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.

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.

Don't punish SNFs for training

Don't punish SNFs for training

The Centers for Medicare & Medicaid Services have made information technology and staff competency a priority for the past five years.

Bridging the gap: Millennials in LTC

Bridging the gap: Millennials in LTC

Millennials were raised to be confident individuals. This confidence can be off-putting to their more seasoned coworkers.

QAPI - Tips for the facility assessment

QAPI - Tips for the facility assessment

The long-awaited QAPI regulations are finally in effect. Facilities now have until November 28, 2017 to create their QAPI plan and present it to state surveyors.

Finding balance and lighting the way

Finding balance and lighting the way

Most of our patients over 80 have vestibular deficits, and that's why they fall.

Making moments count

Making moments count

As a professional caregiver, you see, hear and experience the story of the lives before you, and not just the shell of an aging body. Your actions do not make the evening news, but they should.

When technology fails us: 'We talk'

When technology fails us: 'We talk'

Driving my Grandma to one of her favorite restaurants to celebrate a significant birthday (she prefers that I don't specify which) offered me an important lesson in communication.

Transforming PAC through SNF, ED and hospitalist collaboration

Transforming PAC through SNF, ED and hospitalist collaboration

Patients in post-acute settings are among the most medically fragile, with multiple co-morbidities that often require intensive care

How to survive the likely shift to bundled payments

How to survive the likely shift to bundled payments

Shifting the focus from the volume of services provided to the patient outcomes achieved is remarkably beneficial to both parties.

Mandatory CJR program offers opportunities

Mandatory CJR program offers opportunities

The post-acute area is viewed by most as the leading opportunity to find cost savings and efficiencies.

HHS: RACs not the primary source of the Medicare appeals backlog

HHS: RACs not the primary source of the Medicare appeals backlog

The U.S. Department of Health and Human Services recently issued a brief to the federal D.C. District Court related to the American Hospital Association's case against the agency over the backlog of Medicare appeals.

Three stars will be the new one star

Three stars will be the new one star

Nursing home operators call it low occupancy. Medicare insiders call it a declining census. Economists call it excess capacity.

Easing the family's transition from home to care community

Easing the family's transition from home to care community

Even though I'd worked as an activities director and administrator in long-term care, placing my mother in assisted living and then in memory care was initially a wrenching and emotional experience.

Becoming the MVP of the post-acute sphere

Becoming the MVP of the post-acute sphere

Everyone is aware that the healthcare system for reimbursement is changing rapidly and reimbursement will now be the driver of how we get our business instead of the reward for filling the bed.

Managing through uncertainty

Managing through uncertainty

These are uncertain times. But workplaces are often uncertain places because of rapid changes in market, ownership, business plan, technology.

What is the grade of your referral sources?

What is the grade of your referral sources?

How does the performance of your referral sources impact your outcomes? Turns out ... a lot. If you want to gain a better understanding of a hospital's performance, The Leapfrog Group is a resource to consider checking out.

Addressing rehab 'outcome killers'

Addressing rehab 'outcome killers'

When a resident leaves a skilled nursing facility after a successful rehabilitation, it's a clear signal to the community the facility is doing its job.

Three Medicare changes SNFs can expect under the new administration

Three Medicare changes SNFs can expect under the new administration

Ever since the ACA became law in March 2010, HHS has set a breakneck pace for transforming traditional Medicare fee-for-service payments into a value-based system; with Obama's HHS Secretary projecting that nearly every fee-for-service payment the agency makes in 2018 would be tied, in some way, to value.

Agency staffing on the rise? Believe it — and plan for it

Agency staffing on the rise? Believe it — and plan for it

The use of contract agency staff to fill nurse aide and licensed nurse vacancies is escalating. This increase is seen across many states, not to mention across the nation as a whole. Yes, we have a well-documented nursing shortage. Who, if anyone, is concerned? Let's all take a number and get in line!

It's that time of year again ...

It's that time of year again ...

Currently, we should understand Medicare Part B through the lens of Section 202 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Cracking new PT and OT evaluation codes

Cracking new PT and OT evaluation codes

January 1 will put new evaluation codes for physical and occupational therapy into effect and we all better be paying close attention.

