Finding the passion in long-term care

Finding the passion in long-term care

I observed and wrote a lot about the long-term care industry this summer, but one thing was consistent through all of it: Long-term care providers are passionate.

And the award for most maligned part of long-term care goes to ...

And the award for most maligned part of long-term care goes to ...

It took a while, but I might have finally found something that therapy providers can point to with righteous indignation and say, "That ain't right!"

Winning with the help of Trump

Winning with the help of Trump

When the American Health Care Association sued the Centers for Medicare & Medicaid Services last year, my assessment was that it might win the literal battle, but lose the hearts and minds of consumers.

Person-centered confusion — and the value of a milkshake

Person-centered confusion — and the value of a milkshake

It was a bit disheartening to read some of the comments we received on a story covering a resident-focused care session at a recent national conference. The commenters seemed to immediately pole vault over the advice the speaker was trying to share, into a place of negativity and sarcasm.

How to police recidivist nursing homes: 3 strikes and you're out

How to police recidivist nursing homes: 3 strikes and you're out

The Centers for Medicare & Medicaid Services has the option of terminating nursing homes from the Medicare and Medicaid programs that it deems harmful. But to say the government has been reluctant to do so would be an extreme understatement.

Will governors ride to providers' rescue?

Will governors ride to providers' rescue?

Now that the U.S. Senate has apparently decided to make healthcare somebody else's problem, I suggest keeping an eye on another pack of politicians: the governors.

Recruitment and retention tips direct from frontline workers

Recruitment and retention tips direct from frontline workers

Long-term care managers need to understand what they can do to make their workplaces as employee-centered as possible — or risk losing out on the best workers, experts and front-liners alike emphasized on Tuesday.

The costs of (not) saving time

The costs of (not) saving time

A study last week confirmed what I often discuss with my friends, which is that money really can buy happiness when it's used to increase time.

Time to praise Medicaid and more regulations?

Time to praise Medicaid and more regulations?

If you see two providers having a pleasant conversation, it's unlikely they are discussing the joys of Medicaid -- or new regulations.

Medicare complainers line up here for help

Medicare complainers line up here for help

If you've had some kind of complaint about the rigmarole of Medicare lately — and who hasn't? — now's the time to start getting it fixed.

How healthcare helps you get a job

How healthcare helps you get a job

The fate of many of the members of our long-term care family are now in the hands of the Senate as it debates the future of the Affordable Care Act.

Active-shooter tips from a survivor — how to respond 'when seconds count'

Active-shooter tips from a survivor — how to respond 'when seconds count'

Betty Brunner was sitting down to an appointment at her hair stylist one morning and the next thing she knew, she was diving for the floor, trying to avoid a crazed gunman. Brunner miraculously escaped injury, but her stylist did not: She was one of three people killed by her ex-husband who also shot himself to death.

Trump: Give nursing home employers a break or two — maybe more

Trump: Give nursing home employers a break or two — maybe more

President Trump may be struggling to kill Obamacare. But he is clearly enjoying early success in at least one area: labor policy.

Enraged about an unfair playing field for nursing home admissions

Enraged about an unfair playing field for nursing home admissions

It was not a good sign from the start. The "personal" email stiffly started "Dear Sir," The first line only validated my gnawing feeling: "I can't tell you how enraged I got reading your article ..." It was the start of a new friendship.

Good medicine at Good Samaritan

Good medicine at Good Samaritan

I often hear a reluctance among executives to acknowledge how tough the lives of some of their employees are. In Mark McElwee's case, however, he's not only acknowledging, he's doing something about it.

Critical thinking tips from the happiest place on earth

Critical thinking tips from the happiest place on earth

What comes to mind when you think about critical thinking? For audience members at a session held yesterday at the National Association of Directors of Nursing Administration's annual conference at Disney World, a few things were brought to mind right off the bat.

