Provider Magazine – covers nursing homes – assisted living - memory care – rehab - policy



Executive Director of NCAL Appears on Podcast About Long Term Care<p>​LaShuan Bethea, the executive director of the National Center for Assisted Living, recently joined the <a href="http&#58;//" target="_blank">LTC Heroes</a> podcast to speak about the importance of mentorship and the future outlook of the industry. </p><p><a href="https&#58;//" target="_blank">Listen to the interview</a>. ​<br></p><p><img src="/Breaking-News/PublishingImages/headshots/LaShuanBethea_2022.jpg" alt="LaShuan Bethea" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;200px;height&#58;200px;" />Starting in the industry at just 18 years old, Bethea had to jump through hurdles to gain the respect of her peers. “I had the challenge of trying to figure out the team dynamics, how you work with different people, and age differences,&quot; she said. “I had to be able to not only work with this team but also show that I could be a leader by making decisions, assessing residents, and effectively communicating with the physician.&quot;&#160;<br></p><p>Bethea told <a href="http&#58;//" target="_blank">Experience Care</a>'s Peter Murphy Lewis that she attributes her success to the resilience of her mentors—individuals who prioritized the importance of patient care and outcomes over all else. And she has benefitted from the guidance of a number of capable leaders. “You're not limited to one mentor,&quot; she said. “People give you different things at different points in your life.&quot;&#160;</p><p>Unfortunately, younger generations are not always aware of the potential career paths in long&#160;term care, Bethea shared on the podcast. “There are so many opportunities in long&#160;term care, especially for entrepreneurs in this space,&quot; she said. “It is something that we don't talk about enough, but it really is a gateway for opportunities.&quot; That is why she has decided to become a mentor herself, serving as a resource for tomorrow's leaders in Philadelphia and Baltimore as part of the Year Up program.&#160;</p><p>While the industry has faced major challenges during the pandemic, Bethea is confident that it will bounce back with greater initiatives and emphasis on community. “People are starting to feel more comfortable coming back into assisted living, and that gives a lot of optimism,&quot; she said. “We are also working towards initiatives that allow more workers to come into the long&#160;term care space, which will then allow more assisted living providers to be able to meet the needs of those that are in the community.&quot;​<br></p><p>​</p>2022-11-29T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/headshots/LaShuanBethea_2022.jpg" width="740" style="BORDER&#58;0px solid;" />Assisted LivingWhile the industry has faced major challenges during the pandemic, Bethea is confident that it will bounce back with greater initiatives and emphasis on community.
CEO of AHCA/NCAL Mark Parkinson on Changing Long Term Care for the Better<p> Mark Parkinson, the president and CEO of the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL), recently joined the <a href="https&#58;//" target="_blank">LTC Heroes</a> podcast to discuss the work that he and his team are doing to improve the lives of seniors. </p><p>“We want to create great experiences and a great setting for our residents while they're alive,” he said. He shared with <a href="https&#58;//" target="_blank">Experience Care</a>’s Peter Murphy Lewis the innovative measures AHCA has taken to help make care more accessible. Parkinson also told how AHCA is advocating for fairer wages for long term care employees. You can watch the entire interview below&#58;<br><br> </p><center><iframe src="https&#58;//;origin=https&#58;//" title="&quot;Advocacy for LTC&quot; Mark Parkinson - President &amp; CEO at AHCA" allowfullscreen="" data-gtm-yt-inspected-32388671_20="true" id="772703113" width="560" height="315" frameborder="0"></iframe></center> <br><br>One important step to fulfilling those goals is pushing for reasonable regulations. “We're advocating against negative regulatory proposals, like the idea of requiring 4.1 hours of direct care per resident, whether the money is provided or not,” he said. “At the same time, we're trying to help states so they can continue to receive Medicaid increases by maximizing provider recovery at the state level.”<p></p><p>Still, there is much to be done in terms of filling out long term care teams. That is why Parkinson embraced an innovative idea that came from AHCA’s director of clinical and regulatory services, Pamela Truscott. She proposed developing a temporary nursing aide program in which individuals could be trained in eight to twelve hours. “We put the program together under Pam's leadership, took it to CMS, they approved it, and put the training up on our website for free, even for non-members,” he said. “Over 300,000 people have taken the training and over 200,000 are working in buildings.”