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Consistently legislation of how much staff is enough continues to be on the agenda of the lawmakers and hopefully they will let it lie until we have a better measurement efficiency, acuity and effective management tools including point of service software systems.

Staffing for medical, psychological, social and emotional problems is the challenge since the needs are different for each case and episode. So to dictate staffing on a Per Patient Day is insane … or how many RN’s … or using and MDS assessment rather than the care plan and the outcome goals. The best system is a care plan that links in standard costing principles … labor minutes modeled by interventions linked to medical and therapy diagnosis, problems and measuring outcomes using the predetermined goals.

This is not only best but logical for deductive processes to manage the patient centered care touted by CMS … of course this will be rejected as not administratively simple … in other words why would CMS want to do it right. And why would the providers accept anything less. I’m sure Trump would get it but can he deliver it. If anyone is interested this proposal going from averaging rates to managing care can order my book “The Boomers Are Coming” from Kindle or other publishing outlets.  Jerry Rhoads