December 3, 2009
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
A SPECIAL MESSAGE TO OUR READERS....
Beginning with this issue of the "Newsletter," we are trying out a company that specializes in sending out electronic newsletters like ours. We are doing this because our list of people wanting to keep up with nursing home reform issues has gotten so big. But in transferring our distribution list to this new company, Constant Contact, there may be some problems. Like some of you who had canceled getting the newsletter may be back on the list again; or some of the addresses we may have messed up so that those of you who want to get it won't. Or you are getting multiple copies. We now have more than 2,000 people who receive this newsletter and other messages we send, so we hope you will understand. Just call or write us if you have a problem, and thanks again for supporting nursing home reform.
HEALTH CARE REFORM BILLS IN CONGRESS NOW CONTAIN AMENDMENTS THAT WOULD MAKE HISTORIC CHANGES TO NURSING HOME CARE
The health care reform bill that passed the House contained in it sweeping measures on nursing home reform. Now a health care reform bill has been introduced in the Senate, and it also contains amendments on nursing home reform. One national nursing home reform activist called the amendments to the bill the most significant action on behalf of nursing home residents since a national nursing home reform law was passed in 1987.
What happened? Briefly, supporters of this year's controversial health care reform legislation were able to attach key nursing home reform amendments to it. The amendments would, for example, make nursing homes report their staffing based on payroll data and also report turnover and retention rates and how much they are paying their staff. These and other transparency provisions would go a long way in bringing public opinion to bear on lawmakers and the industry. The legislation also mandates the training of nursing assistants in dementia care and abuse prevention. And the bill would authorize a program of national criminal background checks on all long-term care workers. The Senate version contains provisions of the Elder Care Justice Act. Also in the Senate bill, the nursing home industry was able to insert an amendment that calls for a study of the new Five-Star Rating System for nursing homes. The industry hates the Five-Star because it make public for everyone to see their many shortcomings in caring for residents.
Only one member of Kentucky's delegation in the House voted for the health care reform bill and therefore the nursing home part of it. That was John Yarmuth of Louisville. All the Republicans from Kentucky voted against the bill - Ed Whitfield of Hopkinsville, Brett Guthrie of Bowling Green, Geoff Davis of Northern Kentucky, and Hal Rogers of Somerset. One Democrat in the Kentucky delegation, Ben Chandler of Lexington, also voted against the bill. We are guessing that Mr. Chandler was in a muddle on his vote. He has a history of supporting nursing home reform, but must have felt his objections to the health care reform part of the bill outweighed that.
Next thing to happen will be a vote in the Senate on the bill there. If that passes, and the nursing home reform provisions survive, the historic legislation will go to a conference committee and then another vote in both chambers, and, if passed then, to the President for his signature.
This is the best chance nursing home reform advocates have had for meaningful reform in many years. But because the nursing home reform provisions are tacked on to the health care reform legislation, a very controversial bill, chance for success are in a delicate balance. The nursing home industry is throwing millions of dollars at lawmakers in Congress to keep any reform provisions from passing.
WHAT CAN ADVOCATES DO?
We will be getting suggestions to you soon about contacting your representatives and senators.
DON'T JUMP ON US!
The last time we reported on the health care reform bill in Congress, some of our readers jumped on us because they are against the health care reform bill. Please know that we leave it to you on whether you support this bill or not. But we do want you to know that it contains important provisions for nursing home reform, and that we very much support that part of the legislation. If a national health care reform bill does get passed by Congress, we would hope it has relief for the suffering nursing home residents in it.
NOT SO CLASSY IN THE LONG RUN
A part of the health care reform legislation being considered in the Congress contains something called the CLASS Act. It would provide seniors with federally-backed long-term care and disability insurance. It is being ballyhooed to save the nation money. It has been found, however, that the savings would be for the first 20 years, but after that, according to the Congressional Budget Office it would begin losing money and add to the deficit. The nursing home industry, of course, is working hard to get it passed.
