NORC Gazette

October 10, 2003

National Long Term Care Ombudsman Resource Center

National Citizens’ Coalition for Nursing Home Reform

Due to NCCNHR’s Annual Meeting:

This will be the last Gazette until October 31, 2003


Table of Contents

    Ombudsman Program Updates
1.     WA advocates celebrate Residents’ Rights week

2.     FL advocates highlight residents’ rights through seminars and events

3.     FL State Ombudsman highlights residents’ rights in the media

4.     CA officials recognize Residents’ Rights week

5.     News for Ombudsmen attending NCCNHR’s annual meeting

  Ombudsman Calendar of Events

    Home and Community-Based Care/Olmstead    
6.     CMS funds community living projects       

  Nursing Home News

7.     Nashville nursing home fire update

8.     Nursing home fires rare, but among the most deadly

9.     New York nursing home pays $3 million, averts criminal charges

    Nursing Home Quality Initiative

10.     National Quality Forum adopts new quality measures

    Assisted Living
11.   OR officials scramble to determine why residents are becoming ill

     Medicaid

12.   KY lawsuit attacks Medicaid cutbacks 

13.   Study links low Medicaid reimbursement to resident harm

    Research

14.   New diabetes drugs could cause trouble for some residents

    DC Doins'
15.   OIG includes nursing homes in 2004 work plan

16.   DOL initiative targets the health care workforce

  Other News

17.   Daily Money Management Programs: A protection against elder abuse

18.   NCCNHR board member receives national aging and law award

19.   AoA celebrates Hispanic heritage month  

20.   Families USA announces fellowship opportunity

 

Ombudsman Program Updates

1. WA advocates celebrate Residents’ Rights week
In celebration of residents’ rights week, Washington’s resident councils identified their five top residents’ rights at a pep rally. The five rights highlighted were: (1) the right to communicate without fear of retaliation; (2) the right to use personal belongings; (3) the right not to be transferred or discharged; (4) the right to safe and adequate care; and (5) the right to be treated with dignity and respect. “Residents' rights are not being consistently met in facilities across the country, and a lot of people don't know what their rights are,” said Hilke Faber, advocacy coordinator with the Resident Councils of Washington (RCW) and member of the NCCNHR Board of Directors. The celebration was organized by the state Long-term Care Ombudsman program and the RCW and was marked with a special proclamation from the governor. Facilities participated with parties, skits and games such as resident-rights Bingo throughout the week. Source: Seattle Times, October 7, 2003

2. FL advocates highlight residents’ rights through seminars and events
Florida's Long-Term Care Ombudsman Program will hold an educational seminar in Orlando on October 15th for nursing-home officials and workers as well as residents and their families. The seminar will include topics such as individualized treatment and bathing practices. Speakers include Rose Marie Fagan, executive director of the Pioneer Network, a national organization dedicated to improving living conditions in nursing homes. Additional seminars will take place this month in Tallahassee, Gainesville, Miami, Tampa and Jacksonville. For more information, call 1-813-558-5590.  An event this week, at Florida International University, gave the Pioneer Network an opportunity to promote their nursing home innovations. To read more about the Pioneers participation, please visit: http://www.sun-sentinel.com/news/local/palmbeach/search/sfl-ppioneer08oct08,0,5401900.story.  Source Orlando Sentinel October 6, 2003; The Miami Herald, October 7, 2003; Sun Sentinel, October 8, 2003.

3. FL State Ombudsman highlights residents’ rights in the media
In letters to the editor appearing in the Tampa Tribune, the Naples Daily News and the Miami Herald, Brian Lee, Florida State Ombudsman, emphasized the importance of residents’ rights and encouraged Floridians to educate themselves about the rights guaranteed to residents of long term care facilities.  “In recognition of October being named Residents' Rights Month, the Long-Term Care Ombudsman Program encourages Floridians to learn more about elders' rights and to share that information with seniors. Thanks to our efforts, many seniors enjoy autonomy, fair and courteous treatment, privacy and control of their financial matters,” Lee wrote.  Lee also noted “There are more than 150,000 Floridians residing in nursing homes or other long-term care settings. The state has made great strides in protecting them and ensuring their right to age with dignity. However, too often these individuals aren't made aware of their rights.” Source: Miami Herald. October 7, 2003; Naples Daily news, October 4, 2003; Tampa Tribune, October 3, 2003; Sun Sentinel, October 7, 2003.

