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Frequently Asked Questions
Manchester is happy to provide references!
Manchester Living was founded in 2009 and currently has four residential care homes
which are licensed by the State of Texas as Type B, small. Adam Lampert and Dean
Krasovitsky, the owners, make frequent spontaneous visits to the houses to check on
residents and staff, and are actively involved in the daily details of management and
upkeep of the houses and oversight of resident care issues. In this way, they get to know
all of our residents and their families, which further contributes to the “family” feel that
our residents rave about. We also have a Director of Care, Erin Shuford, who has been
with Manchester since we opened our first home. Erin, with our wonderful caregivers,
are the heart and soul of our homes. Erin visits our houses on a daily basis, offering
oversight and training to our staff and visiting with residents and their families to ensure
that everyone is receiving the very best care and attention. Our Medical Director, Dr.
Kelley Newcomer, is a geriatric specialist who provides training to staff as well as
concierge medical services to our residents, allowing them to receive medical care in the
comfort of their homes.
In our humble opinion, our caregivers are among the very best in the industry. Unlike
most other care homes, ALL of our caregivers are certified nurse’s aides (“CNAs”). In
addition to the many hours of training that they receive prior to taking their CNA exam,
our staff has hundreds if not thousands of hours of hands-on experience and training in
our homes and are provided with more than one hundred hours of additional training
prepared by our staff physician. We encourage anyone interested in moving into a
Manchester home to meet the staff during a house tour. We pride ourselves on staff
longevity and recognize that our staff is our most important asset. With that in mind,
we pay 80% of staff health benefits and we offer no-interest personal loans. All of our
caregivers are full time W2 employees, CNA certified, trained by our in-house staff
Doctor and director of care, and receive extensive training as well as hands-on
experience working with residents with memory issues
Manchester caters to high need residents that most institutional facilities are not able to
care for. We are very selective regarding whom we accept into the homes, and do a
very thorough assessment of all potential residents to better understand their needs
and also to be sure that they will thrive in a residential setting. The owners, medical
director and director of care then meet to discuss the level of care required for your
loved one and create a care plan. Manchester caters to all levels of need and we allow
our residents to age in place.
Dr. Kelley Newcomer is our Medical Director. She graduated from the University of
Texas Southwestern Medical School and is Board Certified in Internal Medicine and
board eligible in Hospice and Palliative Care Medicine. She has worked in a variety of
settings, including: Academic internal medicine, urgent care, and foreign medical
missions. She has devoted her practice to geriatrics and palliative care for the past six
years. While our residents are free to choose whichever medical care providers they
would like, most of our residents elect to use Dr. Newcomer as their primary care
provider. She’s in the homes weekly or as needed, so it’s like having a concierge doctor
without the fee! If bloodwork or x-rays are necessary, we arrange to have those
providers come to the house, so our residents are not forced to leave the house for
those services with all the potential discomfort or risks that might entail. Whether the
family member’s insurance is accepted is up to the medical provider, not us. Other
service providers visit our homes as needed, including podiatrists who visit every three
months, dentists and dental assistants who visit at the request of our residents and their
families, hair dressers who come to the houses weekly and manicurists who visit the
We have at least two CNA caregivers on duty – and awake – at each home 24/7/365.
Each shift varies, but they are typically 8-hour shifts. The caregivers communicate at
shift change briefings as well as through care notes that are entered in our secure care
program that manages medications. The resident to caregiver ratio is always 4 to 1 or
Turnover is low, but does happen. We are always hiring and training to ensure the best
care for our residents. Staff training is overseen by our in-house physician and Director
and Director of Care.
Medication administration and charting is provided in the houses and overseen by our
Director of care. We use Accu-flo, a secure server-based medication administration
system designed for use in institutional pharmacies, assisted living, long-term care, and
rehab facilities. The medicine is stored in a secure locked medi-cart in each home and
distributed by our staff as directed.
Our staff is trained to deal with agitated residents. In the event that a resident becomes
agitated, our staff will immediately take steps to identify and rectify the cause of
agitation, to de-escalate tension and create a safe and calm environment. They focus on
feelings rather than facts and attempt to limit distractions if possible. In addition to
creating a calm environment, they provide reassurance and utilize redirection
techniques in an attempt to engage the resident in an activity or other distraction.
When we know the potential triggers for a resident, we take steps to ensure that those
triggers are minimized in order to maintain calm and ensure that all of our residents are
safe and happy.
Our staff is similarly well trained to deal with medical emergencies. In the event of an
acute medical emergency, emergency medical services are immediately summoned for
non-hospice residents and the hospice provider is notified for hospice residents. After
help is summoned, the appropriate family/emergency contacts are notified and
informed about the nature of the emergency
Our staff are available 24/7 to assist our residents. All residents are provided with call
buttons to immediately notify the staff when assistance is needed. In addition, we
provide pressure pads on the beds of residents who are fall risks or unable to utilize the
call buttons. The pressure pads register movement and trigger alarms both in the
common area and wirelessly to pagers which the staff wear. In addition, our staff
provide bed checks routinely throughout the night.
