NURSING HOME REFORM NEWSLETTER

May 15, 2006
 

WANT TO STAY AT HOME?

Beginning next January, Medicaid will pay for in-home services for individuals who are "at risk" of going into a nursing home, according to Mark Birdwhistell, secretary of the state Cabinet for Health and Family Services.

Mr. Birdwhistell said that people on Medicaid in nursing homes now would not be affected by the new policies being handed down to the states by the federal government.

This is part of a new "flexibility" being put into Medicaid by the Feds. States have been given more say in how they use their Medicaid dollars under the Deficit Reduction Act of 2005. Mr. Birdwhistell said there will be some cases under Medicaid where the state will once again have to seek a waiver.

In the administration of Gov. Paul Patton, which was also seeking to save Medicaid dollars, people were turned out of nursing homes because the state officials claimed that they did not qualify for institutional care under the Medicaid guidelines then. The Fletcher administration changed that as soon as it came to power in Frankfort, and no more people were ejected.

"This is a major, major shift in federal Medicaid thinking," Mr. Birdwhistell said. The only downside, he added, is that paying for people to stay in their homes will be available just for people in a certain income bracket. He did not outline what those brackets are.

He also told us that the state is working on how they will identify those people who are "at risk" of going into a nursing home.

He made the announcement at the spring meeting of the Special Advisory Commission of Senior Citizens.

HIS ELOQUENCE ADMIRED

Mr. Birdwhistell said that he learned first-hand "all of the horror... the pain... the downsides of a nursing home" because two of his relatives ended up there. His eloquence against nursing home care was refreshing, and would make one think that he could be a supporter of Kentuckians For Nursing Home Reform. We have said all along, however, that once you experience nursing home care first-hand, you want to see the care improved. Apparently Mr. Birdwhistell thinks he can do that by keeping people out of nursing homes. His other motivation, however, has to be keeping spiraling nursing home Medicaid costs down.

JUST REMEMBER, MR. BIRDWHISTELL...

We would like to respectfully remind Mr. Birdwhistell that there will always be a need for institutional care, that is, care in a nursing home. That is why we remain dedicated to improving the care in those facilities. The No. 1 task is to improve the staffing ratios in nursing homes. We badly need more people taking care of nursing home residents in most nursing homes in the state. There are many other issues besides staffing that we are also dedicated to, and we must tackle one at a time, which we are.

We were most fortunate to get three issues we backed passed by the 2006 Legislature and signed into law by Gov. Fletcher. But there are more issues out there.

We would hope that no one would have to go to a nursing home. But there often are family and medical reasons that people cannot be cared for in their homes or community agencies for the elderly. Just because Medicaid is finally letting some people stay in their homes is no reason to let down on our effort to protect from harm the people in nursing homes or the ones who inevitably will be there. That should be a goal of Mr. Birdwhistell and his cabinet colleagues, too.

WHAT ABOUT THE NURSING HOME BARONS?

The head of the industry lobbying group that represents nursing homes, Rich Miller of Louisville, says "We support a full continuum of care." They say that the nursing homes in Kentucky are only about 89 percent occupied. Is Mr. Miller worried? "Bottom line, no," he said, pointing to other alternatives to long-term care and the burgeoning of assisted living facilities. We think these "Barons of the Bottom Line" are worried but feel that the growing numbers of old people will bail them out.

WHERE’S THE RUB?

Who’s going to decide, and how are they going to decide who gets Medicaid to stay in their homes? And is it really cheaper for the state to take care of people in their homes and communities than in a nursing home? The state and feds are working on how to decide who will be "at risk" of going to a nursing home (see items above), and let us know by the first of the year. The University of Kentucky is doing a study to help on this big task. And there have been other studies that say it really is not less expensive to take care of people in their homes instead of at a nursing home. And where will all the caregivers come from to visit all these homes?

Lots of questions for the state boys ("The Men in the Black Suits") to answer, but the big one will be this: Who gets to stay home with Medicaid funding paying for it; and who has to go to a nursing home?

Ah, there’s the rub.

GRABBING HEADLINES

Kentucky Gov. Ernie Fletcher grabbed a few good headlines recently by announcing the new Medicaid program for Kentucky, saying "...we are the first state to put a program such as this in place..." The governor said the new program will save the state "billions of dollars" in the next seven years." Asked how the new program would affect people in nursing homes, "Gov. Fletcher said, "We’re not changing the benefit package." He said the new program is called "Kentucky Health Choices." He had a chart beside him at his press conference that said one of the features of the program is that it "increases the use of home and community services rather than institutional, long-term care services."

ADVOCATES MISSING AGAIN

Your organization -- Kentuckians For Nursing Home Reform -- lobbied state officials to make the new Medicaid program one that would not hurt people in nursing homes. And so far, so good. We were worried as the program was laid out, however, because there was a consumer advisory committee, but with no nursing home reform advocates representation. Some of those who were on the advisory committee were not the ideal type representatives of the "Forgotten Kentuckians."

