“A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”

 

NEWSLETTER

 

THE VIEW FROM THE TOP

A bunch of state bureaucrats, including the top health guy in the state himself, Mark Birdwhistell, secretary for the Cabinet of Health and Family Services, joined with all kinds of mental health people and other private public health agency representatives  for a “summit” this week in Lexington.  Even two top dogs from the nursing home industry in Kentucky were there.  The subject was how to develop a new Medicaid system in Kentucky.   Here’s a view from the top of that summit:
 

• Not much was said about nursing home care except that the state will not kick anyone out of nursing homes under the new system.   There will be decisions on who gets into nursing homes in the future, which a top official there calls people “at risk,” but that is apparently saved for a later day.

 

• Nursing home industry reps never made a peep at the two-day meeting, at least when we were there, except when they were asked if they would support a new Medicaid system if it meant less people going into nursing homes (the state wants to take care more of its Medicaid recipients in their community because they believe it will save the state money).    In Oregon, when they did this, the nursing homes lost 15 percent of their residents.  But the Kentucky nursing home reps said they were not concerned because they fully expect there will always be plenty of people  needing institutional care in nursing homes.  They are kind of taking a wait and see stance.  But you can bet that in the end they will be against anything that hurts their bottom lines.

 

• One would wonder if the state is having all these meetings to make it look like there is input from the people they serve while all along the state intends to do what it wants.   Gov. Fletcher is just back from Washington where he crowed about Kentucky’s leadership in modernizing Medicaid and the fact that consumers are being included in all the planning.

 

• A few people at the meeting also wondered what will happen to the grandiose and complicated planning if the current administration in Frankfort gets thrown out in a year or so.  Most of the state people at the meeting were political appointees.

 

• Maybe meetings like this signal a new era of openness in Frankfort emerging.  Even the new Medicaid commissioner is having meetings to update the public.

 

• No matter how all of this goes we will be closely watching the affect it might have on nursing home care.  Too early right now to tell.

 

• And special commendation must go to Mr. Birdwhistell for having the summit in the first place.  And extra special commendation must go to the bevy of bureaucrats who led the discussions, especially Deborah Anderson, a cabinet policy person.  She is a former newspaperwoman in Georgetown and Mount Sterling. (We knew we liked her right away.)  Her mother also will soon go into a nursing home, so she will have a firsthand look at the problems as she helps develop state policy for it.

 

 

WILL KENTUCKY FOLLOW WISCONSIN?

According to The Associated Press, Wisconsin Gov. Jim Doyle signed a bill into law increasing funding for nursing homes that accept Medicaid patients by $26.8 million.  Could it happen in Kentucky?  Doyle had vetoed a similar increase in the state budget last year as part of his action to carve out a bigger funding increase for public schools.  Members of both parties in the state legislature said the veto would harm rural nursing homes and pushed again for an increase.   But this time, Doyle said he could sign the increase because his administration cut costs in Medicaid, the state-federal health insurance program for the poor and disabled, and state revenues had increased at a faster rate than expected.  The bill signed recently provides a 2.8 percent increase in the Medicaid reimbursement rate for nursing home care over two years. That will translate to $11.4 million more in state funding and $15.4 million more in federal funds by mid-2007, Gov. Doyle said.  Here in Kentucky, officials also are crowing about how their new Medicaid program will cut costs.  Just last week, Gov. Ernie Fletcher bragged that the new Medicaid program has saved Kentucky $250 million.  Wonder if Gov. Fletcher is going to do the same thing as Gov. Doyle and pass the savings on to the nursing home industry.   Kentucky nursing homes just received a big boost in Medicaid reimbursement from the increased provider tax that was sneaked through the legislature.  The nursing home industry said they would improve the quality of care with their new-found wealth something we have yet to see happen.  Now of all things, that  provider tax increase is being threatened by proposals being made in Washington to cut the federal part of it in half.  So will Gov. Fletcher do what Gov. Doyle did and bail the “poor old” nursing home industry with money he says he is saving from the revamped Medicaid program?  Stay tuned.

