Rising Storm in LTC How to Prepare for the Worst

Rising Storm in LTCHow to Prepare for the Worst

Economic SqueezeResource ShortageWorkload PressureUnion AttackGovernment Interference

Economic Squeeze

Medicaid/Medicare catastropheLabor Costs & TurnoverAccess to Funding

Medicaid/Medicare

Economic Squeeze

514

2529

Economic Squeeze

$16.79Medicaid/Medicare

Labor Costs: 70%

Turnover rates: 40% - 166%CNA Turnover: 70%Costs: 25% of annual compensation

Labor & Turnover Costs

Economic Squeeze

Access to Funding

Economic Squeeze

Resource Shortage

Aging of AmericaHigh-Growth MarketFewer Trained WorkersHospital Releases

Aging of America

65+2000: 35 million2010: 40 million2020: 55 million2030: 72 million

6.5% 65+ in residential care

Resource Shortage

35 4055

72

Population Over Age 65 (in Millions)

High Growth Market

Direct Care Workers 2nd Largest Occupational Group

New Job Growth:1. Registered Nurses9. Nursing Aides, Orderlies & Attendants

Community Care Facilities: up 31%Nursing Care Facilities: up 28%

Resource Shortage

1,113,000 needed850,736 available

Resource Shortage

Fewer Workers

Needed Available

Hospital Releases

98%1985-2000

Resource Shortage

1985 - 2000

Workload Pressure

Higher AcuityStaffingLitigation Pressure

Higher Acuity

Diabetes Deaths in Nursing Homes Alzheimers ADL Dependence

Workload Pressure

ALL UP

Staffing Shortage

Workload Pressure

Litigation

Workload Pressure

Union Attack

Survival Requires Growth MarketsTargeted CampaignsPolitical Influence

Growth Markets

Union Attack

Targeted Campaigns

Union Attack

Political Influence

Union Attack

Government Regulation

Specialty Healthcare DOL/OLMS Rule ChangesNLRB Rule Changes

Specialty Healthcare Rehabilitation Center of Mobile

Government Regulation

DOL/OLMS Persuader “Advice” Exemption

Government Regulation

June 21, 2011 Notice of Proposed Rulemaking:

The New Rules (proposed)

Persuader activities include drafting, revising or providing:

1. Materials for presentation, dissemination, distribution to employees

2. Speeches3. Audiovisual, multimedia presentation4. Website content5. Planning, conducting one-on-one or group

meetings6. Employee attitude surveys concerning union

awareness, sympathy or “proneness”

Proposed Rulemaking• Not a final rule• 90 days to comment• In effect after comment period• Comment by web

(regulations.gov), hand-delivery or by mail

• Reference 1215-AB79 and 1245-AA03 (29 C.F.R. Parts 405 and 406)

DOL/OLMS Persuader “Advice” Exemption

Government Regulation

June 21, 2011 Notice of Proposed Rulemaking:

The New Rules (proposed)

Persuader activities include drafting, revising or providing:

7. Training supervisors to conduct meetings8. Coordination or directing activities of supervisors9. Establishing or facilitating employee committees10. Developing personnel policies11. Deciding which employees to target for

persuader activity or disciplinary action12. Conducting a seminar for supervisors13. Other (must explain)

Proposed Rulemaking• Not a final rule• 90 days to comment• In effect after comment period• Comment by web

(regulations.gov), hand-delivery or by mail

• Reference 1215-AB79 and 1245-AA03 (29 C.F.R. Parts 405 and 406)

Watch Webinar and Get Other Resources Here:

http://lrionline.com/olms-advice-rule

Comments Due September 21, 2011

DOL/OLMS Persuader “Advice” Exemption

Government Regulation

NLRB “Quickie” Elections Rule

Government Regulation

Hearing suspended to post-election if issues effect less

than 20% of unit

Statement of Position Form (all future litigation limited to statement of position)

Eliminate 25-30 day waiting period to allow review of

Regional Director decisions

Provide voter phone numbers, email, shift &

departments within 2 days of direction of election (and

immediately to Board)

Key Changes

NLRB “Quickie” Elections Rule

Government Regulation

Key Changes

Election can be held within 10 days of transmission of eligibility list (or earlier if

union agrees)

Use of electronic signatures to support a showing of

interest

Election Notices required (electronic posting required

where possible)

Review all individual voter eligibility issues post-

election

NLRB “Quickie” Elections Rule

Government Regulation

Watch Webinar and Get Other Resources Here:

http://lrionline.com/nlrb-streamlined-elections

Comments Due August 22, 2011

What Do I Do Now?

CommentPolitical outreachProactive ER

Government Regulation

BOOM Right of BOOMLeft of BOOM

Situation Assessment

Counter-CampaignStrategy

Alert Legal, Consulting, Jump Team

Vulnerability Assessment

Positive ER, Engagement

Hiring/Onboarding

Tripwire Team

Left of Boom

Frontline Focus

Actual

Goal

35%

40%

18%

30%

23%

20%

20%

10%

4%

In-Group Partially Affiliated NeutralPartially Disaffiliated Out Group

How Companies Screw Up Training

You don’t need one of these

How to Evaluate Effective Training

Intervals shrink the knowing-doing gap

Active intervals - “bursts”Awareness, values, skillsAccountabilityLeverage self-learning

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Awareness

Values SkillsTry one module FREEOne pulse survey FREECopy of Next 52 Weeks

Webinar Conclusion

To participate in training or pulse

survey call Greg at 800-888-9115 or emailgkittinger@lrims.com