What's happening in the Senate is no thing of beauty

What's happening in the Senate is no thing of beauty

When it comes to the Senate's latest healthcare bill, providers have unloaded many valid criticisms of it. Sadly, they may be irrelevant. It's easy to get so caught up in this legislation's shortfalls that its purpose is overlooked.

Increasing understanding of Medicaid

Increasing understanding of Medicaid

When you leave the world of long-term care, you realize how much you know without even knowing it.

Nursing home marketing pros, this is your time to shine

Nursing home marketing pros, this is your time to shine

So many times you see individuals who don't typically get the company headlines hoping to, well, make themselves known and earn some recognition. Nursing home marketers, your table is ready.

Catching nurse impostors — if you can

Catching nurse impostors — if you can

If you've ever seen the movie "Catch Me If You Can," you've probably wondered how in the world the protagonist could get away with his scheme of working jobs he had no qualifications for for so long. You might have also asked yourself that when reading the top story of our Daily Update on Monday morning.

Laugh at Illinois if you must. Just don't be next.

Laugh at Illinois if you must. Just don't be next.

It took more than 700 days, the threat of junk bond status, hefty tax hikes and the spectacle of two stubborn old men playing high-stakes chicken. But Illinois finally has an operating budget. Is this in your future too? .

Why nursing homes can exhale — but not get complacent

Why nursing homes can exhale — but not get complacent

The announced delay of full enforcement of new survey requirements is indeed good news for nursing home operators and all of their compliance officers. Their blood pressure should now lower a few millimeters. If only for a while.

How do people really feel about the ACA?

How do people really feel about the ACA?

When it comes to social media, I tend to think providers worry a little too much.

The House just bet on tort reform. When will they ever learn?

The House just bet on tort reform. When will they ever learn?

The long-term care field quickly embraced last week's House vote to enact some long-overdue tort reform. That's not so surprising, but don't get too carried away just yet, is my advice.

The secret to success ... you

The secret to success ... you

Readers help make McKnight's the outstanding professional news source it has become. So it is that we come to a recent email to the editor.

Lessons in learning your limits

Lessons in learning your limits

Take two friends and toss them at the American Library Association conference and you have a lot of running up to each other speaking in all exclamation points, as well as a solid lesson in how a smart, experienced reader can go awry.

The key to keeping employees around? Kindness

The key to keeping employees around? Kindness

We talk a lot about employee retention in this industry — and I mean a LOT. With the current employment climate of the sector, it would be unwise not to. Here's a key to it.

The fifth vital sign

The fifth vital sign

It turns out Linda Shell's hero had modern medicine right all along, even if her last utterance was well over 100 years ago.

Smoking: A Catch-22 for providers

Smoking: A Catch-22 for providers

Journey with me, children, back to 2003, when yours truly hung out with smokers.

Don't like the new ratings system? Welcome to our world

Don't like the new ratings system? Welcome to our world

The content in the angry letter sounded all-too familiar. "Flawed methodology" and "substantive errors" in CMS's "chosen methodology." Another nursing home organization taking issue with the Five-Star ratings system, right?Actually, the authors were blasting a new ratings system for HOSPITALS.

Why some children may not visit LTC residents

Why some children may not visit LTC residents

A Pioneer Network webinar on Thursday was a good reminder of how easy it can be to judge absent families when caring for the elderly.

It's time to sit for a visit and get caught up

It's time to sit for a visit and get caught up

McKnight's Senior Living's inaugural Online Expo arrives June 20. Just like McKnight's past Online Expos that have attracted thousands of long-term care professionals, it is free to attend and offers free CE credits — three, to be exact.

The secret to 'winning' post-acute care

The secret to 'winning' post-acute care

What does it mean to win post-acute care? There aren't any trophies involved, no big acceptance speeches in front of the industry. What winning providers do have, however, is a deep understanding of their data and a competitive edge in their markets.

Of arbitration victories and payback

Of arbitration victories and payback

In a year already chock full of regulatory victories, last week's development about arbitration clauses might turn out to be the best of the bunch. But ...

