Every now and then, I wander innocently and foolishly into a complex long-term care topic that makes my brain hurt. This time, it was managed care.
For all you passionate, committed long-term care professionals who chose this career path for only the right reasons, I think I've found your kindred spirit.
At the risk of shameless self-promotion, I'm quite sure I've just solved one of the great challenges facing long-term care providers — hiring the right frontline caregivers.
If there's one thing I've learned, it's that everything happens for a reason. In my case, life's challenges are apparently meted out by the gods for the sole purpose of entertaining you, the long-term care professional, at the expense of my personal dignity.
I have to admit that this vilest of seasons, winter, can be a useful teacher, meting out stern but valuable lessons about life, and of course, long-term care.
November 28 is ruined for me now. Thanks, CMS. For years, I've been celebrating it as the fateful day in 1443 when Albanian George Kastriotis Skanderbeg and his forces liberated Kruja in Middle Albania from the Ottomans and raised the Albanian flag. Not anymore.
Reading the disturbing news in McKnight's about the ingestible digital antipsychotic pill that tracks patient data has me all befuddled. I wish I could swallow a pill that would tell me how to feel about it, and what it means for the future of our society and world.
I had a birthday recently. OK, more than just recently. Tuesday. My long-term care colleagues were kind, supportive and treated me to an exquisite lunch. But the rest I've had to deal with on my own.
Despite a few trivial concerns about the societal wisdom and messaging of sending our progeny door-to-door begging for poison, I try not to be a total wet blanket on the annual festivities of Halloween.
I've seen movies about what happens when humans fight robots, and I won't be taking one for the team.
When it comes to flu shots, let's just figure out a way to make the whole thing more convenient for those who choose or are coerced to undergo this crucial or useless procedure.
Like any sensible facility marketing director does, I desperately want opportunities to attract attention. Recently, after considering every available option, I identified what I felt was a sure-fire way to achieve those self-promotional goals — by wearing neon-salmon-colored pants.
Let's make one thing perfectly clear. I'm not suggesting long-term care facilities are exactly like the Department of Motor Vehicles. They're simply not equivalent, though I know many fine people who work on both sides. But there are definitely similarities.
Like it had just pulled an emergency triple-shift, while simultaneously serving as DON, CNA, cook, laundry assistant and defense attorney. That's how the sun looked as I drove to work Tuesday morning after the eclipse.
We've seen many partial political eclipses over the years created by both parties, where selfish interests and ambitions seem to blind them to the possibility of solving actual challenges together.
Much of what I know about success (or failure) in life, love and long-term care has been reinforced by lessons learned over years of hiking. As a result, I now take it as a point of professional pride that regardless of the challenge facing our profession, I can always find an analogy to the trail.
I didn't go to the gym this morning because I had to write this blog about the importance of exercise in the long-term care workplace. Ironic, isn't it? Also, sad!
I should write about the Senate health care bill. I really should. The Better Care Reconciliation Act of 2017 is relevant, as it could significantly impact the long-term care profession. It's happening now, which is as timely as it gets. It's entertaining, like professional wrestling. And it's exciting, because we have no idea how it ends.
When I first started writing about long-term care back in a previous century, our profession's slow embrace of technology and affection for the status quo was widely cited and frequently mocked. It doesn't feel that way anymore.
Even the best managers can sometimes inadvertently make jobs more difficult than they have to be, often just out of habit or inattention.
That's a difference between my father's generation and mine — the way we value, or in my case, don't value, our independence.
It's a lot of pressure, working in long-term care. People are becoming much more process-conscious and data-driven, more aware of competitors and more responsive to market research. Perhaps that's why my colleagues recently demanded I create a QAPI plan for my personal life.
Last time, I wrote about pig bladders, and how they can help bolster the courage of your convictions to innovatively solve any long-term care challenge. So I think you're definitely ready for a frank talk about spiders.
Forget all the bad news of late. It doesn't matter. Not now that pig bladder has been found to hold healing promise for diabetic foot ulcers.
"Astonished" doesn't even begin to cover the feeling. "Disappointed" is also woefully inadequate. To describe a recent, very public, wardrobe humiliation that occurred in the bustling epicenter of a long-term care corporate headquarters, I think I'm going to have to go with "shocking" — dictionary-defined as "causing a feeling of surprise and dismay."
It's shocking to realize the enduring power of the printed word. First I write a column about a giant, possibly rabid squirrel attacking innocent people in a Florida long-term care facility activity room, and next thing we know a 91-year-old resident in a New York assisted living facility stocks his fridge with hand grenades.
I won't be taking up virtual reality advocacy anytime soon, but it has nothing to do with vertigo or motion sickness. I'm simply not actively seeking additional reality in my life.
