Alternative Living Environments – Visit and Interview

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Winterhaven Healthcare Center is a popular place for elder residents in Houston, Texas. The center provides a wide range of nursing care services and is well-known for its advanced approaches to elderly patients. The choice of Winterhaven Healthcare Center was justified by the growing concerns over the quality of long-term care provided by healthcare facilities in Houston. This paper provides a brief report on the interview conducted with one of the healthcare center’s administrators and offers recommendations to improve healthcare administration at Winterhaven Healthcare Center.

For the purpose of privacy, the name of the interviewee is not mentioned. The main questions asked during the interview touched on the issues of waiting lists, demographics and payments, personal nursing care, amenities, and technological issues. Like other nursing care facilities in Houston, Winterhaven Healthcare Center uses waiting lists for patient admission. Although at the last check, the facility had only 90% bed occupancy (Our Parents, 2011), waiting lists tend to facilitate the organization and systematization of information and patient inflow/ outflow at Winterhaven Health Center. It should be noted that, since the 1970s, all nursing homes in Texas have been subject to federal guidelines, with the goal of providing outstanding care to service recipients (Attorney General of Texas, 2010). Unlike other states (for example, Connecticut) Texas does not require that nursing homes use waiting lists. Nevertheless, it is much easier for Winterhaven Healthcare Center to monitor resident inflow and outflow and regulate its administrative processes appropriately.

Like thousands of other nursing homes in the United States, Winterhaven Healthcare Center serves primarily the older and the sick in need of special care. A separate category served by the center includes pregnant women undergoing serious life crises. The latter is the new demographic that profoundly affects the range and nature of services provided by the center. Pregnant women demand special care and conditions of living; this is particularly the case of pregnant teenagers. Needless to say, teen pregnancy remains one of the most serious health and social issues in the U.S. The administrator confesses that the prevailing majority of pregnancies in the teenagers admitted to Winterhaven Healthcare Center is unintended and results from physical/ sexual abuse: this is also what Lawlor and Shaw (2002) write in their article. In these situations, quality psychological and counseling support is crucial to the future of the unborn child and the mother. At Winterhaven Healthcare Center mothers undergoing a life crisis can obtain relevant support and medical assistance.

The marketing strategies employed by Winterhaven Healthcare Center reflect the outdated approaches to administration and marketing among most, if not all, nursing homes. It would be fair to say that the healthcare center does not use any sophisticated marketing tools. Moreover, the organization is rather passive in relation to its position in the healthcare field, due to the unchangeably high demand for its services and the growing number of elderly people willing to become nursing home residents. Historically, nursing homes relied on admissions and social worker/ physician referrals (Cooper & Cronin, 2000). Little or no effort was used to attract more residents and fill nursing home beds (Cooper & Cronin, 2000). Word of mouth was always the most important source of information about the nursing home. However, as the competition in the healthcare market increases, professionally designed marketing campaigns can move Winterhaven Healthcare Center to the forefront of the state’s healthcare industry and add efficiency and profitability to its nursing care operations.

Winterhaven Healthcare Center works with both Medicaid and Medicare. Both are considered primary payers for the nursing services provided by the medical center. However, the system of nursing home payments provided by Medicare and Medicaid differs dramatically. The latter certifies alternative living facilities that want to provide nursing home care and, simultaneously, may pay up to 100% of nursing home costs for eligible patients (Long-Term Care Ombudsman, 2011). Yet, in the end, the amount of payment compensated to nursing home residents through the Medicaid Nursing Facility Program will vary, depending on the level of patients’ income and other considerations. More often than not, nursing home residents will need to pay part of the service provided at Winterhaven from their own pocket. In its turn, Medicare pays only a share of nursing home costs and can provide payment for the episodes of hospitalization for acute illness, but for limited periods of time (Long-Term Care Ombudsman, 2011). Medicaid remains the primary payer for long-term care, whereas Medicare cares mainly for short-term costs that result from acute illnesses.

