Go get your audience (before Kanye West does)

When you ask seniors for their take on twerking, Kanye West and social media, you're bound to get some colorful answers.

Staying on the right side of compliance

In the 403-page Centers for Medicare & Medicaid Services proposed rule, there has been a lot of discussion around arbitration, quality and education. But buried within also are new regulations around compliance programs.

Leadership becomes McChrystal clear

Although I haven't played it much lately, I like the game of golf as a good analogy for task management, or simply getting through life's day-to-day challenges. It doesn't matter if you've ever played, or even like the game. Among other things, it also has noteworthy implications about your leadership style.

A snapshot of successful dementia surveys

I firmly believe the old saying that a picture's worth a thousand words. But for every strong, visual message photograph conveys, there are dozens of more messages that it doesn't, or can't, get across.

This 'crackdown' should really melt your cheese

Can someone please tell me exactly what "melty cheese" is? The product exists in commercials but is apparently not to be found elsewhere. And as far as I can tell, no state regulators are cracking down on firms lauding it — something that does not actually exist. Lucky them.

SNF therapy billing controversy rises from the dead

Despite my love of Halloween, there is one component of it that is distinctly not for me: Horror movies. Still, I'm enough of a pop culture enthusiast that I can appreciate those with an appetite for scary movies and their sequels. If you want to watch the 10 "Halloween" movies or six versions of "Paranormal Activity," I'm not going to judge you. (Much.)

Who takes care of the healthcare worker?

Like observers of a mother driving herself to exhaustion and sickness by taking care of her children day after day, U.S. providers are seeing measured declines in their caregivers. The numbers reveal just how bad it is.

Home sweet home — in the right mood

Moving is always exciting to me. This isn't because I enjoy the stressful process of apartment hunting and packing my life away into boxes like a real-life game of Tetris, because, let's face it, I don't.

Feeling threatened at work? You're probably a woman

Who has the most dangerous jobs in America? Police officers? Fire fighters? Loggers?

Nursing shortage might not be as dire as feared

For the past decade, healthcare experts, including those in long-term care, have been drumming the beat of a looming nursing shortage. A new study details why the shortage might not be as terrible as feared.

Hospitals' plea will soon be nursing homes'

I was truly surprised when I didn't hear long-term care leaders excitedly jumping around, yelling, "See! See! Us too! Us too!" last week. It was a simple report, sure, but one that should have sent the frantic-meter bouncing.

Want better outcomes? Work less

It's no wonder that the latest experiment in shorter, more efficient work days comes out of Europe.

Nuns against the neighbors, and NIMBY takes the lead

I first heard about the sisters of Fraternite Notre Dame last winter, when two boilers broke down at a church they were running on Chicago's West Side. The public ultimately came to their rescue then. A different crowd, however, is now quashing its dreams of expanding into long-term care service.

The start of fall, the end of falls

You have to hand it to the folks at the National Council on Aging, and their affiliated partners. They really know how to tastefully make light of a harrowing situation.

You've got mail — and some work to do

"We don't do email." At first I wasn't sure if I heard the person on the other end of the phone correctly. Here was a long-term care provider in this, the year 2015, who didn't use email. At all.

Long-term care providers selling health insurance? Don't laugh

Signature HealthCARE is known as a high-end provider of skilled care services. Starting next month, it will also begin selling health insurance. As unusual as that might seem, it may not be long before additional operators are following suit.

Diving into disparities

There is little that makes McKnight's readers as defensive as publishing a story about racial disparities in long-term care. The comments often complain that access to care is complicated and shouldn't be simplified to focus on race.

Getting good at goodbyes

It's fairly likely that one or more of your employees will be leaving soon. That's why you need to read this. It will make your organization healthier, and in ways you might have never imagined.

Technology troubles hitting close

We like to assume that healthcare workers are a trustworthy bunch, especially when they're entrusted with caring for people's' loved ones. But manipulation of data, from patients' records to medication logs, seems to be a trend. What happens when a case of electronic data manipulation hits closer to home?

'Forest fires': What's your plan?

Long-term care tends to ignore home- or community-based service technology and data mining, but the era of bundled payments, partnerships and accountable care mean it's time to pay attention. Of course, technology gets healthcare services only so far.

No argument: This Butler did it (and more)

Professionals are often told it's in their best interest to network. Friend of long-term care Kerrick Butler has brought new meaning to the concept.

Grab your Sharpie — LTC's yearbook is here

A new report is out and it is a veritable time capsule of trends driving long-term care. Now in its 30th year, CliftonLarsonAllen's Skilled Nursing Facility Cost Comparison Report came about when the company's long-term clients began asking how they measured up to others.

Nursing homes and loopholes, a love story

You can bet that nursing home-hired actuaries, lawyers, consultants and other assorted bean counters are going over new rules with a fine-tooth comb. They are looking for the next generation of potential revenue streams — and any loopholes to them. If they exist, they will be found, and implemented.

Business etiquette for beginners

Lately it's been irking me that not only thank-you notes but business etiquette seems to be falling by the wayside. We're not talking about using the wrong spoon at dinner, but a genuine failure of manners.

