NORC Gazette
June 24, 2002
National Long Term Care
Ombudsman Resource Center
National Citizens’ Coalition
for Nursing Home Reform
Table
of Contents
Ombudsman Program Updates
1. TX Attorney General seeks ombudsman to
protect residents
2. IL Ombudsman program shares foreign language and other
materials
Ombudsman Calendar of Events
Home and Community-Based Care/Olmstead
3. Information from national
conference on quality available
Nursing Home News
5. AHCA on the road again
6. OK financial resources law
creates provider unease
Assisted Living
7. First Lady encourages assisted
living facility residents to volunteer
8. License of WI assisted living
facility revoked
9. Federal law creates 4-year
waiting list at FL assisted living facility
Staffing
10. Fix New Jersey Nursing Homes! Campaign picks up speed
11. CO nursing assistants speak out about trials, benefits of job
12. HHS OIG finds
disparities in Medicare mental health coverage
Medicaid
13. CT, MO, CO face Medicaid cuts; nursing home
providers react
Research
14. Study examines suicide risk factors
for seniors
DC Doins'
15. House Holds Hearing on Tort Reform
16. Elder abuse and neglect get more attention from the U.S. Senate
17. Senator Breaux calls for long term care reform
18. Illinois Elder Rights Conference to be held in July
Ombudsman Program Updates
1. TX Attorney General seeks ombudsman to protect residents
Texas Attorney General John Cornyn asked a federal
bankruptcy court in Dallas to appoint an ombudsman to oversee resident care and
protect residents of Senior Living Properties, which filed for Chapter 11
bankruptcy protection in May. Senior
Living Properties is an Indiana-based nursing home company that operates 51
facilities in Texas. Cornyn, the
Republican nominee for U.S. Senate, is asking the court to adopt a mechanism
contained in pending congressional legislation that would require the
appointment of an ombudsman in cases of nursing home bankruptcies. According to Cornyn, bankruptcy laws give
the Attorney General’s office the authority to intervene on behalf of
consumers, and he believes such intervention is necessary. “While a number of attorneys are looking out
for the interests of creditors in this bankruptcy proceeding, I believe the
affected nursing home residents also deserve a designated advocate who can
represent them before the court,” Cornyn said.
A July 16 hearing was scheduled to consider Cornyn’s request. Source:
AP Newswires, TX, 6/18/02
2. IL Ombudsman
program shares foreign language and other materials
The
Illinois Ombudsman program has developed and printed new brochures and posters
in several languages. Included are
residents’ rights pamphlets, residents’ rights posters and Ombudsman program
brochures. The languages available are
Russian, Polish, Chinese, Korean, Spanish and English. The materials contain some Illinois-specific
language, but the materials could be modified and used by other states. State Ombudsman, Beverly Rowley, has shared
these materials with the Ombudsman Resource Center, as well as training
materials developed by the Centers for Medicare & Medicaid Services (CMS)
and given to the program by the state survey agency. The CMS items include videos and handouts on Mental Illness in
Nursing Homes, Successful Pain Management, Assuring Dental Health, Surveying
Activities Requirements, and Flu and Pneumonia Immunization. All materials are available for loan through
the Resource Center library. Contact
Julie Meashey at 202-332-2275 or jmeashey@nccnhr.org
for more information.
Ombudsman Calendar of Events
July 24 – 25: American Health
Quality Association national meeting:
Partnerships for Success: The
Federal Initiative on Quality Improvement & Public Reporting in Nursing
Facilities. Wyndham Baltimore Inner
Harbor, Baltimore, MD. Contact Virginia
Paganelli at Vpaganelli@AHQA.org for
more information.
October 6 - 12: Residents’ Rights Week 2002. This year's theme is "Giving Voice to Quality: Affirming Residents' Rights in Long Term Care." Residents' Rights packets will be available in August. For more information contact Julie Meashey at jmeashey@nccnhr.org
October 26 - 30: NCCNHR Annual Meeting. Oct. 26th will be a “Bridge Day” with the NALC that is being held at the same location. More details to follow shortly, please mark your calendars and plan to attend. Theme: “No More Excuses: We Demand Quality Long-Term Care”
Home and Community-Based Care/Olmstead
3. Information from national conference on quality available
“Improving Quality in Community-Based Care,” a national conference
sponsored by the Centers for Medicare and Medicaid Services, was held in
Nashville, Tennessee on May 2-3, 2002.