Winterhaven Healthcare Center is well-known for the range of personal nursing care and amenities available to its elderly residents. The administrator of the facility claims that the center has everything needed to serve the daily needs of its elderly and pregnant residents. The nursing care options available to residents at Winterhaven Healthcare Center include dietary solutions, diagnostic X-ray and a clinical laboratory, occupational therapy, dental and pharmaceutical services, and even housekeeping. Medical services provided by the center include Nursing Home, Continued Care Community, and Skilled Nursing Facility (Our Parents, 2011). Registered nurses, certified nurse aides, and licensed practical nurses to provide continuous support to seniors with severe illnesses and disabilities 24 hours a day (Our Parents, 2011). Rehabilitation facilities are available to those who need short-term rehabilitation after traumas, injuries, or surgeries. Additionally, nursing home residents have access to laundry, meals, and housekeeping services. These are just some of the basic ways to maintain order and meet the standards of nursing care provided in the state of Texas.

Unfortunately, transportation is a serious issue at Winterhaven Healthcare Center. The administrator does not conceal her frustration at being unable to solve these transportation problems effectively. Many elderly residents face the problem of being transported to the facility, unable to pay the high cost of private transport. Certainly, the healthcare center has arrangements with the land and air health transportation services, which are used at times of health emergencies. For example, the Global Air Rescue team offers urgent transportation services, when residents’ lives are at stake (Global Air Rescue, 2011). The team is well equipped to provide urgent cardiac assistance, but the costs of using their services can be unbearable for the elderly patients at Winterhaven. Nevertheless, residents at Winterhaven Healthcare Center are provided with the fullest range of emergency services and transportation, when necessary. The ambulance workers cooperating with the Winterhaven nursing home are familiar with the nature of issues faced by the elderly residents and possess the knowledge and skills required to provide high-quality emergency care.

Apart from transportation, recreation is one of the central issues at Winterhaven Healthcare Center. The administrator confesses that long-term care residents spend most of their time in bed. They are also more likely than their peers in other nursing homes to obtain a pneumococcal and influenza vaccination (Our Parents, 2011). In most cases, residents are physically restrained and develop pressure sores (Our Parents, 2011). In this sense, Winterhaven Healthcare Center reflects the conditions of nursing home living in the entire state of Texas. Despite the growing number of nursing home residents, the concept of quality of life in institutional settings receives minor attention (Ice, 2002). Failing health is the main reason why elders enter nursing homes, and for many of them, being in bed is the best way to avoid unbearable pain and suffering. Nursing home residents are characterized by the presence of numerous chronic conditions and comorbidities (Lee, 2002). Almost every second nursing home resident suffers from emotional and cognitive impairments (Lee, 2002). However, these factors have little to do with the lack of recreation and physical activity opportunities at Winterhaven Healthcare Center. Unfortunately, over the last 25 years, nothing has changed in the way nursing homes in the United States operate. Like decades ago, elders spend most of their time doing nothing (Lee, 2002). They are extremely vulnerable to the risks of boredom and loneliness. They experience lowered self-esteem and helplessness in institutional settings. Given the far-reaching effects of emotional problems on nursing home residents, the administration should become more attentive to what elders do during their free time.

When discussing technological issues, the administrator stated that Winterhaven Healthcare Center had everything needed to provide superior medical service. The center, the nursing home, and the crisis pregnancy center are fully equipped to provide urgent and regular medical care to all residents. Yet, Winterhaven Healthcare Center experiences certain problems with investments in new equipment and training for its medical professionals. The accelerating pace of technological advancement makes it difficult for the nursing home to catch up with the development of new medical technologies. The situation is particularly difficult with those patients who spend the most time in bed: the nursing home needs additional equipment to expand the range of recreational opportunities for the patients restricted in their physical activities due to illness.

