James M. Berklan, McKnight's Editor

Some things I believe and some things I know. And I believe I know there is nothing more important for long-term care providers to do than getting better prepared for an intensified push to decrease rehospitalization rates.

After various discussions with some pretty sharp providers recently, I believe that there are many more “with it” long-term care execs than outsiders realize. They have been building solid foundations to create better relations with hospital execs and discharge planners.

I know, however, that in at least one regard hospitals fit a similar description to that of skilled nursing facilities: They’re all over the place in terms of preparedness for rehospitalization penalties. They don’t know enough, or how, to help themselves. What’s scary for hospitals is that, starting in October, they are the ones who will directly lose funding if rehospitalization rates are bad. SNFs will just lose out on referrals, a fate almost as terrible.

I believe Uncle Sam’s quest for accountability might get mired down among other initiatives and regulatory burdens.

But I know the quest won’t be abandoned.

I believe long-term care providers have a right to remain generally skeptical about the government’s Five-Star Rating system.

I know that within that system duds often receive too many stars and top performers too few. It’s an open secret among providers that in some markets, referring physicians still hold more sway about LTC placements than Five-Star ratings do — despite hoopla and fears otherwise. This further undercuts the credibility of the distrusted system.

I believe Mark Twain was right when he said there are lies, damn lies and statistics.

Yet I know that if, as a skilled nursing operator, you don’t start gathering and learning how to best use statistics about your caregiving outcomes, you can extend Mr. Twain’s quip by four words: providers out of business.

The genie is out of the bottle. If you have poor outcomes or business models that you don’t want inquiring minds to know about, it’s going to be harder and harder to keep them out of sight. Hoping that others will ignore or not notice them is not a good strategy. Uncle Sam is not going to retreat on his drive for more transparency and accountability. Providers ignoring this reality do so at their own peril.