4. CA officials recognize Residents’ Rights week
In spite of all the political happenings in California, Governor Davis issued a Residents’ Rights Week Proclamation. An original document was signed and delivered to all local Ombudsman programs.  In addition, the Ombudsman Services of Northern California received a proclamation from the Sacramento Mayor’s Office.  Kudos to all California advocates for keeping residents’ rights on the radar!  Source: E-mail, October 9, 2003

 

 

5. News for ombudsmen attending NCCNHR’s annual meeting

Conference registration is nearly 300 participants, including 22 state ombudsmen and over 120 local ombudsmen.  We can hardly wait to see you next week! Please feel free to introduce yourself to the staff and plan to attend the receptions and auction to enjoy the fellowship of advocates from across the country.

Scholarships available: 

A limited number of scholarships ($60 value) are available from the National Long-Term Care Ombudsman Resource Center to ombudsmen wanting to attend an intensive at the NCCNHR Annual Meeting, Sunday October 19th.  Ombudsmen who want to attend an intensive, but do not have the funding to do so, please contact John Kafka at NCCNHR, 202-332-2275 by Monday October 13th.   Intensive choices include:         1. Moving the Personal to the Political: Strategies for Grassroots Organizing to Address Neglect and Abuse featuring State Ombudsman Brenda Gallant discussing staffing strategies, Margaret Niederer discussing the IL ombudsman legislative efforts and Lou O'Reilly explaining the TX strategies for advocacy.  2.   Dialogue Between the Disability and Aging Communities - an exciting and unique opportunity for serious dialogue between these two groups that often share common goals but many times do not have joint strategies.  Four activists from Michigan will share their stories that can be an example to all states.  3. Isn't It a Crime! Prosecuting Those who Abuse and Neglect Nursing Home Residents - a careful look at the goals, successes and failures of prosecution.  4. The Nursing Home Reform Law and You:  The Linchpin of Individual and Systems Advocacy for Residents.  This is a skills based intensive that includes participation and using the newly developed "Ombudsman Guide to the Nursing Home Reform Law".  Sarah Greene Burger is the presenter; ombudsmen and citizen advocates will lead breakout groups.

Wanted: NCCNHR conference resource room material

Show off your program in the Resource Room at the NCCNHR Annual Meeting Oct. 18-21.  Brochures, videos, promotional materials, program displays and photos are welcome.  You may bring materials with you or send to NCCNHR now.  Contact Deanna Okrent or John Kafka at dokrent@nccnhr.org or 202-332-2275 for more information and mailing instructions.

    

Ombudsman Calendar of Events     
October 5-11, 2003:  Residents’ Rights Week 2003.  Thanks to each of you who has worked hard to promote quality of life and quality of care for long-term care residents.  

October 15-18, 2003: NALC Conference, Arlington, VA; for more information go to:  http://www.aarp.org/ntltrpro/nalc.html

October 17, 2003: New State Ombudsman Orientation, 10:00 a.m. - 5:00 p.m., Arlington, VA.  Continental breakfast at 9:30 a.m.

October 18, 2003: NCCNHR/NALC Bridge Day

October 18, 2003: NASOP Meeting, 1:00-5:00; NALLTCO Board of Directors, 6:30 - 8:30.

October 18-21, 2003: NCCNHR’s 28th Annual Meeting, Elder Justice: Shaping Policy, Saving Lives, Arlington, Virginia.

October 19, 2003:  NASOP Membership Meeting, Sunday morning; NALLTCO membership meeting, 7:00 - 9:30 pm

October 26-28, 2003: National Home and Community-Based Waiver Conference, Madison, Wisconsin. 

October 28-30, 2003: California Ombudsman Training with Sara Hunt, NORC Consultant

November 2003: National Family Caregivers Month

January 22-14, 2004: Families USA Conference: Health Action 2004. This conference will focus on several broad issues: the future of Medicaid, recent federal Medicare and prescription drug legislation, private market and employer-provided health care, and state strategies for universal health care, among others. A Special Early Bird Registration fee of $235 is available until December 15 (the rate after the 15th is $285). For additional information, please visit: http://www.familiesusa.org/site/PageServer?pagename=conference_2004

March 2-3, 2004: CMS’s 4th Annual Systems Change Conference, Baltimore Marriott Waterfront Hotel, Baltimore MD.  The conference theme is “Building Systems so that Money Can Follow the Person.”  CMS is seeking suggestions for sessions on Systems Management in the areas of: (1) Access - Comprehensive information, simplified eligibility, and single access points (2) Financing - A seamless funding system supporting individual choice (3) Services - Responsive supports across settings and provider types (4) Quality Improvement - Comprehensive systems that assure quality of life services. Please submit suggestions to Csampson@cms.hhs.gov (Carol Sampson) or fax 410-786-9004 by October 20, 2003.