</p><p>Lastly, AHCA works hard to ensure that caregivers are compensated fairly. So when the CMS proposed a 2 percent payment cut, Parkinson and his team got to work. “We went to our members and told them that we need to pull together to fight this,” he said. “We submitted 6,920 unique comments and changed their minds.” The result? “They went from a 2 percent cut to starting this October with a 2.7 percent increase. And it’s just a beautiful example of what can happen when we all pull together and get our message out.” It is that sort of collaborative spirit that drives AHCA forward everyday as part of a mission to improve the lives of America’s older adults and those who care for them.<em><br></em></p><p> <em>Cameron Zargar, Ph.D., is the director of content and editor-in-chief of the Experience Care website.</em><br></p>2022-11-16T05:00:00Z<img alt="Mark Parkinson" src="/PublishingImages/Headshots/MarkParkinson.jpg" style="BORDER&#58;0px solid;" />QualityCameron Zargar, Ph.D.Parkinson recently joined the LTC Heroes podcast to discuss the work that he and his team are doing to improve the lives of seniors.
Population Health Management Summit Offers Assisted Living Education Opportunities<p>​<img src="/Monthly-Issue/2022/SeptOct/PublishingImages/LaShuanBethea.jpg" alt="LaShuan Bethea" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;169px;height&#58;212px;" />The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) will host its 2022 <a href="https&#58;//" target="_blank">Population Health Management Summit</a> December 7-8 at the Gaylord National Harbor in Maryland. This event has grown each year, as value based care and risk-based models move into the forefront of how long term care communities—including assisted living (AL)—continue to deliver quality care and improve the lives of residents.</p><p>You may <a href="/Monthly-Issue/2022/SeptOct/Pages/Celebrating-Joyful-Moments-%26-the-Future-of-Assisted-Living.aspx" target="_blank">recall</a> that population health management (PHM) is the process of improving the health and quality of life for groups of residents. It focuses on wellness, prevention, and proactive care coordination/management. PHM models help achieve the triple aim—the right care, at the right time, in the right place. Although still a fairly new concept within AL, PHM is something that you not only need to understand but also be able to evaluate employing within your communities in order to improve quality outcomes for your residents, position yourself well in the market, and manage risk within communities.</p><p><strong>That is why it is so important for AL providers to </strong><a href="https&#58;//" target="_blank"><strong>attend</strong></a><strong> this year's PHM Summit. </strong>This event features an AL-specific track with sessions that will cover the why, what, and how to help you stay ahead of the curve.</p><p>Highlights include&#58;</p><p><strong>Wednesday, Dec. 7</strong><br></p><ul><li><em>Opening keynote speaker Mark McClellan, M.D., Ph.D., Director at the Margolis Center for Health Policy at Duke University</em>&#58; McClellan is a physician-economist who focuses on quality and value in health care, including payment reform, real-world evidence, and more effective drug and device innovation. He is former administrator of the Centers for Medicare and Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration where he developed and implemented major reforms in health policy.</li><li><em>Healthcare Transformation&#58; Why Should Assisted Living Providers Care?</em> Value based care, population health, I-SNPs, the alphabet soup continues; what does this mean for AL providers and why should they pay attention? Whether you know it or not, payors and referral sources are tracking your outcomes. What are the implications and what can you do?</li><li><em>Considerations for Assisted Living in Value Based </em><em>Care&#58; </em>Join your peers for an interactive discussion on AL, value based care, and PHM, as well as get a better understanding of the sessions focused on assisted living for the next day.</li></ul><p></p><p><strong>Thursday, Dec. 8</strong><br></p><ul><li><em>Market Strategies for Assisted Living</em>—<em>Experience from the Field</em>&#58; Consumers have always expressed their strong preference to receive care in their homes. The COVID-19 pandemic has accelerated the actualization of care-at-home services with growth in virtual care, emerging technologies, and value based care. Presenters will share models and market strategies to succeed in this changing landscape.