I don't need hair. That's my big takeaway from spending a morning with wise and wonderful Fernald recently. It's not what I wear, or having a scalp as arid and vegetation-free as Death Valley. It's being kind and having love in my heart that counts. That's what he said, emphatically, while jabbing his finger my direction, so who am I to argue?
After witnessing a musical performance that left me amazed and stupefied, I went home with a flash of insight and a long-sought analogy — facility administrators are the blues drummers of long-term care.
Even though I've decided not to make my usual naïve New Year's recommendations to veteran long-term care professionals, maybe a quick review of some important industry news from the profession's finest news source can offer guidance or inspiration at the start of this bouncing baby of a new year.
So here we are at the end of 2016. It's been kind of a brutal year — globally, nationally, personally, even as a long-term care profession. Lots of loss, much uncertainty and fear, many reasons to shake our tiny Trump-size fists at the universe, wailing, "Why us? Why now?" Bob has our answer.
Every year about this time, I tell you eagerly and often weepily about "The Trip." The one where 12 veterans, many of them from World War II and living in long-term care, get to hop on a plane to Washington, DC, to see first-hand the memorials created in their honor. This time I'm happy to offer it in video and still shots.
While we've been focused on trivialities like HHS and CMS appointments, declining U.S. dementia rates and electing an orange President, rabid squirrels are terrorizing long-term care communities nationwide.
Nope, I won't do it. I just won't. This is a column about long-term care and the important issues facing our profession. I absolutely refuse to get drawn into a heated discussion about the elephant in the room — not its tail or its Trump, I mean trunk. Gosh darn it, this is already impossible.
The many ways we angrily resist all perceived attacks on independence and image, even when it clearly comes at the expense of our own comfort and safety, has clearly been manifest in my bout with plantar fasciitis.
In a new study highlighted by McKnight's, more than 60% of night shift workers reported "poor sleep quality, insomnia and impaired sleep-related activities of daily living." Reading those words, I had two reactions: 1) how troubling and sad, and 2) these are my people!
Thanks to the inadvertent generosity of Starbucks, I didn't have to climb a mountain in my bare feet or learn to speak Tibetan to discover the secret of peace and happiness. It was delivered personally along with my morning coffee — and the message was steamy fresh and venti.
Of all the forces in the universe, I fear irony the most. It's lethal, and is eventually going to find and destroy me.
This isn't just a story about the World War II veteran who got to fly again, inspiring though it most certainly was. I know, because I was there — holding a video camera, unsteadily at times, as the emotion of the experience threatened to undermine my professionalism.
So, now we learn that flossing is probably useless. It's not even recommended anymore. The government said so.
So anyway, speaking of aging, I got to spend Sunday evening with a delightful old guy named Steve — a spry, perfectly adorable gentleman with a Mike Pence hairdo who plays the banjo and seems to have a natural flair for humor. I think his last name might have been Martin. Perhaps you've heard of him.
After posing questions ever since the bitter childhood discovery that I would never be an astronaut or Bobby Orr, I finally got my answer this week. Why do I exist? To be the guy with jumper cables.
It's a disquieting visual I can't quite get out of my mind — a single hiking boot hanging from a trail sign. Even you, a crisis-tested long-term care professional, might feel surprised and uneasy.
I'm not aware of any formal, airline-style elite upgrade programs for long-term care residents, but when the time arrives, I hope they exist — and that I qualify.
Next to a cozy blanket or mug of cocoa, nothing quite soothes the soul like the calming embrace of pure naiveté. Perhaps that's why more than one-third of Americans apparently believe Medicare will pay for their long-term care needs.
Don't you just hate it when you're having a bad, horrible, rotten, unpleasant day, when you're maybe feeling a little irritated or resentful or hurt or afraid, and then somebody comes along so relentlessly positive and cheerful that you almost want to throw him off the Hertz airport shuttle bus?
It's been a tough few years for antipsychotics. I feel a little bad for them. So maligned and stigmatized. Now the news comes out that they might produce compulsive or uncontrollable urges regarding gambling and sex.This news is shocking, at least to me.
It's about time someone is pushing back against all the vitriolic nonsense and baseless accusations people are willing to spew when they think no one will know who they are. Illinois lawmakers are considering a bill that would outlaw anonymous complaints against nursing homes. I, Gary Tetz, am tired of anonymity being used as a weapon.
I'm not surprised dementia is now being tied to gum disease. I have long believed the mouth offers a convenient and unflinching window to the soul, and that everything important about someone can be ascertained by a careful inspection of his or her teeth and oral cavity.
Benjamin Franklin didn't work in long-term care. Look it up. It's a historical fact. If he had, his hair-brained daylight saving scheme never would have seen the light of day.
It's getting harder and harder to talk to strangers on planes, now that advancing technology has rudely stripped a primary conversation starter away from all of us who are shy travelers.