April 24-27, 2004: Spring Training for State Ombudsmen, St. Louis, MO.  Make your hotel reservations today by calling Embassy Suites Hotel, St. Louis, Downtown at 314-241-4200.  Room rate is $102 (single) & $122 (double) plus local taxes and fees. All rooms are suites that include refrigerator, microwave, wet sink, and coffee maker.  Rate includes a full cook-to-order breakfast in the Garden Atrium and an evening manger's reception.  Be sure to mention you are with the Annual State Long Term Care Ombudsman Training Conference.  Plan to come and spend Friday getting to know your fellow State Ombudsmen and touring this great city.  More details about the training program to follow.

August 4-7, 2004:  Pioneer Conference "There's No Place Like Home", See:  http://pioneernetwork.net/

 

 

Home and Community-Based Care/Olmstead           
6.  CMS funds community living projects
The Centers for Medicare & Medicaid Services (CMS) funded five new demonstration projects aimed at helping recruit, train, and retain personal assistants, including three that will test whether offering health insurance benefits helps keep workers on the job. The grants are intended to help states and other eligible entities make lasting improvements to home- and community-based services programs for people living with disabilities or long-term illnesses. Both sets of grants are part of the New Freedom Initiative, which promotes community living for people with disabilities.  To read a press release about the workforce demo grants, go to http://www.hhs.gov/news/press/2003pres/20031002.html.  To read a press release about the Real Choices grants, go to http://www.hhs.gov/news/press/2003pres/20031002a.html. Source: CMS Press Release October 2, 2003.
    

Nursing Home News

7. Nashville nursing home fire update

Two lawsuits were filed in response to the fire that ultimately killed 11 residents and injured scores of others at a Tennessee nursing home last month. The suit claims National HealthCare Corp. was negligent in failing to provide sprinklers.  The NHC HealthCare Center was exempted from a requirement to have sprinklers because it was built in the 1960s and hadn't been renovated since 1994. The lawsuit will be amended to include the manufacturer of a hospital bed if evidence shows the electrical mechanism in the bed started the fire.  NHC has since announced that it plans to put sprinkler systems in each of its 82 facilities. The initiative is expected to cost upwards of $10 million and take six to nine months to complete.  Tennessee Governor Phil Bredesen has indicated that his administration will work to strengthen nursing home industry regulations upon the legislature’s return in January.  Source: Mcknight’s LTC Daily Update October 8, 2003; Nashville City Paper, October 7, 2003; Teneessean.com. October 7, 2003

 

8. Nursing home fires rare, but among the most deadly

Nursing home fires represent only about 0.5 percent of the 560,000 structure fires each year in the United States, but they're often among the most deadly. The reason is simple: Nursing home residents typically are too old and frail to take care of themselves in an emergency. People older than 65 are twice as likely to die in a home fire than the general population, and the risk increases with age. Earlier this year, a nursing home fire in Hartford, Connecticut killed 16 patients. In the aftermath of that fire, Connecticut lawmakers passed legislation to make all nursing homes install sprinkler systems by July 1, 2005 - the first such law in the country. Ninety-three percent of U.S. nursing homes have smoke alarms, but only about 75 percent have automatic sprinkler systems. If a fire breaks out, the death rate in nursing homes without automatic sprinklers is almost six times higher than the rate in facilities with such protection and property damage is twice as high.  To read the full article, please visit: http://www.stamfordadvocate.com/news/local/state/hc-05125741.apds.m0918.bc-ct--nursoct05,0,6314396.story?coll=hc-headlines-local-wire

Source: The Advocate, October 5, 2003

 

9. New York nursing home pays $3 million, averts criminal charges
The owners of The Waters nursing home chain will pay $3 million to New York State (NYS) to settle allegations the facilities were consistently understaffed and that employees falsified records and neglected patients.  Facility owner, Neil M. Chur Sr., will avoid criminal charges after a three-year grand jury probe by the Medicaid Fraud Control Unit. Under the agreement, Chur will be allowed to operate his other facilities in NYS and his companies will make no admissions of liability or wrongdoing.  The settlement will have no effect on several pending lawsuits filed by families who claim their relatives were neglected or mistreated in The Waters homes.  The $3 million settlement is one of the largest nursing home settlements ever in NYS.  McKnights LTC Daily News, October 7, 2003;   New York Newsday, October 7, 2003; Buffalo News, October 7, 2003.