What the OIG video leaves out

What the OIG video leaves out

One might be forgiven for watching an Office of Inspector General video discussing nursing homes and wish it were about 10 — or 20 — minutes longer. That's because the video is under three minutes long. It tells maybe half the story around the OIG and nursing homes.

A big threat gone, but bigger threat looms

A big threat gone, but bigger threat looms

Providers are thrilled with the administration's decision to rescind an order to ban pre-dispute arbitration agreements. But they also know they can't let their guard down.

An ounce of pressure injury prevention

An ounce of pressure injury prevention

Benjamin Franklin once said that "an ounce of prevention is worth a pound of cure." His 1736 statement was referring to firefighting — better to prevent a fire than deal with putting one out — but it can also apply to one of the most challenging issues in long-term care: Pressure injuries.

Involuntary discharges could lead to a fine mess

Involuntary discharges could lead to a fine mess

Operators might want to keep an eye on new involuntary discharge legislation under consideration in Illinois.

Staying true to a mission while expanding

Staying true to a mission while expanding

It's hard to intrigue me much when it comes to renovations or new buildings. But in the case of Masonic Homes of Kentucky, one element in particular caught my eye: Its history as a refuge for widows and children, and how the latter continues to inspire its mission.

Alarming results in latest study

Alarming results in latest study

In a clear case of being able to learn from a cousin, long-term care providers should take note of results of a baby-monitoring study at a respected pediatric hospital.

Medicaid just might sink Trumpcare

Medicaid just might sink Trumpcare

With recent major funding proposals about Medicaid causing such a tizzy, it's fair to ask why the powers-that-be find Medicaid such a tempting piñata. There are two main drivers. But only one is usually mentioned in polite company.

Summer's here — can you hear me now?

Summer's here — can you hear me now?

Memorial Day heralds the start of summer — and with it risks for both you and your residents.

LTC's 'diamond in the rough' elevated to center stage

LTC's 'diamond in the rough' elevated to center stage

Eye-rollers might be inclined to snort at the thought of "just another" research center popping up. But they might want to have another think after Tuesday's big long-term care announcement.

Hire younger healthcare workers — lives might depend on it

Hire younger healthcare workers — lives might depend on it

Researchers with Harvard's T.H. Chan School of Public Health found slight differences in 30-day mortality rate for hospitalized Medicare beneficiaries when treated by doctors in different age groups.

Why the Obamacare repeal is being held up — at least for now

Why the Obamacare repeal is being held up — at least for now

There was a celebration at the White House earlier this month after the House narrowly voted to replace the nation's health law. More than two weeks later, the House has still not advanced the American Health Care Act to the Senate. And it's beginning to become clear why.

A tip for a good speech: Practice with a pooch

A tip for a good speech: Practice with a pooch

As much as I enjoy presenting or speaking in front of groups of people, it's also true that a moment before I begin, I always experience a moment of sheer panic.

Where your future referrals might be coming from

Where your future referrals might be coming from

Whether you're a kickball captain on the playground, a Little League coach on draft day or a shopper crossing the threshold for a big new sale, you know the look you give.

A milestone for Music & Memory

A milestone for Music & Memory

With how much positive press and research surrounding the benefit music can bring to people with dementia, it came as somewhat of a shock to me to find there had never been a nationwide study of the Music & Memory program — until now.

When an open-door policy goes awry

When an open-door policy goes awry

As an administrator or manager, do you have an open-door policy? Or an open office floor plan? It's often recommended, but in many cases, it can go awry.

How to compare Obamacare and its House GOP replacement bill — in a nutshell

How to compare Obamacare and its House GOP replacement bill — in a nutshell

I'm happy to report I might have found a near CliffsNotes equivalent for the recently passed American Health Care Act. You know, the Obamacare repeal and replace bill that the House passed last week.

