Just one more question

Like the great TV detective Columbo, Long-Term Living

columnist Gary Tetz (Funny You Should Ask) always has one more question. In this bimonthly feature, he talks with long-term care leaders about anything that pops into his mind. He’s as surprised as you are that they’ll speak to him, and apologizes in advance for whatever inanity he might blurt out in the pressure of the moment.

This Month’s Victim:

Rev. Daniel W. Farley, PhD, CNHA

President/CEO, GlenWood Park Retirement Village

Princeton, West Virginia

Besides his duties as president and CEO of a West Virginia CCRC, Rev. Daniel W. Farley, PhD, is also chair of the state’s licensing board for nursing home administrators. He has served as president of both the West Virginia Health Care Association and the American College of Health Care Administrators. In addition, he was twice appointed as a delegate to the White House Conference on Aging.

Farley is an in-demand presenter at state and local conferences and has been frequently published on the pages of this very magazine. Although my call came as a massive winter weather system was closing in outside, he didn’t seem concerned.

Aren’t you in the teeth of a blizzard out there?

This is true.

I’m not sure you should be talking to me at a time like this. But in long-term care we’re always looking for a good metaphor, so does the impending storm remind you of all those Boomers headed our way?

Well, it really does. For some time I have thought that based on what’s happening with the graying of our population, we are heading to a perfect storm.

To drive the metaphor into the ground, are you saying quality is going to skid into the ditch, budgets are going to turn upside-down, and bad political vision will hamper rescue efforts?

I do think that is going to occur, no question about it. We’re in for a real stormy situation.

You’ve been watching this for a while. What can you say to make us feel better?

All I can really say is that if we’ve got the endurance we’ll be okay on the other end. But I think it’s going to be very, very challenging over the next 20 years. One of the things we’ve got to play up more is just how important the generational change is going to be. When we take a look at the Boomers, there are roughly 80 million. But when we look at Generation X, the children of the Boomers, we know the birth rates were down to arguably 46 million. And nobody in a public policy position is really talking about how we’re going to deal with a shortfall of 34 million taxpayers. I think that’s pretty important stuff, particularly at a time when we’ve got such deficit spending and high unemployment.

We’ve known the Boomers are coming for a long time. Why aren’t we prepared?

My sense is that the Boomers have been in denial about aging. They thought it was going to happen to other people, but never to them. So they’ve been more interested in the here and now than in looking to the future.

You’ve written a lot about the importance of high ethical values in long-term care. Where’s the money in that?

Well, sometimes money’s not everything, Gary. And if there is money in it, I think it’s at the end of the day. If the people you’re serving and their families see that you’re consistent in the way you practice, consistent with your beliefs, consistent with how you care for their loved ones, I think you go up a rung or two on the ladder of their appreciation.

It’s how you live it and whether people come to believe you are a person of character and ethics. Because we’re living in a day and time when there’s not a lot of that going around.

You’ve also advocated for more aggressive self-policing for long-term care administrators in your state. How has that been received?

I’ve had the privilege for a number of years to chair the licensure board for administrators in West Virginia. A couple years ago, one of the things we did was put an ethical provision in our regulations that essentially said if you as an administrator put yourself in a situation where you don’t know the difference between right and wrong, that ethical violation could cause you to lose your privilege to practice.

We were pretty faithful in implementing that, and as a result, one of the things we enjoy in our state is a group of administrators who do the right thing more than the wrong thing. Over the last two or three years, we haven’t had to take any significant action, or revocation of license, so we think it’s had a very positive effect.

Self-policing is bound to be unpopular with some, as they’re forced to take a hard look at themselves.

That is so true. But in the long run, if we can do a better job of policing ourselves, the time might come when we don’t have to have so much regulatory oversight. And as we are getting to a point of finite resources, it’s going to be more important for professions to take care of themselves and clean up their own acts.

You also have strong feelings about what should happen when consumer complaints prove to be baseless. You believe accountability goes both ways.

It certainly does. In certain jurisdictions of the country there are laws on the books for frivolous action, and the plaintiff in that situation can be caused to pay some court costs. So I sincerely believe when a complaint is investigated in a long-term care setting and is not substantiated, there ought to be a way to go back and recover some of the costs that were incurred in the investigation.

I go back again to finite resources, back to the storm we’re going to be in for 20 years as money gets tighter and tighter. I think government is going to need to agree. If there is a legitimate complaint against a nursing home and it is found to have substance, then the organization ought to step up and rectify the situation. But on the flip side, if they haven’t done anything wrong to earn negative action, the state should have a way to go back and recover dollars from the complainant.

Is there any system like that in place anywhere right now?

There isn’t that I know of, and I know it’s going to be an uphill battle. But I’ve talked to the director of the agency responsible for surveys in our state, and I plan to begin capturing statistical data on the number of complaints that are filed in a certain calendar period, and how many of those were not substantiated. After that, I’m hoping to be able to get a bill introduced to address the issue.

Now, I don’t kid myself into believing it’s going to be easy; there will be a popular persuasion against it. It’s just the nature of our society today that people want to try to hold others accountable, even when many times there’s nothing to be held accountable for. But if I can get this in the mind of the legislature, things have a way of then getting into the mind of the public, where more and more people can begin to believe we’ve got to do a better job in spending taxpayer money.

Well, I should probably let you go, so you can battle the storm. But I notice you have a “Rev.” in front of your name.

Yes, I’m an ordained deacon in the United Methodist Church. [AAHSA President] Larry Minnix is an ordained elder. There are only two orders in the church. He has one and I have the other.

Who uses more Biblical metaphors, you or Larry?

Well, it would be very difficult to say. My guess is Larry does.

You have both a Rev. and a PhD. Which is more useful when you’re trying to get out of a speeding ticket?

I don’t know how it is in your part of the world, but I’ve never found either one of them to help. I think we are living in a day when it doesn’t make any difference what you call yourself-it’s what people see and how you live it. So you better keep titles in perspective.

To send your comments to the editor, please e-mail mhrehocik@iadvanceseniorcare.com.

Long-Term Living 2010 March;59(3):56-58

Gary Tetz

Gary Tetz is multimedia consultant at Consonus Healthcare Services. He was a columnist for I Advance Senior Care / Long-Term Living from 2005-2012.