Kentuckians For Nursing Home Reform

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NURSING HOME REFORM NEWSLETTER

November 6, 2006
 

NOT SO FAST, GOVERNOR

A lot of you apparently wrote Gov. Ernie Fletcher after we reported that he had come out against minimum staffing standards in nursing homes.  Gov. Fletcher was in Washington, D.C. to attend a meeting of something called the Center for Health Transformation.  It is headed up by former House Speaker Newt Gingrich.  We "attended," too, through the miracle of computer hook-up.   The governor spent most of his time extolling the great job his administration is doing on changing Medicaid in Kentucky and how much the quality of health care is being improved.  Those of us watching by computer were asked to send in questions at the end of his speech, and so we asked him to give his opinion on how Kentucky is relating to improving quality of care in nursing homes by instituting minimum staffing standards.  The governor said he had put more money into long-term care by getting an increase in the provider tax.  He said that increase had netted some $170 million more to the state after a federal match and half of it has gone to the nursing home industry.  "You have to pay providers adequately," Gov. Fletcher went on to say.  And he added that he had just met the night before with the nursing home operators and they were all very pleased at what the state is doing for them.  And then, remembering the question, he said:  "Some folks want to mandate the number of staff.  I don't think that gives the industry the flexibility they need to manage the care.  I think you measure quality another way and that will drive staffing requirements."

 

To us, that sounded like Gov. Fletcher does not support minimum staffing standards.  Lots of you complained to him.  But he has written back to some saying that we took his answer out of context.

 

We stand by our interpretation of what the governor said.  It still does not sound to us like the governor supports staffing standards. 

 

Apparently the governor is very cozy with the nursing home industry.  They have showered big bucks on him in his election campaign and probably will do so if he runs again. 

 

But as someone said:  "Surely the governor being a medical doctor would sympathize more with the plight of people in nursing homes."  

 

Maybe the real reason is that we just have not done a good job of explaining it all to him, because if you haven't been there yourself, you just don't know.  We have been there, and we would be glad to share our experiences with the governor.

 

LET'S CLARIFY ONE THING...

Gov. Fletcher and his friends in the nursing home industry talk about "mandated staffing for nursing homes."   But that's not what we are suggesting.  We don't want to tell the nursing homes how to run their business by telling them how many staff to hire.  What we keep trying to say is that there is a point where inadequate staffing can cause harm to residents.  It's that MINIMUM point, that danger point, if you will, that we want mandated so that no nursing home can go below it and harm their residents.  As far as hiring staff -- Once a nursing home meets the minimum level, it is up to them to decide how many to hire over and above the safety floor -- the minimum staffing standard.  That's how you handle the acuity problem the industry is always using in discussions with advocates.  It's just a big crutch, an excuse.   We suspect that Gov. Fletcher and the nursing home industry know this.  But to battle any kind of mandated staffing they twist the meaning.  Why?  There are many nursing homes where hiring an adequate number of staff to keep residents safe from neglect and abuse will dig into their corporate profits.  And some of them don't mind to pile up big profits for their stockholders even if it's on the backs of the frail residents whom they open up to abuse and neglect.

 

AND ANOTHER THING...

And if Gov. Fletcher doesn't understand staffing problems in nursing homes, he should know this:  In Kentucky, unanswered call lights was the No. 1 complaint to nursing home ombudsmen last year, representing 6.74 percent of all nursing home complaints -- higher than the national average.  This information  comes from the National Association of State Units on Aging.  Why aren't these call lights -- request from residents for help -- being answered?  Because there are usually not enough front-line staff on duty to answer them!

 

GETTING SOME TEETH INTO IT

What about dental care in nursing homes?   KENTUCKIANS FOR NURSING HOME REFORM and a committee of dentists, a speech pathologist and a state board of dentistry official met with Inspector General Robert Benvenuti and his deputy director Steve D. Davis and asked them what their nursing home inspectors are doing to enforce good dental care.  They said they basically do five things:  (1) Require an assessment of a new resident within 14 days of arriving at the nursing home; (2) check nurses' notes and medical records on residents to see if a complaint involving oral care has been handled properly; (3) make sure the nursing home is complying with federal regulations; (4) sometimes interview a resident and/or family members about specific complaints, and (5) making sure that the nursing home reacts promptly to resident complaints involving oral health.

