The Nursing Home Podcast

Timestamps(00:00:02) Introduction (00:01:01) Healthcare Risk Management Experience (00:02:18) Fair Housing Act Explanation (00:08:15) Prohibition of Disability Discrimination (00:15:57) Understanding Essential Requirements (00:23:15) Rules Around Common Accommodations (00:29:42) Risks & Fair Housing Marketing (00:34:55) Legalities for Assisted Living Services (00:40:17) FSA & Housing Education (00:43:22) Rules Disregard in Senior Living (00:47:41) Risk Tolerance Discussion (00:49:06) Risk Management in Senior Living  So as you mentioned, I did medical malpractice defense for a number of years in New York,and then I moved to Pennsylvania because I was getting married and my husband was fromout of state.And when I moved, I decided to switch hats, and I decided to do healthcare risk management.So I was tasked with starting up a risk management program for FSA.At the time, we started with 12 organizations, nonprofit, faith-based communities, generallyin the Philadelphia area.Since then, we've expanded quite a bit, and we now have 37 sites in six states.And so I give guidance and consultation on risk management issues.So today, we are going to talk about marketing risks, but I'm going to talk about it frommy perspective, you know, from a risk management perspective and a fair housing perspective.Okay.So thanks for that background.So let's get right into it.What is the worst-case scenario if someone says, you know, I'm going to market howeverI want to market?I'm going to say what I want to say, do what I want to do.What have you seen as like a worst-case scenario of someone has done this and this horribleoutcome has happened?Great question.Nothing like the fear factor right from the beginning.So what I'm going to preface that question with is an explanation of why there are risksin this venue, in this area.And so in 1968, Congress enacted the Fair Housing Act, which was what I like to callthe third leg of the stool for civil rights litigation, legislation rather.And so we had the Civil Rights Act, then the Voting Rights Act. And then in 1968, they passed the Fair Housing Act.And that precluded discrimination in housing choices and lending based upon what we callthe protected class status.So started out with race, religion, national origin, color, gender, which now includesgender identity and sexual orientation, and national origin.In 1988, Congress amended the act to include two additional protected class categories.Familial status, meaning that you are not supposed to be able to discriminate againstfamilies with children.And of course, there is a carve-out for our senior living settings.And the one for purposes of our discussion today, which will be very pivotal, is it sayshandicapped, but it's what we would refer to as disability.So you have now protections under the Fair Housing Act, and we just call it FHA for boththe Amendments Act and the original act for all those protected classes, which actessentially as a floor, not a ceiling.So state and local jurisdictions can also add an additional protected class categories,like, for example, maybe marital status, saying that, you know, you can't discriminateagainst somebody because they're unmarried or, you know, because they cohabitatetogether, for example, or source of income is another one that's fairly common.So I think for a lot of senior living communities, they don't necessarily recognizethat they are covered by this act as a housing provider, because I think for a lot ofcommunities, they say justifiably, well, we're not a housing provider because we do somuch more than that. And you do.However, in the eyes of the government, you are a housing provider and you are subject tothe Fair Housing Act.And so there are lots of risks that come along with that.Now, if you choose as an organization just to decide that you're going to market any wayyou want to and you're not going to pay attention to various marketing risks, includingfair housing risks, what's the worst case scenario?The worst case scenario is that you end up being in litigation, sued by potentially afederal government. So it's now the United States of America versus, you know, seniorliving community, A.B.State. You are in litigation with the government.You are being sued for housing discrimination.Almost always that ends very badly for the community.Almost always winds up in a monetary settlement.Many times there is also a settlement compensation fund where the community has toadvertise in multiple places for people that have been subject to what they've just beenfound by the government to be illegally doing.Let's just say discriminating against those with scooters, for example.And so they would have to advertise for anyone that's been impacted by that to give themmoney. In addition, there's almost always what we call a consent decree that comes withthat. It's sort of, if you're familiar with the world of compliance, it's similar toa CIA or a corporate integrity agreement whereby the government puts you into thisconsent decree.And the consent decree not only sets out the exact amount of money that you're going tohave to pay and how you would advertise to those who have been subject to yourdiscriminatory practices to give them money.But there's also usually quite onerous burdens that are placed on the community,including things like they get to and the government will review your actions for aperiod of time. Usually it's about five years.And so they will oversee and have to approve the policies, put policies in place forwhatever the particular topic is, change contracts, sometimes hire a fair housingofficer to perform acts to training and education for the staff on an ongoing basis.And again, being overseen by the government for a period of time.In addition, I would also say that you don't want to be the poster child for that.So again, I happen to mention scooters.And one of the pivotal cases in the world of, you know, communities that have been suedfor improper restrictions on scooters is a community called Twining Village.And I don't like to use them, you know, but that that case is out there and everybodyknows about it. So you don't want to end up having the reputational damage in our worldof, you know, senior living where it's like, oh, that's the Twining Village case.And so, you know, everybody knows based on that case, you know, some of the policiesthat you have to have in place and the no-nos, the things that you shouldn't be doing.You don't want to become the poster child for that, which can very easily happen.Well, so a couple of questions.Thank you for that. I mean, that's quite an overview.So it were someone to actually go ahead and let me just back up.So you're saying that there's the fair housing law, which puts nursing homes together inthat category. So therefore, they have these discrimination laws like you've outlined.So is this, first of all, is this specific to marketing?Are we talking about someone denies a patient because we don't take we don't want patientswith scooters because patients with scooters are dumb or whatever.Yeah. So I'm speaking broadly about senior living communities.Right. So it's anywhere that a person lives.Okay. So if you are running a short term rehab only, then potentially you are excluded fromthe Fair Housing Act because that's not someone's home.The intention is to treat them for a brief period of time with the intention to dischargethem. However, it does apply clearly.All the case law is very clear on this.It does apply to settings like CCRC, independent living, assisted living, personal care,long term care. So all of those things, you know, adult foster care, it does apply to allthose settings. It is questionable whether it would apply in the context of a short termrehab strictly.Okay. So let's back up.If I don't have if I have a regular store and I sell chocolate and desserts and flowers andwhat else? I can discriminate all I want?No. There are other laws.There are other laws that prohibit you from from doing that, that we're not necessarilyspeaking about today. But again, when it comes to housing, we are under the auspices ofmultifamily housing specifically, which means four or more people in a unit or, you know,four or more units, I should say, not four more people.Then you are subject to the Fair Housing Act.So. Okay.So the Civil Rights Act says that you can't discriminate.Right. Suggested.I understand that. So my point is that you have extra laws when it comes to if you'remanaging or you own a home that has multiple families, say for like you said, four unitsor more. So then you have you have extra focus.So now let's assume someone has an assisted living facility, a long term care facility,really can be an apartment building, too.But we're saying even senior living facilities and they're going to and then theydiscriminate against someone.So does that mean that they refuse admission to someone?Okay. So that's a great question.So discrimination can take multiple forms.It can be just as you said, refusal of admission or refusal to someone, an applicant tobe denied admission.That can be a form of discrimination.It can also be a form of discrimination, which is very common.Probably the most common form of discrimination is the refusal to grant what we call areasonable accommodation for disability.And that's where the scooters would come in, for example.So if I was disabled and I had a mobility impairment and I required a scooter to enableme to get around and to meet what we call the essential requirements of tenancy.And you, as the provider, refuse to allow me to have that scooter or, for example, thatservice animal, like you have a no pet policy and I wanted to come in with a serviceanimal. Well, that's not a pet, that's a service animal.That's for my disability. That's a reasonable accommodation.So you can refuse and then you could again potentially be sued for that.But in addition to also refusing to admit somebody, which is a form of discrimination,there a

