1. All your local listings should display accurate name, address, phone number and website (NAPW) information across the entire web — and we mean everywhere. A great place to start is the information listed on your Google My Business (GMB) page.
2. In addition to being up-to-date, make sure your GMB page is managed well. Keep your GMB page fresh with updated business hours, answering questions asked by consumers and even posting FAQs. Updated photos are good, but what’s even better is to make a simple video that displays any signs with your business name, the main entrance and lobby area, and a brief walkthrough of the building.
3. Be on the lookout for any authoritative sources that carry a lot of weight within your industry. Online directories are a great place to claim your business listing and ensure that your NAPW is accurate.
   Industry-specific directories are a great resource to accurately tie out your business information across the web. Getting content published and securing a backlink to your website from high-value, relevant sites like these are critical in ensuring your digital success in a competitive industry. n

This includes job descriptions that are clear, concise and completely free of jargon. Be transparent about benefits. Waste no time after receiving an applicant’s resume to deliver a personal, quick and sincere acknowledgment.

“This destroys most applicants’ assumptions their resumes land in black holes,” Corless says.2

Tailor your recruiting messages to specific audiences, says Martha Abercrombie, product marketing strategist for HealthcareSource. 

“Millennials, for example, want to establish an emotional connection and will emphasize the importance of fit with the employer’s culture and current employees over everything else when looking for a job,” she says. “Be authentic” when conveying your company’s culture and values, she adds.3

Get noticed amid the noise of your competition with words that convey what makes your company unique, says Kendra Nicastro, director of business development for LeaderStat. 

A current employee testimonial can be powerful. Describe job duties with bullet points and, of course, avoid writing errors.4

Buzzwords are powerful attention grabbers, remarks Brandi Kurtyka, CEO of myCNAjobs and HealthHire. “Flexibility” and “competitive” are big ones. Jan Wilson, director of learning design and outcomes for Relias, believes the phrase “individual professional development” will capture attention more than anything.5

Choose the medium wisely to maximize the power of your message.

“Good recruitment includes a variety of channels, strategies and communication methods,” says Kurtyka.

“Some of the best mediums are the job posting sites themselves,” says Corless.

“You need to consider where your audience is and then deliver content that makes sense for the platform,” Abercrombie adds.

A Source & CRM (candidate relationship management) solution also can help recruiters build a pipeline of potential certified nursing aides.

Nicastro suggests including an image with any online post. Refresh your posting frequently to ensure it stays highly visible. Engage current workers to share open jobs on their own social media channels.

One of the most effective recruiting mediums is SMS text. 

“Text messages are now the preferred method for scheduling and changing appointments and 90 percent of text messages are read in three minutes,” Corless notes. 

The best messaging gets wasted if it’s used in the wrong medium. Places to avoid, according to Corless: newspapers, classifieds and sites such as Craigslist. 

Another tip often forgotten: Hand out business cards at conferences and other events.6

 Avoid common gaffes that can terminate the best-laid recruitment plan. A big mistake is being too specific in job requirements. Kurtyka says many great candidates might not even bother to apply.

Megan Pulliam, business development manager for Jobalign, concurs, adding that many companies looking for the perfect candidate tend to list too many desired qualifications. “You may list ‘must have 7 years of experience’ as a requirement when in reality you are open to interviewing someone who has less experience or similar work experience,” Pulliam says. “In order to maximize candidate volume, you should only list the minimum requirements that are absolute deal breakers.”

Other gaffes:

• Generalized messages and broad-based recruitment marketing initiatives, which don’t build candidate pools as effectively as targeted, personalized communication.

• Frighteningly long applications.

• Leaving voice or emails. Today’s applicants respond more positively to personal texts.

• Dominating the interview. “If your hiring managers or recruiters are doing all the talking, you are in trouble,” Wilson says.7

Take care to include the following messages during your “preboarding” recruitment phase, says Larry Florio, national director, post-acute and senior living for Kronos Inc.: a leadership “welcome” message on your new-talent online portal or linked in your welcome email; a day one agenda; and electronic availability of critical information.

