Communication lessons from Yoda

What can long-term care professionals learn from Yoda from "Star Wars"? On the surface, probably not a lot — unless you ask Stacey Starling, Ph.D.

Long-term care operators feeling alone again, naturally

Say what you will about Republican lawmakers and their notions of healthcare reform: at least they're consistent. Like their Democratic colleagues, they simply don't seem to realize that long-term care is a part of the package deal.

Flu-misty covered memories of the way we were

Within the conspiracy theories around the flu vaccine — and trust me, healthcare reporters have heard them all — there's also one secret lurking within people's refusal to receive the shot. It involves a sharp needle stabbing into one's arm.

ACOs and the big squeeze

Try as the researchers and regulars might, there's still head-scratching going on about accountable care organizations. While the future of value-based purchasing seems secure, what ACOs will look like and how widely they'll be adopted is still up in the air.

  • ACO

A tiny Alzheimer's study with huge results

If 2025 seems like it's ambitiously close for finding an Alzheimer's disease cure or game-changer, take heart — there's a recently released Alzheimer's study that may serve as a turning point in this seemingly never-ending battle.

Now that was one tough week

Most long-term care facilities would probably like to forget about last week. That's because two figurative bombshells exploded.

Evaluating California's dual eligible program

I'm not a person with particularly complex healthcare needs. That said, over the course of my life, I've seen a series of crummy physicians, ranging from those with a poor bedside manner who left me in tears to those who pushed duplicate tests, unnecessary procedures or ill-advised medications.

View from the finish line: The way to a life with no regrets

"Regret avoidance" is a worthy goal in everyone's life. This man's research makes it attainable.

Big Brother is watching (you wash your hands ... or not)

I'm one of those people who sings, and occasionally dances, while they drive. Nothing too out of control, of course, but just passionately enough where you might be concerned that I was having a medical issue if you passed me on the freeway.

The Alzheimer's investment that's not being made

Our best hope to make progress against Alzheimer's disease probably lies in the form of increased research funding.

Embracing managed care

What was clear from the panel was managed care, skilled nursing and home health have to build partnerships.

The Muhammad Ali allure

The first time I met Muhammad Ali was the most memorable. I wound up in his hotel room with a handful of others, watching him perform magic tricks as numerous jiggling young bombshells showered him with overindulgent praise.

Facebook for SNF residents? It could be on its way

Take a moment and think of all the online communities you're a part of.

When one future strategy isn't enough

You are unlikely to meet many people who understand this field quite like Robert G. Kramer. When he talks about what skilled care operators should be doing to get past the turbulent years to come, it's probably a good idea to listen up.

Finding illumination on PBJ

I don't mind saying that hearing a Center for Medicare & Medicaid Services official discuss Payroll-Based Journaling yesterday was the first time a light bulb went off for me about the new system.

This lifesaving coincidence definitely makes you swallow deeply

It wasn't enough that Patty Ris was saved from choking in the dining room at her continuing care retirement community. She and her rescuer made worldwide headlines.

Reading beyond the rankings

It's easy to take big, national health reports like the 2016 America's Health Ranking Senior Report, skim the results for your state and leave it at that.

Infections connected to Alzheimer's disease

Alzheimer's disease and a long-term care magazine is analogous to nursing home administrators and the Centers for Medicare & Medicaid Services: No matter what you do, you're not breaking them apart.

Keep the village — he recommends a system

If the figures represented a stock chart, David Gifford would be not only a happy man but also a very rich one. The numbers and performance both show upswings. But they don't reflect a stock's rising value.

Yes, you do need to prepare for transgender residents

I was a Girl Scout growing up, and despite our slight rivalry with our Boy Scout counterparts (Girl Scout cookies are better than popcorn in every conceivable way, please stop fooling yourselves) I can still appreciate their motto: Be prepared.

Looking to survive in long-term care? Then it's time to 'pay' up

If you want to build an organization that's built to last for very long time, say multiple generations, follow the three-payment plan.

Improper payments often about inaccuracy

One of the common aphorisms uttered in the Newman house is Hanlon's razor. It has various iterations, but it is basically "never assume malice what can be explained by stupidity."

Neutrality an elusive concept in 'site-neutral' payment talk

It's fitting we're in the midst of Triple Crown season. That means it's time to pick a horse as your next winner — and it could possibly be a very big winner.

Want to ward off dementia? Follow Madonna's lead

If you really want to help cut your risks of cognitive impairment and memory loss, it might be time to go outside your comfort zone and take a few tips from the Material Girl herself.

SNFs and cabbies agree that more regs are needed — for the other guy

You can gain real insights about your future by examining what the competition is up to. Remarkably, there are still some skilled care operators who don't see assisted living as the competition. For them I have only two words: dementia care.

Shirtless nurse creates controversy

Good news, female nurses, you are now respected professionals valued for your experience and education.

