Presidential Debates and the Core of Health Policy

Tonight marks Round 1 in the three-part series of presidential debates.  Why Round 1 is interesting, aside from the political points and positioning each side craves (in his favor) is that this round is supposedly focused on domestic issues. Deficits, tax policy, education and yes, health policy will no doubt work through each candidate’s comments.  As debates … Read more

SNFs: Its All About Quality Now

Across a recent engagement that spanned a large system, wide geography and about a year’s worth of work, I had the chance to reflect numerous times on “what” has changed in the post-acute arena, particularly applicable to SNFs, over my 30 years.  Below I’ve organized my thoughts in “eras” or periods of time. Cost Based/The … Read more

Post-Acute Issues Worth Watching

In my recent work and across recent discussions, phone conferences, etc., I’ve encountered a thematic trend; a circle of issues or as in reference to geese, perhaps a gaggle. Doing a bit of research and sifting through notes written over the past few weeks, here is what is trending. Pharmacy: In October of last year, … Read more

Accountable Care Organizations: A Post-Acute Perspective

Suffice to say, I am behind in getting this post “out”.  My best intentions of a month or so ago were quickly dashed by other more pressing commitments. Nonetheless, I did read the proposed regulations as produced by the Department of Health and Human Services/CMS on April 7 and worked through a stack of research on the subject of Accountable … Read more

Compliance, the Courts and a Risk Reminder

In previous posts I’ve written about the need for providers in all industry sectors to fully understand the compliance and legal risks that are inherent to the appropriate industry sector, as well as to health care today in general.  As someone who has been immersed in health care operations and health policy for the past … Read more

Five Things Every Administrator Should Focus On

I had a phone conversation earlier today with a friend and colleague (he’s part owner of a rehab consulting and management company) and as we talked, the conversation reminded me about the host of issues facing health care administrators.  Our conversation flowed to long-term care and specifically, SNFs (he spends a lot of his time … Read more

GAO Releases Report on Poor Perfoming Nursing Homes

In 1998, CMS created the Special Focus Facility initiative or program designed to target or focus attention on improving the poorest performing facilities (performance defined by survey/compliance history).  Each state selects up to 15 of the poorest performing facilities until the program reaches its cap or maximum of 136 facilities.  The requirements from CMS to … Read more

Hospice Contract Reminders for SNFs

On a fairly routine basis, I run across SNF Administrators and Directors of Nursing that continue to have issues with hospice patients in their facilities but not from the standpoint of the patient typically; from the standpoint of dealing with the Hospice and the terms of the contract between the Hospice and the SNF.  In … Read more

Getting Risks Under Control: Improving Organizational Prosperity

Healthcare is a risky business; particularly in heavily regulated environments such as nursing homes and home health and hospice.  The fact that a certain level of risk is omnipresent means that the opportunity constantly exists for an organization that improperly identifies and manages its risks, to suffer expensive damages ranging from financial loss to loss … Read more

Duties of Boards: An OIG Perspective

This seemed to be a natural successor topic to my last post, “Why Quality Matters”; principally arising out of recent press releases from the OIG.  For example, in June the OIG reported that it had recovered $2.4 Billion in fraud, waste and abuse.  In July, an OIG release reported that a Nursing Home Executive was banned … Read more