Despite the success of most nursing home initiatives, several recommendations could help Winterhaven Healthcare Center to improve the quality of service. First, the organization should develop and implement a broad marketing campaign, in order to broadcast its superior quality care image in Houston, Texas, and in order to gather additional finances and update its technologies and recreation facilities. The latter will contribute to the provision of quality services and outstanding care by Winterhaven Healthcare Center. Second, special attention needs to be paid to the recreational services (or, rather, their lack) in Winterhaven Healthcare Center. This is where the center should be particularly creative. The fact is that offering group recreational activities for the elders at Winterhaven Healthcare Center will be unfeasible for two reasons: first, few elders enjoy engaging in group activities; second, the nursing home is facing serious budget constraints (Ice, 2002). Only innovative approaches to interactions and socialization in the nursing home can create a truly engaging environment. For example, Ice (2002) suggests that elders carry memory books and fill them with the information they deem to be important in their lives, such as stories, memories, photographs, and other things. Also Winterhaven Healthcare Center can engage volunteers in its recreational programs – for example, volunteers will visit nursing home residents and support them, as they are trying to overcome their physical and emotional health problems (Ice, 2002). All these activities will help medical professionals at Winterhaven to enhance the quality of medical and nursing care provided to elders.

The current state of research provides ample information concerning the future planning of the facility and its demographics. As noted above, Ice (2002) described several ideas of recreational activities for elders in nursing homes, and these ideas have the potential to change the nature of planning procedures at Winterhaven Healthcare Center. Another study was conducted by Tappen, Roach, Applegate, and Stowell (2000), with the goal of analyzing the effectiveness of combined walking and conversation interventions in nursing home residents with Alzheimer’s disease. It should be noted, that elders with Alzheimer’s disease make up a considerable amount of elder residents at Winterhaven Healthcare Center (Our Parents, 2011). The researchers found that the intervention and communication contributed to the functional mobility of elders with Alzheimer’s disease living in institutionalized environments (Pillemer et al., 2003; Tappen et al., 2000). Again, the discussed intervention has the potential to alter the nature of administrative planning procedures at Winterhaven Healthcare Center: combined walking and conversation intervention will have to be included in the basic range of functional activities for elders, whereas the staff will need additional training to ensure the successful implementation of the proposed program.

Winterhaven Healthcare Center is well-known for the broad range of medical and functional services provided to elderly residents of Houston, Texas. The nursing home serves primarily elders with serious diseases and pregnant women undergoing major life crises. The center claims to have everything needed for the provision of quality care. Nevertheless, the problems of transport and recreation continue to persist. Recreation and marketing will have to become the top administrative priorities for Winterhaven Healthcare Center in the nearest future. This is the best way to ensure that nursing home residents are secured from the risks of boredom and low self-esteem within the walls of the nursing home.


Attorney General of Texas. (2011). Selecting a nursing home. Attorney General of Texas Greg Abbott. Web.

Cooper, J. & Cronin, J.J. (2000). Internal marketing: A competitive strategy for the long-term care industry. Journal of Business Research, 48, 177-181.

Global Air Rescue. (2011). Winterhaven Healthcare Center. Global Air Rescue. Web. 

Ice, G.H. (2002). Daily life in a nursing home: Has it changed in 25 years? Journal of Aging Studies, 16, 345-359.

Lawlor, D.A. & Shaw, M. (2002). Too much too young? Teenage pregnancy is not a public health problem. International Journal of Epidemiology, 31, 552-554.

Long-term Care Ombudsman. (2011). Financing nursing home care. The Department of Aging and Disability Services. Web.

Our Parents. (2011). Winterhaven Healthcare Center. Our Parents. Web.

Pillemer, K., Suitor, J., Henderson, C.R., Meador, R., Schultz, L. & Hegeman, C. (2003). A cooperative communication intervention for nursing home staff and family members of residents. The Gerontologist, 43(II), 96-106.

Tappen, R.M., Roach, K.E., Applegate, E.B. & Stowell, P. (2000). Effect of combined walking and conversation intervention on functional mobility of nursing home residents with Alzheimer disease. Alzheimer Disease and Associative Disorders, 14(4), 196-201.

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NursingBird. (2022, April 30). Alternative Living Environments – Visit and Interview. Retrieved from


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"Alternative Living Environments – Visit and Interview." NursingBird, 30 Apr. 2022,


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1. NursingBird. "Alternative Living Environments – Visit and Interview." April 30, 2022.


NursingBird. "Alternative Living Environments – Visit and Interview." April 30, 2022.