August 4, 2008
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
MARK YOUR CALENDARS NOW FOR THESE FREE SEMINARS!
SUNDAY, SEPTEMBER 14, LEXINGTON
What’s Your Question About Nursing Homes?
With a Lexington nursing home ombudsman, a top nursing home attorney, and a representative of the state Office of Inspector General there to answer any question.
2 p.m. at Tate’s Creek Branch of the Lexington Public Library
SUNDAY, SEPTEMBER 28, LOUISVILLE
What’s Your Question About Nursing Homes?
With a Louisville nursing home ombudsman, a top nursing home attorney, and a representative of the state Office of Inspector General.
2 p.m. at Beargrass Christian Church, Brown’s Lane and Shelbyville Rd.
SUNDAY, NOVEMBER 2, LEXINGTON
Who Pays for Nursing Home Care?
With a nursing home operator, an expert counselor to families on nursing home care, and a Medicaid representative.
2 p.m. at Beaumont Branch of the Lexington Public Library
ATTEND THIS ONE, TOO, IN NOVEMBER
Here’s another conference in November that is a must to attend for all supporters of nursing home reform— the Conference for Healthcare Transparency & Patient Advocacy, Nov. 20 at the Four Points Sheraton in Lexington. Kentuckians For Nursing Home Reform is an official participating partner in this meeting, sponsored by Health Watch USA, so we urge all our members to attend. There will be a discussion at the conference, for example, of minimum staffing standards for nursing homes. Go to www.healthconference.org to find out more and to register. See you there!
WASHINGTON UPDATE
It’s been a busy year in Washington for nursing home reform. An official of our national organization, National Citizens’ Coalition for Nursing Home Reform, says that is has been “one of the most promising legislative years in a very long time!” But the progress so far has happened without much help from Kentucky’s senators.
Here’s a quick update on the legislation, with the Kentucky connection, if any:
H.R. 6126, Fairness in Nursing Home Arbitration Act
The Fairness in Nursing Home Arbitration Act, passed the House Judiciary Committee July 30 after a long debate and in spite of strong opposition from the nursing home industry, the banking industry and other business interests, all the Republicans on the committee, and the Bush Administration. This is the bill that would stop nursing homes from tricking unsuspecting people applying for residency from agreeing to arbitration on any disputes with the nursing home. In the haste and confusion of getting a nursing home bed, people just quickly sign all the papers and find out later that if they want to sue the nursing home, they cannot. There are 14 sponsors of this bill, but none from Kentucky.
S. 2838, Fairness in Nursing Home Arbitration Act
The focus is now on the Senate's arbitration bill. S. 2838 is tentatively expected to be voted on in the Senate Judiciary Committee in September. Neither Mitch McConnell or Jim Bunning have signed on to support this bill.
S. 1070, Elder Justice Act
The Senate Finance Committee put off its vote on the Elder Justice Act until Sept. 10 leaving supporters of the measure with “great disappointment.” There are 28 senators co-sponsoring this bill, but not Sen. McConnell or Sen. Bunning. But in the U.S. House of Representatives, Reps. Ben Chandler and John Yarmuth are co-sponsors of the House version.
S.1577, the Patient Safety and Abuse Prevention Act of 2007
This is the bill on criminal background checks for nursing home workers introduced by Sen. Herb Kohl, D-Wi, to require screening, including national criminal history background checks, of direct patient access employees of nursing facilities, and other long-term care facilities and providers. This bill, too, has been held up for a vote until September. There are 16 co-sponsors of it, but not Sens. McConnell or Bunning.
S. 2641, Nursing Home Transparency and Improvement Act
With only few working days remaining in this Congress, the primary aim for the remainder of the time is to get more co-sponsors for S. 2641. This bill has been called one of the best pieces of nursing home reform legislation in many years, but sadly Sen. McConnell and Sen. Bunning – in spite of hundreds of calls from their constituents in Kentucky -- have not yet signed on as co-sponsors. They are not alone in ignoring this bill. There are only four co-sponsors so far in the entire Senate. Work is underway to have a similar bill introduced in the House.
WHAT DOES ALL THIS MEAN?