“Collect fun information about your new employee as a conversation starter to share with your team,” Florio adds.

It’s just that she was awarded yet another grant to study avoiding hospitalizations in nursing home residents. The grant runs until 2020. 

“It’s what I do and I just couldn’t let it go, so I reeled it in,” says Rantz, 69, who next year will celebrate her 50th year as a nurse. 

Rantz has made a name for herself nationally since the 1990s in areas such as measuring the effectiveness of nurse care coordination and finding new delivery models of care for older adults. 

“Really, my passion is to improve nursing homes and improve options for older adults to help them age in place,” she explains.

That interest led to the creation of TigerPlace, a 15-year-old facility in Columbia, MO, which has a special aging-in-place designation. The sensor technology she helped develop there with nurse researchers and the U of M College of Engineering is now sold commercially.

Her success with environmentally embedded technology that measures mental and physical function also resulted in her induction into the National Academy of Medicine in 2012 — one of her proudest achievements. 

“I was sad that my mom and dad were both gone when that happened,” she notes.

It actually was a fall that her mom suffered at home, which contributed to her death, that put Rantz on the path to finding tech solutions to problems of aging. 

An earlier career-turning point occurred when she was finishing her master of science in nursing degree at Marquette University and took a job as a resident care administrator at a nursing home a few miles from her house. 

“I just fell in love with it,” she says of her first brush with long-term care. “I loved the residents. I loved the staff, the families.”

That fueled the next part of her career: being an academic at the U of M. There is no question she carries legendary status among researchers in her field. 

“She’s kind of the epitome of a nurse scientist who has just stayed true to her passion of improving care in nursing homes,” says Amy Vogelsmeier, Ph.D., RN, FAAN, an associate professor at the Sinclair School of Nursing who began working with Rantz as a master’s student in the 1990s. 

Claudia J. Beverly, Ph.D., RN, a nurse researcher at the University of Arkansas agrees: “She has a fantastic vision for what the health of older adults, quality of care and quality of life, should be,” Beverly says. 

A mother of two and grandmother of six, Rantz loves quilting and attending Mizzou sporting events with her husband Wally. She’s happy to continue mining the field of long-term care quality improvement. But she also wouldn’t mind passing the reins every now and then. 

“I’d just like to quilt a little bit more now,” she says. “That’s my new goal.” 

Grace Lutheran Communities – River Pines purchased the motor-assist trishaw last year but had to wait for the winter thaw.

“They were pleasantly surprised by the experience,” administrator Jennifer Cohen told McKnight’s after the maiden voyage. “They can connect with the outdoors again, being outside and feeling the wind in their hair.”

Though some residents were apprehensive about climbing aboard, a crowd soon gathered. Passengers can board alone or with a friend, and the vehicle is accessible to “virtually anybody.” 

“Folks who use a wheelchair, they may need some help getting in, but once they’re in, there are seat belts to keep them safe,” Cohen said.

Resident Mary Dominski told Eau Claire’s WQOW that she had a “wonderful” first ride.

“I was very impressed by its comfort,” she said.

Cohen said Grace Lutheran covered the cost of the trishaw with two grants, one from Wisconsin’s civil monetary penalty fund and the other from the local Park Family Foundation.

River Pines’ trishaw rides will be piloted at most times by volunteers, with staff providing training and scheduling support.

But its role as a temperature regulator, pathogen barrier, and sheer complexity as the placeholder for more than 11 miles of blood vessels, makes skin one of the most challenging parts of the human body to keep whole. The process of aging complicates it even more as years of immobility, poor diet and exposure to sun and medications take a heavy toll.

Long-term caregivers still struggle with the most basic tasks of keeping an incontinent woman’s skin intact or an elderly man’s stubborn diabetic ulcer from worsening. Wound care resources are often thin and cost-containment pressures can be oppressive. In addition, chronic workforce issues can lead to costly shortcuts.

