Archive for the ‘Blog’ Category

Six Things about Nursing Homes you may have not known!

Thursday, January 5th, 2012

Technology, politics, medicine, manufacturing, retail, even the natural universe is in a constant state of change. Change leaves no one behind, and that includes . . . Nursing Homes. But what do most people know about nursing homes? Very little unless you live there, work there, or have a family member residing there.

If you haven’t been to visit one lately, you’d be surprised at the changes. Changes are noticeable in design, in dinning, in the quality of health care delivery, and even in daily activities [read: computers more . . . bingo less].

If visiting a nursing home in the near future is unlikely, you may be interested in learning of 6 things about nursing homes that you may have not known!

1) Nationally, the demand for the traditional nursing home is declining in spite of the fact of the dramatic increase of our aging population. What some might consider nursing home alternatives such as Assisted Living and Home Health are showing an increase in demand.

2) Nursing Homes are the nation’s MOST REGULATED ‘industry.’ Federal, State, and local rules, regulations, codes, statutes, and laws, along with regular and intensive state and federal inspections / surveys provides oversight that surpasses the scrutiny of even the nuclear industry!

3) Not-for-Profit nursing homes, when compared to For-Profit nursing homes, consistently rate higher for resident satisfaction, lower staff turn-over, and less regulatory deficiencies.

4) The majority of revenue for our nation’s nursing homes come from Medicaid and Medicare (Federal and State reimbursement subsidies).
Those reimbursement sources do not fund nearly the costs for the nursing homes to provide care to its residents. They are left to find other ways to make up the losses.

5) Many times after someone is discharged from surgery from a hospital (acute care), and especially in the case of older people, rehabilitation therapy is often ordered by the physician. Only nursing homes (SNF – skilled care facilities) are licensed to provide this therapy (subacute) care. The goal is to complete successful physical, and/or occupational, speech therapy and be discharged to go back to one’s private home. In other cases, Home Health Care agencies provide this therapy in the private home as directed by the doctor.

6) Under the new National Health Care Reform legislation, ACO’s (Accountable Care Organizations) are being established to coordinate patient care having acute care, subacute care, long term care, and home health care organizations work together to provide cost effective and comprehensive health care.

Why do people gift to charity?