Lost without translation

Lost without translation

In an age where 1 in 5,000 households speak a language other than English, language barriers between healthcare workers and the patients they care for can have care-related consequences, including higher risk of readmissions, longer inpatient stays and more adverse events.

Two tech developments you won't want to miss

Two tech developments you won't want to miss

Technology has been a true game-changer in long-term care. That's why it gives me such great pleasure to announce that the 2017 McKnight's Technology Awards contest will kick off Thursday (May 11).

The cost of a healthcare win

The cost of a healthcare win

Yesterday was a great day for House Republicans as they passed a bill that slashes $840 billion from the Medicaid program over the next decade and will cause an estimated 24 million Americans to lose their health insurance in the next decade.

Long-term care pharmacy: missed opportunities

Long-term care pharmacy: missed opportunities

One thing I've learned since joining this business years ago is that if you want a creative, persuasive thinker on your team, you could do a whole lot worse than Alan Rosenbloom.

Step away from the vending machine: Real life nutrition tips for healthcare workers

Step away from the vending machine: Real life nutrition tips for healthcare workers

Long-term care leaders can encourage healthy activity among their staff, starting with modeling healthy behaviors themselves. But what about the frontline healthcare workers with just a few minutes a day to eat, or employees whose stressful duties are taking a toll on their own health?

With pay hikes like this, you might need a bankruptcy attorney

With pay hikes like this, you might need a bankruptcy attorney

President Trump just announced a new plan to slash tax rates for long-term care operators and other businesses. But his desire to aid the corporate class has apparently not made its way to the Centers for Medicare & Medicaid Services.

Agility, attracting millennials among top 2017 workforce trends

Agility, attracting millennials among top 2017 workforce trends

"You cannot make long-term successful change with people who are blocking it," a long-term care workforce expert said Thursday. He's, oh, so right, about this and other staffing challenges.

20 career dos and don'ts ... and more

20 career dos and don'ts ... and more

I don't think I'd ever heard of Menlo College in California before Wednesday, but if I had a college choice to make again, I might seriously consider going there. If only to learn more from its president and how he might help my career, and yours.

Don't drop the Diet Coke just yet

Don't drop the Diet Coke just yet

Every so often a new study will be published that reminds me of my favorite Onion headline of all time: "Man Who Drinks 5 Diet Cokes Per Day Hoping Doctors Working On Cure For Whatever He's Getting."

Don't overlook this new mandate in the PBJ manual

Don't overlook this new mandate in the PBJ manual

The Centers for Medicare & Medicaid Services inserted an important new requirement in the latest version of its Payroll-Based Journal manual. It's one of those innocent-looking provisions that are fairly easy to skim over. But your facility might quickly find itself in hot water should it be ignored.

The high costs of bad health among front line caregivers

The high costs of bad health among front line caregivers

We are what we eat, and there's a lot of evidence that our nursing home workforce is struggling to be good.

GoFundMe campaign covers nurse's fine, but should it ever be paid?

GoFundMe campaign covers nurse's fine, but should it ever be paid?

The saga of nurse Carolyn Strom has been one of our most popular over the last six months. She is, of course, the Canadian who vented about her grandparents' healthcare on Facebook and was fined for it.

It's time to take your medicine — seriously

It's time to take your medicine — seriously

People not following their doctors' medication orders contributes to an estimated 125,000 deaths and 10% of hospitalizations per year, along with somewhere between $100 billion and $289 billion in healthcare costs. A lot are like like certain geniuses on my Facebook page.

Finally, some good occupancy news

Finally, some good occupancy news

You could almost hear the collective sigh of relief when NIC released its first-quarter tally on skilled nursing occupancy levels. To be sure, the 87.2% rate is not exactly a cause for celebration. Then again, maybe it is.

A better opioid policy shouldn't mean seniors suffer

A better opioid policy shouldn't mean seniors suffer

In addition to the terrible tragedy of opioid addiction in the United States right now, long-term care providers have an additional challenge: Figuring out both how to make sure seniors retain access to pain medication and how to keep those medications from leading to addiction.

