The New York Times conducted research on voters support of TrumpCare by analyzing data from several different polls and factoring in state and demographic profiles.  According to the research, “Across all the states that voted for President Trump last year, we estimate that support for the A.H.C.A. is rarely over 35 percent.”

A separate poll supports these findings, with CNBC reporting that the recent survey found “62 percent of American voters disapprove of the Republican health-care plan, compared with just 17 percent who approve of it.”

And even the states that appear to have the most backing for the bill—like Oklahoma, West Virginia, Tennessee, and Florida—the percentage of residents who oppose it is still higher.

The House bill, which cuts back on federal Medicaid spending and replaces Obama-era subsidies with inadequate tax credits, has been estimated by the CBO and other nonpartisan experts to cause 23 million more people to lose their insurance.

CBS News reports that several prominent groups have since spoken out against it including the American Medical Association and the American College of Physicians.

President Trump is also said to have recently called the House health care bill “mean,” according to news outlets which were told about his comments to Republican senators by inside sources.

The Centers for Medicare & Medicaid Services (CMS) issued proposed revisions to arbitration agreement requirements for long–term care facilities. These proposed revisions would increase transparency in the arbitration process, reduce unnecessary provider burden and support residents’ rights to make informed decisions about important aspects of their health care.

Proposed Revisions to Arbitration Requirements

This proposed rule focuses on the transparency surrounding the arbitration process and includes the following proposals:

  • The prohibition on pre–dispute binding arbitration agreements is removed.
  • All agreements for binding arbitration must be in plain language.
  • If signing the agreement for binding arbitration is a condition of admission into the facility, the language of the agreement must be in plain writing and in the admissions contract.
  • The agreement must be explained to the resident and his or her representative in a form and manner they understand, including that it must be in a language they understand.
  • The resident must acknowledge that he or she understands the agreement.
  • The agreement must not contain any language that prohibits or discourages the resident or anyone else from communicating with federal, state, or local officials, including federal and state surveyors, other federal or state health department employees, or representatives of the State Long–Term Care Ombudsman.
  • If a facility resolves a dispute with a resident through arbitration, it must retain a copy of the signed agreement for binding arbitration and the arbitrator’s final decision so it can be inspected by CMS or its designee.
  • The facility must post a notice regarding its use of binding arbitration in an area that is visible to both residents and visitors.


The Kaiser Family Foundation fielded a poll in April focused on whom voters would blame if the Affordable Care Act stopped working. Sixty-one percent said it would be Republicans’ fault if the law doesn’t work.  “People think that the current government is the government in charge, and they own it,” Kaiser Family Foundation president Drew Altman said.

Quality Care Properties Inc., one of the largest U.S. healthcare landlords, said it is meeting with lenders to discuss up to $500 million in funding to acquire its main tenant, No. 2 U.S. nursing home chain HCR ManorCare.

HCR, which accounts for nearly all of Quality Care’s revenues, failed to make a full rent payment in June. It owes about $300 million in past rent, the landlord said in a regulatory filing.  Moody’s downgraded Quality Care and put the rating on review given uncertainty surrounding its ability to reach an out-of-court restructuring deal with HCR.

Quality Care said it is asking lenders for a term loan of up to $400 million and a $100 million letter of credit to refinance current debt and provide working capital. The company said it hoped to have a commitment by tomorrow.

Private equity firm Carlyle Group bought HCR ManorCare in a 2007 leveraged buyout for $6.3 billion and sold the properties to HCP for $6.1 billion in 2010.



Gov. Jay Inslee, D-Wash., issued the following statement:

“The chaos and uncertainty caused by President Trump and the Republicans in Congress with their efforts to repeal the Affordable Care Act are sabotaging health insurance markets across the country.

“This Administration is willfully destabilizing markets with their threats to withhold funds and refusal to enforce the parts of the ACA that ensure a viable market. Congress is destabilizing the markets with their inept dithering about repeal. It’s no wonder consumers and health insurers alike are nervous.

“And now even in states like ours, where we’ve seen such tremendous success, insurers are questioning whether they will be able to continue serving consumers in places like Grays Harbor and Klickitat counties.

“The worst part of what Trump and the Republicans are doing is that they want to take away health care so they can hand out tax breaks for the wealthiest Americans.

“We will not allow the chaos of D.C. to hurt the ability of Washingtonians to access health care, and I appreciate the efforts of Insurance Commissioner Kreidler who is working on options to resolve this issue.

“In the meantime, I remind Washington’s congressional delegation that I stand ready and willing to work on ways to improve the ACA but will continue to vigorously oppose any effort to take away Washingtonians’ health care.”

