OUTCOME (continued from MEDICARE COVERAGE SOLUTION)

In our businesses: our accounting, consulting clients and owned facilities were able to discharge 43,500 more patients than they had before we got involved, because of our Caregiver Management System.  Over the years, I setup spreadsheets documenting the successes in restoring bodily and cognitive function for patients that were discharged home or to the community compared to previous outcomes. As a result, our clients became better providers of rehabilitation therapies because they were assured they would be paid by Medicare for the services, and even though some would be denied our firm handled the appeal and they got paid anyway.  They also increased their occupancy because the more they discharged patients to home, rather than readmitted to the hospital or on Medicaid for years or going to the grave too early, the more admissions came to their door.

In 2004, when my wife’s mom was killed in a nursing home, we decided to try to implement our ideas and systems in our own nursing homes. In, 2009 we purchased three skilled nursing facilities (500 beds) and had to turn them into something other than warehouses for the elderly and disabled.  This took $1.5 million dollars of physical improvements just to get them presentable and smelling like home.  We had to replace over 500 staff over the 6 ½ years we owned them just to get a professional looking and acting team.   We implemented the team concept for staffing so we wouldn’t be short of help and instituted different attractive uniforms that depicted their roles and improved the food, activity programs with “happy hour” each Friday, therapy plans of treatment and nursing restorative programming.

Our families loved our activity programs that included music, trips outside the facility, celebrations for every holiday, birthdays for all the patients (I called them patients not “residents” required by our regulators because they were there to get better and leave not rent out rooms). Shari was the Administrator for All-American Care of Washington (Iowa) and I was the Administrator for All-American Care of Muscatine (Iowa) and for a time All-American Care of Little Rock (Arkansas).  Kip Rhoads was the Director of Systems and operational software, who implemented computers in each of the All-American Care facilities so we could implement the Caregiver Management Systems. After some frustrating confrontations with the regulators who were not interested in our innovations and continued to harass us to the point we felt they ran the homes not us we were forced to sell them to another warehouse … and be sure we were running them far better than our predecessor who they had blessed with their narrow definition of quality of care and life.   Typically, some 75% of the nursing homes are not owned locally and merely function as a real estate investment not a people business.  We believe that a proven franchise model (enterprise model) is a part of the solution that we have been seeking for 50 years under government control.

How does any of this translate to our How to Live Forever book, our current endeavor. Obviously, our success with Medicare and Medicaid patients and disabled veterans is something we are very proud of.  We lost some battles with the Federal and State government from their bully pulpit but we feel the war is not lost.  The war of preventing chronic diseases and preserving the health of our aging Americans is where we can be most effective.   The book focuses on the 12 habits for healthy aging using approaches we perfected in our own lives and in the lives of over 43,500 of our patients in over 140 locations in the country.  There are 77 million baby boomers filing for Medicare and Medicaid at the rate of 7,000 per day.  Obama Care certainly leaves them dependent on younger populations that aren’t going to sign up till they get sick.  Trump Care is struggling to get a foothold on a better way without a solution.   In All-American Care and my books we were proposing that our Caregiver Management System become the standard and that cost accounting be the underlying solution for making the providers accountable for their costs and prices.

Without this standard there will be no containment of costs or chronic diseases since the beneficiaries don’t internalize the necessity for them to be responsible for their own health and welfare. Our proposal is to move away from government managed care to enterprise managed care.  Then all beneficiaries under the new form of health insurance (as “my fault insurance”) are responsible for staying healthy at their own cost (investment) through health insurance withholding savings accounts.  Then health care isn’t a “right” but a privilege as it should be.  It’s internal to their share of the cost, that increases the accountability and competition for providers, by focusing on the 12 habits for healthy living … see www.lifestylesforaging.com for the way to SHIFT (Self Health Investment Funding Trust) the paradigm to chronic disease prevention and preservation of health from government to every American.  With the beneficiaries being their own buyer of services, with only a mutually owned Fiscal Intermediary approving payments, there is no need for deductibles, coinsurance and limitations on preexisting conditions and catastrophic coverage … as safety nets Medicare and Medicaid still supply risk pool insurance funded by a percentage of the withholding accounts.  This type of system is currently practiced in Singapore that has the lowest cost per covered lives and is number one in quality.