Fauquier County Board of Supervisors

Puller Veterans Care Center

Project Update

Steven Combs
Chief Deputy Commissioner
Virginia Department of Veterans Services
April 8, 2021
 State Veterans Homes
What do they do, how many there are, and who gets in?
Long-term Care Facilities (LTCFs) for veterans; four All 50 states have them
levels of care • 157 state veterans homes (SVHs)
• Virginia’s veterans care centers deliver four levels • All 50 states and Puerto Rico
of care to Virginia’s veterans: • CA, TX = 8 SVH each; FL, MO, and OK = 7 each
1. Skilled nursing • First SVH established 1864 (Connecticut)
2. Alzheimer’s/memory • Federal operating supplement – 1888
3. Rehabilitation • Federal construction grants – 1930
4. Assisted Living (domiciliary) – Roanoke only • More planned: 20 new construction and 10
replacement projects on USDVA FFY20/21 priority lists

Virginia has two and is building two more Eligibility requirements – Virginia:
1. Virginia Veterans Care Center, Roanoke (1992) • Honorably discharged Veteran
2. Sitter & Barfoot Veterans Care Center, • Current resident of Virginia or entered military service
Richmond (2007) from Virginia
3. Puller Veterans Care Center, Vint Hill, • Must have medical need for level of care we provide
Fauquier County (2022) • We must be able to provide the level of care needed
4. Jones & Cabacoy Veterans Care Center,
Virginia Beach (2022)
 New Veterans Care Centers – Overview and Timeline

Puller Veterans Care Center (Puller VCC) Event/Milestone Puller VCC J&C VCC
• 30 acres donated by Vint Hill EDA and Vint Hill Land donated 2016 2016
Village (Fauquier County) Design complete March 2019 March 2019
• Named for three Virginia heroes/public servants: VA awards matching grant December 2019 December 2019
o Lt General Lewis B. (Chesty) Puller
Contract signed with CM March 2020 March 2020
o Lewis B. Puller, Jr.
o Linda T. (Toddy) Puller Construction started March 2020 March 2020
Month -8 (hiring starts) July 2021 December 2021
Construction complete January 2022 June 2022
Jones & Cabacoy Veterans Care Center (J&C VCC) Month 1 (1st residents March 2022 August 2022
• 25 acres donated by the City of Virginia Beach admitted)
• Named for two Virginia heroes: Month 3 (“regular” cycle June 2022 November 2022
o Col William A. Jones, III, USAF, MOH recipient, of admissions begins”)
Vietnam Month 17 (target for full August 2023 January 2024
o SSgt Christopher Cabacoy, U.S. Army, Killed in occupancy)
action, Afghanistan, 2010. Virginia Beach
Month 19/20 (target November April 2024
native breakeven) 2023
Puller VCC – Birdseye View - Design

www.dvs.virginia.gov 4
J&C VCC – Birdseye View - Design

www.dvs.virginia.gov 5
Puller VCC – Birdseye View – Oct 24, 2019

www.dvs.virginia.gov 6
Puller VCC – Birdseye View – Sep 2, 2020

www.dvs.virginia.gov 7
Puller VCC – Birdseye View – Sep 2, 2020

www.dvs.virginia.gov 8
Puller VCC – Birdseye View – Dec 10, 2020

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Puller VCC – Birdseye View – Feb 09, 2021

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Puller VCC – Birdseye View – Feb 09, 2021

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Household Interior

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Resident Courtyard

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 Staffing, Census, and Funding
• Staffing:
• 24/7/365 operations – three shifts/day, plus M-F employees
• “Whole Person” approach to care – blends medical care with recreational, therapeutic, and social
opportunities that contribute to overall physical and mental health/well being
• Operate the care centers as symbols of the Commonwealth’s commitment to her veterans
• Hire/train/retain a team dedicated to delivering exceptional, personalized care
• Households are basic unit of direct care delivery. Direct care staffing in multiples of 8 (ex. 1 CNA for 8
residents, 1 LPN for 16 residents, etc.)
• Census
• Admissions will average 2/week (or 8/month) until full occupancy (assumes that there will have to be some
weeks with 3 admissions/week to make up for losses
• Target = 95% or greater occupancy
• Revenue:
• Medicaid, U.S. Department of Veterans Affairs, Medicare, Private Pay

