Daily Editors' Notes

Such a bargain: 2013 closeout has plenty of concerns

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James M. Berklan
James M. Berklan

If you're feeling the suction of the end-of-year vortex grabbing you, you're certainly not alone. Whether it's holiday preparations, work deadlines, challenging weather or a combination of them, you have company. Even if it's just me, you would have company.

But if you're a long-term care provider, you have a few extra things adding anxiety to your 2013 closeout.

Take that antipsychotics reduction goal thing. When you hear a lot of proud, pre-emptive notices saying, “We almost got there,” you eventually realize: Almost means you're not.

Then there's the increasing scrutiny on rehospitalization rates. Fairly or not, it's becoming a referendum on whether your fine establishment does good work. Never mind if some of your residents arrive in worse shape than others, destined to head back to the hospital they just came from, regardless of how strong your staffing ratios are or how fantastic your therapy department is.

That's the really puzzling one: A hospital can do a lousy job but as long as it can deliver a warm body to your census, the onus then falls on you.

This is going to get more complicated, too, because the Office of Inspector General has recommended federal regulators create a new quality measure concerning your rehospitalization rates. It's supposed to be completed and unveiled by the end of the year — as in within 12 days.

No need to hold your breath on that one. But this QM will be coming, eventually.

And so will lower rates of antipsychotics use. Just not now.

Is that good enough? It's going to have to be. After all, if you're on a diet and don't hit your target weight right away, it doesn't mean you should go on eating binges. Halfway is not inconsequential.

While the folks at the American Health Care Association try to parse the numbers on this issue, those at LeadingAge do not. Members are not asked to submit usage rates. Yet at least one LeadingAge top manager knows she is pleased with the trend.

“I'm actually very positive and enthusiastic. [Not hitting the 15% reduction goal yet] is not a measure of failure,” LeadingAge's vice president of quality, Cheryl Phillips, told me.

And then she added the most insightful comment of all: “It's a really tough culture change, not unlike physical restraints two decades ago.”

The momentum is there. In fact, when it comes to antipsychotics overuse, it is widely believed the decreases will increase. Just as providers rightfully did with the physical restraints issue.


James M. Berklan is the Editor at McKnight's.


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Daily Editors' Notes

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.

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