Our Mission

“We support Skilled and Community Based Care Providers in the delivery of person-centered compassionate care.”

Our Vision

“Haffenreffer and Associates, Inc. is instrumental in the cultural transformation of care and caring.”

Haffenreffer Values and Core Competencies

  • Common Sense – Sustainable approaches that optimize resources
  • Communication – Understanding is empathy plus precision
  • Compassion – For residents, families, and the entire care team
  • Comprehension – Thorough, up to date understanding of regulatory requirements and standards of care – theory and practice
  • Commitment – To personal, professional and institutional learning
  • Community – Relationships within and around each facility
  • Consultation – Leading edge professional nurse consultation

A Comprehensive Analytical Tool

Haffenreffer’s 20 Person-Centered Standards (Click here)

Our People

Demetria (Demi) Haffenreffer, RN, MBA, has made long-term care her profession since 1973, first as a Director of Nursing and for the last thirty-five years as a consultant.  Demi is known as a dynamic and interesting presenter. Her thorough knowledge of the regulations combined with her extensive hands-on experience provide for practical, everyday solutions to the challenges facing the care giver and facility.

In 2011, Demi assisted the Colorado Foundation for Medical Care with a CMS grant to publish the Model Program for Quality Performance called “QAPI.”  Demi is a facilitator for the AHCA Leadership Excellence Self-Assessment System and is currently serving on the Washington Health Care Association Quality Improvement Committee. She has served on the American Healthcare Association (AHCA) Quality Improvement Committee, Oregon State Resident Safety Review Council, the Steering Committee of MOVE (Making Oregon Vital for Elders, an outreach of the Pioneer Network), as a member of Oregon Patient Safety Commission, and as a Master Examiner on the Board of Examiners for the AHCA’s Quality Improvement Award, an award granted to the top performing facilities in the Nation.  Demi has taught workshops nationally and internationally on a variety of subjects pertinent to long-term care and has authored five policy and procedure manuals.

Her depth of knowledge, breadth of experience and her communication skills have made her a sought after  resource and advocate for facilities facing regulatory disputes, as well as for expert review and testimony for attorneys facing litigation in the Pacific Northwest and nationwide.


Annie Andruszko, RN, WCC has made long-term care her profession since 1972, working her way up from CNA, to Charge Nurse and then for six years as a Director of Nursing. Annie has experience as a Resident Care Manager and also with infection control and staff development. She has been with Haffenreffer & Associates, Inc., since 1996 as consultant and instructor.  Her special interest is skin care especially prevention and treatment of pressure ulcers and is Wound Care Certified.

Susan Banks, RN, BS joined Haffenreffer and Associates, Inc. after providing Adult Foster Care, Home Health and Hospice Care for many years.  She has also provided operations and logistic support and supervised the nursing staff in an outpatient clinic.

Kira Buresh has been in long term care since 2007 working in skilled nursing and community based care.  Kira has experience in operations as an internal policy and procedure compliance auditor as well as Executive Director for assisted livings throughout Oregon and Washington.