Rising Storm in LTC
How to Prepare for the Worst
Economic Squeeze
Resource Shortage
Workload Pressure
Union Attack
Government Interference
Economic Squeeze
Medicaid/Medicare catastrophe
Labor Costs & Turnover
Access to Funding
Medicaid/Medicare
25
29
14
5
Economic Squeeze
Medicaid/Medicare
Economic Squeeze
Labor & Turnover Costs
Labor Costs: 70%
Turnover rates: 40% - 166%
CNA Turnover: 70%
Costs: 25% of annual compensation
Economic Squeeze
Access to Funding
Economic Squeeze
Resource Shortage
Aging of America
High-Growth Market
Fewer Trained Workers
Hospital Releases
Aging of America
Population Over Age 65 (in Millions)
65+
72
2000: 35 million
2010: 40 million 55
2020: 55 40
million
35 72 million
2030:
6.5% 65+ in residential care
Resource Shortage
High Growth Market
Direct Care Workers 2nd Largest Occupational Group
New Job Growth:
1. Registered Nurses
9. Nursing Aides, Orderlies & Attendants
Community Care Facilities: up 31%
Nursing Care Facilities: up 28%
Resource Shortage
Fewer Workers
1,113,000 needed
850,736 available
Needed
Available
Resource Shortage
Hospital Releases
1985 - 2000
1985-2000
Resource Shortage
Workload Pressure
Higher Acuity
Staffing
Litigation Pressure
Higher Acuity
Diabetes
Deaths in Nursing Homes
Alzheimers
ADL Dependence
Workload Pressure
Staffing Shortage
Workload Pressure
Litigation
Workload Pressure
Union Attack
Survival Requires Growth Markets
Targeted Campaigns
Political Influence
Growth Markets
Union Attack
Targeted Campaigns
Union Attack
Political Influence
Union Attack
Government Regulation
Specialty Healthcare
DOL/OLMS Rule Changes
NLRB Rule Changes
Specialty Healthcare Rehabilitation
Center of Mobile
Government Regulation
DOL/OLMS Persuader “Advice” Exemption
June 21, 2011 Notice of
Proposed Rulemaking:
The New Rules (proposed)
Proposed Rulemaking
• Not a final rule
• 90 days to comment
• In effect after comment
period
• Comment by web
(regulations.gov), handdelivery or by mail
• Reference 1215-AB79 and
1245-AA03 (29 C.F.R. Parts
405 and 406)
Persuader activities include drafting,
revising or providing:
1.
2.
3.
4.
5.
6.
Materials for presentation, dissemination,
distribution to employees
Speeches
Audiovisual, multimedia presentation
Website content
Planning, conducting one-on-one or group
meetings
Employee attitude surveys concerning union
awareness, sympathy or “proneness”
Government Regulation
DOL/OLMS Persuader “Advice” Exemption
June 21, 2011 Notice of
Proposed Rulemaking:
The New Rules (proposed)
Proposed Rulemaking
• Not a final rule
• 90 days to comment
• In effect after comment
period
• Comment by web
(regulations.gov), handdelivery or by mail
• Reference 1215-AB79 and
1245-AA03 (29 C.F.R. Parts
405 and 406)
Persuader activities include drafting,
revising or providing:
7.
8.
9.
10.
11.
Training supervisors to conduct meetings
Coordination or directing activities of supervisors
Establishing or facilitating employee committees
Developing personnel policies
Deciding which employees to target for
persuader activity or disciplinary action
12. Conducting a seminar for supervisors
13. Other (must explain)
Government Regulation
DOL/OLMS Persuader “Advice” Exemption
Watch Webinar and Get Other
Resources Here:
http://lrionline.com/olms-advice-rule
Comments Due September 21, 2011
Government Regulation
NLRB “Quickie” Elections Rule
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
Hearing suspended to postelection if issues effect less
than 20% of unit
Provide voter phone
numbers, email, shift &
departments within 2 days
of direction of election (and
immediately to Board)
Key Changes
Government Regulation
NLRB “Quickie” Elections Rule
Election can be held within
10 days of transmission of
eligibility list (or earlier if
union agrees)
Election Notices required
(electronic posting required
where possible)
Use of electronic signatures
to support a showing of
interest
Review all individual voter
eligibility issues postelection
Key Changes
Government Regulation
NLRB “Quickie” Elections Rule
Watch Webinar and Get Other
Resources Here:
http://lrionline.com/nlrb-streamlinedelections
Comments Due August 22, 2011
Government Regulation
What Do I Do Now?
Comment
Political outreach
Proactive ER
Government Regulation
Left of Boom
Left of BOOM
BOOM
Hiring/Onboarding
Positive ER, Engagement
Vulnerability Assessment
Tripwire Team
Right of BOOM
Counter-Campaign
Strategy
Situation Assessment
Alert Legal, Consulting,
Jump Team
Frontline Focus
Goal
Actual
In-Group
40%
35%
Partially Affiliated
30%
18%
Neutral
20%
23%
Partially Disaffiliated
20%
10%
4%
Out Group
How Companies Screw Up Training
You don’t need one of these
How to Evaluate Effective Training
Active intervals - “bursts”
Awareness, values, skills
Accountability
Leverage self-learning
Intervals shrink the knowingdoing gap
Try Active Intervals
Values
Skills
Try one module FREE
One pulse survey FREE
Copy of Next 52 Weeks
Awareness
Webinar Conclusion
To participate in
training or pulse
survey call Greg at
800-888-9115 or email
gkittinger@lrims.com