires us to dig deep, requires us to measure, requires us to set benchmarks, requires us to determine the ability for us to afford that in the long run. So, those are things that the actuarial piece gave us in support of the activities that we’ve been doing with COLLAGE in our intervention and wellness programs."

Gary Mohn, President and CEO, Alexian Village of Milwaukee, WI

"The thing about programs like COLLAGE, it’s built on continuous quality improvement and management principles which we’ve known now for two generations work. So, if I’m a consumer and I have some idea of what I might expect out of quality of life, then I can judge those people who’ve helped me acquire that. If I’m an organization and I want to improve, then I can take that data and say, 'We’re doing pretty well here, but we’ve got a lot of work to do in this particular domain.'...What we’re looking for in our field, especially in the emerging settings like housing venues, is how do you define quality of life and how do you define quality of the service which means a healthy living culture and a continuous quality improvement management culture. That’s what we’re trying to achieve. A project like COLLAGE integrates those things."

Larry Minnix, President & CEO, American Association of Homes and Services for the Aging (AAHSA), Washington, DC

"...the COLLAGE reports contained key information in a visual format allowing us to easily identify the profile of our residents across our continuum of care... We now have access to information about our residents’ health risks, and tapping into this offers us a treasure chest of data to guide decision making about the kinds of programs and services we ought to be developing. We are ecstatic about what the new reports will help us achieve."

Denise Dickinsen, Vice President of Planned Growth and Development, Lutheran Homes of South Carolina, Irmo, SC

"What we’ve identified through COLLAGE is that historically there has been many residents who have still fallen through the cracks. We're now able, with COLLAGE, to more reliably identify where their needs are and have helped residents' identify a host of new services. To prevent re-hospitalizations, prevent people from having to move from their home into a skilled nursing facility or other health care setting has been a real success story for us."

Kathy Locke, Vice President of Clinical Services, National Church Residences, Columbus, OH

"It has been rewarding for me to see the renewed interest that residents are having in owning their individual health and wellness as a direct result of participating in COLLAGE. It's also been especially gratifying to see residents realize their own goals in areas they may not have focused on otherwise."

Melissa Markey, Wellness Coach, Westminster Canterbury Richmond, Richmond, VA

"COLLAGE is really one of the very first endeavors of assessment that has had positive buy-in by every resident that we use COLLAGE with. They love the conversation, they don’t feel like they’re being interviewed, they don’t feel like we’re digging into private matters that we maybe should have no intention of digging into, they feel connected to us as a staff and they trust us with the information that they’ve shared with us."

Lynn Zuellig, Vice President, Home and Community-based Services, Lutheran Homes of Michigan, Saginaw, MI

"I am very excited about COLLAGE and am able to see immediate responses of residents working on their goals. The word is spreading and residents are asking to participate. Yeah!!!!"

Melissa Batten, Wellness Nurse, Carroll Lutheran Village, Westminster, MD

"This past week I did two COLLAGE assessments with individuals who were hesitant to have them (one refused three years in a row) and after we were done they both left feeling very positive about it. The first resident said he felt as if I was the only person who spent the time to let him express himself and really get to know what he needs. The second resident I assessed shared that she had been dreading the assessment interview. However, when we concluded she reported she felt so good about our conversation that she felt positive the whole day. Makes me happy to be able to help someone who has had some challenges with depression. Sometimes it's just letting them know you are listening and here to help -- it can change a person's whole outlook. I am so glad we have COLLAGE!"

Terri Lanham, Resident Care Nurse, Kendal Northern Ohio, Oberlin, OH

"Our quest led us to an exciting new approach called COLLAGE…it represents a soft, gentle approach that allows the elder to explore his/her own issues in life, identifying for us and with us those areas where support and programs might be of benefit. It allows us, ultimately, to work with the individual to create an aging experience customized to who they are. Ultimately, it will be a tool by which further transformation occurs."

David Gehm, CEO, Lutheran Homes of Michigan, Saginaw, MI

"Our acute care statistics speak for themselves: since utilizing COLLAGE, hospitalizations dropped from 173 in 2004 to 137 in 2006; pain as a reason for hospital admission dropped from 11 in 2004 to 4 in 2006. This is very significant."

Karri Sears, Director of Wellness, Alexian Village of Milwaukee, WI

"The most important thing that COLLAGE has brought to the community is solid hard core clinical data for decision making. In the past it’s been hit and miss, someone’s opinion, our decisions were too subjective and not based on good data."

