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.

Compassion from LTC managers? Only if they want better resident care, lower liability risks

A funny thing happened in the making of a recent insurance company analysis of claims in the aging services market: a primer broke out on how to achieve better healthcare and liability outcomes by creating better management-staff relationships.

Your future ratings rest in residents' hands

Any news story that heralds a something as the "next frontier" in healthcare is probably worth clicking on, right?

Getting to the teeth of the matter

"I have a bone to pick with you," proclaimed the indignant voice on the other line. In my experience, conversations that begin with that invitation seldom go well.

Price says the right things on Medicare, Medicaid

It would be unwise to assume that Rep. Tom Price (R-GA), the likely new head of Health and Human Services, is always going to align with the values of long-term care providers. But in the midst of a whirlwind of news around cabinet appointments, it is worthwhile for nursing home providers to take a deep breath and read about what Price did — and more importantly, did not — say this week.

Former CMS head has new job: keeping Obamacare alive

Former Centers for Medicare & Medicaid Services leader Andy Slavitt burst out of the back room to state his intention to keep Obamacare alive. Bold words from a man not particularly known for bold actions.

Your FitBit might just save your life — and your residents'

Even though I fell off the wearable fitness monitor bandwagon, recent research from the Stanford University School of Medicine might just serve as the incentive I need to jump back on it.

MedPAC's message to nursing homes: No soup for you!

Whenever MedPAC releases payment recommendations affecting skilled care, I'm reminded of the Soup Nazi.

A sensible approach to clearing the Medicare appeals backlog

While hospitals and long-term care providers often disagree, providers are united on the thorny topic of backlogs for Medicare appeals.

The heart of the matter with advanced directives and why you need to push more for them

In their most crass interpretation, advance directives can save the healthcare system a lot of money. At their most heartfelt, they can reduce a lot of pain and suffering. They also are the essence of patient-centered care.

Keep your goals for 2017 short and tweet

You could write out a long list of personal or work-related goals for 2017 to cover all your bases, but you run the risk of getting overwhelmed or focusing on some goals over others. Instead, take the 140-character Twitter approach.

Stretching out resolutions (emphasis on the stretching)

It was heartening to read about a study from the University of California San Diego School of Medicine Researchers that found sessions of moderate exercise can be anti-inflammatory. That matters because of increasing research linking inflammation to arthritis, which has recently hit my back and toes.

With so many political changes to consider, keep your eyes on this

Judging recent national political events by any measure, one can come to a seemingly obvious conclusion: A lot of change is in the air. But what a lot of people aren't talking about is this: The things that aren't going to change. For long-term care providers, this is critical.

Read all about it: Journalists writing residents' stories leads to success

There's a question that's key to the long-term care industry but all too often — for a variety of reasons — goes unanswered: Who were your residents before they became your residents?

Attention bundled payment critics: Curb your enthusiasm

A recent study found that bundling Medicare payments can dramatically cut costs without sacrificing quality. But the man likely to be the next Health and Human Services secretary is no fan of this new approach

A mundane hospital hack

It's worthwhile to examine news from Concord, NH, involving a data breach of 15,000 patient records. On first blush, the question both providers and journalists might ask is if the compromised records were a result of a sophisticated hacking scheme. The answer is a resounding "nope" and provides a teachable incident for us all.

Socialized medicine a must in LTC

Chalk up another one for that disruptive New Yorker who crisscrossed the nation the last two years, speaking to big crowds, imploring change. His words are proving prophetic again. Bill Thomas, M.D., doesn't know it any other way.

How songs of the season help residents

My love of specific types of Christmas music is one of the reasons I was thrilled to see a new case study once again showing the positive impact of personalized music playlists for residents in long-term care facilities.

Historic effort underway to build future generation of aging services leaders

Federal lawmakers often seem to look down on aging care professionals, but it might not be long before they're looking up to them to learn how to get things done.

Some hot news for a cold day

If you can somehow find your way to a sauna amid this harsh winter weather striking most of the country, and continue to do so even in warmer months, there's good news: Working up a sweat in a sauna a few times a week can do more than just warm you up.

Should operators comply with rules that might never happen?

Mick Jones allegedly wrote "Should I stay or should I go" in 1981 while contemplating whether to leave The Clash. The context may be different this time, but many long-term care operators can well relate to the song's sentiment.

Why the Oklahoma sign law is far from 'OK'

Perhaps it's a sign of growing older when your response to a new government law is not, "That's horrible!" but rather, "Who is going to pay for that?!" Such was the case when I read about Oklahoma's Humanity of the Unborn Child Act and Public Restrooms Act.

Sports memorabilia — the next Alzheimer's aid?

