It's not just charity that should begin at home

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John O'Connor
John O'Connor

Long-term care operators tend to be a nervous lot. Rightfully so.

This is a field where trouble always seems to be lurking just around the corner. The latest cause for concern is the very real possibility that Medicaid — and more to the point, Medicaid funding — may soon be changed in some very undesirable ways.

But there's plenty more where that came from. It remains to be seen whether value-based purchasing will ultimately help or harm, whether other forms of post-acute care will become the darlings of hospital discharge planners, or whether rehab care can continue to be a major benefactor. And that's just for starters.

The reality we know all too well is that there are a lot of external factors that can undermine the field's ability to survive, much less thrive.

But while this sector is finely attuned to its numerous outside threats, it remains remarkably uncurious about the ongoing self-inflicted wounds taking place all too often.

I was reminded of this blind spot again last year, when I wrote a blog suggesting it was not so difficult for operators to upcode their Medicare charges. Judging by the numerous phone calls and emails I soon received, you'd have thought I was spreading false, ugly rumors.

In fact, if it wasn't for the dozens of operators who have since been charged with doing exactly that, I really would have felt terrible.

But back to the self-inflicted wounds. Here are actual headlines from some of the most popular stories we ran in the past week:

•   Jury awards families $5.2 million in medical negligence case against SNF

•  Provider pays $5.5 million in HIPAA settlement

•  MN health officials overwhelmed by nursing home complaints, report says

•  CNN investigation: Sexual assaults in nursing homes a 'widespread' issue

Again, this is from just one week. See a common theme?

It gives me no pleasure to point this out, but there are a lot of operators who continue to do things they probably won't be bragging about to their grandchildren.

I'm sure many providers are perusing our stories as a way to stay better informed about industry developments. But I can't help but wonder how many others read about troubling developments and conclude, “There but for the grace of God go I.”

To be clear, I firmly believe that most of the people in this field truly want to make a difference. Most operators see themselves primarily as caregivers delivering a much-needed service.

But we would be mistaken to insist that those with nefarious intentions are just “a few bad apples.” The negative stories that are all too common make a mockery of that viewpoint.

It would be naïve and foolish to suggest operators go after the miscreants in our midst. There really isn't much upside to that sort of thing. But I would recommend this: To the extent possible, try to avoid being part of the problem.


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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.