October 8, 2009
NEWSLETTER
A non-profit organization dedicated to the welfare of the “Forgotten Kentuckians”
GOVERNOR MEETS ON NURSING HOME REFORM
A delegation from Kentuckians for Nursing Home Reform met with Gov. Steve Beshear in his Capitol office on Sept. 23 to urge his support on five projects that advocates believe would improve the quality of care. Gov. Beshear thanked the group for coming to see him and said he would give the requests consideration and get back to them with his decisions on the requests. The meeting actually was historic, because it was probably the first time that any delegation has met with a Kentucky governor formally to request his help on nursing home reform.
CRYIN’ ALL THE WAY TO THE BANK
Those fat cat nursing homes — most of them owned by big corporate investors on Wall Street — are at it again. Moaning and groaning over every proposal made as the Congress looks at national health care reform, they are scaring their residents and trying to intimidate the public and lawmakers to believe that they will be closing their doors and going out of business. The truth is, of course, that they are crying all the way to the bank. Profits have never been so huge. Take one of the companies that owns the land and buildings – Ventas, Inc., right here in Louisville, KY. They are the landlord of Kindred Healthcare of Louisville that operates nursing homes. Ventas reported a 60 percent rise in earnings for the first six months of this year to more than $164 million. Meanwhile, nursing home chief propagandist Bruce Yarwood told his annual convention crowd that the problems facing long-term care are like a “tsunami.” “Healthcare reform does nothing for long-term care,” he told a packed house of 2,300 industry leaders in Chicago. The problem, he said, are things like legislation in the Congress that would take away mandatory arbitration and the development of the Five-Star Rating System. He said that the Five-Star System “sucks…. pure and simple.” Nice talk from a so-called professional. And, oh yes, if the nursing home people are so poor, then how can they afford to turn out in record numbers at a meeting in Chicago?
CRYIN’ IN KENTUCKY?
Kentucky nursing home people have been known to give the poor-mouth, too. It’s the favorite excuse when they don’t want to dip into their profits and hire adequate staff. One of the complaints they make is about state and federal support for their Medicaid residents. But new figures are out on that, and in the State Fiscal Year 2009 nursing homes in Kentucky were paid $880,079,421 (that’s almost a billion dollars!) in state and federal Medicaid reimbursements. That’s a 10 percent gain over the previous year and a 48 percent increase in just the last five years. Now here’s an industry in our state always complaining that they don’t have enough money to hire adequate staff while their revenues go up in an economy with almost zero inflation. How many businesses in Kentucky in these days and times would like to have a 10 percent increase in income over the past; and almost 50 percent in just five years? If your local nursing home is not moaning and groaning yet, they will be soon. Crying in Kentucky? Yep, all the way to the bank.
WATCH OUT FOR INCREASES
With all this talk by the nursing home industry about how bad they are hurting financially, we are also hearing about some rate increases. For example, nursing homes in the Manor Care-Carlyle Group — there are two in Kentucky — just announced another increase. And we are hearing of budgeting cutbacks by nursing homes across the country.
MEDICAID GETS SHORT SHRIFT
Only three of the 13 members of a citizens’ advisory committee on the state Medicaid program showed up for a meeting last week. The state Advisory Council for Medical Assistance meets quarterly to review Medicaid programs. What with the grim outlook and predictions for funding cuts in Medicaid in the next fiscal years, it was surprising to see such obvious disinterest. State Medicaid Commissioner Elizabeth Johnson said she was disappointed with the turnout. She also said, in answer to a question, that her staff is working on how to operate the program if funds are cut, although no formal committee has yet been set up to discuss what might be done. Program funding for the current fiscal year was saved by the input of federal stimulus funds. The legislature will take up the problem when it considers the state budget in the 2010 session beginning in January.
