How to help residents manage the nutritional side effects of cancer

How to help residents manage the nutritional side effects of cancer

Cancer treatment can cause a multitude of side effects for patient resident who is suffering from the disease, many of which can affect nutritional status.

Come fly with us!

Come fly with us!

Watching the news these days, it's easy to feel like nursing homes and those of us working in them aren't doing anything right. I want to suggest otherwise.

Why ASC 606 elevates risk for LTC providers

Why ASC 606 elevates risk for LTC providers

The Department of Justice's largest-ever healthcare fraud enforcement action, announced in mid-July, sends a clear signal about the federal government's escalating efforts to eradicate and penalize fraud in healthcare: They're here to stay.

CMS requirement for Legionnaires' disease control in LTC

CMS requirement for Legionnaires' disease control in LTC

Nineteen percent of all Legionnaires' disease (LD) outbreaks are LTC related.

Antibiotic Stewardship: At the heart of what we do

Antibiotic Stewardship: At the heart of what we do

It's not news that our planet has a serious antibiotic resistance problem on its hands, or that better antibiotic stewardship across the health care spectrum is essential to solving it.

Advice from a daughter to caregivers

Advice from a daughter to caregivers

Some tips from a daughter's perspective.

RCS-1 says goodbye to rehab? Yes & No

RCS-1 says goodbye to rehab? Yes & No

The more minutes of therapy, the higher the payment. Are there unintended consequences from the current model? Of course.

I rinse out my plastic bags

I rinse out my plastic bags

I rinse out my used plastic bags. Maybe not all the time, but often ... I do love our Mother Earth, but that wasn't driving my behavior.

Sharing secrets to success in ventilator weaning

Sharing secrets to success in ventilator weaning

Post-acute care facilities must excel at weaning patients off ventilators. After all, what hospital wants to transfer a patient to a facility with mediocre weaning success rates, after its staff has worked very hard to help its patient recover throughout a lengthy ICU stay?

Managing RCS-1

Managing RCS-1

The new Resident Classification System, which may be implemented Oct 1, 2018, is changing the game. I say "may be implemented" because there's reason to believe that it may be delayed a year.

A lesson in disaster preparedness for LTC facilities

A lesson in disaster preparedness for LTC facilities

As healthcare entities throughout Texas and Florida work tirelessly to put back the pieces following hurricanes Harvey and Irma, reflection is likely top of mind.

Psychotherapy creates meaningful identity for the LTC resident

Psychotherapy creates meaningful identity for the LTC resident

Yet many long-term care residents know, deep down, there is "something more" out there; and that "something more" is often something unfinished - a hope or aspiration that never came to full fruition in their lives

Sexual orientation dispute takes new turn

Sexual orientation dispute takes new turn

The ongoing court dispute over whether Title VII of the Civil Rights Act of 1964 outlaws discrimination on the grounds of sexual orientation — as opposed to gender — has taken a new turn with the filing of a brief by the Department of Justice arguing that it does not.

Employee engagement: What story does the data tell leadership?

Employee engagement: What story does the data tell leadership?

The first time I used the words "resilience" and "engagement" was with my leadership team at the time. I asked, "What can we do to advance engagement and help people to be more resilient?" Suddenly, everyone around the table had important emails to read on their phone.

Caregiving and curbing sibling discord

Caregiving and curbing sibling discord

Serving as a caregiver for an ailing parent or parents can be extremely challenging. It can be physically, mentally and emotionally draining.

Why your business needs hired and non-owned auto liability coverage

Why your business needs hired and non-owned auto liability coverage

Is there ever a time when your employees might use their private vehicles to perform company business?

Understanding the Braden Scale with pressure ulcer management

Understanding the Braden Scale with pressure ulcer management

Multiple studies have demonstrated the validity and reliability of the Braden Scale. However the accuracy of the risk assessment is dependent upon an understanding of the multiple risk factors contributing to the development of pressure ulcers, particularly for residents with risk for lower extremity wounds.

