The state is now investigating a local nursing home days after a Channel 9 investigation exposed allegations of abuse. [Nursing home faces lawsuits after employee pleads guilty to sexually assaulting patient].

The Channel 9 investigation aired Thursday and by the weekend, state investigators were at Lake Park Nursing and Rehabilitation Center in Indian Trail. Eyewitness News anchor John Paul went back to the facility looking for answers.  Paul talked to new family members who said they’re concerned about some of the conditions they’ve witnessed there.

Before this investigation, two lawsuits were filed on behalf of residents who are now deceased. The suits alleged sexual assault, poor treatment and untimely death.

According to Nursing Home Compare on the Medicare website cms.gov, Lake Park is a one-star facility owned and operated by PRINCIPLE LONG TERM CARE, INC tha tis on the Special Focus facility watch list. On January 15, 2016, the facility was fined $132, 600 and then again on November 2, 2016 for $277,052.

Vox reported that Health and Human Services Secretary Tom Price gave multiple interviews defending the Republican plan to repeal and replace Obamacare.

He repeatedly lied and made false promises about what the American Health Care Act would do.  He told CNN that the bill would “absolutely not” result in millions of Americans losing Medicaid.  (The Congressional Budget Office evaluated a previous version of the bill and estimated that it would cut $880 billion from the Medicaid program.)
He told NBC that the goal of the Republican plan is to “make certain that every single person has health coverage.”  (The CBO also estimates that the AHCA would cause 14 million people to lose their Medicaid coverage by 2026.)
He has described it as protecting people with preexisting conditions and reducing deductibles, while it does neither of those things. (Most midlevel plans sold on the marketplace have significant deductibles, which can be as high as $6,000.)

Nonpartisan analysis of the bill shows that none of these claims is true. The Republican plan would result in millions of Americans losing Medicaid coverage. Passing the bill would reduce rather than increase how many people have coverage.

The most recent CBO estimate predicts that 24 million Americans would lose coverage under AHCA. The majority of those people losing coverage would be Medicaid enrollees, but 2 million Americans would also lose individual plans. An additional 7 million Americans would lose coverage, as the CBO expects the Republican plan would encourage some workplaces to drop their offerings.

NPR reported on the new Propublica investigation into wasted prescription drugs at nursing homes.  Millions of dollars of perfectly useful drugs are thrown away every year instead of being recycled.  In Iowa, they have a program set up to retrieve these drugs and redistribute them to uninsured or underinsured patients for free. And they’re getting about $5 million worth of these drugs this year.

These drugs, experts say, might be wasting hundreds of millions of dollars a year.

 

Conservative writer Andrew Sullivan’s reaction to Trumpcare in New York Magazine was excellent.

“A word on Obamacare. I relied on it until just recently when I joined New York’s staff and went on an employer’s plan, and, to tell the truth, part of me didn’t even want to make the change — even though it will obviously save me a lot of money. What Obamacare did for me, living with the preexisting condition of HIV, was, first of all, give me far more independence and freedom. It gave me the confidence to quit a previous job and start my own little media company — my blog, the Dish. It gave me peace of mind when I subsequently shut that business down and was able to stay on the same plan. It allowed me to be a freelance writer without fear of personal bankruptcy. I got no subsidy, but I was glad to pay the premiums for me and my husband because it gave me a sense of control over our finances and our future. I knew I wouldn’t suddenly find myself facing soaring health-care costs or no health care at all — and the premium actually went down a smidgen last year.

The TrumpGOP’s attempt to abolish it is therefore, to my mind, neither conservative nor decent.

You might think Obamacare would violate my generally conservative principles, but it didn’t. In fact, it seemed to me to be an effective marriage of conservative principles and, well, human decency. The decency part comes from not blaming or punishing the sick for their condition. The conservative part comes from the incremental nature of the reform, and its reliance on the private sector to provide a public good. For good measure, it actually saved the government money, and it slowed soaring health-care costs. The exchanges, with predictable early hiccups, largely worked — a case study in the benefits of market competition. The law allowed for experiments to test how efficient health care could be. It even insisted on personal responsibility by mandating individual coverage. And the concept of insurance is not socialism; it’s a matter simply of pooling risk as widely as possible. If any European conservative party were to propose such a system, it would be pilloried as a far-right plot. And yet the Republican Party opposed it with a passion that became very hard for me to disentangle from hatred of Obama himself.

The Trump GOP’s attempt to abolish it is therefore, to my mind, neither conservative nor decent. It’s reactionary and callous. Its effective abandonment of 95 percent of us with preexisting conditions will strike real terror in a lot of people’s hearts. Its gutting of Medicaid will force millions of the poor to lose health care almost altogether. It will bankrupt the struggling members of the working and middle classes who find themselves in a serious health crisis. It could hurt Republicans in the midterms —though that will be cold comfort for the countless forced into penury or sickness because of Trump’s desire for a “win.” But it’s clarifying for me. It forces me to back a Democratic Party I don’t particularly care for. And it destroys any notion I might have had that American conservatism gives a damn about the vulnerable. It really is a deal-breaker for me. I hope many others feel exactly the same way.”

