Holiday cheer.

I don't know about you, but I think I've had enough bad news for one year: Clinton/Lewinsky, Kenneth Starr, Kosovo, Russia's ruble rubble, Japan's fun-loving bank ers, Wall Street's gloom-and-doomers, not to mention long-term care's latest list of government-imposed challenges. But this is the holiday season - a season of good cheer, a time for bucking up, putting on a smile and looking for the good in life. So, after rummaging about a bit, I think I've extracted a few plums from the long-term care industry's pie. I would enjoy sharing them with you, although be warned, not all of them are quite as sweet as they look. For example:

* Skilled nursing facilities that are geared up for the Medicare Prospective Payment System (PPS) may find it proving to be a business boon. Confronted by Medicare's new Fiscal stringency, hospitals are finally admitting that they can't compete with well-run SNFs on costs and, in many cases, are phasing out their transitional care units and other post-acute services and are presumably entering the market for good SNF referral partners. A potential crimp in this, unfortunately, is posed by Medicare's new transfer rules - that is, a hospital's moving a DRG patient to a lower level of care is now interpreted as a transfer rather than a discharge, the result being a possibly decreased DRG and therefore an incentive to hang on to those patients. Time will tell whether this will impact on SNF post-acute admissions as PPS unfolds.

* States have not, for the most part, rushed to cut nursing homes' Medicaid reimbursements, despite the absence of Boren amendment protection. This is quite rightly attributed to good economic times and resulting state budget surpluses, rather than anything particularly wonderful that nursing homes have done. But, especially as states begin to observe the political fallout from Medicare cutbacks, there's hope that they won't be eager to cut Medicaid for the elderly. (They just might reroute some of that money, though, to "alternative" sites like assisted living and adult day care.)

* Private long-term care insurance continues to grow as a financing option, with employer-based sales (the marketplace that really make sense) now accounting for 20% of all new policies. That may not seem like such a big deal in absolute numbers - only a tiny percentage of the eligible market has acquired policies thus far - but it is a hopeful sign that at least some Americans really are attempting to fend for themselves and avoid reliance on tax-supported programs.

* Long-term care campuses and networks continue to spread, offering the promise of "one-stop shopping" for a broad array of long-term care services. The administrative challenge of managing an organization offering everything from post-acute care to adult day care to chronic support services is one that was barely imagined 10 years ago. It appears, though, that there are administrators and managers among us who have found it within themselves to rise to the challenge. Look around you and see who they are. Perhaps you're among them. I hope so, because they are tomorrow's long-term care leaders.

* Recent visits by yours truly into the field have disclosed to me a number of administrators and DONs who, despite all mass media images to the contrary, truly care for their residents and their staffs. Space doesn't permit me to elaborate, but look for their stories in future issues of this magazine.

Also, on a personal and unfortunately somewhat sadder note, I report that Glen Duncan is leaving The Beverly Foundation to pursue new career opportunities. Glen has been a driving force behind the annual Optima Award contest co-sponsored by Beverly and Nursing Homes/Long Term Care Management for the past three years. It was he, for example, who designed the award and devised the ingenious scoring system that judges have commented upon as being not only fair, but fun. We plan to continue to build on Glen's hard work, and wish him the best in his future endeavors.