ADVANCE Perspective: LTC : Business

Reliable Nursing Home Information Lacking

Heather Simons — Tue, 29 Sep 2009 15:52:00 GMT

Reliable information on the quality of nursing homes is hard to come by these days, according to an article in the Los Angeles Times.

Currently, a Web site called Nursing Home Compare, which was created by the Centers for Medicare and Medicaid Services in 1998, provides information on nursing homes, from characteristics of residents to staffing and quality. But the Web site has been criticized since its inception over a decade ago.

Legislation included in a health care reform bill could revamp the site, making it more accurate and comprehensive:

That legislation, the Nursing Home Transparency and Improvement Act, would require the site to provide more precise data on staffing ratios and facility ownership, and improve and accelerate the complaint process. It would also require the Department of Health and Human Services to scrutinize the site to ensure the information provided is clear to consumers.

The bill has long been awaited by advocates of nursing home reform.

To read the full article, including shortcomings and assets of the government-run Web site, click here.

Not Just Part of the Job

Maureen Salera — Fri, 18 Sep 2009 02:24:00 GMT

Most people figure that work-related injuries are just part of the job for nurses. With all that lifting, turning, repositioning and transferring that nurses do, injuries abound. In fact, a report on the American Nurses Association Web site indicates that an estimated 12 percent of nurses leave the profession every year because of back injuries and more than 52 percent experience chronic back pain.

But it doesn't have to be this way. As I've learned from researching this topic for an upcoming Safety column, no-lift policies--which can help prevent these injuries--are increasingly becoming a mandated policy at many types of health care facilities.

To learn more about safer patient handling, look for an article in the Safety column in an upcoming issue of ADVANCE.

Report Outlines How Health Reform Will Help Seniors

Heather Simons — Fri, 04 Sep 2009 18:54:00 GMT

A recent report at HealthReform.gov outlines exactly how health insurance reform, if passed, would strengthen health care for seniors and long-term care residents. "America's Seniors and Health Insurance Reform: Protecting Coverage and Strengthening Medicare" outlines, step by step, why the current health care system is ultimately unsustainable and why a reformed health care system would prove beneficial for everyone.

The report included the following ways to reduce health care costs for seniors:

Eliminating overpayments to Medicare Advantage plans could save the Federal government, taxpayers and Medicare beneficiaries $177 billion over the next 10 years.
Waste, fraud and abuse lead to an increase in Medicare costs for all seniors; reduction in these discrepancies could save $1.3 billion over 10 years.
Rising drug costs prevent seniors from taking their medication regularly; health care reform would cut drug costs by 50 percent.
Prevention of chronic illness, such as obesity, in people of all ages can decrease Medicare costs down the road.

To read the rest of the article, including more reasons why the current health care system is on shaky ground and how health insurance reform will improve access to care for seniors and long-term care residents, visit the HealthReform Web site here.

Employment Trends

Adkins-Ali Carrie — Wed, 15 Jul 2009 13:37:00 GMT

Many health care employers are working to improve their employer status to attract workers when the economy improves, according to a press release from Career Builder.

33 percent are outlining potential career paths for current and future employees
33 percent are offering more employee recognition programs
28 percent are offering more flexible work schedules
20 percent are revising job listings to emphasize a positive work culture
18 percent are revising recruitment materials
26 percent are revamping their company career sites.

This release runs counter to other articles I've been reading that say many employers are using the recession to crack down on "unnecessary" retention tools and re-establish a more traditional culture.

What trends are you seeing at your facility?

Obama's Health Plan Needs More Help for LTC

Liz Rosto — Mon, 22 Jun 2009 15:13:00 GMT

As the Obama administration tackles health care reform, many feel that long-term care issues are being left behind. How will new legislation help your facility?

A few Senators have proposed provisions for long-term care:

-Sens. Maria Cantwell, D-Wash., a member of the Senate Finance Committee, and Herb Kohl, D-Wis., chairman of the Senate Special Committee on Aging, co-sponsors of the Home and Community Balanced Incentives Act.

-Sen. Edward M. Kennedy, D-Mass., has proposed a public-funding option for long-term care in his health care reform bill, the Affordable Health Choices Act.

The Kohl-Cantwell bill seeks a temporary increase in federal contributions to Medicaid programs as an incentive for states to restructure their programs to provide the elderly with services at their homes. The Kennedy bill creates an LTC taxpayer-funded program that pays out a minimum of $50 a day in LTC benefits to participants after a five-year vesting period.

Source: http://www.investmentnews.com/apps/pbcs.dll/article?AID=/20090621/REG/306219973/1024/COMPLIANCE

AAHSA to Study Telehealth Blood Pressure Monitoring

Maureen Salera — Thu, 18 Jun 2009 17:42:00 GMT

The American Association of Homes and Services for the Aging has been awarded a contract from the Agency for Healthcare Research and Quality to investigate the impact of telehealth monitoring for blood pressure management among older adults, according to a news release from AAHSA.