 

 

 

 

Nursing Home Quality Initiative

10. National Quality Forum adopts new quality measures

The National Quality Forum (NQF), an independent contractor for the Centers for Medicaid and Medicare Services (CMS), recommended a consensus set of “Nursing Home Performance Measures” for CMS to adopt.  For long-term skilled nursing facility residents, the NQF recommended that CMS add measures to assess residents who are in bed most of the time, experience decreased ability to move about, have urinary tract infections, have moderate or severe pain, were physically restrained during the seven-day assessment period, or experience worsening of depression or anxiety. The only addition for short-term care residents the NQF suggested was a Quality Measure (QM) for residents who lose bladder or bowel control or have an indwelling catheter despite being at low-risk for these issues. Two QMs the NQF endorsed for all residents were the receipt of pneumonia and flu vaccines. Weight loss in long-term care residents and nurse staffing were placed on the back burner for further study. Source: NQF Press Release, October 3, 2003; McKnights LTC Daily News Update, October 7, 2003; SNFInfo E-Newsletter, October 7, 2003

 

 

Assisted Living
11. OR officials scramble to determine why residents are becoming ill

State health officials are searching for reasons to explain why 22 residents from two Wilsonville, OR-based senior health care facilities--an assisted living facility (ALF) and an independent living facility--developed pneumonia. In July one resident contracted the illness, leading to five in August, and then jumping to 21 in September. Though not every case was diagnosed as pneumonia, three of the sickened residents were diagnosed with Legionnaires' disease--a disease caused by breathing in contaminated water vapor, such as that emitted from air conditioners or vents. Health officials admit that they are unsure as to the cause of the surge in pneumonia cases in the two facilities but say that the investigation is ongoing.

Source:  BAL Weekly E-Newsletter, October 1, 2003

 

 

Medicaid

12.  KY Lawsuit attacks Medicaid cutbacks 
Legal Aid lawyers filed a federal lawsuit aimed at blocking controversial cuts to the Kentucky’s Medicaid program that are forcing hundreds of elderly and disabled Kentuckians to lose nursing home care and other services. The lawsuit, filed on behalf of 10 elderly or disabled people being cut from Medicaid, alleges the cuts violate federal law that requires states to set "reasonable standards" for providing Medicaid services. It also alleges the state has violated rights of Medicaid clients by providing inadequate or confusing and conflicting notices that they are being terminated from Medicaid. Advocates have had some success getting the courts to block cuts in other states struggling with Medicaid shortfalls. Judges in Connecticut, Massachusetts, Missouri, Michigan, Nebraska and Tennessee have restricted efforts to cut Medicaid benefits after opponents filed suit.  To read the full article, please visit, http://www.courier-journal.com/localnews/2003/10/03ky/wir-front-suit1003-8320.html.

Source The Courier-Journal, October 3, 2003

 

13.  Study links low Medicaid reimbursement to resident harm

An independent study released by Lake Success, NY based MyZiva.Net in September found that government fiscal policies have become a major contributing factor in poor nursing home care in the United States. The study, which linked staffing levels and Medicaid reimbursement to facility performance, found that nursing homes in states with the lowest Medicaid reimbursement rates tend to have staffing levels substantially lower than the national average of 3.84 nursing hours per day. According to MyZiva.Net, analysis of Centers for Medicare and Medicaid Services (CMS) data shows that current staffing and Medicaid policies negatively affect resident care and the ability of nursing homes to provide care that complies with standards. Out of the 20 states with the lowest Medicaid reimbursement in the nation, 77% of their nursing homes have staffing levels below the national average, the study reported. Visit http://www.myziva.net/press/pressrel/20030929.php  for additional information. Source: MyZiva.net News Release, September 29, 2003

 

Research

14. New diabetes drugs could cause trouble for some residents

Researchers at the University of Texas discovered that two popular diabetes medications may cause congestive heart failure and pulmonary edema in some patients. More than six million Americans take Pioglitazone and Rosiglitazone, but those with Type 2 diabetes who also have left ventricular dysfunction or chronic renal insufficiency should avoid these drugs. Both drugs are relatively new and researchers should study potential side effects in more depth. The researchers studied six people with Type 2 diabetes who were all admitted to the hospital with signs of congestive heart failure. Each person took one of the drugs for one to 16 months. When they received diuretics and stopped taking the drugs, they no longer had any symptoms of congestive heart failure. Source SNFInfo Connection E-newsletter, Sept. 30

 

DC Doins'

