How to be a traitor in long-term care

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John O'Connor
John O'Connor

Another day, another love letter.

This one comes from one of my less-than-adoring fans. I'll skip to the juicy part: “You fat, ignorant SOB. Why are you always picking on operators?”

Ouch! For the record, I am trying to drop a few pounds.

My lame attempt at humor aside, I guess I can understand the writer's sentiment. After all, I have used this forum to point out some rather disturbing things.

Things like upcoding can be easy and remains rampant, that many skilled care operators use a crappy business model, that the sector does a miserable job of policing its bad actors, and that the field has mostly itself to blame for heavy-handed regulations, to name but a few.

It's not hard to see why such suggestions might feel less like a helping hand, and more like a slap. And I can understand how some readers might conclude I must take some kind of sick pleasure in biting the proverbial hand that feeds me.

In fact, nothing could be further from the truth. What I want more than anything is for this to be a field we can all be proud to call our own.

I have been with McKnight's for more than 28 years. I have met many truly remarkable people in this sector during that time. And I truly believe that most operators are here for the right reason: to provide help and compassion to others during a time of great need. Day in and day out, that happens at thousands of facilities. And for that noble achievement, the skilled care sector deserves lavish praise.

But to conclude that such service makes everything else OK would be naïve at best. The reality is this: Many operators are doing things they probably won't be bragging to their grandchildren about. Sadly, there are still all sorts of shady things taking place in the skilled care sector. They are happening regardless of my notice. To overlook that reality is to live in a state of extreme denial.

Some of the unethical behavior is born of desperation. Quite a bit of it stems from simple greed. If we were talking about the widget business, that might be less of a problem. (And make no mistake: There are widget-makers, as well as cops, judges, teachers, clergy and members of just about any profession, who exhibit questionable ethics.)

But long-term care operators have been deputized to give their best to those in need. Whenever that task takes a back seat to convenience or the bottom line, people can get hurt. Moreover, there is a spillover effect. Need I point out that skilled care operators do not exactly enjoy a sterling reputation these days? Gee, I wonder why that might be?

For all the good this sector does, problems remain.

Had he not been assassinated 50 years ago tomorrow, Robert Kennedy probably would have won the 1968 presidential election. He famously once said, "Some men see things as they are and ask 'Why?' I dream things that never were and ask, 'Why not?'”

It would be hard to find words that better reflect the challenge and opportunity facing skilled care operators today.

John O'Connor is McKnight's Editorial Director.


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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Marty Stempniak.