Note that Sen. McConnell, who is up for re-election this year, has not supported any of the nursing home reform legislation. Nor has Sen. Bunning. This in spite of hundreds of calls to their offices asking them to help our “forgotten Kentuckians.” Also, note that the only congressmen from Kentucky to support any of the proposed legislation are Reps. Chandler and Yarmuth….that’s two our of six in the Kentucky delegation in the House. So in baseball language, nursing home reform support from our Kentucky delegation is 0 for 2 in the Senate; and 2 for 6 in the House! (We try to write this stuff so Sen. Bunning can understand it.)
AN INTERESTING SIDE NOTE . . .
Sen. McConnell, a Republican, who so far has not supported any nursing home legislation in this session of Congress, is being opposed in his re-election bid by the Democrat, Bruce Lunsford of Louisville. Mr. Lunsford was the founder and top man at the big nursing home real estate company, Vencor. All kinds of charges of alleged neglect and abuse were made against Mr. Lunsford when he ran his nursing home corporation, and it was also alleged that he even kicked elderly Medicaid patients out of his facilities in Florida because he thought what the government paid him for taking care of them – the Medicaid reimbursement -- was too little. So that leaves Kentucky voters who support nursing home reform the choice between one man, the incumbent, who so far has not supported nursing home legislation in this session of congress, vs. another man who allegedly kicked elderly patients out of his nursing homes in Florida.
WHAT CAN YOU DO?
We can’t tell you how to vote in this upcoming senate election, but we can keep you informed about what the candidates say and do about nursing home reform, if anything. Our issues, however, could play a key role in the election. In Mr. Lunsford’s last election bid to be the Democratic nominee for governor, his opponent Ben Chandler ran a scathing television spot about Lunsford’s alleged mistreatment of nursing home residents. Mr. Lunsford shortly thereafter dropped out of the race and Mr. Chandler won the nomination. Look for Sen. McConnell to try this tactic, too. These candidates are constantly being pressured by the big nursing home fat cats with all kinds of donations to their election campaigns in exchange for their not supporting nursing home reform. On the other hand, advocates for reform are asking Sen. McConnell, for example, to support reform legislation now on his desk. What can you do? Keep calling Sen. McConnell . . . and call Mr. Lunsford. Tell them to change their ways and to help the 23,000 persons in nursing homes in Kentucky. Sen. McConnell’s number is (202) 224-2541; and Mr. Lunsford’s campaign office number is (502) 458-7500.
GET ACTIVE. ASK THE POLITICIANS . . .
We can’t get after the candidates or other politicians in state or federal government, because the rules for non-profits won’t allow us. But you can! And you often do. The last time we asked you to call the McConnell offices you flooded them with reportedly “hundreds of calls.” One of our members said that the McConnell receptionist got so upset over the huge number of calls that she just hung up on one caller. But please keep on calling the senator. And please be courteous when you call. As the minority leader in the U.S. Senate, Mr. McConnell could really help nursing home reform. You should also ask the Lunsford Campaign how Mr. Lunsford feels now about nursing home reform. If he is elected, will he support the legislation that we just reviewed for you above? And when Gov. Steve Beshear is out on the stump, ask him what his administration is going to do about nursing home reform. To his credit, the governor already has moved on one of our requests to him – making the position of state long-term care ombudsman no longer a political appointment. He and his associates have promised to help further. So, get active. Ask the politicians! Remember also that they are very sensitive to your urgings when an election is at stake.
POLITICAL PROGNOSTICATOR?
We don’t like to get into any guesses about political races unless it might affect nursing home reform. Well, the race between Mitch McConnell, the incumbent U.S. Senator from Kentucky and Bruce Lunsford, the nursing home magnate, could indeed affect what happens in nursing home reform. Whoever wins could change the outcome of nursing home reform in the U.S. Senate. But who will win? It says here Bruce Lunsford in an upset. Why? Our guess is that Barack Obama is going to win the presidential race, and that many Democrats like Mr. Lunsford will ride in on his coattails. A lot of votes in Kentucky for the Democrat Obama could be just enough to pull Mr. Lunsford through in what will most likely be a close race against a well-funded incumbent, Sen. Mitch McConnell . . . Just a guess . . . but won’t that be interesting? A guy who has yet to support nursing home reform, that we know of, after 24 years in the Senate, loses to a guy who is not only in the pocket of the nursing home industry, but who owns a big part of it. That’s my prognostication….. as gloomy to nursing home reformers as it may be. All we can hope is that one of the candidates, or both of them, will change before the election and pledge to help nursing home residents. And oh, yes…….. this is my personal prediction, not the official one of our organization.
