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Robert Abrams: "I Want to Create the Nursing Home Community"

February 1, 2004
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Interview with Robert Abrams, founder of MyZiva
Robert Abrams: 'I Want to Create the Nursing Home Community'

INTERVIEW WITH THE FOUNDER OF MYZIVA The late 1980s were an auspicious time for multitalented Robert Abrams. After several years of working in special education for the developmentally disabled, Abrams-in the space of one week-got a nursing home administrator's license and took the New York State Bar exam, preparatory to becoming a healthcare lawyer. That was in 1987. That same year saw Congress pass the now-famous (or infamous) OBRA '87, as well as the creation of a new legal field called elder law. Abrams soon became the first chair of the New York State Bar Association's Elder Law Section and proprietor of his own law practice devoted to nursing home compliance with federal and state law. Over the years the practice grew to represent more than 100 nursing homes. In 2000, when he merged the practice with the New York law firm of Fensterman & Fensterman, Abrams served a second New York Bar chairmanship-the Health Law Section-and had authored professional and consumer-market books on guardianship practices and basic health system knowledge for baby boomers. He decided that year to put it all together-the social concern, the legal expertise, the media experience-to develop an information technology platform he called MyZiva ("ziva" being the symbol from Slavic mythology for a long and healthy life). Under the mantra that long-term care providers and consumers are not adversaries, but collaborators in promoting quality care, Abrams has since committed more than $5 million and all of his time to spreading the word about the MyZiva platform, which he believes will create a true nursing home community. Recently he fielded several questions on his long-term care observations, philosophies, and hopes for the future in an interview with Nursing Homes/Long Term Care Management Editor-in-Chief Richard L. Peck.

Peck: First, can you provide a brief description of MyZiva?

Abrams: It is a comprehensive Internet-based platform that provides valuable resources and applications for the entire nursing home community. Our consumer application, MyZiva.net, provides consumers with a wealth of information about searching for, evaluating and paying for nursing home care, along with a section that allows providers to tell their own stories. Our provider platform, MyZiva.com, is a suite of management, financial, clinical, and regulatory information that enables providers to manage their facilities better with more up-to-date knowledge of their own operations, their competitors' operations, and regulatory changes, and to engage in continuing education. The site is aimed at helping them to address their end of the quality-of-care equation in long-term care.

Peck: What led you to conclude that so much information was required and demanded in this field?

Abrams: There seemed to be a growing disjunction between consumers and nursing homes, and between nursing homes and government. Consumers were perceiving most nursing homes as cold, uncaring institutions interested primarily in money. On that basis, nursing homes were an easy target for news media and politicians seeking to score points with consumers; moreover, government regulators and, more recently, plaintiff's attorneys seemed more than willing to take that same tack. Meanwhile, nursing homes felt beleaguered, ostracized, and misunderstood. None of these perceptions are wholly accurate or necessary-not if people have the information they need. The impact that such an adversarial and destructive environment has on resident care is of greatest concern.

Peck: Recently your organization published a study of the nursing home field that some might take as somewhat unflattering-finding, for example, that nursing homes nationwide had been hit with survey deficiencies 44% of which could have produced "possible harm." The study also found that there was no absolute linkage between quality and reimbursement or staffing. Would you elaborate?

Abrams: First, all of this indicates the objective stance we take with the industry. Although it is clear that some providers are not providing the quality of care that we want, that 44% also indicates problems with the survey process itself-for example, that "harm" is not clearly defined, nor are the surveys conducted consistently from state to state, or even within states. It shows that people have to look past the numbers to truly evaluate nursing homes.

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