MOVE ‘EM OUT
If you are on Medicaid, you might be able to get out of your nursing home and move back into your old home or community. It’s the Money Follows the Person program and the federal government will pay for your care at home because they think it is less than paying for you to stay in a nursing home. The program has sputtered but now is reporting that they have moved 30 people, 24 of them out of nursing homes, back into their old communities. The program runs for four more years and is funded by $49 million from the feds. That’s a pretty hefty price tag for moving just 30 people — like about $1.6 million a person so far, but the goal is to move another 500 more people in the next four years. f you are in a nursing home and on Medicaid, you should have received a letter explaining the program. If you want to know more, call toll free 877-564-0330.
SPECIAL FOCUS FACILITIES
There are three nursing homes in Kentucky on the federal government’s list of Special Focus Facilities. These are the nursing homes that consistently have problems. In its latest report, the Centers for Medicare and Medicaid Services (CMS), which monitors these Special Focus Facilities across the nation, said that two of them in Kentucky — Britthaven of Somerset and Cambridge Place in Lexington — have “shown some improvement.” The third one — Richmond Health & Rehabilitation Complex-Madison — according to CMS, “has not improved.”
E-MAILS…. WE GET E-MAILS……
When Kentucky Attorney General Jack Conway joined 30 other attorneys general across the nation in calling for a discontinuation of the new Five-Star Rating System for nursing homes he caused a storm of controversy. Many, including us, did not agree with General Conway’s action and many contacted him and told him so, and some wrote us to comment on it and other nursing home issues. Here are a few of the emails we received:
‘You have a lot to learn….’
To Attorney General Conway: There is a good reason the Centers for Medicare and Medicaid Services has a Five-Star Rating System for nursing homes. Nursing homes are understaffed to the point of negligence of the most vulnerable of populations — the frail elderly. Families have a right to know a facility's rating before they admit their loved one.
My mother-in-law’s nursing home doesn't hire feeders on the weekend. (Yes, feeders do exactly what the name implies — they feed those people to weak to feed themselves.) Her nursing home deserves its 2-Star rating.
I'd tell you specifically in which nursing home my mother-in-law is a patient but we live in fear that the staff will retaliate for speaking out. That's a fact all families live with, the fear of antagonizing the staff or the administration no matter which nursing home their loved one is in.
You are a young man. You have a lot to learn. I pray that you learn before you have to admit a relative that you love to such a place. A good starting place is with family members of residents.
Alternatives to nursing homes are available to the Ronald Reagans of this world. Few families have those monetary resources.
(Name withheld)
‘A non-caring person….’
Sounds like another person added to the list of THE FORGOTTEN PEOPLE IN KENTUCKY, a non-caring person drawing a big salary. So many laws and rules should be "looked" into. All of the reports the state inspectors do should be inspected by the families of the ones who are living the facility and tell of the errors in the inspection. I could surely give some information to someone. My mother is experiencing some needed attention tonight that I can’t seem to get the facility to do. Thanking you.
(Name withheld)
‘Money steps in….’
This is another example of the vise grip that greed has on our society. When we try to require accountability or improve a gruesome system of care for the elderly, money steps in and we have to take a back seat. I am very depressed about the fact that the very people who need help are the ones talked into advocating against themselves. They must follow their own instincts and not listen to the politicians and the advocates who want to keep the money flowing into the pockets of the greedy. This is true in dealing with the whole "health care" system from the bottom up--this includes the nursing homes.
It should be illegal to profit from the sickness and death of other people. This needs to be followed and ingrained into the code of our people!!
Sincerely,
Elizabeth Kikuchi, Lexington
State Inspectors: ‘Well-informed’ to ‘dimwits’
I do wish Bernie Vonderheide was as informed as he is enthusiastic. I write as a registered nurse with over 35 years of experience, having worked as a hospital discharge planner involved with numerous nursing homes and more recently as the director of nursing in a 4-Star facility.
There is no doubt in my mind that all nursing homes need vigilant scrutiny. The scrutiny and reporting system would be more effective if the process was objective and transparent. I have been through the survey process and random inspections several times. While I cannot speak for any state but Kentucky, it has been my experience that inspectors can run the gamut from well informed, tough and fair to petty, punitive, politically directed dimwits. Actually, my best survey was from a dimwit.
