Anna Ortigara on Learning from Direct-Care Workers

“There has been a lot of paternalism about direct-care staff – the notion that they are not really adults,” says Anna Ortigara. “People wonder: Are they really capable of being in a lead role? Can they be trusted to make good decisions? Are they capable of self-direction?”

Instead of these questions, Ortigara believes, we should ask ourselves: “How can we possibly think we are going to improve long term care without involving frontline workers? We need them at the table in order to achieve cultural transformation - and why wouldn’t we want them at the table?”

When Long-Term Care Becomes Wrong-Term Care

The term “long-term care” is revealing. Long-term care is usually about long-term loss: the loss of authority, money, health, and connections to family and community. Our system is based on an expert and medical model of passive consumption and limited choices. And because none of us really want this, we avoid talking about it or planning for it . . .

We need to begin an intergenerational discussion to redefine the issue in radically new - civic - terms . . .

We should talk about how we all age, not just about “the elderly”; about harnessing wisdom and building individual capacity, not just providing more/better services and care. We should talk about health and wellness, not just chronic illness; about taking personal responsibility for our retirement and for the economic health of future generations, not just how we pay the bills for the current troubled system . . .

The Grief Experiences of CNAs

By failing to acknowledge CNAs' grief, nursing homes often make it harder for workers to deal with their feelings, according to a study of how nursing assistants cope with the death that is so much a part of life in nursing homes. CNAs are often left to deal with their emotions on their own, creating a sense of emotional "disenfranchisement." Read more and comment

Innovative Program “OPENS” Doors for MI Health Care Workers, Employers

Michigan’s innovative Kent County Health Field Collaborative (HFC), through its pilot Opportunity Partnership & Empowerment Network (OPEN) program, offers exciting potential to address the “care gap” - Michigan’s rapidly growing number of elders and people with disabilities and ever-shrinking pool of caregivers. The HFC consists of a group of employers working together - along with partners from government, educational institutions, and other not-for-profits - to solve recruitment and retention challenges in health care. Together they identified the challenges employers face now and in the future with growing the workforce.According to a new case study by PHI, a nonprofit organization that supports quality long-term care by improving the quality of direct-care jobs, the OPEN program has achieved impressive results with employee retention. The OPEN program, which the HFC based on a retention model developed by The Source (a coalition of Grand Rapids area manufacturers dedicated to collaborative approaches to employee retention and advancement), saw among its key results significant drops in the overall turnover rates of direct-care workers - those who provide services and supports to elders and people living with disabilities.

COMMISSION LOOKS TOWARD TECHNOLOGY TO IMPROVE LONG-TERM CARE

A report issued by the National Commission for Quality Long-Term Care warns of a coming long-term care crisis and includes recommendations to advance long-term care reform in four areas: quality, workforce, technology and finance.

As we continue to look at this report, entitled “Isolation to Integration: Recommendations to Improve Quality in Long-Term Care,” today’s article details suggestions regarding technology.

Senator Grassley Introduces Nursing Home Transparency and Improvement Act of 2008

On February 14, 2008, Senator Charles Grassley and Senator Herb Kohl introduced the Nursing Home Transparency and Improvement Act of 2008 (S.2641). According to a related Press Release, S.2641 aims to bring more transparency to consumers regarding nursing home quality, improve enforcement, and strengthen nursing home staff training requirements.

Among other things, S.2641 would reportedly require that "special focus facility" designations be placed on the Nursing Home Compare website. S.2641 would also require that CMS develop a standardized complaint form and require more uniform reporting of nursing staff levels so that comparisons can be made across nursing homes. S.2641 would also strengthen the available penalties. For instance, S.2641 would reportedly allow the Secretary to impose civil monetary penalties of up to $100,000 for a deficiency resulting in death, $3,000-$25,000 for deficiencies at the level of actual harm or immediate jeopardy, and not more than $3,000 for other deficiencies. Finally, S.2641 would attempt to improve staff training by including dementia management and abuse prevention training as part of pre-employment training.

CMS to Hold Skilled Nursing Facility/Long-Term Care Open Door Forum

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will hold the next Skilled Nursing Facility/Long-Term Care Open Door Forum at 3:30 p.m. (EST) on February 27, 2008.

To participate by telephone, one must dial 1-800-837-1935 and reference conference ID 18796437. To participate in person, one must RSVP by 2:00 p.m. (EST) on February 25, 2008 to SNF_LTCODF-L@cms.hhs.gov, and include your name, organization, phone number, and “SNF/LTC” in the subject line. The Open Door Forum will take place at the Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. CMS asks that attendees arrive no later than 3:00 p.m. (EST).