State News for January 2015

Assemblyman Vincent Mazzeo visited the Buena Senior Center in Minotola.
Assemblyman Vincent Mazzeo visited the Buena Senior Center in Minotola.

SOUTHEAST

Lowered award tied to judge

ARKANSAS — The family of a Greenbrier nursing home resident filed new legal proceedings following their deceased mother's wrongful death suit, after allegations surfaced that at least one defendant's campaign contribution may have influenced a judge to substantially lower the jury's award.

The family of Martha Bull was initially granted $5.2 million at the conclusion of the 2013 trial; Circuit Court Judge Mike Maggio, however, later lowered the award to $1 million.

The current lawsuit alleges that one of the defendants in the original negligence case donated $21,000 to several political action committees assisting Maggio's campaign for an Appellate Court judgeship on the day of the jury award. In September, the state Supreme Court ordered Maggio stripped of his post, without pay, for leaking confidential details about an adoption involving movie star Charlize Theron.

Illegal drug use downplayed

KENTUCKY — New research attempts to draw parallels between swelling baby boomer resident populations and relaxed administrative standards on illicit drug use inside the state's long-term care facilities.

Reporting recently in the journal Educational Gerontology, researchers noted their interviews of 40 nursing home administrators revealed most had not experienced “problems” with illegal drug use by residents. Fewer than one-third reported having any formal policies to address the practice, and one-third of the administrators acknowledged they would support medical marijuana use for sanctioned purposes.

Study authors called for more research on the issue, as well as heightened screening and greater staff education on recreational drug use in nursing homes.

MDS adds end-of-life form

LOUISIANA — The state Legislature has approved a measure to officially incorporate an often-used end-of-life planning document into the MDS assessment used in nursing homes.

Created as a best-practice model for advance-care planning through the efforts of a statewide network of healthcare professionals, the so-called LaPOST (Louisiana Physician Orders for Scope of Treatment) form will now be integrated as an official, though voluntary, document in the state's Minimum Data Set assessment for skilled nursing facilities.

Supporters of the measure, including the Louisiana State Medical Society, claim the document will go far in eliminating rash decisions made in a resident's final days, and smooth transitions from one care setting to another. LaPOST is modeled closely after the Physician Order for Life-Sustaining Treatment form used across the country.

MIDWEST

Outcomes worse in SNFs

OHIO — Chronic obstructive pulmonary disease patients discharged to a nursing home following hospitalization face mortality rates as much as twice as high than those going elsewhere, researchers recently concluded after a review of nearly half a million Medicare beneficiaries living in the central and southeast parts of the state.

The study, published in Chest, found 34% of nursing home patients with the most severe form of COPD – DRG 190, or COPD with major obstruction and morbidity – were likely to die within 180 days of a hospital discharge, compared to 16% among those not discharged to a nursing home. Much the same proportion occurred among patients 360 days after hospitalization. High mortality rates also were common among other COPD DRGs. Researchers theorized the high rates for COPD patients discharged to a nursing home reflect more severe underlying COPD, the presence of multiple chronic conditions, and/or poor physical conditioning.

Sexual conduct guidelines

WISCONSIN — Long-term care providers are welcoming new guidelines designed to protect residents with Alzheimer's and various forms of dementia from sexual abuse and assault.

Existing laws deem sexual interactions of any kind a form of assault on residents with a mental condition that impairs their capacity to make decisions about their personal conduct. The issue gained traction earlier this year after a state lawmaker in Iowa allegedly had sexual relations with his 78-year-old wife who was staying in a nursing home while diagnosed with Alzheimer's.

Amy Panosh, who serves as ombudsman for the state's Board of Aging and Long-Term Care, recently announced four guidelines for determining residents' capacity for agreeing to consensual sex. The guidelines center on the resident's ability to understand the sexual nature of conduct, the sanctity of the body, potential health risks, and the possibility of disapproval by family members or other residents.

NORTHEAST

High-tech aging solutions

MAINE — Students at the University of Maine-Orono recently unveiled eye-popping innovations designed to improve safety and quality of life for the aging. Some include high-tech lightweight headgear for the head injury-prone, sophisticated tracking systems and virtual reality goggles that facilitate a better understanding of the visually impaired.

The research comes at a good time in a state that hosts the country's oldest population (at 42.7 median years) and one of the nation's largest proportions of citizens over 65.

