Government funding showdown includes special LTC drama

As drama rages over whether Congress will allow the federal government to grind to a halt Friday night due to a funding tug-of-war, long-term care providers will anxiously watch to see if a repeal of Medicare Part B therapy caps will be a part of any solution.

Presenting to win

In a profile about House Majority Leader Kevin McCarthy (R-CA), one detail about how he treated President Trump was seized upon by a variety of media outlets, for good reason.

Long-term care operators, meet Jan Brady

Middle daughters around the world still relate to the fictional Jan Brady's exasperation with her TV big sister — "Marcia! Marcia! Marcia!" So too should long-term care operators. But instead of being jealous of an older sibling, this field's indignation might be better directed at nearby hospitals.

You already know the LTC story to watch this year (and so do they)

Look into the crystal balls out there to speculate about the rest of 2018. But remember, too, that examining the past is also a very good way to know the road ahead.

New night shift study sounds the alarm

Over the years, I've heard what seems like every possible explanation for cancer. Sometimes it's cancer patients blaming themselves through questionable science — "I was too stressed" or "I should have eaten less sugar" — and other times it's more legitimate — "She was a lifelong smoker" or "She had the BRCA1 gene."

Three things that won't happen in long-term care during 2018

Last week I offered three fearless predictions for the year ahead in long-term care. So without further ado, here are three predictions every long-term care operator can count on. As in, count on NOT to occur.

Nursing homes catching a break? What do you think?

When stuff hits the fan, it's often all a matter of perspective. That's the pickle nursing homes find themselves in today.

Watching out for the hungry HIPAA

Amid all the focus on new rules for nursing homes, we can't forget the old ones and the need to audit, train and document.

3 bold predictions for the coming year in long-term care

There's nothing like a budding new year to awaken that urge in scribes to warn better-informed readers what to expect. It must be some kind of occupational hazard. So in the spirit of not always being right but never being in doubt, here are three predictions you can take to the bank.

And the Long-Term Care Newsmaker of the Year is ...

There's never been a newsier time in the world of senior care. Numerous huge issues and personalities have shaped the last 12 months. But there's one clear choice for who should be "The Long-Term Care Newsmaker of the Year."

Certain healthcare words are worth fighting for

Last week, long-term care providers likely celebrated the slashing of regulations announced by the Trump administration. This week, they should be appalled by a move that may impact how they do their jobs.

Yes, the regulatory picture is actually improving

Believe it or not, the overall picture has been improving. And it might get even better in 2018.

Disaster or learning opportunity?

It pays to know that amid the byzantine architecture of the Department of Health and Human Services there are QIN-QIOs. That's Quality Innovation Network-Quality Improvement Networks for those with plenty of ink in their cartridges.

A MRSA vaccine may be on the horizon

If a MRSA vaccine could be developed for adults, it could potentially save nursing homes a lot of money, not to mention reset some of our infection control protocols.

A no-brainer plan for Medicare and Medicaid

But for those of you who think outrageous political trickery is dead, please let me point you in the direction of Capitol Hill. For we appear to be in the midst of one of the better con jobs to come along in quite some time, and it's threatening your supply of Medicare and Medicaid dollars.

Now that it's teed up, providers need to keep an eye on this ball

Golfing great Jack Nicklaus had an insightful comment that long-term care providers might find helpful as they struggle with day-to-day tasks.

Give yourself the gift of chilling out this holiday season

Taking time to step back and reevaluate how you're using your time — and if you're a manager, how your employees are faring this time of year — can pay off big time.

A provider lesson in saying goodbye gracefully

I was impressed recently when I saw the press release announcing that Villa Healthcare was closing its Villa at River Parkway in Milwaukee in March.

Tax bill reveals a great divide in long-term care

One of the more interesting aspects of the epic battle over the tax reform bill has been this sector's response. One major long-term care organization continues to blast proposed changes while the other has remained largely silent.

A reason for providers to smile amid so much angst

Sure, a tax overhaul bill that has a significant segment of providers quivering is picking up steam and should be on the president's desk soon. But there's also other legislation being considered that should have providers acting like tiny tots with their eyes all aglow.

Let nurses take the wheel

At the end of the day, who's really making sure a resident's move to a skilled nursing facility is the right one?

CMS gives providers a mug with a gift card

Never have Rolling Stones' lyrics come faster into my head than when I saw the Centers for Medicare & Medicaid Services would give an 18-month enforcement delay for certain Phase 2 regulations.

Fire, rain and the elephant on the 40th floor

You never know when freak storms or unexpected fires might strike. But you can be sure that if and when one does, angry people will line up to demand that you be held more accountable.

How does your staff feel about person-centered care?

For just about every study, conference talk or article touting the benefits of person-centered care in nursing homes, it seems an argument can be raised to dispute the findings.

When leaders leave

Diane Carter's decision "was one of the toughest I've made," she says.

