If you didn't work in long-term care and I asked you to specify what Illinois, Washington, Texas, Oklahoma and New Mexico have in common, we could be waiting for your answer for a very long time.
The lessons keep flowing from the political debacle that has been Sarah Palin's political career. You'll recall it was Palin who launched the irresponsible phrase "death panels" into the stratosphere back in 2009, a time when conservatives and liberals were battling over the very life of the Affordable Care Act.
When President Obama took the podium on the morning of July 13, he thrust aging and long-term care into a reinvigorated spotlight.
It's an odd thing to see the king of the jungle become the hunted instead of the hunter. But that's what happened when CVS announced it was buying Omnicare.
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.
Never mind the mantras about the long-term care profession being "high touch." The focus has been hijacked and it appears most providers are now consumed by documentation.
One gets the feeling that federal regulators, no matter how proper the official talk went, took a bit of pleasure in sending a message to providers when recently rebasing their star ratings.
Long-term care providers weren't outwardly jumping for joy when it was announced that Medicare is going to start paying for quality, and not quantity, of services.
Growing up, we had a saying when we wanted to cross a busy street but couldn't catch a break from drivers. "C'mon," one of us would gamely yell, while pulling the others onto the roadway, "there's safety in numbers!" OK, so I still do it on occasion and sometimes we shout, "There's strength in numbers!"
Federal health officials have signaled that they are intent on getting this accountable care organization thing right.
There is a memorable scene in the movie "Forrest Gump" when Lt. Dan chews out the well-intentioned title soldier for saluting him while the enemy is likely watching. The implication is that if you want to strike a crushing blow to something, you take out its leader.
If there's anything that's become clear about this ACO business lately, it's that it's not going to be as simple as A-B-C.
Don't let anyone tell you that long-term care operators don't know how to read between the lines. They might not have known to fear a McKnight's Daily Update item before it appeared Sept. 8. But it quickly and definitely earned their attention — and apprehension.
As a long-term caregiver, you get yelled at, told off, put down and dumped on regularly — and that's during good weeks.
With another summer of huge movies nearly behind us, it's a good time for providers to exhale in relief. Or wonder anxiously if they have been on camera themselves. Especially if Mike DeWine would be the film's producer.
As spring blends into summer, some nursing home operators are going to start feeling more heat. The federal government is moving to reclaim some form of "normalcy" after sequestration cuts lopped funding for many things, including its "very bad boys" list.
It appears that the nation's largest association of nursing home operators has decided to buy itself a whole lot of credibility. I mean that only in a good way.
Hidden gems are often the best kind. They surprise us and keep us hopeful and optimistic for the future. This is how I feel about McKnight's Technology Awards, the third annual version of which is being sponsored by Tena and started accepting entries this month.
A funny thing happened on the way to a semi-annual eye rolling about a MedPAC report. It contained some information that could make long-term care providers happy.
As a parent looking at options for a high school student about to enter college, I know why it seems like everyone talks about the high cost of education. It is high.
Lost in the year-end shuffle was nursing home operators' most optimistic story of 2013: The public has an all-time high opinion of you.
What the long-term care insurance market could use right now is a healthy dose of capitalism. But it isn't going to happen.
Now, even three or four years down the road, the impression of the long-term care leader cowering like a guilty child is haunting.
When we at McKnight's host a special roundtable discussion, I look forward to getting to know the esteemed participants. Captains of the profession, they typically have evolved from nurses, business managers and doctors into C-suite inhabitants — extremely observant top executives, in fact.
Sometimes long-term care providers struggle to find meaning in the signs that are strewn in their path. Whether it's legalese, regulatory gobbledy-gook or some form of bureaucracy, uncertain messages confront providers seemingly every day.
When you complain about bizarre government conditions or regulations, as columnists are wont to do, you usually have to assume you're just whispering into a stiff wind. But now comes word that no less than the Office of Inspector General of your Department of Health and Human Services is jumping on the bandwagon to change the hospital "observation stay" madness.
