Yes, you do need to prepare for transgender residents

I was a Girl Scout growing up, and despite our slight rivalry with our Boy Scout counterparts (Girl Scout cookies are better than popcorn in every conceivable way, please stop fooling yourselves) I can still appreciate their motto: Be prepared.

Looking to survive in long-term care? Then it's time to 'pay' up

If you want to build an organization that's built to last for very long time, say multiple generations, follow the three-payment plan.

Improper payments often about inaccuracy

One of the common aphorisms uttered in the Newman house is Hanlon's razor. It has various iterations, but it is basically "never assume malice what can be explained by stupidity."

Neutrality an elusive concept in 'site-neutral' payment talk

It's fitting we're in the midst of Triple Crown season. That means it's time to pick a horse as your next winner — and it could possibly be a very big winner.

Want to ward off dementia? Follow Madonna's lead

If you really want to help cut your risks of cognitive impairment and memory loss, it might be time to go outside your comfort zone and take a few tips from the Material Girl herself.

SNFs and cabbies agree that more regs are needed — for the other guy

You can gain real insights about your future by examining what the competition is up to. Remarkably, there are still some skilled care operators who don't see assisted living as the competition. For them I have only two words: dementia care.

Shirtless nurse creates controversy

Good news, female nurses, you are now respected professionals valued for your experience and education.

Providers shake off gloomy forecasts with pride, optimism

First, the crowd of top-flight nursing home operators took the punch to the gut in silence. Then, they shed the stoicism and got even.

Person-centered care, Chopped style

If there was such thing as an armchair quarterback for the Food Network show Chopped, it'd be me. My friends and I have logged an almost embarrassing amount of time watching it (eight hours on one recent rainy day binge), yelling critiques at the on-screen chefs' dishes as we eat something totally unimpressive, such as microwave popcorn.

More frivolous lawsuits ahead? You can bank on it

Eldercare service providers would be well advised to watch proposed arbitration rules that have been aimed primarily at banks — for now.

The difference between addiction and dependence with opioids

While I love long-term care and the people who work in it, I don't think anyone would assert that it's cool.

Examiners see the churn and corporate SNF operators feel the burn

I imagined nursing home chain executives wincing two days ago at the sight of yet another study apparently finding they're doing a poor job.

Is no news really good news?

Long-term care doesn't exist in a vacuum. Every once in awhile, the issues you face in your facilities each day "leak" out of the healthcare realm and on to the pages of a major newspaper, for better or for worse.

Dealing with that other f-word

If there is one universal zero-tolerance policy at most facilities, it is this: Don't fail. Executives and others who don't meet prescribed goals tend to be quickly shown the door. It's almost as if failure is a disease that must be eradicated. This can be very wrong.

The need for semi-skilled workers in LTC

What do the meat and poultry industry and long-term care have in common, other than often dealing with turkeys? It turns out both have challenges in hiring semi-skilled workers, which is addressed in a bill proposed last week by Sen. Jeff Flake (R-AZ).

The cheapest Alzheimer's aid, and regrettably overlooked

What if it were announced that a new pill was available that could put off Alzheimer's disease onset or symptoms for more than four years? It turns out such a solution has existed for years.

Tales you might never expect from the frontlines of fraud

The healthcare world currently ranks as the fourth most victimized industry when it comes to fraud, falling prey to roughly 6.6% of all fraud incidents. In the long-term care sector, experts recently shared, one area gets hit harder than others: resident trust funds.

Are anonymous tips constitutional? Turns out there may be more than one answer

No nursing home operator wants to be accused of abuse or neglect by someone who can't be held accountable. Yet it happens with alarming regularity.

Medicare to reimburse certain genetic tests

News about how there will be Medicare reimbursement for hereditary cancer-related disorders, under a new CPT code for multi-gene panels, gives more options to some long-term care residents.

Time for a palliative care makeover

Celebrity party animals have done it. Nursing homes have done it. Now, it's time for palliative care providers to do it.

Finally, some good news about social media

PHILADELPHIA — McKnight's resident millennial here reporting live from The City of Brotherly Love with some exciting news: Despite all the social horror media stories we've seen cycle through the news recently, it's not all that bad for long-term care.

Great staffing ideas from the best in the business

For those of you feeling a bit overwhelmed about staffing issues, please let me offer a simple suggestion. Take a look at the March 15 issue of Fortune magazine. You're likely to discover many ways to make your facility a more attractive place to work.

Therapy revisions remain a CMS goal

If there's one sentence from this week's Office of Inspector General report that should be pulled out and displayed on your bulletin board, it's this: "We found that Medicare payments for therapy greatly exceeded SNFs' costs for therapy." In long-term care, them's fightin' words.

They're comfortable with dying, but ...

A new study shows that many of the "oldest old" are OK with dying. But nobody knows it. Well, almost nobody. This is a waste.

Learning to distrust technology

We live in a society that relies on technology for just about everything. This isn't my opinion as someone who was raised in the advent of the internet and smartphones. This is a fact.