How nursing homes can put themselves out of business: skimp on tech

When you read between the lines, the troubling message in a new study is this: Skilled care operators had better stop being tech cheapskates — before it's too late.

Hollywood Hills owners up off the mat, courtroom drama all but guaranteed

Lawyers and legal finaglings are rich fodder for some of the most popular movies and television productions ever made. Get ready for another big show in that regard, and long-term care will be at its core.

An unexpected consequence of workplace violence

The healthcare industry is well aware of the consequences of workplace violence. With workplace violence-related injuries in the sector clocking in at nearly five times the rate as the private sector as a whole, it'd be hard not to.

Perceptions of stress impact our views on promotion

It would be unusual to find anyone working in the long-term care industry who wouldn't regularly think of themselves as stressed.

Work shirts and staff attitudes

For most of his adult life, my dad was an operating engineer for Sears Roebuck & Company. He wore shirts with its name almost non-stop. Such choices might not reveal much. Then again, they could be quite telling

Why the new 'Best Workplaces in Aging Services' list matters so much

Providers around the country should share the enthusiasm for Fortune magazine's new "Best Workplaces in Aging Services" list. All of them will benefit from the good vibes the list will generate.

Embracing — and encouraging — online reviews

It's time again to talk about an issue that's been increasingly on healthcare providers' minds in recent years — and will probably only continue to grow more urgent: patients' online reviews.

What not to do when criticized

If you want to see the trickle-down impact of lowering the bar related to our expectations of public political decorum, look no farther than Missouri Gov. Eric Greitens (R).

A new way to think about long-term care funding

During a talk last Monday at the LeadingAge conference, Harvard Professor Jennifer McCrea served up an interesting take on the warping nature of money.

New LeadingAge board chair declares it's time to play ball

Several thousand LeadingAge members got their first look at new board chairman Steve Fleming on Monday, and if initial meetings are any indication, it's going to be a wonderful relationship.

Shining a light on domestic violence within your staff

Domestic abuse can harm a workplace from the outside, with victims reporting higher rates of lost productivity, absenteeism and difficulty focusing on work due to their abuse. In nursing homes, domestic violence has led to headline-grabbing tragedies, including the case of two employees and a police officer shot to death in May by the estranged boyfriend of a nurse.

What we can (still) learn from Dr. Ruth

It shouldn't have been surprising to see the throngs of folks lined up to see Dr. Ruth Westheimer, speaking during LeadingAge's annual conference on Monday. She fittingly fronted an exhibit called Sex, Drugs and Rock 'n' Roll, and it was inspiring.

Nursing shortage relief from an unexpected source

When it comes to skilled-care staffing, the future outlook is bleak. If it's possible, the situation for nurses might be even worse. But at least a partial solution could be in the offing from a surprising source.

Therapy caps a big step closer to extinction

Could this really be happening? Medicare Part B therapy caps took a huge step toward vanishing for good on Thursday.

Time for some Halloween magic — senior style

It's recently come to my attention that some people haven't seen the greatest Halloween movie of all time. No, it's not a slasher flick or anything that relies too heavily on jump scares. I'm talking about the 1993 masterpiece "Hocus Pocus."

Isolated nurses and the crisis of LTC identity

A new English study is both interesting and concerning related to long-term care nurses. These nurses feel isolated and excluded compared to others in the healthcare profession, and that can have big implications for you.

Are you ready for some political football?

Well you just knew things were about to start getting nasty for Florida nursing homes. That's what generally happens when more than a dozen residents die for reasons that are hard to believe.

The hell with this guy

Speaking at the same Mandalay Bay complex in Las Vegas from which a "madman" committed the deadliest mass shooting by a single person in U.S. history just two weeks earlier, American Health Care Association CEO Mark Parkinon delivered a bold, unscripted edict.

What's on LTC's 'to-don't' list?

My main takeaway from a key speech Monday is likely something that hit home for others in the audience as well: we should focus less on what we should be doing, and more on what we shouldn't.

The 20-mile march in LTC

It's rare for smart leaders in any industry to not be familiar with Jim Collins, especially his signature work, "Good to Great."

Promising signs on the regulatory front

President Trump is no fan of regulations, and long-term care operators have more than their fair share to contend with. So it's a welcome breeze when Trump says he wants to start eliminating some regulations. But the industry ought to do something more on its own.

Here's a road map to the LTC leaders you should be following

You could make good use of talking pens, drone technology and a program that brings 70% reduction in incontinent episodes, right? Yes, you could — just like your fellow providers have.

Could end-of-life care be getting worse?

With more providers and patients than ever focusing on palliative and hospice care, shouldn't the quality improve at least a little bit? Not necessarily.

Stop claiming 'resident rights' in discrimination cases

Administrators wiser than me have offered advice on what to do when there's a racist resident.

Time for long-term care to go postal?

