Playing the population health game in long-term care

When discussing the hospital field, just about every other word out of someone's mouth has something to do with "value" or "population health." The wave is about to long-term care with full force.

Will drug price list bring clarity or just transparency?

Centers for Medicare & Medicaid Services Administrator Seema Verma announced Tuesday that her agency will be publishing "Drug Dashboards" to show the public how much drug prices covered by her agency are rising.

A pro-union move that will put 'democracy' to the test

A newly proposed bill could give unions quite a boost. At your expense. Called the "Workplace Democracy Act," don't let the name fool you. From an operator's perspective, there's not much in the proposal that might even remotely be called democratic.

Making sense out of quality measures in long-term care

Dan Ciolek has spent some 30 years in long-term care, and though he's become adept at quite a few topics in the field, one thing he's still trying to make sense of is quality measures.

When acute and post-acute talk, good things can happen

A young parent's fond wish is that her child, or children, play well together with others. A busy young parent's fondest wish often is that the kids pretty much do it on their own. That's the situation healthcare providers find themselves in quite often nowadays.

Skilled care operators might want to curb their PDPM enthusiasm

If some operators are getting the PDPM tingly-dinglys, I'm experiencing something else: a sense of déjà vu.

Come on folks, do we really need a 'national day' for this?

Forgive me for being such a cynic at my age, but I'm suffering from severe "National Day" fatigue.

Providers rewarded for sticking with it

One could excuse long-term care providers if they're walking around looking over their shoulders right now. I can personally identify with that.

We're shocked — shocked! — that bribery is going on here

Few sectors are as vulnerable to Washington's fickle winds as long-term care.

Are you the Superman, Wonder Woman or Dwight Schrute of long-term care?

When the day starts to drag, and the fantasies begin rolling through your head at work, what fictional character do you start picturing yourself as? Are you the Wonder Woman of the nursing home field? Homer Simpson? Freddy Krueger?

Is it the docs' turn to get stoned?

The Centers for Medicare & Medicaid Services brought out its equivalent of a brass band and confetti machine Tuesday to tout a new provider payment strategy. One could almost hear strains of "Happy Days Are Here Again" in the background.

What should long-term care make of these scathing reviews?

Two stories that resonated the most over the past year have been personal blogs from long-term care operators who have left the profession. That's a very interesting fact.

4 steps toward slaying the zombies in your nursing home

They're everywhere — in your billing department, food services, human resources or janitorial — and they're secretly sabotaging your nursing home, one day at a time. We all know some.

'Omni-mom' Barbara Bush gives providers a gift

The tributes to former First Lady Barbara Bush will wash over the media landscape for at least a few news cycles, as well they should. But then, unfortunately, the world will go back to its twisted ways and the airwaves will be dominated by tantrums, tweets and twits.

Will the new mantra for nursing home operators be 'quality over quantity'? Yes and no

A new study from the Kaiser Family Foundation confirms a shift that most skilled care operators can relate to. While resident occupancy levels continue to bottom out, the new arrivals are in worse shape than ever.

Job well done, Grosso has eye out for next adventure

Frank Grosso has done a lot in his 67 years. But he's not done. That much he wants to make abundantly clear.

Bold moves that won't do long-term care any favors

By most accounts, the election of Donald J. Trump as our 45th President has been great news for long-term care operators. But amid various success stories, a serious misstep may be in the works.

Aid for aides: 40 hours' pay for 30 hours' work

To some it could be like studying less for an important exam. Taking food away from a person in need of nutrition. Donating one's modest paycheck to the millionaire's club.

Come for the bargain prices, stay for your annual review

Do you want to work for Walmart? You might not have a choice some day soon.

Time to hit the reset button on readmissions?

It's purely coincidental that it's Easter week and I'm writing about putting all of your eggs in one basket. The researchers put me up to it.

What's a nursing home operator to do? Make adjustments!

Operators who can make some adjustments and ride out the current regulatory and operating storm might not just survive, but thrive.

LTC's 'story of the year' awaiting next chapter

Providers and other stakeholders must feel like school children sitting in the principal's outer office, anxiously — if not eagerly — awaiting their fate.

The skilled care sector may be doomed. What else is new?

If this field had a mantra, it would be: We'll find a way, no matter what.

