NORC Gazette
January 31, 2002
National Long Term Care
Ombudsman Resource Center
National Citizens’ Coalition
for Nursing Home Reform
Table
of Contents
Ombudsman Program Updates
1. Colorado Ombudsman
Program wins major legal battle!
2. Iowa Ombudsman’s report focuses attention
on residential facilities
Ombudsman Calendar of Events
Home and Community Based Care/Olmstead
3. Audit finds Florida elder care
program lacking
4. VA publishes final rule governing
adult day care for veterans
Nursing Home News
5. “Grannycams” make the news in Florida and
Louisiana
6.
Florida nursing homes
start their own insurance company
7. ADA calls for tougher oral care standards
Staffing
8. Wyoming report
recommends pay raise for direct care workers
9. Laws banning mandatory overtime
gain momentum
12. Medicare panel calls for more spending
Research
14. Alzheimer's residents take to
water
DC Doins'
15. Advocate steering committee forms
to monitor HHS regulatory group
16. United Seniors Health Council merges with NCOA
17. AARP Medicare Training Module now available online
18. National Aging and Law Conference to be held in October
Ombudsman Program Updates
1. Colorado Ombudsman Program wins major legal battle!
The Colorado Ombudsman Program recently won a major victory when an administrative law judge ruled that private pay personal care boarding homes fall under ombudsman jurisdiction. The ruling grew out of an incident in which Westland Meridian Personal Care Boarding home kicked ombudsmen out of the facility. Meridian argued that the ombudsman program has no authority in the facility because Westland only accepts private pay residents. The administrative law judge found that Westland Meridian fits the definition of a licensed personal care boarding home, and thus falls under the jurisdiction of the ombudsman program. Source: Rocky Mountain News, 1/30/02.
2.
Iowa Ombudsman’s report focuses attention on residential facilities
Debi Meyers, Iowa State Ombudsman, said in a recent report that the state may need to re-examine the regulations imposed on residential care facilities. She said there is a wide variation in the quality of these homes, with some of them striving to meet residents’ needs and others exposing residents to “dangerous conditions.” Meyers’ report led to a recent state investigation of 6 boarding homes to determine whether they are housing residents who require the services of a licensed residential care facility. Two of these homes had given up their licenses last year, but have continued to house mentally disabled people. The four others never have been licensed and claim they provide a level of care that does not require a license. Meyers pointed out in her report that while the state had determined that the homes were operating as unlicensed care facilities, mentally disabled people still lived there. Source: Des Moines Register, 1/27/02
Ombudsman Calendar of Events
January 31 – February 2: NASOP Conference: “Long Term Care Ombudsman
Program: Rethinking and Retooling For the Future.”
February 14: NCCNHR Virtual Annual Meeting session, "Quality and Allocation of Resources in Survey and Enforcement" 2-3:30 pm EST. Contact John Kafka at 202-332-2275 to register ($90 charge).
February 27: "New" State Ombudsman Orientation phone conference, 3 pm EST. Contact Julie Meashey at 202-332-2275 or jmeashey@nccnhr.org
March 5: NCCNHR Virtual Annual Meeting session, "Complaint Investigations by Regulatory Agencies" 2-3:30 pm EST. Contact John Kafka at 202-332-2275 to register ($90 charge).
March 14: Hotel
reservation due for State Ombudsman spring conference. Call Holiday Inn at
(614) 885-3334 in Columbus, Ohio and indicate your reservation in connection
with the "National Ombudsman Training Conference." Contact Mark
Miller at mmiller@nasua.org
April
13 - 16: State Ombudsman spring conference, Columbus, Ohio. Contact
Mark Miller at mmiller@nasua.org
Home
and Community Based Care/Olmstead
3. Audit finds Florida elder care program lacking
An Office of Program Policy
Analysis and Government Accountability audit found that the Florida Department
of Elder Affairs failed to meet the needs of the elderly in the state in
critical areas. Of 2,604 people at risk of nursing home placement, 426 had
received no help by the end of last year, the audit reports. Of those, 24
people had died and 32 had entered nursing homes. State Rep. Sandra Murman (R-Tampa) called for an all-inclusive
system of elder care. Rather than asking for more money, Murman proposes to
move tax dollars away from nursing homes and into building the eldercare
services program.
Source: SNALF.com, 1/23/02
4. VA publishes final
rule governing adult day care for veterans
The Department of Veterans Affairs has
established regulations setting forth a mechanism for paying per diem to State
homes providing adult day health care to eligible veterans. The rule sets forth
several criteria that must be met for homes to be eligible for reimbursement.
The intended effect of the rule is to ensure that veterans receive high quality
care in State homes. To read the entire
rule, go to the section entitled “Veterans Affairs Department” at http://www.access.gpo.gov/su_docs/fedreg/a020107c.html
Nursing Home News
5. “Grannycams” make the news in Florida and Louisiana
A Florida task force has come out
in favor of “grannycams.” In a report sent to state legislators, the task force,
made up of Agency for Health Care Administration officials and representatives
from the Attorney General’s office, recommends a law requiring nursing homes to
install video monitoring devices in residents’ rooms, if requested by residents
or their families. Residents should foot the bill for installation and
maintenance, and the privacy of visitors and roommates should be protected, the
report says. Meanwhile, in Louisiana, state Representative Sharon Broome has
proposed a bill that would allow nursing home residents or their families to
install room-monitoring video systems at their own expense. The bill would
require that all staff be told about the monitoring. Source: SNALF.com
1/25/02, 1/28/02
6.