In a recent open house provided for the Maine Health Access Foundation, the university showcased numerous projects that are the outgrowth of the Successful Aging Initiative for Living, a cross-disciplinary initiative it pioneered to encourage collaborative investigation into the physical challenges of aging. Much of the research is being conducted in the university's Virtual Environments and Multimodal Interaction Laboratory, as well as the Advanced Manufacturing Center.

Bill would grant relief to provider pay delays

NEW JERSEY — Lawmakers here will soon debate the merits of a bill that would require the state to pay facilities up to half of the money owed for uncompensated care for residents whose Medicaid applications remain mired in limbo after three months.

The “Uncompensated Pending Medicaid Beneficiary Payment Relief Act” (A-3928) would partially reimburse nursing facilities, assisted living residences and comprehensive personal care homes for the care of residents whose payments fail to come 90 days after their initial request for participation. 

The bill also would require the state to pay the balance due within 30 days of initial payment, or recover all advance payments for those applicants later deemed ineligible by reducing payments to the facility.

The bill is sponsored by Gary S. Schaer (District 36-Bergen and Passaic) and Vincent Mazzeo (District 2-Atlantic).

Several states have sued the state and federal governments for lengthy Medicaid reimbursement delays. In Illinois, a citizen watchdog group called Deadbeat Illinois recently found that Medicaid expansion there could lead to more payment delays. 


Storm imperiled hundreds

NEW YORK — Near-historic winter storms that pummeled the East Coast in late November crippled long-term care facilities across a 10-county area.

Snowfalls approaching six feet led to a facility evacuation in Cheektowaga. Residents were transferred to a shopping mall and on to nearby nursing homes.

All told, 13 people perished in the epic storm and its aftermath, including a 92-year-old Cheektowaga nursing home resident who died during the evacuation procedure.

PLAINS/MOUNTAINS

Evacuations leaving mark

NORTH DAKOTA — A series of large-scale emergency evacuations that have occurred in the state over a 20-year period have left scars on the frail elderly, but the epic floods that rocked Fargo's five nursing homes in 2009 had the most serious consequences, according to Walden University researcher Tracy Miller, Ph.D.

Miller's research focused on the health impact the 2009 evacuations had on the residents, identifying notable declines in cognitive status, mood and physical function. Miller used health status data about facility residents in Bismarck, Grand Forks and Minot as a control and applied Meleis's theory of transitions, which explores the ability of people to effectively move from one life event to another.

SOUTHWEST

Plan for inmate SNF eyed

OKLAHOMA — Overcrowded prisons filled with individuals with lengthy sentences has led to a healthcare crisis among aging convicts. As a result, the Department of Corrections is mulling a pilot program that would house in a long-term care facility.

The DOC presented its case to a Senate Public Safety Committee studying the impact of an aging prison population near press time, outlining a proposal by one nursing home operator to house and care for the inmates. A nursing home advocate with A Perfect Cause told one media outlet that 2008 legislation already allows the DOC to contract with a private nursing home to care for chronically ill registered sex offenders.

The mounting issue, fueled by mandatory sentencing and life-without-parole laws, has led to skyrocketing healthcare costs that are straining the state's correctional system, according to the Journal of American Medicine.

WEST

Elder abuse on the rise

OREGON — State officials can offer no specific reason for a notable rise in elder abuse. Nearly twice as many incidences appear to be happening outside institutional settings, according to the Office of Adult Abuse Prevention and Investigations.

Overall, the number of complaints of abuse against seniors and people with disabilities rose 36% from 2012, according to published reports.

Investigators substantiated 2,306 abuse complaints that came from outside long-term care settings last year. The remaining 1,344 confirmed complaints originated from an adult foster home, residential care facility, assisted living facility or nursing home. Residential care facilities were the most commonly cited (366), followed by assisted-living facilities (355), nursing homes (319) and adult foster homes (303). Neglect and financial exploitation are among the most commonly cited.

Quality, foreign staff linked

WASHINGTON — A study cohort recently told researchers the presence of foreign-born staff correlates directly with higher quality of care and facility performance.

Research published in the Journal of Aging and Health says the state now relies heavily on foreign-born staff. While three-fourths of administrators said they have challenges with language barriers and a third reported cultural differences, almost all attributed high performance rankings to foreign-born staff. n