SOMETHING TO GET YOUR TEETH INTO
A Louisville insurance firm has begun to offer a dental care plan to nursing home residents in a 75-mile radius of the city and next year in a 150-mile radius which will include Lexington and beyond. Even though a 1987 federal law mandated that nursing homes be responsible for the oral health needs of their residents, a study showed that in Kentucky nearly 80 percent of nursing home residents had only fair to poor overall dental health Citizens Security Life Insurance Co. of Louisville is selling a plan for nursing home residents. Dentists with Healthy Seniors Dental of Louisville will provide covered nursing home residents examinations and treatments where they live, without their having to leave the facility. Company Senior Vice President James Knox said the plan will cover a complete treatment plan for residents, including soft tissue exams, identification of any gingivitis or periodontal disease, teeth cleaning every six months, fillings, and teeth extraction. There also is a treatment plan for residents with dentures. Portable dental units with local Kentucky dentists, along with dental assistants and X-Ray technicians, will go from nursing home to nursing home to provide the care. The policy will be provided at no net cost to certain qualifying residents on Medicaid. Medicaid residents of a nursing facility who have personal income, and who must turn over all their monthly income to the nursing facility, are allowed to have certain expenses qualify as an allowable deduction where they can use their income prior to turning it over. By law, this includes dental insurance premiums. Medicaid residents simply redirect some of their income to pay for the dental care insurance premium. The result is a dental policy that funds dental care at no additional net cost to the Medicaid resident or the facility. For more information, call James Knox, (502) 244-2471.
STAFFING IS THE BIG PROBLEM
U.S. News & World Report interviewed Los Angeles attorney Eric Carlson about what to look for when choosing a nursing home. (And we get that question all the time, too.) Carlson, an expert on nursing home care and author "20 Common Nursing Home Problems and How to Solve Them," was asked: What is the biggest factor when it comes to quality of care?
His answer: "Staffing. Annual turnover for nurse aides runs at 100 percent or higher. Nurse turnover rates are also high at 50 percent annually. Existing staff winds up working double shifts. Seek out homes with low staff turnover and a high ratio of staff members to patients, particularly those for the nurse aides, who do the lion's share of the hands-on work. One staff member assigned to five or six residents is best. An administrator or director of nursing may not be willing to cite staff turnover rates but should be able to answer simple questions about how long employees have worked there."
SO WHY CAN'T WE DO IT IN KENTUCKY?
Advocates for nursing home reform in Kentucky have been trying for several years now to get legislation passed mandating staffing levels in nursing homes that would ensure quality care. Heavy lobbying by the Kentucky nursing home industry has prevented passage of any such legislation. But now comes along the state of Florida. They passed a law in 2001 mandating 2.9 hours per resident day of direct care by nursing assistants. Researchers from the University of South Florida, the University of Florida and Texas A&M have studied the effect of this legislation which was implemented in 2007. Their findings: "... Quality of care has substantially improved in Florida nursing homes since the introduction of increased nurse staffing levels and other quality standards...." And the researchers went on to say that in Florida the "average deficiencies per facility have decreased," and most importantly, "the citations for the more serious deficiencies have decreased dramatically." Question to ask your state legislator: "Why can't we do this in Kentucky?"
SHORT STUFF
- The Lexington Herald-Leader has done it again. Another block-buster on the front page of the Wednesday Dec. 2 edition. They report that the U.S. Government Accountability Office has identified a Richmond nursing home as the second worst in the nation. That's where someone caught their alleged poor care on a hidden camera. Don't you wish you had a Granny Cam in the nursing home you are watching?
- Eric Friedlander, a longtime official in the Cabinet for Health and Family Services, has been named deputy secretary of the cabinet, making him the No. 2 person to Cabinet Secretary Janie Miller. In the past, he has demonstrated interest in nursing home advocacy issues.
- They still don't have an Inspector General in the Cabinet for Health and Family Services. They are operating with a temporary one, Kerry Harvey, who joined the cabinet last February as general counsel. Sadiqa Reynolds held the post until last June when the governor appointed her to a judgeship in Jefferson County.
- Always ready with a criticism or an excuse, the head of a big nursing home lobbying group, Larry Minnix, was caught recently commenting on the new Five-Star Rating System for nursing homes, saying: "The concept is a good idea. But they're not really measuring the most meaningful things, like patient and staff satisfaction surveys...." To which, reform advocates might reply: Have you ever seen a survey of nursing home patients or staff that comes out critical of the care? That's because the nursing homes pay for the surveys and the patients are scared of retribution from the nursing home staff; and the staff are scared they would lose their jobs if they were ever caught telling it like it really is.