The study is centered on establishing telehealth kiosks at rural nutrition centers that serve low income seniors. Seniors with hypertension will be encouraged to use these kiosks to monitor their blood pressure when they visit these centers for meals. The data will then be sent to a central server where it will be monitored by nurse-researchers who collaborate with participants' primary care physicians.

This project is a collaboration among AAHSA's Institute for the Future of Aging Services, Center for Aging Services Technologies, AHRQ, Wright State University College of Nursing, the Nursing Institute of West Central Ohio, Title III and private nutrition centers in the state of Ohio and HealthAnywhere, a technology company.

Penn State program aims to cut health care costs

Maureen Salera — Wed, 10 Jun 2009 13:44:00 GMT

A new Penn State program is attempting to give front line health care employees tools to improve efficiencies and cut waste, according to an article on the Penn State Newswire.

For example, clarifying medical orders, not having the right supplies and waiting for patients and lab results are all tasks that waste time, said Susan Sheehy, RN, director of education, innovation and implementation for Lean Healthcare West, in the article.

To address this, Sheehy, a doctoral candidate, will facilitate the first training program for 16 health care employees from long-term and acute-care facilities in north central Pennsylvania.

The training program adapts principles from the successful Toyota Production System to the health care industry using the "realizing exceptional VALUE IN EVERYDAY WORK" (reVIEW) curriculum. The focus is on examining current processes, taking the processes apart and finding ways to do things better, Sheehy explained.

Guest Blog: "It's Time for Transparency in Long-Term Care"

Liz Rosto — Tue, 09 Jun 2009 14:52:00 GMT

The following is a guest blog by Anthony Cirillo:

The Senate Finance Committee has released a report entitled Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs. A portion of the report addresses long -erm care. Some of the proposed enactments:

More detail on the ownership of facilities both direct and indirect including governing bodies and officers.
More compliance and ethics programs.
More quality assessment and improvement programs.
Enhancements to the Nursing Home Compare website including standardized staffing data, links to state web sites, a complaint form, summary of enforcement actions and a summary of the experience of direct care workers.
Demonstration projects for best practices in culture change.
Dementia management training and abuse protection.

At the end of the day, enhanced resident care is the goal but a means to that end is a case of total transparency in the industry.

Here's the deal. Your best marketing is word of mouth. Great word of mouth results when an employee has a great experience and turns around and spreads that to the residents they care for daily. When there is mystery and cloudiness, the employee and resident experience suffers and ultimately the facility suffers. Transparency leads to trust.

So how can organizations become more trusting?

First, stay in front of these regulations and actually enact what is being called for now without waiting for it to become law. That sends a message of sincerity and trust in the community.
Ask yourself if you promote transparency at all levels? This is not just quality and price transparency but simple things like publishing the emails and phone numbers of senior staff so people can contact them directly. CEO blogs promote transparency. Take a lesson from Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston. His hospital has suffered through some costly medical errors. While these same errors happen in long term care facilities, they usually are not revealed until the lawsuits starts flying. Levy addresses these in his blog, Running a Hospital, warts and all. In the end this builds trust and confidence even from the very situations that might otherwise not. For a great article on CEO transparency check out Wired Magazine.
Data Collection: I preach a lot about how organizations can leverage word of mouth for strategic gain and trust building. Data collection can aid this. Let's not talk CRM but anecdotal and observational information. What do you really know about the people you care for? Give you an example. I had an endoscopy recently. And before I went under I was talking to the staff about what I did and we happened to get into the fact that I sang and one of the staff sang as well. So when I received a thank you note from the team they mentioned that little tidbit. Made me feel special. Built my trust. And if I go back they will probably have a record of it and mention it again. What do you really know about your employees and your residents?
Create Community: Harley has an annual road rally. I have talked to people who have attended. It is not about Harley as much as it is about bringing people together, stepping out of the way and letting them talk to each other. In the end they remember who brought them together. Shouldice Hospital in Canada has this down to a science. An annual patient reunion dinner attracts 1,000 people. At one hospital we staged a Bicycle Safety Day that brought numerous constituents together. As CMO I grew tired of it and tried to ditch it. The community said no way. Community is also about groups on Linked In and Facebook. Let people meet and move out of the way. It builds trust.
Adopt Causes: adopt causes that are strategic to your services. So an orthopedic service line or a long term care facility might adopt fall prevention as a cause (not the season!). Sounds counter-intuitive but if you can keep people healthy and in a quality of life longer inevitably something will happen to someone and they will need that knee or hip replacement and rehabilitation. Who will they look to first? The people that tried to keep them healthy longer. Again, this builds trust.

Transparency and Trust. Sort of go together like chocolate and peanut butter. That's a tasty combination. Try it.