15. OIG includes nursing homes in 2004 work plan

The Office of Inspector General (OIG) Work Plan sets forth various projects to be addressed during the fiscal year. The Work Plan includes projects planned in each of the Department's major entities including the Centers for Medicare & Medicaid Services.  Next year, OIG reports will include; access to skilled nursing facilities (SNF) under the prospective payment system (PPS); nurse aid registries; nursing home reporting of minimum data sets, resource utilization group assignments: follow up; nursing home payment system controls; SNFs’ involvement in consecutive inpatient stays; Part B payments for beneficiaries in nursing homes; imaging and laboratory services in nursing homes; nursing home compliance with dietary services requirements, state compliance with investigation guidelines; nursing home informal dispute resolution trends; nursing home enforcement; hospital patient transfers, payments to public nursing facilities; payments for ancillary services in nursing homes, nursing facility administrative costs; nursing home quality-of-care sanctions.  To read the full OIG work plan please visit: http://oig.hhs.gov/publications/workplan.html#1. Source: Department of Health & Human Services E-mail, October 1, 2003

 

16. DOL initiative targets the health care workforce
The U.S. Department of Labor (DOL) has chosen health care as one of the areas of focus for its new High Growth Job Training Initiative. The goal of the initiative is to address the nation’s most severe workforce deficits.  The High Growth initiative, she said, seeks to create partnerships with educators, employers and the public workforce system where all three will work collaboratively to meet today's workforce needs. Other job growth initiatives include one by the Council for Adult and Experiential Learning (CAEL), a nonprofit organization that helps adult’s access educational programs. With the help of DOL funding, CAEL is increasing the number of CNAs, LPNs, and RNs at five demonstration sites throughout the country through various means, including CNA apprenticeship training programs for both incumbent and prospective workers. To read DeRocco’s speech, go to: http://www.doleta.gov/whatsnew/DeRocco_Speeches/MD_HC.cfm. 

Source:  Quality Jobs/Quality Care E-newsletter, October 7, 2003.

 

 

Other News

17. NCCNHR board member receives national aging and law award
Congratulations to NCCNHR board member Alison Hirschel who is this year's recipient of the National Aging and Law Award.  Alison works as a Staff Attorney for the Michigan Poverty Law Program and is considered one of the preeminent legal advocates for this nation's low-income and frail elders.  Alison is highly regarded as one of the leading experts in the United States in legal matters pertaining to nursing home residents.  She is respected on both state and national levels.  Alison is an extremely dedicated advocate and both NCCNHR and the NORC are honored to have her as part of our team!  Source: E-mail from Ada Albright, AARP, September 25, 2003

 

18. Daily Money Management Programs: A protection against elder abuse           
Advocates working with elders recognize that seniors who are unable to manage their finances are susceptible to exploitation by unscrupulous family members, acquaintances, and predators. Daily Money Management (DMM) is increasingly being viewed as a promising way to protect seniors from those who exploit them. A manual from the San Francisco Consortium for Elder Abuse Prevention describes what DMM is, how programs are organized and administered, and the potential role such programs might play in preventing elder abuse and neglect. Source: http://www.elderabusecenter.org/. Manual developed June 2003

 

19. AoA celebrates Hispanic heritage month
The Administration on Aging (AoA) honors the rich history and cultural traditions of the nation’s growing Hispanic population by recognizing October as Hispanic Heritage Month. October is a time to celebrate the many contributions that Hispanic Americans have made in education, medicine, the arts, industry and politics. It is also a time to reflect on how we can continue to assist our Hispanic elders to remain healthy, active, integral part of their families and their communities. In 2000 Hispanic Americans made up nearly 6 percent of the older population. By 2028, the Hispanic population over age 65 is projected to be the largest racial/ethnic minority group in the 65+ age group.  For additional information, please visit http://www.aoa.gov.  Source: AoA Website, October 8, 2003

 

20. Families USA announces fellowship opportunity
Families USA announced the creation of the Wellstone Fellowship for Social Justice to honor the late Senator Paul D. Wellstone of Minnesota. The Wellstone Fellowship is a year-long, full-time, salaried position that will begin in September 2004. The fellow will be engaged in health care advocacy work in Families USA’s office in Washington, D.C., where he or she will learn about Medicare, Medicaid, efforts to achieve universal coverage, and other important health policy issues. Specifically, the fellow will be engaged in Families USA’s outreach to and mobilization of communities of color. Through this work, the fellow will also learn about conducting health care campaigns, and part of his or her time will be spent working with state-based health care advocacy organizations. For instructions on how to apply and a copy of the application form, please visit.  http://www.familiesusa.org/site/PageServer?pagename=Wellstone_Fellowship_Apply&JServSessionIdr002=a2gwyrw3f1.app2b The deadline for applications is February 6, 2004.
Source: Families USA E-mail, October 8, 2003

 

 

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 Jennifer Hirsch, Communications / Policy Coordinator, NCCNHR, jhirsch@nccnhr.org .

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 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.