Smoking: A Catch-22 for providers

Journey with me, children, back to 2003, when yours truly hung out with smokers.

Don't like the new ratings system? Welcome to our world

The content in the angry letter sounded all-too familiar. "Flawed methodology" and "substantive errors" in CMS's "chosen methodology." Another nursing home organization taking issue with the Five-Star ratings system, right?Actually, the authors were blasting a new ratings system for HOSPITALS.

Why some children may not visit LTC residents

A Pioneer Network webinar on Thursday was a good reminder of how easy it can be to judge absent families when caring for the elderly.

It's time to sit for a visit and get caught up

McKnight's Senior Living's inaugural Online Expo arrives June 20. Just like McKnight's past Online Expos that have attracted thousands of long-term care professionals, it is free to attend and offers free CE credits — three, to be exact.

The secret to 'winning' post-acute care

What does it mean to win post-acute care? There aren't any trophies involved, no big acceptance speeches in front of the industry. What winning providers do have, however, is a deep understanding of their data and a competitive edge in their markets.

Of arbitration victories and payback

In a year already chock full of regulatory victories, last week's development about arbitration clauses might turn out to be the best of the bunch. But ...

What the OIG video leaves out

One might be forgiven for watching an Office of Inspector General video discussing nursing homes and wish it were about 10 — or 20 — minutes longer. That's because the video is under three minutes long. It tells maybe half the story around the OIG and nursing homes.

A big threat gone, but bigger threat looms

Providers are thrilled with the administration's decision to rescind an order to ban pre-dispute arbitration agreements. But they also know they can't let their guard down.

An ounce of pressure injury prevention

Benjamin Franklin once said that "an ounce of prevention is worth a pound of cure." His 1736 statement was referring to firefighting — better to prevent a fire than deal with putting one out — but it can also apply to one of the most challenging issues in long-term care: Pressure injuries.

Involuntary discharges could lead to a fine mess

Operators might want to keep an eye on new involuntary discharge legislation under consideration in Illinois.

Staying true to a mission while expanding

It's hard to intrigue me much when it comes to renovations or new buildings. But in the case of Masonic Homes of Kentucky, one element in particular caught my eye: Its history as a refuge for widows and children, and how the latter continues to inspire its mission.

Alarming results in latest study

In a clear case of being able to learn from a cousin, long-term care providers should take note of results of a baby-monitoring study at a respected pediatric hospital.

Medicaid just might sink Trumpcare

With recent major funding proposals about Medicaid causing such a tizzy, it's fair to ask why the powers-that-be find Medicaid such a tempting piñata. There are two main drivers. But only one is usually mentioned in polite company.

Summer's here — can you hear me now?

Memorial Day heralds the start of summer — and with it risks for both you and your residents.

LTC's 'diamond in the rough' elevated to center stage

Eye-rollers might be inclined to snort at the thought of "just another" research center popping up. But they might want to have another think after Tuesday's big long-term care announcement.

Hire younger healthcare workers — lives might depend on it

Researchers with Harvard's T.H. Chan School of Public Health found slight differences in 30-day mortality rate for hospitalized Medicare beneficiaries when treated by doctors in different age groups.

Why the Obamacare repeal is being held up — at least for now

There was a celebration at the White House earlier this month after the House narrowly voted to replace the nation's health law. More than two weeks later, the House has still not advanced the American Health Care Act to the Senate. And it's beginning to become clear why.

A tip for a good speech: Practice with a pooch

As much as I enjoy presenting or speaking in front of groups of people, it's also true that a moment before I begin, I always experience a moment of sheer panic.

Where your future referrals might be coming from

Whether you're a kickball captain on the playground, a Little League coach on draft day or a shopper crossing the threshold for a big new sale, you know the look you give.

A milestone for Music & Memory

With how much positive press and research surrounding the benefit music can bring to people with dementia, it came as somewhat of a shock to me to find there had never been a nationwide study of the Music & Memory program — until now.

When an open-door policy goes awry

As an administrator or manager, do you have an open-door policy? Or an open office floor plan? It's often recommended, but in many cases, it can go awry.

How to compare Obamacare and its House GOP replacement bill — in a nutshell

I'm happy to report I might have found a near CliffsNotes equivalent for the recently passed American Health Care Act. You know, the Obamacare repeal and replace bill that the House passed last week.

Lost without translation

In an age where 1 in 5,000 households speak a language other than English, language barriers between healthcare workers and the patients they care for can have care-related consequences, including higher risk of readmissions, longer inpatient stays and more adverse events.

Two tech developments you won't want to miss

Technology has been a true game-changer in long-term care. That's why it gives me such great pleasure to announce that the 2017 McKnight's Technology Awards contest will kick off Thursday (May 11).

The cost of a healthcare win

Yesterday was a great day for House Republicans as they passed a bill that slashes $840 billion from the Medicaid program over the next decade and will cause an estimated 24 million Americans to lose their health insurance in the next decade.

