Agility, attracting millennials among top 2017 workforce trends

"You cannot make long-term successful change with people who are blocking it," a long-term care workforce expert said Thursday. He's, oh, so right, about this and other staffing challenges.

20 career dos and don'ts ... and more

I don't think I'd ever heard of Menlo College in California before Wednesday, but if I had a college choice to make again, I might seriously consider going there. If only to learn more from its president and how he might help my career, and yours.

Don't drop the Diet Coke just yet

Every so often a new study will be published that reminds me of my favorite Onion headline of all time: "Man Who Drinks 5 Diet Cokes Per Day Hoping Doctors Working On Cure For Whatever He's Getting."

Don't overlook this new mandate in the PBJ manual

The Centers for Medicare & Medicaid Services inserted an important new requirement in the latest version of its Payroll-Based Journal manual. It's one of those innocent-looking provisions that are fairly easy to skim over. But your facility might quickly find itself in hot water should it be ignored.

The high costs of bad health among front line caregivers

We are what we eat, and there's a lot of evidence that our nursing home workforce is struggling to be good.

GoFundMe campaign covers nurse's fine, but should it ever be paid?

The saga of nurse Carolyn Strom has been one of our most popular over the last six months. She is, of course, the Canadian who vented about her grandparents' healthcare on Facebook and was fined for it.

It's time to take your medicine — seriously

People not following their doctors' medication orders contributes to an estimated 125,000 deaths and 10% of hospitalizations per year, along with somewhere between $100 billion and $289 billion in healthcare costs. A lot are like like certain geniuses on my Facebook page.

Finally, some good occupancy news

You could almost hear the collective sigh of relief when NIC released its first-quarter tally on skilled nursing occupancy levels. To be sure, the 87.2% rate is not exactly a cause for celebration. Then again, maybe it is.

A better opioid policy shouldn't mean seniors suffer

In addition to the terrible tragedy of opioid addiction in the United States right now, long-term care providers have an additional challenge: Figuring out both how to make sure seniors retain access to pain medication and how to keep those medications from leading to addiction.

Life in the slow lane: SNF employment

With one son in college and another trying to figure out where to attend, the future job market is a topic near and dear to this writer's heart. Believe me.

Award winning advice on keeping employees engaged

As a teenager I spent a few weeks one summer working at a very popular food stand at the Wisconsin State Fair. "Very popular" is an understatement — the stand serves thousands of people each day, with some customers I spoke with driving from out of state just to eat there.

MedPAC wants to put SNF Medicare claims to the test

Skilled operators have been telling lawmakers and regulators that they are the cheapest post-acute care option out there, and it appears the Medicare Payment Advisory Commission has not only heard the claim, but wants to take the industry up on it.

The broken record of bad public relations

If there's an area that I would argue is as bad as it was when I wrote about it in 2012, it would be how-long term care operators handle a public relations crisis.

Bank that sleep now

When I was very young, my parents used to chuckle at how I, a through-and-through suburban kid, would rise so early and turn on the TV to watch ... the farm report.

When resident rights could be wrongs

What happens when a resident's wishes clash with the regulations with which long-term care providers must comply?

Medicaid as an attractive funding source?

It wasn't too long ago that thousands of nursing homes were fleeing the Medicaid program.

When perfect is the enemy of good

One of the common refrains you heard last week as the GOP healthcare plan marched to its demise was Republicans saying that "we're letting perfect be the enemy of good."

Keeping the glass half full

If you need a little encouragement to stay positive next time something goes awry, look no further than this story from the New York Times.

For long-term care operators, there's no time for a pity party

Skilled care operators have their work cut out for themselves. But I have to say I'm feeling better about the sector's prospects after spending some time at last week's NIC Spring Investment Forum in San Diego.

Rooting out the cause of a cat problem

Hearing the phrase "root cause analysis" always strikes a bit of fear into my heart because it always seems to be a complex process. In long-term care, this is often framed as not only knowing that a resident fell, for example, but why she fell.

This is what admired long-term care leaders do

We found some long-term care employees willing to talk about how their managers make a real impact by giving help. These are long-term care managers who talk the talk AND walk the walk — and earn the admiration of workers.

Deathly serious: Time for more talking; odds not great without it

For all the benefits that end-of-life care talks can bring, a new study indicates that even when such talks take place, patients' preferences aren't always understood or effectively communicated. In total, just 20% of the surrogates interviewed correctly predicted the veterans' end-of-life care preferences.

Does your back have room for another target?

As Momma used to say, not everyone who wears respectable clothes is respectable.

Hit the road with your staff

The most delightful story in politics this week leads us to some great tips for getting to know your co-workers better, and includes a reference to Willie Nelson. What could be better than that?

Put those loudmouth family members to work

Whoever said politics makes strange bedfellows could have a field day with this one.

The hidden threat lurking in your facility

I don't mean to make your lives more difficult by adding another issue onto that pile, but according to a recent survey from the National Safety Council, there's a problem plaguing American workplaces that needs addressing: prescription drug abuse.

Don't be worried about Medicaid funding cuts — be very afraid

The long-term care industry's worst fears about what a Trump healthcare plan might contain have not just been met after last week's unveiling, they have been far exceeded.

What the new health insurance plan would mean for long-term care

As a long-term care provider — and very importantly, employer — you might not be thinking about the full costs of what the House's newly proposed health insurance plan could be. Let's break it down.

It's time to take sides about Obamacare's future

Tuesday's statement from the American Health Care Association on Republicans' plan to repeal and replace Obamacare was striking. There was no walking a tightrope or mealy-mouthed ambiguity in it.

Multi-generational mixer builds great collegian-CCRC resident bonds

From adding cheerleaders to finding backgammon partners and sharing farming advice, a collaboration project between a CCRC and Fresno State students has been a rousing success.

Snobbery that skilled care operators can ill afford

Quite a few skilled care operators tend to look at assisted living as being not quite equal. Many on the skilled side tend to see themselves as being a bit, ahem, more qualified.

How to make your leave policies better

While most businesses offer at least two weeks of vacation at a minimum, the topic of a recent article in Crain's caught my eye: Companies offering unlimited vacation.

Your money's no good here

I'd say the thing we write about most often in this line of work is payment issues. As a long-term care provider, you are eternally under pressure with whether there will be enough to pay for everything.

Why so blue?

I've been in a fight with my computer monitor for the past couple of days. The screen was crisp and bright looking, but after a few hours I'd start getting a headache. I had been blaming that on a lack of coffee, until I started doing some research.

It's not just charity that should begin at home

Long-term care operators tend to be a nervous lot. Rightfully so.

Re-evaluating CT for dementia residents

For all of our interest in cognitive training for dementia patients, we are nagged by knowing that studies on the topic have varied in quality and reliability.

Bad-mouthing the cost of long-term care

Finally. That's was my silent reaction when I received the email from a top long-term care provider last week. What took so long? I still wonder.

There's another tsunami coming you probably haven't thought about

There's a significant facet of the coming "silver tsunami" that most providers might be overlooking, according to a recently published report.

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.

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