- We don't want to be partisan, but we have to be honest and report that we were amazed when one of the lesser-known candidates for the GOP nomination for the U.S. Senate seat, Maurice Sweeney of Eastwood, was the only one at a candidate panel at the University of Kentucky to even mention interest in senior citizens issues. Maybe it'll catch on with the rest of the Republican candidates. And the Democrats, too.
- Most nursing home residents are scared to talk about the problems they encounter every day for fear of retribution from the staff. That's why big nursing home corporations like to hire survey firms to interview them and then claim that almost every resident they talked to loves the nursing home. And that also may be the trap that Cincinnati television station WCPO-TV fell into when they interviewed residents of nursing homes who raved about how great their facility is. The Cincy TV reporters also talked to administrators who also, of course, said the new federal Five-Star rating system is flawed and that their low-ranked facility could be good if it wanted to. So if you live in the reach of WCPO-TV, take with a grain of salt the "investigation" their news reporters did of nursing homes in the Tri-State area. It was at best amateurish.
- A Bronx nursing home allegedly paid a hospital social worker to steer elderly patients their way, the New York Post newspaper reported. No word on how widespread such a practice may be, but if you know of examples, please contact Kentuckians for Nursing Home Reform.
STOP ALL THAT CRYING
Nursing homes in Kentucky will probably be paid less in federal-state Medicaid reimbursement in the current state fiscal year than they were in the just-ended one. Medicaid budget director Neville Wise estimates right now that for 2010 fiscal year (that's the year that ends June 30, 2010), the amount will be about $848 million, compared to $880 million in 2009. That's because in the last fiscal year the nursing homes got paid for 13 months due to pay requirements in the federal stimulus act. Mr. Wise cautioned that his new estimate is subject to change "as we update the latest monthly payments." But for the present time, don't pay any attention when the nursing homes start publicly crying again about how poor they are.
YOUR DOLLARS CAN HELP
This Newsletter is published by Kentuckians for Nursing Home Reform, a non-profit organization comprised of volunteers working to improve the lives of the 23,000 "Forgotten Kentuckians" destined to live out their lives at the mercy of nursing homes. If you would like to assist in our charitable work by helping underwrite expenses of conducting educational seminars, lobbying for residents' rights in the State Legislature, or publishing informative materials, you may send your contribution to Kentuckians for Nursing Home Reform, 1530 Nicholasville Rd., Lexington KY 40503. Contributions are tax deductible as allowed by law. To volunteer, write to the same address or e-mail KyNursingHomeReform@yahoo.com. Thank you.
P.S.
Thoughts from an old guy like your editor......
I was thinking about how a status symbol of today is those cell phones that everyone has clipped onto their belt or purse. I can't afford one, so I'm wearing my garage door opener.
I also made a cover for my hearing aid and now I have what they call blue teeth, I think.
You know, I spent a fortune on deodorant before I realized that people didn't like me anyway.
I was thinking that women should put pictures of missing husbands on beer cans!
I was thinking about old age and decided that old age is 'when you still have something on the ball, but you are just too tired to bounce it.'
I thought about making a fitness movie, for folks my age, and call it 'Pumping Rust.'
I have gotten that dreaded furniture disease. That's when your chest is falling into your drawers!
I know, when people see a cat's litter box, they always say, 'Oh, have you got a cat?' Just once I'd like to say, 'No, it's for company!'
Employment application blanks always ask who is to be notified in case of an emergency. I think you should write, 'A Good Doctor!'
Why do they put pictures of criminals up in the Post Office? What are we supposed to do, write to these men? Why don't they just put their pictures on the postage stamps so the mailmen could look for them while they deliver the mail? Or better yet, arrest them while they are taking their pictures!
I was thinking, why pay taxes? People who owe taxes seem to get good government jobs.
I was thinking about how people seem to read the Bible a whole lot more as they get older. Then, it dawned on me, they were cramming for their finals. As for me, I'm just hoping God grades on the curve.
Enjoy your days and love your life, because life is a journey to be savored.