EXCUSES, EXCUSES . . .
If the nursing home industry was as good at providing quality care as they are for providing excuses for not hiring enough staff, a lot of problems would be solved. The latest excuse, not a new one, is that they just don’t have enough money to hire more staff. And they blame government for what they consider a low rate of reimbursement – the amount they get from the state and feds for taking care of Medicaid and Medicare patients. We almost fell into the trap that many lawmakers have in believing them until we saw a recent report on Kindred Healthcare, the big Louisville-based nursing home company. Market expert James Kumpel “upgraded” the behemoth corporation to “outperform” for the second half of this year, citing increased income from Medicare and fewer lawsuits. Mr. Kumpel looks for Kindred stock to hit $39 share by the end of this year. He predicted a 32.8 percent rise in the stock price over the next year. Sounds like Kindred is rolling. But our question to the company is, “When will you hire sufficient staff in your nursing homes?” Look for more nursing home corporations to announce record stock prices but still be telling the public and lawmakers that they cannot afford to hire sufficient staff. And now the kicker – Kindred just reported a $21.7 million profit from the second quarter. This follows the government announcement of a $780 million increase next year in Medicare reimbursements to nursing homes. The feds said they are increasing the reimbursements because the cost of providing skilled care by the likes of Kindred has gone up 3.4 percent. Yep. Just poor folks . . .
THE GREENHOUSE IS COMING . . . MAYBE
Rumors are that Christian Care Communities, headquartered in Louisville, is actively exploring the possibility of building a new nursing home using the “Greenhouse” concept. That’s where residents live in small, individual units with each one having its own cadre of nurses helping the residents. It’s a concept that is gaining support nationally, but there has been no move to build such a project in Kentucky until just recently. The Christian Care Communities board of directors, according to a source close to the project, has voted to go forward with the project pending approvals by the state, and, most importantly, a successful capital campaign to raise money to build the structures. Word also has it that the facilities will be near Midway College in Woodford County and will have beds for about 50 residents. Stay tuned.
SHORT STUFF . . .
- A total of 20 percent of the nursing homes in the United States deliver care that is directly harmful to residents, according to Lewis Morris, chief counsel to the U.S. Department of Health and Human Services’ office of inspector general. Mr. Morris went on to tell a congressional committee that the onus for improvement of care rests on nursing homes, owners and directors. What can the feds do about it? Acting administrator of the Centers for Medicare and Medicaid Services, Kerry Weems, told the committee members that his agency is working on quality initiatives, including a campaign to reduce the use of restraints and incidence of pressure sores, and a renewed focus on quality improvement organizations like Health Care Excel, the one we have in Kentucky but never hear anything from. The QIOs, as they are called, rack in big dough for their owners, but seldom report to the public the progress, if any, they are making in improving nursing home care.
- State officials and others are doing a study to assess what progress is being made in Kentucky to create a “balanced” long-term care system. This, of course, includes care in nursing homes. Kentuckians For Nursing Home Reform is represented on the study committee. The study is one of those projects that easily could end up on the shelf collecting dust. But one of the components is to assess “quality management” in long-term care. It will be interesting to see what the study says about the quality of care in nursing homes and what can be done to improve it. Linda Kuder of Lexington, a volunteer with AARP, and Dr. Carla Mahan with the state Cabinet for Health and Family Services seem to be the mainstays of the study thus far.
- WHAS-TV reporter Mark Hebert has been doing a series of sensational investigative reports on alleged wrong-doing in the state program to inspect nursing homes. The subject of the reports, an employee of the state office of inspector general, was fired by the state, but denies all the charges or any suggestions that he tipped off a Northern Kentucky nursing home about when state inspectors were going to arrive, or that he lived rent-free in a Lexington house owned by the nursing home operator. Another state worker also has been implicated in the mess. She also denies the charges. What’s sad about this thing is that if the charges are true, it means that a lot of innocent nursing home residents have been hurt because someone allegedly played footsie with a nursing home operator, and maybe even tipped him off about upcoming inspections of the facility. No one has noted so far, however, that there is a state law which says state workers will be fired if they tip off a nursing home that it is going to be inspected. Also, it is not clear that the new law even came into play in this situation. Kentuckians For Nursing Home Reform got that law passed with the legislative leadership of Sen. Tom Buford of Nicholasville.
