Data Trails

Have you ever thought what our country would be like without LTC facilities? Nursing homes, skilled nursing units, rest homes or whatever you want to call them provide a tremendous service to our aging population. If you think about what it would be like without them, you realize how valuable they really are.

According to the Center for Disease Control and Prevention there are over 16,000 nursing homes in the United States, housing 1.5 million residence. Those numbers are climbing, and will continue to climb everyday. The early baby boomers are in their mid to late 60′s, and many will soon join the already large population of LTC facility residents.

LTC facilities provide a cost-effective way to enable aging patients with injuries, acute illnesses or postoperative care needs to recover in an environment outside a hospital. When these patients are admitted from a hospital, Medicare will cover the cost. Nursing home facilities started as a way for patients to recover for an extended time away from the hospital. As time went on, the elderly population grew. People lived longer as time went on. The average life expectancy in 1921 was only 56.4 years. Thirty years later it increased to 68.1, and thirty years after that it increased to 73.9. Currently, it is about 78 years.

The demand for long-term care services will increase in coming decades when the baby boomers reach their 80s. Declining family sizes, increasing childlessness, and rising divorce rates will limit the number of family members that are able to help. The simulations show that even under the most optimistic scenario long-term care burdens on families and institutions will increase substantially.

Originally posted by Marti Bowman – VP Marketing – OnShift

So much attention has been paid to Medicare cuts that it’s almost like a black cloud is following long-term care. There’s no question the impact of the cuts is significant. But after spending some time at the LeadingAge Conference in D.C. last week, I came away reinvigorated. That’s because of the conversations I had with so many providers who are evolving their strategies to cope with the cuts and prepare for what could be even bigger changes ahead.

These providers are on top of things! They remain focused on providing high quality care at lower costs. They’re looking at new and better ways of doing business – to attract new families and residents, to increase operational efficiencies, to control costs, and to improve the types of services they offer to residents and patients.

I’m thankful that I had the opportunity to connect with so many of you who are taking action during this difficult time of change. It’s not clear what the future holds, but those with persistence, focus and innovation are well positioned to thrive during these challenging times.

You can learn about adapting to change and coming out stronger from Jeff Amann, VP of Operations at American Baptist Homes of the Midwest. He’ll share his story in an upcoming webinar, “Adapt to the New Reality of Senior Care With Proactive Staffing Strategies.” Spend some time with Jeff, Jim Berklan from McKnight’s and Mark Woodka from OnShift to learn best practices for controlling labor costs and driving efficiencies. Your staffing strategy is an important one, especially now. Find out how your next steps can make a big difference to your organization, today and into the future.

Originally posted by Marti Bowman, VP Marketing – OnShift

We are seeing a variety of reactions in long-term care and senior living to the Medicare cuts that hit October 1^st. Some are in panic mode, fearful they’ll have to shut their doors because the cuts will so severely impact their bottom lines. Others are focusing on their strategies, from resident care and intakes to cutting costs and driving operational efficiencies. And it’s business as usual for those who don’t rely on Medicare payments, although perhaps with more focus on optimizing their organizations and controlling costs.

With different perspectives and strategies in play across the industry, there is a common thread that can and will help all organizations thrive during these challenging times. Focusing on your largest expense – labor – will drive cost savings and efficiencies with just a few tweaks and modifications to your day-to-day staffing. Give your labor management strategy a good, hard look for areas you can improve. Got overtime? Reduce it. Using a staffing agency? Eliminate it. Running above your labor budget? Optimize it.

If you have any overtime at all, now is the time to look for ways to reduce it. You’d be surprised how much just a 1% reduction to your overtime rate can save your organization! Curious? Find out by reading Mark Woodka’s article in Long-Term Living, A Manager’s Guide to Labor Cost Management. You’ll pick up strategies, advice and next steps that will not only help your organization save money, but run more efficiently, more profitably, and with even higher quality care. That’s a remedy for any organization in today’s challenging times, no matter how big a toll the Medicare cuts may, or may not, take on your homes.

Healthcare has seen some major changes over the last several years, and the nursing profession has changed along with it. The result has been a reduction in the supply of qualified, experienced nurses. Those who remain are working under conditions of larger  case loads, complex technology complexity and increased knowledge of patients. A medical issue which once warranted a lengthy in-patient stay is now treated on an out-patient basis, because of managed care requirements.

The nurse’s role of patient care is still the same, but the importance level  has risen. Since hospital stays have become shorter, a patient who undergoes surgery used to stay for one week, but now only stays two to three days. Nurses must now assist the patient to bring him or her to a functioning level and put together an exit plan to support the patient and assure quality care, while discharging the patient earlier. This makes efficiency and quality of work vital. Nurses have always said, when talking about the changing environment, that the problem has been the actual working conditions. These conditions include too few nurses, lack of support, an uncertain future, and forced overtime.

