It's hardly a mystery why more long-term care facilities are putting independent contractors in place: lower costs. Operators can save almost a third on wages by avoiding payroll taxes, unemployment insurance, worker's compensation coverage and other benefits directed toward regular employees, experts say.
Should there be any doubt that some long-term care providers have a persecution complex, it's evident in a response to Tim Mullaney's blog Tuesday.
Depending on the numbers you choose to believe, senior living profit margins are a razor thin 3% — or more like 20%. Regardless, many would like to believe operators are engaging in a fairly despicable business practice: intentionally underpaying the help.
A common quip has been that the way to a man's heart is through his stomach. Now, there's a long-term care provider who's hoping to prove that the stomach is also the way to the brain.
Long-term care workers and Centers for Medicare & Medicaid Services employees might have a lot in common — and that's not entirely good news.
Like many bad habits, the overuse of antipsychotics is not going down without a fight. Still, there are reasons for long-term optimism.
There's a tremendous lack of evidence-based research practices in nursing homes and much of what happens every day is based on belief rather than fact. We need to embrace research as a way to improve quality standards for long-term care residents.
Billy Beane's data-driven approach to baseball recruiting made the Oakland A's a winning franchise, inspired a Brad Pitt movie — and might soon change the way long-term care operators hire staff.
When you buy a pack of cigarettes in this country, you also get an admonition from the Surgeon General. Why? To point out how dangerous going near tobacco products can be.
Say what you will about bad bosses: They always seem to create great stories. But not usually as intended.
To give credit where it's due, when the New York Times does a story on nursing homes, it tends to give up enough space to get multiple sides, not to mention sources that include the industry checklist of Professional People With Thoughts.
If you've ever been involved with salary negotiations, you might have some idea of what's going on among Medicare officials, long-term care advocates and hospital lobbyists. It would be kind of amusing if it weren't so painful for so many.
There's been a lot of talk lately about what constitutes "comprehensive" health insurance coverage — and long-term care notably has not been part of this national conversation.
Not all the news out of Congress these days is bad. Last week, the House passed long-overdue legislation that fines plaintiffs who file frivolous lawsuits.
It's no secret that our nation's long-term care facilities need additional caregivers. More than 43,000 direct care staff positions remain unfilled, according to figures from the American Health Care Association.
I'd like to propose a suggestion for a fun party trick. Ask those around you which profession was more dangerous in terms of injuries in 2012: Mining, forestry and logging, or working in a nursing home.
Of all the clever and eye-opening things encountered at the recent LeadingAge annual conference in Dallas, a particularly dear one was unfortunately tucked off to the side. Relatively few might have seen it. After all, we all could use more happiness in our lives.
Alzheimer's researchers — or the public relations machines breathlessly trumpeting their work — should chill out. I see so much of this type of Alzheimer's news that it's hard to get excited when yet another AD press release comes in. So it was with a reluctant click of the mouse that I opened an Alzheimer's-related report from the New York Academy of Sciences last week. I'm glad that I did.
What boss wouldn't want to have Kathleen Sebelius for a deputy?
We know that speaking two languages has positive effects, ranging from an ability to switch between tasks to cognitive quickness in older adults.
Two big reactions hit me when news of Johnson & Johnson's $2.2 billion Risperdal settlement with the government landed this week. First, J&J probably made a lot more than it's paying out and, second, some individual probably is going to cash a nice paycheck for bringing it all to light.
I've recently drawn up my plans for the winter, and I'm very excited about what's in store! I'd like to share my ideas with you and get some feedback. Let's call this the "Winter 2014 Agenda: Discussion Draft."
It's not hard to see why federal regulators want fewer residents going to hospitals. It's good to see somebody's trying to make it happen, too.
Here we go again: This week saw the release of yet another breathless study claiming the cure for Alzheimer's disease is getting closer — maybe.
For all of our discussions about emergency preparedness, there's a crucial component missing: how long-term care staff should talk to residents after a traumatic event. A session at the LeadingAge annual meeting Wednesday explained both how issues of traumatic stress should be handled, and how long-term care residents have unusual challenges.
You haven't truly lived until you've wandered into a convention lecture room with low expectations and encountered a man in a white curly wig, conducting a mock trial that sends both shivers and titters through a room. I learned that in a delightful way Tuesday afternoon.
LeadingAge's leaders delivered a simple but challenging message to long-term care providers at this year's annual conference:To thrive, become indispensable.