Exercise is more important than you thought

Exercise is more important than you thought

For those of us approaching the age where some of our peers are starting to show decline in their cognition, it's certainly worth doing everything we can and exploring all options to preserve the physical and mental health of our clients.

The cheese has moved ... will Sniff find it?

The cheese has moved ... will Sniff find it?

Imagine my surprise when several people came bearing the shocking news that "the MDS will not matter anymore" and that RCS-1 is "the end of the MDS." Wait, what? Not on your life!

Technology and the senior ethical terrain

Technology and the senior ethical terrain

One of the tasks of gerontology schools, nursing facilities, senior living facilities in an increasing geriatric society must seek ways of linking high-tech inanimate objects with value rituals of seniors.

Understanding and dealing with negativity in the workplace

Understanding and dealing with negativity in the workplace

Negativity is one of the most common, and deeply ingrained, obstacles to a healthy work environment.

Is the Trump administration signaling no employment protection based on sexual orientation?

Is the Trump administration signaling no employment protection based on sexual orientation?

Would you be surprised to learn that a conflict exists within the Trump administration? I didn't think so.

Effective rehabilitation influences success of care

Effective rehabilitation influences success of care

When it comes to rehabilitation and skilled nursing care, the majority of seniors and their families are looking for an effective and comprehensive process which will get them back home with a decreased chance of re-admission to the hospital.

Physiatrists: Optimizing and expediting PAC

Physiatrists: Optimizing and expediting PAC

With Medicare essentially stamping "declined" on more and more attempts to discharge post-acute patients to inpatient rehab facility care, skilled nursing facilities have become the preferred setting.

Improving end-of-life care begins with honoring patient preferences

Improving end-of-life care begins with honoring patient preferences

While hospitalizations and aggressive disease treatment are common in serious illness, hospice and palliative care specialists support patients through the entire trajectory of disease to include educating and empowering patients about the benefits and burdens of various interventions.

4 steps to creating an interactive music therapy program

4 steps to creating an interactive music therapy program

Music therapy is in the news a lot lately, and there's a reason for that: it works.

Emergency preparedness: More than an act of paperwork

Emergency preparedness: More than an act of paperwork

My phone rang and the voice said, "We are activating our incident command center." I asked, "Is this a drill?" The voice in a solid tone replied, "This is not a drill."

Monitoring quality of care for contracted services

Monitoring quality of care for contracted services

Regulatory and accrediting agencies such as Centers for Medicare & Medicaid Services and The Joint Commission expect healthcare organizations to monitor the activities of their external contractors to ensure the quality of care, treatment and services they provide.

And he did it 'his way' — will you and yours?

And he did it 'his way' — will you and yours?

Packing for New Jersey to help Bernie (my father-in-law, whom I was honored to call "Dad") navigate his transition from hospitalization to SNF, something told me to pack a suit.

Sector-specific LTC pharmacy data warehouse now a reality

Sector-specific LTC pharmacy data warehouse now a reality

Ensuring the provision of quality post-acute care in skilled nursing and assisted living facilities requires the need to direct and perform an increasingly complex array of medication management regimes and clinical functions.

Embracing tai chi in long-term care

Embracing tai chi in long-term care

When residents take initiative to create programs that flow from their passions, the result is greater engagement.

Facility assessment, emergency preparedness and QAPI — a service delivery exercise

Facility assessment, emergency preparedness and QAPI — a service delivery exercise

Your post-acute/long-term care organization should be well on its way to developing its Facility Assessment, Emergency Preparedness Plan and written QAPI plan for compliance by November 2017. The best way to address these three new RoPs/CoPs is by transitioning your healthcare organization into one focused on service delivery.

Learn how to advocate in D.C.

Learn how to advocate in D.C.

I've had the pleasure and honor of participating in advocacy in a variety ways in the last 10 years .