Tele-ing it like it is: We've got a lot to learn

On its face, this process seems so simple, especially given technology advances lately. Kids do it, even grandmas and grandpas are doing it. So why can't the U.S. medical community do it better?

Are some skilled-care owners doing good and doing too well?

Fortune magazine just released its latest list of billionaires. And this year's compilation contains at least one representative from the long-term care sector. Frankly, I'm not sure whether this development qualifies as helpful or hurtful.

LTC needs to be like Mike

I was worried I wouldn't appear too excited about the Christmas present. Because I wasn't really.

Are we entering skilled care's Golden Age? The answer might surprise you.

It's very possible historians may look back at 2018 as a kind of Golden Age for skilled care. No, I have not been drinking.

End the quarter on a high note

You have every opportunity to make your year a winner even though it's only March.

A case for the flu shot, even with the flu

The time has come, dear readers, to confess a secret. I caught the flu after Christmas. And I had received the flu shot in September.

NAB is making major CE changes. Register now or suffer later.

Long-term care professionals in the habit of obtaining continuing education credits from the National Association of Long Term Care Administrator Boards had better brace for some dramatic changes that kick in April 1. For beginning on that date, many of the old rules will expire.

Note to providers: Go down swinging or get eaten alive

If you feel like you're getting picked on, you should fight back. Scrap like hell, thrash about and do anything you can to cause a ruckus and save yourself. What does this have to do with long-term care providers? Possibly everything.

OIG's chiropractic report should draw more attention

A report last week from the Health and Human Services Office of Inspector General on fraud related to Medicare and chiropractic reimbursement led me to ask the following question aloud: "Wait, Medicare covers chiropractic stuff?"

This hospice study might make nursing homes less comfortable

What's the best eldercare development we've seen in the past quarter century? For my money, nothing compares to the ongoing expansion of hospice care services.

What to expect with the therapy caps repealed

Don't ever let Congress plan your next party. That's my sincere recommendation.

Yes to leisure, no to idle time

In healthcare, the idea of anyone having idle time at work would likely be met with a laugh. Our collective wisdom indicates that American workers are terribly busy, whether they are working in a nursing home, a school or in a corporate role.

Did OSHA just tell nursing homes to cut back on care?

The Occupational Safety and Health Administration dropped the hammer on a Colorado facility last week. Given what's happened, OSHA's response might seem reasonable. At least on paper.

Remember to let your residents test drive

Earlier this week I landed in the hospital, a story filled with highs and lows that I won't bore you with. But I did want to share what I learned about a topic near and dear to the hearts of long-term care operators. It's probably not what you're thinking.

If your New Year's resolutions aren't still intact ... (a professional lift)

Reassert yourself to the optimistic, goal-oriented ideas you early latched onto at the start of the year.

The Supreme Court is about to deliver another blow to unions

An upcoming Supreme Court ruling might be the end of public unions. As far as most nursing home operators are concerned, it's too bad the same fate wouldn't extend to non-public unions as well.

With no promise of therapy caps fix, real pain hitting home

Long-term care providers who supply therapy weren't invited to the big party Thursday, but they're hoping they'll still have reason to celebrate soon anyway.

A bad surveyor workplace hurts providers

As difficult as your job may be — and I know there are many long days — it's worthwhile to remind yourself it could always be worse. You could be a nursing home surveyor in Idaho.

Maybe they should be called Medicare Disadvantage plans?

How well are Medicaid Advantage plans working for participants when it comes to skilled-care placements? There are doubts.

There's no time like the past, wherever you are

Let there be no more questions about whether creating long-term care facilities to reflect different eras is a good idea.

Managing family expectations in antibiotic reduction

It was different, and helpful, to hear Philip D. Sloane, M.D., MPH, a University of North Carolina Chapel Hill professor, discuss how to talk to families about antibiotic reduction during a McKnight's Super Tuesday webinar yesterday.

The boss at CMS has some nice things to say about regulations

It appears there may be some good news ahead, courtesy of the boss at the Centers for Medicare & Medicaid Services.

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

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 Marty Stempniak.

    Contributors

    James M. Berklan
    Editor

    Elizabeth Leis Newman
    Senior Editor

    John O'Connor
    Editorial Director

    Marty Stempniak
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