CMS, it's time to listen up

The options for finding the most appropriate nursing home for a loved one are, shall we say, somewhat limited, especially when compared cars and other products. But there may be a solution to that.

  • CMS

Other states should follow Nebraska's nurse protection example

If you have any doubt that lawmakers pay attention to news that comes across their desk, meet Omaha Sen. Brett Lindstrom (R). Lindstrom spearheaded a whistleblower protection bill.

25 years later, this plague is still among us

Somewhere Dr. Bill must have been smiling. That was my conclusion when I read a recent dazzling article from Pulitzer Prize winner Amy Ellis Nutt.

Good brews

My relationship with coffee has been a tumultuous one over the years. The good news is there's more research that shows why I (and fellow coffee fanatics) don't have to give it up any time soon.

Lower the temperature and see a whittled waistline?

I found results of a recent study bittersweet. They showed that lower home temperatures in the winter were associated with lower waist measurements. Specifically, elderly adults grow bigger in the middle when they turn the heat up during cold season.

Who wants to be a billionaire?

The March 21 issue of Forbes, which lists the richest people on the planet, is as much fun as the Sears Christmas Wish Book.

How should long-term care providers celebrate? Let us count the ways

Long-term care operators have plenty of reasons to recoil and lick their wounds over the course of a year. But there are also good times when they should find reason to smile. Like this past week.

March Gladness

The college basketball gods were not smiling down on me this season, because going into the Sweet Sixteen I had only one hope of winning our friendly office competition for NCAA team champion: Wisconsin. It's my home state's flagship team, one that seemed to be doing well and was known for giving the world this adorable viral video

The Department of Pro-Labor is at it again

Do you own or help manage a non-union facility? If so, your professional life might soon get more complicated. For that you can thank the Department of Labor, again.

Investments in lower back pain needed

This week the Patient-Centered Outcomes Research Institute announce this week it was authorizing $22 million to study ways to improve treatment of chronic low back pain, along with another $12.5 million for Patient-Powered Research Network demonstration projects.

A person-centered road trip

The road to person-centered care is a long one, paved with good intentions but filled with potential barriers and roadblocks.

Some poignant observations about life (and death) in nursing homes

Despite Stephen Covey's warning, most of us are ruled by the tyranny of the urgent.

Politics and leadership require ability to compromise

Collectively as a country and specifically as an industry, we have to recognize success is delivered not only from speaking up, but also understanding compromise.

When opportunity knocks, LTC pros answer

Say what you want about long-term care professionals because I've just about heard it all. They work too hard, they whine too much, they work for too little, they should be watched closer, and so on. But one thing is inarguable: They're opportunists, and they like to find a good deal.

Long-term care's fear factor

If you've been keeping up with McKnight's Daily Editor's' Notes, you'll know former LeadingAge CEO and President Larry Minnix's potential presidential platform includes an initiative that would put high school graduates to work on public service projects — including volunteering in nursing homes. Even if we don't see Minnix throw his hat into the election ring, the initiative could help satisfy long-term care's ongoing volunteer conundrum.

The root cause of naked photos

Sen. Tom Carper (D-DE) had never crossed my radar before this week, but he certainly has my attention now. He's demanding feedback from federal regulators on their tracking of social media exploitation by rogue nursing home employees.

A message from the future president of the United States

Last week in this space, I solved our nation's problems, and long-term care's, all in one fell swoop. Since then, there have been more embarrassing debates among bickering candidates for president, making my nomination of retired long-term care executive Larry Minnix look all the more genius

Time for a cyber security update? You better believe it

Advances in technology and providers who lag behind on updating their information technology systems have created a "perfect storm" of vulnerabilities in healthcare IT security, one expert warned us. Worst of all, providers don't seem to being paying attention.

Equal pay for equal work? Has MedPAC lost its mind?

If you are a post-acute provider, the big health news last week was not Donald Trump unveiling his post-Obamacare blueprint. It was the fact that MedPAC is getting closer to a rather brazen new approach to post-acute payments: equal pay for equal work.

Healthcare pushed aside in 2016 race

Lady Healthcare and her child, the Affordable Care Act, were once the bon vivant of public discourse. But they are of little interest today, giving way to the economy, jobs, foreign policy, immigration and other inflammatory subjects.

LTC's smart choice for president

The nation should have a better idea soon as to who will be slinging mud at one another this fall for the top office in the nation. One way or another, it's not looking good for long-term care interests. Unless I get my way.

Meditation can help with back pain

My first introduction to meditation was not in a peaceful, spa-like setting. There were no candles burning, and if there was any light music playing in the background I didn't hear it.

Maybe it's time to reconsider the labor challenge

When it comes to recruitment and retention, many operators need to start doing a better job. It starts at the very beginning of the process.

When to take away the gun?

While we spend a lot of time talking about depression and loneliness in long-term care, we spend less time talking about suicidal seniors. Here's why we need to.

Proof election year is no time to take anything for granted

It seems you can't count on anything for certain in an election year — just ask any Trump skeptic - and that could mean special things for long-term care.