One of my favorite gone-off-the-rails fundraising stories involves one of my former college roommates.

Nurse staffing crisis averted? Thank the millennials

It's your friendly neighborhood millennial here, back with some exciting news about the age cohort that's been mystifying employers and apparently annoying everyone else over the past decade or so — we might have just helped the healthcare industry avoid a huge problem.

Failing better

As the week begins with even worse-than-usual news — on many fronts — I decided to forego what I was going to write about (interpreting the OIG's latest report) and make a recommendation.

Is it time for operators to focus on small ball?

Rick Matros tweaked more than a few noses last week when he made some rather disparaging remarks about the benefits of investing in behemoths. As he sees it, there pretty much are none.

Gingrich: Providers able to fix workforce problems themselves

Newt Gingrich tells long-term care providers not to wait for the government to fix their staffing challenges. He also claims some relatively easy solutions are at operators' fingertips.

Urban opportunities for providers

When you think of the top places people want to retire to, the location that comes to mind probably isn't a huge, bustling city.

The value of RN-to-BSN programs

The idea of a BSN programs should be a big draw to long-term care RNs.

Biting off your nose to spite Obama's face

It's hard to describe how incredibly dangerous and stupid the latest GOP effort to replace Obamacare really is. But I'll try.

When no comment says a lot: A tale for nursing homes and hospitals

One should never forget that some of the most brutal fights occur between brothers or sisters.

Gear up for another healthcare payment fight

Watching the GOP try to force through its latest healthcare reform plan, which would once again hit Medicaid hard, I was reminded of something my mother used to jokingly say: "It's like deja vu all over again."

Time to increase your dose of overprescribing education

It turns out seniors who might be victims of overprescribing recognize it an issue all too well, according to new research.

Here we go again: All nursing homes are bad

There is no way to sugarcoat what happened last week in Hollywood Hills, FL. Eight skilled care residents died in the wake of Hurricane Irma. Our condolences go out to the victims and their families. But there is another troubling aspect to this that deserves attention. Namely, it's becoming clear that nursing home bashing is in vogue again.

Provider gives perfect response to Hurricane Harvey evacuation critics ... and then gets taken to court

Late last week, I latched onto what I thought — and still think — is a great example of how a provider should respond to a bad public relations incident. We're talking standing up to critics in the wake of Hurricane Harvey.

EHRs that suck away the physician's soul

It's not a secret that in long-term care, direct-care workers often resent physicians.

Who's thriving? Here's the shopping list for it

People most likely to thrive are ... (drumroll please) ...

On second thought, I'll walk in my own shoes

Nothing matters more to hospitals than the wellbeing of the people they serve. Well, there may be one thing — money. Maybe that's why you're unlikely to find any hospital commercials touting the remarkably loose ways they can define "observation status."

Do you pass the free-time test at work?

Now that summer is essentially over, can you say your employer is one of the better ones when it comes to vacation and warm-weather perks? More important, how do your choices rate? Many signs aren't good.

Harvey response brings heartfelt tugs from all of LTC

Amid the massive amount of tragic news related to Hurricane Harvey, there also have been many ways long-term care stakeholders have risen to the challenge. The list includes providers as well as the volunteers and suppliers who enable them to take care of those in their care.

Something new to think about for flu season

Allow me to get ahead (slightly) of the deluge of news articles, press releases and conference sessions on influenza and vaccinations that are about to hit, with the results of a new study throwing a new wrench into vaccination efforts: race.

Out of the bad we shall find good

"Out of the bad we shall find good." That sounds kind of biblical, doesn't it? But I didn't hear it while sitting in a pew on a Sunday. It came from a resolute skilled nursing manager I was talking with a while back.

A Baptist Home blast from the past

Coming from a long line of folks who hate to throw anything away, culling more than 250 books this summer from our house has been physically painful. But the cleaning also has resulted in some unexpected treasures.

Put on your boogie shoes — your brain will thank you

I'm a fan of dancing. I've been known to bust a move in bars, at weddings, in school musicals and during obligatory dance breaks at college football games. But one thing I actively tried to avoid at all costs was dance workout classes — until recently.

Make arbitration an option — an obvious one

Like so many other contemporary debates, the arbitration issue has degenerated into a talking-points battle.

You're not too busy to know this CMS news is good news

It's nice to have friends in high places. Even better if she speaks of clearing regulatory clutter.

Regarding working, with help from Google

It's worth checking out Google's blog, "re: Work," which shares tools and documents used by Google managers, all for free.

In case you missed it, there's a new Medicare audit process coming

it's understandable if a story we ran last — about the Centers for Medicare & Medicaid Services revamping its Medicare audit process — slipped under your radar. Here's what you need to know to catch up.

Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

    Contributors

    James M. Berklan
    Editor

    Elizabeth Leis Newman
    Senior Editor

    John O'Connor
    Editorial Director

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