Anthony Cirillo, FACHE, ABC is a healthcare consultant, ombudsman and expert blogger for Wellsphere in the area of aging and senior health. 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?" a book that dispels myths about long-term care. His company, Fast Forward Consulting empowers organizations to change the healthcare experience and leverage it in their marketing. To read more, go to www.4wardfast.com and www.anthonyssong.com.

Hospice in long-term care

Maureen Salera — Fri, 05 Jun 2009 17:31:00 GMT

A little more than a year ago, I wrote an article about integrating palliative care into nursing homes. My research and my sources seemed to agree that end-of-life care wasn't anywhere near where it needed to be in long-term care. In fact, in some long-term care organizations, palliative care had no place at all. Others were trying, but there was still a lot of work to be done.

I'm now writing another story on hospice for an upcoming issue of ADVANCE so I was eager to see if this has changed. I started out by looking for long-term care providers who have somehow integrated hospice services into their continuums of care. My preliminary research indicates that an increasing number of senior living providers across the country are somehow getting involved in hospice.

I have a lot of questions for these providers so keep your eyes out for their answers in an upcoming issue of ADVANCE. In the meantime, feel free to comment on your experience with hospice.

Boost Morale Now

Adkins-Ali Carrie — Wed, 13 May 2009 13:05:00 GMT

In the current job climate, many companies are using the climate of fear to cut back on morale-boosting costs and activities. Employees don't need morale to stay with your company, the thinking goes, because they have no choice.

But in the article "Employee Engagement - How to Navigate the Most Difficult Economic Times since the Great Depression," Sonya Sullins, founder of Human Capital Management Institute LLC, explains that boosting morale right now is vital.

"It is clear that disengaged and actively disengaged employees pose a risk to any employer, negatively affecting nearly every facet of your organization, including occupancy, resident care, customer devotion and, of course the bottom line," she writes.

Read the article here.

Does an Economic Downturn = Better Service?

Liz Rosto — Mon, 24 Nov 2008 18:02:00 GMT

Spending a good amount of time in our nation's retail outlets this past weekend, I noticed an interesting trend: with stores vying for consumer dollars, they are really stepping up their customer service efforts in order to increase sales.

From the supermarket to the Home Depot, sales associates could not have been more cheerful or helpful in their attempts to assist me. Some outlets are going to even greater lengths. In the American auto industry on the brink of disaster, there are tales of dealerships giving away used cars when you buy a new one.

While it is disheartening that there are fewer jobs to come by this holiday season, I have to think that one positive byproduct of the current economic downturn is better customer service. (That, and great bargains!)

I will explore the topic of customer service in greater depth in the cover story of our January/February 2009 issue.

How Will Wall Street's Woes Affect LTC?

Liz Rosto — Wed, 01 Oct 2008 14:22:00 GMT

In our upcoming special edition for administrators, owners and executive-level leaders, Steven W. Kennedy Jr. of Lancaster Pollard writes about the industry's future growth prospects in a shaky U.S. economy.

Since then, we've seen a major financial crisis on Wall Street, with potentially more serious outcomes. We'd like to know, how do you see the credit crunch affecting your business if it hasn't already?

Get the discussion going by posting your feedback in the comments section below and look for our Administrator Supplement in your mailbox October 13. If you're not already on our mailing list, click here to sign up.

DON Salary Results Revealed

Adkins-Ali Carrie — Tue, 08 Jul 2008 17:46:00 GMT

The national average salary of directors of nursing in CCRCs increased 4.07 percent in 2008, according to the AAHSA Continuing Care Retirement Community Salary and Benefits Report, published by Hospital & Healthcare Compensation Services.

Nationally, the average salary of DONs in CCRCs with a revenue size up to $14,999,999 was $72,666, compared with a national average salary of $81,632 in CCRCs with a revenue greater than $15,000.

Salary Information

Adkins-Ali Carrie — Fri, 11 Apr 2008 14:29:00 GMT

Last year, we ran a salary survey for a variety of long-term care professionals. Some of the results are highlighted below. Do these figures hold true for you? How has the economic downturn affected your salary?

Average Salary by Job Title

Administrator: $82,869

Asst. Administrator: $62,476

CEO: $115, 510

CFO: $108,333

COO: $156,500

Director of Operations: $105,400

Executive Director: $92,064

Owner: $118,000

President: $127,250

Vice President: $102,875

Presidential Candidates Health Care Plans

Adkins-Ali Carrie — Fri, 11 Apr 2008 14:18:00 GMT

I recently heard a comment that when the Clintons tried to reform health care, it had an unforseen negative impact on nursing. Hospitals, my source noted, were laying off nurses because they did not think they were going to have enough money to pay them because of the cuts. Many nurses left the profession and others decided against nursing careers.

How do you think the presidential candidates stated plans will affect the industry? Which candidate's plan, of any, do you support?