Long-term care pharmacy: missed opportunities

One thing I've learned since joining this business years ago is that if you want a creative, persuasive thinker on your team, you could do a whole lot worse than Alan Rosenbloom.

Step away from the vending machine: Real life nutrition tips for healthcare workers

Long-term care leaders can encourage healthy activity among their staff, starting with modeling healthy behaviors themselves. But what about the frontline healthcare workers with just a few minutes a day to eat, or employees whose stressful duties are taking a toll on their own health?

With pay hikes like this, you might need a bankruptcy attorney

President Trump just announced a new plan to slash tax rates for long-term care operators and other businesses. But his desire to aid the corporate class has apparently not made its way to the Centers for Medicare & Medicaid Services.

Agility, attracting millennials among top 2017 workforce trends

"You cannot make long-term successful change with people who are blocking it," a long-term care workforce expert said Thursday. He's, oh, so right, about this and other staffing challenges.

20 career dos and don'ts ... and more

I don't think I'd ever heard of Menlo College in California before Wednesday, but if I had a college choice to make again, I might seriously consider going there. If only to learn more from its president and how he might help my career, and yours.

Don't drop the Diet Coke just yet

Every so often a new study will be published that reminds me of my favorite Onion headline of all time: "Man Who Drinks 5 Diet Cokes Per Day Hoping Doctors Working On Cure For Whatever He's Getting."

Don't overlook this new mandate in the PBJ manual

The Centers for Medicare & Medicaid Services inserted an important new requirement in the latest version of its Payroll-Based Journal manual. It's one of those innocent-looking provisions that are fairly easy to skim over. But your facility might quickly find itself in hot water should it be ignored.

The high costs of bad health among front line caregivers

We are what we eat, and there's a lot of evidence that our nursing home workforce is struggling to be good.

GoFundMe campaign covers nurse's fine, but should it ever be paid?

The saga of nurse Carolyn Strom has been one of our most popular over the last six months. She is, of course, the Canadian who vented about her grandparents' healthcare on Facebook and was fined for it.

It's time to take your medicine — seriously

People not following their doctors' medication orders contributes to an estimated 125,000 deaths and 10% of hospitalizations per year, along with somewhere between $100 billion and $289 billion in healthcare costs. A lot are like like certain geniuses on my Facebook page.

Finally, some good occupancy news

You could almost hear the collective sigh of relief when NIC released its first-quarter tally on skilled nursing occupancy levels. To be sure, the 87.2% rate is not exactly a cause for celebration. Then again, maybe it is.

A better opioid policy shouldn't mean seniors suffer

In addition to the terrible tragedy of opioid addiction in the United States right now, long-term care providers have an additional challenge: Figuring out both how to make sure seniors retain access to pain medication and how to keep those medications from leading to addiction.

Life in the slow lane: SNF employment

With one son in college and another trying to figure out where to attend, the future job market is a topic near and dear to this writer's heart. Believe me.

Award winning advice on keeping employees engaged

As a teenager I spent a few weeks one summer working at a very popular food stand at the Wisconsin State Fair. "Very popular" is an understatement — the stand serves thousands of people each day, with some customers I spoke with driving from out of state just to eat there.

MedPAC wants to put SNF Medicare claims to the test

Skilled operators have been telling lawmakers and regulators that they are the cheapest post-acute care option out there, and it appears the Medicare Payment Advisory Commission has not only heard the claim, but wants to take the industry up on it.

The broken record of bad public relations

If there's an area that I would argue is as bad as it was when I wrote about it in 2012, it would be how-long term care operators handle a public relations crisis.

Bank that sleep now

When I was very young, my parents used to chuckle at how I, a through-and-through suburban kid, would rise so early and turn on the TV to watch ... the farm report.

When resident rights could be wrongs

What happens when a resident's wishes clash with the regulations with which long-term care providers must comply?

Medicaid as an attractive funding source?

It wasn't too long ago that thousands of nursing homes were fleeing the Medicaid program.

When perfect is the enemy of good

One of the common refrains you heard last week as the GOP healthcare plan marched to its demise was Republicans saying that "we're letting perfect be the enemy of good."

Keeping the glass half full

If you need a little encouragement to stay positive next time something goes awry, look no further than this story from the New York Times.

For long-term care operators, there's no time for a pity party

Skilled care operators have their work cut out for themselves. But I have to say I'm feeling better about the sector's prospects after spending some time at last week's NIC Spring Investment Forum in San Diego.

Rooting out the cause of a cat problem

Hearing the phrase "root cause analysis" always strikes a bit of fear into my heart because it always seems to be a complex process. In long-term care, this is often framed as not only knowing that a resident fell, for example, but why she fell.

This is what admired long-term care leaders do

We found some long-term care employees willing to talk about how their managers make a real impact by giving help. These are long-term care managers who talk the talk AND walk the walk — and earn the admiration of workers.

