Gov. Jan Brewer (R) asked Arizona’s congressional delegation, as well as U.S. House Speaker John Boehner (R-OH), to introduce legislation that would remove the spending requirement for state Medicaid programs.
A letter from Brewer said increased Medicaid spending is one of the biggest culprits in the state’s budget crisis, The Arizona Republic reported.
The state has made other attempts to curb Medicaid spending, including eliminating coverage for certain types of organ transplants and cutting the $22 million program KidsCare, which it eventually reinstated. This year, as a result of the recession, the state’s Medicaid program, Arizona Health Care Cost Containment System, covers one in five Arizonans, at a cost of $1.4 billion.
Brewer also has said she would ask the federal government for a waiver from the eligibility requirement, which governors were allowed to do after Dec. 31.
WEST
Nursing homes post ratings
CALIFORNIA—Effective Jan. 1, nursing homes in California have been required to publicly post their facilities’ ratings as determined by the federal Five-Star Quality Rating System.
It becomes the first state in the country to require facilities to post their score, according to the Los Angeles Times. State officials say this system encourages operators to maintain high-quality care and safety practices. They say it also helps residents and their families pay attention to how well the homes adhere to state regulations.
As part of this state legislation, nursing homes are required to post information explaining the ratings, as well as how to find the state’s licensing records via the Department of Public Health. The federal system gives nursing homes a rating of one to five stars, based on the quality of care, similar to the way hotels and restaurants are rated.
The system’s critics argue that the federal five star ratings will hurt well-run homes that provide care to the most critically ill residents, which don’t fare as well in the ratings as do homes with healthier residents. The federal ratings don’t consider more recent violations, critics add.
Headhunters filling rooms
WASHINGTON—The state of Washington is home to dozens of senior-care placement companies that match seniors in need of skilled nursing care with facilities that pay large finders fees. The placement companies, in some cases, do not screen facilities for abuse violations, according to a Seattle Times analysis of Department of Social and Health Services documents.
The paper’s analysis revealed that in three years there were 143 cases of care violations—sometimes fatal—involving individuals put in long-term care by placement agencies. In some of these cases, dementia patients were locked in rooms to prevent wandering. Other residents were left unattended in their rooms for up to 16 hours.
Agents in these agencies work on commission. On average, homes will pay agencies the equivalent of one-month’s rent, or $3,500 per placement. State ombudsmen are observing these agencies with a critical eye.
MIDWEST
Nominee has industry ties
IOWA—Gov. Terry Branstad (R) nominated Rod Roberts to head Iowa’s Department of Inspections. This, despite critics’ allegations that Roberts has conflicts of interest, The Des Moines Register reported. Roberts is an Iowa state legislator and a former Republican gubernatorial candidate who has sat on the board of the New Hope Village care center and its charitable foundation, in Carroll, IA, the newspaper reported.
His wife, Patricia, reportedly worked at St. Anthony Regional Hospital and Nursing Home in Carroll for about 17 years. Now, she is the director of development for a foundation that gives St. Anthony financial support. Also, Patricia works for a lobbying organization in support of Iowa hospitals.
When Branstad was running for governor he made statements on Iowa Public Television criticizing Iowa’s nursing home regulators, accusing them of having a “gotcha” attitude with regard to reporting nursing home code violations.
A spokesman for Branstad said the governor is certain there are no conflicts of interest between Roberts and his involvement in the nursing home industry.
Need help for gay residents
MINNESOTA—Agencies that provide assistance to the elderly do not have the training necessary to effectively help gay, lesbian, bisexual and transgender senior citizens, according to a new report from the University of Minnesota and the PFund Foundation, an organization that specializes in gay rights.
The findings are based on surveys from 15 “Agencies on Aging” in Iowa, Minnesota, North Dakota, South Dakota and Wisconsin.
While agencies surveyed for the study say they treat clients in this population equally, and are open to specialized training, funding for training presents a challenge, the Twin Cities Pioneer Press reported. But experts who regularly work with gay, bisexual and transgender senior citizens say it isn’t enough for agencies to say they treat everyone equally. The issue is helping these seniors feel comfortable talking about their nuclear families during the intake process.
PFund Foundation’s report says it would like to see more gay and lesbians on advisory boards of organizations that serve seniors.
Aggressive seniors focus
WISCONSIN—A Southeastern Wisconsin group, The Alzheimer’s Challenging Behaviors Task Force, wants to change the way the city of Milwaukee’s legal and police departments handle aggressive behavior from older adults.