 

CAN YOU BELIEVE ‘EM?

The nursing home industry is always telling us how good their nursing homes look in number of nursing care hours.  The information is located on a government web site for Medicare called “Nursing Home Compare.”  They say, “Just look there and you will see that we are above average in Kentucky on the number of hours our front-line nurses give residents.”   We always say that these figures do look good on “Nursing Home Compare” but they are highly suspect.  That’s because they are given to state and federal inspectors by the nursing homes themselves and are not audited.  If you don’t think it and more happen, read this:

 

WASHINGTON, Sept. 26 /U.S. Newswire/ -- Horizon West Inc. and its wholly owned subsidiary, Horizon West Healthcare Inc., have agreed to pay the United States $14.7 million to settle allegations that the companies violated the civil False Claims Act, the Justice Department announced today. Rocklin, Calif.- based Horizon runs a nursing home chain with approximately 30 facilities in California and Utah.

 

The government alleged that the companies falsely inflated the number of nursing hours spent on Medicare patients when reporting their costs to Medicare from 1991 to 1998. The $14.7 million settlement by the defendants will end the case. "The Department of Justice is committed to investigating cases that threaten the integrity of the Medicare program," said Assistant Attorney General Peter D. Keisler. "We will protect the public from these kinds of inappropriate billings to the Medicare program."

 

The settlement resolves the civil case United States ex rel. Lee v. Horizon West, Inc., et al., which was filed in 2000 by a former Horizon West employee. Julia Lee filed the case under the qui tam or whistleblower provisions of the False Claims Act, which authorize private parties to file lawsuits on behalf of the United States. The government intervened in the case on June 24, 2005, and the U.S. District Court in Oakland unsealed the case on July 11, 2005. The United States filed its complaint in the case on Oct. 21, 2005.

 

The case was investigated by the U.S. Department of Health and Human Services, Office of Inspector General; and the Federal Bureau of Investigation. The matter was handled by the Justice Department's Civil Division and the U.S. Attorney's Office for the Northern District of California in San Francisco.

(http://www.usnewswire.com/)

 

The only way we know of getting the correct information on how many front-line caregivers there are at a given time in a nursing facility is to go in yourself and count them.   The federal regulation on posting staffing numbers also is abused by nursing homes.  Check for yourself.  Count the direct care staff and then look at that required posting.  We would like to see an investigation on the situation in Kentucky.  What a great service Attorney General Greg Stumbo could perform by doing this for the Forgotten Kentuckians.

 

HERE’S WHAT WE’RE UP AGAINST

The political action committee of the Kentucky Association of Health Care Facilities generously feeds the election efforts of legislators.  (The association is the bigger of two lobbying groups for nursing homes in Kentucky.)   What they do is all perfectly legal and the records are open to the public.  It also does not mean that the legislators accommodated by industry gifts will do the industry’s bidding, but you can be sure that the gifts do ensure that the industry is listened to carefully.   On examination one will note that since the primary elections of 1998, the nursing home industry has given $111,900 to legislators to help them get elected.   The industry has a drive on now to raise more money from its member nursing home owners for its political action committee, so you can expect legislators running in November to be taken care of.  This is just one example of what advocates for nursing home reform are up against over in Frankfort.  Lots of industry big dollars.  All perfectly legal but tough to battle.   Only your voice can top the influence the dollars pouring in from the rich nursing homes have on legislators.

 

 

A LETTER TO THE GOVERNOR

When we heard Gov. Ernie Fletcher indicate he was not for minimum staffing standards in Kentucky nursing homes at a recent conference in Washington, we were amazed and surprised.  We also asked our supporters to write him and tell him why they think he should change his mind.  Lots of you did, and many of you sent us a copy of your letter.  Here is a good example:

Dear Governor Fletcher,

I am writing to ask it you will PLEASE support the minimum staffing standards in nursing homes in Kentucky. If you had a loved one in a nursing home you would certainly understand the value of this bill.