The Gaston Gazette reported that Heritage Oaks in Gastonia is not allowed to admit new residents to the adult home after a 135 page report pointing out conditions that were “detrimental to the health and safety” came to light.

The state Department of Health and Human Services went to the adult assisted-living center to do a compliance check in March after receiving six complaints. Their findings were published in the 135-page report, and the department sent a letter on May 25 barring the home from accepting any new residents.

 Violations in the report include black substances found at baseboards in the building, a lack of bath towels causing residents to not shower as frequently as they should be, faculty not documenting blood sugar levels correctly and some residents not receiving the medications they were supposed to.

Cobey Culton, a press assistant with the Department of Health and Human Services, said the department received six complaints between December of last year and this past March, when former Heritage Oaks maintenance worker Richard Bosquez III had his mother call and complain.

According to a Quinnipiac University poll, 17 per cent of US voters approve the Republican Healthcare plan. Sixty-two per cent of people polled disapprove, and 21 per cent said they don’t know.

Of the people polled, 65 per cent opposed decreasing federal funding for Medicaid.  Trump’s Budget plan also indicates a bleak future for many currently on Medicaid.

Under the proposal, put together by Office of Management and Budget Director Mick Mulvaney, cuts of between $800 billion and $1.4 trillion in future spending have been proposed.

TrumpCare would also allow states to waive rules which currently prevents insurers from charging new customers more because of their medical history.  This pre-existing condition protection is popular and needed.

House Republicans approved a plan for the Affordable Healthcare Act, referred to as ‘Trumpcare’ in May, and the Senate is attempting to pass a version in the summer. had an interesting article about lack of staffing at nursing homes compared to what CMS expects the staffing to be based on the resident’s needs.  An Inquirer analysis of data from Medicare cost reports provided by SNFdata Resources LLC found that the median nursing home (half are above; half are below) in the eight-county Philadelphia region provided 71 percent of the registered nursing care expected by the federal Centers for Medicare and Medicaid Services based on how sick the facility’s residents were during the annual inspection.

Brookside Healthcare & Rehabilitation Center provided 39 percent of the registered nursing a day expected by federal regulators during a recent three-year period.  Advocates, academics, and other experts state that’s a sign of a company out to boost profits.

For overall nursing care, which includes RNs, LPNs, and nursing assistants, Brookside’s 4.1 hours per patient day was well below the 4.9 hours a day expectation calculated by federal regulators based on the mix of patients at Brookside during annual inspections.

The federal expectation is not a legal requirement but what is expected by CMS based on reimbursement and payments.  “That’s one of the problems. They don’t have to use the money that they get for staffing, and they don’t have limits on administrative costs and profits,” said Charlene Harrington, a professor emeritus at the University of California-San Francisco, who has found that RN and total nursing hours correlate with better care. “The whole point of the money is to give it for nursing care.”

Shareese Reynolds, an LPN who has worked in nursing homes for 20 years, said she has seen the gap between RNs and other nursing staff firsthand. RNs who serve as unit managers are sometimes counted as direct-care staff, but they don’t give much direct care. “They are in meetings all day, and I believe they leave it up to LPNs to really do most of the work,” Reynolds said.

The public’s view of staffing is expected to improve next year, when CMS starts publishing staffing data that come straight from nursing homes’ payroll systems.

A rat-infested nursing home littered with dead flies has been shut down after caregivers were accused of disconnecting a call bell because they thought it was “irritating”. Inspectors from the Care Quality Commission found residents wearing the same clothes for days, dead flies in a potato peeler and people “not treated with dignity” at Bentley Care Home in Liverpool.

The report added: “The premises were not safe, with faulty electrics regularly giving staff static shocks, and people permitted to smoke in their bedrooms – putting everyone at a potentially devastating fire risk.”

Debbie Westhead, CQC deputy chief inspector for adult social care, said: “The care we found provided at Bentley Care Home was appalling. It’s disgraceful the call systems were broken, or taken away from people who required help because they were described as a nuisance.

In December, Maryland Attorney General Brian Frosh sued Neiswanger Management Services.  The lawsuit contends the firm wrongfully evicted patients without their consent once their Medicare coverage ran out, and without the planning the state requires for placing them in a safe, secure environment.  Frosh accused the company of evicting hundreds of vulnerable residents, in some cases dumping them in homeless shelters or unlicensed facilities, to maximize payments from public health plans.

Federal and state officials have terminated NMS Healthcare of Hagerstown from being authorized to serve Medicare and Medicaid consumers, according to the Maryland Department of Health and Mental Hygiene.

The U.S. Centers for Medicare & Medicaid Services informed the facility in a May 19 letter that it would be dropped from the Medicare program because it was not in substantial compliance with federal regulations.