Powerball is one of the great tests of work-based friendship in long-term care.Those 13 California nursing home nurses who came within one number of winning the whole $1.5 billion lottery are almost certainly discovering that right now. With one series of semi-lucky numbers, they've probably compromised every close workplace relationship they've taken years to build.
We baby boomers think we'll live forever. Data now suggests we might just be right.
You think Five Star is bad? That cherry-picked data can lead to misinterpretation? That it's unfair to be publicly vilified online, and perhaps eternally defined, by every little mistake? You're lucky you're not Blair Walsh.
Let the record show that on the evening of Dec. 30, 2015 — otherwise known as New Year's Eve Eve — I found myself in a buoyant and celebratory mood, craving a buoyant and celebratory beverage. But then Happy Hour rapidly descended into Extremely Unhappy Minute.
As the weather turns bleak and cold, the prospect of mandatory bundled payments gets more attractive all the time. Meanwhile, the flu virus is out jumping in the puddles, shrieking with unbridled joy. Here are some tips to survive it all this winter.
Chickens absolutely love Thanksgiving. At least on that one special day, they can finally breathe a little easier while chefs from humble homes to long-term care kitchens choose a larger bird for celebratory slaughter.
"Well, gosh. Just my luck." I don't know for certain that's how the Pennsylvania nursing home housekeeper responded after being fired for using bad language at work. But regardless, it's nothing compared with what she probably said when the court ruled she wouldn't get unemployment compensation either.
"That TSA agent made my day." You don't hear that sentence very often. On any list of unlikely utterances, it's right up there with "Those Republicans and Democrats really work well together," or "I wish this stomach flu could last forever."
Anyone worried about the macro-challenges perpetually facing long-term care, and the country, should spend some quality time with Mr. Lincoln — preferably at night.
I feel a little dirty even talking about this. But there's disconcerting news from the world of hand washing, and no amount of anti-microbial goo will sanitize some very frightening statistics about LTC — lousy thumb cleaning.
Some things probably shouldn't require a law. Kittens shouldn't be water-boarded. Toddlers shouldn't have to work in coal mines, at least not in the dark or winter. Seniors in long-term care facilities should get some personal attention. But in the Netherlands, legislation is what it's coming to.
Here's how yesterday felt in my endless pursuit of long-term care-related service and perfection. As challenges multiplied, I'm pretty sure I was strapped inside an old wooden pickle barrel, pushed into the middle of the raging Niagara River and carried over the falls.
When I was a wee boy living in the Canadian wilderness, we needed to dig a well, so my dad hired a creepy-looking guy called a "water witch" to wander the property holding a forked stick out in front of him. If only finding the right long-term care employee were that easy.
Let's say you bought your long-term care administrator an expensive venti tall double-half frappalatte on your way to work yesterday, and he didn't reimburse you for it. Should you A) playfully remind him about it when you pass in the hall; B) consider it an investment in your future and move on; or C) sucker punch him in the face at the next stand-up?
Well, this is disappointing. I was convinced Donald Trump was going to be our first real long-term care president — a tireless and compassionate advocate for the profession and those we serve. Guess not. It just proves you never really know people.
I was scared, I'll admit it. I had never used it before. It was all so intimidating and new. The old system worked fine for me, and I was comfortable with its inadequacies. You might think I'm describing the terrifying transition to electronic health records in long-term care, but I'm not. This is about my first ride with Uber.
Long-term care has far too many professionals with a depth and range of skill and training that the public almost never gets to see.
After a particularly painful experience at a local restaurant, an irate friend of mine feels strongly that heat descriptions for spicy meals should be nationally monitored and controlled. But since I spend my life in and around the long-term care profession — one of the most heavily regulated in the universe — I'm skeptical.
There's a legendary photo of General Douglas MacArthur wading ashore upon a heroic return to the Philippines in World War II, and that's what popped into my mind recently when I saw an elderly gentleman walk triumphantly into the dining room of a post-acute rehab facility.
Last time we talked, it was peppers and hooch. Now it's liquor and prostitutes. As a long-term care professional, I imagine you're wondering what you've done wrong to encourage this trending moral free-fall in your facilities. But let me put your mind at ease. It's not you. It's me.
You are correct. "Peppers and Hooch" does sound like a bad buddy cop show from the '80s. But in the world of Nebraskan long-term care, the lethal combination could be threatening the whole profession.
It's notoriously difficult, not to mention foolish, to try to predict the future of long-term care in America. In all of our nation's recorded history, only one man can lay claim to true prescience on this topic. His name? Dr. Seuss.
Crowdfunding isn't the only way to raise money for a good cause, though it has recently netted one provider 60 televisions. Nudity is also an ever-attractive option.
My very adorable, but now elderly puppy has developed a serious problem with wandering. The last time, he was almost hit by a truck. It's rather troubling, to say the least. But long-term care providers may have shown me the way.
