Future-Ready Facilities: Introduction

I'll never forget my first day working in long-term care. I was coming from working at Liberty Mutual as an insurance salesman. I used to sell home and auto insurance, that kind of thing. I was changing courses and starting my AIT to become an administrator. On the first day I arrived, the administrator locked me away in an old admissions office, threw massive stacks of paper on the desk, and said, "Andrew, I need you to audit the personnel files for me." Naturally, I said, "Huh?".

You have to understand that I was coming from a Fortune 500 company; I may not have used a single piece of paper while I was there. It was all on our nice new computers with double screens and shared folders. Now, I was sitting in an admissions office looking through the 100-page personnel file of a dietary aide who started working at the facility in 1992, trying to find the crinkled piece of paper with a coffee stain on it that showed she wasn't listed on the abuse registry. And it was difficult because the computer monitor was taking up half the space on the desk, it was so big.

The little culture shock on my first day was just a tiny piece of the state of technology in long-term care. We all know it needs work. This article series is all about that technology. Operating a long-term care facility is only becoming more complex. Well, adding some focus on your technology will only help increase the capability of your facility and make your life less stressful.

I'm Andrew, Vice President of Operations at Choice Companies. I grew up in a family of nursing home people. My mother was an administrator and operator, and she was a great one, which meant she was always working, and I was constantly running around in her facilities. My sister, aunt, cousin, and cousin's cousin all worked in long-term care; it's in our blood. My first words may have been, "State is in the building."

On the other hand, I always said there was no way I would get into the field. I wanted nothing to do with the problems I saw my family dealing with. I always said there was no way I would be an administrator and that I would never live in Cleveland. The next thing you know, I was the administrator at a facility in Cleveland, the same facility where I used to run around as a kid. Don't you hate it when your mom is right? I spent 3 years working for a larger company in long-term care, where I was stationed at eight different facilities, administrator of four of those. I then moved to the ancillary side of healthcare when I transitioned to Choice Companies to run Choice IT Services and Choice Supply Company. Now, I focus on supporting those in the industry.

So, IT. It's something that all of us only really look at when something is going wrong. You'll be surprised to hear that we don't get that many calls at Choice IT from users just to let us know that their internet connection is working great. But I understand. You're just trying to take care of your residents; you don't care about upgrading your tech, sometimes you're just trying to get through lunchtime. Well, let's talk about some things that are coming that make the focus on technology more critical than it ever has been.

Staffing.

Everyone's favorite. I'm sure some of you have had to check your phones a few times today to make sure that your staff is showing up for the second shift. Well, I have some bad news. It seems like it's going to get worse.

There are currently 58.8 million people aged 65 or older in the US, about 16.9% of the population. The United States Census Bureau estimates that by 2050, that number will grow by 23.2 million for a total of 82 million people in the US aged 65 and older, which is 22% of the population. A 32% increase from now.

This already presents a strain on the system; we're going to have more people in need of long-term care. But then you factor in the increasing issue of healthcare worker shortages; based on current projections, it's estimated that by the same year, we'll have a shortage of about 700,000 RNs. RNs will only account for about 0.17% of the population.

With this, we have a larger gap developing when it comes to the demand on nursing homes and the available staff to help take care of that demand. Embracing new technologies is going to be a critical factor in staying afloat.

Cybersecurity

Something we hear about quite a bit but doesn't seem to be one that would affect us. According to the US Department of Health and Human Services, from 2018 to 2022, there was a 93% increase in significant data breaches, with a 278% increase in breaches involving ransomware. Ransomware is exactly how it sounds; a hacker holds your data or devices hostage until you pay up. CMS even released a memo in June of this year warning providers of increased phishing scams for medical records. You know, if CMS is putting out a memo, it's a real problem. We had a customer recently that was under attack for about a month. They had a similar style of hacker trying to break into the system from different angles. The problem is that these people talk with one another; real humans are on the other side. And there are lists out there. If a group thinks someone is vulnerable and they attack, there's a high chance that it will end up causing more attacks; it's a ripple effect.

Let's talk about what this looks like.

Have you heard of phishing? With a "ph", not an "f". This is where a hacker sends a link or a file via email, and just by a user clicking on this, it gives the person on the other side full access to the recipient's system. The tricky thing is that with everything being so connected if one user in a system is corrupted, the entire system is. You can have a housekeeping director at one of your facilities in Utah click the wrong link, and your CEO in Pennsylvania is at risk of being compromised.

Then, we have social engineering. Now, the defense to this isn't as simple as "don't click the link." These are thought-out and meticulous plans that try to manipulate individuals in a system. You may receive an email from someone; the display name says "Andrew Perkins," but I definitely didn't send that email. That's why it's always important to look at the email address from which something is coming; sometimes, you'll see it has the name "Andrew Perkins," but it came from a Yahoo email. Other times, it may be extremely close to the email it should be, with something barely different. They could have added one letter or hyphen to the email address. Everything else in the email address could be identical to mine, but I'm not on the other side of that chain. And in some cases, it may come from my actual email! They could be inside my server, sending emails from my address, and have a rule set up where those sent emails are automatically deleted from my side and the same with any replies you send back so that they could be having a whole conversation with you from my email inbox, and I have no idea.

There are all kinds of things that can happen, so you always have to stay vigilant. And if something seems off in an email, i.e., grammar or the nature of the request... Listen, if the owner of your company emails you to ask if you'll go buy some gift cards, you probably shouldn't. Always pick up the phone and call the person to confirm, and make sure you send it to your IT provider. If they know what they're doing, they'll take care of it.

These are just two of the threats we're facing. I didn't even touch on the operational headache that comes with lagging technology. In this series, I'm going to discuss some of the amazing technological things coming that could revolutionize the way we see healthcare, where we are now, and some tips on how we can move things forward.

We all come from different places and do different things. But when it comes down to it, we all want the same thing: to improve this industry. Well, by educating ourselves and taking the first step, we can do that together. Thanks for reading, stay tuned for more.