How family expectations change a healthcare organization

How family expectations change a healthcare organization

It has long been speculated that a patient's (or their family's) disappointment with the care they receive in the healthcare system is a key driver for complaints and sometimes even litigation.

Managing an unexpected emergency or natural disaster

Managing an unexpected emergency or natural disaster

"Information is King" when an unexpected emergency or natural disaster strikes. Not just for those tasked with responding to and managing the crisis but for everyone impacted.

How nursing homes are filling the gap in continuity of post-acute care

How nursing homes are filling the gap in continuity of post-acute care

Dispelling a myth, changing a perception and instigating a cultural transformation is a heavy lift and takes a lot of time. But all of those things are taking place in nursing homes across the country, even amidst challenges of a nursing shortage, low wages for long-term care employees and a burgeoning elderly population that is living longer and with more complex health conditions.

Three considerations when implementing a new model

Three considerations when implementing a new model

This past spring, we at Jewish Senior Life broke ground on a campus transformation project that will redefine home for our elders and revolutionize the way we deliver care.

5 ways to increase occupancy with LGBT and ally residents

5 ways to increase occupancy with LGBT and ally residents

Plus, we know that LGBT older adults are less likely to access care, and when they do, they feel they have to go back into the closet in order to minimize the risk of being mistreated.

CMS issues final rule on requirements of participation for nursing homes

CMS issues final rule on requirements of participation for nursing homes

At the end of September, CMS published the final rule revising the health and safety standards that long-term care facilities must meet to participate in the Medicare and Medicaid programs.

House calls coming back for seniors needing care

House calls coming back for seniors needing care

Baby boomers likely recall, in flickering black-and-white, kindly physicians making house calls on television and in the movies.

Congress, we must reform Medicare appeals

Congress, we must reform Medicare appeals

Ten years - that's how long the U.S. Department of Health and Human Services Office of Medicare Hearings and Appeals estimates the Medicare appeals backlog of 750,000 cases will take to clear.

Staring into the abyss when the abyss won't make eye contact

Staring into the abyss when the abyss won't make eye contact

In this world of RACs, ADRs, denials and incentivized payback demands, it behooves us as providers to stare back at The Abyss and defy the illogical and irrational edicts of "PLOF" as the determining factor for payment.

Defending nursing homes cited with F-Tag 314

Defending nursing homes cited with F-Tag 314

With these recent decisions, we have discovered that there is success in demonstrating to a jury or arbitration panel how a pressure injury can be unavoidable as defined under F-Tag 314.

Commit to reducing stroke

Commit to reducing stroke

The most common type of arrhythmia, AFib increases stroke risk by five-fold and disproportionately impacts older Americans, with close to half of all atrial fibrillation-associated strokes occurring in patients ages 75 and older.

Be careful about showing appreciation during unstable times

Be careful about showing appreciation during unstable times

Sometimes well-meaning supervisors (and sometimes leaders who don't want to do the hard work of dealing with problems) try to use appreciation as a "quick fix" for deeper issues that need to be addressed.

Section GG: Collaboration with rehab

Section GG: Collaboration with rehab

The new GG Section of the MDS has been in practice for almost a month — just enough time to see what questions about nursing and therapy departments cooperating still need answering.

Commitment to care coordination: Finishing what we've started

Commitment to care coordination: Finishing what we've started

When California launched Cal MediConnect, its landmark dual eligible demonstration project, its architects knew the challenge they were accepting.

Selling fear: Are you buying?

Selling fear: Are you buying?

Fearmongering has certainly played a major role in the 2016 presidential race, but you might not realize it's also become more and more common in our own industry as well.

Losing our landmarks

Losing our landmarks

To build a courageous pathway for their organizations, long-term care leaders need to have a clear vision of what they want the future to be — for themselves and those they want to lead. Then, they have to remove what appears to be "fabricated evidence" that tends to snap a person back into usual patterns or decisions.

It's time to bundle up

It's time to bundle up

As we are moving towards new payment systems, it is imperative that we are involved and offer comments when we are able to as this will greatly impact us as providers. We also need to stay informed so we can modify our policies and procedures to be reflective of the changes.

Senior Olympics tap into the spirit of winning

Senior Olympics tap into the spirit of winning

Each year we bring hundreds of elders together in many states to compete for top medals and trophies in a heartwarming competition.