Life in the slow lane: SNF employment

Life in the slow lane: SNF employment

With one son in college and another trying to figure out where to attend, the future job market is a topic near and dear to this writer's heart. Believe me.

Award winning advice on keeping employees engaged

Award winning advice on keeping employees engaged

As a teenager I spent a few weeks one summer working at a very popular food stand at the Wisconsin State Fair. "Very popular" is an understatement — the stand serves thousands of people each day, with some customers I spoke with driving from out of state just to eat there.

MedPAC wants to put SNF Medicare claims to the test

MedPAC wants to put SNF Medicare claims to the test

Skilled operators have been telling lawmakers and regulators that they are the cheapest post-acute care option out there, and it appears the Medicare Payment Advisory Commission has not only heard the claim, but wants to take the industry up on it.

The broken record of bad public relations

The broken record of bad public relations

If there's an area that I would argue is as bad as it was when I wrote about it in 2012, it would be how-long term care operators handle a public relations crisis.

Bank that sleep now

Bank that sleep now

When I was very young, my parents used to chuckle at how I, a through-and-through suburban kid, would rise so early and turn on the TV to watch ... the farm report.

When resident rights could be wrongs

When resident rights could be wrongs

What happens when a resident's wishes clash with the regulations with which long-term care providers must comply?

Medicaid as an attractive funding source?

Medicaid as an attractive funding source?

It wasn't too long ago that thousands of nursing homes were fleeing the Medicaid program.

When perfect is the enemy of good

When perfect is the enemy of good

One of the common refrains you heard last week as the GOP healthcare plan marched to its demise was Republicans saying that "we're letting perfect be the enemy of good."

Keeping the glass half full

Keeping the glass half full

If you need a little encouragement to stay positive next time something goes awry, look no further than this story from the New York Times.

For long-term care operators, there's no time for a pity party

For long-term care operators, there's no time for a pity party

Skilled care operators have their work cut out for themselves. But I have to say I'm feeling better about the sector's prospects after spending some time at last week's NIC Spring Investment Forum in San Diego.

Rooting out the cause of a cat problem

Rooting out the cause of a cat problem

Hearing the phrase "root cause analysis" always strikes a bit of fear into my heart because it always seems to be a complex process. In long-term care, this is often framed as not only knowing that a resident fell, for example, but why she fell.

This is what admired long-term care leaders do

This is what admired long-term care leaders do

We found some long-term care employees willing to talk about how their managers make a real impact by giving help. These are long-term care managers who talk the talk AND walk the walk — and earn the admiration of workers.

Deathly serious: Time for more talking; odds not great without it

Deathly serious: Time for more talking; odds not great without it

For all the benefits that end-of-life care talks can bring, a new study indicates that even when such talks take place, patients' preferences aren't always understood or effectively communicated. In total, just 20% of the surrogates interviewed correctly predicted the veterans' end-of-life care preferences.

Does your back have room for another target?

Does your back have room for another target?

As Momma used to say, not everyone who wears respectable clothes is respectable.

Hit the road with your staff

Hit the road with your staff

The most delightful story in politics this week leads us to some great tips for getting to know your co-workers better, and includes a reference to Willie Nelson. What could be better than that?

Put those loudmouth family members to work

Put those loudmouth family members to work

Whoever said politics makes strange bedfellows could have a field day with this one.

The hidden threat lurking in your facility

The hidden threat lurking in your facility

I don't mean to make your lives more difficult by adding another issue onto that pile, but according to a recent survey from the National Safety Council, there's a problem plaguing American workplaces that needs addressing: prescription drug abuse.

Don't be worried about Medicaid funding cuts — be very afraid

Don't be worried about Medicaid funding cuts — be very afraid

The long-term care industry's worst fears about what a Trump healthcare plan might contain have not just been met after last week's unveiling, they have been far exceeded.