The goal of the conference was to provide an opportunity for information
exchange among decision-makers in the design and implementation of quality
management/improvement in programs for persons with chronic conditions and
disabilities. The conference was
designed to facilitate communication around quality management among state
staff, federal agency staff, providers, and consumers/advocates involved in
community-based care. The agenda
included presentations on “Perspectives on Quality in Community-Based Care,”
“Quality Improvement in Home Health Care,” “The Consumer’s Role in Improving
Quality,” “Involving Consumers, Families and Advocates in the Quality Agenda,”
and a range of other topics. To access
the agenda and presentations, go to: http://www.hcbs.org/cms2002conference/presentations.htm
.
Source: Home and Community Based Services website, http://www.hcbs.org/index.htm
Nursing Home News
5. AHCA on the road again
The American Health Care Association (AHCA) has another cross country petition drive going - this time to oppose Medicare funding cuts. AHCA says that without congressional action, about $2 billion a year in Medicare payments approved in 1999 will expire at the end of September. AHCA representatives stopped at a Nebraska nursing home for a rally last week. AHCA plans to visit 45 states to gain signatures on the petition that will be presented to Congress in September.
6. OK financial resources law creates provider unease
A new Oklahoma law which goes into effect November 1 of this year will require Oklahoma nursing homes to have enough financial resources on hand to operate for 45 days. The law will also empower the Oklahoma Health Department to put a manager in charge of a nursing home that fails to meet the 45 day requirement. The Health Department would be permitted to issue an order - effective immediately and without a hearing - to address any alleged problems, even allowing the state to borrow money and present the bill to the nursing home. Hank Hartsell, Chief of Health Resources Development Services with the Health Department, has said that the purpose of the law “is not to make nursing homes go out of business but rather to allow the Health Department to take effective action before financial problems cause harm to patients.” The big question among nursing home operators is defining what is meant by “financial resources on hand.” Some providers have said that if this is interpreted as meaning “cash on hand,” the new law would spell disaster for nursing homes because there are not likely to be any homes in the state that would have that kind of cash on hand. Hartsell said that these issues will be addressed through a public rule making process to implement the new law. This process will begin this summer and include public meetings. Source: The Oklahoman, 6/15/02
Assisted Living
7. First Lady encourages
assisted living facility residents to volunteer
In an effort to build “a nation of volunteers,” First Lady Laura
Bush recently spoke at the Brighton Gardens Assisted Living Community in Salt
Lake City, asking seniors to dedicate some of their time to volunteer
efforts. During this presentation,
industry leaders announced an alliance between Senior Corps, a service
organization for the elderly, and Marriott Senior Living Services. Marriott has pledged to make it easy and
convenient for its assisted living facility residents to partake in volunteer
programs, thus expanding the ranks of Senior Corps. To learn more about Senior Corps volunteering opportunities, go
to http://www.seniorcorps.org
Source: BAL Weekly, 6/19/02
8. License of WI assisted living facility revoked
State officials revoked the license of Kletzch Park Residence, a Glendale, Wisconsin assisted living facility, after accusations arose that it had purposely covered up a staff member’s criminal background. Facility operators were fined $12,500, barred from admitting new residents, and now face charges of resident neglect and insufficient staffing, according to the Milwaukee Journal Sentinel. The caregiver in question was convicted twice for disorderly conduct, but the owner’s president allegedly told staff to hide the findings because the facility didn’t complete the background check until after the caregiver was hired. Wisconsin law requires that criminal background checks be done on all newly hired employees who have contact with residents in nursing homes and assisted living facilities. State records reveal that a resident on the caregiver’s shift was injured on three occasions and that the facility later fired the caregiver. The facility is appealing the state’s actions. Source: Milwaukee Journal Sentinel, 6/14/02; BAL Weekly, 6/19/02
9. Federal law creates 4-year waiting list at FL
assisted living facility