Florida
nursing homes start their own insurance company
A group of nursing homes in Florida received a permit this month from
the Florida Department of Insurance to begin the process of forming their own
liability insurance company. A permit
was granted to the stock insurance company, The Long Term Care Risk Retention
Group (LTC). Once LTC secures $9
million in capital, it can apply for approval to issue policies. LTC plans to offer liability insurance only
to centers that meet its quality standards, which will limit the risk. The
group believes by pooling these low risk facilities, it may be able to contain
some of the skyrocketing costs of insurance.
The group aims to have at least 125 homes by the end of the first
quarter. LTC has set rates for plans
and aims to keep the rates flat for the next three years. The LTC premium for a nursing home is $2,000
annually, while the average nursing home pays $6,434 annually now, according to
a study by the University of South Florida.
Source: Florida Times-Union,
1/23/02
7. ADA calls for tougher oral care standards
The American Dental Association says oral health problems among
long-term care residents are more serious than most people realize. Data used
by the Centers for Medicare & Medicaid Services to shape federal
regulations grossly underestimate the prevalence of oral disease in nursing
home residents, according to the ADA. While national CMS data indicates that
less than one percent of LTC patients have gum disease, smaller sample studies
find gum disease in over 37 percent of nursing home residents, the ADA says.
ADA President Gregory Chadwick called on Congress and CMS to work with the ADA
to improve dental care among the elderly, including, as a first step, making
the assessment process more accurate. The ADA recommends that nursing facility
staff and state surveyors be trained and then required to look into the mouth
as part of their review process. Chadwick praised the efforts of Sen. John
Breaux (D-LA) and the Senate Special Committee on Aging to improve dental care
in the nation’s nursing homes. For
more information go to: http://www.ada.org/public/media/newsrel/0201/nr-02.html
Staffing
8. Wyoming report recommends pay raise for direct care workers
The Wyoming Institute for Disabilities
at the University of Wyoming released a report recommending that wages for
nurses’ aides and other direct care workers should be increased by more than
$3.00 an hour. Direct care workers make an average of $6.92 an hour in Wyoming,
while the same job in one of the states bordering Wyoming pays, on average,
$11.81 an hour, says Ken Heinlein, executive director of the Institute. The
report, requested by the state legislature, recommends raising the base pay for
nonprofessional direct care workers to $10.23 an hour. To read the full report, go to http://ddd.state.wy.us/
9. Laws banning mandatory overtime gain
momentum
New Jersey recently became the first state to ban mandatory overtime for nursing assistants. New Jersey’s law, which applies to all hourly health care workers in all types of settings involved in patient care or clinical services, says workers may not be forced to work more than their regular shift or a 40-hour week. Staff may still be required to do so in an emergency, which is defined as an unpredictable or unavoidable occurrence at unscheduled intervals relating to health care delivery that requires immediate action, but they must be allowed up to an hour to make child care or other arrangements. Voluntary overtime is still permissible. Long-term care facilities and home- and community-based service providers have 18 months to comply with the new law, which was signed on January 2. Acute care hospitals must be in compliance as of January 1, 2003. Legislation to ban mandatory overtime has also been introduced in Florida and Washington state. Source: National Clearinghouse on Direct Care Workforce, 1/29/02; AHA News, 1/25/02, 1/28/02
10. Bush budget includes
nurse education loan repayment program money
Health and Human Services Secretary Tommy Thompson announced that
President
Bush's budget proposal for fiscal 2003 would include increased spending for
the Nurse Education Loan Repayment
Program. This program would receive a 50% increase from last year's budget,
bringing a total of $15 million for 2003 to support up to 800 new loan
agreements. Thompson said the nursing shortage is severe and as the
demand for health care grows, it is critical that more of the nation's top
students are encouraged to choose careers in nursing. To read the full HHS press release, go to:
http://www.hhs.gov/press/2002pres/20020122.html
California is the first state in the nation to establish minimum nurse-to-patient ratios. The new rules spell out minimum numbers of licensed nurses needed to assure patient safety throughout the hospital setting, depending on the unit. For example, the ratios would be at least one nurse for every four patients in emergency rooms, and one nurse for every five patients in Medical and Surgical units after an initial phase in period of one year to 18 months. The rules will be finalized after a public comment period. Members of the California Nursing Association had campaigned for 10 years for enactment of this reform. To read more about the new ratios, go to http://www.calnurse.org
Medicare
12.