No magic pill exists to fix all of the problems with skin care. Instead, clinical specialists and other experts extol the virtues of common sense and vigilance as the best remedies available, and they hope for better advances in skin care.

Care impediments

What’s holding caregivers back from even the fundamentals?

A lay person would be stunned to learn of one major culprit, as Amin Setoodeh, RN, senior vice president of skin health and clinical services for Medline, explains:

“As the population of aging individuals continues to increase in the next few decades, care providers will continue to face the daunting task of preventing and treating skin injuries in the community or in the institutional settings,” he says. “I believe there is a false sense of security when it comes to the basics of skin care.”

Infection preventionists and epidemiologists may preach about it until their faces turn blue, but here are two other givens: 

“The number one culprit is handwashing,” says Ellen Thompson, RN, wound and product specialist for Gentell. “The lack of proper handwashing is responsible for the spread of countless infections of the skin.”

Poor diet and skipping simple moisturizers cause problems.

“Residents of nursing homes are at risk for skin issues due to pre-existing factors such as diabetes, immobility, autoimmune disorders, dehydration and nutritional compromise,” Thompson adds. “Providing the needed nutritional support is paramount in preventing skin disorders. Offering fluids to maintain hydration is key. Providing moisturizing lotions is necessary to maintain the health of aging skin.”

But even the basics are wasted on non-compliant patients, according to nursing expert Amy Stewart, MSN.

“Nursing home staff do indeed know the basics of skin care but there are circumstances that are out of the control of staff,” says Stewart, who serves as vice president of curriculum development for the American Association of Post-Acute Care Nursing. 

For example, a resident may refuse some or all types of skin care and that puts them at an increased risk for skin breakdown. This might include refusal to eat, including supplements that provide much needed protein, or refusals to be turned and repositioned, or participate in a toileting plan.

Another major impediment is a woeful lack of resources, such as too little staff with not enough expertise, or who can perform proper assessments. Setoodeh says many skilled facilities are affected by deficits of all three.

“The biggest issue today in our industry is a lack of required resources for us to provide appropriate skin care for complex patients,” says Setoodeh, who spends a lot of time visiting facilities around the nation, with quality ratings ranging from one to five stars. 

“Care providers try to do their best with what they have, but clinical bias in practice and lack of focus on evidence-based practice impacts progress,” he notes.

Medline’s own internal studies have shown Setoodeh and others that facilities with higher star ratings invest heavily on prevention rather than taking a reactive focus on treatment of skin injuries.

A lack of appropriate products is another culprit.

In many cases, poor quality incontinence products are used and staff shortages hinder the ability to change dressings as frequently as they should, according to Mihaela Grigore, chief operating officer of TZMO USA. Even if inadequate products are changed more frequently, residents are deprived of restorative sleep from all the interruptions, she adds.

Incontinence-damaged skin typically requires special low alkaline pH cleansers, but many facilities opt for the cheaper “water and soap” approach, which “often results in drier, more vulnerable skin,” Grigore adds. In some facilities, caregivers have been known to skip using any incontinence products at all — a practice referred to as “airing.”

Grigore and others say cost containment pressures are at the heart of so many poor product decisions.

“Skin and wound care management should be individualized based on each specific patient’s needs, rather than just focusing on the CMS allowable to cover supply cost,” says Setoodeh. 

Adds Grigore, “From our experience, unfortunately, priority for many nursing home clients is the unit cost per item and not the overall expense with incontinence products. Using poor quality products with low performance generates problems with the skin. We need to look differently at the cost of care and focus on prevention more.”

Being restricted to certain products doesn’t help.

“Skin care products are developed daily and many nurses want to try these new innovative products, but they may be hindered by the fact that their facility has a formulary that allows them to only use certain approved products,” Stewart adds. 

Wound care experts are unified in promoting a multidisciplinary approach to geriatric skin care. 