The D.C. Circuit, divided, ruled for the National Railroad Passenger Corp.—Amtrak—in a dispute over the firing of an officer named Sarah Bryant. An arbitrator said Bryant, fired for misconduct in 2012, should receive reinstatement, with back pay and lost seniority. A Washington federal trial judge later vacated that award.

Bryant, through the Fraternal Order of Police, appealed to the D.C. Circuit. The arbitrator had said the internal investigation violated a part of the collective bargaining agreement that governs interrogations. Two judges on the D.C. Circuit panel, A. Raymond Randolph and Brett Kavanaugh, said Amtrak’s inspector general’s office was not bound by that rule in the agreement.

Judges don’t have much flexibility when it comes to vacating arbitration awards. Randolph and Kavanaugh turned to one rarely used exception—for “public policy.” That exception gives judges the power to strike an award that is contrary to “law or public policy.”  The exception can overturn an arbitration award on grounds that it violates a law or compels an employer to violate a law.

Randolph, writing for the majority, said the exception should be applied in Bryant’s case because the court would essentially be enforcing an illegal contractual obligation. The inspector general should not have been restricted by any rules created in collective bargaining agreements to conduct investigations.

“An arbitration award may not be enforced if it transgresses well defined and dominant laws and legal precedents,” Randolph said in the opinion.

The Intercept had an article on how TrumpCare will affect nursing home residents with Medicaid.  Daniel Webster, a Republican representative from the 11th Congressional District in central Florida, acknowledged this when he announced he would vote for the AHCA. Medicaid pays the bills for over 60 percent of nursing home residents — people who cannot care for themselves and without Medicaid would have literally nowhere to go.

“I have been very concerned about Florida’s Medicaid-funded nursing home beds,” Webster said. “These are critical to the access some of our senior population has to our nursing homes.”

“Many middle-class Americans are unaware that the huge cost of nursing home care – which in some areas can run over $100,000 a year — is not covered by Medicare. Those who need it and cannot pay for it themselves can generally receive coverage from Medicaid, though they usually must spend down all their savings first.”

TrumpCare slashes $880 billion dollars from Medicaid spending over the next ten years, or about one-sixth of the $5 trillion it would otherwise cost the federal government.  The bill accomplishes these cuts by changing Medicaid from an entitlement, in which the federal government automatically provides states with funding based on the needs of their population, to either a block grant or a per capita allocation.  It will inevitably have serious consequences over the next 20 years due to the aging of the baby boom generation.

Nursing care is one big reason Medicaid recipients over 85 cost the program 2.5 times more than those who are between the ages of 65 and 74. If Medicaid were to remain an entitlement, states would automatically receive increased federal funds to cover these greater costs as baby boomers age. Under the AHCA, the per-capita payments to states will increase far too slowly to cover them.

 

With the aging of America comes the constant debate on the issue of stay at-home care verses nursing home care. The Louisiana AARP has strong opinions, claiming we are heading the wrong way.  Listen to the AARP’s Andrew Muhl with WWL’s Tommy Tucker here.  AARP spokesman Andrew Muhl breaks down the finances:

Right now the annual cost per person on average for at-home or community based services is around $18,000 a year,” said Muhl, “while the average cost for nursing home care runs close to $50,000 a year.”

Muhl says stay at-home care is not always possible but it’s by far more popular.

Overwhelmingly, what we’ve learned is that people want to age in place and receive care at home,” he explained. “There is a large majority of people in nursing homes that don’t need 24-7 care, they just need a little care that they can receive at home,” Muhl said.

Unfortunately, Muhl says there are fewer and fewer resources for the elderly who want to stay at home and live independently.

Less than a third of Americans support the GOP health care bill aimed at repealing the Affordable Care Act that passed the House last week, according to a new poll.

While 31% of Americans said they support the bill, 44% of respondents said they oppose it and a quarter said they were unsure, according to the HuffPost/YouGov survey.

More of those surveyed (39%) said the American Health Care Act would likely be worse than the Affordable Care Act than said it would be better (26%).

The GOP bill passed narrowly in the House and now faces consideration in the Senate.

The poll, conducted online on May 6, surveyed 1,000 adults and had a margin of error of +/- 4.5%.

The Advocate had a great editorial.

“The ongoing debate about government’s role in health care involves a compelling reality – namely, that when elected officials are charged with guiding help for the sick and the elderly, political expedience can trump policy choices that do the most good for the most people.

Louisiana offers a vivid case study of such cynical gamesmanship in the way that lawmakers and governors have steered patients and money toward nursing homes over the years when cheaper and more effective options such as community and home-based care are available. It’s no secret why nursing homes remain favored at the state Capitol, as a three-part Advocate special report that concludes today makes clear. The industry contributes lavishly to political campaigns, virtually ensuring that when governors and legislators decide how lucrative Medicaid dollars get spent, nursing home operators stand at the head of the line.

