October 3, 2008
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
NOV. 2 SEMINAR POSTPONED
We are postponing the seminar we previously announced for Nov. 2 in Lexington. Our plans are to reschedule it for next fall.
HAVE YOU WRITTEN THAT LETTER?
Many of our readers received an alert from us about writing a letter to The Courier-Journal of Louisville about an article they published on the high rate of deficiencies in Kentucky nursing homes. We hope you will indeed write your own letter and tell your own experiences with the poor care. If you did not get our alert, go to our Web site where we have reprinted the article and information on writing and sending letters-to-the-editor.
MOREHEAD MAN MAKES HISTORY . . .
A 55-year-old man from Morehead has become the first person to be moved from his nursing home back into his community under the new Money Follows the Person voluntary program. This is the program that lets qualifying nursing home residents keep their support from the Medicaid program but live in a community setting instead of the institutional setting. The Morehead man was in a nursing home for eight years, but on Oct. 1 he moved into a new apartment that accommodates his needs. State Medicaid officials have estimated they will move 546 people out of nursing homes into the community over the next five years. For more information on the program, call 877-564-0330.
. . . AND THERE’S OTHER ‘MOVING OUT’ NEWS
- At a regional AARP meeting in Lexington, a hand-out on the organization’s 2009 legislative agenda says that AARP-Kentucky is working on a long-term care agenda that includes “working on the establishment of a Governor’s Commission on Long-Term Care... that would increase the opportunities for home and community based services for those wishing to age in place.” No mention on whether they would propose initiatives to improve the quality of care for people who must remain in nursing homes, like passing a minimum staffing standards bill.
- Medicaid recipients in Florida have filed a federal class-action lawsuit on behalf of 8,500 residents of nursing homes in that state who say they have been forced into the nursing homes. “There’s a lot of concern that the nursing home industry is very powerful in many states and has made sure that a lot of Medicaid dollars go to institutional care as opposed to home and community-based care,” said Toby Edelman, an attorney at the Center for Medicare Advocacy. AARP is leading the way in Florida on the lawsuit. AARP is also pushing Medicaid waivers in Kentucky to move people out of nursing homes and back into their communities.
- On a technicality we are not sure we understand completely, nursing homes sometimes can actually get a financial break on losing Medicaid residents who have opted to leave and go back under a new waiver program that pays for them to live in the community. When a Medicaid resident leaves, the state no longer has to reimburse the nursing home for the ex-resident’s room and board. That would seem like a loss of revenue to the nursing home. But if in leaving the resident actually causes the nursing home to have a higher acuity ratio, then the nursing home gets more money in the long run, because the sicker the resident the more the nursing home gets paid by the state and federal governments. This can happen when the resident who is leaving is less sick than the average of those residents who are left. This may be why the nursing home industry seemingly accepts the Kentucky’s new Money Follows the Person program. We have heard no squawk from them since discussions in Kentucky began more than two years ago. The net result of the new program can be that the industry will actually gain revenue from the federal and state government matching program. Also, it seems that even when a resident leaves to go back and live on their own, with the help of the new Medicaid waiver, there are plenty others waiting to become Medicaid eligible and take the vacant bed. It still all seems suspicious, however, in that nursing homes are always complaining that they are not being reimbursed sufficiently by Medicaid.
NEW STATE OMBUDSMAN COMING
Kentuckians For Nursing Home Reform had a representative on the selection committee to pick a new state long-term care ombudsman. The position has been vacant since Jacqueline Strader resigned to become deputy executive director of the other ombudsman program in the Cabinet for Health and Family Services. It’s confusing – but there is a long-term care ombudsman program that deals with problems in nursing homes and another one that deals mostly with problems with child care and state social workers. Ms. Strader jumped ship when it was announced that Gov. Steve Beshear, acting on requests from Kentuckians For Nursing Home Reform, took the long-term care position out of politics and made it a state Merit System position. Ms. Strader would have had to take a pay cut if she had remained in the state long-term care ombudsman position. The state long-term care ombudsman salary is about half that of the person who directs the other ombudsman program, Sandra Brock. (We will have more information about that inconsistency in a future edition of the Newsletter.) Advocates for nursing home reform were sorry to lose Ms. Strader, but applauded the governor in acting to keep politics out of future nursing home ombudsman work. Look for a new state long-term care ombudsman to be named in the next two weeks.
REGISTER NOW
FOR THIS IMPORTANT CONFERENCE
A Somerset physician, Dr. Kevin Kavanagh, has been working for more than two years to improve health care in hospitals. His organization, Health Watch USA, is sponsoring an all-day conference on healthcare transparency and patient advocacy Nov. 20 at the Four Points Sheraton in Lexington.
On the conference program will be a session on minimum staffing standards for nursing homes which you will want to hear. Kentuckians For Nursing Home Reform is one of the conference’s participating organizations.
To register for the conference and obtain the updated brochure and agenda please go to www.healthconference.org
Or, call 606-875-3642.
YOUR POCKETBOOK . . .
According to a national survey, a bed in a semi-private room in a nursing home will cost about $197 a day or just over $70,000 a year. The average cost for assisted living residents is about $108 a day or $3,241 a month. The survey was done by Prudential Financial.
SHORT STUFF
- Sen. Mitch McConnell received high praise from the big nursing home national lobbying organizations for his “leadership” in stopping cuts in the amounts of money the feds reimburse nursing homes for taking care of Medicare patients. The praise came a planned $770 million cut in Medicare Part A payments to nursing homes was stopped....In the meantime, no word from the senator, or any of the Kentucky delegation in Congress, on whether they will become co-sponsors of four important nursing home reform and elder abuse reform bills. The guess is that they are too busy bailing out Wall Street.
