Jonathan Chait wrote: “Health-care reform is extremely complicated even under the best of circumstances. But when you combine the inherent complexities of the subject with the ideological rigidities of the conservative movement, the problem goes from hard to prohibitively impossible. Providing access to medical care to the tens of millions of Americans who can’t afford it on their own, because they’re too poor or too sick, is arithmetically futile if you’re bound by a dogma that opposes redistribution from the rich and healthy to the poor and sick.”

The Republican Party set in motion the process of repealing Obamacare through a process known as “budget reconciliation,” which would allow the party to gut the law with a single party-line vote. But fissures quickly emerged within the party as public opinion shifted against the G.O.P.’s original plan to repeal the A.C.A. without a ready replacement.

The Republican party is split between Trump, who has promised that nobody will lose their coverage under his “terrific” plan; reasonable Republicans, who hope to keep the A.C.A. infrastructure in place, but repair certain elements with more “conservative incentives”; and more ideological conservatives who don’t believe in any government role in health care and believe that not everyone deserves to receive health care.

The Wall Street Journal reports that Paul Ryan and Mitch McConnell, lacking the votes from fellow Republicans for a plan that would create significant humanitarian and economic damage to the health-care sector and millions of voters who would lose their access to care, want to just push the bill ahead anyway.

84 percent of Americans—and 69 percent of Republican voters—are in favor of the Medicaid expansion, through which an estimated 12 million Americans have gained coverage.

CNN had a heartbreaking article written by Bobbi Young about the rape her mother suffered at a nursing home.

I scanned my mother’s bed, pulled back the rumpled sheets and uncovered her shivering naked body. I stared at her bruised inner thighs, her sheets wet with urine and blood, her catheter pulled completely out of her. I covered her with a blanket and held her close as she pleaded, “Get me out of here.”

I kissed her forehead, our tears mixing, and promised no one was going to stop me. She would not spend another night in this nursing home.
I pushed the call button. No response. I followed the cord to the wall and found it disconnected. My heart racing, I tracked down an aide and demanded that a nurse come to my mother’s room immediately. At 88, she was examined with nonchalance and covered back up.
I called the manager to her room and told her I was taking Mom home.
The nursing staff gathered in force, attempting to convince me that her release was a long process, that my mother could still benefit from their help. Her stay in the nursing home had been a temporary transition needed after being hospitalized with a stroke.
But I knew my mother had been harmed. I feared the worse. And I feared for her life if she stayed there.
I called her doctor to sign a release form, and I phoned a service for private medical transport. I also called my husband and said, “I need to bring Mom home with us today. Go get Daddy.”
At the front door of the nursing home, the management staff lined up to wish us well. They invited us to come back and visit.
“Thank you,” I told them, “but we will never drive by this road again.”
When we arrived home, the driver unloaded my bundled mother and the rain momentarily stopped. I looked up and saw my father, his hand pressed to the window, tears in his eyes and mouthing the words “Mama … Mama’s home.” Married 69 years, my parents experienced every second apart as an eternity.
Once settled in their own bed, Daddy curled up next to Mother, held her hand, prayed with her, assured her she was OK now, home safe. She was still recovering from her stroke, and even though my father sensed some harm had come to her, he didn’t ask. He didn’t want to stress her more. He never left her side.
Over the weeks that followed, my mother complained of pain in her groin area. Doctors increased the doses of pain medication, but she still awoke in anguish, day after day. I finally had to examine her — and my heart sank.
I knew she needed to be seen by her gynecologist as soon as possible.
A nurse practitioner examined my mother and ran tests to confirm her suspicions: a sexually transmitted disease. Had my mother shown these symptoms before, she asked. The answer was no. Had my mother had any sexual partners besides my father in her lifetime? The answer was no.
When I told her about what had happened in the nursing home, the nurse said my father would need to be tested for the disease. My mother was visibly shaken. I asked the nurse, if my father was negative, what would be the next step? She said, you need to call the California Department of Public Health and file a report.
We drove home silently. My mind struggled with how much my mother had been through; now we were minutes away from devastating my father. I asked if she wanted my help in telling Daddy. The answer was yes.
As I spoke, Daddy didn’t hesitate to agree to be tested. Then he asked what all of this meant. What would proving he was negative for the disease mean?
Mama, her voice choked with sadness, replied: “I was raped.”
My father held my mother, crying, shaking his head in disbelief and apologizing for not being able to keep her safe.
I grew up believing my parents were strong and took comfort trusting I would always be safe. They both worked two or three jobs throughout my childhood to buy me and my siblings encyclopedias to enhance our knowledge of the world long before Google existed.
Witnessing this wound inflicted on my parents cut deeply to the core of my own foundation. The hospital had recommended the nursing home as a transitional step; her own internist was the director of the facility: What could possibly go wrong?
There were no warning flags. We failed to protect her against something we could not even imagine existed. A distress signal is only as good as the person who sees it. When I saw it, I took action. But it was too late.
For months, my parents comforted each other, not wanting to be even a foot apart. Their love never wavered; it only deepened. I would walk past their bedroom and see them snuggled tightly together, whispering. My father later told me they were praying and planning to renew their wedding vows on their 70th anniversary.
Beyond the harm the perpetrator had inflicted on my mother, he took a toll on my father’s remaining strength and stole some of the precious time my parents had left. Still, together they decided to fight for reform, which my husband and I fully supported. We filed a civil lawsuit against the facility, arguing that more should have been done to protect my mother. She was brave enough to appear at the center of a public service video created by a nonprofit calling for nursing home reform.
On the day my father died, my husband was diagnosed with terminal cancer. His painful journey ended 17 months later. But our commitment to choose love and joy enabled Mother and I to embrace our faith and carry on. I promised my husband I would not be sad or bitter. I had promised my father I would care for Mama and keep her safe.
I feared that I would not be able to fulfill those promises.
But there are moments in life that transcend fear. They mend twisted hearts. This became one of those moments.
After my husband’s funeral, all of my mother’s nurturing traits intensified. I had promised to care for her, and now she was providing me with what felt like a second childhood. She took the reins, suggesting remedies such as extra locks on doors and an alarm system to quiet our fears. She reminded me of recipes to help stretch our dollars to survive — such as making “imagination cookies.” When I looked sad, she would talk about funny things my husband did to make her laugh. We prayed together, planned our spring garden, went for drives on hot days with the windows down, hair blowing in the wind, laughing with memories.
I promised my mother I would honor her vow to carry on her courageous battle for justice all the days of my life by telling her story. While her perpetrator will likely never be found, it was one of her last wishes for people to understand that no one is too old to become a victim of rape.
My mother died in January. She was 94. As I walk around my home now, I look at the empty rocking chair in which she soothed her children. I can feel her brushing my long hair. The seedlings she planted in eggshells on Christmas Day are bursting toward spring. I can hear her laughter and her reminder to me: “The gifts God gave you, he did not give to another; respect them and share them wisely. …”
Who was this woman in my life? Why was she made to suffer so?
An answer fills my sorrowful heart:
Suffering can carve two types of people, monsters and angels. I am fortunate to have been raised by angels. And I pray to one day be worthy of that divine fabric that still holds me tightly together — love.

