“Nursinghometalk.com is pleased to host online forums for nursing home administrators and welcomes your participation. We want your online experience to be positive and mutually beneficial. Of course, all participants must adhere to the general forum rules regarding discussions and protocol. Relative to discussions focused on the NAB Nursing Home Administrator exam, we ask that all participants be cognizant of the confidentiality agreement and obligations required by NAB that all candidates accept when taking the exam. There should be no disclosure of any NHA exam items, questions or answers, to any individual or entity in any context. The forum is monitored and any inappropriate discussions or disclosures will be addressed by NAB and subject to sanction. Monitors will report to the licensing board of the applicant’s state any impropriety as an ‘ethics’ allegation/violation for further investigation. Thank you for your cooperation.”

Older adults need positive role models such as LaLanne to promote health and well-being. This can be especially helpful to seniors undergoing nursing home rehabilitation such as physical or occupational therapy. My spirits were lifted today when I read an article in the New York Times about Olga Kotelko, an incredible nonagenarian that can jump 5.8 feet and holds two world records in javelin for women over the age of 85.

As the article states, motivation is the challenge. Finding reasons to keep exercising is a universal issue to us all. “Even rats seem to bristle, eventually, at voluntary exercise, studies suggest. Young rats seem intrinsically driven to run on the wheels you put in their cages. But one day those wheels just stop turning. The aging athlete must manufacture strategies to keep pushing in the face of plenty of perfectly rational reasons not to: things hurt, you’ve achieved a lot of your goals and the friends you used to do it for and with are disappearing.”

But competition and positive results can be a huge motivator. Add in a positive team of supporters and role models such as Kotelko and we can be inspired to keep our drive. For more information on Kotelko, click on this link.

Considering that most residents in a nursing home are relatively vulnerable and could fall victim to a predator, I applaud the decision. Yes, it is requiring more regulation in an already seemingly over regulated industry, but it will make it easier to determine who is “eligible” to work in a nursing home and/or assisted living. I have heard past stories regarding employees who committed a crime and then switched to home health or another facility that may have looser policies that would overlook such issues due to being short-staffed or various other reasons.

With the baby boomers coming into Medicare age, a large percentage of them will eventually need nursing home or assisted living care. I contemplate why we have strict guidelines on our staff but ignore background screening future residents. For example, one of my colleagues learned after accepting a particular resident, that the resident had killed someone (in self defense). They never would have known about the resident if he didn’t tell them, and it was easily confirmed on the public record. I began wondering how commonly this occurs.

Nursing home residents tend to be vulnerable individuals that have likely left their criminal years behind them. But what about the individuals who are just there for rehab–younger, more agile, baby boomers that could cause potential damage to residents and/or staff members. In our area, it is hard enough to keep the facility census up (especially with particular payers) without having to worry about a background screening that could inhibit the process. Why would we go through medically and financially checking potential residents, just to skip the step that could provide additional safety in a vulnerable environment?

I will get off the bandwagon for now. It is just a thought…but, I know I would not want my parent living next to a convicted murderer. Would you?

Donna A. wrote, “Do you recommend an online self-study course? If so which one would you recommend? What have you experienced as the best study plan to pass the exam on the first attempt? Thanks for you assistance.”

I personally haven’t had experience with any of the online prep courses, and to recommend one wouldn’t be a fair assessment. So if you or someone you know has some helpful advice for Donna, please respond to this post.

Thanks for reading!

Erin Blakely

“If this outlook holds true, this season could be one of the more active on record,” said Jane Lubchenco, Ph.D., under secretary of commerce for oceans and atmosphere and NOAA administrator. “The greater likelihood of storms brings an increased risk of a landfall. In short, we urge everyone to be prepared.”

Preparation is key to the best survival rates. It can make the difference between life and death, especially for the vulnerable nursing home resident population. Here are some important tips to keep in mind:

1. Every facility should have a weather radio. If you don’t have one, check out this link. HAM radios have also gotten a lot of good press lately for emergency situations — “works, when all else fails.” Check out this link.