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 Admission Criteria, Census Growth, and Staffing
• Admission criteria
• Honorable discharge
• Virginia resident at time of admission, or entered service from Virginia
• Veteran must have a medical need for the level of care that Puller VCC provides
• Puller VCC must be able to provide the level of medical care that the Veteran needs
Census
• First residents admitted in Month 1 (March 2022)
• New households open in steps (ex. HH1 full, HH2 filling, HH3 preparing to open) until all eight open
• Full census (95% or better) will be reached around Month 17 (August 2023)
Staffing
• First hire is the Administrator in Month -8 (July 2021)
• Next are Dir of Nursing, HR Dir, Finance Dir, Facilities Mgr, and Admissions Dir in Months -6/-5
• Approximately 70 staff on board before first resident admitted, with many of them being direct care staff
hired in Months -2/-1
• Hiring then proceeds in steps – with staff being hired 1-2 months before a new household is opened,
until full staff levels reached in May 2023 15
 Hiring Begins Eight Months Prior to Opening
• First Hire is the Administrator
• Next are Director of Nursing, HR Director, Finance Director, Facilities Manager, and
Admissions Director
Number of Hires, by Month – Puller Veterans Care Center
35 33
30
25
20 19 19

15 13 13
11 11 11 10 11
10 8 8 9
7 6 7 6 6 6
5 3 2
1 0
0
1

2
2

3
21

22

22

22

23
2

3
22

23
2

3
21

21

22

22
1

2
t -2

t -2
-2

-2
r-2

r-2
l-2

l-2
c-2

c-2
-2

-2
n-
p-

b-

p-

b-
n-

n-
g-

v-

g-

v-
ar

ar
ay

ay
Ju

Ju
Oc

Oc
Ap

Ap
De

De
Au

No

Au

No
Ju
Ja

Ja
Se

Fe

Se

Fe
M

M
M

M
NOTE: Jones & Cabacoy VCC hiring: shift five months to the right 16
 Staff Levels plateau in Month 15; Census in Month 18
• Staff must be hired/trained before residents are admitted
• Admissions will look like a “stair step” pattern: 10 new admissions and 2
discharges per month until target census (95%) occupancy is reached in Month 17
Staffing Levels and Average Census
250

200

150

100

50

0
21

22

23

4
2

4
1

3
22

23

24
21

22

23
-2

-2

-2
-2

-2

-2
l-2

l-2

l-2
n-

n-

n-
p-

p-

p-
v-

v-

v-
ar

ar

ar
ay

ay

ay
Ju

Ju

Ju
No

No

No
Ja

Ja

Ja
Se

Se

Se
M

M
M

M
Staffing Levels - Puller Average Census - Puller Staffing Levels - J&C Average Census - J&C 17
 As we countdown to the March 2022 opening,
be on the lookout for…

• Staffing:
• Job announcements on state jobs website (jobs.Virginia.gov), local media/websites
• Hiring fairs (towards end of year)
• Partnership opportunities: Examples include with LFCC for workforce services
• Contract/purchasing announcements
• eVA state procurement system
• Examples could include food, service contracts, etc.
• Fauquier County Office of Economic Development will help push out
announcements/opportunities to local business community

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 As we countdown to the March 2022 opening,
be on the lookout for…

• Community engagement – build opportunities for:

• “Open house” tours
• Volunteer opportunities
• Veterans groups, schools, churches, civic groups – both at Puller VCC and at sites in the community
• Become a real part of the Vint Hill/Fauquier County/NoVA community!!!
• Work with Fauquier County Office of Economic Development on plan to build awareness of
the many local opportunities for families/visitors
• Web presence: examples include Facebook page, enhanced website, etc.
• Contacts, events, forms, photos, videos. Sample fly-by video
• Admissions applications will be accepted Nov/Dec (after Admissions Director is hired)

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 QUESTIONS/COMMENTS?

Contact
• Steven Combs, 804-221-3602 (cell), Steven.Combs@dvs.virginia.gov

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