Guest Blog: Transparency Rules in a Consumer World
The following is a guest blog from Anthony Cirillo, FACHE, ABC:
In the last few months, there have been several items in the news that would probably make the consumer do a double take when it comes to nursing home care. As caregivers shop for a home for an elder they are more sophisticated than ever and they leave no stone unturned in their information quest. So instead of having them turn the stone do it for them.
Some cases in point: Gov. Rick Scott (R) fired the director of Florida's Long-term Care Ombudsman Program, Brian Lee, suddenly on Monday, February 7. Lee, in the position for seven years, had recently asked Florida's 677 nursing homes to submit detailed information regarding ownership stakes. Operators and nursing home advocates had complained that the Feb. 27 deadline Lee gave for turning in detailed ownership information was much too soon. Lee said the request was authorized under new federal healthcare legislation.
Against that backdrop, two large real estate deals were transacted on February 28. Health Care REIT bought the real estate of Genesis HealthCare for $2.4 billion, covering 147 properties in 11 states in the Northeast and mid-Atlantic, including Massachusetts, New Jersey and West Virgina. Ventas agreed to buy Nationwide Health Properties for about $5.7 billion in stock, forming the biggest health care real estate investment trust in the country, with a large presence in senior citizen housing.
Point of Transparency: When nursing homes hedge on divulging ownership and real estate transactions muddy the waters of who does what, it calls attention to the issue of ownership. The New York Times investigated the ownership of nursing homes in 2007 but was looking at them more from a structural standpoint. They explored how ownership is sometimes structured in ways that separate real estate from operations and decentralize ownership across distinct sub-companies. So in essence if there is litigation, it becomes hard to both know who to sue and where to collect. Since then there have been studies that suggest that care differs depending on for-profit versus not-for-profit status. Research by consumer advocates and labor union representatives suggest that staffing and quality decreased after private equity firms purchased nursing homes from national chains.
This is public knowledge and a savvy consumer is going to start asking you questions about ownership and if it matters. So be proactive and address the issue before it becomes an issue.
Next....
The U.S. Department of Health and Human Services (HHS) Office of the Inspector General issued a report that concludes that more than 90 percent of nursing homes employ one or more people who have been convicted of at least one crime. Five percent of all nursing home employees working in 92 percent of facilities have at least one criminal conviction. To qualify this, most often, criminal convictions were for crimes against property (e.g., burglary, shoplifting, and writing bad checks) and occurred prior to employment. For 16 percent of employees with convictions, the most recent offense occurred after they had started work in a nursing home. The report also noted that most States required, and/or nursing facilities reported conducting some type of background check.
Point of Transparency: This study was big news so people are going to ask you about if and how you conduct background checks and they are going to ask you whether there are any staff members who have ever been convicted of a crime. You can be proactive in telling the story of background checks if you have a story to tell. And you can be prepared to answer the second question should it arise.
Next... The National Quality Forum (NQF) came out in support of 21 measures to be used to care for both long-term nursing home residents and short-stay patients. These measures will be included in the Centers for Medicare & Medicaid Services' Nursing Home Compare website. The 17 measures that were previously endorsed will be retired and, in some instances, be replaced by the newly endorsed measures.
Point of Transparency: These measures are designed to help consumers "better understand and compare quality of care when selecting nursing homes," according to Dr. David Gifford, who co-chaired NQF's Steering Committee on Nursing Homes while serving as Director of the Rhode Island State Department of Health. So be proactive in making your statistics available without someone having to hunt the CMS site for them. People will appreciate it. And even if not every score is up to snuff, you have opportunity to show and tell your story about how you are improving care every day.
Got transparency? You'll need it.
Anthony Cirillo is the about.com expert in assisted living. A speaker, health care consultant, senior advocate and blogger, he consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures?" His company, Fast Forward Consulting empowers organizations to change the healthcare experience and leverage it in their marketing. For more information go to More at www.4wardfast.com and www.anthonycirillo.com. He will be speaking at the Cleveland Clinic Patient Experience and Innovation Summit in May.
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