Setoodeh’s assertion, meanwhile, leaves no doubt: “Critical thinking and the ability to make important decisions is crucial,” he says. “The biggest culprit for mismanagement of skin health is a lack of a cohesive team approach for holistic skin health management.”

Setoodeh offers the following four red flags that would correctly trigger a team-based assessment:

1) Daily wound care dressing changes without supported clinical evidence — something that could increase cost and staff workload burden.

2) Lack of access to an updated evidence-based guideline with a focus on skin health prevention, intervention and treatment. Programs that don’t reflect changes in clinical practice lead to poor skin care practices.

3) Inconsistent assessments of the patient’s environment such as seating, support surfaces and off-loading, which could lead to poor outcomes.

4) Sporadic training on skin health management. 

Corrective measures

Caregivers should take solace in knowing that skin care course corrections, while challenging, pay significant dividends down the road.

A successful skin care program begins with “strong leadership defining what the facility’s approach to skin care will look like. From there, a commitment to building a foundation of proactive skin care,” Setoodeh says.

Staff education and training must be consistent and ongoing.

It’s not enough to educate. There must be validation that staff understand what they’ve learned, says Stewart, who discourages a “cookie-cutter” approach to interventions. 

Show caregivers what to do with combatant, non-compliant residents, and how to enlist family to reverse the behavior. Thompson urges all facilities to also include good nutrition and hydration as a vital skin care tool.

 Proper skin care inside a skilled facility can be challenged by cost pressures, but Grigore recommends managers take the long view on spending. 

“Evaluate the incontinence care cost as an overall cost and not by looking at the price per unit only for the main product,” she says. Remember to include all additional expenses associated with incontinence — from gloves and wipes to laundry and staff time needed in dressings and briefs changes.

Finally, experts agree a back-to-basics approach to skin care is always a good idea.

“A holistic approach of total care, which combines care plans to address all these issues along with the proper choice of incontinence products, proper skin cleansing and caring routines, is the best way to achieve better skin health,” says Tony Forsberg, RN, national clinical director for ESSITY HMS North America. “Prevention is always better than a cure.”

Selling the appearance of a residential setting by mirroring home and hospitality trends was paramount.

While you’ll still find plenty of nods to current décor trends — hello, neutral grays and barn wood embellishment — there’s a new theme in both furniture and design.

Technology is driving product development, with skilled nursing facilities selecting innovative pieces that meet their residents’ needs, keep their employees safe and keep pace with the ever-evolving digital capabilities of consumer and home electronics.

“Ten years ago, most nursing home residents were on the verge of accepting technology,” says Brian Roth, vice president of marketing and sales for bed and chair maker Med-Mizer. “Now, every future generation is used to this playing a key part of their life, and we feel nursing homes and manufacturers will have to find out ways to incorporate this technology moving forward.”    

Sometimes, the technology is visible. Think signage; flat-screen TVs; and in-room, wall-mounted tablets or voice-activated lighting controls.

But just as often, the technological advances are embedded within products, whether that means improvements in mechanical operations; man-made, performance materials; or new, digital components such as built-in charging ports.

“A lot of the furniture now is powered [equipped with electrical ports], which we never saw before,” says Kristy Yang, senior interior designer with Direct Supply Aptura. “That makes it more accessible to residents who want to bring their iPad into a common space, and it’s appealing and drawing visitors and families to common spaces, too.”

The kinds of innovation now tucked into everyday pieces clearly influence both function and appearance.

One major trend over the last decade has been the rise of wood replacements made using new manufacturing processes, such as thermoformed flooring surfaces that don’t require edge treatments. Gone are bulky thresholds. Better acoustics are an added bonus from the improvements.

“Alternate products to wood have taken a strong hold in our market,” says Jacki Zumsteg, director of interior design for Invacare. “Aluminum frame chairs and 3D laminate are all providing options to the wood product.”

Many of the changes have been driven by manufacturers, who are responding to providers’ requests for durable, lightweight materials that last and include some added advantage for their residents.

