The Chicago Sun Times had an article about the excessive cost of long term care. Long-term care costs are surging again and the most expensive option — a private nursing home room — may soon top $100,000 per year. This is shocking considering the epidemic of abuse and neglect in the nursing home industry.
The median cost of care increased an average of 4.5 percent this year, according to a survey released by Genworth Financial. The cost of home health aide services rose 6 percent, to $21.50 an hour. Private nursing home care now costs more than $97,000.
“Long-term care can impose a crushing financial burden on individuals or families in part because Medicare, the federal health coverage program for people over age 65, provides limited help. That can force people who don’t have private coverage to spend down their assets until they qualify for the government’s health insurance program for the poor, Medicaid.”
WCBI reported that the town of Okolona in Mississippi did an emergency response drill at local nursing homes. Okolona law enforcement, first responders, and the Mississippi Emergency Management Agency participated in the drill. Incidents, like the one in Las Vegas, are exactly why the town of Okolona isn’t taking any chances.
“I hate to think anyone would come into the facility and do this sort of thing but this day and age you really just don’t know,”said Nursing Home Administrator said Aileen Holt.
“We much rather find out our deficiencies in a drill than in a real live situation. We can go back and critique our plan, talk about it, and be glad we did it in our emergency response plan drill or exercise instead of an actual event,” said Griffin.
“A drill at this magnitude is a great thing to keep people aware, in the community that, things can happen and things happen that we don’t expect to happen, even at the nursing home setting. Our staff is trained to try and keep everybody as safe as possible,”said Holt.
” You know they are at a disadvantage because they are a vulnerable population. We have to consider something like that happening and we have to approach them in a different manner because of their capabilities of exacting events. It’s more on our part to do more to move them, to communicate with them,”said Griffin.
“A lot of this training here, we don’t get till we are in a police academy. It’s an eye opener, when that call comes. I’ve been in service since 2011 so that’s when I came out, it’s 2017. If you don’t run any drills, it’s what I plan on starting with our police department now is running drills to keep us up on our ability to handle situations like this,” said Randle.
NPR had an article about the effect of Medicaid cuts on nursing home residents. The nation has 1.4 million nursing home residents — two-thirds of whom are covered by the state-federal health care program for people with low incomes or those with disabilities. Medicaid pays less than other forms of insurance. As a result, nursing homes make more than 10 percent on Medicare residents, but lose about 2 percent on the rest of their residents because so many have care paid for by Medicaid.
“Nursing homes that rely the most on Medicaid tend to provide the worst care for their residents — not just the people covered by the program but also those who pay privately or have Medicare coverage.”
The reason for the disparity in quality of care, researchers have found, is that nursing homes with the most Medicaid residents can’t afford as many nurses and aides so they operate short-staffed. ”
The average five-star home has enough nurses and aides to provide 5.4 hours of care a day for each resident, while the average one-star home provides 3.0 hours of daily care per resident. At the best-staffed homes (five stars), only 4 of 10 residents are on Medicaid, meaning the remainder of residents are more lucrative for those facilities. At the worst-staffed homes (one star), 7 of 10 residents are on Medicaid.”
At nursing homes with worst inspection records (one star), an average 65 percent of residents are on Medicaid. Places with the best inspection records (five stars) have an average 47 percent of residents on Medicaid.
McKnight’s reported that Aggeus Healthcare CEO James Sayadzal pleaded guilty last year to a conspiracy charge and sentenced in federal court to 366 days in prison and ordered to repay $1.77 million to Medicare. He was one of three company officers and six doctors who defrauded Medicare related to podiatry services provided to residents of nursing homes and long-term care facilities.
Prosecutors say they carried out a broad scheme from 2009-2015 by creating an electronic medical billing system that would lead Medicare to pay for procedures that weren’t performed or wouldn’t have been covered. Nursing homes were told that Aggeus podiatrists would treat every resident for no cost to the facility. Some Aggeus doctors then performed unnecessary procedures or billed for procedures that weren’t performed, at Gray’s urging, charging documents say.
Gray’s wife, Natalie Gray was sentenced in February to 366 days in prison on the conspiracy charge and ordered to repay nearly $1 million. Natalie Gray was former director of corporate and legal affairs for the company.
Aggeus once had offices in 16 states and provided podiatry and other services to thousands of patients. Podiatrists and nursing homes had complained about inaccurate medical notes or potential fraud.
St. Louis Today reported the tragic death of a nursing home resident who choked and died in July after the patient was fed through a tube in 30 minutes instead of the one hour that was prescribed, according to a federal report. Then a nurse failed to check on the patient, perform CPR and call 911, as required by the patient’s medical record and the nursing home’s policies, investigators with the U.S. Centers for Medicare and Medicaid Services found during an August inspection. The home was cited for placing residents in immediate jeopardy and could be fined for the incident.
