As is fitting this time of year, when many people are exchanging gifts and then making New Year’s resolutions, I’ve come up with my wish list for key long-term care players and stakeholders.

For directors of nursing in the nation’s skilled care facilities

The gift of bunches of eager, resolute staff members. It’s hard to keep the boat moving when somebody’s always handing back her or his oar, or there simply aren’t enough people rowing.

The resolution they should make: To develop more patience for those whom they may hire. And remember: No snacking on young staff members allowed. It’s been acknowledged many times by nursing leaders that for some reason, experienced nurses tend to treat newcomers brusquely, to put it politely, or that they tend “to eat their own” to phrase it not so politely. Play nice. Period.

For building administrators

The gift: A lasting supply of directors of nursing, probably the most pivotal leader in your buildings.

The resolution: To become better communicators. The only way to make sure gossip or unfounded speculation ruins morale and sometimes the reputation of your facility is to let it go unchecked, or get started in the first place. 

For the residents

The gift of consistent assignment of their direct caregivers. There is no way this gift can be overvalued. Ever.

The resolution: To keep your family members in line, and fully appreciative of those who diligently take care of you 24/7/365.

For unscrupulous contract nurse agencies

The gift: A big lump of coal. You’re right up there with the gas stations who charge $10 a gallon or more after a hurricane ravages an area.

The resolution: To develop some kind of conscience to help the industry you profess to be saving while lining your own pockets to excessive levels.

For nursing home owners

A gift of lower inflation rates, while also being able to harvest some of the value that higher interest rates bring. But mostly lower inflation. 

The resolution: To be more transparent about who you are and what you’re doing. Then again, the feds say they’ll be helping you with this one so hopefully you see fit to play ball. Let the disinfectant of sunshine shine on whoever’s running the show in town.

Private equity investors

The gift of a decent crystal ball so you can figure out who really needs you most. Then behave appropriately.

The resolution: A tempered appetite. They may be just Hollywood examples, but if you want to see how a business leader can modify ravenish financial desires while still keeping hold of a pretty good buck, check out the classic “It Happened on 5th Avenue” or, heck, even “Pretty Woman.”

The states

May they all enjoy the gift of a burgeoning economy in 2023.

The resolution: To share the wealth from a healthier economy with their Medicaid programs, and therefore, skilled nursing stakeholders.


May it enjoy the present of another technology executive like Majd Alwan. His long-time second-in-command, Scott Code, could be just the guy.

The resolution: To never give up the good fight. Advocacy statements out of President and CEO Katie Smith Sloan and the rest of her leadership team during the pandemic have been powerful, pointed and unapologetic. Shockingly so in some cases. Good for them.

The American Health Care Association

May 2023 bring the gift of another quality, fun annual conference, like the one in Nashville in October 2022. (Minus, ahem, the case of COVID-19 that some of us arrived home with.)

The resolution: More national news show appearances for President and CEO Mark Parkinson, who’s never been better than in the early days of the pandemic, when he let the nation know that long-term care providers were victims as much as anybody since their patients were most susceptible to the most dangerous public health scourge in at least a century. Double down on that with more public exposure for gifted speaker AHCA Senior Vice President of Government Affairs Clif Porter, too.

The Centers for Medicare & Medicaid Services

Let CMS have the gift of wisdom when it unveils its promised nursing home minimum staffing standard early in 2023. The absolute right way to do this may not be known yet, but there are definitely easily recognized wrong ways to go about it.

The resolution: To consistently listen more and act for the good of the entire system that the agency is both patron and overseer to. The circumspect decision-making that went into switching from a drastic funding pay cut in the proposed Fiscal 2023 SNF PPS rule to a more moderate package that also phased in funding take backs was a welcome breath of fresh air and clearheadedness.

And to all of our readers, as always, I wish you good health and outstanding days ahead.

James M. Berklan is McKnight’s Executive Editor.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.