If we've seen anything this month, it's this: Changing a healthcare system is no easy task. Just ask the White House.
President John F. Kennedy signed the Community Mental Health Act 50 years ago today. Half a century later, the landmark measure's legacy is both troubled and troubling.
In life, as Donald Rumsfeld once said, there are known knowns, known unknowns and unknown unknowns. This may sound like gobbledygook, but it's actually relevant to business and long-term care.
A traditional portrayal of a Boy Scout has him helping a little old lady cross the street. But what if the senior citizen turned around and helped the young man advance to Scouting's highest rank? It happened, and not once or twice, but three times recently at a Colorado senior care complex.
Earlier this month, I was excited to learn that one of my favorite writers, Alice Munro, had been awarded this year's Nobel Prize in Literature. To mark the honor, The New Yorker republished one of her classic short stories — one set mainly in a nursing home.
We've been hearing a lot lately about problems uninsured people are having with health exchanges. But not much is being reported about a different kind of exchange many long-term care managers might soon be dealing with.
I recently participated in a roundtable discussion that addressed the field's challenges and opportunities. Several remedies for improving care and payments surfaced during the conversation. But one unique suggestion really stood out: Perhaps long-term care should become a public utility.
About a year from now, the story coming out of the National Investment Center for the Seniors Housing & Care Industry conference will be around how operators are clutching their pearls about the decline in assisted living occupancy.
Even before the fall convention season started, providers could be pretty sure about what grand messages they were going to hear from the big guys: Work hard, produce good records, make better networking connections. But that wasn't all.
There are many odd animals roaming our healthcare industrial complex. But few are more bizarre than Medicare's three-day rule. Or more deserving of extinction.
As many of you know, this is long-term care conference season, which means having a quality smartphone is essentially a must. Since my old phone could best be described as "temperamental," before I headed to AHCA/NCAL I picked up the new Motorola Moto X Android. This phone is so amazing I keep waiting for it to do my laundry. But in the meantime, it makes it tons easier to shoot off emails, use Twitter, shoot video and edit stories. Most importantly, the new phone has Tetris.
Barring a shocker that would be akin to Uncle Sam suddenly handing out a double-digit market basket increase to Medicare reimbursement rates, Len Russ will become the next board chairman of the American Health Care Association today. Call it a big win for a "little guy."
A country famous for caning its youngsters ought to be better known for the way it cares for its elders. At least, that's the argument of a new book by William Haseltine, a former Harvard Medical School Professor and prominent biotech entrepreneur.
What happened last week in Washington was not exactly highlight reel material. That is, unless you want to showcase public sector dysfunction.
One of the benefits of social media is that you find out people you follow are occasionally idiots.
Captains of the long-term care profession get to their lofty positions by using their intellect and superior vision skills, as a gathering of minds recently re-emphasized.
As you read this, you might be eyeing the new RAI manual that takes effect today, and are feeling a bit overwhelmed at the sheer number of new pages. So it's with great regret that I have to add yet another burden, and let you know that it looks like a whole new therapy discipline will need to be provided at long-term care facilities around the country.
Many a long-term care provider has been known to sample Cub Scout choirs, tamburitza bands and alleyways of off-off-off Broadway in search of talent to entertain his or her residents. Then, there are the folks at Sterling Court, an assisted living facility in St. George, UT, who did nothing of the sort and wound up with viral Internet stardom on their hands.
Many long-term care providers seem to be experiencing a case of budget battle fatigue right about now. Yes, it was earlier this year that a fiscal cliff compromise was reached. And now two more budget-related crises are about to kick in? Care to guess how these developments might affect your future reimbursement outlook?
Of the many questions you hopefully know you can't ask during a hiring interview, a big one is whether the candidate is pregnant or planning to become pregnant. So why is it okay for Pennsylvania State University to ask this of its employees on a questionnaire?
Do you ever feel that people don't really "get" what you do as a long-term care provider? You might take heart from the fact that professionals in other fields also feel this way, according to a recent study. And you might be disturbed at how this lack of understanding affects job performance.
I have a friend who might be best described as a curmudgeon-in-training. He seems to live in a world where almost everything was better than it is now.
It's hard to comment on the Commission on Long-Term Care's just-submitted report without getting hacked off. Really, really hacked off. To call it a fool's errand would be to insult misdirected dimwits.
Miss Florida competed in the Miss America pageant last Sunday despite an ACL tear, earning admiration. She should have quit.