We get all residents up, dressed and groomed every day. Residents are typically
showered three times a week, or as needed, in their own private en-suite bathrooms. In
addition, we assist our residents daily with shaving, hair and grooming, make-up
application and tooth brushing.
The majority of our residents require assistance when they use the restroom. If a
resident is or becomes incontinent, we will change them regularly and try to get them
on a regular cycle of going to the restroom every two hours in order to prevent
Breakfast is a la carte. Everyone gets up at different times and likes different things for
breakfast, so breakfast time is flexible and informal, and we keep a lot of breakfast
options on hand to cater to our residents’ personal preferences. A communal lunch is
served around noon and dinner at around 5. We prefer for all of our residents to eat
together at the dining table to encourage socialization, but we allow residents to take
meals in their rooms if they prefer. We encourage family to join at any meal time – free
of charge – to eat with their loved ones. Our delicious and nutritionally balanced weekly
menus are always posted in the kitchen.
Our Director of Care meets individually with prospective clients to determine the level
of care required. The results of that assessment will determine the cost of care. The
level of care is evaluated annually or when there is a material change in the resident’s
Our monthly fee includes all medication management, meals, showers, toileting, transfers and
ambulation, laundry service, room cleaning, television, utilities and basic cable.
While we are happy to assist your family in securing VA and long-term care benefits, the
family/resident is responsible for timely payment of all fees to Manchester.
Incontinence supplies, personal grooming supplies, medication, private caregivers,
supplemental nutrition (Boost/Ensure), pressure pads, personal phones, linens and
clothing are among the items which are not provided by Manchester. We are happy to
assist our residents in sourcing and procuring these items, and pass the costs directly
through to our residents.
Each of our rooms comes equipped with a large, wall-mounted flat screen television and
basic cable. If a resident wishes to include additional movie channels or premium
packages, the client may procure them on their own, or we arrange for service and will
pass the cost of those services or a DVR box directly through to the client.
Rent is due in full on the first day of each month and we prefer check or ACH
(Automated Clearing House) / direct withdrawal. Rent must be mailed to our office; it
cannot be left in the houses.
Rates assessed at admission are honored until care needs change. The annual rent
increase is 3%.
There is a one-time, non-refundable community fee of $1,500.
The exterior doors in our houses are locked and we’re very grateful that we’ve never
had a security issue. Since our caregivers are awake and working 24/7, the house is not
attractive to criminals. The staff checks on each resident overnight, throughout the day
and in the evenings.
Our staff is trained and proficient with multi-person transfers. In addition, we have
Hoyer lifts which we can utilize if necessary.
Our houses have no set visiting hours and friends and family are welcome and
encouraged to visit as often as possible, although for obvious reasons we prefer to limit
late night visits for fear of disturbing other residents. Families are able to take their
loved ones out anytime.
Rooms are available on a first come, first serve basis, subject to a waiting list. Out of
fairness to other families who may also be interested in a room, we do not hold rooms.
Since we allow all of our residents to age in place, we are unable to predict availability of
rooms, and often have a wait list for each house.
Each room is painted and the carpet is cleaned before each move in. We furnish a large
wall-mounted, flat screen television. The rest is up to the family to furnish and decorate
as they wish. We encourage our residents to make the rooms as comfy and close to
what they had at home as possible.
After the tour, if you decide that you’d like to move forward we will schedule an
assessment with our Director of Care. Once that is complete and we determine what it
will take to meet your care needs, we will draft a lease agreement and set a move-in
date. The process could take a few days, but is usually no longer than that.
Each family works with Erin Shuford, our Director of Care, to establish a game plan and
logistics for move-in. Move-ins generally take place between 8 am and 2 pm, Monday
through Friday. Furniture may be moved into the house in advance of resident move-in.
Laundry is typically done three times a week or as needed and rooms are cleaned daily.
. We do not directly provide transportation for our residents, but we are happy to assist
the family in arranging transportation for resident outings. Families may also choose to
hire a private caregiver to drive residents to and from appointments, and we are happy
to help arrange that as well.
We know that for some residents, cherished pets are like members of the family and we
are happy to consider them in our houses, presuming that they are well socialized, fully
housebroken and up to date on all immunizations. However, for the safety, comfort and
welfare of all of our residents, we reserve the right to evaluate each case on an
Transitions can be difficult, and each resident may respond to change differently. The
Director of Care will meet with each family and prospective resident to determine what
course of action is best, and will monitor the transition carefully to watch for any sign
that might indicate that a modification to the plan is necessary