The role that the patient’s family plays has also changed in the last decade. Both patients and their families are more educated and involved in the process now. Families used to trust the care of the patient to physicians and nurses; now it is normal for family members to stay 24 hours a day, ask questions about the care, and put more demands on the nurses.

Article written by Mike Pumphrey – OnShift

The mood of the American Health Care Association’s annual meeting was unlike years past. At the keynote address, AHCA President and CEO Mark Parkinson proclaimed that massive cuts to Medicare and Medicaid have providers “fighting for their survival.” This was a much different tone than years past where a 1 or 2 percent change in funding was the main topic of conversation. Providers realize that the time to react is now.

This sense of urgency translated to a lot of show floor activity. Providers proactively sought out solutions that can help them improve care, increase efficiencies and reduce costs. This wasn’t a crowd focused on tchotchkes. They were focused on finding answers.

OnShift’s booth was bustling with providers. These providers understood that the most effective way to offset these massive funding cuts is to get control of their largest expense – labor. OnShift staff scheduling and shift management software allows long-term care providers to automate scheduling, prevent overtime before it occurs, and increase efficiencies through open shift management. Our booth was filled with a common reaction … “Wow”. Providers were blown away by how easy it is to use and the amount of money that they can save.

AHCA’s annual meeting gave us a forum to focus, learn and develop strategies to help this industry. That’s just what we’ve done. Because we understand the challenges ahead, OnShift is now offering reduced pricing. We hope this offer will make long-term care providers cost control efforts a little easier — and a lot more impactful.

Believe it or not, there is a shortage of nurses. The current shortage in qualified, experienced nurses is not predicted to get any better during next several years. Add to that, most of the senior level nurses and nurse managers are getting close to retirement. When they leave, a small number of nurses will be available or even willing to take on a management role. The current climate of understaffing, 24-hour shifts and increased management responsibility leaves younger nurses reluctant to fill the gap.

Picture originally posted in www.scrubsmag.com

Dean Munro sees the problem continuing. “Most nurses are around 45 years old, white, suburban women, 80% of whom are currently working full-time. As they retire, they often leave because they’re burnt out; unfortunately, there are simply not enough nurses to replace them.”

Not long ago, industry analysts were saying that there were too many nurses – not so anymore. Why aren’t there enough nurses to replace those who are retiring or leaving the profession? Hiring managers are finding that younger Baby Boomers and Generation Xers are no longer viewing nursing as a viable profession because of the difficult work environment combined with a desire for more control, quality and balance in their lives. Sounds like we are lazy. In addition, women have more choices of fields to enter. There are more options open to women interested in healthcare; before there was only nursing. To many, the working conditions are bad, the responsibility is very large and the workload  is heavy.

The average age of new nurses used to be around 21 or 22; now graduates have varied ages, often well into the 30’s. For many, nursing is a second choice career. They enter into a more acute clinical environment, the patients are sicker and more complex. Many schools have changed the curriculum, but still entry level grads have only basic skills.

Hospitals are in competition with each other to attract and retain nurses in a very competitive market. Some hospitals are using programs similar to internships for doctors to ease the transition of recent college graduates into fast-paced, technologically complex clinical settings. Since the new grads need more experience, many hospitals create a professional development transition program. Starting with a week-long orientation, this program combines classroom time, and hands-on time with an experienced staff member for six months. Preceptors are compensated while they are trained Mentors are sometimes volunteers. It is a supportive atmosphere and has received a very positive results.

Hospitals have been forced to be very flexible in their approach to overcome the shortage of nurses. Some use travel nurses to fills gaps wherever needed. Many nurses often work “per diem” to keep working without the pressure of a full-time commitment. Other approaches include sign-on bonuses worth several thousands of dollars, referral bonuses, and flexible hours. Flexibility of hours may allow nurses to work three 16-hour days.

Many  hospitals are now focusing their efforts on retention. It is becoming critical to pay attention to all factors that are important to RNs in the clinical setting: having a voice and the ability to have some control over the practice of nursing. For example, a unit council meeting takes place on a regular basis and identifies problems and concerns in regards to patient care. Years ago the nurse manager addressed this issue. Now TQM mandates that more people are involved in the resolution and decision-making. Staff members are more involved in operational issues these days.

The professional relationship between the nurses and physicians is a factor concerning the retention of nurses. If there is a positive relationship, one that is consultative, respectful, and supportive, then job satisfaction is at a high level. On the other hand, if the relationship is negative, turnover is high.