Every enterprise needs worker bees. Clearly, if the work is going to get done, those on the frontline — and elsewhere — must soldier on. But if an enterprise — be it a company, industry or other entity — is going to survive into the future, it also needs a visionary. Without forward-looking inspiration, any enterprise will surely fade, just as a houseplant will shrivel without mindful tending.
Raise your hand if you've ever had a family that just didn't "get it" when dealing with the staff at your nursing home or long-term care facility. OK, put your hand down now. It's time to learn why Marie Marley could be your next best friend.
If you hang around long enough, you learn there are only two things long-term care providers fear after Republicans and Democrats. That would be hospitals and doctors.
I'm not going to worry too much about the Second Annual McKnight's Technology Awards program, which kicks off this month. The first one last year was a smashing success. I have no reason to believe there are any fewer proud and successful programs out there this year.
There are plenty of legal concerns that keep nursing home administrators awake at night. Many times, the demons can be kept under the bed or locked in the closet. But not always.
If you're like me, you're a big believer in the saying "Attitude determines altitude." Eldercare professionals should have this embedded in their minds — for their good and the benefit of those they care for.
It's no wonder you, as a long-term care provider, might get fed up with the general media. Sometimes it has to seem that mass media journalists must sit around the office, wondering what they can do to score flash points with editors, plaintiff lawyers and talk shows.
I'm fascinated with long-term care topics that at first blush seem to be speaking about residents, but upon closer reflection they could be even more interesting personally to long-term care professionals.
By the time December rolls around, it's safe to say many thoughts are toward finishing the year on a high note. Or for pragmatists and forward-thinkers, setting up strongly for the flip of the calendar page.
Not all association conventions are remembered equally. Some have dynamite entertainment, some a few great speakers. Often, it doesn't go much beyond that.
When you move workspaces, there are endless unexpected discoveries. Some depress, some thrill, some just boggle the mind.
Long-term care providers might find they have some wrenching decisions to make, thanks to the Romney-Ryan presidential ticket.
In case you had not checked lately, you're liable to be paying more than ever just to run your basic eldercare business.
Mark Parkinson makes a lot of sense when he talks about the future of long-term care. One of his key points is that providers must be the cost and quality solution.
Do you and your colleagues do good work? Of course you do. But why is that? You care for your residents. Check. You care about professionalism. Check. Maybe you just don't know any other way. Check.
Even in generosity, it seems, nursing home leaders can't catch a break. The headlines, from the Washington Post to the Huffington Post, implied as much. There they were in bold, tall type, touting the fact that a "nursing home group" had donated $175,000 toward Sen. Orrin Hatch's (R-UT) re-election effort.
If you feel like you've been bombarded with antipsychotic news lately, it's not in your imagination. People inside and outside of long-term care alike have been feeling the pressure to lessen antipsychotics' use in what has become a hot-button issue.
If long-term care providers (and their residents and families) needed any more depressing confirmation that they are not on the presidential radar screen, they've gotten it full-blast recently.
With warmer days of spring around the corner, now is the perfect time to hunker down and get your professional affairs in order. I have a solution that involves no paperwork or heavy lifting.
Sometimes long-term care nurses feel like step-sisters to their acute-care counterparts. Face it: Hospital nurses usually get the glory.
It was both flattering and intimidating. At the LeadingAge convention, someone asked me to state my hopes for the future of long-term care. What a thrill to be asked, but with all the possibilities, where should one start?
Hopefully a certain bound-to-be viral video has already gotten to you. If not, you can thank me later.
So this is what it comes to when No. 1 attempts to buy No. 2. This could be some lively theater by the time the final curtain drops.
If you thought the politicians' recent stomach-turning brinksmanship over the national debt ceiling wasn't fun — and who did? — you have no reason to look forward to the end of November and December.