What the new health insurance plan would mean for long-term care

What the new health insurance plan would mean for long-term care

As a long-term care provider — and very importantly, employer — you might not be thinking about the full costs of what the House's newly proposed health insurance plan could be. Let's break it down.

It's time to take sides about Obamacare's future

It's time to take sides about Obamacare's future

Tuesday's statement from the American Health Care Association on Republicans' plan to repeal and replace Obamacare was striking. There was no walking a tightrope or mealy-mouthed ambiguity in it.

Multi-generational mixer builds great collegian-CCRC resident bonds

Multi-generational mixer builds great collegian-CCRC resident bonds

From adding cheerleaders to finding backgammon partners and sharing farming advice, a collaboration project between a CCRC and Fresno State students has been a rousing success.

Snobbery that skilled care operators can ill afford

Snobbery that skilled care operators can ill afford

Quite a few skilled care operators tend to look at assisted living as being not quite equal. Many on the skilled side tend to see themselves as being a bit, ahem, more qualified.

How to make your leave policies better

How to make your leave policies better

While most businesses offer at least two weeks of vacation at a minimum, the topic of a recent article in Crain's caught my eye: Companies offering unlimited vacation.

Your money's no good here

Your money's no good here

I'd say the thing we write about most often in this line of work is payment issues. As a long-term care provider, you are eternally under pressure with whether there will be enough to pay for everything.

Why so blue?

Why so blue?

I've been in a fight with my computer monitor for the past couple of days. The screen was crisp and bright looking, but after a few hours I'd start getting a headache. I had been blaming that on a lack of coffee, until I started doing some research.

It's not just charity that should begin at home

It's not just charity that should begin at home

Long-term care operators tend to be a nervous lot. Rightfully so.

Re-evaluating CT for dementia residents

Re-evaluating CT for dementia residents

For all of our interest in cognitive training for dementia patients, we are nagged by knowing that studies on the topic have varied in quality and reliability.

Bad-mouthing the cost of long-term care

Bad-mouthing the cost of long-term care

Finally. That's was my silent reaction when I received the email from a top long-term care provider last week. What took so long? I still wonder.

There's another tsunami coming you probably haven't thought about

There's another tsunami coming you probably haven't thought about

There's a significant facet of the coming "silver tsunami" that most providers might be overlooking, according to a recently published report.

Seeking feedback in pursuit of gritty greatness

Seeking feedback in pursuit of gritty greatness

How often do you, as an administrator, CEO or manager, ask for feedback of colleagues? What I'm talking about is a casual conversation related to improving quality and strengthening company culture, especially with employees lower on the totem pole.

No wonder so many have pounding headaches

No wonder so many have pounding headaches

A very wise man once told me that when your only tool is a hammer, everything looks like a nail.

Change is coming: what to expect from Verma's CMS

Change is coming: what to expect from Verma's CMS

With former Georgia Congressman Tom Price confirmed as the new head of the Department of Health and Human Services, it's time to turn the focus on the person picked by President Donald Trump to helm the agency most closely linked to long-term care.

Our new health secretary is making big plans, at your expense

Our new health secretary is making big plans, at your expense

On Friday, Dr. Tom Price was sworn in as Secretary of the Department of Health and Human Services. Long-term care operators should cast a wary eye toward the new HHS boss for two reasons: Medicaid and Medicare. By all accounts, he plans to make changes to both programs that just might pose an existential threat to this field.

Chat up your in-house counsel

Chat up your in-house counsel

Sessions at the LeadingAge Institute covered the need to have documentation and delegation to reduce nursing liability, and another reflected an in-house counsel's perspective on hot legal topics.

Hold off celebrating until you see the proof from CMS

Hold off celebrating until you see the proof from CMS

Don't uncork the champagne just yet. That was my sentiment in August when a federal court ruled that the Centers for Medicare & Medicaid Services had come up short in its obligation to educate beneficiaries and providers about the historic Jimmo settlement. It's also my view today.