Recently I was challenged to start sharing my thoughts and experience about senior care, especially about challenges, best practices, and where we might be going in the future as we deal with the care of seniors and the disabled. The suggestion came from Gloria Garvey of the Brand Strategy Group which was helping our organization to look at how to communicate more effectively with various aspects of the community. So, here, I go. Let me start by saying that I hope that what I write here in the "blog" might stimulate some thoughts, ideas, interchange and maybe create some disagreement. And, since I have never read a blog before, if you know of someone else in the "blog world" that is writing about similar issues, please direct me to their blog page.
I have also lived in Hawaii since I was 17 (I am now 58) and from time to time I might spin some yarn, reminisce or just provide some thoughts about our beautiful state and its people.
Consumer Reports - A scorecard on nursing homes
In the past week Consumer Reports has published an article which rates nursing homes in various states. The report indicated that generally non profit nursing homes (such as Hale Makua) generally provide better care than those operated for profit or by companies that run numerous nursing homes. I went to the Consumer Reports website and I have to say that their criteria for choosing a good nursing home was better than most. Specifically, "check the ownership, read the federal form 2567, don't rely on the federal website, visit the home at least twice, talk with the administrator " were all good ideas. The one I like most is to ask to read the 2567 form. This provides both the specific concerns cited by the state survey teams but it also provides the facility's;s response.The federal "nursing home compare" website only provide the general description of the "nursing facilities' deficiencies" but doesn't give you the opportunity to see what the facility had to say in its defense or what it plans to do about it. I was disappointed when I went to see which homes were listed for Hawaii in their web report on nursing homes. There were only two listed to consider and one to avoid. Of the two to consider one was actually a continuing care retirement center in a high rise with one floor of nursing home beds. This facility is primarily for it's retirees who pay a $350,000 or more entry fee and $2,000-$3,000 per month to stay there. It's life care. The other nursing home to consider wasn't a nursing home at all but what Kaiser Hospital called its skilled nursing beds within the hospital. Staffing for long term care beds in hospitals is usually far greater than in free-standing nursing homes.
Do You Get What You Pay For?
Every nursing home in the United States loses money on every Medicaid patient they admit. In Hawaii the difference between the daily cost of care and the Medicaid reimbursement for that care is a loss of $11.40 a day. Eighty to ninety percent of Hale Makua's residents in its two nursing facilities are Medicaid recipients. And, as our private paying clients look for care at other service delivery systems such as retirement centers and assisted living, we are finding it hard to stay solvent. Our board is working with me on other ideas but I must say that the financial squeeze is tighter than I've ever seen it in the 25 years that I have been here. Residents and their families have much higher expectation of our direct care staff, our food service etc. etc. And yet most folks do not pay for their care and rely on government assistance. So what's the answer. I'll have some thoughts on this in future blog sessions..... that is.. if I can keep up the discipline to keep writing while doing my real job.
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