November 18, 2008
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
WHAT A GREAT BUSINESS!
Nursing homes are a business. Big business. Most of them get a lot of their revenue from the state and federal governments in return for taking care of their Medicaid patients. Latest figures we saw showed that about 64 percent nursing homes patients are on Medicaid support. Of course the nursing home industry is always complaining that what they get in Medicaid reimbursement is not enough. This is why it may surprise you that In the 2008 State Fiscal Year, nursing homes received $800,481,793.42 from Medicaid reimbursement. That’s right – more than $800 million to nursing homes in just Kentucky alone. That’s a pretty hefty amount of money and a 7.4 percent increase over the year before. Not many businesses had a 7 percent increase in revenue in the past year. The nursing home industry in Kentucky set themselves up for being supported at such a high level. On the last day of the 2004 legislative session the industry sneaked through an increase in what is called the “provider tax.” That’s where nursing homes pay a “tax” to the state but then get back some $3 of it for every $1 put in because of federal Medicaid matching funds. Pretty good deal. Industry lobbyists assured legislators that they would use this significant increase in funding to provide better care. Of course, that hasn’t happened. Since the provider tax was increased, in what amounted to about a $50 million a year windfall for the nursing home industry in Kentucky, Medicaid reimbursement has gone up from $593,649,490 in 2004 to the current $800 million. That’s an increase of $206 million, or 35 percent. And for those millions of dollars all we get are excuses from the industry for poor care and constant whining that they need even more money. What a great business, huh?
ELECTION LEFT-OVERS….
WHAS-TV political reporter Mark Hebert asked Lt. Gov. Mongiardo if he is thinking of taking on Sen. Jim Bunning when he comes up for re-election in 2010. Lt. Gov. Mongiardo replied that right now “I’m on a path to fix health care. If that takes me through the U.S. Senate, so be it.” Nursing home reform advocates hope that some of that “fixing” involves long-term care…. President-elect Barack Obama has said he is for higher pay for caregivers, increased nurse training and more funding for home-care initiatives. But the Los Angeles Times said that he’ll have little time for healthcare reform what with the rigors of passing a large-scale economic stimulus package. However, in his first press conference, the president-elect indicated that he would move ahead on many of his ideas in addition to fixing the economy. Stay tuned.
GOV. BESHEAR COMMENTS….
In a news release sent statewide to the media, Gov. Steve Beshear had this to say about the appointment of a new State Long-Term Care Ombudsman:
“It is important that the person who represents the interests of some of the state’s most vulnerable residents be taken out of the potential realm of political influence. We want Kentucky’s long-term facility residents to rest assured they have someone to count on, someone consistent and dedicated, who will represent their interests only.”
Acting on a suggestion by Kentuckians For Nursing Home Reform, the governor directed that the state long-term care ombudsman job no longer be a political appointment but rather made a state Merit System job.
The news release in which the governor made his statement announced the appointment of Kimberly Baker to the position. She has begun work already.
IMPROVING ASSISTED LIVING….
New regulations for assisted living communities are on the way, thanks to some hard work by Commissioner Deborah Anderson and her staff in the Kentucky Department of Aging and Independent Living. The assisted living regs on certification of the facilities have been tightened up, and one particularly important addition says that assisted living facility owners must act within 48 hours to help a resident in a dangerous situation, such as one discovered by state inspectors or brought to the state’s attention by someone. The new regs are going through the long and tedious review process now and probably will not be official until January or February. We will keep you posted.
NEED A RIDE?
ITNBluegrass is a new service in Fayette County that for a fee will pick you up and drop you off wherever you want to go. You must be over 60 years old or be a visually-impaired adult to use the service, says Gale Reece, the executive director. For more information, call 859-252-8665. Next year, according to Ms. Reece, they hope to have the service up and running in Jessamine, Woodford, Bourbon and Scott counties too.
ONLY IN THE NURSING HOME INDUSTRY….