CNN conducted a special investigation into the epidemic of sexual assaults and rapes in nursing homes.  “The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them.”

“It’s impossible to know just how many victims are out there. But through an exclusive analysis of state and federal data and interviews with experts, regulators and the families of victims, CNN has found that this little-discussed issue is more widespread than anyone would imagine.”

“Even more disturbing: In many cases, nursing homes and the government officials who oversee them are doing little — or nothing — to stop it.”

“In cases reviewed by CNN, victims and their families were failed at every stage. Nursing homes were slow to investigate and report allegations because of a reluctance to believe the accusations — or a desire to hide them. Police viewed the claims as unlikely at the outset, dismissing potential victims because of failing memories or jumbled allegations. And because of the high bar set for substantiating abuse, state regulators failed to flag patterns of repeated allegations against a single caregiver.”

It’s these systemic failures that make it especially hard for victims to get justice — and even easier for perpetrators to get away with their crimes.”

“Some accounts of alleged sexual abuse come from civil and criminal court documents filed against nursing homes, assisted living facilities and individuals who work there. Other incidents are buried in detailed reports filed by state health investigators.”

“Most of the cases examined by CNN involved lone actors. But in some cases, a mob mentality fueled the abuse. And it’s not just women who have been victimized.”

“Despite the litany of abuses detailed in government reports, there is no comprehensive, national data on how many cases of sexual abuse have been reported in facilities housing the elderly.”

“More than 16,000 complaints of sexual abuse have been reported since 2000 in long-term care facilities (which include both nursing homes and assisted living facilities),according to federal data housed by the Administration for Community Living. But agency officials warned that this figure doesn’t capture everything — only those cases in which state long-term care ombudsmen (who act as advocates for facility residents) were somehow involved in resolving the complaints.”

“The result: CNN exclusively found that the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities during this period. (This includes some of the cases provided by the Centers for Medicare & Medicaid Services.) And nearly 100 of these facilities have been cited multiple times during the same period.  Complaints and allegations that don’t result in a citation, which the government calls a “deficiency,” aren’t included in these Medicare reports. In addition, national studies have found that a large percentage of rape victims typically never report their assaults. So these numbers likely represent only a fraction of the alleged sexual abuse incidents in nursing homes nationwide.”

