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. 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.

Residents and sex: It's time to re-examine what's appropriate

It's so easy to think of older people as being done with sex. And truth be told, many are. But as anyone who has spent time in a skilled care setting can attest, that's hardly a one-size-fits-all notion.

Providers suffering Medicare appeals backlog — at their own hand?

If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn't be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise, the auditors themselves.

A good book's unintended lesson and tears for a great friend

One of the best signs of a good book is its unplanned lessons. While its title might profess how to fix this or do better at that, a high-quality book also will lead the reader to enlightenment for reasons a PR agent might not promote. Such is my personal experience with Atul Gawande's "Being Mortal."

Maybe it's time for ADAPT to adapt

What kind of cruel, heartless person could openly criticize disabled people in wheelchairs? I guess that cruel, heartless person would have to be me.

Salary matters in long-term care

The University of Pittsburgh's research involving certified nursing assistants and why they leave is among the most interesting I've seen recently in long-term care. Salary, it turns out, is not nearly as important as respect and flexibility in scheduling.

Who cleans up after the 'fix' is in?

It will be interesting to see what happens when the guitars are put away and the strains of "Kumbaya" die down after last week's ballyhooed passage of a new Medicare doctor payment rule.

Our government is a terrible thing — to hate (and a thank-you)

Providers are finding their personal and professional relationships with the government tested these days. But before we all grab our torches and pitchforks, let's take a deep breath.

Wristband holds hope for depressed patients

The verdict is still out on how practical or helpful some of new wristbands and other monitoring devices are among long-term care residents. But one new study indicates that a particular wristband may be able to track how depressed patients will respond to common drugs such as Prozac.

Mind games the way to recover from stroke

Do we need another reminder that a positive attitude or strong mind helps healing? We do. This time, it's with regard to stroke survivors who can't move body parts.

Operators could take a lesson from this program

Here's a win-win arrangement that really stands out. For providers wanting to inject a little extra youthful stimulation and outside perspective into their communities, it's worth a look

5 pieces of Facebook guidance for the uncool

As some of you know, none of the cool kids are using Facebook anymore. However, given its growth among those above age 65 (your residents) and its continued use among 30-somethings and up (your employees), it's worth being clear on some easily-avoidable professional and personal problems. Here are some examples.

We were all in on the scheme and didn't even know it

The recent past came rushing up other day, and it wound up whisking all of us onto the set of some fast-paced, financial mayhem-filled movie. Yes, you were there, too — though like me, you might not have realized it.

They told us everything we need to know about the future — except what to do

What should long-term care operators be doing to prepare for the future? Take your pick of these three things.

New editor stages coup

Greetings. Today seemed like the day to tell you that I, Elana, have taken over Elizabeth Newman's column. McKnight's made the decision after a detailed data analysis related to what drives pageviews. (Have you surfed the Internet lately?!)

Can we get that in writing? We better

If you asked long-term care providers what their main concern is, you would think it would be "patient care," right? It turns out, that's not reality. Most providers, it appears, are consumed by documentation.

An emerging union challenge: 'micro' management

The National Labor Relations Board's willingness to let smaller groups of people form "micro unions" has many operators on edge.

Genetic testing opens can of worms for Alzheimer's patients

Healthcare professionals tend to have a belief in facts, and as a corollary believe in conventional wisdom that knowledge is power. Of course, what people SAY they want to know and how they actually act is often miles apart.

Volunteer calls out nursing homes for not delivering

After five years, Gary Gamponia says he has had enough frustration. His message to nursing home administrators and activities directors would likely be, "I'm mad as hell and I'm not going to take it anymore" — if only he had enough leverage, that is.

The mess that is long-term care funding

In some ways, my parents did their children a great favor by dying early.

What long-term care can learn from Van Halen

David Lee Roth, best known for being the theatrical frontman of the rock band Van Halen, is a decision-making genius whom long-term care providers can learn a lot from.

Alarming headline about safety gives incomplete picture

Curse the headline writers, for they sometimes don't do stories justice. The nursing home profession knows this as well as anyone.

Are glowing acquisition reports a cause for optimism, or concern?

Taken collectively, two recent reports show that last year was a great time to sell a property in this field — and this year may be even better. That may be good news for the movers and shakers. But is it an encouraging sign for the sector overall?

The hidden gem of the Online Expo

Maybe you look like a supermodel, or maybe you are morbidly obese. You might be a CEO who looks like a college student, or in a scooter. Either way, when you attend any conference and visit the Expo Hall, you may wonder how vendors will take you. That's one of the often overlooked aspects of the virtues of the McKnight's Online Expo Hall.

Nursing homes receive an unexpected compliment

Would anyone recommend duplicating something if they didn't feel it was worthy or successful? Of course not. It's this reasoning that should give skilled nursing operators comfort and pride.

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