"Take me back to the ballgame." It's not my line, nor Riverdale's, though we both wish it was.

Nurse Strom and the comment section conundrum

It's very fitting, and not at all surprising to me, that a story on social media comments has stirred up some of most intense reader response I've seen on this site in a while.

Your most important staffing challenge? It's probably not what you think

If you're focusing on the so-called worker bees in your organization, you're ignoring a larger challenge: the importance of finding the best future leaders.

Book these choices: How to pick out a great gift

With an eye on offering some excellent possible gift recommendations this holiday season, I'd like to make some book recommendations for everyone in your life. The catch is, of course, that all discuss or celebrate the life of seniors.

This long-term care legal trend is liable to upset you

Liability costs are expected to rise 6% in 2017 for skilled nursing operators, according to a new report. But there's a more disturbing stat than that to be reckoned with.

Find your group, and the health benefits will follow

individuals who get involved, and stayed involved, with civic and social groups such as neighborhood watch or volunteer organizations score higher on cognitive tests once they reached middle age. Even more telling, these cognitive scores increase for each extra group an individual participates in. There's a lesson here for everyone — especially working professionals. This isn't just kid stuff by any means.

A sure-fire way to make nursing homes less dangerous

There is nothing nice to be said about nursing home fires. Yet nobody seems to be demanding an obvious way to ensure that fewer take place: ban smoking.

Medicaid's future might not be rosy under new administration

It's possible Centers for Medicare & Medicaid Services administrator nominee Seema Verma will lead the agency in a new direction that is positive for both long-term care residents and providers. But how you feel about this direction is somewhat dependent on your philosophical and practical views about the chronically sick and poor.

The politics of why long-term care leaders are smiling

Sometimes when things go wrong, they're right. Oh, so right. That's the position long-term care professionals now find themselves in — or at least hope they do.

Help your employees 'craft' their jobs — no glue required

Memories of elementary school, where we'd glue together an assortment of foam, glitter and fake flowers until it looked somewhat like a picture frame or keychain, compelled me to do a bit of research when a study touting the effects of "job crafting" for long-term care workers popped onto my radar this week.

Operators have good reason to thank Judge Mazzant — twice

When a federal judge in Texas put the Labor Department's overtime rule on hold Tuesday, you could almost hear the industry let out a sigh of relief. If enacted, the measure would have placed massive fiscal and compliance burdens on this nation's 15,000 nursing facilities.

More pain ahead for big providers?

Take it from a guy who's experienced the ups and downs of being, shall we say, not normally sized throughout life. There are definitely times when you prefer to be larger than others, and then there are instances when it's certainly not as good. Some long-term care operators are finding this out the hard way.

'Tis the season for not checking email

As I set my own out of office reply last week for a quick trip to visit some college friends, I was reminded of a story I heard on NPR of a Texas newspaper editor who infuses his out-of-office replies with personal stories to placate those who might try to contact him while he's away.

Red tape relief? There's a chance it might actually happen

Here we go again. Another President-elect is promising to trim the red tape. Will it be different this time? Believe it or not, there's a chance.

The complicated truth behind a nursing shortage

Conventional wisdom often leads us to incorrect conclusions, whether it's in politics or healthcare. Nowhere is this more true than when we discuss our nursing shortage.

Judgment day is here again

I can only imagine what it's like to have your every move and outcome scrutinized. And then have a "report card" issued, one that is published where literally the whole world can see it. But that's your fate, long-term care provider, and today it's could get worse.

Your work-life juggling act just got a little trickier

Achieving some form of work-life balance has been proven to improve employee productivity, reduce staff turnover, and make for a healthier, happier staff overall. But now experts are saying the wa to achieve work-life balance is to NOT actively think about it?! Hmmm.

Giving Trump a chance

It's interesting to see how this sector has generally responded to Donald Trump's recent presidential victory. In some quarters, demonstrators have taken to the streets. Others are predicting Armageddon. As for the long-term care sector's response? You might say the silence has been just about deafening. So was the field pulling for Trump all along?

Looking forward to 2017

In a historic week for the country, there's been a lot of discussion about media, most of it negative. That's why it made me feel good to talk to two administrators who saw a McKnight's article and ran with an idea.

Like Trump, arbitration clauses up off the deck

Politics makes strange bedfellows. Another great illustration of this could be the many nursing home operators waking up to their previously unrealized love affair with President-elect Trump. That's right: Whether they know it or not, they might just get to really like this Trump guy.

It's time to talk about long-term care's diversity problem

Long-term care leadership has a diversity problem. Don't believe it? Travel to a national long-term care convention and look around — what do the majority of attendees look like?