Providers shake off gloomy forecasts with pride, optimism

First, the crowd of top-flight nursing home operators took the punch to the gut in silence. Then, they shed the stoicism and got even.

Person-centered care, Chopped style

If there was such thing as an armchair quarterback for the Food Network show Chopped, it'd be me. My friends and I have logged an almost embarrassing amount of time watching it (eight hours on one recent rainy day binge), yelling critiques at the on-screen chefs' dishes as we eat something totally unimpressive, such as microwave popcorn.

More frivolous lawsuits ahead? You can bank on it

Eldercare service providers would be well advised to watch proposed arbitration rules that have been aimed primarily at banks — for now.

The difference between addiction and dependence with opioids

While I love long-term care and the people who work in it, I don't think anyone would assert that it's cool.

Examiners see the churn and corporate SNF operators feel the burn

I imagined nursing home chain executives wincing two days ago at the sight of yet another study apparently finding they're doing a poor job.

Is no news really good news?

Long-term care doesn't exist in a vacuum. Every once in awhile, the issues you face in your facilities each day "leak" out of the healthcare realm and on to the pages of a major newspaper, for better or for worse.

Dealing with that other f-word

If there is one universal zero-tolerance policy at most facilities, it is this: Don't fail. Executives and others who don't meet prescribed goals tend to be quickly shown the door. It's almost as if failure is a disease that must be eradicated. This can be very wrong.

The need for semi-skilled workers in LTC

What do the meat and poultry industry and long-term care have in common, other than often dealing with turkeys? It turns out both have challenges in hiring semi-skilled workers, which is addressed in a bill proposed last week by Sen. Jeff Flake (R-AZ).

The cheapest Alzheimer's aid, and regrettably overlooked

What if it were announced that a new pill was available that could put off Alzheimer's disease onset or symptoms for more than four years? It turns out such a solution has existed for years.

Tales you might never expect from the frontlines of fraud

The healthcare world currently ranks as the fourth most victimized industry when it comes to fraud, falling prey to roughly 6.6% of all fraud incidents. In the long-term care sector, experts recently shared, one area gets hit harder than others: resident trust funds.

Are anonymous tips constitutional? Turns out there may be more than one answer

No nursing home operator wants to be accused of abuse or neglect by someone who can't be held accountable. Yet it happens with alarming regularity.

Medicare to reimburse certain genetic tests

News about how there will be Medicare reimbursement for hereditary cancer-related disorders, under a new CPT code for multi-gene panels, gives more options to some long-term care residents.

Time for a palliative care makeover

Celebrity party animals have done it. Nursing homes have done it. Now, it's time for palliative care providers to do it.

Finally, some good news about social media

PHILADELPHIA — McKnight's resident millennial here reporting live from The City of Brotherly Love with some exciting news: Despite all the social horror media stories we've seen cycle through the news recently, it's not all that bad for long-term care.

Great staffing ideas from the best in the business

For those of you feeling a bit overwhelmed about staffing issues, please let me offer a simple suggestion. Take a look at the March 15 issue of Fortune magazine. You're likely to discover many ways to make your facility a more attractive place to work.

Therapy revisions remain a CMS goal

If there's one sentence from this week's Office of Inspector General report that should be pulled out and displayed on your bulletin board, it's this: "We found that Medicare payments for therapy greatly exceeded SNFs' costs for therapy." In long-term care, them's fightin' words.

They're comfortable with dying, but ...

A new study shows that many of the "oldest old" are OK with dying. But nobody knows it. Well, almost nobody. This is a waste.

Learning to distrust technology

We live in a society that relies on technology for just about everything. This isn't my opinion as someone who was raised in the advent of the internet and smartphones. This is a fact.

CMS, it's time to listen up

The options for finding the most appropriate nursing home for a loved one are, shall we say, somewhat limited, especially when compared cars and other products. But there may be a solution to that.

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Other states should follow Nebraska's nurse protection example

If you have any doubt that lawmakers pay attention to news that comes across their desk, meet Omaha Sen. Brett Lindstrom (R). Lindstrom spearheaded a whistleblower protection bill.

25 years later, this plague is still among us

Somewhere Dr. Bill must have been smiling. That was my conclusion when I read a recent dazzling article from Pulitzer Prize winner Amy Ellis Nutt.

Good brews

My relationship with coffee has been a tumultuous one over the years. The good news is there's more research that shows why I (and fellow coffee fanatics) don't have to give it up any time soon.

Lower the temperature and see a whittled waistline?

I found results of a recent study bittersweet. They showed that lower home temperatures in the winter were associated with lower waist measurements. Specifically, elderly adults grow bigger in the middle when they turn the heat up during cold season.

Who wants to be a billionaire?

The March 21 issue of Forbes, which lists the richest people on the planet, is as much fun as the Sears Christmas Wish Book.

