The New York Times reported on Trump’s decision to abandon a rule that would have protected nursing home residents from injuries caused by substandard care, abuse or neglect. Trump will now allow nursing homes to require residents to waive their constitutional right to a jury trial by requiring the residents to sign mandatory pre-dispute arbitration clauses as a condition of admission to the home.
“About half of nursing home residents have Alzheimer’s disease or other dementia, according to the National Center for Health Statistics, and consumer advocates say harried family members could easily miss the arbitration clauses as they move a loved one into a home offering care.”
The attorneys general of 16 states, led by Brian E. Frosh of Maryland and Xavier Becerra of California, and consumer advocates strongly opposed the Trump administration proposal. Thirty-one senators, led by Ron Wyden of Oregon and Al Franken of Minnesota, both Democrats, also objected to the Trump administration proposal. With Medicaid and Medicare spending more than $80 billion a year on nursing home care, they said, nursing homes should not be able to cover up wrongdoing by forcing patients to relinquish the right to sue.
Long-term care ombudsmen, who receive federal funds to serve as advocates for nursing home residents in each state, are skeptical of the new initiative. “The proposed rule would undermine the rights of people living in nursing homes — rights established in a 1987 law,” said Patty Ducayet, the Texas ombudswoman, who is a state employee.
Guest Post by: Andy C.; Targeting Cancer (TCA)
Being diagnosed with cancer is a difficult time, not just for the patients but for the family too. Living with a cancer patient means that you will not only have to provide them with physical support but will also provide them with enough emotional support.
At the end of the day, irrespective of the kind of support you provide a cancer patient you need to make sure that you have the right information to pass on to them as well. This means that the sources from where you obtain your information which will consequently allow you to streamline your support strategies for them need to be reliable. Whether it is finding out more about radiation oncology information and other radiology techniques or finding out more about cancer support groups for them to join your job as a caregiver for a cancer patient has no room for any loopholes.
There are experts available in every field to help you out with any problem you may encounter. However, even with this extra assistance you may still find a couple of hassles. A good example to demonstrate this is the dietary recommendations which the cancer patients receive. When undergoing treatment, one of the most common side effects that cancer patients experience is the loss of their appetite. They find it difficult to maintain a healthy diet, but still their body needs the nutrition to keep fighting.
A nutrition expert who recommends individual diet plans for cancer patients that are evidence based can be of great help. Unfortunately, not all cancer patients receive these recommendations. They or their families then turn to the internet where they spend countless hours looking for dietary recommendations. We do not mean to label all the internet resources for providing information to cancer patients as unreliable, but generally there is a lack of consensus which is observed in what they all have to say.
One source will have you follow one rule which will only be marked as something which must be avoided in all cases by another source. You cannot afford this kind of confusion when providing care for a cancer patient. One wrong move can cause you a string of very serious problems.
Some of the information that you look for online can also give you false hopes. Everyone knows that clinical trials are an important part of cancer treatment. Every day there are clinical efforts being made to make treatments for various types of cancer as effective as possible. Reading about the findings of these clinical trials especially of those where they have unearthed some groundbreaking information can be very encouraging.
They can be encouraging only when they are coming from authentic sources!
A good idea here would be to cross check information that you obtain from the internet. If something does not add up, make the extra effort to reach out to cancer specialists and seek their professional opinion.
You are looking after somebody’s life; you have got to be careful.
Syracuse.com had two articles (here and here) about James Square Nursing and Rehabilitation Center. In 2015, two out-of-state nursing home operators cut jobs at the 440-bed facility to save money. A recent inspection found there were so few certified nurse aides some residents had to eat meals in bed and could not get up until late in the day. A shortage of nurses and aides led to medication errors, delays in people getting showers and incontinence care, a woman falling out of a wheelchair and fracturing her shoulder and many other problems, according to the inspection.
In the unusual raid, armed investigators from the AG’s office seized records from the nursing home. The inspection report said fewer nurses and aides were working in January than James Square’s staffing schedules showed. The inspection found discrepancies between those schedules and documented time clock and time sheet records.
Four families have filed lawsuits claiming a loved one died because of poor care and neglect. The lawsuits claim James Square administrators failed to adequately staff the facility with qualified people, and failed to promote quality of care to the residents. A large number of wrongful death claims could be an indicator of patient care problems, according to a nursing home expert.
Richard Mollot, executive director of the Long Term Community Care Coalition, called the number of wrongful death claims at James Square “extremely troubling.”
“People very rarely sue when there is nursing home neglect or abuse, even when it leads to the death of the resident,” Mollot said.”If a facility has been sued by several different families it indicates, to me, that there is a risk that poor care may be persistent or widespread, or both.”
The Senate version of the American Health Care Act institutes deeper Medicaid cuts than the House bill to help pay the cost of its expensive tax credits. The House version holds the program to the inflation rate plus one percent — which is historically lower than medical costs have risen, meaning that the program would have to curtail benefits for its beneficiaries, who tend to be poor and very sick. The Senate bill would cut growth down to the inflation rate, without the extra one percent.
