James Berklan

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.

It seems like a lousy pre-occupation for people tending to frail, mostly elderly people entrusted to their care.

Yet the No. 1 challenge listed in a polling of more than 1,200 providers was “documentation.” In fact, 21% who visited the Harmony Healthcare International website in 2014 said it was their biggest challenge. 

The other categories were: denied claims (12.1%), census (11.9%), business operations (11.6%), education and training (10.8%), revenue/reimbursement (10.7%), management (7.1%), patient care (6.9%) and regulatory/compliance (6.1%).

Non-C-level workers (23.4%) were more concerned about documentation than C-level (13.4%).That’s not surprising, considering who has to actually fill out endless MDS and nursing evaluation forms. It’s something bosses should take to heart.

The “Harmony Healthcare International 2015 Post-Acute Care Trends Report” showed C-suiters are more concerned about census (18.8%) and business operations (17.8%), as they should be. Nonetheless, they need to remember how much pressure their workforce is under due to documentation. 

Concerns about documentation were pervasive across most cross-sections of respondents. Every geographic region except the Pacific Northwest (where “education and training” was top vote-getter) named documentation the most urgent challenge. The most dominant showing overall was with first-year employees, where 37% said documentation was their biggest concern.

Most remarkable is that “patient care” as a No. 1 concern never rises above 8.4% for any of the responding groups. Is this because providers are so confident in their direct care? Or is it because they’re being so distracted by non-patient care tasks? Perhaps both?

Kris Mastrangelo, Harmony Healthcare’s president and CEO, had one indisputable conclusion: “Our industry is still very focused on the day-to-day tasks of getting the job done.”

A continual day-to-day focus doesn’t leave much time for planning for the future. Unfortunately, there is no way documentation will fade too far off providers’ worry screen any time soon.

A sad vision for providers — but an even worse reflection of regulators.