Steve Cutshaw, Administrator, C.C. Young, Dallas, TX

"My staff has been offering Community Based Services in our independent setting for years. I think they know as much as any staff could about meeting their needs. When they started using the COLLAGE assessment, it opened up a whole new way to organize their information for decision making. It gave them new tools to discuss issues with departments, family, and administration. I heard “wow” many times as they looked at new report possibilities to serve our residents through the continuum. I would urge you to take a look at what COLLAGE can do for those you serve. As my staff prepares for re-accreditation under CARF, we have a whole new resource to measure our impact with those we serve in independent living and in the community."

Barbara Thomas, CEO, Kendal Northern Ohio, Oberlin, OH

"One thing that’s come out of the COLLAGE assessments is the need for a vision support group and so I will be starting that in the next two months. There are a lot of people who are losing different parts of their visions and therefore not driving and having a lot of issues."

Bridget Day, Social Service Coordinator, Deerfield Episcopal Retirement Community, Asheville, NC

"We are vested in helping our residents live as full a life as possible no matter what their situation is, whether that’s assisted living, nursing or residential. We don’t want to look at deficiencies we want to be able to look at how we can maximize where they are so they can have the fullest life possible. COLLAGE will help us do this."

Ben Burks, Vice President of Life Enrichment, Virginia Mennonite Retirement Community, Harrisonville, VA

"When I get the residents to talk about how they do their daily activities I can often hone in on those residents that can only speak in generalizations. It helps me then understand their executive functions, i.e., their decision making capability, etc., and whether they even understand the question I’m asking. Now that I have this information in hard data through the COLLAGE assessment, our level of care decisions are based on concrete data."

Betty Mininger, Nurse Consultant, Dockwoods Community, Lansdale, PA

"The COLLAGE tool has really been a help to not only me but a lot of the other departments I’m working with. I’m finding a larger scope of people that could use a lot more assistance in their daily activities."

Christine Felcyn Resident Services Coordinator, Beatitudes Campus, Phoenix, AZ

"We joined COLLAGE because we were looking for a way to be able to really measure and give good scientific numbers to what we believe we already knew in theory about our residents but COLLAGE gave a way to capture this through its computerized database – this allows us to put what we think we know to hard numbers."

Karri Sears, Director of Wellness, Alexian Village of Milwaukee, WI

"Close to 50% of the last 113 resident assessments completed using the COLLAGE tool were referred for additional services, appointments, tests or evaluations including:

• Balance training and physical therapy: 13 residents (9 because of pain);
• Medical specialists: 9 residents (Orthopedics, Audiologists, Dermatologists, Oncologists);
• Physical exams: 14 residents scheduled (all overdue);
• Psychologist: 6 residents for depression, loneliness, anxiety and grief help;
• Tests: 10 residents for bone density, blood, colonoscopy and mammogram (all overdue);
• Driver evaluation: 2 residents were scheduled;
• Dozens of medication sheets were update.

"We’re delighted to have a tool to help us focus on important health maintenance goals through COLLAGE."

Terri Lanham, Resident Care Nurse, Kendal Northern Ohio, Oberlin, OH

"I think the thing I enjoy the most about the COLLAGE project is that we’ve been able to be part of it from the grass roots and COLLAGE has been really good about wanting the members’ ideas and opinions. We’re the ones in the field that are using it so they’ve been really receptive to anything we have to say."

Kerri Sears, Director of Wellness, Alexian Village of Milwaukee, WI

"COLLAGE has really helped us. If residents transfer to healthcare we’ve got almost a mini MDS. So that we can see, okay, four months ago this is what we saw out in independent living. And now, this is what the changes are - it really helps us develop a service plan with continuity."

Theresa Halliday, Administrator, Deerfield Episcopal Retirement Community, Asheville, NC

"It’s been good to have someone else to talk to about these issues, to give them suggestions on how to meet their goals to be more healthy. And for some who are already doing all the right things, just to have a vote of confidence in the program that they’ve set up for themselves has been a real plus."

Miriam Martin, Nurse Coordinator, Virginia Mennonite Retirement Community, Harrisonville, VA

"Particularly in my role as Vice President of Operation, the thing that’s working well is if I want to retrieve information about a resident because some sort of issue has arisen, all I have to do is pull up the COLLAGE assessment on my personal computer and I have a solid amount of information to weigh in on. It gives me a quick overview and clinical picture on this resident to inform a variety of decisions, sometimes it may be family decisions, level of care or service decisions, maybe how to deal with this resident in a more productive way, etc."

Joy Sutter, Vice President of Operations, Dockwoods Community, Lansdale, PA

"On-site training was excellent because of the ability to have hands on coaching experiences and involve residents in the process. Our residents are now COLLAGE’s biggest cheerleaders on campus. The implementation was an eye opener for my staff as they found that they were learning more about their residents holistically and developing opportunities to improve the quality of life and focus on wellness in our community. Most of all, we were engaged positively with residents and saw first hand that COLLAGE is so much more than data collection."