As an example, Yang’s fellow senior interior designer Amy Warden points to the new range of fabrics that give communities seemingly unending options for comfortable and beautiful seating.

“The feel of the fabric is so much nicer than it was 10 years ago,” she says. “Now, fabric barriers feel like treatments you would have at home.”

The trick is in nanotechnology coatings — many now use environmentally friendly solutions in response to clean air standards — that are backed up by durable interior materials.

 Today’s designs often accommodate a wide range of medical or social needs with looks that belie their healthcare roots.

Those barn doors so popular in design magazines and on HGTV? Turns out they brought a warm aesthetic and new function to a skilled nursing home client Yang recently worked with in Illinois.

Used for an in-room bathroom, the barn door slides behind furnishings when opened and requires no door frame. That means a wider, more accessible entrance for residents, especially those who use a wheelchair.

Changing needs

Major drivers for innovation include ergonomics that limit staff injuries, resident mobility and liability concerns.

 “When we can innovate and design solutions to improve outcomes and help nursing homes provide more effective and efficient care, it’s a win-win for everyone,” Roth says.

Med-Mizer looks to trends in hospitals and hospitality for inspiration, he adds. But the company also considers how payment models change and how the metrics used in nursing homes can drive needs. Merger and acquisition activity, especially as it relates to single companies providing a continuum of care, also motivates furniture makers to think differently.

The obesity epidemic and changing acuity levels also have been major factors over the last decade. At Med-Mizer, they led to the development of a new tilt-in-space chair.

“During our design phase, we spoke to countless clinicians who all complained about the current ergonomics — hand grip placement, caster/steering challenges, residents sliding down and to the side in the chairs,” Roth says.

Designers added new hand grips, dual-steering casters and a patent-pending Vback to keep residents and staff more comfortable when using the chair.

 Likewise, Comfort Tek created its Chair CADDIE after considering how a caregiver moves a seated person up to or away from a table — and how much damage regular chairs can do to expensive flooring.

The sled-like device was made to “specifically reduce the effort required on behalf of a caregiver when moving a mobility challenged person up to the table,” says president Randy Schellenberg. 

He says the device can help stabilize chairs that have been damaged by tugging and twisting, extending life. The CADDIE adds only about ¾ of an inch to chair height, and the casters lock. Those features were incorporated with safety in mind.

The idea that skilled nursing home residents are entering older and sicker will drive the development of more specialized equipment, Roth predicts. His company recently launched the AllCare floor-level bed as a tool for facilities, limiting the use of side rails. 

“Floor-level beds, wider width, larger weight capacity, advanced positioning, and more advanced features … are having demand increase as nursing homes have to face the challenges of dealing with rising levels of acuity,” he says.

Digital presence

Among the features Roth sees gaining popularity are high-tech ones, like embedded scales and fall notification systems.

That’s just the beginning of how technology is influencing design and function in today’s facilities.

 “We see the entire healthcare market ready to explode when it comes to Wi-Fi and the possibilities for residents,” says Josh Lambert, vice president of sales for Allbridge, provider of data, video and voice technology. “Tablets and smartphones will continue to advance and we believe that the resident’s adoption of these pieces of technology and their features will rapidly grow and become the norm.”

The evolution means designers have been able to get rid of some clutter while incorporating new functional elements.

Lambert says he has seen great advances in TV hardware in healthcare settings over the last two years, a trend, like most, that follows hospitality adoptions. Clunky speakers and cable boxes are gone, as are multiple remotes. Wireless access points now allow entertainment and resident engagement services to stream on in-room TVs with simplicity.

“In my opinion, internet connectivity is the key to future technological success in the LTC space,” Lambert adds. “Simple things that we all do now, such as FaceTime or Skype, watching YouTube videos or streaming Netflix will be a basic starting point for the demands of the residents and their families.”

Features like voice command — now available to power in-room lighting and bathroom mirrors — will continue to influence design as more seniors become familiar with the capabilities.