</li><li><em>Sorting Through the ACO Maze</em>&#58; Learn about one of the primary trends driving all of health care towards more value based, alternative payment arrangements, accountable care organizations (ACOs). Take a deeper dive into the two main ACO models and gain insight into what you must consider when thinking about ACO partnerships.</li><li><em>Primary Care&#58; Do you Own, Contract, or Partner?</em> Primary care is the building block of PHM models. Given its primacy, how do LTC providers approach engagement with physicians and advance practice professionals? What do you need to consider as you evaluate your options?</li><li><em>Closing keynote speaker Ellen Lukens, Deputy Director of the CMS Innovation Center&#58; </em>Lukens has deep experience both within and outside the government tackling complex health policy issues. Prior to this role, she served as the Group Director of the Policy and Programs Group within the CMS Innovation Center, where she led the team that provides cross-cutting support for Center-wide policy and portfolio management.</li></ul><p></p><p>The time to plan for the future of AL is now—and that includes population health management. This Summit offers an invaluable opportunity to learn more about how to be successful utilizing PHM strategies and models in your communities.</p><p>I look forward to seeing you there!</p><p>Online registration for the Population Health Management Summit is open through November 30.<em> </em><a href="https&#58;//" target="_blank"><em>Register today!</em></a></p><p><em>LaShuan Bethea is the executive director of the National Center for Assisted Living (NCAL).</em></p>2022-11-07T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/2022/PHM_2022.jpg" style="BORDER&#58;0px solid;" />Population Health ManagementLaShuan BetheaThis event has grown each year, as value based care and risk-based models move into the forefront of how long term care communities—including assisted living (AL)—continue to deliver quality care and improve the lives of residents.
Finding Answers to the Workforce Crisis<p>​<img src="/PublishingImages/Headshots/PaulBergeron.jpg" alt="Paul Bergeron" class="ms-rtePosition-2" style="margin&#58;5px;width&#58;128px;height&#58;128px;" />Employing and retaining staff at long term care (LTC) facilities continues to be a challenge with nursing shortages, leading to potentially lower staff morale from more challenging workload and insufficient nurse-to-resident ratios.</p><p>Many LTC companies are at their wit’s end over the situation while others are thinking creatively to help develop more certified nursing assistants. </p><h3>‘Never Seen Anything Like It’</h3><p>Frank Romano is owner of Massachusetts-based Elder Services, and he said that in his 45 years in this industry he’s “never seen anything like it. Our centers are about 80 percent occupied so we have empty beds—not because there aren’t patients, but because we don’t have enough staff.”</p><p>Christopher Schmidt, president and CEO, Schmidt Wallace Healthcare, based in Alabama, said, “lately, we lost some workers who we never thought we’d lose as they pursued other professional opportunities. These were workers who we thought would spend their entire careers with us, but things are different now. You have situations where if one person contracts COVID-19 then 20 walk out the door.”</p><h3>Other Industries Are ‘Stealing Our Workers’</h3><p>Matthew Yarnell, president of SEIU Healthcare Pennsylvania, which negotiated the recent contract with several nursing-home operators, recently told <em>The Wall Street Journal (WSJ)</em> that 30 percent of the industry’s workforce nationwide exited during the COVID-19 pandemic.</p><p>For example, in 2019 in Pennsylvania, 7,000 people applied for CNA certification. That dropped to 2,000 a year in 2020 and 2021. The overall rigors of the job can be measured through CNA-to-patient ratios. In a 7.5-hour day shift, Yarnell said a CNA could expect to serve 20—and perhaps as many as 50—residents.</p><p>“People cannot take care of 20 individuals on a day shift and feel good about their work,” he said. The new contract raises hourly pay by an average of 20 to 25 percent and incorporates new state rules limiting a CNA to just 12 residents per day shift, later dropping to 10, <em>WSJ</em> reported.</p><p>Romano said raising wages can help to make a difference. </p><p>“Other industries are stealing our workers,” he said. “In Milford, Amazon was offering $22 per hour with full benefits and was supporting their employees’ college tuitions. Bank tellers are making $22 per hour. It’s hard for us to pay that. I believe wages for CNAs will be $30 by next year. And, making it tougher, Medicare and Medicaid haven’t been keeping up with the wage hikes.”