How should long-term care providers celebrate? Let us count the ways

Long-term care operators have plenty of reasons to recoil and lick their wounds over the course of a year. But there are also good times when they should find reason to smile. Like this past week.

March Gladness

The college basketball gods were not smiling down on me this season, because going into the Sweet Sixteen I had only one hope of winning our friendly office competition for NCAA team champion: Wisconsin. It's my home state's flagship team, one that seemed to be doing well and was known for giving the world this adorable viral video

The Department of Pro-Labor is at it again

Do you own or help manage a non-union facility? If so, your professional life might soon get more complicated. For that you can thank the Department of Labor, again.

Investments in lower back pain needed

This week the Patient-Centered Outcomes Research Institute announce this week it was authorizing $22 million to study ways to improve treatment of chronic low back pain, along with another $12.5 million for Patient-Powered Research Network demonstration projects.

A person-centered road trip

The road to person-centered care is a long one, paved with good intentions but filled with potential barriers and roadblocks.

Some poignant observations about life (and death) in nursing homes

Despite Stephen Covey's warning, most of us are ruled by the tyranny of the urgent.

Politics and leadership require ability to compromise

Collectively as a country and specifically as an industry, we have to recognize success is delivered not only from speaking up, but also understanding compromise.

When opportunity knocks, LTC pros answer

Say what you want about long-term care professionals because I've just about heard it all. They work too hard, they whine too much, they work for too little, they should be watched closer, and so on. But one thing is inarguable: They're opportunists, and they like to find a good deal.

Long-term care's fear factor

If you've been keeping up with McKnight's Daily Editor's' Notes, you'll know former LeadingAge CEO and President Larry Minnix's potential presidential platform includes an initiative that would put high school graduates to work on public service projects — including volunteering in nursing homes. Even if we don't see Minnix throw his hat into the election ring, the initiative could help satisfy long-term care's ongoing volunteer conundrum.

The root cause of naked photos

Sen. Tom Carper (D-DE) had never crossed my radar before this week, but he certainly has my attention now. He's demanding feedback from federal regulators on their tracking of social media exploitation by rogue nursing home employees.

A message from the future president of the United States

Last week in this space, I solved our nation's problems, and long-term care's, all in one fell swoop. Since then, there have been more embarrassing debates among bickering candidates for president, making my nomination of retired long-term care executive Larry Minnix look all the more genius

Time for a cyber security update? You better believe it

Advances in technology and providers who lag behind on updating their information technology systems have created a "perfect storm" of vulnerabilities in healthcare IT security, one expert warned us. Worst of all, providers don't seem to being paying attention.

Equal pay for equal work? Has MedPAC lost its mind?

If you are a post-acute provider, the big health news last week was not Donald Trump unveiling his post-Obamacare blueprint. It was the fact that MedPAC is getting closer to a rather brazen new approach to post-acute payments: equal pay for equal work.

Healthcare pushed aside in 2016 race

Lady Healthcare and her child, the Affordable Care Act, were once the bon vivant of public discourse. But they are of little interest today, giving way to the economy, jobs, foreign policy, immigration and other inflammatory subjects.

LTC's smart choice for president

The nation should have a better idea soon as to who will be slinging mud at one another this fall for the top office in the nation. One way or another, it's not looking good for long-term care interests. Unless I get my way.

Meditation can help with back pain

My first introduction to meditation was not in a peaceful, spa-like setting. There were no candles burning, and if there was any light music playing in the background I didn't hear it.

Maybe it's time to reconsider the labor challenge

When it comes to recruitment and retention, many operators need to start doing a better job. It starts at the very beginning of the process.

When to take away the gun?

While we spend a lot of time talking about depression and loneliness in long-term care, we spend less time talking about suicidal seniors. Here's why we need to.

Proof election year is no time to take anything for granted

It seems you can't count on anything for certain in an election year — just ask any Trump skeptic - and that could mean special things for long-term care.

In it for the long term

There was one positive highlight the day I started working as a cashier at a Culver's restaurant long ago: meeting Betty. She had to at least be in her 80s. She was tiny and spunky, greeting us all with "Morning time!" as she arrived for work each day.

His advice: You're probably doing it all wrong

George Cloutier has been giving nursing homes and other small business clients this troubling message for three decades: You don't know what you are doing.

Accidents can lead to progress

Ignaz Semmelweis, who died in ignominy and is largely forgotten, is responsible for one of our greatest healthcare discoveries.

We hate to say we told you so, but ...

Take it to heart when we say that long-term care is going to be reimbursed differently in the not-too-distant future. Put off plans for it at your own peril.

These residents won the Super Bowl

If you watched this month's Super Bowl game between the Carolina Panthers and the Denver Broncos, you know the Broncos took home the title. At Gastonia Care and Rehabilitation in Gastonia, NC, however, the game had a slightly different outcome.

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