Sara Well spent 12 years as a critical care trauma nurse on the acute side. She watched again and again as her facility’s money was put into much less pressing issues than staffing and saw how it impacted not just care and quality outcomes but overall revenue.She saw how archaic many of the systems in place for staffing were, and with her tech background realized that this comprehensive issue was a scalable solution with a huge addressable market. Nurses are often perceived as a cost rather than a revenue driver. They have been historically under-appreciated despite how much their presence and work directly impacts the length of stay which is not always covered by insurance.The flaws already present in the healthcare conveyor belt were exacerbated by the arrival of the pandemic. An estimated 500,000 nurses were lost to COVID fatigue, switching to other less taxing professions. At the same time many new travel nursing and outsource labor companies began to pop up, luring staff away from their traditional in-house positions with the promise of higher pay. These companies then sold the nurses back to the same types of facilities they came from at a much higher cost. Though facilities were able to get staff quickly and easily, it was not cheap and cost them the integrity of their in-house teams.Dropstat seeks to re-empower healthcare organizations, working with them to update and automate safe staffing processes, and give total transparent insight into their labor costs.They see the most important relationship as the triad between patient, provider, and the organization that brings them together.Dropstat uses machine learning and AI to predict a facility's staffing needs 60 days in advance.  are able trace increased costs of standard labor and premium labor costs whether its agency or overtime bonuses. With this data they create patterns and recommendations and feed them back to the client.When asked about the problem of staff leaving for a $2-3 raise Sara had some powerful insight to share. She states that just like those serving in the military, healthcare workers see death and loss on a sometimes daily basis. But while the military has instigated an entire culture of comradery and airtight family dynamics within groups, the same is often not present in healthcare.  Sara concludes that if a facility is able to culture hack and ensure with authenticity that nurses feel loved, valued, connected, appreciated, that they are the key to aiding the aging population, they won't have to worry about losing staff because of pay. FOLLOW SARA AND DROPSTATWebsiteLinkedIn RELATED EPISODESEp. 94: Innovative Solutions to the Staffing Shortage in HealthcareEp. 71: Combating Staff Turnover & Burnout In Nursing HomesEp. 42: Healthcare Workers Need Self-Care During Covid-19

