Long-Term Care in 2014: Doing More with Less

​For long-term care, the “mantra going forward” is going to be “doing a lot more with a lot less,” said Richard G. Stefanacci, D.O., M.G.H., M.B.A., AGSF, CMD, a practicing internist and geriatrician and chief medical officer of the Access Group. Speaking October 17, 2013, at the National Aging Services Risk Management (NASRM) conference in Chicago, Stefanacci identified major issues for long-term care providers in 2014 and beyond. The impact of healthcare reform on long-term care generally falls into four categories, he said: expansion of insurance coverage, including state expansion of Medicaid and increased Medicare coverage of preventive care; tightened reimbursement and bundled payments; new care models that emphasize transitions and care coordination; and innovative delivery systems. Hospitalization of residents is “probably the biggest” area of risk and a potential driver of decisions regarding admission to long-term care. Stefanacci suggested finding ways to safely manage residents in the nursing home. For example, staff must spot and report changes in condition earlier.