 

The inspector general also volunteered to work with Dr. Jim Cecil, administrator of the state oral health program, and Dr. Robert Henry, a dentist at UK and the VA, to create an educational program on dental care for nursing home operators.  Money from the Civil Monetary Penalties fund, where nursing home fines for non-compliance go, would be used to pay for the new program.

 

Dr. Henry also presented results of a just-released statewide survey which showed  that nursing home residents have more than twice the problems with oral hygiene and about two times  more decayed teeth than so called "well-elders"; and that residents of nursing homes need overall dental treatment three times over their well-elders on the outside.  Fifty-one percent of elders residing in nursing homes reported difficulty in obtaining basic dental services compared to the well-elders who are independent and living in their own homes.

 

THE UK DEAL...

Remember all the hub-bub about the big University of Kentucky deal to put a continuing care community on the UK Coldstream Research Campus, then they switched the site to almost on top of the Spindletop Club?   The club members had a fit over that.  Well, UK finally dropped the whole thing and last we heard the university is looking for another location.  And they still insist that the developer doesn't want it on Coldstream because of the "noise."  H-m-m-m-m.

 

Could that really be the noise they're getting from some short-sighted trustee?

 

SHORT STUFF

  • Kentucky has been recognized as the eighth most digitally advanced state government in the nation, according to the Center for Digital Government's 2006 Digital States Survey. If you have ever been a meeting with state officials, you know why. Ever notice that everyone of the officials carries around a BlackBerry, one of those pocket computer/cell phone... and sometimes even uses it while the meeting is going on?
     

  • Last year, the state told nursing home operators that they could trade extra beds they have back and forth among facilities. According to Chris Corbin of the state Office of Health Policy, the state has so far approved only 14 applications to relocate a total of 119 beds to a long-term care facility in another county -- and this could include so-called "swing-beds" in facilities other than nursing homes, like hospitals, Mr. Corbin said.
     

  • The Second Edition of Clark's Kentucky Almanac will have in it a page on long-term care in Kentucky. We are proud to have been the author.
     

  • The federal government and the nursing home industry are ballyhooing a program called "Advancing Excellence in America's Nursing Homes." They have even persuaded the National Citizens' Coalition of Nursing Home Reform (NCCNHR) to be part of it. It's a voluntary program for the nursing homes, of course. But -- get this -- the nursing homes participating won't publicly report on their progress (or lack of it). Typical industry fluff -- but why is NCCNHR aiding and abetting such trickery? "Better to be right there watching them than looking in from the outside," said a NCCNHR spokesperson. Good point. 
     

  • Thank goodness for Rep. Kathy Stein, D-Lexington. She represents the only chance nursing home reform has to be heard at a meeting of the Special Advisory Commission of Senior Citizens in Frankfort Nov. 2-3. She gets a chance to speak because she is co-chair of a legislative subcommittee that hears nursing home reform issues. You can bet Fearless Kathy will tell it like it is to a group that is weighted heavily to what AARP wants to do and not much else. (The state AARP has been very little help on improving the quality of care in nursing homes.) And the meeting's leaders even invited Gov. Ernie Fletcher to speak at a dinner. Remember he's the guy who went to Washington recently and said that minimum staffing standards for nursing homes would not do much good. 
     

  • While top Kentucky officials, including the governor, are running all over the place ballyhooing the state's reorganization of the Medicaid program and how much money it is saving by letting people stay in their homes instead of going to a nursing home, along comes the Congressional Quarterly, a highly respected publication, that says not so fast. In a recent issue, the Quarterly warns that staying in homes does not necessarily mean there will be better care nor will it lower costs. One wag suggested that the nursing home industry, which stands to lose residents from this new idea, sponsored the Quarterly report. Our position always has been that there will be need for institutional care and the quality of it should be good -- not poor the way it is in most facilities now.
     

  • The average cost of a private room in a nursing home in the United States is $206 per day or $75,190 annually. ($181 per day in Lexington; and $184 in Louisville) Nationally, a semi-private room averages $183 per day. (No figures on Kentucky.) All this from the MetLife Market Survey of Nursing Home Costs.
     