The group was formed after an 85-year-old dementia patient died while being shuffled between hospitals, senior care centers and emergency detention centers in Milwaukee, following an incident in which he displayed aggressive behavior, the Milwaukee Journal-Sentinel reported.
The group issued a report offering several recommendations for improving the system.
One suggestion includes developing a network of Alzheimer’s care centers and “mobile, triage teams” that specialize in more difficult patients. The group said it also would like to see better training for family members, nursing home caregivers, and emergency responders such as police and fire department professionals.
The focus of the report is finding alternatives to Chapter 51, a statute that allows police to take elderly people exhibiting aggression, confusion and agitation into custody. The advocates say Chapter 51 is inappropriate, as well as dangerous and traumatic to the patient.
According to the report, as of April 30, 2010, Wisconsin had 15,264 dementia patients living in nursing homes. Of this group, 32% displayed aggressive behavior within the previous week, the newspaper reported.
Younger residents surge
OHIO—Ohio nursing homes now have four times the number of patients under the age of 60 than they had in 1994, according to a recent study. In 2009, 16% of Ohio nursing home residents were under 60, noted researchers with the Ohio Long-Term Care Research project at Miami University’s Scripps Gerontology Center.
In addition, nearly three out of four nursing home residents under 60 have severe mental illnesses, researchers say. A 30% cut to Ohio’s mental health system in recent years has forced a number of mental health facilities to move their residents to nursing homes. This creates a problem since traditional nursing home staffs have not been properly trained.
Mental health professionals in Ohio have advocated for creating behavioral health “medical homes,” which would give the mentally ill improved to access to healthcare options.
Researchers say the surge in younger nursing home residents also reflects the trend of using nursing homes for lower-cost rehabilitation after knee and hip replacements and other hospital procedures.
SOUTHEAST
Background checks bill
KENTUCKY—New legislation that would require criminal background checks for all nursing home employees has been filed by State Sen. Tom Buford.
The state currently requires checks only for employees who provide direct care to patients in nursing homes and assisted living facilities. Buford argues that all employees, including custodians, maintenance workers and food service workers, have easy access to residents.
This legislation, also known as Bill 44, would not allow any long-term care facility to knowingly hire someone convicted of a felony related to theft; the sale of illegal drugs; abuse, neglect or exploitation of an adult; or a sexual crime. Background checks would be conducted by Kentucky’s Justice and Public Safety Cabinet.
NORTHEAST
‘Stomach bugs’ feared
PENNSYLVANIA—Nursing homes in Pennsylvania were preparing for what they expected to be a rougher “stomach bug” season than usual. The term “stomach bug” refers to the gastrointestinal virus non-clostridium difficile acute gastroenteritis. These bugs can wreak havoc in nursing homes where residents interact more frequently and aren’t as separated as they might be in hospitals.
In the first three months of 2010, Pennsylvania nursing homes reported 4,040 norovirus cases, stirring concerns that 2011 will be worse, according to The Morning Call newspaper.
To prevent stomach bug outbreaks, facilities in the state are taking precautions, including educating residents, visitors and caregivers about virus transmission; stocking up on single-use equipment and toileting supplies; and training workers to identify symptoms early.
Life insurance law support
NEW YORK—Former New York Gov. David Paterson (D) signed a bill at the end of his term that will let individuals use part of their life insurance policies to pay for nursing home or other long-term care costs.
“We’re supportive of it as it gives seniors more flexibility in planning for their future,” Richard Herrick, president and CEO of the New York State Center For Assisted Living, told McKnight’s.
The law expands the way the state defines the term “life insurance.” As written, the bill lets seniors use life insurance to cover nursing home costs once they’ve been a resident for three months. State lawmakers say the bill will lessen the state’s reliance on Medicaid and help the estimated 2 million New Yorkers who will need skilled nursing services by 2015.
Aging committee gets boost
CONNECTICUT—The state of Connecticut’s Select Committee on Aging recently underwent an upgrade that changed its name to the Committee on Aging.
The change was not just in name only. The Committee on Aging now can direct legislation directly to the state House and Senate, which it couldn’t do before.
This is good news for a state in which 14% of the residents is over the age of 65. Chairwoman State Sen. Edith Prague (D) will lead the committee.
From the February 01, 2011 Issue of McKnight's Long-Term Care News
