Welcome, sweet springtime.

Spring is a-blooming as I write this (at least Cleveland's somewhat chilly version of spring). And, like so many people, I like to kick back a bit at this time of year and relax. It gets tiring being serious all the time, don't you think?

I like to let idle thoughts and impressions run through my head and see what kind of amusement they might offer me. And there have been some goings-on in long-term care that are well suited to my purposelessness.

For example, despite all the gloomy talk about Medicaid and hard-hearted politicians sharpening their budgetary knives to get at it, I noticed a story indicating one state's positive take on all this. In Michigan, Gov. Jennifer Granholm is proposing that selected nursing homes receive a $5 per Medicaid resident per day supplement to encourage them to renovate as "community-oriented" housing--and, in the process, generate construction jobs throughout the state. It wasn't entirely clear from the story what community-oriented housing is and how a nursing home might be adapted to it. But it's nice to see a constructive approach to long-term care, even in the most literal sense.

Perusing the highly informative newsletter Eli's Long-Term Care Report, I read of a new movement in long-term care aimed at reducing nursing homes' liability exposure more significantly than any tort reform legislation. It's called "Extreme Honesty." This encouraging-sounding concept has an interest group behind it called the Sorry Works! Coalition. The group is lobbying for the idea that when something goes wrong, facilities should 'fess up to the error, sincerely apologize to the injured parties, and then take action to correct the problem. This, it is argued, will stop many lawsuits before they start. Interestingly enough, a Coalition spokesperson suggests that Extreme Honesty is "catching on."

Finally, while attending a recent American Association of Nurse Assessment Coordinators (AANAC) conference, I listened to two representatives from the federal Centers for Medicare & Medicaid Services (CMS) discuss how they've been rewriting various portions of the RAI Manual. The idea is to clarify sections that nursing home staff have had difficulty understanding over the years. Needless to say, I respect attempts at editorial precision, a particularly good idea when it comes to regulations having the force of law. (One wonders how many nursing homes have wandered dangerously astray in attempting to interpret the past versions.)

But that thought led to another--the people at CMS are just like you and me: hardworking family types, conscientious, motivated to do well, and to do good. After crafting a document that could quite conceivably turn an entire industry on its ear, they knock off on Friday evening, maybe go to a movie, have dinner with friends, do a little yard work over the weekend, perhaps take in a ball game or two. Then it's back to work Monday, inadvertently scaring the pants off the solid citizens they regulate. Strange world we live in, isn't it?

Anyway, taking in a ball game sounds pretty good to me right now. See ya later.

BY RICHARD L. PECK, EDITOR-IN-CHIEF

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