The waiting list at Bayshore Manor, an assisted living facility on Stock Island, Florida, is 4 years old and 13 people long, despite the fact that four bedrooms stand empty in the facility. The director of the facility, Joan Higgs, explained that the predicament is caused by a federal law that makes increased occupancy impossible. Higgs said if Bayshore added the four beds, five of its current residents who are on Supplemental Security Income (SSI) would lose their monthly SSI stipend and the Medicaid benefits that are tied to the supplemental income program. Higgs has been working on a solution to the problem for the past 4 years, but it reached critical proportions this year when the county’s other two assisted living facilities went out of business, making Bayshore Manor the only option for elder Keys residents not yet in need of a nursing home. Higgs thinks she has found a solution and help from U.S. Representative Peter Deutch, who has introduced a resolution in the House of Representatives that would exempt Bayshore Manor from the 16-bed limit and set a new cap of 40 residents. Source: The Key West Citizen, www.keysnews.com, 6/20/02
Staffing
10. Fix New Jersey Nursing Homes! Campaign picks up
speed
The Fix New Jersey Nursing Homes! Campaign has announced that it now has the support of 64 state legislators, 105 professional, community and advocacy organizations, and 37 town councils. A majority of legislators in both legislative houses now support efforts to improve the quality of care in the state’s nursing homes. The campaign is calling for state leaders to set safe staffing ratios, provide living wages and benefits to reduce turnover, and fix the way nursing homes are funded. Campaign solutions include converting the state’s staffing standard to staff-to-resident ratios, requiring homes to disclose staffing levels, and convening a task force to fix the funding systems. Source: PRNewswire via CONTEX, 6/19/02
11. CO nursing assistants speak out about trials,
benefits of job
One hundred fifty-five (155) certified nursing assistants gathered at Aims Community College at the fifth annual Nurse Aide Leadership Day, organized by the Centennial Area Health Education Center of Greeley, Colorado. The aides shared their experiences with each other and spoke about both the challenges and the rewards of the job. One nursing assistant said the workload sometimes can become a problem and noted that she often wishes she could spend more time with patients. “If you have very many patients that need a lot of time and a lot of care, you just don’t have time for them,” she said. She stated that she thought there was a shortage of aides everywhere. Another assistant said the demanding nature of the job makes it difficult. She said nursing aides must be willing to arrange their lives around their work and work difficult hours in a high risk environment. “You literally put your life and your health at risk to help patients,” she said. However, she noted that, “When somebody says, ‘You’re an angel,’ that makes your day.” In fact, she remarked that, “It makes your day for a long time.” Source: Greeley Tribune, 6/13/02
Medicare
12. HHS OIG finds disparities
in Medicare mental health coverage
According to the Department of Health and Human Services Office of
Inspector General (OIG), the Centers for Medicare & Medicaid Services (CMS)
does not have a national mental health coverage policy. Instead, Medicare carriers (companies that
review Medicare claims for the government) develop their own policies based on
a format given by CMS. This has led to
significant variation among carrier policies and, in some cases, the OIG found
that carriers had no or limited coverage policies for mental health
services. Such inconsistent local
Medicare coverage policies mean that people with Medicare in some parts of the
country get less mental health services than others. Source: MRC Flash,
6/18/02
Medicaid
13.
CT, MO, CO face Medicaid cuts; nursing home providers react
States across the country are continuing to slash Medicaid budgets. In Colorado, a state board recently came up with Medicaid cuts totaling $37 million. The cuts will affect nursing homes, pharmacies, hospitals and other organizations. In Missouri, a group of nursing homes has filed a lawsuit challenging budget cuts of nearly $20.7 million. The lawsuit asks for an injunction against the budget cut before the June 30th end of the fiscal year and requests an order that the money be released to nursing homes. Facilities in Connecticut are taking a different approach to proposed Medicaid cuts. The state’s nursing homes have begun a mail campaign to Connecticut taxpayers warning that a state budget that cuts funding to the homes could hurt programs for the elderly. Source: Denver Post Medical Writer, 6/15/02; stltoday.com, 6/15/02; AP, 6/13/02; Boston Globe, 6/14/02
Research
14. Study examines suicide risk factors for seniors
Swedish scientists have found that poor health may be a risk factor for
suicide in the elderly. In a study of
100 suicide cases of people over 65 in Scandinavia, researchers found that in
the elderly, serious physical illness, impaired vision, neurological disorders,
and malignant disease were linked to higher rates of suicide, especially among
men, according to a study published in the current issue of the British Medical Journal. The study’s authors note that seniors who
are considering suicide often don’t tell their doctors about their
feelings. The authors recommend further
research into the detection and treatment of depression and suicidal thoughts
in the context of physical disease.