Deathly serious: Time for more talking; odds not great without it

For all the benefits that end-of-life care talks can bring, a new study indicates that even when such talks take place, patients' preferences aren't always understood or effectively communicated. In total, just 20% of the surrogates interviewed correctly predicted the veterans' end-of-life care preferences.

Does your back have room for another target?

As Momma used to say, not everyone who wears respectable clothes is respectable.

Hit the road with your staff

The most delightful story in politics this week leads us to some great tips for getting to know your co-workers better, and includes a reference to Willie Nelson. What could be better than that?

Put those loudmouth family members to work

Whoever said politics makes strange bedfellows could have a field day with this one.

The hidden threat lurking in your facility

I don't mean to make your lives more difficult by adding another issue onto that pile, but according to a recent survey from the National Safety Council, there's a problem plaguing American workplaces that needs addressing: prescription drug abuse.

Don't be worried about Medicaid funding cuts — be very afraid

The long-term care industry's worst fears about what a Trump healthcare plan might contain have not just been met after last week's unveiling, they have been far exceeded.

What the new health insurance plan would mean for long-term care

As a long-term care provider — and very importantly, employer — you might not be thinking about the full costs of what the House's newly proposed health insurance plan could be. Let's break it down.

It's time to take sides about Obamacare's future

Tuesday's statement from the American Health Care Association on Republicans' plan to repeal and replace Obamacare was striking. There was no walking a tightrope or mealy-mouthed ambiguity in it.

Multi-generational mixer builds great collegian-CCRC resident bonds

From adding cheerleaders to finding backgammon partners and sharing farming advice, a collaboration project between a CCRC and Fresno State students has been a rousing success.

Snobbery that skilled care operators can ill afford

Quite a few skilled care operators tend to look at assisted living as being not quite equal. Many on the skilled side tend to see themselves as being a bit, ahem, more qualified.

How to make your leave policies better

While most businesses offer at least two weeks of vacation at a minimum, the topic of a recent article in Crain's caught my eye: Companies offering unlimited vacation.

Your money's no good here

I'd say the thing we write about most often in this line of work is payment issues. As a long-term care provider, you are eternally under pressure with whether there will be enough to pay for everything.

Why so blue?

I've been in a fight with my computer monitor for the past couple of days. The screen was crisp and bright looking, but after a few hours I'd start getting a headache. I had been blaming that on a lack of coffee, until I started doing some research.

It's not just charity that should begin at home

Long-term care operators tend to be a nervous lot. Rightfully so.

Re-evaluating CT for dementia residents

For all of our interest in cognitive training for dementia patients, we are nagged by knowing that studies on the topic have varied in quality and reliability.

Bad-mouthing the cost of long-term care

Finally. That's was my silent reaction when I received the email from a top long-term care provider last week. What took so long? I still wonder.

There's another tsunami coming you probably haven't thought about

There's a significant facet of the coming "silver tsunami" that most providers might be overlooking, according to a recently published report.

Seeking feedback in pursuit of gritty greatness

How often do you, as an administrator, CEO or manager, ask for feedback of colleagues? What I'm talking about is a casual conversation related to improving quality and strengthening company culture, especially with employees lower on the totem pole.

No wonder so many have pounding headaches

A very wise man once told me that when your only tool is a hammer, everything looks like a nail.

Change is coming: what to expect from Verma's CMS

With former Georgia Congressman Tom Price confirmed as the new head of the Department of Health and Human Services, it's time to turn the focus on the person picked by President Donald Trump to helm the agency most closely linked to long-term care.

Our new health secretary is making big plans, at your expense

On Friday, Dr. Tom Price was sworn in as Secretary of the Department of Health and Human Services. Long-term care operators should cast a wary eye toward the new HHS boss for two reasons: Medicaid and Medicare. By all accounts, he plans to make changes to both programs that just might pose an existential threat to this field.

Chat up your in-house counsel

Sessions at the LeadingAge Institute covered the need to have documentation and delegation to reduce nursing liability, and another reflected an in-house counsel's perspective on hot legal topics.

Hold off celebrating until you see the proof from CMS

Don't uncork the champagne just yet. That was my sentiment in August when a federal court ruled that the Centers for Medicare & Medicaid Services had come up short in its obligation to educate beneficiaries and providers about the historic Jimmo settlement. It's also my view today.

Keeping the love alive after the honeymoon

Recent research from a long-term care employee research group has found first-year workers in the sector are nearly 10% more engaged that workers who have been at their jobs for more than a year. Managers need to consider the implications of this.

Is Donald Trump a friend or foe of long-term care?

There's an old saying in Chicago politics: Once you're bought, stay bought. In other words, if you are being paid to behave a certain way, don't flip-flop. Those who would like to think they understand our new president would do well to keep that adage in mind.

LTC needs a game plan on immigration

Less than a year ago, it seems as if the long-term care sector was making positive strides in its workforce shortage issue by supporting a bill that would have brought in foreign semi-skilled workers, such as registered nurses, to the United States. Now, things are uncertain and it's not clear where leadership wants to go on these matters.

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