Only in the nursing home industry will you find the government getting after a facility for bad care on one hand and then turning around and giving the facility a “bonus” reward with the other. Read all about such a situation on Dave Poland’s blog, “Nursing Home Reality.” You can share your own stories about nursing home care there, too. Just go to http://nursinghomereality.wordpress.com/
QUOTABLE QUOTE
“ Should we be at all upset with so many deficiency violations in nursing homes? Only if we are in the institutions. If someone else is in them, oh well.”
SHORT STUFF
- According to the prestigious Met Life Market Survey, average rates for a semi-private room in a nursing home increased 1.1 percent in 2008 to $191 a day, or $69,715 annually….. Assisted living rates increased to $3,031 a month, or $36,372 a year.
- Great news. The Kentucky Association For Gerontology is undergoing a streamlining and new leadership. A brochure lists “long-term care reform and quality of care in nursing facilities” as one of its “action steps” in 2009.
- Nursing home ombudsmen, beware. In California, Gov. Arnold Schwarzenneger has just cut state funding for local ombudsman programs. Closer to home, however, Kentucky Gov. Steve Beshear is supporting the nursing home ombudsman program, in fact, just recently moved to improve the state long-term care ombudsman position by taking it away from being a political appointment and making it a state merit system job. (See item above.)
- There’s concern about social programs in Kentucky because of looming budget cuts…. “States will have a difficult time paying for both Medicaid and other priority areas such as education, criminal justice and transportation,” according to a report by the health insurance industry. The report said that Kentucky is expected to need $12.6 billion in the next 20 years to fund Medicaid. That’s an annual average growth in Medicaid in Kentucky of 3.8 percent. Per-capita costs are predicted to grow from $99 this year to $195 in 2027.
- Lawyers at Work -- In Florida, about 8,500 Medicaid patients in nursing homes have filed a federal class action lawsuit claiming they are being forced to live in nursing homes. They want to get out but they want Medicaid to support them in their homes and communities….. In Illinois, an 83-year-old woman died in a nursing home and her estate alleged in a lawsuit it was because of poor care and won a million dollar settlement.
- Where do long-term care issues rank up there in priority in the Kentucky General Assembly? The answer is probably way down low, if a new state publication is any indicator. In the more than 60 pages of the Legislative Research Commission publication, Issues Confronting the 2009 Kentucky General Assembly, there’s not a single mention of any issue directly affecting long-term care, nursing homes, or even the elderly. The LRC does give itself an excuse, however, by saying “The listing of issues in this publication in not exhaustive.” Yeah, sure.
- Sunrise Senior Living, the largest assisted living chain in the U.S., says it lost nearly $69 million in the third quarter of 2008. Its CEO said, “Our team has been fully committed to grinding down cash outflows by reducing overhead……” OUR COMMENT: How do you do that… cut staffing just like the nursing homes?
- A U.S. senator from Montana, Max Baucus, wants to reform long-term care by reducing federal funding of nursing homes and putting that money to helping keep people in their homes. Naturally the nursing home industry doesn’t like the suggestion and quoted a study that says home-based care does not significantly reduce overall long-term care costs. In Kentucky, using Medicaid dollars in the form of waivers for home-based care was pushed by the Fletcher administration as a way to save the sate money. Nothing much as happened on that, but the state continues to work on it.
STILL TIME TO REGISTER
If you are into advocating for better care in hospitals and nursing homes, you should plan on attending the Conference for Healthcare Transparency and Patient Advocacy on Nov. 20 in Lexington. This is the second year that Somerset physician Kevin Kavanagh has put an all-day meeting together and if you go you will learn a lot of things about a lot of important issues. Kentuckians For Nursing Home Reform is one of the conference’s participating organizations and will be on the program to discuss minimum staffing legislation. There is still time to register. Just go to www.healthconference.org or call 800-679-7426.
P.S.
A little girl asked her mother, “How did the human race begin?”
The mother answered, “God made Adam and Eve and they had children and so was all mankind made.”
Two days later the little girl asked her father the same question.
The father answered, “Many years ago there were monkeys from which the human race evolved.”
The confused girl returned to her mother and said, “Mom, how is it possible that you told me the human race was created by God, and Dad said they developed from monkeys?”
The mother answered, “Well, dear, it is very simple. I told you about my side of the family... and your father told you about his.”