It’s a nice deal for the nursing homes and the politicos who feed at the industry’s campaign trough, but the losers, of course, are the frail and physically impaired Louisiana citizens who depend on state government to be their champion. Taxpayers at large get the shaft, too. Louisiana could, by one estimate, eventually save up to $200 million a year by guiding patients toward other kinds of care beyond nursing homes. As the state continues to hemorrhage red ink, such a wrong-headed fiscal policy should be a public scandal.

Nursing homes will always be needed for those who require specialized, around-the-clock care. But The Advocate’s investigation revealed that patients who seem ideal candidates for cheaper, less extensive assistance are often driven into nursing homes because state policy is stacked against them.

Nursing homes now get 77 cents of every Medicaid dollar Louisiana spends on care for the elderly and physically disabled, while home- and community-based programs get the rest. That ratio, among the highest in the country, has been increasing steadily since 2013.

On average, a nursing home costs the state $47,331 per resident per year. By comparison, it costs the state between $13,758 a year and $33,117 a year to care for an elderly or disabled person at home, depending on the level of care they require.

 As most states have shifted away from institutionalized care, Louisiana has gone in the opposite direction – a dubious distinction that’s been a boondoggle of bipartisan design. Former Gov. Bobby Jindal, a Republican, made a nod towards reforming the system, then abruptly ditched it after the nursing home industry, which had contributed hundreds of thousands of dollars to his political ambitions, raised objections. His successor, Democratic Gov. John Bel Edwards, also seems to be backing off his own promises about reform. Nursing home interests have written him big campaign checks, too, and the industry’s influence in the Legislature also crosses party lines.

In Louisiana, where so many residents trumpet family values, self-sufficiency, and fiscal discipline, state leaders should embrace health care alternatives that keep people at home with their loved ones, allow them to do what they can for themselves, and save as many tax dollars as possible.

As The Advocate’s special report demonstrated, our present Medicaid policies do exactly the opposite.”

Politico had an article on Republicans’ blatant hypocrisy.  “For seven years, Republicans campaigned on a single message: Obamacare was rammed through Congress by power-hungry Democrats who rushed a hastily written bill riddled with backroom kickbacks.”  Republicans are doing the exact same thing — or worse — that they blasted Democrats for repeatedly. Here’s how:

1. No CBO score: With all the last-minute changes to Republicans’ original repeal plan, the Congressional Budget Office won’t have an estimate of the potential impact for several days, if not weeks. That means lawmakers voted on a bill with no idea whether it will still lead to 24 million people uninsured — like the first proposal — or cause premiums to skyrocket.

House Speaker Paul Ryan, then ranking member on the Budget Committee, railed against the prospect of voting without a CBO report during the Obamacare debate. I don’t think we should pass bills that we haven’t read, that we don’t know what they cost,” Ryan said on MSNBC in 2009. And in fact, the Democratic-led House only voted on the bill after it received a CBO analysis.

2. Voting on a bill they haven’t read: Republicans blasted Democrats for years for voting on a bill without fully understanding the consequences.  “Have you read the bill? Have you read the reconciliation bill? Have you read the manager’s amendment? Hell no you haven’t!” then-House Minority Leader John Boehner (R-Ohio) said in a fiery floor speech shortly before the Affordable Care Act passed the House.

But some GOP lawmakers readily admitted they would back a bill that they hadn’t even read. “I don’t think any individual has read the whole bill,” Rep. Thomas Garrett (R-Va.) said on MSNBC Thursday. “That’s why we have staff.”

3. Congressional carve out: The initial compromise released last week by House Freedom Caucus Chairman Mark Meadows (R-N.C.) and moderate Rep. Tom MacArthur (R-N.J.) included an exemption for lawmakers and their staff. House Democrats’ campaign arm quickly seized on the provision, saying Republicans’ repeal plan was so bad, even they didn’t want to be affected by it.

4. No committee hearings: The revised repeal plan lawmakers voted on Thursday had significant changes and was considered on the House floor without a single hearing by the main committees of jurisdiction. The bill did go through the Rules Committee, which governs floor debate.

A bill — finalized yesterday, has not been scored, amendments not allowed, and 3 hours final debate — should be viewed with caution,” Sen. Lindsey Graham (R-S.C.) tweeted Thursday.

5. Partisan vote: House Republicans eagerly point out that Democrats passed Obamacare in 2010 without a single GOP vote. Democrats counter that one of the main tenets of Obamacare — the individual mandate — was inspired by Republican Gov. Mitt Romney’s health care plan in Massachusetts.

Democrats also point out that as Obamacare moved through the committee process, several Republican amendments were considered and adopted. Senate Democrats also spent months negotiating with Republicans to try to win bipartisan support.

“Rank hypocrisy [and] situational ethics,” House Minority Whip Steny Hoyer (D-Md.) said in an interview. “It’s okay if we do it, it wasn’t okay if you do it. It’s phony and they know it’s phony.”