</p><p>Romano added that long term care employment agencies “are stealing our full-time workers because they can offer them the opportunity to work four days per week (not five) and have a three-day weekend. Who wouldn’t want that? Our industry needs to do a better job at creating a career ladder. There are nursing schools, but enrollment is limited because there aren’t enough certified instructors.”</p><p>Romano said nursing schools are receiving 4,000 applicants, but have only 120 slots because of faculty shortages. </p><p>“Class sizes probably won’t be getting bigger any time soon because nurses typically aren’t the type that pursue secondary education in order to teach,” he said.</p><h3>Hiring an Entire Team of Recruiters</h3><p>Tom Grape is founder, chairman, and CEO of Benchmark Senior Living, a Waltham, Mass.-based provider of senior living in the Northeast with 64 communities. He said that at Benchmark, the company is building an entire team of recruiters within an entirely new structure, headed by a new leader of the talent and acquisition teams. It is also hiring a recruiter for each region; someone who is well-versed in the needs and issues particular to their regions.</p><p>“Having an entire team dedicated to recruitment will also lead to more robust brainstorming and innovation,” Grape said.</p><p>Benchmark also continues to expand its partnerships with vocational schools, high schools, and colleges, helping students who are interested in long term care to begin working with the company, in appropriate roles, even before they are certified or have graduated.</p><p>“Once they’ve achieved certification or a degree, they can move into essential care roles with a full understanding of our communities, the residents, and the work we do,” Grape said. He said his company’s longevity is indicative of their satisfaction. It has more than 100 employees who have been with Benchmark for at least 20 years. </p><p>“The company has been successful by living our values and creating a supportive and inclusive culture—an attribute that our employees consistently cite as the reason they choose to work here,” Grape said. </p><p>“We’re retooling our marketing to depict this culture and highlight our accomplishments in ways that will capture the attention of young people launching their careers. One way is to do a better job bringing this information forward at job fairs and onto popular social media channels,” Grape said.</p><p>“Our investment in these workforce recruitment efforts, as well as our retention programs, demonstrates the vital importance of attracting talented caregivers, and giving them the ongoing support that they need to develop and grow in their careers,” he added. </p><h3>Company-Wide Zoom Calls Identify Hiring Needs</h3><p>Schmidt Wallace Healthcare is a family-run business with five facilities and 780 patients. It employs 1,110 and does not use a hiring agency.</p><p>“We’ve put in new systems to help recruit, retain, and develop a stronger culture,” Schmidt said.</p><p>Every Friday, it has a Zoom call with its centers and checks in to see how many and what type of job openings they have. Team members then share ideas on how to fill them, Schmidt said. These meetings also are a chance for Schmidt to get his facility leaders’ minds “organized” because their jobs are tough with so many things are going on all the time.</p><p>Schmidt recruits aggressively when pursuing candidates, reaching out via call, text, and email. </p><p>“We determine where our population of workers is hanging out and go there to recruit,” he said. “We visit grocery stores, soccer fields, churches during their evening classes. We are working to establish better apprenticeship programs at the community colleges.”</p><h3>From Soccer Fields to Nursing Field</h3><p>Four years ago, Schmidt established a strong international recruiting program—focused on Kenya. </p><p>“We’ve hired employees from Kenya, but more than that, we ask them to reach out to their relatives and try to persuade them to work in the US. We’ve established liaisons to these potential candidates through local taxi drivers, and we’ve traveled to Nairobi the past two summers and set up job fairs that about 300 locals attended.”</p><p>He said he’s persuaded about 30 to start working for Schmidt Wallace Healthcare. At his facility in Talladega, Ala., he provides housing for them at an apartment building across the street.</p><p>For his existing employees, Schmidt relies on the career-ladder approach, letting those who first join his team know that they can better themselves if they stay with the company. Three of his five nursing directors began at the company as CNAs. To further address the shortage of nurses, Schmidt created four Nursing Assistant Academies that teach students how to become sanctioned through the Alabama Health Department; 450 CNAs graduated from the academies last year.