After returning from military service, Eric Alvarez got his start in academia before moving to healthcare and delving into startups. It was this time working with students that led him to the idea of Grapefruit Health. By the year 2026 healthcare will be short by 3.2 million healthcare workers. Eric states that many of the current solutions for this problem greatly reduce performance and output while driving up costs. The year 2030 was always slated to be the year that our clinical aging workforce would max out, with baby boomers retiring at a much higher ratio than newcomers entering the profession. Many clinicians have either transitioned to part time or moved on to a gig economy platform. We have heard from various perspectives on the healthcare staffing shortage on this podcast and Grapefruit Health brings a new solution to address this monumental problem. They have created the world's first and only healthcare workforce composed solely of clinical students. Healthcare facilities often run programs to employ students, but this calls for a training preceptor and ultimately leads to an unproductive workflow. Grapefruit Health employees on the other hand provide assistance with remote, low acuity, high volume, repetitive telephonic tasks.These include medication adherence, senior isolation and loneliness outreach calls, and post discharge follow up calls. All of these tasks are clinical in nature but do not require licensure.About 10% of these telephonic tasks need a pharmacist interaction, in which case the employee will do a warm transfer to a pharmacist. This cuts down time greatly for short staffed pharmacy teams who would otherwise have to make all these repetitive calls themselves. Grapefruit Health offers their services at $5 per interaction and doesn’t charge for unsuccessful interactions such as when a call goes through to voicemail or a patient hangs up. Typically their client organizations have a program that's failing and are looking to supplement it or outsource it. After understanding the situation and what tasks and roles need to be filled, Grapefruit Health can build scripts and employ students and train them for the job in just six weeks.Eric states that students are eager to learn with their clinical education fresh in their mind. Grapefruit Health leaves their employees with great skills and experience and even full time opportunities with the client organizations they worked with once they graduate. FOLLOW ERIC AND GRAPEFRUIT HEALTHWebsiteLinkedIn RELATED EPISODESEp. 89: Take Full Ownership of Your RecruitmentEp. 85: 5 Strategies You Can Implement Today to Boost Your Recruitment Success RateEp. 79: Smart Hiring for Nursing Homes

Erica has had 30 years of experience as a nursing home administrator and specializes in regulatory compliance. Her nonprofit senior living campus is so excellent at staffing retention that they have managed successfully to never bring in outside agencies. In today's senior care facilities, where administrators constantly struggle to keep staff from leaving, this is an incredible achievement. Erica outlines some of the means by which she and her leadership team have made it happen. Firstly, they have made sure to be visible in the local community. They are involved with two chambers of commerce, hold lots of events, and have great working relationships with the local high-schools.High-school seniors who have completed one year as nursing assistants and want to stay on, will receive 75% tuition reimbursement towards starting a nursing degree at community college. They also hold raffles for those applying and bonuses to current employees for referring someone. For current employees, there is a career ladder in place throughout all departments and excellent tenure. Staff can work to advance themselves and see results for their hard work rather than feeling stuck in a static position. There are also many amenities provided including an excellent break room, and regular socials that help to create a great work atmosphere. Above all, Erica holds that having a work family, all pulling together towards the same mission statement, is essential. Right from the interview she assigns new hires a mentor in their department. By being present at the interview, that person will also be able to decide on behalf of their department whether they want to move forward with hiring. She maintains a strong philosophy of servant leadership and strives to let all her staff know that she cares for and appreciates them.  FOLLOW ERICALinkedIn RELATED EPISODESEp. 88: Hire and Retain the Best CNAsEp. 77: CNAs: Make Them Want To StayEp. 71: Combating Staff Turnover & Burnout In Nursing Homes