$20 MILLION!

A jury in Franklin Circuit Court has awarded the estate of a man who died in a nursing home in Frankfort $20 million. Said his daughter, Wanda Delaplane of Lexington, about the verdict: "I hope it is heard by a lot of people." Said her attorney, Ken Connor of Lynchburg, Va.: "Send a message to Beverly that if you come to Kentucky, you better take care of ‘em." The suit was against Beverly Health and Rehabilitation of Frankfort. The nursing home is owned by Beverly Enterprises, the second largest nursing home corporation in the nation. They have nine nursing homes in this state.

The trial centered on charges that Beverly allegedly failed to promptly respond to cries for help from Loren Richards, Ms. Delaplane’s father. There was considerable testimony alleging a shortage of sufficient staff in the nursing home.

CHARTING PARTIES

The big trial in Frankfort lasted seven weeks. One piece of information that came out alleged that charts for patients were not kept up to date, and in order to do so before state inspectors arrived, the nursing home would have "charting parties" for staff to fill in the blanks with anything they wanted but to make the facility look like it was in compliance.

SHORT STUFF

* Rep. Tom Burch, D-Louisville, says he is looking for "input and suggestions" for his new subcommittee on aging, disabilities and long-term care. They were about to leave out "long-term care" in the subcommittee mix, when a representative of Kentuckians For Nursing Home Reform spoke up, and Mr. Burch and his committee agreed to add long-term care to the subcommittee’s charge...

* Jeane Robertson of Bowling Green has suggested an Amber Alert program for the elderly for those who manage to slip away from nursing homes. She suggests calling it a Golden Alert. The state advisory commission on senior citizens voted to promote the idea in the 2007 Legislature...

* That senior advisory commission for the first time in a number of years did not pass a resolution backing minimum staffing standards for nursing homes. It was probably because Lexington activist Abby Marlatt was unable to attend. She championed the cause of staffing standards...

* And congratulations to Ms. Marlatt on receiving an honorary degree from the University of Kentucky. She was a longtime faculty member there...

* Attorney General Greg Stumbo has a new "Manual for Prosecution of Crimes Against the Elderly." It is the work of Assistant Attorney General Pam Murphy, who in the Patton administration was the state inspector general in the Cabinet of Health and Family Services. She now heads the attorney general’s Medicaid Fraud and Abuse Control Division. They have set up a toll free number to report neglect and abuse, 1-877-ABUSE-TIP (1-877-228-7384)...

THE ILL-FATED LETTER

The official newspaper of the Roman Catholic Diocese of Lexington would not print a letter-to-the-editor we sent them criticizing their lobbyists in Frankfort for not supporting minimum staffing ratios in nursing homes. But don’t blame the newspaper’s editor. The bishop of the diocese nixed it, the editor told us. We thought that our Catholic readers, at least, should read our letter, so it is reproduced on our web site. Just go to
http://www.KyNursingHomeReform.org to read it for yourself.

QUOTE OF THE MONTH

"The (long-term care) system is broken... The costs are just ridiculous... There is a stigma, the lack of sufficient staff." -- From remarks by the new state long-term care ombudsman, Larry Smith, speaking to a group of senior citizens.

P.S.

THE NAKED TRUTH

The old farmer had a large pond in the back, fixed up nicely; picnic
tables, barbecue pit, horseshoe courts, along with some apple and peach trees.

The pond was properly shaped and fixed up for swimming when it was built.

One evening, the old guy decided to go down to the pond and look it
over. He hadn't been there for a while. He grabbed a five-gallon bucket to bring back some fruit.

As he neared the pond, he heard voices shouting and laughing with glee. As he came closer, he saw it was a bunch of young women skinny dipping in his pond.

As he approached, he made the women aware of his presence.

At once, they all went to the deep end.

One of the women shouted to him, "We're not coming out until you leave."

The old man frowned, "I did not come down here to watch you young ladies swim naked, or to make you get out of the pond naked."

Holding up the bucket, he said, "I'm here to feed the alligator.

Moral: Old men can still think fast.

DON’T FORGET...

MORE THAN 23,000 PEOPLE IN NURSING HOMES IN KENTUCKY NEED US. THEY ARE KENTUCKY’S FORGOTTEN PEOPLE.

AND BY THE WAY...

We love to hear from you. Tell us your experiences with the nursing homes and let us know if we can use your letters in this e-mail newsletter or web site. Many of your comments we also share with legislators. And we do not use your names or the names of the facilities if you so request. We appreciate your suggestions, too. Our e-mail address is below.

BERNIE VONDERHEIDE

KENTUCKIANS FOR NURSING HOME REFORM

E-mail:
KyNursingHomeReform@yahoo.com

Telephone: (859) 312-5617