Hi,

    My name is Joe Jacobi. I have been a Registered Nurse since May 1993 and have worked as a Certified Nursing Assistant from 1991 until I was licensed as an RN. Early on I worked in hospitals, and home health for about 3 years and then worked exclusively in nursing homes since then with a one year stint as a Director of Nursing in a 126 unit Assisted Living Facility on Oahu in 2019-2020. In 2004 I started working as a Director of Nursing and in 2008 I added “Consultant” to my resume. At that point I began taking temporary assignments in 9 states lasting from 30 days to 18 months. The assignments consisted of filling the DON position while the company searched for the “right candidate.” Some assignments were in facilities that recently completed their annual survey by the state health department inspectors and the outcome was known as Denial-of-Payment. That means any new admissions funded by Medicaid or Medicare, will not be reimbursed by the state/Feds until the health department is satisfied with the Action Plan developed to prevent another occurrence of the offending practice. That process effectively shuts down admissions while discharges continue along with payroll and all the expenses associated with hiring health care workers and the costs associated with operating a healthcare facility.

    In my career I have worked with a multitude of MD’s, nurses, therapists, social workers, pharmacists, diagnostic laboratory managers, registered dietitians, wound care consultants, corporate consultants, state surveyors and their extenders/assistants. From these folks I have learned a lot.

    Currently I work in the home health arena for a year now. It was time for a much needed break from the 50 + hour a week wire walking without a net, balance pole and the increasing speed of those north winds. I have been retained by attorneys wanting to utilize my knowledge of Standards of Care and State/Federal regulations. I have never had any of my half a dozen or so state licenses sanctioned in any way. Haven’t recently counted but I believe I have worked in close to 40 facilities.

    I’ve never been a writer, and I’m sure it shows, but feel compelled to share insights given the current thrust to steer patients to their home instead of long term care facilities upon discharge from a hospital. This creates a tsunami of knowledge needs. In addition there is a tectonic shift currently occurring  in the Long Term Care industry. subscribe?

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