Sam Gopinathan only got started in his field after the 2008 recession when he was forced to leave his job as a mechanical engineer. But Sam didn’t get into his current field by chance.  After a life-changing experience of helping to provide relief to a community devastated by a natural disaster, he learned that establishing a connection is a fundamental foundation of caring for others.  He decided to work in home health care because it aligned with his professional goals and personal values. Every day he goes to work he is helping someone with their life.  Sam states that long-term care insurance is the only product that will definitively cover the costs of care when one needs it.  Medicare will only pay for the medical side of things. It covers high acuity events, but not the nursing home stays that many people will need afterward. Unless someone has less than $2,000 in assets, they won't qualify for Medicaid coverage and will instead pay for the latter privately.  So how much care is provided by home healthcare? Sam explains that New Wave Home Care offers a minimum of 4 hours of care and a maximum of 24 hours. They help out with basic necessities like showering, meal preparation, and any other tasks that someone might not be able to complete physically.Having the right amount of care early on can save expenses down the line, such as those that will occur if someone is injured.In regards to payment, Sam states that 80-85% of clients pay via private funds, with 15% of clients using long-term care insurance. Depending on what policy someone has, they can get almost 100% off care expenses.Lastly, Sam examines the benefits of a professional long-term caregiver over a private caregiver such as a family member, friend, or trusted employee. By seeking out help privately, someone can be risking a lot.If you are employing someone privately, you are their employer on all records which can lead to a lot of trouble with lawsuits. It is also difficult to do background checks on a potential caregiver.  In theory, a family member or spouse would be the best solution. Still, the emotional burdens often become a problem made even more complicated if the caregiver is a similar age. With their assurance of expertise and knowledge, and ability to do complex background checks, agencies are the best option.  FOLLOW SAM AND NEW WAVE HOME CAREWebsiteLinkedInRELATED EPISODESEp. 87: Dementia Education; WhyEp. 60: The Best Healthcare Happens At HomeEp. 27: Should I Purchase Long Term Care Insurance?

Lindsay Mclaughlin is an expert multitasker! Managing to juggle running a successful full-time venture, teaching others to do the same, and being a working mom, she wears many hats.Her high-poweredness can be seen in the fact that she recorded this episode with us only a few days after the birth of her new baby! Despite going into nursing school, Lindsay knew for a long time that she wanted to be self employed before her thirties.Developing and running residential assisted living homes allows her to combine her background and skill-set with her long-time ambitions of entrepreneurship. But what are residential assisted living homes and how do they differ from traditional, larger assisted living facilities?Lindsay states that even though she prefers to build most of her homes from the ground up, the buildings themselves look and feel like cozy residential homes. Instead of hundreds of residents, most residential assisted living homes usually only have 8-10 beds, and no more than two-dozen. Rather than a host of amenities, clubs, and excursions to fill residents’ schedules, the homes offer a cozy, close environment where residents can gather in the common area, get to know each other, and feel like they are living in a real house with a found family. Though they can’t provide care to higher acuity patients, such as those who need feeding tubes, residential assisted living homes can take on most patients and provide them with more focused and hands-on care.Lindsay says that the set up of these homes is also very encouraging to the families who may be nervous and reluctant to send their loved one to a large, traditional facility.The smaller setup allows for a more direct line of communication that families can use to receive more personal news and updates. They are also more inclined to feel better about sending their loved one to somewhere that feels like a home. To sum it all up, Lindsay states that anyone looking to get into this sector of the senior care industry has to know what they want realistically before entering the business. The job can be hands-on and emotionally taxing, but it also allows an owner to build a space from the ground up, set their own culture, and run their own show, even if they do not have a large budget going into it.For those interested in this growing field, Lindsay is holding a 2023 flagship event where she gives attendees hands-on experience in running a residential assisted living home. FOLLOW LINDSAYWebsiteLinkedIn RELATED EPISODESEp. 79: Buying Your First Nursing HomeEp. 60: The Best Healthcare Happens At HomeEp. 54: What Is The Green House Model?

Nebras Hayek’s incredible career in marketing throughout multiple industries is the result of her high-powered mindset and can-do attitude.  Though she has worked in a number of interesting places, Nebras got into healthcare marketing partly through the connections she made while hosting events for various healthcare related groups.In addition to her intensive day job, she is also an active military combat engineer in North Carolina, a position which on top of everything else demonstrates her love for challenges.  Nebras started out at Gentell as a regional manager covering only a few states but rapidly ascended to assistant vice president of the company, covering all 49 states.  Her significant experience in senior care has shown that progress is best made through building authentic connections and establishing dependability and trust with others in the industry.  Senior care faces a lot of current challenges. While the largest issue may be staffing, census is still a very high priority problem for many facilities.So what can a nursing home do to fix its census?Nebras advises that before judging that a nursing home is struggling, you need to go in, find out what’s actually going on, and only target that specific issue rather than making a lot of large irreversible changes.She states that some major points to be examined and evaluated are the facility’s current Medical Director and the actions of its Admission Directors.Medical Directors are supposed to be representatives and advocates for their facility. They should be ready to fix the problems they encounter or delegate the process of fixing.It is important to check in regularly with Admission Directors and find out what they are doing. Ask what challenges they are facing, who they are marketing to, and what's happening with referrals.  Lastly, when asked about the relevance of social media for both facility and vendors in senior care, Nebras states that, for both of these parties, the more recognition and familiarity the better. This is best done through authentic video content which is more informative than pictures. FOLLOW NEBRASEmailLinkedIn RELATED EPISODESEp. 79: Smart Hiring for Nursing HomesEp. 69: Should Nursing Homes Be On TikTok?Ep. 62: Social Media Marketing for Nursing Homes