- One of our former board members, Frank Losey, was upset about the bed-hold policy in Kentucky which is 14 days. That means if you leave a Kentucky nursing home, you have 14 days to get back and still have a bed, unless you want to pay out of your own pocket to have it held for you. Mr. Losey enlisted a promise from state bureaucrats to get the bed-hold days increased to 24. But in his words, that effort “died” when Ernie Fletcher lost his re-election bid. “I am still pursuing this initiative,” Mr. Losey told us recently.
- A personal letter I received from Sen. Jim Bunning in reply to my request to him to support S. 2641, the Nursing Home Transparency and Improvement Act (see above), said -- in that typical form-letter language -- : “I will keep your views in mind should this legislation come before me in the Senate.” That was a strike-out as far as I was concerned. So I wrote back and told the senator that I wasn’t contacting him to just “keep the bill in mind,” I want him to be a co-sponsor. I suggest you do the same if you hear in form letter style from any of these lawmakers. By the way, I wrote him as a private citizen.
- Headline on a state news release: “Prisons Receive Perfect Scores in National Re-Accreditation Audits.” Advocate’s reaction: Oh that we could make the same announcement on the care in Kentucky nursing homes. But, hey, we’re glad, I guess, that they’re at least treating prisoners well.
- Said a Courier-Journal editorial: “. . . The Mitch McConnell-led obstruction of important legislation continued when his Republican minority blocked consideration of a bill to help low-income families pay their cooling and heating bills.” Now there go The Courier-Journal editorial writers again, getting on the senator’s case. With editorial attacks like that , the senator never will help the low-income people being mistreated in nursing homes, although most of them have sufficient heating and cooling…. just not enough staff.
- Have you heard that Sen. Ernesto Scorsone, D-Lexington, is leaving the legislature in hopes of becoming a circuit judge? That’s a loss to advocates for nursing home reform because the senator was a big supporter of nursing home reform efforts in the legislature. But now Rep. Kathy Stein, D-Lexington, says she will run to take Sen. Scorsone’s place. That’s good news for nursing home reform advocates. She has consistently supported nursing home reform. Her opponent, by the way, may be Lexington councilman Chuck Ellinger II, and we don’t know his views yet on nursing home reform.
QUOTABLE QUOTES . . .
“ At this point, most of the nursing homes in each state are owned by out-of-state REITs (real estate investment trusts), and run by out-of-state management companies…. We’re planning on slowly but diligently tracking down the ownership and management of each of Maryland’s 233 nursing homes. “
—Kate Ricks, Voices for Quality Care, a nursing home reform group in Maryland.
“ Today’s economic woes have already impacted the lives of the aging community, and if things don’t turn around, the aging community will be faced with a major crisis in 2009.”
—Sandy Markwood, head of the National Association of Area Agencies on Aging.
THAT’S IT FOR THIS TIME, BUT DON’T FORGET . . .
MORE THAN 23,000 PEOPLE IN NURSING HOMES IN KENTUCKY NEED US. THEY ARE KENTUCKY’S “FORGOTTEN PEOPLE.”
BERNIE VONDERHEIDE
KENTUCKIANS FOR NURSING HOME REFORM
E-mail: KyNursingHomeReform@yahoo.com
Web Site: http://www.KyNursingHomeReform.org
Telephone: (859) 312-5617
P.S. - Baptism
Three little boys were concerned because they couldn't get anyone to play with them.
They decided it was because they had not been baptized and didn't go to Sunday School.
So they went to the nearest church.
But, only the janitor was there.
One little boy said, “We need to be baptized because no one will come out and play with us.
Will you baptize us?”
“Sure,” said the janitor.
So he took them into the bathroom and dunked their little heads in the toilet bowl, one at a time.
Then he said, “You are now baptized!”
When they got outside, one of them asked, “What religion do you think we are now?”
The oldest one said,
“We're not Kathlick,
because they pour the water on you.”
“We're not Babtis, because they dunk all of you in the water.”
“We're not Methdiss, because they just sprinkle water on you.”
The littlest one said,
“Didn't you smell that water?!”
They all joined in asking,
“Yeah! What do you think that means?”
“I think it means we're Pisscopailians.”
— Passed on to me by my wife who is one of them Kathlicks.