Seeing is believing, and other tough truths for providers

If you didn't work in long-term care and I asked you to specify what these five states — Illinois, Washington, Texas, Oklahoma and New Mexico — have in common, we could be waiting for your answer until Donald Trump had more than a snowball's chance in hell at winning the Republican nomination for president.

Small staff, big hearts — simple needs

Mary Tellis-Nayak often makes it a point to visit nursing homes in other countries when she and her husband, Vivian, travel. A 2012 trip to his hometown of Mangalore, India, was no different.

Tired of looking for stuff in all the wrong places?

Many senior living professionals have had to settle for content that was created for another sector that's not quite them. Or worse, settle for stuff that has little to do with their day job. The good news is that those days are officially over. McKnightsSeniorLiving.com is now live.

Likelihood of hospice use may vary by where you live

We tend to paint hospice with broad strokes. A new study indicates how it can vary by states, with Oregon emerging as the best example of a place that seems to be doing it right.

Angels (with great connections) in our midst

The ability to make a senior feel a part of the outside world can mean the difference between having a catatonic lump or a bon vivant on your hands. Luckily, there's never been a better time to overcome mobility issues.

Stop with the Snapchats, already!

It looks like Snapchat will take the crown in this week's edition of "What Smartphone App Is Causing Providers Grief Now?!" (Yelp won that distinction last week, for those keeping score at home).

A dangerous combination at too many nursing homes

It would appear that nursing facilities are becoming more reluctant to admit younger people with mental illnesses. At the risk of sounding like an insensitive jerk, that's a good thing.

Hands off the arbitration options

Whether it's a J.K. Rowling novel, Tom Clancy adventure or run-of-the-sawmill book of government regulations, when there's 403 pages, it's going to take time to digest. With regulation revisions, heartburn often follows.

Blended lessons

In an attempt to cook, a good lesson emerges in knowing one's limits.

Giving person-centered care the green light

I'm one of those people who see the numbers ticking down on a crosswalk signal as a challenge. Five seconds? No problem. Three? Let's just say if you've ever been waiting at a stoplight only to hear a blond-haired pedestrian yell "WE CAN MAKE IT," I was probably the culprit.

Finally, a leader who's willing to speak out

Among the police, it's known as the blue wall of silence. This unwritten rule regularly comes into play when a fellow officer's errors, poor behavior or possible crimes are under scrutiny. Its basic message: Keep your mouth shut.

Yelping at online reviews

If there's one service long-term care providers almost universally dislike, it's online websites geared towards consumers and healthcare.

You want culture change? Stop complaining

Things have been kind of tough lately, haven't they? And they're probably going to get tougher, right? If you have thought or possibly mouthed those words yourself, stop. Just stop. Quit your complaining ... for one day at least.

Long-term care bear

She spends her free time doing puzzles, and walking around outside, has cataracts and high blood pressure. She celebrated her most recent birthday with a special cake made by her loved ones and caregivers. That description could probably fit any number of your residents, but I'm willing to bet they don't stay fit by somersaulting down hills — or by snacking on 20 to 40 pounds of bamboo each day.

Operators grapple with the $31,000 (or so) question

Many operators probably broke out in flop sweat earlier this week when House Minority Leader Nancy Pelosi (D-CA) endorsed a $15 minimum wage.

Rare long-term care double win

So much for the dog days of summer getting close. Long-term care advocates were already at full woof on Tuesday — and that's a good thing.

GAO addresses troubling fraud

It's always tempting to think reports issued from the Government Accountability Office are written by bureaucrats sharpening pencils and tapping into computer databases.

The lawsuits are coming! The lawsuits are coming!

Given the nature of what they do, it's not surprising that nursing homes sometimes find themselves targeted in lawsuits. Unfortunately, it appears that this discomforting reality is about to become more uncomfortable.

Can't we all just talk (about death)? Yes, we can

The lessons keep flowing from the political debacle that has been Sarah Palin's political career since she left her job as mayor of a small Alaska town. You'll recall it was Palin who launched the irresponsible phrase "death panels" into the stratosphere back in 2009.

Assisted living's portrayal in "Trainwreck"

It's not revolutionary to see long-term care come up in a feature film, from "Away from Her" to "The Savages." But it's brave to incorporate it into a comedy, especially one where the star isn't (yet) a household name.

It's pretty clear what they're really committed to

It was quite a week for ironic juxtaposition in the nation's capital.

Beyond the 403-page elephant in the room

Civics class was in full session Monday, when long-term care providers received a summer reading assignment that should keep them busy — and anxiety-ridden — for many days to come. But, hey, at least they know the president of the United States is now paying attention.

Into the woods

I might not be the best advertising for it, but a new study confirms what I have suspected in my gut — nature is good for you. And that definitely includes seniors.

Cameras: Families like them, lawyers love them

Illinois may soon become the fifth state that lets families install cameras in nursing homes. Advocates see the move as a way to help ensure peace of mind. But for many nursing homes, the development may do just the opposite

This is what your employees want

What persists and cannot fade, despite the best erasure efforts of days on a cross-country train, weeks of total detachment from the Internet and phone signals, AND 65 miles of arduous backpacking in mountains far from home? Good advice about fellow workers, that's what.