</p><h3>Improving Culture</h3><p>Owners also are becoming more focused on improving company culture, in the hopes it prevents staff from walking away. For example, Schmidt makes an effort to have every staff member know every teammate’s and patient's names. </p><p>At orientation, he has all new hires fill out a card, listing their favorite animal, candy bar, hobby, and television show. The information is entered into a spreadsheet, which everyone has access so that it helps them get to know each other more easily and build relationships. For fun, on every new person’s first day, they are given their favorite candy bar.</p><p>He also has supervisors share their cellphone numbers with their staffs so that each member can reach them at all times if there is a problem.</p><p>“Our employees know that at any time if a problem such as a materials shortage or difficult situation arises, they can reach out for help,” he said.</p><p>The company also established its “Gold Standard” of service. Comprised of 10 rules, all employees are trained to help each other. One rule is, when walking the halls, no staff member should bypass a call light or spill light if it has been activated. Another is, when passing each other in the hallway, they are to address the other person by name or with a wave. </p><p>“All of these little things make a huge difference in improving our culture,” Schmidt said. “We want to make a such a strong connection with each employee that they can truly feel it.”<br><br><em>Paul Bergeron is a freelance writer based in Herndon, VA.</em></p>2022-11-01T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/1020_News1.jpg" style="BORDER&#58;0px solid;" />WorkforcePaul BergeronEmploying and retaining staff at LTC facilities continues to be a challenge with nursing shortages, leading to potentially lower staff morale from more challenging workload and insufficient nurse-to-resident ratios.



A Leader's Responsibility to Fight Compassion Fatigue's-Responsibility-to-Fight-Compassion-Fatigue.aspxA Leader's Responsibility to Fight Compassion Fatigue<p></p><p>Health care professionals are known for their honesty, their ethics, and their trustworthiness. For 20-years running, nurses have received the <a href="" target="_blank">highest ratings in honesty, ethics, and trust</a> than any other profession, according to Gallup's annual polls. They show up with a level of compassion unheard of in most other industries, and that compassion for their patients is what helps to enhance the quality of care.</p><p><img src="/Topics/Guest-Columns/PublishingImages/2022/BentPhilipson.jpg" alt="Bent Philipson" class="ms-rtePosition-1" style="margin:5px;width:200px;height:200px;" />At the beginning of the COVID-19 pandemic, nurses didn't let that compassion falter. They sacrificed their time—and sadly for some, their lives—to take care of a growing number of sick patients during an unprecedented time. They worked long hours and double shifts to meet the growing demand for health care workers in short-staffed facilities. They gave up time with their families and exposed themselves to the coronavirus every time they went to work, especially when personal protective equipment was so scarce at the time.</p><p>After weeks, months, and years of this, you can imagine how the exhaustion and overwhelming need to be always-on started chipping away at their compassion. This is the new reality nurses are facing. And if you're a health care executive, this is the reality for <em>your</em> staff.</p><p>What can we do to help fight compassion fatigue in our assisted living communities, long term care centers, and skilled nursing facilities? It is our responsibility as leaders.​<br></p><p><strong>Understanding Compassion Fatigue</strong><br>In order to address compassion fatigue in health care, leaders must understand exactly what compassion fatigue is. In short, it's an extreme malaise that develops from caring for patients throughout their entire care journey. Over time, this “cost of compassion" results in strain and exhaustion. It starts with feelings of discomfort, transitions into stress, and then ends in a state of fatigue, which is much harder to recover from. This is why early detection and preventative measures are so important. If not addressed right away, it can permanently hinder a caregiver's ability to provide compassionate care to patients.</p><p>The extreme empathy nurses feel for patients and their families coupled with the grief they experience on the job leaves them vulnerable to compassion fatigue. They're so enmeshed in their patients' lives and, ultimately, their recoveries, which can lead them to feeling guilt, impotence, anger, or even blaming themselves when a situation doesn't have a happy ending.