Norman DeLisle, MDRC
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News, Notes, and Opinions from Michigan about the progress of choice-based long term care
Long term care facilities such as nursing homes across America will, for the first time, have to protect their residents by installing sprinkler systems throughout their buildings if they wish to continue to serve Medicare and Medicaid beneficiaries, under a new regulation to be issued by the Centers for Medicare & Medicaid Services. Facilities will have a five-year phase-in period to be fully compliant with the new rule.
Approximately three million elderly and disabled Americans reside in the nation’s 16,000 nursing homes, all of which must have comprehensive sprinkler systems in place by 2013. To date, there has never been a multiple-fatality fire in a facility with a sprinkler system that meets the requirements of today’s rule.
“CMS is taking further action to protect the lives of our beneficiaries through a more comprehensive and effective approach to fire safety,” said Kerry Weems, acting administrator of CMS. “In the past, certain older facilities were exempt from having an automatic sprinkler system, but we now will hold all 16,000 nursing homes in the nation to this standard.”
Nursing homes not only can but must change the way they operate, becoming better places to live and work. Only then will they be able to reduce the epidemic of violence that currently plagues them, according to an article in the Journal of Gerontological Nursing, Vol. 34 No. 3.
CNAs often experience “harassment, threats, and assaults” from residents, and the number of those incidents is probably “seriously underestimated,” according to “Policy Recommendations on the Prevention of Violence in Long-Term Care Facilities.” (The article is free to subscribers only; others must pay.)
Those attacks cause emotional distress, which can lead to more confrontations. “Frustrated and fearful, CNAs’ voices might be louder and their movements rougher, causing residents to respond in an aggressive manner,” notes the report. A vicious cycle of abuse can also occur when, “in retaliation, such aggressive behavior results in staff-to-resident abuse.”
The Centers for Medicare & Medicaid Services today announced it will soon launch a ground-breaking ranking system of America’s nursing homes, giving each a “star” rating. CMS is requesting comments on the system designed to provide patients and their families an easy to understand assessment of nursing home quality, making meaningful distinctions between high performing and low performing homes.
The ratings will be posted on the agency’s Nursing Home Compare Web site by the end of this year. A sample screen shot of the proposed star ratings is available at www.cms.hhs.gov/PressContacts/10_PR_fivestar.asp. Medicare Compare can be found at www.medicare.gov.
“More than three million Americans rely on services provided by a nursing home at some point during the year. The new “five-star” rating system will provide a composite view of the quality and safety information currently on Nursing Home Compare to help beneficiaries, their families, and caregivers compare nursing homes more easily,” said Kerry Weems, CMS acting administrator.
In the report, to be issued on Thursday, the investigators, from the Government Accountability Office, say they have found widespread “understatement of deficiencies,” including malnutrition, severe bedsores, overuse of prescription medications and abuse of nursing home residents.
Nursing homes are typically inspected once a year by state employees working under contract with the federal government, which sets stringent standards. Federal officials try to validate the work of state inspectors by accompanying them or doing follow-up surveys within a few weeks.
The accountability office found that state employees had missed at least one serious deficiency in 15 percent of the inspections checked by federal officials. In nine states, inspectors missed serious problems in more than 25 percent of the surveys analyzed from 2002 to 2007.
The nine states most likely to miss serious deficiencies were Alabama, Arizona, Missouri, New Mexico, Oklahoma, South Carolina, South Dakota, Tennessee and Wyoming, the report said.
Jodi Shapuras and Lindsay Egan, undergraduate students in the social work program at ISU, conducted the research at their internships as part of a senior-level field practicum class.
“We are both interested in working with the elderly population in our careers, so we conducted this research to get a better feel for the prevalence of depression in those who need some level of outside care,” said Shapuras of Mitchell, Ind. “As social workers, it is important to understand the mental health issues, such as depression, within the different care settings.”
Shapuras and Egan said they weren’t surprised by their findings.
“We actually hypothesized that the long-term care patients would utilize antidepressants more and would self-report depression more,” said Egan of Terre Haute, Ind. “When an individual moves to a long-term care facility, they undergo a tremendous amount of changes. They are no longer able to live independently and are relying on others for care, and this greatly affects how they feel about themselves and the world around them.”
Shapuras added that in the home-care setting, elders are still residing within a familiar environment.
NEW YORK (AP) - The costs for long-term care have gone up for a fifth straight year.
Genworth Financial has found that charges for nursing homes, assisted living facilities and some in-home care services are up anywhere from 7 to 25% in the last five years.
The national average annual cost of a nursing home is more than $76,000, a 17% jump since 2004. The cost of assisted living facilities went up by 25%, from just under $29,000 to more than $36,000.
The study predicts that those fees will continue to rise because of a shortage of long-term care workers at a time when more baby boomers are reaching retirement.
The Elder Justice Act (HR 1783) received a heap of accolades from senior care advocates and industry representatives at a hearing on Capitol Hill Thursday.
Testimony from AARP and Robert Blancato, national coordinator of the Elder Justice Coalition, highlighted the care community's support of the bill, which was introduced last year by Representative Rahm Emanuel (D-IL).
Among the more than 556,000 confirmed cases of elder abuse recorded in 2004, 20,000 of those occurred in a nursing home or long-term care facility, said Blancato, speaking to the House Judiciary Subcommittee on Crime, Terrorism and Homeland Security. In its submitted testimony, AARP echoed Blancato's sentiments of concern and praised the legislation.
ST. PETERSBURG, Fla. — Since a stroke four years ago, 66-year-old Bud Lee can't lift himself out of bed or take himself to the bathroom. He would like to regain a bit of his old independence.
John Boyd, 50, has been paralyzed since 14. He would like an apartment of his own and a job, like when he answered customer service phones for Red Lobster a few years back.
Instead, both men live in nursing homes, a frequent situation when Florida Medicaid pays the bills.
That may change.
Lee, Boyd and five other nursing home residents backed by the AARP Foundation have filed a class-action lawsuit against the state of Florida under the Americans with Disabilities Act, citing a 1999 court ruling that helped spring mentally ill people from big, impersonal hospitals.