The culture of Kansas

Everyone in long-term care loves culture change. But there's a secret.

Operators working overtime to deal with new labor realities

Labor costs typically eat up 50% to 75% of a facility's operating budget. So it's small wonder that wage issues are at the heart of so many management-labor battles.

Flashing the badge at conferences

One of the more mortifying moments of attending a recent conference was when I went up to a participant and asked to interview her. She nicely reminded me that I had interviewed her 10 minutes before.

Keeping workers healthy may harm your bottom line

Long-term care operators are in the business of solving problems. They make problems disappear for residents, families and the government. And let's not forget employees.

Group On: Why it's important for LTC to be joiners

Group memberships improve self-esteem, say Canadian Institute for Advanced Research fellows, who were specifically looking at school children, the homeless and the elderly. The caveat is that the groups have to contribute to the sense of who they were and their social identity.

Maybe we should start calling it short-term care?

We used to call them nursing homes. But that changed during the '80s and '90s. The term would eventually lose out to another moniker with less negative baggage: long-term care.

Has MedPAC been infiltrated?

Don't look now, but it appears that nursing home owners might have sneaked one of their own onto the Medicare Payment Advisory Commission.

The volunteer conundrum

While it's hard to have firm data on visitors to nursing home residents, it's estimated that at least half never have a visitor. This can be for a variety of reasons: A relocation away from a community, estrangement or busy families, or outliving most friends and relatives.

What's more frightening than the nursing shortage? What's driving it

To better appreciate this sector's alarming nurse-staffing nightmare, it's helpful to recall the warden's famous line in Cool Hand Luke: "What we've got here is failure to communicate.

Now here's how you celebrate 'The Voice' (the original one)

There's a reason you go back to your favorite restaurant, television show or shoe store. They're good, and you can count on them being good. That's how I feel about the public relations folks at Erickson Living Communities. They "get" it, and their newest project is a perfect example.

The ballad of the MDS coordinator

A NADONA presentation focused on preparing documentation and audits spent time diving into the way MDS managers are treated — and it doesn't look great.

Obtaining critical claims data may soon get easier

The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?

Campaign to archive dementia love stories stumbles

Jane Youell appeared to have hit the jackpot with her timing, but now that's exactly what she still needs: a financial jackpot. The British researcher is attempting to build a first-ever love-and-dementia archive.

Catching payroll bandits

The big news last week wasn't that two women were charged with stealing $144,000 from a nursing home in Pennsylvania. It was that their alleged scam lasted for three years.

Many regulations are truly bad — but ...

Long-term care operators are rightfully concerned about the never-ending onslaught of new rules and regulations. But a deadly fire in China this week might frame things in a new way for them, if they give it a chance.

CVS purchase of Omnicare to bring severe teeth gnashing

It's an odd thing to see the king of the jungle become the hunted instead of the hunter. But now that the smoke has started to clear from last week's announcement that pharmacy giant CVS will be buying Omnicare, the future is coming into better focus.

Debate over engaging seniors' brains

New research indicates too much time playing video games may reduce our memory skills.

Where's your next lawsuit coming from?

If a recent survey of about 800 corporate attorneys is to be believed, there's no shortage of things to lose sleep over.

Having standards isn't enough

There's a country music song that popularly declares, "You've got to stand for something or you'll fall for anything." Well, I'm here to tell you, having standards isn't the answer.

Failure in discharge planning

There's a feel-good national story that debuted last week around how emergency responders helped an 81-year-old man. Wonderful people came to his aid. But why did it have to come to this?

Note to associations: Give General Powell a break

The first time I heard Gen. Colin Powell speak at a trade show was in the mid-1990s, and he gave one of the most spellbinding presentations I'd ever witnessed. That said, it's now probably time for senior living organizations to stop hiring him.

Answers about your top 5 technology challenges

I've learned after many years of covering long-term care that certain things are sure to arouse providers' anger — over regulation, under payment and reckless media accounts among them. What provokes fear is even easier to identify: technology.

Winning recognition for your facility

Here's how you know a program is successful: When people keep asking you when it's coming back.

Alzheimer's drug maker sends a different message in the courtroom

It's almost impossible to turn on the tube these days without seeing an ad from a drug company. The typical scenario goes something like this: Person with a disease or problem is all smiles, thanks to the benefits of the advertised drug. But there's a catch.

The engine behind ACOs is showing its muscle

The American West was largely settled by pioneers in covered wagons. It looks like a couple hundred years later, the American healthcare landscape is going to be infiltrated by covered Pioneers. And this wagon train is only picking up momentum.

Playing fast and loose with Medicaid termination

There are many benefits to communicating to your cohorts in neighboring states, and not the least of it may be knowing when a provider is kicked out of Medicaid.

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

    James M. Berklan

    Elizabeth Leis Newman
    Senior Editor

    Elizabeth Leis Newman

    John O'Connor
    Editorial Director

    John O'Connor

    Emily Mongan
    Staff Writer

    Emily Mongan