Source: SNALF.com, 6/11/02
DC Doins’
15. House Holds Hearing on Tort Reform
On June 12, 2002, the House Subcommittee on Commercial and Administrative Law held an oversight hearing entitled "Health Care Litigation Reform: Does Liability Restrict Access to Health Care?" The focus of the debate was higher malpractice premiums driving medical providers out of the market, and whether the increase in premiums was caused by an increase in litigation costs. There was a significant amount of testimony regarding California's MICRA, the Medical Injury Compensation Reform Act of 1975. A sharp disagreement arose concerning the success of this Act, and whether it should be used as a model for federal legislation. There was also disagreement as to whether the increase in medical malpractice premiums was due to normal insurance cycles, or to an increase in litigation and high jury awards.
Subcommittee members present included Rep. Bob Barr (GA), Rep. Tammy Baldwin (WI), Rep. Jeff Flake (AR), Mr. Melvin Watt (NC), Rep. Maxine Waters (CA), Rep. Jerrold Nadler (NY), and Rep. George Gekas (PA). Testifying were Donald Palmisano, M.D., J.D., Secretary - Treasurer of the American Medical Association, Joanne Doroshow, Executive Director of the Center for Justice and Democracy, Danielle Walters, Executive Vice President of Californians Allied for Patient Protection, and Lawrence E. Smarr, President of the Physician Insurers Association of America. Written statements were also presented by the American Association of Nurse Anesthetists, the American Osteopathic Association, the American College of Surgeons, the Heatlh Care Liability Alliance, the American College of Obstetricians and Gynecologists, and the American Association of Orthopaedic Surgeons. Copies are available at: http://www.house.gov/judiciary/commercial.htm
16. Elder abuse and neglect get more
attention from the U.S. Senate
A
panel of experts told members of the U.S. Senate Finance Committee last week
that more needs to be done to combat elder abuse and neglect. The committee heard testimony that as many
as 8 in 10 cases of abuse go unreported.
The National Academy of Sciences testified to the committee about its
newly released report revealing that elder abuse is currently ill-defined,
often undetected and inadequately addressed.
The report details the injuries, exploitation and mistreatment the
nation’s seniors suffer each year and offers research approaches to prevent
these abuses in the future. Catherine Hawes, Ph.D., Professor at Texas A &
M University System’s Health Science Center in College Station, testified that
residents in nursing homes and other institutional settings are most at risk
for abuse and neglect. She noted that
skilled nursing facility residents are particularly vulnerable because of their
heavy reliance on facility staff due to cognitive and physical
impairments. Hawes told the committee
that, “If I were going to do only one thing to reduce abuse and neglect, it
would be to increase staffing in the nation’s nursing homes.” A number of experts called for oversight on
the federal level. Source: Reuters, 6/18/02; SNALF.com, 6/19/02
17. Senator Breaux calls for long term care reform
At a Senate Special Committee on
Aging hearing on June 20 entitled “Long-Term Care Financing: Blueprints for
Reform,” committee chair Senator John Breaux (D-LA) released a report on the
findings from the committee’s 13 hearings on long term care. Breaux urged Congress to initiate
comprehensive long-term care reform. “Our series of hearings illuminated the
fractured way we currently address the nation’s long-term care needs, costing
billions of dollars for minimal benefit to American families,” Breaux
commented. The committee heard from
expert witnesses, including Senator John Rockefeller (D-WV) and Governor Howard
Dean (D-VT), who offered solutions to issues raised throughout the
hearings. In a statement presented at
the hearing, American Association for Homes and Services for the Aging Senior
Vice President Suzanne Weiss called for both short-term and long-term solutions
to the problem of long term care financing.
In particular, she advocated federal standards for state nursing home
reimbursement. To find out more about the committee hearing, go to http://aging.senate.gov/events/. Source: SNALF.com, 6/21/02
Other
News
18. Illinois Elder Rights Conference to be
held in July
The Illinois Department on Aging is sponsoring its 16th Annual Elder Rights Conference in Chicago July 23-25. The conference is designed for elder abuse workers, long term care ombudsmen and legal services providers. Sessions include preparing restaurant quality food and service while saving money in long term care facilities; the legal and psychological aspects of undue influence; sexual assault of the elderly; 15 nursing home myths; ethical end of life issues; and death investigations of nursing home residents, as well as other topics. The keynote speaker for the conference is Terry Tafoya, Ph.D., a Native American who uses Indian ritual and ceremony to present on a variety of subjects such as cultural diversity, family therapy, grief and loss, and mental health. The conference flyer can be found at http://www.state.il.us/aging/training_er-conf2002.pdf
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