March 30, 2009
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
STAR WATCH BY U.S. NEWS
The nursing home industry may not like the federal Five-Star Rating System, but apparently the editors of U.S. News & World Report do. The magazine, which long has rated universities and hospitals, has just begun carrying rankings of nursing homes. U.S. News bases its rankings on the federal system, but staff writer Avery Comarow said their rankings are “more flexible” and “easier to navigate.” A couple Kentucky tid-bits from the U.S. News rankings—in the list of “10 Worst States for Top (5-Star) Nursing Homes,” Kentucky was 6th, and in the U.S. News “Honor Roll” of best nursing homes, the Home of the Innocents in Louisville was listed. Only 9 percent of the nursing homes in Kentucky got a U.S. News 5-Star rating. Go to www.usnews.com to see the ratings and a complete explanation of them.
STAR WATCH THE FEDERAL WAY
The ratings in the new federal Five-Star Rating System for nursing homes are updated every month on the fourth Thursday of every month. But you won’t see the rating of a facility change unless there has been a state inspection or investigation of some kind that changes basic data. Ed Mortimore, an official of the Centers for Medicare and Medicaid Services, said they are studying ways to improve the system and get some of the bugs out. And the National Citizens’ Coalition for Nursing Home Reform (NCCNHR) is planning a nationwide conference call among citizen advocates to get their input. Apparently the ratings have been a hit nationwide, but, as expected, the nursing home industry doesn’t like them. Hurts to have your dirty laundry aired publicly.,,,,
SWEET TO SOUR
That resolution introduced in the just-concluded legislature that exuded sweetness to the nursing homes, in the end turned sour. The resolution was introduced in the House by Rep. David Osborne and in the Senate by Sen. Julie Denton. The idea was pushed by Louisville nursing home reform advocate Sherry Cooke. The resolution simply said (as amended), “Be it resolved by the General Assembly of the Commonwealth of Kentucky that the Commonwealth of Kentucky recognizes that nursing home quality of care and dignity of residents are a priority and hereby salutes nursing home employees, residents, and families for their commitment to quality nursing home care in the Commonwealth.” How could anyone be against something that sweet? And in fact, in the Senate it passed unanimously. But it hit a sour note when it was sent to the House Health & Welfare Committee and never got out for a vote.
PURPLE PEOPLE PROTECTORS
John Karem, the Louisvillian whose mother was involved in a heart-rending situation where she was resuscitated even though her family didn’t want her to be, is on a personal crusade to get a state law passed that mandates a uniform system for recognizing DNR (Do Not Resuscitate) patients in nursing homes. He is working with Rep. Bob DeWeese, R-Louisville, officials of the Cabinet for Health and Family Services, nursing home industry officials, and advocates for nursing home reform to come up with a good system. Mr. Karem says his research convinces him that all DNR patients in nursing homes should wear a purple colored wristband. He says that 11 states now have such a system and 30 are in the process of setting one up. His efforts became the subject of a front-page article in the Lexington Herald-Leader (see our Web site http://www.KyNursingHomeReform.org) and an hour-long talk show on WVLK in Lexington. A meeting is expected soon to proceed on the project. Kentuckians for Nursing Home Reform is supporting Mr. Karem.
PROBLEMS WITH ASSISTED LIVING?
Assisted living, as it is called, is popular with many elderly people, and the number of people living in assisted living communities is growing. There have been problems for residents, however, so the state has begun to watch the operation of assisted living facilities more closely. For example, a new set of assisted living regulations has just been officially approved. One of the new regs says that if a resident is found in a dangerous situation, the assisted living operator must correct the situation in 48 hours (or by 4:30 p.m. Monday if the complaint is filed by the state on a Friday). Deborah Anderson, the commissioner for the Department of Aging and Independent Living, has been pushing for more regulation of assisted living, sometimes to the consternation of assisted living facility owners. Also, you may soon see the state let consumer know about problems at assisted living sites by posting complaint investigations on the Web site of the Cabinet for Health and Family Services. Lawyers for the state are checking this idea out right now. In the meantime, if you have questions or problems about how you or a loved one is being treated in one of these communities, call (502) 564-6430. Phyllis Sosa is in charge of assisted living regulatory activities for the state.
NATIONAL AP STORY A SHOCKER
The Associated Press, in a story they released for national distribution, reported that over the past several years nursing homes nationwide have become dumping grounds for young and middle-age persons with mental illness. Is it happening in Kentucky? AP Kentucky correspondent Roger Alford said that federal government numbers show Kentucky had 1,916 mentally ill patients in nursing homes last year, up from 1,220 in 2002, a 55 percent increase and the 10th highest in the nation. That could mean that on the average there are seven mentally ill patients in every one of the 287 nursing homes in the state. .Sadiqa Reynolds, inspector general in the state Cabinet for Health and Family Services, provided copies of state regulations that seem to indicate that there should be a pre-admission screening for mentally ill individuals and those with mental retardation before they are admitted to a nursing home in Kentucky. Apparently the mentally ill and retarded can live in a nursing home if it is determined that they require the level of services required by a nursing home.