Nurse morale and its impact on LTC

Nurse morale and its impact on LTC

Nursing is a demanding occupation - a career as a nursing professional is often associated with long hours and high stress. Especially in long-term care facilities, where patients receive both physical and cognitive assistance around the clock, the emotionally taxing atmosphere can increase the likelihood of low employee morale.

Being a leader who leads as if there were no tomorrow

Being a leader who leads as if there were no tomorrow

What would our leadership look like if we thought that tomorrow would not come? If we ask ourselves that question, we immediately will reason there is a tomorrow. That is our challenge: We always give ourselves time. Time, in this case, is not our friend.

Don't mess with my Uber rating!

Don't mess with my Uber rating!

My most recent trip to Washington, D.C., was wrapping up like most others. I was heading to Reagan Airport by way of Uber, but what happened next was not typical — and drove me to write this piece.

Leadership lessons from cleaning ladies

Leadership lessons from cleaning ladies

Effective leaders leave powerful clues.

Understanding chiropractic care in LTC

Understanding chiropractic care in LTC

LTC health professionals know all too well that musculoskeletal pain is a common patient complaint.

Discerning between confidence and competence

Discerning between confidence and competence

The Harvard Business Review spoke to an issue a few years ago that has concerned many of us in and out of healthcare for some time: "Why do so many incompetent men become leaders?"

The call you do not want to make

The call you do not want to make

I can still remember it clearly when the phone rang and a serious voice on the other end of the line told me what happened. My loved one fell and, luckily, didn't break any bones.

Payment accuracy is a calling

Payment accuracy is a calling

Careers in the healthcare field span such a wide variety of applications - with some passionately drawn to provide care for vulnerable patients like children or the elderly, while others are attracted to fast-paced, hospital settings.

Residents with cognitive impairment don't feel pain

Residents with cognitive impairment don't feel pain

Please, someone tell me why we are still challenged with identifying and treating pain in the elderly, particularly those with dementia.

Acute care and PAC: A friendship long overdue

Acute care and PAC: A friendship long overdue

Hospitals and health systems are increasingly shifting their focus to managing an episode of care.

The ACA repeal and its impact on nursing homes

The ACA repeal and its impact on nursing homes

The public dialogue surrounding repeal of the Patient Protection and Affordable Care Act, also known as Obamacare, has made little mention of the nuts and bolts of the legislation that would be lost when it is gone.

The X-Attackman of LTC

The X-Attackman of LTC

While watching my son's lacrosse game this weekend, I realized those of us practicing in long term care could learn from the offensive team member positioned behind the goal—the X-attackman.

GAO gets it right with need for more IT

GAO gets it right with need for more IT

It's good to have a "big dog" recognize that the long-term and post-acute care sectors should be given more help with information technology and exchange.

A path to success for LTC antibiotic stewardship

A path to success for LTC antibiotic stewardship

There are two dates fast approaching that will have a major impact on long-term care operations and revenue.

How a 15-year-old inventor flew across the world to help pressure injuries

How a 15-year-old inventor flew across the world to help pressure injuries

The adage "you are never too young to teach and never too old to learn" took a new meaning at the National Pressure Ulcer Advisory Panel (NPUAP) Biennial conference held in New Orleans..

Navigating the discharge process

Navigating the discharge process

Not long ago, my mother broke her hip and spent time in the hospital. Upon discharge, the social worker gave us a list of post-acute care facilities.

Making the leap to person-directed care

Making the leap to person-directed care

How do we shape a new reality for long term care? With the aging sector in general under attack and ageism on the rise in today's society we have a larger obligation than ever to reach for something more. Transformation in its literal definition means to go beyond. The question then becomes how do we go beyond what we see?

How to address progress in therapy documentation

How to address progress in therapy documentation

One of the fallacies that we suffer under as therapists in SNFs is the mythology of the "Plateau."

Malnourishment: Your issue and mine

Malnourishment: Your issue and mine

I was amazed how I lost 10 pounds while being in the hospital. I made a joke with a friend of mine who is a dietician about the "hospital diet." She became very serious and stated, "You know we do more harm than good to our patients by the lack of attention to malnourishment." In looking to the research, she is correct.