“Yet the facilities that currently house more than 1 million senior citizens typically pay low wages to nursing assistants (about $11 or $12 an hour), making it difficult to attract and keep quality workers. And during the most vulnerable hours, the night shift, there are often few supervisors.”

The article discusses numerous horrific examples; I encourage you to read the full article.

Legal advocates, government regulators, criminal investigators and medical experts agree that sexual abuse in nursing homes can be extremely challenging to prevent and detect. But they say many facilities should be doing much more to protect vulnerable residents.

  1. “When you have a sexual assault claim, you shouldn’t go to a conclusion she’s a problem patient. You should investigate as a sexual assault until proven otherwise.” — Dave Young, district attorney for Colorado’s 17th Judicial District
  2. “Preserve evidence! Don’t bathe or change clothing, sheets, etc., when an assault is suspected.” — Sherry Culp, Kentucky long-term care ombudsman
  3. “Most abuse is undetected and never reported mainly because observable signs are missed or misinterpreted. A little training could go a long way.” — Tony Chicotel, staff attorney at California Advocates for Nursing Home Reform
  4. “As with nearly every type of abuse and neglect seen in nursing homes, the better staffed the facility the less likely sexual abuse will occur. This is a crime of opportunity, so the more supervision the better.” — Kirsten Fish, elder abuse attorney
  5. “There needs to be a reporting system. …The system doesn’t keep track of cases that haven’t been substantiated, [and] their rules for substantiating a complaint are just astronomical. It’s virtually impossible to substantiate a complaint.” — Lt. Chris Chandler, Waynesville, North Carolina, Police Department

 

 

WDAY reported on the lack of regulatory oversight in Minnesota. The Minnesota Health Department performed on-site investigations of just 10 percent of the 3,400 complaint allegations it received from the public about nursing home and home-care treatment last year, according to the agency’s statistics. The agency only did on-site inspections of 102 allegations — less than 1 percent — of the nearly 21,000 allegations it received from providers’ reports.

The number of vulnerable adults receiving care and the ease of lodging complaints have both grown in recent years, resulting in an exponential increase in the number of complaints the department takes in.

“Thousands of complaints are not investigated so maltreatment continues, and less severe issues may escalate to more serious harm,” the agency said in a budget request this year. Those uninvestigated complaints in the last year included more than 4,000 falls, nearly 2,000 complaints of emotional or physical abuse by staff and nearly 3,000 “unexplained injuries,” the department said.

The Chillicothe Gazette reported that Kali Jo Craiglow who assaulted her nursing home patient in March will spend a year in prison.  Craiglow punched Leona Alexander in the face, thrown a glass of water in her face, and threatened she would get worse once they were in the shower. The assault left Alexander’s eyes swollen and blackened, the skin on her hand torn. Reports on the assault indicate her clothing also had been torn and there was a bloody pillowcase on the floor.

Ross County Common Pleas Judge Scott Nusbaum told Craiglow if it had been his mother, he would want to “jump over this bench,” eliciting sounds of approval from nearly two dozen people in the courtroom.

“You’re going to be placed with inmates that are a lot tougher than an 85-year-old. You may be marked … Don’t allow the stress you’re under to take drugs or join gangs,” Nusbaum told Craiglow. “You’ve committed a horrendous offense, but your life is not over.”

The resident’s daughter, Stacy Williamson, says her mother is constantly scared of being attacked again.

After the beating that Kali Craiglow gave our mother, we had to have someone sit with her all night for several months, and she would call us at all hours of the night because of how scared she was that someone would beat her again … The time she has left is miserable thanks to you,” Williamson said through tears during her victim impact statement in court.

Williamson said she’s just glad to know Craiglow is going to prison for what she did. She urges others with loved ones in nursing homes to check on them every day.

In an article from SC Lawyer’s Weekly, written by Phillip Bantz, the highest pretrial nursing home settlement is discussed. Poliakoff & Associates and Jackson Law Offices represented Daniel Gouveia, who died after less than a month in Pepper Hill Nursing & Rehabilitation Center, a nursing home in Aiken, SC. Gouveia developed a stage 4 sacral ulcer which became infected, leading to his death. In addition to the obvious care deficiencies Gouveia received, there were a number of other issues related to Gouveia’s care, including false documentation. Medical documentation is a vitally important component of care, as it communicates medical issues with caregivers. Missing, edited, or false documentation is a serious breach in the standard of care. For more information, read the full article here.

GQ had an article about how Republicans are still lying about the Affordable Care Act. Republicans have spent the years since the ACA was passed spreading lies about the bill. Paul Ryan has said that it’s bankrupting Medicare, when in fact the truth is just the opposite. Literally the exact opposite is true. This comes from FactCheck.org.