Having served as assistant administrator at a small facility with extensive experience in the senior care industry, Avi Richman understands the extreme challenges facilities face these days in staffingThere is a constant fight over employees and many states cap admissions when a facility is only operating at very low levels of staff. Many facilities attempt to address the problem of staffing through working on their public appearance to prospective employees.Avi states that this method often won’t work because it's almost impossible for most facilities to scale the idea of what they want their vibe and company culture to feel like. The only situation in which this would work would be if the facility concerned was small, and standalone.Avi gives an example of such a facility that deepened their company culture by creating an employee counsel that served as a legitimate decision making body.But is there a sole strategy that will contribute with certainty to the success of staffing endeavors? Avi asserts that facilities need to focus their time and energy on making sure the processes they plan are executed smoothly and to completion from start to finish. It is easy to say that this will happen but very difficult in reality, the only way it will work is if the process is monitored and nurtured 24/7. FOLLOW AVI AND VITA HEALTHCARE GROUPWebsiteLinkedIn RELATED EPISODESEp. 85: 5 Strategies You Can Implement Today to Boost Your Recruitment Success RateEp. 79: Smart Hiring for Nursing HomesEp. 77: CNAs: Make Them Want To Stay

During her research into health disparities at John Hopkins, Athena witnessed the difficulties that aspiring healthcare workers who were underprivileged and financially insecure had in starting their career. Single parents who were already working paycheck to paycheck could not afford to put themself through a CNA training program. There is also the issue of overcomplication and outdatedness present in CNA training school sign-ups. Websites are hard to reach or do not even exist. Application documents are difficult to fill out and obtain. Many of the people coming up against these problems are truly passionate about helping others and often already have experience and understanding of what they will face. On the other side of the equation, facilities search high and low for CNAs to hire on.In the post pandemic world, many CNAs have turned to other careers and it is often a struggle to find qualified CNAs who will stay on for more than a few weeks. Athena’s company Dreambound addresses both of these problems simultaneously. Dreambound works with 150 schools and training programs in multiple states. If there’s a school that’s currently not on the platform all they have to do is sign up on the website and start getting students.Instead of a complicated application process, prospective students have only to fill out one universal application which will be directed to any of the schools on the platform. For facilities, Dreambound provides a system by which they can choose students to sponsor who will come and work for them afterwards. Athena also states that many schools are looking for clinical sites for their training. By taking this position, a facility will attract a lot more graduating CNAs who will have already trained there and decide to stay on out of the closeness and convenience. FOLLOW ATHENA AND DREAMBOUNDWebsiteLinkedIn RELATED EPISODESEp. 78: CNAs Care About Company CultureEp. 73: Make Your Staff WANT To Stay!Ep. 71: Combating Staff Turnover & Burnout In Nursing Homes

As a clinical psychologist with over twelve years of experience in the senior living space, Dr. Jennifer Stelter has a lot of experience with dementia. Dr. Jennifer is critical of the idea that pharmacological methods are the only way to address mental health conditions and she strives to provide knowledge of non-pharmacological tools and coping skills that can be used firstly. Together with her business partner Jessica Ryan, biologist, and aromatherapy educator, she created the dementia connection model which employs these types of tools for addressing dementia onset. Dr. Jennifer states that while dementia training should be part of any clinical psychology studies, it is instead left all down to nursing homes. Since most dementia training is just regulatory compliance, it will often be carried out without much real thought or planning and will not be effective. When there is a lack of education in this area staff will not know how to empathize and interact with residents with dementia which leaves them more inclined to become overwhelmed and quit.  In order for a dementia training to be effective, it must be engaging and ideally use sensory based exercises to put employees and caregivers in the position of those with dementia. Exercises that push people to think on their feet are also very important because this is an essential skill when caring for people with dementia. In a post pandemic world, these trainings should be up to date, after all there is evidence that COVID-19 can be a factor of dementia onset. Dr. Jennifer and Jessica will be opening their Dementia Connection Institute which provides in-person and virtual CE seminars and presentations, and staff trainings in all the tools and strategies of their model to staff and caregivers. FOLLOW DR. JENNIFER, AND JESSICA, & THEIR PRESENT AND  UPCOMING DEVELOPMENTSDr. Jennifer's LinkedInJessica's LinkedInThe Dementia Connection Institute  RELATED EPISODESEp. 84: Understanding Our Nursing Home ResidentsEp. 72: Are We Treating Our Seniors Worse Than Horses?Ep. 70: Memory: It's All In Your Head