A case for interoperability: Electronic lynchpin for long-term success

A case for interoperability: Electronic lynchpin for long-term success

As an owner-operator, you likely are on information overload when it comes to electronic health record (EHR) systems.

Have you met Jimmo's stepbrother Jimmo?

Have you met Jimmo's stepbrother Jimmo?

Therapy utilization will be as scrutinized as much as it ever has been, even though the "improvement standard" has once again been deemed deceased.

Focusing on senior housing's big picture

Focusing on senior housing's big picture

As 2017 continues, and the dynamics change, it's critical that lenders, owners and operators be patient and take a holistic view of the market — particularly the demographics and particulars of their sub-markets.

Grassley deserves credit for fighting fraud and abuse

Grassley deserves credit for fighting fraud and abuse

Most people would acknowledge the President of the United States as the most powerful person in the world. If those same people were asked to identify who is currently the most powerful person in the healthcare industry, most outside the healthcare industry would not have a ready answer.

Customer service at its finest?

Customer service at its finest?

I've had the privilege to speak with two different medical entities today and wanted to share the experience with my readers and colleagues.

Control your claims: Pressure ulcer/wound care management

Control your claims: Pressure ulcer/wound care management

Our loss trending experience has shown us that the same issues that result in F-tags during a survey can also result in a patient event or claim.

When lifting patients, an ounce of prevention is worth a pound of cure

When lifting patients, an ounce of prevention is worth a pound of cure

We've all heard the old adage attributed to Benjamin Franklin that "an ounce of prevention is worth a pound of cure." And while Franklin's famous words were written nearly 285 years ago, they still resonate today, particularly with regards to implementing a safe resident handling program.

Celebrating 40 years of AMDA

Celebrating 40 years of AMDA

Even since I joined the Society as Executive Director four years ago, I have seen the Society and the setting change a great deal.

Creativity, cognition and coloring

Creativity, cognition and coloring

As awareness of mindfulness and stress management self-care techniques grows, adults are rediscovering the simple pleasures of engaging in coloring to relax, while also improving their brain function.

Community-based care models that reduce re-hospitalization

Community-based care models that reduce re-hospitalization

The Centers for Medicare & Medicaid Services' Bundled Payments for Care Improvement (BPCI) initiative has handed skilled nursing facility professionals an opportunity to play a greater role in post-discharge care coordination.

Getting started with culture change

Getting started with culture change

One question that has come up repeatedly over the years when I have been working with leaders that are new to the idea of culture change is, "Where do I start?"

The SNF mental health revolution

The SNF mental health revolution

SNF administrators must ask themselves, "Did we provide the kind of care the resident really needed to maximize her 'whole emotional and mental well-being?'"

Where are we going with long-term care?

Where are we going with long-term care?

Long-term care was never planned. It was never even consistently defined. A generally useful definition is that it is a set of services to assist persons who have lost, or never acquired, basic capabilities for self-care and management.

I was a HIMSS Virgin (#HIMSSnewbie)

I was a HIMSS Virgin (#HIMSSnewbie)

Yes, this was my first time. I was nervous and did not know what to expect. Let me start with a confession: Five years ago, I didn't even know what HIMSS (Healthcare Information and Management Systems Society) was.

Arbitration agreement case in Georgia: What to understand

Arbitration agreement case in Georgia: What to understand

A recent decision from the Supreme Court of Georgia makes clear that a plaintiff who brings a wrongful death claim against a decedent's nursing home is bound by the arbitration agreement entered into by the decedent and/or her power of attorney.

Tips to help staff increase familiarity with LTC regulations

Tips to help staff increase familiarity with LTC regulations

CMS' views about the unfamiliarity of existing and proposed requirements by hard working professionals and family caregivers, and the fact that they are troubled by it, is a point well taken

Warnings about Medicare's future continue to be ignored

Warnings about Medicare's future continue to be ignored

The Government Accountability Office has released its 2017 "High Risk List," which identifies federal agencies and programs vulnerable to fraud, waste, abuse and mismanagement.