My husband dedicated his life to public service and he is now suffering from Alzheimer’s Disease and is in a nursing home. Staff is so slight that if I didn’t get there (and I work 9 hours a day) every day I would hate to think what shape he would be in. Most of the time when I get there in the evening he is soaked because there are only 2 aides for 18 residents. I feed him his evening meal. I have been a care giver for 30 years and involved with nursing homes for that period of time first with parents and now my husband. Believe me, if you were there on a day to day basis with a loved one you would change your mind in a heart beat!

Thank you,

 (NAME WITHHELD TO PROTECT THE WRITER)

 

WHATTA  ‘BOUT THE SENIORS?

In between legislative sessions, the legislators have what they call Interim Joint Committee Meetings.  This week there is one called, “Seniors, Veterans, Military Affairs & Public Protection.”    The committee has not done much for senior citizens since we have been watching it, in fact  this committee seldom has anything on its agenda regarding senior citizens even though that’s supposed to be part of its work.  Take the meeting this Thursday Oct. 5.  They will have a discussion on military family assistance, hear from a retired brigadier general and someone from the Kentucky Department of Military Affairs and other subjects that have nothing to do with seniors.  We recall that in days gone by this committee did take up senior issues.  But none we can recall recently.   Rep. Mike Weaver, D-Elizabethtown, and candidate for Congress in the upcoming November election in the 2^nd District, is co-chair of the committee.   Some years ago he was on a special task force to study long-term care.  He once told us right after that, when we asked him to support staffing standards in nursing homes, that telling American businesses how to run their businesses was something he could not support.  And he thought that setting minimum staffing standards was telling the nursing home businesses how to run their nursing homes.  After that, we have not expected anything on the committee agenda about nursing homes. But Rep. Weaver is a retired Army colonel so it is not surprising when so much of the committee work has to do with military stuff.  Just like the meeting this week.  We think the committee would do well to take up some senior issues.  There are plenty of them out there and many are given short shrift by the legislature.  Maybe Rep. Weaver will win his race for Congress and leave the state legislature.  Then maybe someone like Rep. Kathy Stein, D-Lexington, will become the committee chair.  She has a sincere feeling about helping seniors and is a good legislator unafraid of anything -- even big, tough military guys.   As for Rep. Weaver, if he is elected to Congress he will find legislation up there in Washington on minimum staffing standards and we will have to start all over to convince him that seniors are important in this country and need our help.  Col. Weaver: That’s something we all should salute.

 

 

 READ THIS STORY….

91 Year Old Man Charged With Sexual Battery

Kim Fields

October 4,2006

 

A convicted sex offender may be too close for comfort at a north Georgia assisted living facility. And because of complaints against him, the Dade County sheriff's office is investigating. Detectives with the Dade County Sheriff's Office say the incident happened September 28 at Clara's Place in Trenton, Georgia. They say 91 year old William Robinson inappropriately touched another lady that lives at the assisted living center. They say a worker at Clara's Place saw the incident and reported it to authorities. Robinson has been charged with sexual battery. But, Detective Jennifer Cooley says this isn't the first time he's been accused of sexual misconduct. Robinson is a registered sex offender and is listed on the Georgia Bureau of Investigation's website. As an 84 year old, Robinson was convicted of child molestation in Catoosa County, Georgia. Detective Cooley says she is now investigating other allegations against Robinson that might have occurred inside Clara's Place.

"We've been continuing the investigation and during the investigation, we've have had reports of other occurrences of similar circumstances, sexually inappropriate behavior."   Clara's Place is located within one thousand feet of Dade County High School, which is illegal for registered sex offenders, but Detective Cooley says the assisted living facility will not be charged in this case. She says the center's management knew about Robinson's past and have been cooperating with authorities. Robinson has been released from jail on his own recognizance. A court date has not been set. The Dade County Sheriff's Office says Robinson's family lives in Walker County, Georgia. He's now living with at a private residence there.

 

Here’s what nursing home advocate Bee Becker from Evansville, IN, said about this story:

 

“Again, the providers won't turn down a warm body, so we need a federal reg that bans the systems from warehousing these sexual predators and other convicted violent criminals in these facilities!!!  Unless the perps are in a coma, there is ZERO justification for forcing traditional nursing home/ALF patients to endure their presence in their living quarters.”