THE SADDEST PEOPLE OF ALL
The saddest people of all in a nursing home are those with Alzheimer’s Disease. It is estimated that the average nursing home has upwards of 70 percent of its residents with some kind of dementia. These are “happy campers.” Many of them are mistreated and they don’t even know it. Sad. But now a new blue ribbon group of national celebrities has gathered in Washington to form an Alzheimer’s Study Group. Some of the members include former Supreme Court Justice Sandra Day O’Connor, former Speaker of the House Newt Gingrich, former senator Bob Kerrey, and Maria Shriver, first lady of California. One of the things they are working on is getting better trained caregivers of Alzheimer’s patients, including those in nursing homes. It’s a worthy cause and one that the Kentucky Alzheimer’s Association has tried to get done, but with only moderate success so far. A bill died in the 2008 session to mandate the training in nursing homes, and instead money was appropriated to do a pilot study in six nursing homes on dementia training. Any day now the results of that study are expected to be released.
ANGELS OF MERCY? WE DON’T THINK SO
With a full head of steam, the nursing home industry is leading an effort in the Tennessee legislature to cripple quality nursing home care. Just recently, for example, the rich and powerful industry persuaded nurses to march on the Tennessee state capitol in support of a bill to limit the liability of nursing homes in lawsuits against them. The fact of the matter, however, is that if the legislation passes, it would just about ruin state inspection of nursing homes in Tennessee and make it almost impossible for residents and their families to sue. What is being tried is called “tort reform.” The nursing home industry calls their legislation the “Choose Care Tennessee Act.” But the opposition fighting to preserve quality care – the Tennessee Justice Association, NAACP, and AARP – call it the “Kill Old People Cheap Act.” Minimizing the monetary punishment on nursing homes found at fault is an old tactic of the nursing home industry. But it is sad that at the rally some 1,300 nurses joined in. The industry has told the nurses that if the state doesn’t put a cap on lawsuits they may never get a decent pay raise. Bankrolling the attack is Tennessee Health Management, Inc., a big corporation that owns some 30 nursing homes in the state. They are out there publicly blaming out-of-state trial lawyers for what they call ”predatory actions,” including lawsuits that they allege take away from their ability to provide patient care. What a shame that some nurses in Tennessee have been gullible enough to buy in to such trash. Angels of Mercy…… we think not.
WATCH ON WASHINGTON
- Congressman Ben Chandler, longtime supporter of nursing home reform, has introduced a bill “to prevent the abuse and exploitation of older individuals.” Main thrust of the measure is to reject any parole for persons convicted of sexual offenses committed against the elderly or for sexually violent predators.
- The U.S. House has passed the “Silver Alert Act,” which would help in the search for missing adults similar to the Amber Alert program for missing children. Kentucky is ahead on this one, having passed the same legislation in the 2008 session of the legislature which established a “Golden Alert.” It was sponsored by Sen. Denise Harper Angel, D-Louisville. But no one from the Kentucky delegation is a co-sponsor of the federal measure.
- A very important bill has been introduced once again in the U.S. Senate – “The Fairness in Nursing Home Arbitration Act of 2009.” This is the one that would prevent incoming nursing home residents from being tricked into signing away their rights to legal action against a nursing home. It is sponsored by Republican Mel Martinez of Florida and Democrat Herb Kohl of Wisconsin. But so far neither Kentucky senator – Mitch McConnell or Jim Bunning -- has signed on to support it.
SHORT STUFF
- As of early this month, only seven people have been allowed to leave nursing homes and given Medicaid support to live in their own homes. It’s a program called Money Follows the Person, a result of a $49 million federal grant to Kentucky. There are about a dozen state employees now running the program, but one of the problems they have run into is that many nursing homes won’t allow nursing home ombudsmen to promote the program in their facilities. If you want to know more about it, however, you can call the state office at 1-877-564-0330.
- Suzanne Hornstein has been named the new deputy inspector general for the state Cabinet for Health and Family Services. She has had many years of experience in long-term care with Indiana state agencies, and is former president of the National Association of Health Facility Survey Agencies.
- The nursing home ombudsman program in California is in trouble. California Gov. Arnold Schwarzenegger cut $3.8 million in funding from the ombudsman program there resulting in the layoff of local ombudsmen and reduction in services.
- Want to buy a nursing home or assisted living facility? After hitting record prices in 2007, the average price per bed to buy a skilled nursing facility fell by 18 percent in 2008; and for assisted living down 21 percent. Levin Associated Inc. said the drop was largely because less attractive and less profitable facilities were being put on the market while investors held on to the better ones during the current economic crunch.
- Sunrise Senior Living, a big nursing home corporation with 400 facilities worldwide – and three in Kentucky – is reportedly in financial trouble. Sources say they may be able to meet their obligations only until the end of this month. The Kentucky facilities are Brighton Gardens in Edgewood and Eden Terrace and Sunrise in Louisville.
- “It is just outrageous how many nursing homes in Arkansas are being reimbursed for their liability insurance premium,” says reform advocate Martha Deaver. But is this happening in Kentucky? Neville Wise of the state Department for Medicaid Services said, “Information in regards to liability insurance premiums is not reported…. and therefore not available.”
P.S.
Beatitudes for Friends of the Aged
Blessed are they who understand
My faltering step and palsied hand,
Blessed are they who know that my ears today
Must strain to catch the things they say.
Blessed are they who seem to know
That my eyes are dim and my wits are slow.
Blessed are they who looked away
When coffee spilled at table today.
Blessed are they with a cheery smile
Who stop to chat for a little while.
Blessed are they who never say,
"You've told that story twice today."
Blessed are they who know the ways
to bring back memories of yesterdays.
Blessed are they who make it known
That I'm loved, respected and not alone.
Blessed are they who know I'm at a loss
To find the strength to carry the Cross.
Blessed are they who ease the days
On my journey Home in loving ways.
— submitted by Collette Irtz. Credit to Fr. Al Fritsch.