Monday, December 12th, 2011

There’s been a lot of talk in the media about the Obama administration proposal to reduce the income tax deduction for charitable donations for individuals with annual incomes of more than $200,000 and couples with more than $250,000.
The value of the deduction would be capped to the max deduction allowed for the 28 percent income tax rate. That is a reduced value of about 20 percent from the current top income tax rate of 35 percent. If the highest income tax rate rises to 39.6 percent, as proposed by the Obama administration, nearly 40 percent of the income-tax deduction for charitable giving disappears.
Will the wealthy, the ones in the best position to donate, give less if the value of the tax deduction falls? Yes, according to an October study by the Center on Philanthropy at Indiana University. No, according to the Grassroots Fundraising Journal.
So why do people give to charity? What are their intrinsic motivations for giving to any charitable cause? Economic benefits such as tax savings are much less a reason than most people realize. Most money given away in the private sector comes from individuals, and most of the gifts are from middle class, working class and poor people. That’s most people: 91 percent of Americans earn less than $100,000 per year, and 70 percent of adults give away money. More than half receive no tax benefit for their giving because they file a short tax form.
So while your organization must be clear about the tax deductible status of your organization, this is clearly not a motivation for most people. More than anything, donors are motivated by their own experiences and values. A review of Maslow’s hierarchy of needs reveals many of the reasons that people donate fall into the higher categories of love/belonging/social needs, esteem needs, and self-actualization.
With that in mind, here’s a look at the top 5 reasons that people generally donate to charitable causes:
1. Personal Experience
Donors will often feel an affinity for a cause for a variety reasons related to their life experiences such as health issues, education or personal interests and talents.
2. They want to make a difference.
People often say they donate or volunteer in order to “make a difference.” This phrase means many different things to many different people.
Some people want to make an impact in the lives of an individual person. They would like to see a lasting and tangible change as the result of their contribution. They may not even be concerned with how long this change takes, just so long as it does take place. Other people want to see an immediate impact, for example food distributed to those who are hungry and other types of emergency aid. Still others have a long term vision for a societal change they want to see take place.
Another element of “making a difference” is simply a grateful spirit that wishes to give back to society.
3. They want to do something active about a problem or take a stand on a particular issue.
Today we are literally bombarded by information about the world’s problems through a wide variety of channels. We can’t escape from knowing about misery, injustice, and wasted human potential. Most feel powerless in the face of this grim reality but charity offers us a way to respond.
Many social problems seem too large for any one person to make a difference. Making a donation gives the donor personal power over a complex issue that is much larger in scope for one person to deal with. It’s one way that we can feel more in control of our world. Making financial donations is also a way to take a stand on an issue.
4. Many people like to be publicly acknowledged for their gifts to charity. On the high end of this scale is a building naming rights program. Donor recognition plaques large and small serve to acknowledge gifts. Sometimes just a simple “thank you” is all a person needs. All of these fulfill a psychological and emotional need to be recognized.
5. Giving is a good thing to do.
While all of the above reasons and many others may be true, there is no doubt that the majority of people simply believe in the value of giving itself. Some give out of an accepted moral or spiritual obligation. Others subconsciously know that it just feels good to give.
Jeff Brooks in his blog post Yet again: scientists show that giving is good says:
“Giving is good. It just feels good. Scientists will back me up on that. A recent NIH study looked into people’s brains with MRIs while they made decisions to give….Dr. Jorge Moll, the lead researcher on the study, said what they saw “strongly supports the existence of ‘warm glow’ at a biological level. It helps convince people that doing good can make them feel good; altruism therefore doesn’t need to be ONLY sacrifice.”

What if the world of medicine no longer rotated around hospitals?

Wednesday, November 23rd, 2011

A colleague of mine recently, told me this true story. He was a hospital administrator in a small city. The hospital was affiliated with several other regional hospitals. He was a participant in the gathering of those hospital CEO’s, and they were asked to think about the future of medicine. The goal was to eventually create a master strategic plan for the entire organization. The CEO’s were huddled into smaller groups and were given a large sheet of paper and a variety of markers. Instructions were simple. They were asked to ‘draw a picture’ of what health care delivery would look like in the next ten years.

Without exception, each group put in the center of the picture, a drawing of the hospital. Virtually all participants then added lines connecting all other medical disciplines and healthcare providers to the hospital. The message in the minds of hospital administrators was quite clear and apparent . . . ‘the hospital is the source of medical care.’ They were the SUN. Everyone else was the PLANETS, merely circling the sun. The rest of the medical providers, it was assumed, got their energy, their sustenance from the center of their universe, namely the hospital. Very interesting!

That gathering of hospital CEO’s occurred nearly 20 years ago. I would be hard pressed to say that this scenario has changed in the minds of most hospital CEOs today. It seems they continue to assume that health care radiates out from the ‘mother ship’ . . . the hospital.

It would be wrong to suggest that the hospital’s acute medical care isn’t extremely important, but I would contend a ‘new order’ of the medical universe is emerging. Brought about by several factors such as: National Health Care Reform legislation; a dramatic increase in medical specialties in large modern clinics; ACO’s; Substantial increase in demand for Nursing home based Subacute Care; Changes in Medicaid and Medicare funding; Increased demand for Home Health and Hospice; Sophisticated therapy care; New technologies; and several other factors have lead to the new order.

A drawing today of what health care delivery might look like would probably equate to a large round table. Each health care provider would have an equal seat at the table with an equal voice. Communications is key! All health care providers need to be working from a single agenda which now puts the patient at the head of the table. Health care providers have a new boss and rightly so. Patient-centered care is the future and rightly so! The role of tomorrow’s health care provider is to work cooperatively with each other seeking the highest outcome for the patient. CEO perceptions and egos must be set aside. Their new role is that of servant-leader!