Having worked on the front lines with hundreds of nursing homes to develop effective infection control strategies, Dr. Buffy got a firsthand look at the way in which these facilities were targeted during the height of the pandemic.She was moved by the stories she heard and problems she observed, to write her best selling novel Broken which highlights the difficulties faced by nursing homes in implementing infection control. Most of these difficulties stem predictably from staffing and budget challenges. All nursing homes are required to have at least a part time infection preventionist on staff, but many take on the role while also holding other positions and with little training or hands on experience. Dr. Buffy’s company, IPCWell, helps in these common situations by working with facilities to teach and support their infection preventionist in developing efficient and effective methods that will function inside a facility’s means and budget. However, a considerable amount of difficulty is also brought about by the barrage of continuously changing rules and regulations.Responsible regulations are always needed for the functioning of any industry. However, Dr. Buffy states that their sheer volume is crippling for senior care and makes it nearly impossible for facilities to operate inside. This came to a head in 2020 when, instead of helping nursing homes suffering from no PPE and with overworked staff who were risking their lives, the government invested $80,000,000 in targeted infection control surveys. In an effort to show that this money was being put to use, even the smallest action not following regulations word for word was cited. Dr. Buffy states that instead of punishing nursing homes, this funding and attention should be put towards helping them and advocating for them. The last chapter of Broken  explains how anyone who has a relative in a nursing home can advocate for their facility.  FOLLOW DR. BUFFYTo purchase BrokenTo follow her on LinkedInTo visit the IPCWell website RELATED EPISODESEp. 71: Combating Staff Turnover & Burnout In Nursing HomesEp. 38: Administrator Vs The SurveyorEp. 33: Infection Control - Out of the Binder

It's time for a mindset shift. Recruitment needs to be as important as census and marketing. You can even use some of the same resources and people to promote your recruitment activities. Go out to your local supermarket and stop anyone with scrubs and offer them an interview. Find out where else they're hanging out and develop a presence there on or offline. Improve the interview process. Treat them like royalty and make them feel like they arrived home. Have a user-friendly application process, and please, go easy on the paper. Nobody loves filling out tens of pages of the same information over and over again. Ensure your rates are competitive. Need some help? Reach out to Quality Recruit and see how we can help you with this --> shmuel@qualityrecruit.com  Related Episodes:Ep. 76 - Employee LiabilitiesEp. 73 - Make Your Staff Want to Stay!Ep. 71 - Combating Staff Turnover & Burnout In Nursing Homes

Jennifer has been a practicing physiotherapist for 14 years, and shares about her experiences and what she has learned in this space, as a podcaster, author, and speaker.She served as her dad’s caregiver for many years while he was housebound and through this experience can empathize and understand the struggles of residents and their families.Most times, going into long term care is no one’s choice and therefore its essential for residents to feel independent and at-home.Jennifer approaches every interaction with residents with the understanding that she is in their home and in their space as opposed to them being in her space because she is the therapist.As a physiotherapist her job is to assess patients mobility, balance, and strength and she strives to enable and empower their independence while also minimizing their fall risk. She advises physicians to try and tailor their sessions and treatments to the resident and their goals rather than rushing through and only thinking about the problem, not the person. In order for an at-home environment to be established, residents must feel trust and rapport with their physicians and caregivers. This rapport can only be gained if caregivers and physicians stay present with residents and remember that their role is to guide and inform, not to be authoritative and make decisions against the resident’s desires. Jennifer states that compassion and empathy only takes moments and even small gestures can go a long way towards making residents feel comfortable in their surroundings.  FOLLOW JENNIFERRead Her Book - Communication is Care: 9 Empowering Strategies to Guide Patient HealingHer Podcast - The Healthcare Provider Happy HourHer LinkedIn RELATED EPISODESEp. 72: Are We Treating Our Seniors Worse Than Horses?Ep. 56: Phone Calls Help Alleviate Loneliness in Nursing HomesEp. 54: What is the Greenhouse Model? 

