The Kansas City Star has an article about a study from the National Senior Citizens Law Center discussing clauses in nursing home agreements that violate the law.  Some admission agreements skirt state and federal laws, misleading consumers about the care they can expect and inducing them to sign away critical consumer protections.  Advocates for the elderly said the study raised serious questions about how some nursing homes operate.

The National Senior Citizens Law Center, a Washington-based nonprofit legal advocacy group for seniors and elder-care lawyers, reviewed 175 admission agreements voluntarily provided by nursing homes. The study found agreements which improperly limited a nursing home’s obligations. Others allowed discharges for vague reasons, or stuck relatives with bills they legally didn’t owe.

Toby S. Edelman, a spokesman for the Center for Medicare Advocacy in Washington, said similar studies in other states also show “ongoing concerns” with nursing home agreements.

The Missouri study found that nursing homes protect themselves by persuading seniors to waive their right to a jury trial. In 18 percent of the agreements, seniors were required to submit a dispute to arbitration, rather than sue in court.   Trial lawyers contend they have successfully fought the provisions in court as unconstitutional and unenforceable in health-care cases.

The study contends the agreements also thwart federal law by inserting provisions making it easier to evict residents. Federal law sets out six conditions that justify evicting a resident.

Carlson, the study’s author, said that under the federal reform law nursing homes cannot require a relative or a friend to become financially liable for nursing home expenses. Yet, the study found that 19 percent of the admission agreements required a financial guarantee “in direct violation” of federal law.   Such “co-guarantor clauses” are becoming more common. has a good article about the difficulty the government has in evaluating funding levels for Medicaid.  The article insists that an expansive view of nursing homes industry is needed to determine funding needs.

The Bush Administration’s FY 2009 budget will include no Medicare funding update to help care for the growing number of seniors who need high acuity nursing home care.  The Alliance for Quality Nursing Home Care will work to demonstrate that Medicare funding decisions can be accurately determined only by taking a more expansive, complete view of the industry’s operating environment. 

This White House has often cited the work of the Medicare Payment Advisory Commission (MedPAC).   Alan G. Rosenbloom, President of the Alliance, stated, "On behalf of nursing home patients and the hundreds of thousands of caregivers who serve them, we are disappointed that again, MedPAC’s flawed funding policy guidance is being adopted, and superseding the economic realities experienced by providers in the long term care marketplace.  By failing to consider the substantial Medicaid payment shortfalls to nursing homes in formulating its recommendations, MedPAC provides the Administration, Congress and the public a flawed basis upon which to assess the funding landscape, and to ultimately determine the best policy." 

Medicare funding is important when states are cutting Mediciad to balance their budgets. 

SOURCE The Alliance for Quality Nursing Home Care