Growing old is a choice. I realize that now. But it took some straight talk from neurosurgeon and likely Republican presidential candidate Ben Carson to help me see the light.
I'm feeling extremely unsettled lately. On edge. Anxious. It's not the threat of rising sea levels, or the erosion of public confidence in the integrity of Nightly News anchors, or the possibility that my hard-earned Four Star Rating might suddenly become a three. It's something far scarier than all those things combined. Larry Minnix is retiring.
That headline will only make sense if you were either alive or conscious during the 1960s, or care about good music. It's a lyric from a Beatles song, written by John Lennon for his mother, Julia. And it just happens to describe how I feel right now, trying to write something meaningful about an entirely different Julia.
A group of very fine long-term care people and I just spent the last 10 days in Nicaragua. I'll blog about why we went in a future installment, but first need to share the most important lesson learned on the trip.
People have wondered if I was awake to welcome the New Year. I think it's another way to find out if I'm old, like one of those trick long-term care job interview questions that would be illegal if you asked it directly. In fact, plenty of important questions need answers.
Social media overlords have their sights set on enslaving the planet's seniors. They might be in for a surprise.
My dog has a microchip embedded between his shoulder blades, and it's really setting my mind at ease. So I think it might be time for every member of your nursing staff to get one, too.
For success in long-term care, you want your employees to stay well, and especially not dead. If it isn't already, that should probably be a primary component of your business plan. A dead staff member is notoriously unreliable, often not even having the courtesy to call in, finish tasks as assigned or complete a proper exit interview. So you need your people alive. It's just good business.
Food. It's important. I once foolishly tried to go several weeks without any. I almost died and was finally forced to start eating again. Evidence suggests I overcorrected, so it's definitely a fine line.
Feeling a little cynical about life or country? Spend a day with a few World War II veterans on the National Mall. I guarantee a complete recovery, or your money back.
How dare you, Patrick! And just when my day was going so well.
Over a beer one day, tipsy researchers decided to study ... beer. Now, before you install a keg in every nurses' station in every memory care unit, you should know that they didn't exactly determine it was a cure-all for cognitive decline. But they did conclude that the study itself was a darn good idea, and one they intend to repeat every Friday afternoon indefinitely. Just to confirm their results, you understand. For the good of science.
I have been blessed with an astute business mind, and am always on the lookout for new pricing models for long-term care. I know we're in this profession for love, not money. But no margin, no mission, as they say. Which is much better than what they used to say — no profit, no point.
When I saw the New York Times article illuminating the clever ways devious operators could inflate their Medicare star ratings, I had mixed emotions ranging from fury to rage.
Lost in all the recent hubbub about the Ebola virus, Justin Bieber going to anger management class and a guy eating a nursing home resident's pain patch, is breaking news from the exciting world of stress, mice, science and skin.
Have you ever heard an eldercare researcher tell a joke? It can be a painful experience. No simple knock-knock. No guy walking into a bar.
After stealthily observing long-term care professionals in the wild for the past 15 years or so, I've come to see you as a perplexing and elusive study in contrasts. Perhaps you haven't noticed me. I've been conducting my research from a camouflaged duck blind in the lobby.
Here's what I've decided. Canada is the long-term care employee of the world.
Those Germans. They're even hungrier than caterpillars. After mastering the culinary artistry of Zwiebelkuchen, Schupfnudel, Maultaschen and Käsespätzle, which I'm not even going to bother defining because I'm so exhausted from figuring out how to type an umlaut, they've turned their prowess to creating 3D-printed food for residents in 1,000 German retirement homes.
Everyone struggles with who they are and their purpose in life. Whatever you do — whether you're a long-term care administrator, director of nursing, med aide or maintenance associate — you're pondering it. We all are. But some things aren't necessarily meant to get all figured out.
Nothing is clear these days — in long-term care or life. Everything's brutally ambiguous. We're living an endless good-news, bad-news life loop, where all the things we think are good for us will eventually also prove our demise. Coffee. Chocolate. Wine. They're our salvation, and our downfall, so it's impossible to know what to think or do. About anything.
Here's an innovative new way, and maybe the only one you haven't already tried, to make sure more people visit your lonely nursing home residents. Sentence them to do it.
The median annual cost of a nursing home room is now more than $87,000, according to a recent survey. To an uninformed member of the public, I'm sure that seems like a lot. But what the average person doesn't know is that the price also includes strippers, so it's actually pretty reasonable.
We hear a lot about drawing lines these days. And that's what long-term care employees need to immediately do — stand up tall to your facility overlords, muster your courage and draw a big, bold line. For anything short of an actual emergency, you're not going to be accessible after work any more.
First came the razor, deforesting small circles on my expansive torso. Then came the electrodes, streaming off my chest like ribbons from a departing ocean liner. I wasn't sure if I was being prepped for execution or a stress test, so seeing the doctor walk in instead of the chaplain was a huge relief.