After the loss of his grandparent, who received terrible treatment in rehab after surgery, Ryan resolved to address some of the issues in post-acute care by buying a software company already active in that space and using his expertise to build it up. VoiceFriend addresses the problem of inefficient communication faced in facilities where the many different stakeholders, including residents, families, and employees make for a quagmire of related issues. With varying levels of technological proficiency among these stakeholders, there have to be many different methods in place for communicating and conveying information. This type of chaotic system means that information and things said often slip through the cracks or can only be found again after a lengthy search which wastes time and effort. While there are other tools designed to improve this problem, they often only cover a section of facility communication or don’t work well with software already in place. Ryan explains that VoiceFriend is not a tool but a system designed to serve as the core communication platform of facilities by which all other means of communication already in place pass through. The software can convey messages over a wide variety of platforms including text, phone, and even Amazon Alexa.Recipients can set their own preferences to reflect how they would like to receive communications. VoiceFriend’s simplicity and ease of use are great strengths and by integrating it, a facility can dramatically streamline its communication and enhance processes already in place.  FOLLOW RYAN AND VOICEFRIENDWebsiteLinkedIn RELATED EPISODESEp. 81: Nursing Home Communication Ep. 67:  Can Nursing Homes Be Less Chaotic?Ep. 37: What Should I post on Linkedin?

Jana has represented many healthcare clients and serves as the outside general counsel for a large healthcare entity. The False Claims Act was created to address fraud being perpetrated against the government. To free up government time and resources, private individuals referred to as relators were permitted to bring those suits. Relators have to be an original source with inside information. In healthcare-related cases, they are often disgruntled, former employees or family members. Jana has handled many false claims cases and asserts that the most important first step in making sure that a facility is aware and compliant with the regulations under the False Claims Act is to install a Comprehensive Corporate Compliance Program.This type of program can be drawn up by a lawyer and details all the regulations that a particular facility will need to follow and what they can do to follow them to avoid causing claims to be made against them.Common claims in a healthcare setting often involve billing for services that weren’t provided or are insufficient. If an operator or administrator catches wind of this, they should investigate immediately and if a violation is found make a voluntary disclosure to the government and pay any difference that might be owed. In a worse scenario, the government will find out about the violation first and send a Civil Investigative Demand requesting the production of certain documents or an inner view of an employee. In this situation, the facility should act fast to hire experienced counsel and contact the government to negotiate a settlement rather than being taken to court. Fox Rothchild has offices all over the country and can provide all sorts of services to healthcare facilities in the areas of corporate employment, real estate, compliance services for if a facility is involved in litigation or receives a subpoena or Civil Investigative Demand.   LEARN MORE ABOUT JANA AND FOX ROTHCHILD LLPWebsiteLinkedIn RELATED EPISODESEp. 81 - Nursing Home Communication Ep. 76 - Employee Liabilities Ep. 38 - Administrator Vs The Surveyor

Fast and efficient communication is vital in senior care, and may often be the difference between life or death.Even disregarding such dire medical circumstances, a typical facility must constantly interface with numerous parties including residents, their families, employees, and external vendors at all times.Needless to say, without adequate methods in place to streamline all these fractured lines of interaction, accidents are bound to happen. Unfortunately, most senior care facilities still use antiquated means of communication.Terry has spent his whole career modernizing antiquated processes. With Carefeed, he created an all-in-one system that can bring the communication methods of any facility up to speed. The platform provides the most up-to-date technologies for every type of interaction that typically occurs in a facility.Carefeed identifies and addresses all of the outdated, redundant, and faulty communication methods currently in use by a facility, automating and digitizing them. Because of its all-inclusive approach, Carefeed is known as the central place for seamless communication and engagement with residents, family, and staff.FOLLOW TERRY AND CAREFEEDWebsiteLinkedInRELATED EPISODESEp. 69: Should Nursing Homes Be On TikTok?Ep. 66: We Only Notice When IT Stops WorkingEp. 30: Don't You Love All That Admission Paperwork?!