A doctor at the nursing home told investigators that the formula coming out of the patient’s nose and mouth at the time of death indicated that he or she choked on the food and suffocated.
Because of the patient’s risk for choking, the formula tube feeding was supposed to be infused over one hour with supervision. At a 4 a.m. feeding on July 23, the nurse infused the formula through the tube in 30 minutes and left the patient after checking vital signs. One hour later, a nursing aide checked on the patient and couldn’t find a pulse. The aide called the nurse, who tried and failed to take the patient’s blood pressure and also could not locate a pulse, according to investigators’ interviews with the staff.
The nurse then looked at the medical records and realized that CPR should have been performed and 911 called. In the report, investigators wrote “during that shift, Nurse A was very overwhelmed with trying to learn the facility procedures and there were no other nurses on duty to answer his/her questions … Nurse A knew what was expected of him/her and there was no excuse for failing to follow proper procedure.”
The Coumbus Dispatch had an article about Trump’s decision to side with the nursing home industry over the vulnerable residents in their care. Trump has reversed a ban on forced arbitration hidden in nursing home admission contracts. When the ban is withdrawn, nursing homes will require residents to sign pre-dispute mandatory arbitration agreements before they are provided the care they need.
Consumer advocates, experts, and critics say Trump’s proposal favors nursing homes because residents and their families have unequal bargaining power. They often don’t have time to “shop around” for deals because of the limited number of homes with available beds and the tight time frames to make arrangements for care. Unlike a court process involving a judge or jury, arbitration usually allows the nursing home to select the arbitrator, a power that is laid out in the nursing home’s contract terms, and the proceedings are conducted in private and kept secret. Arbitration agreements also can set limits on the damages a party can recover. Appeals are not allowed.
WUSA reported that the police are investigating a nursing home for alleged sexual misconduct between an employee and one of the senior citizens. A similar allegation against an employee was already being investigated. Forestville Health and Rehabilitation Center is owned by an company called CommuniCare.
“Many of America’s roughly 15,600 nursing homes are unprepared for disasters like Hurricane Irma, which recently killed 11 elderly patients in South Florida after the Rehabilitation Center at Hollywood Hills lost power.” The Huffington Post had a great article explaining why the tragic disaster that occurred at a Florida nursing home can happen anyway.
The problem starts with inadequate staffing, an issue that plagues most of the industry. Roughly half of American nursing homes are understaffed compared to expert recommendations, and at least a quarter are considered “dangerously” low-staffed, according to a 2016 review of studies into the issue.
“Federal regulators have cited at least 2,300 facilities for violations of emergency preparedness regulations in the past two years alone, according to a Kaiser Health News review of federal records.”
“Efforts to improve the way nursing homes prepare for emergencies have at times run into opposition from an industry concerned with the cost of new regulations. Industry lobbyists, for instance, successfully derailed a 2006 Florida bill that could have forced nursing homes to have generators on-site. A 2015 federal proposal to increase staffing requirements died thanks to similar opposition.”
Nursing home industry lobbyist LeadingAge Florida is challenging Gov. Rick Scott’s order to install generators at the facilities after this most recent tragedy.
The Tampa Bay Times reported the omission of information in Florida’s investigations into nursing home abuse and neglect complaints. In the past year, Governor Scott’s Agency for Health Care Administration has purchased and employed new redaction software that removes key words, dates and descriptions from the inspection reports posted online and used by the public to monitor conditions at the 683 nursing homes and more than 3,100 assisted-living facilities in the state.
For family members that want information about what state regulators know about a nursing home, Governor Scott has increasingly made access to that information harder to get, said Brian Lee, the head of a national watchdog group called Families for Better Care. “There’s no rhyme or reason to it,” Lee said. “They are so indiscernible now, they’re almost useless. If the feds can put this same information on its web site, why can’t the state? It’s a favor to the industry by the Scott administration.”
The Huffington Post had an interesting article about the loss of rural hospitals and their effect on the rural economy. “Rural hospitals are in danger across the country, their closures both a symptom of economic trouble in small-town America and a catalyst for further decline.”
Since 2010, 82 rural hospitals have closed nationwide. As many as 700 more are at risk of closing within the next 10 years, according to Alan Morgan, the CEO of the National Rural Health Association, a nonprofit professional organization that lobbies on rural health issues.
The South also has the largest cluster of states that have not expanded Medicaid under the Affordable Care Act: Alabama, Florida, Georgia, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia. Expanding Medicaid would have meant greater access to insurance for low-income people and more reimbursement for hospitals, thus helping their bottom lines.