- Something called the Kentucky Primary Care Association is having a program on “Lean Management in Health Care.” Observed an advocate for nursing home reform: All they need do is look at the nursing home industry. They excel in lean management, and they do it by hiring as few people as possible to take care of the patients.
- There’s a new nursing home district ombudsman in the Lincoln Trail district, Normaline Skees. She replaces Carol Dupin, who has been assigned to other duties in the ADD district office. Ms. Skees is a nurse with extensive experience in serving the elderly population. She also has coordinated and supervised staff in nursing homes and provided training on patients’ rights. She has operated an adult day-care center and conducted programs for monitoring patient care issues. The position serves nursing home residents in eight counties – Breckinridge, Grayson, Meade, Hardin, Larue, Nelson, Washington and Marion.
- Courier-Journal reporter Deborah Yetter reports that the government is cutting off Medicaid and Medicare funds to the Green Meadows Health Care Center, a nursing home in Mount Washington, for not meeting federal standards. In effect, that closes the facility down. It is owned by Mt. Washington Health Care, LLC, according to state records. Ms. Yetter’s story said that a state citation had alleged that some residents of the nursing home were being attacked and injured by other residents and that the nursing home failed to stop such incidents.
- The national median salary for nursing home administrators is $85,464, an increase of 3.6 percent over last year, according to the Hospital & Healthcare Compensation Service. Nursing home directors of nursing are making $75,000 a year. Anyone wonder where nursing homes are spending their money? Not on hiring more front-line caregivers....
- Something called The Commonwealth Fund Long-Term Care Opinion Leader Survey listed among its findings that 67.7 percent of people surveyed think that the regulation of assisted living facilities should be more stringent. People responding to the survey said assisted living facilities should be inspected just like nursing homes, on a regular basis. But there are only five state staff (including the supervisor) in the Kentucky Department of Aging and Independent Living checking on the 100 or so assisted living facilities in Kentucky. Look for updated safety regulations soon for Kentucky facilities. We will keep you posted.
- Detective Chris Russell, who investigates elder abuse in Lexington, told a group recently that “Exploitation of nursing home residents has increased markedly.” Why? “Because of the economy and rising gas prices,” he said.
- Martha Baker, one of our members in Paducah, says she complimented Gov. Steve Beshear at his town hall meeting in Paducah for making the state long-term care ombudsman position a merit-system job. “He very graciously responded by explaining in extended detail the duties of an ombudsman and why he thought it should not be a political assignment, but under the merit system,” she says. Maybe this is one reason why the governor’s approval rating has now zoomed to 60 percent. Why, with a popular governor like this, no telling what great things he will do for nursing home residents. Stay tuned.
- The federal government has issued regulations that will require all nursing homes to have a fire sprinkler system in place by 2013. In Kentucky, at last count, four nursing homes allegedly had no fire sprinkler system; and 11 were only partially sprinklered.
- Kindred Healthcare, the nursing home giant based in Louisville, announced income of $21.7 million in the second quarter and said that it expects its full-year income to total as high as $62 million.
- A British study has revealed that 51 percent of nursing home patients are being given inappropriate psychoactive drugs. We suspect this same practice is going on in many Kentucky nursing homes. These are the people you sometimes see in the hallways slumped over in their wheelchairs. One nurse in the study said that prescribing the psychoactive drugs is done “during times of staff shortages, and could be seen as a way of keeping the residents calm and to make life easier in some homes.”
- A new service for senior citizens in the Lexington area, ITN Bluegrass, will provide transportation service for adults 60 years and older who are visually impaired. Get more information by going the Web site, http://www.itnbluegrass.org.
- People: The new state president of the AARP Executive Council is Karen Cassidy of Louisville. She has worked for Kindred Healthcare’s hospital division and is a tenured professor at the University of Louisville School of Nursing....Ed Monohan of Lexington has left the Catholic Conference of Kentucky, a lobbying organization for the Roman Catholic bishops in the state, to head the public advocacy program in Kentucky. Mr. Monohan led his organization in opposing minimum staffing standards for nursing homes, mostly because of the additional expense he said it would cause Catholic facilities....Alice Hedt has announced that she is leaving the top job at the National Citizens’ Coalition for Nursing Home Reform in Washington after five years. No successor has yet been named.
WHAT THEY’RE SAYING . . .
(We get a lot of calls and e-mails from people who are upset about care in nursing homes. From time to time we will share these with Newsletter readers. You will note that we do not identify the writers or nursing homes.)
“ I had an elderly aunt who was put into a nursing home in Louisville. She was not there long before they left her in a chair unattended and she tried to get back in bed and fell striking her head on the table. She died as a result of this.”
“I am a nurse and have been a director of nurses for the most part of 20 years. I have always been frustrated by the corporations and their bottom-line mentality.”
“I’m very proud of what we’re doing....”
WE HAVE A NEW WEB SITE!
Thanks to one of our members, Russ Lay, we have a new Web site. Our former Webmaster, Janet Powell, resigned from our board and the Web site, so that left us looking for help. Along came Mr. Lay who not only introduced us to Gisele Legere, a very talented graphic designer in Lexington, but he also offered to pay for any cost incurred in revamping and maintaining the Web site.
DO YOUR PART: GET PETITION SIGNATURES
Everybody agrees that we need minimum staffing standards for nursing homes in Kentucky. But because of the immense political clout of the nursing home industry, the state legislature has been slow to get interested in this issue. We need to convince lawmakers that many citizens want these standards. YOU can help by getting one of our petitions and getting all your friends to sign it. We have over a thousand names now on the petition, but we need to double that. Time is growing short. The legislature will be back in session in early January. We want to present the signed petitions to them then. So please get busy now. The petition and instructions on just what to do are on our Web site. Just click on http://www.kynursinghomereform.org/petition.html