Lynn Zuellig, Vice President, Home and Community-based Services, Lutheran Homes of Michigan, Saginaw, MI

"It really has helped us identify the issues going on and either get them to the doctor, get their funeral arrangements made, and all the myriad of issues that that come up with death and dying. We’ve even gotten residents back with estranged families. I feel that we’ve made a lot more progress participating in COLLAGE."

Theresa Halliday, Administrator, Deerfield Episcopal Retirement Community, Asheville, NC

"We have completed 1/3 of our resident population and residents are starting to ask each other if they have been 'COLLAGEd'! We referred 18 residents to therapy and four to support groups; assisted 11 residents with information/completion of living wills and related forms; provided funeral arrangement information to three couples; started a 1:1 volunteer base to assist residents with shopping, physician visits, dog walking, and bill paying. COLLAGE has assisted with identifying residents needing to transition to a higher level of care and has allowed us adequate time to prepare the resident/family for the move. It has also helped us to identify issues before problems arise so that assistance can be provided to keep residents independent. The initial fear voiced by the residents that we would use their personal information to make them move is quickly being dispelled as the residents share that we have helped them and that our goal is to maintain their independence. We are looking forward to the updates and the upcoming reports. We think COLLAGE is wonderful."

Theresa Halliday, Administrator, Deerfield Episcopal Retirement Community, Asheville, NC

"The power of COLLAGE and our BeWell program literally came to life for our staff and residents. The opportunity to put our assessment and technological learning applications into actual practice by interviewing with our "new wellness teachers" (aka our residents) was tremendously valuable. Staff who thought they "knew" residents well were surprised to discover the rest of the story revealed during the Community Health Assessment (CHA) and Wellness interviews. Residents relished in the opportunities to sit down with someone who truly was interested in listening to them talk about their personal concerns and well-being. Our last training session reached a crescendo when our group literally got up and danced the Cha-Cha after completing their first full CHA (Community Health Assessment) interviews AND simultaneously keying their data on the laptops! We look forward to utilizing COLLAGE to identify meaningful information to help us best develop our services and programs to promote successful aging for our residents."

Denise Dickinsen, Vice President of Planned Growth and Development, Lutheran Homes of South Carolina, Irmo, SC

"The COLLAGE program holds our residents and staff accountable---they know we’re coming back to meet with them again."
"COLLAGE questions pick up loneliness and social isolation earlier -- versus waiting for signs and symptoms of depression to emerge."
"COLLAGE helps us identify fall risk more consistently as well as catch unreported falls – we can more easily align ourselves with the philosophy, no fall is a small fall."
"COLLAGE helps us and our residents plan a way to better treat pain, and leads to a stronger campus-wide strategy to manage it."
"COLLAGE’s ADL section helps us pinpoint residents who express feeling unsafe in the shower, and we have taken action to change this before an adverse event takes place."
"COLLAGE helps us stay on top of fluid consumption -- something the older adult may not be thinking of -- …to ward off UTIs, hospital stays, etc."

Karri Sears, Director of Wellness, Alexian Village of Milwaukee, WI

"I feel like an explorer and you are there to show me the way. Your attentiveness to our training is one of the most valuable aspects of being a part of the COLLAGE family."

Melissa Batten, Wellness Nurse, Carroll Lutheran Village, Westminster, MD

"By joining the COLLAGE consortium you have the opportunity to be at the top of your field -– to be on top of programming and planning for your residents. I can’t imagine being part of a CCRC continuum without having a tool like COLLAGE....From an operations standpoint and from a wellness standpoint, COLLAGE has been vital to the growth of our organization for us to expand our wellness programming, to expand a real true focus on healthy aging that is impacting not only our residents but residents and individuals in the entire field of aging."

Denise Dickinsen, Vice President of Planned Growth and Development, Lutheran Homes of South Carolina, Irmo, SC

"What I think makes COLLAGE stand out and be unique, is that it’s a science-based program. We’ve all collected assessment data for residents for years. What knits this together is that it’s based in valid, reliable questions. And from it we have the capacity to compare outcomes from one community to another, based on good solid evidence. ...I think the organizations that will embrace COLLAGE at this stage of its life are those that are really committed to quality first, for example. Those that have decided they want to be a part of lifting the quality in our field and want to establish a strong scientific foundation for asserting that quality."

John Diffey, President and CEO, The Kendal Corporation, Kennett Square, PA

"The COLLAGE training was wonderful -- the students and their teachers were very engaged. Your training was outstanding and the troops are ready move forward. What more could we ask for!?!?! As always, many blessings and my humble thanks for the inspirational education provided. COLLAGE is changing lives."

Lynn Zuellig, Vice President, Home and Community-based Services, Lutheran Homes of Michigan, Saginaw, MI