Voters want Medicare to be fully funded

A newly released poll from Zogby International shows that 63% of respondents oppose President Bush's proposed nursing home Medicare cuts.

Also, 61% of those surveyed would be less likely to vote to re-elect their representative in Congress if he or she voted for the president's plan containing Medicare reductions. Bush's proposed budget would slash $24 billion to the nursing home benefit over five years. Zogby conducted the poll for the American Health Care Association, a major lobbying group for the nursing home industry.

Other results of the poll: 50% of respondents say that any nursing home benefit cuts would have "a negative impact on the quality of care for seniors" and 73% say they would support a presidential candidate who will not reduce Medicare funding for nursing homes.

Medicaid funding

Foxbusines.com has a good article about the difficulty the government has in evaluating funding levels for Medicaid.  The article insists that an expansive view of nursing homes industry is needed to determine funding needs.

The Bush Administration's FY 2009 budget will include no Medicare funding update to help care for the growing number of seniors who need high acuity nursing home care.  The Alliance for Quality Nursing Home Care will work to demonstrate that Medicare funding decisions can be accurately determined only by taking a more expansive, complete view of the industry's operating environment. 

This White House has often cited the work of the Medicare Payment Advisory Commission (MedPAC).   Alan G. Rosenbloom, President of the Alliance, stated, "On behalf of nursing home patients and the hundreds of thousands of caregivers who serve them, we are disappointed that again, MedPAC's flawed funding policy guidance is being adopted, and superseding the economic realities experienced by providers in the long term care marketplace.  By failing to consider the substantial Medicaid payment shortfalls to nursing homes in formulating its recommendations, MedPAC provides the Administration, Congress and the public a flawed basis upon which to assess the funding landscape, and to ultimately determine the best policy." 

Medicare funding is important when states are cutting Mediciad to balance their budgets. 

SOURCE The Alliance for Quality Nursing Home Care

Nursing home loses funding because of neglect

Here is an article about a nursing home in Arizona losing its Medicare and Medicaid funding because of patient neglect.   This action is the only one the multi-chain corporation understand.  Government oversight must be increased and serious consequences of neglect must be felt by the corporations.

Some Evergreen Foothills Health and Rehabilitation Center residents would have to be relocated to a facility capable of providing good care. The state is working to move those patients.

Arizona Department of Health Services records paint a disturbing picture. Problems cited include: failing to investigate injuries to rule out abuse; failing to provide regular catheter cleansing for one patient; and failing to notice when one patient had three broken ribs.

Evergreen's corporate defense attorney stressed that, although Medicare and Medicaid funding will officially be cut next month, the state is allowing the center to remain open for now.  I am sure that is a relief to the neglected residents who remain.

Spotlight on Tennessee nursing homes

There is a great article at Tennessean.com about dozens of deficient Tennessee nursing homes that have been closed or fined as a result of neglect including drug dealers visiting The Cornelia House nursing home to sell crack to employees and residents; at Mitchell Manor, patients went without necessary pain medication for a week because the facility was out; and at McKendree Village, staffing shortages caused multiple problems, such as one patient lying in his own feces for 3½ hours, despite pushing the call light five times.

"Things aren't right here," one Cornelia House resident told a state inspector. "Residents are buying drugs almost every night. … Staff are aware but don't do anything. The patients are left wet and not taken care of." 

The 159-bed Cornelia House and the 42-bed Mitchell Manor have closed since losing tax payer funding. The 300-bed McKendree is still open to private-pay residents, but 200 of its residents dependent on federal funding must find a new place to live by Dec. 29.   However, plenty of nursing homes in Tennessee have been identified as having serious violations without losing funding. 

While lots of facilities have been cited with these serious violations, the facilities that lost their funding were unable to fix the problems within the reasonable time given or were unable to stay in compliance.

"These facilities were afforded the same number of days as others across the country to develop and implement a plan to correct the violations, maintaining an appropriate standard of care for residents," said Christy Allen, assistant commissioner of the Tennessee Department of Health, Bureau of Health Licensure and Regulation.

The Cornelia House has had a history of problems.  For the last four  years, the nursing home was repeatedly cited with immediate jeopardy violations. Inspection reports show that residents had wallets and clothes stolen; patients were observed smoking crack; residents were told to go to the bathroom in their pants; and their health-care needs weren't attended to, among other problems.

Officials with McKendree Village declined to be interviewed for this story. However, they assert that  the issues identified by the state have not resulted in any "actual harm".

They say that many of the state's findings are related to documentation. For example, the inspectors found that the facility failed to investigate the cause of injuries for 11 of 42 residents to ensure that abuse or negligence had not occurred. However, they argue that doesn't mean that abuse or negligence did occur.  Well, if they didn't investigate, how do we know?

The Health Department's Allen said immediate jeopardy is determined through a multi-tiered process of checks and balances that includes state and federal officials. 

According to the state inspection reports, many residents weren't happy with the care they received. The documents show the facility was short-staffed and that contract employees in particular didn't receive proper training and sometimes neglected patients.  Another said staffers respond like snails to call lights, but "break their necks" when state inspectors are on the prowl.

"We need TLC, not being stomped on," one resident said.


Medicaid is failing our elderly

A new report shows that Medicaid programs are failing to deliver adequate medical services to the low-income populations they were designed to serve including nursing home residents.  The non-profit consumer advocacy organization Public Citizen issued a report ranking Medicaid programs by how they met and surpassed federal mandates in four categories: eligibility, scope of services, quality of care and provider reimbursement.

Fifty-five million, mostly low-income Americans get their health care coverage through their state Medicaid program. The worst Medicaid programs in the country, according to Public Citizen, are those in Alabama, Colorado, Idaho, Indiana, Mississippi, Missouri, Oklahoma, South Carolina, South Dakota and Texas.

Public Citizen ranked states by the optional health care services that states provide beyond legally mandated services.
"Medicaid desperately needs nationwide uniform standards of quality of care and an effective means of monitoring and upholding those standards," said Ms. Ramirez de Arellano.

See story here

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