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Going with the flow.

As the start of a new year gives rise to new beginnings, this is as good a time as any to make changes to this column. Alert readers will have already noticed one major change - the title of the column itself. Why "post-acute" rather than "subacute"? Mainly because the ever-changing health care environment is creating more opportunities for nursing homes than ever before. They are, today, in a good position to take an almost limitless view of possible services that might be provided to patients in various stages of post-acute care. These include, but are far broader than, the possibilities inherent in subacute care.

They would include: traditional skilled nursing care; longer-term rehabilitation; geropsychiatric care, including partial hospitalization; outpatient services of varying descriptions; assisted living; congregate living; hospice; home health care; adult day care; respite care; case management; and an array of community services. All are open to nursing home-based initiatives and all will be impacted by numerous outside forces: reimbursement policies; government regulation; managed care; legal issues; developments in case management and care coordination; availability of services and supplies; information management systems; geographic and cultural considerations; and issues involving quality and ethics.

There is no shortage of issues to address in the column, and won't be for the foreseeable future. Subacute care can still be in your future - but perhaps you've done a feasibility study and found that your community doesn't need or want your particular strengths in that area, or that reimbursement will be inadequate, or indeed that a need does exist for a service much closer to your traditional line of business. The ability to keep an open mind and to be flexible is a very important attribute for nursing homes to carry into the future. The results will be that your community's needs will be better served, and you will experience a greater potential to enhance your organization's revenues.

Don't forget the opportunities to educate other providers in the community about the services you are ready to provide. Vendors and/or distributors might be helpful to you in disseminating the word; suppliers of goods and services can be highly effective allies in supporting your educational presentations. Selected professionals and organizations, such as hospitals or medical groups, may prove ready and willing to help you develop such educational programs, as well. And these relationships can grow into strong alliances, sharing mutual goals and interests in patient outcomes.

The horizon offers exciting prospects. Payers are seeking providers who are willing to offer alternative site services that are cost-effective. The successful nursing home will be, not an observer, but a participant in its health care community. As one who has had experience in varied levels of health care - from acute, subacute and long-term to community-based care - it is my privilege to help you explore these transitional times.
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Title Annotation:trends in nursing home care
Author:Hyatt, Laura
Publication:Nursing Homes
Date:Feb 1, 1996
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