The most important design feature is that the Senate bill retains all the tax cuts in the House bill. By eliminating nearly a trillion dollars in revenue, it necessarily creates a trillion dollars in cuts for coverage subsidies.
New York Magazine had an article about GOP moderates worried about TrumpCare’s health care cuts affecting the opiod crisis. “During the worst year of the HIV/AIDS crisis, 43,000 Americans lost their lives to the virus. In 2015, 52,000 died of a drug overdose. Never in recorded history had opioids killed so many Americans in a single year; the drug-induced death toll was so staggering, it helped reduce life expectancy in the United States for the first time since 1993.”
The Medicaid cuts in TrumpCare will devastate addiction resources. Medicaid expansion accounted for 61 percent of total Medicaid spending on substance abuse treatment in Kentucky, 47 percent in West Virginia, 56 percent in Michigan, 59 percent in Maryland, and 31 percent in Rhode Island. In Ohio, the expansion accounted for 43 percent of Medicaid spending in 2016 on behavioral health, a category that includes mental health and substance abuse.
As the New York Times reports:
Republican senators from states that have been hit hard by the opioid drug crisis have tried to cushion the Medicaid blow with a separate funding stream of $45 billion over 10 years for substance abuse treatment and prevention costs, now covered by the expansion of Medicaid under the Affordable Care Act.
But that, too, is running into opposition from conservatives. They have been tussling over the issue with moderate Republican senators like Rob Portman of Ohio, Shelley Moore Capito of West Virginia and Susan Collins of Maine.
Without some opioid funding, Mr. Portman cannot vote for the bill, he said, adding, “Any replacement is going to have to do something to address this opioid crisis that is gripping our country.”
Contagion Live had a discussion with Nicola Thompson, PhD, epidemiologist, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention who shared what is needed to estimate the burden of healthcare-associated infections in nursing homes.
Interview Transcript (slightly modified for readability): “There has been a lot of work outside of the United States, in Europe, and also recently in the United States by the Centers for Disease Control and Prevention (CDC) to look at the prevalence of healthcare-associated infections in acute care hospitals. That data that has been collected has been used to translate the prevalence of infection into the burden over the course of the year. That has been done by a long-standing formula that has been out and has been published and used many times. That formula includes in it information on the average length of stay [for a patient].
Essentially the model that is used to estimate the burden of healthcare-associated infections from the prevalence takes into account the average length of hospital stay for people with a healthcare-associated infection, compared [with] the average length of hospital stay for people without a healthcare-associated infection. Those are the pieces for the inputs for the model. The differences between lengths of stay is used to estimate the national burden [of disease].
The concept of ‘length of stay’ does not really hold up when we think about the nursing home setting because the vast majority of people that are in a nursing home go there long-term to receive care and they are not anticipating a discharge. [Therefore,] we need to come up with a different approach to estimating the burden of [healthcare-associated] infections in nursing homes that does not rely on information, or take into account information on length of stay. That is really where the work that has been done by the European CDC (ECDC) to look at the burden estimation in nursing homes has been helpful to us.”
Salon had an interesting perspective on TrumpCare. The new freedom is based on individual choice according to ideologues. “You’re free to be poor, free to be politically powerless or free to be ill and uncared for; it’s all a matter of decisions you freely make in life, and our larger society has no business interfering with your free will.” So that’s what Republicans’ Trumpcare is offering us, this “freedom” from health care.
“This is what passes for a philosophical framework behind many of the policies of today’s Republican congressional leaders. For example, they say their plan to eliminate health coverage for millions of Americans and do away with such essential health benefits as maternity care for millions more is just a matter of good old free-market consumerism. As explained by Jason Chaffetz, a Utah Tea Party Republican, “Americans have choices. And so maybe, rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest in their own health care.”
Paul Ryan: “Freedom is the ability to buy what you want to fit what you need.” Yes, apparently, you are as free as you can afford to be.
Illinois Public Media News reported that Champaign County Administrator Rick Snider says his nursing home is cooperating with an investigation into the death of a resident of the home. According to the News-Gazette, the county coroner and Illinois State Police are investigating the death of a 78-year-old woman who was discovered in the courtyard and may have been outside in high temperatures for as many as three hours.
The investigation comes as the county board looks to hire a management firm to run the nursing home and continues to discuss options for selling it. A majority of voters in April’s election backed a referendum in support of selling or closing the nursing home.
New York and California are taking steps toward state-based single-payer health insurance systems that would provide universal coverage without insurance premiums, deductibles, or co-pays.
In New York last week the State Assembly passed a single-payer proposal for the third consecutive year. Prospects for Senate passage have gone up significantly thanks to backing from the Independent Democratic Caucus. The New York bill contemplates that all existing federal health-care dollars will be “pooled” in the state trust fund that would pay for services and insulate patients from virtually all out-of-pocket costs. Assuming Obamacare is not repealed, it’s possible the state could get megawaivers to use both Obamacare individual insurance subsidies and Medicaid for a new system.
In California, Democratic supermajorities in both legislative chambers have enhanced prospects for single payer among other progressive priorities, and a new bill has already cleared one hurdle in the lower chamber of the legislature.
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.