This year I promise to...

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John O'Connor, editorial director, McKnight's Long-Term Care News
John O'Connor, editorial director, McKnight's Long-Term Care News
It's very possible that as you are reading this, you have already abandoned those sincere New Year's promises you made to yourself as 2011 was ringing in. If so, you're hardly alone.

Still, resolutions are a good idea. They can help focus our thoughts and guide us toward better destinations. In that spirit, I am suggesting four New Year's resolutions that I think could pay big dividends. Like many proposals, they may require some short-term discomfort, but the payoff more than justifies the effort. Here we go:

1. Federalize surveyor training: Why is a cracked eggshell a life safety issue in one state and barely noticed in another? Because each state trains its own surveyors. The federal government needs to quit subcontracting this duty and take over. A federally run program will help unify and professionalize surveys, while also making inspections much fairer across the nation.

2. Federalize Medicaid: If you think the way states variously train inspectors is an embarrassment, what about the way states pay nursing homes? The care that any resident receives should never depend on a particular state's budgetary woes. Fold Medicaid into Medicare and many of the goofy payment issues we now see will be eliminated.

3. Start self-policing: The long-term care industry has made commendable strides toward providing better quality care in recent years. For this, much praise is due. But let's face it: There are still a lot of rascals out there.
Providers need to quit looking at their shoes when they know fellow operators are playing fast and loose with the rules, or worse. Associations should be moving aggressively to promote self-policing among members, as should any organization that purports to stand for quality care. The alternative is to do nothing and let state and federal regulators deal with the mess.

4. Embrace the Five-Star rating system: Yes, embrace it. Why? Because it's here to stay. Consumers and the government are for it. Frankly, they're not terribly interested in hearing about the ways you're not. So do yourself a huge favor and get with the program. Better yet, use it as a catalyst to improve the care your community delivers. It just might become something that once seemed unimaginable: a marketing tool. n
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