My concern would be that a consumer would make a decision based on the current rating system, and that rating may or may not be an accurate reflection of the care provided in a nursing home. Surveys and staffing records are a matter of public record and are posted on the Internet and available in hard copy in every nursing home. I think the current system may actually be a disservice to consumers.
would propose that resources could be expended more appropriately training inspectors and ombudsmen to ensure that surveys and inspections will truly be objective and documented accurately and then the star rating will be meaningful.
Mary Ellen McKnight, RN, BSN, ACCM
Why can’t state inspectors check nursing home data?
When the state inspects the facility each year or so, and the forms are completed, the form states a nurse spends a certain amount of time with each patient. Why can’t the inspectors check one-on-one to see if this is correct? My mother is in a facility and I know for a fact that is incorrect for all patients there. Please, could this be done and why are all employees not checked for drugs, etc.? It seems like the more we suggest improvement the worse it gets….
(Name withheld)
SENIORS FEAR NURSING HOMES
Senior citizens fear moving into a nursing home and losing their independence more than they fear death, according to a study, “Aging in Place in America,” commissioned by Clarity and The EAR Foundation, which also found that the Baby Boomer children of seniors also fear for their parents.
Boomers express particular concern about their parents’ emotional and physical wellbeing should they have to enter a nursing home, finds the study, which examines the attitudes and anxieties of the nation’s elderly population (via MediaPost).
When asked what they fear most, seniors rated loss of independence (26%) and moving out of home into a nursing home (13%) as their greatest fears. Death was cited as the greatest fear for just 3% of seniors.
WE ARE SO UNDERSTAFFED’
EDITOR’S NOTE: We often get letters like this from people working in nursing homes who are disgusted with the understaffing they encounter but who cannot speak out. Read on….
“I am an employee of a nursing home I can remember when we had enough staff to care for our fellow Kentuckians, sometimes seeming as if we were family. Now it seems boards and administrators of care facilities keep just enough staff to run a ‘production plant’ or ‘assembly line.’ We are so understaffed.
“It's painful to know there is care you can't give because there is just not enough staff. Most of my day is spent giving just the minimal amount of care, enough to make sure my residents are comfortable, when they deserve so much more.
“Our elderly Americans should be our most celebrated citizens. It is they who prayed for us, raised us, built our schools, roads, and fought in wars to protect our rights and freedom in hopes that their later years would be comfortable and worry free. But the sadness is they lose everything they worked for all their life to pay for care they don't and can't receive.
“I enjoy my residents and the service I can give them, have grown quite fond of them, and in some instances, I am the only face they see. I would regret losing that bond. Which is where my dilemma lies. I don't want to lose my job. But I would dearly love to see the media get involved and bring this problem to the average Kentuckian, would even talk to the media myself, but I am not sure how to proceed. Any advice in how I could help would very much be appreciated.”
YOUR DOLLARS CAN HELP
This Newsletter is published by Kentuckians for Nursing Home Reform, a non-profit organization comprised of volunteers working to improve the lives of the 23,000 "Forgotten Kentuckians" destined to live out their lives at the mercy of nursing homes. If you would like to assist in our charitable work by helping underwrite expenses of conducting educational seminars, lobbying for residents' rights in the State Legislature, or publishing informative materials, you may send your contribution to Kentuckians for Nursing Home Reform, 1530 Nicholasville Rd., Lexington KY 40503. Contributions are tax deductible as allowed by law. To volunteer, write to the same address or e-mail KyNursingHomeReform@yahoo.com. Thank you.
MEMORIALIZE YOUR LOVED ONES
KENTUCKIANS FOR NURSING HOME REFORM is a non-profit organization. That means that any donations to the organization are tax deductible by the donor. With that in mind, we offer for your consideration the thought that memorials at the time of the passing of a loved one or friend could be in the form of donations to KENTUCKIANS FOR NURSING HOME REFORM, 1530 Nicholasville Road, Lexington, KY 40503.