The latest controversy in long-term care has nothing to do with upcoding, sex among seniors or Medicare scams. Rather, it evolves around "exporting" one's loved one to another country for cheaper care.
I sat down to watch an episode or two of "Derek" over the weekend. I thought I'd write a blog about my impressions of this Ricky Gervais show set in an English nursing home, newly released on Netflix. I ended up binge-watching all seven episodes of the first season.
We now share the planet with six billion of our fellow Earthlings. And we're spread across roughly 200 nations. Those of us near the top, however, are paying a price late in life.
My first day as a McKnight's intern started with my editor, Elizabeth Newman, rattling off information about CMS. I listened for a few minutes before confessing that I had no idea what CMS meant. And so began my long-term care education.
Of the many hot words in long-term care, two are guaranteed to get people's ears to perk up: "abuse" and "kickbacks."
My grandmother passed away on Sept. 1. In the days since, those who knew and loved her have celebrated her life and mourned her passing together — and the obituary we wrote for her has gone viral on the Internet. A nurse and a funny, generous person with great bits of advice, I think she's somebody you would have liked to know.
The United States is certainly struggling with its long-term care challenges. But compared to many parts of the world, we're practically amateurs.
For those who think that long-term care providers aren't sitting up and taking sufficient notice of healthcare reform changes on the way, I say take another think. Providers know they're in for change — they just don't really know what to do about all of it yet.
As you may know, 64-year-old Diana Nyad became the first person to complete a 110-mile swim between Cuba and Florida without a shark cage Monday. Let's remember that she's not the oldest woman or only woman. She is the only person, period, full stop.
When talking to long-term care leaders about new construction or facility renovations, I hear the word "residential" spoken often, and with great excitement and pride. And I've accepted that a less institutional, more homelike building is indeed something to celebrate. But two things — a recent experience and a conversation — have gotten me thinking.
There's an informal nickname that describes the many acronyms being used in healthcare these days: alphabet soup. We may have just experienced an Olympic record for it.
When I was a child, I had various non-life-threatening medical problems. Any treatment involved a lengthy discussion with my healthcare provider. Which is why I started laughing when I came across an example Mark V. Williams, M.D., a professor at the Northwestern University Feinberg School of Medicine, uses to explain "teachback.
At their blandest, associations can be conglomerations of disparate members, known for collecting dues for unrecognized purposes and forming mission statements that are forgotten quicker than they are created. But when they get something right, the meaning and impact of their work can bring no bigger smile to your face.
I got together with a few friends last weekend, and one of them mentioned she had volunteered in a nursing home during high school. She shared one of her vivid memories, of a certain resident who was sweet as pie with the white volunteers, but who scowled and cursed — in Spanish (her native language) — at a volunteer from India.
I first began attending American Health Care Association shows in the 1990s. They tended to be lively events, but not for reasons that had much to do with educational sessions, networking or the goodies being distributed in the expo halls.
Any provider who sees the program as anything less than a blessing sorely needs a class on recognizing gifts.
Researchers recently conducted three studies to evaluate the emotional benefits of giving to charity. They found that what they called "pro-social spending" means the giver becomes happier.
It's easier to have empathy for people if you know specific things about them. Long-term care providers know this, and it is behind many valuable programs to learn more about residents' lives. Journalists also know this to be true, as shown by the recent Frontline/ProPublica expose on assisted living.
When it comes to life spans, we are the chosen ones.
Long-term care administrators should embrace pro-breastfeeding policies in order to retain talented working mothers.
If a profession were going to grow so much it could dominate certain employment sectors in the near future, it would only make sense to start focusing more on that profession, wouldn't it? Long-term care operators and managers, get ready to gain a lot more sense about your biggest employee group.
Here's the scenario: You're going to receive an electric shock. It's part of a study, and you're willing to undergo the highly unpleasant shock for the sake of science. Before you get started, the researcher in charge gives you the option of pressing a button, to end the shock 10 seconds earlier than it would otherwise last. Do you press the button?
Did you hear the one about life's great lies? Here's part of the punch line: "I'm from the government and I came to help you." Providers familiar with the joke may have experienced a vague sense of déjà vu last week when the White House made this announcement: They are launching a healthcare reform website for business owners
A friend who is a dentist used to regularly see residents at a nearby facility. There, he would examine patients and make arrangements for them to visit his dental office when necessary. But he stopped doing this about two years ago. Why? The hassle just wasn't worth it.
McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.
James M. Berklan
Elizabeth Leis Newman