  • The hospitals lobbying organization and three other provider groups -- including the big one for the nursing home industry -- urged the U.S. Supreme Court to limit the definition of who qualifies as a whistle-blower plaintiff in False Claims Act lawsuits. Whistle-blower law requires plaintiffs to be the "original source" of information in a complaint. In a friends-of-the-court brief, the provider groups argued that the 10th Circuit accepted too broad a definition of "original source." "A clear, consistent and strict 'original source' rule" could "ward off illegitimate qui tam strike suits," the groups said in the amici brief The worried organizations included the American Health Care Association, a big and powerful national lobbying group for nursing homes. We wonder when states attorneys general will get in on this whistleblower stuff. Attorney General Stumbo: Are you listening? 
     

ALL THAT GLITTERS...

The big nursing home company headquartered in Louisville, Kindred Healthcare, sent out a news release bragging about its nursing homes that received rewards for quality care from the American Health Care Association.  Three of them are in Kentucky, but get this -- in the past three years the three Kindred award winners racked up 40 deficiencies, one alleging actual harm to a resident.  And, oh yes, the American Health Care Association, which sponsored the awards, is the nursing home industry's big lobbying group. 

 

QUOTE OF THE MONTH

"Medicaid has become the nation's largest payer of long-term care services, funding approximately 50 percent of long-term care spending and nearly two-thirds of the cost for all nursing home residents... Medicaid simply cannot continue to afford to be the predominant provider of long-term care coverage for seniors."  --  From the National Governors Association letter to the federal Medicaid Commission, a study group appointed by President Bush.

 

LETTERS... WE WANT YOUR  LETTERS

The general public and lawmakers -- even our governor -- do not realize what is going on in many nursing homes.  They are unaware of the spills, the falls, the loss of weight, bedsores, and the lack of enough trained staff, and much more.  

 

We have a big education problem.  The nursing home industry constantly proclaims how wonderful their care is.  They are telling people how great they are and some of the people they are telling are believing it.  We must let people know that much of the industry propaganda is just excuses -- that in many nursing homes the care is very bad.

 

You can help us by taking the time to e-mail to us your experiences with a nursing home.  We will pass your comments on to key legislators and to the public through our web site. 

 

WE WILL KEEP ALL OF YOUR E-MAILS CONFIDENTIAL.  WE WILL NOT USE YOUR NAME OR THE NAME OF THE NURSING HOME, USUALLY NOT EVEN THE LOCATION.  THAT'S OUR PROMISE.

 

We realize that you are fearful of retribution by the nursing home.

 

But you can help the cause of nursing home reform by sharing your problems with each other and with us.

 

Just send your e-mails to KyNursingHomeReform@yahoo.com

 

Don't be surprised if you see what you have written, or part of it, on our web site which is http://www.KyNursingHomeReform.org

 

P.S.

 A man and his wife are dining at a table in a plush restaurant, and the
husband keeps staring at a drunken lady swigging her drink as she sits
alone at a nearby table.

The wife asks, "Do you know her?"

"Yes," sighs the husband, "She's my ex-girlfriend. I understand she took to
drinking right after we split up seven years ago, and I hear she hasn't
been sober since."

"My gosh!" says the wife, "Who would think a person could go on celebrating
that long?"

  -- from our good friend, Don Feltner

 

NEWS NOTES...

We get tons of information that affect nursing home reform.   We want to share this information with those of you who are interested, but rather than putting it all in our newsletter we will post it regularly on our web site:  http://www.KyNursingHomeReform.org

 

Take a look and see what we mean.  It's on the home page under "News Notes."
 

 

DON'T FORGET...

MORE THAN 23,000 PEOPLE IN NURSING HOMES IN KENTUCKY NEED US. THEY ARE THE "FORGOTTEN PEOPLE."



Bernie Vonderheide
KENTUCKIANS FOR NURSING HOME REFORM
Tel: (859) 312-5617

 

 

how to contact us

Name: Bernie Vonderheide 

Email: KyNursingHomeReform
@yahoo.com 

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