4 strategies for increasing ownership in your team

4 strategies for increasing ownership in your team

It's possible to create your work dream team instead of settling for a drama team. Here are four quick mindsets you can incorporate today to get the drama out of your team and help them take a new level of ownership.

A mixed year ahead for SNF providers

A mixed year ahead for SNF providers

It was an eventful year in 2016, especially for the seniors housing and care sector. Aging baby boomers, diminished finances and divestiture of skilled nursing facilities were topics on the mind on many providers in the past 12 months.

The LTC industry should be ashamed

The LTC industry should be ashamed

I left long-term care in 2016. One day, I sat across a long conference room table and was awestruck by the decimation I observed before me.

What is the value of your brand?

What is the value of your brand?

As a nursing leader, I rarely gave credence to branding and the value of a name, until I was sitting in a local coffee shop. I was interviewing for a new position at a nearby hospital in town when I observed an interesting group wearing branded clothing. Person after person saw the brand and came over to the group to mention how much their hospital meant to them.

How we create a homelike environment for rehab patients

How we create a homelike environment for rehab patients

The staff at Shuksan provided opportunities for Arlene to feel in control, in a situation where self-reliance lacked.

A workers' compensation success story

A workers' compensation success story

When an injured employee is out of work, there is a potential that the injury will impact an organization's productivity, efficiency and overtime costs.

Antibiotics in LTC: Changing from 'Just in case' to 'Only when needed'

Antibiotics in LTC: Changing from 'Just in case' to 'Only when needed'

Prior to the discovery of antibiotics, the most common cause of death was infection. There was no good treatment for pneumonia, complications of urine or ear infections were common, and many people died of simple wounds.

This blog makes me think of 'Seinfeld'

This blog makes me think of 'Seinfeld'

Jerry Seinfeld's successful nine-season comedy sitcom was a "show about nothing," yet it won more than 40 international awards. Although this blog might not receive such international acclaim, it reminds me of "Seinfeld" because, well ...

A new movement: exercising the tongue

A new movement: exercising the tongue

Swallowing difficulties can create havoc for long-term care residents, and their direct caregivers. Luckily, there is a relatively new focus for saving residents and staff from a lot of frustration, and potentially dangerous circumstances: tongue exercises.

Factoring in social risk to your value-based strategy

Factoring in social risk to your value-based strategy

Providers that were hoping to see adjustments to value-based purchasing programs based on the social risk factors of the patients they serve may likely have to wait until larger revisions to healthcare reform are settled.

Understanding and responding to PTSD

Understanding and responding to PTSD

I was recently asked to evaluate a skilled nursing resident who, in his short time at the facility, was presenting a confusing picture to staff.

Short-handed or short-sighted?

Short-handed or short-sighted?

When we communicate that we are having staffing issues, whether or not that communication is correct, we are telling the residents and their families that we can't do our jobs.

Building championship teams during uncertain times for SNFs

Building championship teams during uncertain times for SNFs

As we face payment reform, delivery reform, the aging of America, the strength and challenge of an increasingly age and ethnically diverse workforce and the consumer demands of aging boomers, now more than ever before is the time to build championship teams.

Lower the risk and deter elopement

Lower the risk and deter elopement

The single most cited F-tag in a Centers for Medicare & Medicaid Services survey is F-323 in regards to resident safety and supervision.

Muse moments — engaging the hearts of those you lead

Muse moments — engaging the hearts of those you lead

The celebration of Valentine's Day is a celebration of love and connection. It also is statistically one of the highest dates for engagements to happen. When you translate that to the world of healthcare, how then do you engage the hearts of those you lead on a daily basis when our traditions seem to be a once-a-year event?

