The adage about keeping friends close and enemies closer has been variously attributed.

Whether borrowed from the lips of a mobster in “The Godfather 2” or derived from the strategic wisdom of Sun Tzu’s “The Art of War,” its relevance for long-term care operators is pretty clear.

Now perhaps it’s a bit extreme to brand as enemies the many folks outside this field who have their own improvement ideas. Maybe adversaries, non-aligned stakeholders or simply misinformed idealists is a better descriptor.

Take, for instance, the Long Term Care Community Coalition. This group is  driven by a strong desire to reshape the landscape of long-term care in favor of consumers.

During a recent webinar, the organization challenged prevailing notions that nursing homes are over-regulated and underpaid, dismissing them as mere “myths.”

I can think of thousands of skilled care operators who could readily attest to the stark reality behind these purported myths. Yet, what’s more concerning is the underlying sentiment that seems to guide the coalition’s perspective: that nursing home operators are full of the stuff male cows leave behind.

Perhaps more troubling still — at least from a provider’s perspective — is the group’s four-point program for making things better. That remedy consists of:

  • Instituting “meaningful accountability” via more frequent surveys and more rigorous enforcement.
  • Improving “accountability for the funds allocated for resident care” by implementing caregiver-to-resident ratios, more rigorous fiscal monitoring, and eliminating Medicare-Medicaid cost-shifting.
  • Enhancing ownership/management transparency and accountability by subjecting chains to greater scrutiny — and requiring prior authorization for facility sales.
  • Ensuring “safe, sufficient, and humane staffing levels” by enforcing existing staffing rules, establishing additional staffing standards, mandating a 24/7 RN presence, and “guaranteeing competitive wages and benefits for nursing staff.”

Apparently, these reformers feel that facilities should have sufficient cash reserves for these unfunded mandates. All this and more, from your friends at the Long Term Care Community Coalition.

Which reminds me of another saying. It has to do with paving practices often seen on a road that leads due south.

John O’Connor is editorial director for McKnight’s.

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