 

Right now, there are convicted sexual predators living in nursing homes in Kentucky.  What do you think should be done?  Do you agree with Ms. Becker?

 

 

PEOPLE STUFF

• Harborside Healthcare of Boston, with regional offices in Louisville and Owensboro, has purchased 11 Wells Health Systems of Owensboro nursing facilities in Western Kentucky for an undisclosed amount.  Wells held on to one property, the Wellington Park of Owensboro facility, according to Jean Wells, co-owner of the Wells Health System along with her former husband, Jack Wells.  Ms. Wells said that Wellington was the first Alzheimer’s facility in Kentucky.  Ms. Wells also told us that Wells Health Systems would continue to manage five facilities in the state.   Ms. Wells has been prominent in industry legislative efforts in Kentucky.  She heads up the legislative committee of the Kentucky Association of Health Care Facilities.

 

• We were first to tell you that Ruby Jo Cummings is the new president of the Kentucky Association of Health Care Facilities.  Now we get word that the man she succeeded, Rich Miller, is looking for a new job somewhere.  He apparently left the Kentucky industry trade and lobbying group when he could not come to terms on a new job contract.  Rumor is he may go to Washington state where his wife is from.

 

• HHS Secretary Mike Leavitt named Leslie Norwalk as acting administrator for the CMS effective Oct. 15. Ms. Norwalk has served as deputy administrator for the agency that oversees $740 billion in federal spending on Medicare and Medicaid. She replaces Mark McClellan, who resigned from the CMS on Sept. 5.

 

• Congrats to Steve D. Davis, everybody’s “nice guy” in the Office of Inspector General.  He is the deputy director.  And he and his wife Ellen are also new parents of a baby boy, their first.  He looked bleary eyed at a recent meeting which he said was from helping with those middle-of-the-night bottles.

 

• Secretary of the Cabinet for Health and Family Services Mark Birdwhistell is getting very well known apparently.  We found a newspaper clipping about him on the bulletin board of the Maggard General Store in Lothair, Ky.   They say you have really made it if you get on Ima Jean Maggard’s bulletin board.

 

 

P.S.

Morals and Aunt Shirley

A teacher in Springfield, Kentucky, gave her class of nine-year-olds an assignment: Get their parents to tell them a story with a moral at the end of it. The next day the kids came back and one by one began to tell their stories.

Will said, "My mom and I have a lot of egg-laying hens. One time she was taking eggs to different people who buy them in a basket on the front seat of the van when she hit a big bump in the road  -- and all the eggs went flying and broke and made a mess, and the moral of the story is --

'Don't put all your eggs in one basket!'"

"Very good," said the teacher.

Next Caitlin raised her hand and said, "Our family are farmers, too. But we raise chickens for the meat market. One time my daddy and mom had 500 eggs in incubators, but when they hatched they only got 460 live chicks, and the moral to this story is --

'Don't count your chickens before they're hatched'."

"That was a fine story, Caitlin, said the teacher.  Michael, do you have a story to share?"

"Yes. My father told me this story about my Great-aunt Shirley who is his aunt who lives over at Frankfort. Aunt Shirley was a flight engineer on a plane in the old Gulf War a long time ago and her plane got hit. She had to bail out over the desert and all she had was a bottle of whiskey, a machine gun, and a machete.

My father said she drank the whiskey on the way down so it wouldn't break, and then she landed right in the middle of about 100 enemy troops. She killed about seventy of them with the machine gun until she ran out of bullets. Then she killed about twenty more with the machete until the blade broke. And then she killed about ten that were left with her bare hands."

"Good heavens!" said the horrified teacher, "What kind of moral did your father tell you from that horrible story?"

"Stay away from Aunt Shirley when she's been drinking."

 

DON’T FORGET….

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

 

           

BERNIE VONDERHEIDE
KENTUCKIANS FOR NURSING HOME REFORM
1530 Nicholasville Road
Lexington, KY  40503

 

Tel:  (859) 312-5617