As an occupational therapist with an MBA who has, at one point, been responsible for 120 facilities at one time, Jean is an expert in both the care and business sides of senior care. With his groundbreaking new designs and programs conceived to influence the lives, thought processes and social engagement of residents, he has become recognized as an incredible innovator in the space. Jean’s buildings are structured to engage all five senses. Through natural lighting or LED-controlled “Sky Ceilings,” they allow those with memory-related conditions to tell the time. With a design based on the nineteen twenties, thirties, or forties, residents experiencing Retrogenesis and mentally reverting back to their youth can feel at-home in their surroundings. Jean is passionate about the vision of his buildings from a clinical perspective and also understands that this cannot be accomplished without adequate financial backing. He tells investors the true story, that by creating these spaces he is reducing clients’ pain and helping them to live longer and healthier lives and that this in-turn makes for significant cash flow. With his penchant for innovation, Jean has been planning and developing various new programs and ideas. Currently he is evolving his informational senior care, Alzheimer's, and dementia focused video platform Okrah.Jean first had the idea for this concept after producing his own documentary on one woman’s experience of Alzheimer's and realizing how little media existed around that important topic.FOLLOW JEAN, THE LANTERN GROUP, AND OKRAHLinkedInThe Lantern Group OkrahRELATED EPISODESEp. 75: Flooring; The Biggest DifferenceEp. 72: Are We Treating Our Seniors Worse Than Horses?Ep. 70: Memory: It's All In Your Head

Adam Lewis is the CEO of Apploi, a hiring software company centered around healthcare. With a background in HR, he has spent lots of time working with healthcare companies to identify and remove roadblocks in their job application processes. Two of the largest problems often encountered in healthcare recruiting are: how to attract more candidates into the application funnel and how to successfully move them through said funnel. To start with the latter of these issues, Adam states that out of all industries, healthcare takes the longest amount of time to recruit personnel with the average span being 40 days. This is often the result of an application being too lengthy and complicated. In order to make this process more frictionless, the application should feature fewer questions upfront and be mobile optimized so as to be accessible to nurses, CNAs, and LPNs who will likely be filling it out on their phones. The job postings themselves should also be created with the needs of current healthcare workers in mind. Rather than going by the old method of copying and pasting the needs of a position, employers must be more creative to grab the attention of job seekers in this modern competitive market. Job postings should narrate the experience of company culture, the perks that employees will receive, and the value that they will be regarded with.  FOLLOW ADAM AND APPLOI!WebsiteLinkedIn RELATED EPISODESEp. 77: CNAs: Make Them Want To StayEp. 73: Make Your Staff WANT To Stay!Ep. 71: Combating Staff Turnover & Burnout In Nursing Homes

Jeffrey is the founder and CEO of Cambridge Realty Capital, a real estate company centered around the nursing and senior care market that has made over 500 transactions in that space.From his own experience, he states that those looking to make their first nursing home real estate deal and become an operator often possess experience in the industry but lack the funds.For this reason, it is essential for first-time deal-makers to find a good investing partner to make the purchase with them.Firstly though, they must be sure to make an economical deal with the seller that is written down in the form of a tangible document.This will allow them to show the deal to different parties without being worried about people going behind their back. Maintaining this control is the most important part of making a deal.  Next is the question of loans and finding a good lender to work with.HUD Loans, supplied by the Department of Housing and Urban Development, are an excellent resource but require the assistance of a HUD Lender who can interface with the department.Lastly Jeffrey states the market is very lucrative and for those experienced in the administrative side of senior care, it's always a good time to break into the business. FOLLOW JEFFREY AND CAMBRIDGE REALTY CAPITALWebsiteLinkedIn RELATED EPISODESEp. 52: Investors Focusing on the Senior Care Space - LinkedIn Best PracticesEp. 40: Did The Coronavirus Make Nursing Homes Rich?Ep. 39: Administrators Speak Up; Time For a Change!

Quanisah Bernard is a talented and experienced CNA and, with more than fourteen years of the profession under her belt, has a deep knowledge of the ins and outs of CNA culture.After graduating from high-school in 2006 she started working at a nursing home in the dietary department. Soon after, she took a month-long CNA class which kicked off her journey as a CNA. Since Quanisah had entered her first facility right after high-school she felt as though it was a second family. Rather than treating her as a cog in the machine the administrators noticed her talent and proceeded to foster her skills and give her some chances to shine and be recognized. It was only when the management changed and became less focused on providing this important acknowledgement and care to their employees that Quanisah decided to leave. Though she had begun to think about the lack of a good salary, she states that it was this particular shift in company culture that forced her hand. Though at this time, when senior care facilities are under intense pressure, it is difficult for them to pay employees a higher salary, it is important that they follow through with all financially related promises. Quanisah states that even though the assurance of a raise or bonus may reflect well on a facility, not following through will cause CNAs to leave and let their colleagues know not to work there either. Lastly, she explains that getting involved with colleges would be a great way to find and attract potential future CNAs who will be looking to apply for internships and positions at facilities.   RELATED EPISODES Ep. 77: CNAs: Make Them Want To StayEp. 73: Make Your Staff WANT To Stay!Ep. 71: Combating Staff Turnover & Burnout In Nursing Homes