</p><p><strong>How to Fight Compassion Fatigue </strong><br>Health care workers are at a unique disadvantage for two reasons. The first is that there hasn't been much global recognition about the negative impacts of working in the industry—until the COVID-19 pandemic. Second, health care staff provide ongoing care to patients and their families and experience trauma on a consistent basis. They can't just walk away from these situations, which makes preventative measures and support even more critical.</p><p><strong>Prioritizing Work/Life Balance</strong><br>COVID-19 not only exacerbated the problem of compassion fatigue, it resulted in a nursing shortage crisis, <a href="" target="_blank">which hasn't yet resolved itself</a>. The staffing shortage only leads to more compassion fatigue, thus trapping them in a vicious cycle.</p><p>While nurses are viewed as caring and nurturing individuals, many find caring for themselves difficult. Facilities must promote a culture where work/life balance is important and give workers the necessary time to invest in themselves. When your employees have the time to focus on non-work-related activities that make them happy, it helps to alleviate the weight of work they carry on their shoulders every day.</p><p>It's difficult to leave work at work when you work in health care, so as leaders, it's even more important that we not only instill a work/life balance in our facilities, but that we model it as well.</p><p><strong>Ongoing Training/Education</strong><br>A lack of training and ongoing education can be part of the reason why your employees are struggling at work. By giving them strategies for how to better support their patients, communicate with families who are under stress, and deal with complex situations, you're helping equip your employees with the necessary skills to excel.</p><p>Nurses who feel they lack these skills may believe they're incompetent, which leads to more severe anxiety and depression. It's important for leaders to make ongoing training and education a part of their mission, especially when it comes to how to emotionally support patients and families. In skilled nursing facilities and long term centers, for example, training that's centered around end-of-life care will help prepare employees to feel adept in their roles when these situations arise.</p><p><strong>Workplace Interventions</strong><br>Making workplace interventions available to employees will help lessen the emotional strain that nurses feel. Facilities that implement these interventions <a href="" target="_blank">experience less turnover and generally have happier staff</a> as a result. The sooner we focus on these initiatives, the quicker the health care industry can begin healing itself.</p><p>If your facility currently has no offerings, or your menu of interventions is limited, here are three ideas you can start implementing:<br></p><ul><li><strong>Peer support groups.</strong> No one understands what your employees are going through better than their colleagues. Peer support groups are an easy but meaningful way to address emotional difficulties within your facility.</li><li><strong>On-site counseling.</strong> Peer support groups are impactful, but inviting in a trained therapist or counselor takes mental health support to the next level. Encourage employees to take advantage of these counseling sessions when they're available, and make sure they're accessible to everyone.</li><li><strong>Debriefing sessions.</strong> These sessions are an opportunity to share and explore an employee's thoughts after a certain event has taken place at the facility, usually one that's traumatic or concerning. These are not formal reviews, but rather should lead to genuine conversations with staff and senior leadership. </li></ul><p></p><p>While compassion fatigue is commonplace in the health care industry, we should not accept it as such. Leaders must step up to the plate and devote their attention to combating compassion fatigue in the workplace. If we don't, we're failing our employees. </p><p><em>Bent Philipson</em><em> is the founder of Philosophy Care, a consulting firm providing a range of services to skilled nursing facilities throughout New York and New Jersey.</em></p>What can we do to help fight compassion fatigue in our assisted living communities, long term care centers, and skilled nursing facilities? 2022-11-29T05:00:00Z<img alt="" src="/Topics/Guest-Columns/PublishingImages/2022/BentPhilipson.jpg" style="BORDER:0px solid;" />Bent Philipson

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