Nursing Home Funding: A Closer Look

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A great photo stopped me dead in the middle of a LinkedIn scroll earlier this week.

In a stream filled with company logos and job advertisements was nursing home administrator Lakeshia Bell, resplendent in a satin black dress, ruffles flying off one shoulder and a layered cut-glass necklace completing her look.

Lakeshia Bell stands in the halls of Hartford Nursing and Rehabilitation in Detroit. Credit Nic Antaya/Crain’s Detroit Business

Bell’s unmistakable personal style—deftly set off by the muted colors of a traditional-looking nursing home hallway—made me want to click through for a closer look at what she’d been up to in Detroit.

It turns out that Bell, head of Hartford Nursing and Rehabilitation, managed to take his facility from an overall rating of 2 stars on the Centers for Medicare & Medicaid Services’ Care Compare site to 5 stars in just two years.

The article does not dive deeply into how these changes occurred throughout the survey process; instead, it highlights Bell’s role in making residents feel as special as she looks in this photo.

Among her strategies: holding a monthly “administrator’s tea”, during which the six guest residents are encouraged to dress up for dinner and are served by the staff.

“It’s the usual lunch they would normally get, but with five-star treatment,” Bell told Crain’s Detroit Business. “Patients share their stories. They are waiting for it impatiently. They dress. It’s just us talking, but it’s really about assessing patients’ needs and making everyone feel important.

Here’s the thing: we all like to feel heard, to be seen, to feel confident and beautiful when we’re seen.

But when it comes to nursing homes, we as a society have abandoned beauty in our quest to see below the surface. Yes, we have to hold suppliers accountable for even the ugliest details. How often residents go to the washroom, where cleaning supplies are stored, these are important to resident care and safety.

But as much as the investigative process relies on paperwork, process, and data (and then more data), looks and feelings really matter.

They count to attract residents. They count for referral partners. They matter when it comes to community reputation. Damn, nice lighting, clean dining rooms, residents with their nails cut and their hair styled, these little things get the attention of inspectors because even the government recognizes that they matter.

But on the most important things, we’ve built a retirement home funding system that neglects outward beauty. When times get tight – and inflation and personnel costs see to it – suppliers cut capital expenditures first. Many may swap furniture or wall coverings in indoor common areas, but how many older buildings do you drive past where someone has clearly invested money in an exterior that feels fresh and new?

The harsh truth is that when operators are forced to limit their spending – and more of these choices will surely arise if recession predictions come true – non-functional upgrades drop to the bottom of the to-do list. do or are entirely outside of it.

This leaves residents, especially those on Medicaid, with little choice when it comes to living in a beautiful place. The community hospital can shine from the outside; but the neighborhood retirement home is too often abandoned to its surroundings.

Long-term care needs a capital funding mechanism to support the kind of ambitious goals the White House is calling for, especially when it comes to upgrading facilities and reducing shared rooms. How can today’s suppliers be expected to cover the short and long term costs of downsizing when they are struggling?

The Green House operators, set aside as an example of the industry, were able to build from scratch, largely due to nonprofit status, patronage, and cheap land in rural areas. But until payment reform happens, further new construction of qualified nurses and even major renovations will remain extremely limited. The country’s facility inventory is aging, and so are the elderly who will soon need skilled care.

We know we have many Lakeshia Bells who do their best to make residents and staff feel beautiful and appreciated every day. Don’t they deserve equally admirable homes?

Kimberly Marselas is editor-in-chief of Long-Term Care News from McKnight.

The opinions expressed in McKnight Long Term Care News the columns are not necessarily those of At McKnight.

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