As for Ryan’s claim that Obamacare had worsened Medicare’s financing, that’s not the case, either. In fact, the law both expanded Medicare funding—adding a 0.9 percent tax on earnings above $200,000 for single taxpayers or $250,000 for married couples—and cut the growth of future spending. Additional revenue and savings actually extend the life of the trust fund. The trustees’ 2010 report estimated that the ACA had added 12 years to the life of the Part A trust fund.

The ACA has PROLONGED Medicare’s life. But the worst of the lies that Republicans have trotted out is the trusty old “Death Panels”, or the idea that a government panel would decide if elderly people weren’t worthy of care anymore. This blatant lie has been debunked over and over again.

Well, that’s not stopping some GOP officials from trotting that idea out in the debate over the potential repeal of Obamacare.  Take for instance this amazing moment from a town hall in Florida when local Republican official Bill Akins tried to use “Death Panels” as an argument for the repeal of a law that gives 20 million people healthcare.

Obamacare is more popular today than it has ever been before.

The Kansas City Star had a great article about the groundswell of support by voters now that Obamacare is on the chopping block.  Democratic pollster Mark Mellman, contending that “nothing concentrates the mind like a hanging.  However, Obamacare has never been more popular.  A Fox News poll found that 50 percent of voters feel favorably, compared to 41 percent who felt favorably about the law the last time the network polled on it, in the summer of 2015.

Ahead of a congressional recess next week, Democratic leaders in the House and Senate are asking their members to host rallies, visit hospitals and talk to enrollees in their districts over the next week in a bid to keep the successful health care law alive.

The call for action, along with a grassroots movement that is staging rowdy protests at Republican town halls nationally, is complicating Republican efforts to move swiftly on their threats to repeal the 2010 law.

Florida Rep. Kathy Castor, D-Tampa, says she’s held events “constantly” and plans to hold an event Saturday to boost social media activism. She and a number of Democrats also plan to bring Obamacare enrollees as their guests to President Donald Trump’s first address before Congress on Feb. 28.

“It’s unlike anything I’ve seen,” Castor said. “Phones are ringing off the hook. The Republicans have no plan and that’s created a lot of fear back home.”

Antipathy to Donald Trump’s election also plays a considerable role for many Americans who otherwise may have been neutral on the health care law, Mellman said.

Indeed, congressional Republicans have already heard an earful from groups loudly voicing opposition to Trump – and in some cases efforts to repeal Obamacare – at district town halls across the country.

Mcknight’s reported that the family of a deceased Kentucky nursing home resident will not have to arbitrate a dispute with the facility following a federal court’s ruling. The Kentucky case involves the son of Judith VanArsdale, a former resident of a Preferred Care facility. He filed a suit in state court claiming her death was caused by negligence.

Preferred Care filed a case in federal court seeking an order to compel arbitration of VanArsdale’s claims.  The facility where VanArsdale lived was taken over by Preferred Care two years after she was admitted. As part of that transition VanArsdale’s son, who had power of attorney, signed an arbitration agreement on her behalf.

The state court found that the arbitration agreement signed by VanArsdale’s son was not enforceable since Kentucky law did not give him authority to enter such an agreement on his mother’s behalf. The court also stayed the provider’s federal action pending the conclusion of the state suit. Preferred Care then sought an injunction from the U.S. District Court for the Eastern District of Kentucky.

The U.S. Court of Appeals for the Sixth Circuit agreed with the District Court’s decision to decline the provider’s injunction, citing the previous opinion that VanArsdale’s son lacked the authority to sign the arbitration agreement. The appeals court’s ruling puts the federal case on hold until the state case is resolved. This is the second arbitration-related court case involving Preferred Care in recent weeks. The Sixth Circuit last Wednesday denied a request from a resident’s estate seeking to appeal a lower court decision that required them to arbitrate their dispute.

CNN reported on an interesting bit of blatant hypocrisy from the Republicans on Obamacare.  Three years ago, House Republicans sued the Obama White House to block the administration from diverting funds to pay health care insurers to help cover low-income Americans. The House argued that that the cost-sharing reduction payments were illegal because Congress — not the executive branch — had control over allocating spending, and Congress had not appropriated the money.

They won the lawsuit and now control the White House and Congress. But that means they’re facing a deadline to determine how they will do what they sued to stop: spending taxpayer money to insurers to subsidize insurance for low-income Americans.
Republican leaders are acknowledging that they will need to allocate billions of dollars in what are known as cost-sharing reduction payments. They also have to act fast — they need to update the judge in the lawsuit tomorrow — and figure out how to placate insurers and skeptical conservatives.
One of the issues with cost-sharing reductions is that if they aren’t paid, insurers can leave the Obamacare marketplace. Without many choices, that would drive up costs for consumers and likely have devastating political consequences.
Some conservatives say that allocating the money at all would be disingenuous after members railed against the payments for years. They argue that if the market collapsed because the House refused to appropriate CSR payments that would not be the Republicans’ fault.