2. Update your emergency preparedness manual and make sure every department head has a copy. Emergency contracts need to be current and able to meet regulations, but more importantly—your facility’s requirements. It’s just a worthless piece of paper unless you know it will workable solution in a time of crisis.

2a. Try out your contracts ahead of time as practice. Yes, this can be costly, but I bet you will be surprised how many of them will be unable to meet your needs. Transportation contracts often have these issues because of FEMA and other similar organizations that end up needing emergency assistance. Problem solve ahead of time by thinking out alternative strategies if something were to go awry.

2b. Consider developing relationships with churches in the area. They have been found to be quite reliable (CDL), and often go under the radar of available transportation during a disaster.

3. Practice, practice, practice! OK, we all know drills can be a bit hokey and tiresome. So try new ideas to keep your staff interested while at the same time reiterate the importance of these practice sessions. If your staff is goofing off—how will the react in a real emergency?

4. Be flexible! As we all know when a emergency occurs very rarely do things go as planned. If this were to happen at your nursing home, learn to adapt to the surroundings and think logically. This could prevent not only wasted time and energy, but possibly save someone’s life.

5. Last resort–relocation to another facility. While some may disagree, transporting nursing home residents to another facility can be more dangerous than the actual storm. From skin tears to death, uprooting fragile residents should be as stated, the last resort.

If anyone has any more tips to add, please comment on this post. Working together we can be better serve our residents!

For example, diabetic medication and supplies can be costly especially for individuals without insurance. Abbott Laboratories has a program that provides these things for FREE. Check out the links for more information.

1. My personal favorite: NAB Study Guide. I extensively used the 4th edition, and now there is a 5th edition. So far I haven’t had any experience with the newest version, but the older version was a “must buy.” However, don’t expect to get by with passing the exam just using this guide. It is just one of many tools to help prepare you. To purchase the new version, click on this link to the NAB website. Sometimes I was able to find used 4th editions of the “NAB Study Guide 4th Edition” at a better price.

2. Another one of my favorite books is “Principles of Health Care Administration” by Wilborn Davis and Joseph Townsend. Although it isn’t a study guide, I found that this book covered information essential to passing the NAB exam.

3. For all nursing home administrators (and future administrators), you will want to purchase “The Long Term Care Survey” which contains the latest CMS updates, regulations, and survey procedures. Go to the AHCA bookstore to purchase. The latest version is currently September 2009.

4. James E. Allen’s 5th Edition Study Guide is a helpful resource—not my preferred favorite but a useful tool nonetheless. He also has a Nursing Home Administration 5th Edition.

5. The Licensing Exam Review Guide in Nursing Home Administration: 1000 Test Questions in the Nation Examination Format on the 1996 Domains of Practice

Other Useful Resources:

1. One helpful management book for nursing home administrators is
“Effective Management of Long Term Care” by Douglas Singh.

2. “The Toyota Way to Healthcare Excellence: Increase Efficiency and Improve Quality with Lean (ACHE Management)” by John Black is another useful management book.

3. The “Eden Alternative” has become popular in recent years which involves transforming nursing homes into lively environments with gardens, animals, and children. The book, “Life Worth Living: How Someone You Love Can Still Enjoy Life in a Nursing Home – The Eden Alternative in Action” by William H. Thomas, M.D. explores ways to promote life and engage residents – a must read for administrators and/or nursing home staff.

4. For those of you who are visionaries, check out Beth Baker’s “Old Age in a New Age: The Promise of Transformative Nursing Homes.” In this book, Baker discovers ways to value staff and avoid high turnover, reduce dementia behavioral issues through the environment, and provide better care to residents without costing the nursing home more money.

5. To get a different perspective on resident care, here is a book written by a CNA, entitled “Nobody’s Home: Candid Reflections of a Nursing Home Aide.”

6. An old favorite that I still reference from time to time is Dale Carnegie’s, “How to Win Friends and Influence People.”

For more suggestions, check out my recommended books link.