Medicare panel calls for more spending
The Medicare Payment Advisory Commission has recommended that the federal government increase Medicare payments to most providers, saying that cutting reimbursements or keeping them at current levels “could jeopardize access to care for the elderly and disabled.” MedPAC approved the following recommendations: 1) increase physician payments by 2.5%; 2) increase payment by 2.35% for hospitals in large urban regions and by 2.9% for all other hospitals; 3) eliminate a 15% reduction in payments to home health agencies scheduled for Oct. 1 and increase payments by 3.2% in 2003; and 4) increase the reimbursement to hospital-based nursing homes by 10%. The commission concluded that payment to free standing nursing homes was adequate and did not recommend any increase in reimbursement for these entities. Source: New York Times, 1/21/02
On recommendations from the National Institute of Health’s National Eye Institute, Medicare this month began covering an annual dilated eye examination meant to detect the presence of glaucoma. The test, which involves using eye drops to dilate a patient's pupils, will be offered to all Medicare beneficiaries “at high risk for glaucoma,” including people with diabetes, people with a family history of glaucoma and African Americans age 50 and older. Glaucoma is a leading cause of blindness and affects about three million Americans, but half are undiagnosed. The disease is five times more likely to afflict African Americans than whites and nearly four times more likely to cause African Americans to go blind. To read the NIH news release, go to http://www.nih.giv/news/pr/jan2002/nei-22.htm
Research
14. Alzheimer's residents take to water
Alzheimer’s residents in a Cornish
nursing home began exhibiting numerous behavioral improvements after the home
instituted weekly hour-long swimming sessions. Aggressive residents became
calmer and more content after swimming, and insomniacs got a good night’s
sleep. Many residents were more responsive and happier after their swim. The
swimming sessions, known as the Waterworks project, are the brainchild of Penny
Smith, a registered mental health nurse, who has won a research grant from the
Queen’s Nursing Institute and the Alzheimer’s Society for her work. To read the
full article, go to http://www.guardian.co.uk/Archive/Article/0,4273,4335688,00.html
DC Doins’
15.Advocate
steering committee forms to monitor HHS regulatory group
The National Senior Citizens Law Center, the Center for Medicare Advocacy, the National Health Law Program and other groups, including NCCNHR, have formed a steering committee to monitor the HHS Regulatory Reform Advisory Committee and to organize the work of advocates nationally with respect to the HHS committee. This advocate steering committee is seeking input from advocates in the field about Medicaid and Medicare regulations that protect beneficiaries and should not be eliminated. Examples can be submitted to: kglaun@nsclc.org. In addition, comments on the HHS federal register notice about “unnecessary or unreasonable” regulations are due on March 5, 2002.
The HHS Advisory Committee will be holding committee meetings around the country. The schedule is: Miami: February 25-26; San Francisco: March 20-21; NY/Philadelphia corridor: April 17-18; Denver: May 15-16; Minneapolis: June 10-11; D.C.: August 28-29. Minutes and summaries of the HHS committee meetings can be found at www.regreform.hhs.gov (under meeting transcripts and minutes).
16. United Seniors Health Council merges with NCOA
The United Seniors Health Council (USHC), an organization offering older consumers advice on such issues as financial planning, home care, and long term care insurance, has joined forces with The National Council on Aging (NCOA). Effective January 1, 2002, USHC is officially an NCOA program. To read the press release go to: http://ncoa.org/press/merge.htm
The AARP Foundation’s National Legal Training Project has announced the availability of a free, online version of its Medicare Training Module. This law module can be used as a training guide as well as a desk reference for Medicare advocates. A copy can be accessed at www.povertylaw.org/medicare/index.htm
Save the date! The Third Annual National Aging and Law Conference will be held October 23-26, 2002 in Arlington, Virginia. More information on the conference and a Request for Proposals to present a workshop will be available by February 15, 2002.
This publication of the National Ombudsman
Resource Center (NORC), at the National Citizens' Coalition for Nursing Home
Reform, updates State and Local LTC Ombudsmen on the latest information,
resources, ideas, and practices in the full range of long-term health care.
The Gazette is organized for your easy reading. Information is grouped by
topics (Ombudsman Program Updates,
Nursing Home News, Assisted Living, Staffing, etc) and numbered.
You can quickly see if any articles are of interest and immediately go to
those articles.
In order to get this info to you ASAP, there is little to no additional verification
work or search of resources.
The information comes from a number of sources including the Washington Post,
the New York Times, and two daily listservices. (one from the Kaiser Family
Foundation and the American Hospital Association) and other sources happened
upon by NORC staff and consultants. To start a subscription to AHA News
Now, send a message from your subscribing e-mail address listserv@ahals.aha.org and write in
the message area: subscribe ahanewsnow. Please submit suggestions for
improvement or information to Robyn Grant, NORC consultant, at robyngrant@att.net
The National Long Term
Care Ombudsman Resource Center provides technical assistance and support to
state and local long term care ombudsman programs. This summary was
supported, in part, by a grant, No. 90AM2139, from the Administration on Aging,
Department of Health and Human Services. Grantees undertaking projects
under government sponsorship are encouraged to express freely their findings
and conclusions. Points of view or opinions do not, therefore,
necessarily represent official Administration on Aging policy.
For more information contact the National Long Term
Care Ombudsman Resource Center, at (202) 332-2275 or ombudcenter@nccnhr.org