JLW,RN

Hey guys, I currently work for HCR ManorCare. Some of the info above was close, but not quite the truth. This company used to be two separate companies. ManorCare was a company that, at one time, specialized in attracting private pay clients. As such, their facilities and staffing were actually quite good (especially for a publicly held company). HCR (Health Care and Retirement) was a smaller company who "merged with" (read: acquired) ManorCare in 1998. I worked for the old MC as a DoN, and later as a consultant. I left for four years, and returned (recruited back by a friend of mine) a couple of years ago. There are a couple of things every nurse will want to be aware of when interviewing with the company. 1. The company focus for the last three years has been to maximize revenue and profits by focusing on very ill, very complex subacute residents who are paid for by Medicare or Managed Care (their term for it is "M2"). This focus has caused them to increase their profits enormously over the last few years (look up their stock "HCR" and see how the Earning Per Share [EPS]) has skyrocketed). That, in itself would not be bad, except.... 2. In the facilities I work in, the staffing has not been increased to handle the extra workload involved with the high admission and discharge rate required to maintain the "M2" census. This may not be true in all facilities, but if they are looking to hire you on their "Medicare" or "M2" unit(s), I'd be quite leery. Also... 3. In many place the marketing department is the most aggressive I've every seen. There are facilities in which they do not want the DoN or Administrator involved in the admission process in any way - because they might say no. I've seen cases where residents have shown up requiring special equipment or medications, which were not provided timely because of the "no-notice" admission. All that having been said, some of their facilities are quite well run, and nice to work in. I would not take the above as a condemnation of every facility, but it's certainly some things to keep in mind. Hope this helps. Good luck. J

Hey guys, I was wondering if anyone on the board had taken the exam recently? I'm getting ready to take it and was wondering what feedback others might give me? Thanks in advance... J

This is the very thing I've hated the most...the nature of "for profit" long term care, especially in large publicly held companies. For a long time, I thought that long term care should be a non-profit profession, but realized that would never happen, since we're a capitalistic society (which is not bad per se, just has its dark side). Unfortunately, there is little reward for giving good care (just give good enough to keep the beds filled and to keep out of serious trouble with the state), and little penalty for giving poor care. I'm thinking now it would be better if nursing homes and companies were evaluted every year (say...using the annual survey, a customer satisfaction survey, and an employee satisfaction survey). The facilities in the state that were above the state average this year would get a "quality bonus" next year (20%?), the facilities that were below average would get a "quality penalty". Be below average a couple of years running, and you'd be out of business. Be above average a couple of years running, and you'd make your stockholders happy. What do you guys think? I've been working on a book proposing changes in long term care and would love to hear any ideas.

I couldn't help but weight in. I became a nurse following a tour as an infantryman with the 82d Airborne Division. I've found that there may be a certain percentage of people with a preconception about men as nurses, but 99% of them will judge you based on how you carry yourself...period. When I still lived in Fayetteville, I'd get some flack from the young paratroopers out in nightclubs, but "coining" them (showing them my unit coin) usually shut them up. I also enjoyed being the "rare" commodity in my nursing class. (Something I occassionally remind my wife of, just to get under her skin!)

You did the right thing. Good for you. Let us know how it worked out.