Letter from the Administrator
Long term care has changed a lot over the years. During my twenty-year career, regulations have changed, reimbursement has become more challenging, and our niche in the health care system has evolved. But one thing hasn’t changed – the people who are drawn to this profession are by and large compassionate souls who are driven by their need to help others.
From a regulatory perspective, the government continues to raise expectations regarding the services provided. This is good, of course, up to a point. Some regulations require staff hours spent on paperwork compliance which takes hours away from resident care. Often regulations are written with the care of the elderly in mind but in reality are applied to a diverse population with different care needs. By regulation, we are to provide a home like setting, in one of the most regulated fields in the U.S. And enforcement by the government can quickly become heavy handed and punitive rather than approaching the oversight in a way which helps providers improve. If the “helping hand” fails, then bring out the hand slap.
The pursuit of premium Medicare dollars has led to the development of a constant stream of newer and nicer facilities. This leaves older facilities relying more on Medicaid which pays much less, often not enough to break even. And in Kansas, the process of approving residents for Medicaid is plagued by inconceivable delays and ineptitude. On top of this, regulatory fines and denials of payment, as well review and denial of claims have all become more prevalent. All of this results in facilities struggling to make ends meet and can only have a negative impact on resident care.
We don’t call ourselves nursing homes anymore, we are Skilled Nursing Facilities. What used to be where grandmother moved to at the end of her life, has become a nursing and rehabilitation center. As “skilled nursing facilities” we occupy one step in the health care system. This system gets more people back home in better shape so they are more likely to live successfully (not returning to the hospital.) Many different options exist now: Hospital; Acute Rehab; Skilled Nursing; Home Health; Assisted Living; Homes Plus. All these options help people lead more independent lives. These are positive changes.
Through all of this, what remains the same is the good hearted, helping people who are drawn to this profession. They come to work and give their all to help the residents. They work hard, don’t get paid enough, sometimes deal with really tough things, and then come to work the next day and do it all again. And they do it for the residents. Through all the challenges we face, the drive to help residents helps us to persevere. Its why we were here yesterday, today, and each day moving forward.