For one glorious moment, a warped perspective makes sense — sort of

If you look at America's sports-addicted dynamic from a purely logical standpoint, it defies logic. Cities and states pull funds away from needed services in order to comfort the comfortable? In what universe would that move make sense? I might have a partial answer.

Changing corporate culture

As the holidays approach, it was touching at LeadingAge to hear a story about a CEO who goes out of his way to make employees and associates feel appreciated.

Workforce pressures: It's not about just millennials

The youngest generation of employees entering the long-term care workforce will affect professional attitudes and policies profoundly. And that's not entirely a bad thing. Just don't take your eye off your non-millennial employees' well-being as well.

Getting gritty with the Fresh Prince of Bel-Air

Whatever your workforce issues are, Angela Duckworth, Ph.D., might have just the answer you're looking for. And it involves a little advice from the Fresh Prince of Bel-Air.

It may be time to reorganize, but are you ready?

Many organizations, including yours at one time or another, will need to through reorganization. How you go about it is as important as - and sometimes more important than - what you do.

Work-life balance: I say 'Boo'

A few years ago, I threw a fit when the American Assisted Living Nurses Association scheduled its conference during Yom Kippur. I stand by that, but also am sympathetic to how many LeadingAge members and vendors are struggling with a big holiday next week.

Full speed ahead as Sloan closes in on first anniversary atop LeadingAge

Nine months after landing at the top of the LeadingAge letterhead, Katie Smith Sloan makes it clear she's only getting started.

Hospice is changing, are you?

Long-term care providers need to change their mindset when it comes to hospice care. Here's why.

How to quickly size up the health of any facility

When it comes to measuring how well a long-term care facility is doing, we all know the usual benchmarks: revenues, profits and census levels.

What the debate's entitlement discussion means for LTC

While I never expected long-term care to be a serious part of discussion within the three presidential debates, the wonky part of my heart still jumped for joy when moderator Chris Wallace asked about entitlement programs during the last debate Wednesday night.

Nursing homes laying it on the line over arbitration

You think there are a lot of negative headlines about providers getting sued now? Just watch the floodgates open if arbitration clauses aren't allowed.

Time to make your Egg McMuffin

If you're among the group of providers and vendors gathered in Nashville this week for the American Health Care Association's 67th Annual Convention & Expo, and you have the bonus of absolutely not being a morning person (i.e. me), you probably got your wakeup call around 10 a.m. Monday morning during the general session.

Sure you want to go there? Litigation more perilous in some areas than others

We might soon start to see the emergence of a divestiture trend based less on undesirable holdings and more on undesirable locales. The obvious choices will be cities and states with a plaintiff-friendly reputation, where lawsuit risks can rise dramatically.

Saying no to the hugging resident

While leaving my car this morning in our office parking lot, I noticed a gray-haired man shuffling towards me. I assumed he was heading towards his car, but he stopped in front of me and demanded, "Hey, where's my hug?" while holding out his arms.

It's time to lean on compliance officers

If administrators and long-term care managers were ever looking for a good time to make their mark, this is it. And they better be looking to, or start creating, high-quality compliance officers as well.

Don't snooze? You lose

A new Centers for Disease Control and Prevention study noting health concerns for night-shift workers didn't exactly give the day-shift crowd a clean bill of health, either. Day-shift workers still reported experiencing insomnia and other sleep issues, with nearly 20% of all employees saying they had poor sleep quality. Women workers also fared worse.

The evolution of swag

Vendors heading into a myriad of fall conferences have plenty to worry about. Months ago, most probably had a serious debate about what swag to offer at their exhibit booths.

Fighting the stains on your profession

Some journalists are jerks or untrustworthy. Or both. There, I said it.

Let the government teach you a lesson about millennials

The stars in the workforce-strategy universe must have aligned on Thursday, because a new government report about millennials dropped around the same time that we kicked off a webcast on hiring and retaining millennial workers.

New arbitration rule doesn't have much of a silver lining

Any way you slice it, last week was a rough one for long-term care operators.

Debating the obscure parts of the final rule

If misery loves company, take comfort in knowing many of your long-term care colleagues are doing the same thing this week.

'This is what it's all about'

One line, more than any other, hit home during my discussion with Carol Silver Elliott on Wednesday: "If we're really in the business of taking care of older adults, this is what it's all about."

Got kidney stones? It may be time to visit Disney World

Before you jump on the "Who paid for THAT study?!" bandwagon, know that this research wasn't borne from some scientist's Nyquil-induced fever dream.

ACLU takes on nursing homes

Of course precautions have to be taken in a healthcare setting to prevent the spread of AIDS, but they are things you'd also use as a basic standard of care.

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