Maybe we should start calling it short-term care?
We used to call them nursing homes.
But that changed during the ‘80s and ‘90s. The term would eventually lose out to another moniker with less negative baggage: long-term care. Alas, it appears change is in the air once again.
Many operators are now finding themselves under unprecedented pressure to get non-Alzheimer's patients out the door as quickly as possible. Which raises a legitimate question: Should care in skilled settings be called something more in tune with this altered reality?
Say what you will about nursing homes/long-term care facilities/skilled nursing facilities/post-acute operators — they have always been quick to embrace new funding options. Frankly, it's probably the main reason why the field continues to exist. Necessity is one mother of an invention, and there have been two kinds of skilled care operators over the years. The quick. And the dead. These days, the smart money says there's more money to be had by betting short.
Michael Beal, who is President of Kindred Healthcare's Nursing Center Division, was the latest person to point out the adjustment. Speaking in Chicago at a recent Health Industry Distributors Association forum, he noted skilled care operators are under unprecedented pressure to flip those beds.
He accurately noted that the push to get residents out the door in as little as a week is being driven by an emerging “value-based” business model. You have to wonder if the people who came up with the term “value-based healthcare” are the same ones who originated jumbo shrimp, Great Depression, random order and recorded live? Because there is something quite unsettling about the notion of improving care by incentivizing providers to deliver less of it.
That is, unless you buy into the notion that residents have been lolly gagging in facilities for no good reason lo these many years.
I can certainly understand the push to trim waste, fraud and abuse. And if more efficient care can be delivered at a lower cost, so much the better for everyone.
But let's not kid ourselves. Sometimes less may be more. But as a general rule, less is usually less. And as operators find themselves forced to trim service, we shouldn't be surprised if that comes at a steep price for many residents.
Some say we are moving to a world of short-term care. I guess that's one way to describe rationing.
John O'Connor is the Editorial Director at McKnight's.