Many senior living communities are already experimenting with such technologies, and these are expected to begin trickling in to nursing homes sooner rather than later.

In New York City, an upscale community being designed by Maplewood Senior Living will offer an even more comprehensive solution for its residents — including those in memory care. Many communities have been using technology that incorporates Amazon’s Alexa. Front Porch Center for Innovation and Wellbeing, for example, in 2017 launched a six-month Amazon Alexa Pilot Study at Carlsbad By The Sea, a continuing care retirement community in San Diego. Civitas Senior Living also has used Alexa in each of its independent living apartments in suburban Houston.

Eskaton Chief Strategy Officer Sheri Peifer says creating adaptive living environments will “empower the independence and well-being of all residents, regardless of age and ability.

A nursing home activity program? Nope, my high school reunion. 

How many years had it been? I’d rather not say. But when I was born, Eisenhower was still president. You do the math. 

Walking into the room was a surreal experience, as I hadn’t seen most of these folks in decades. Some were strangers to me. Others seemed permanently frozen in time, especially in hair and wardrobe choices.

Limps and grimaces abounded, as did unsightly bulges and other age-related disfigurements — and that’s just me I’m describing. Thankfully, my classmates showed similar symptoms. 

Once the hugs and handshakes were done, conversations ensued. The voices sounded familiar, but they emanated from different faces and bodies. A woman who’d known me well showed no recognition, until she heard me speak. Then her eyes got big like she’d just seen Elvis alive.

Through it all, I felt enormous resistance to being seen this way, and looking back, understand more clearly how seniors feel when life plunks them in a nursing home. 

I wanted to gather everyone around and stand on a table like Beto O’Rourke. “What you see isn’t really me, don’t you people understand?” I’d implore. “The person you remember is still here behind this barren scalp and multi-chin. Stop judging me!”

But of course they weren’t judging me, because we were all in it together. After all these years, no one had escaped the ravages of time. Yet in every way that was important, we hadn’t changed, either.

That’s a crucial reassurance we should relentlessly offer our residents: letting them know that we see the person they’ve always been underneath appearances and ailments. 

That we know who they really are — behind the chins and all. 

And when you bring skilled nursing into the picture? Oh, brother, forget it. They’re the behind of the behind.

I believe the labels of inadequacy are overblown, or at least framed wrong, and I’d like your help proving it.

Sure, the banking and computing industries may have mind-blowing computer security programs, and other industries may offer layer after layer of automation genius.

But think to yourself: How many hands do the players in those industries hold? How many hearts and lives do they enlarge? How often do they help an elderly, fragile person feel “at home”? 

Largely, they don’t. So there’s no shaming when we want to talk about skilled nursing and tech. You simply use processes and formulas in different ways.

We want to hear about it. Hundreds of providers have told us in the past how they do care right. And they’ve been honored in the annual McKnight’s Excellence in Technology Awards program. Now, it’s your turn.

Rather than asking yourself, “Hmmm, what great ‘techie’ thing can we try to impress with?” Instead, ask: “What do we do particularly well?” Then work backwards and tell us how it happens.

The McKnight’s annual awards competition puts “technology” out front, but it emphasizes the ways long-term care providers improve care. You know all about care. Others don’t.

It’s time to tell us how it gets done. High-tech or low-tech, there’s plenty at work that is praiseworthy. Don’t be shy.

Check out our simple entry form at www.mcknightstechawards.com now. There’s no time to waste. Entries will be accepted until July 24. 

The entry fee couldn’t be less expensive (it’s free), but the payoff is priceless: National recognition for the great care you do.

The six categories have soft boundaries. Enter in one or more of them: Quality, High Tech/High Touch, Innovator of the Year, Keep It Super Simple, Safety, and Transitions. If you aren’t doing something good in at least a few of these, you aren’t in business.

Judges will recognize providers at the Gold, Silver, Bronze and Honorable Mention level. 

Don’t let others always get all the attention. It’s your turn now.