Avoid lawsuits and protect licenses

Avoid lawsuits and protect licenses

Document, document, document! Those words echo through the halls in a myriad of places − from the firing of an employee for cause, to substantiating or absolving an accusation of abuse or wrongful act.

Abe's Garden expands access to dementia care

Abe's Garden expands access to dementia care

At Abe's Garden, we know the alarming statistics about Alzheimer's and dementia. However, the focus of all who work and volunteer here are the unique adults we care for every day.

Practicing gratitude to heal the soul

Practicing gratitude to heal the soul

Wednesday is "gratitude journaling" day at Shuksan and for the next 30 minutes these residents will reflect upon their day and the past week, thinking back on whether there was anything that made them feel grateful. Anything at all.

What is your vision for PACE expansion and innovation?

What is your vision for PACE expansion and innovation?

In the final days of the Obama administration, the Center for Medicare & Medicaid Services provided a parting gift to the PACE community by issuing a Request for Information seeking stakeholder input on the design and implementation of a broad range of PACE pilots.

New accounting standard presents unique challenges for PAC providers

New accounting standard presents unique challenges for PAC providers

Healthcare companies, particularly post-acute care providers, may feel the pain more than others, and they - along with their investors - should prepare sooner rather than later.

What makes a Five-Star nursing home?

What makes a Five-Star nursing home?

The philosophy we've followed at Presbyterian Village at Hollidaysburg in order to achieve our Five-Star rating has always been to constantly evolve and strive for innovative and creative ways to provide the best care possible.

Maybe you don't want to be in that preferred network ...

Maybe you don't want to be in that preferred network ...

When it comes to contemplating joining caregiving networks, maybe you have more in common with the hospital than you think. Poor-performing hospitals tend to coexist in the same market as poor-performing skilled nursing facilities. Surprised?

Opportunity: Improve care for Americans who need it most

Opportunity: Improve care for Americans who need it most

For people with complex health and social needs, getting better isn't simply finding and receiving the best care they can access at their local hospital.

Caregivers and nurses: Knowing when to get involved in issues of elder intimacy

Caregivers and nurses: Knowing when to get involved in issues of elder intimacy

As caretakers of elderly people we focus on their health, comfort and emotions. We monitor their eating, bathroom routines, and even their socialization.

Understanding the risk of dialysis for LTC residents

Understanding the risk of dialysis for LTC residents

Researchers, doctors, nurses, patients and caregivers have already gone a long way in preventing catheter related bloodstream infections.

What to do when a POA agent doesn't pay

What to do when a POA agent doesn't pay

Long-term care facilities traditionally take steps to ensure that residents have a financial and a healthcare power of attorney in place upon admittance. But what happens when an agent named under a POA fails to make payments for the resident's stay at the facility?

A two-pronged approach to protecting SNF residents from influenza

A two-pronged approach to protecting SNF residents from influenza

Good news: More skilled nursing facility staff are getting their annual influenza vaccine than ever before. Last season, nearly 70% were vaccinated, up from 64% a year earlier. Bad news: SNF staff still have the lowest influenza vaccination coverage rates of healthcare professionals by work location.

Behavioral and psychiatric challenges in SNFS

Behavioral and psychiatric challenges in SNFS

"Bonnie" was admitted to the skilled nursing facility following surgery for a right hip fracture. Prior to her fall, she said she was living by herself, fully independent. Although she claimed she wanted to return to her apartment following rehabilitation, she was slow to make gains in her therapy, often complaining of great pain and isolating herself in bed.

Understanding 'Unbefriended'

Understanding 'Unbefriended'

We're wrapping up a time of year when many of us are heartened by seeing family and friends for the holidays. But what if residents don't have anyone?

Want to prevent lawsuits? Talk to us!

Want to prevent lawsuits? Talk to us!

I've heard a lot of talk lately about suing nursing homes - not only from family members distraught over an elderly loved one's injury or death in an SNF, but also from the growing chorus of lawyers trolling the local airwaves for potential plaintiffs.