In it for the long term

There was one positive highlight the day I started working as a cashier at a Culver's restaurant long ago: meeting Betty. She had to at least be in her 80s. She was tiny and spunky, greeting us all with "Morning time!" as she arrived for work each day.

His advice: You're probably doing it all wrong

George Cloutier has been giving nursing homes and other small business clients this troubling message for three decades: You don't know what you are doing.

Accidents can lead to progress

Ignaz Semmelweis, who died in ignominy and is largely forgotten, is responsible for one of our greatest healthcare discoveries.

We hate to say we told you so, but ...

Take it to heart when we say that long-term care is going to be reimbursed differently in the not-too-distant future. Put off plans for it at your own peril.

These residents won the Super Bowl

If you watched this month's Super Bowl game between the Carolina Panthers and the Denver Broncos, you know the Broncos took home the title. At Gastonia Care and Rehabilitation in Gastonia, NC, however, the game had a slightly different outcome.

Cues from canines in dementia research

There's debate in the Leis/Newman households over the intelligence of the family basset hound, Daisy Mae. My mother believes Daisy Mae is purely food-driven, rather than intellectually gifted. I disagree.

His passion is LTC policy and funding, thank goodness

There is an unusually strong fire in Doug Burr that keeps him going, and for this, long-term care providers everywhere should be thankful.

The robot revolution

Every once in awhile, I come across a research report that falls into what I like to call the "duh" category. These are the studies that announce the "scientific breakthrough" of something that just seems to me like common sense. The latest study to trigger my duh alarm came with this headline: "Senior citizens may accept robot helpers, but fear robot masters."

Why the field's biggest problem is not going away anytime soon

There are many serious problems in long-term care: funding, regulations, legal concerns, staffing and more. But none of these is the biggest.

Speech plans shouldn't be a hard act to swallow

How do you discuss a speech or swallow-care plan with someone who might not be able to communicate well?

Solution to workforce woes in providers' own hands

Former baseball executive Branch Rickey is famous for bringing Jackie Robinson to the Major Leagues to break the color barrier in 1947. It is especially noteworthy since this is Black History Month, but providers should admire Rickey for another reason as well.

Don't fear the millennials

When you're a young person who began mulling career choices in the midst of the Great Recession, and then went on to pick a profession lovingly referred to as "dying," odds are you'll go to great lengths to ensure that you have a stable job upon college graduation.

Just when you think Medicaid payments couldn't get worse ...

Providers have long-enjoyed a like-hate relationship with Medicaid. Many operators view the program much as a circus trainer might eye a recently acquired wild animal: There's lots of potential, but danger too.

Interviewing — and hiring — millennials

There's a running joke at McKnight's about an interview I conducted with a millennial last year in which the candidate, on a Skype interview, wore a suit. This was notable given how most Skype candidates had opted for a casual look.

When blinding conditions open the eyes

It would be reasonable to think that a storm that caused dozens of deaths and the shutdown of federal government offices is a bad thing, a very bad thing. But you would be only half right.

A potential lawsuit in every worker's pockets?

Here's a pop quiz: Guess which camera now takes the most photos? If you chose Canon, Nikon, Pentax, Olympus or Sony, try again.

Adding life to end-of-life care

As I suspect of most journalists, I'm an eavesdropper. Recently I heard a pizza shop employee say to another employee, "No one was being honest with her," and the other employee said, "I can't believe it. Well, at least she doesn't have kids." It killed me that they started whispering after that.

Study reminds providers about the tough prospect of putting up or stepping aside

My friend Rich admittedly didn't know much about the group of school kids he was about to oversee. But as a business manager, he told me he had his own favorite method of ironing out disagreements between two squabbling parties. Stop the emails, third-party negotiating and excuse-making. Just put them face-to-face in a room together.

Cloudy with chance of flu

For many parts of the United States, this winter has been a weird one — if you can call it a winter at all. Consider it a bonus if you're a long-term care provider.

Tracking antibiotics in LTC

The announcement Thursday of the official end to the deadliest Ebola outbreak on record was cause for a rare public health celebration. It also served as a reminder of the need for better infection prevention and management in healthcare.

Bigger and better than ever: McKnight's Online Expo returns

Try to remember when you were 10 years old. Still a big future ahead of you, but you had already seen a lot and, man, were you ever full of energy!

Get S.M.A.R.T.

Odds are you haven't seen this expert advice to make sure your personal New Year's resolutions — and those for your facility — stick around even after you stop accidentally writing 2015 on your checks.

Knowing when your LTC organization needs to change

An underlying resistance to change continues to persist in this field. How do you know when it's time to fundamentally transform? Actually, there's quite a bit of literature out there on the subject.

Let the people go to work

The news that Pennsylvania may have to loosen its ban on those with criminal histories working in nursing homes could seem scary, but is actually good news.

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.


    James M. Berklan

    Elizabeth Leis Newman
    Senior Editor

    John O'Connor
    Editorial Director

    Emily Mongan
    Staff Writer