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Assemblyman Ron Dancer wants stricter trust fund oversight.
Assemblyman Ron Dancer wants stricter trust fund oversight.

WEST

‘Senior tsunami' to come

CALIFORNIA – After digesting the findings of a university study it funded, the California Partnership for Long Term Care became just the latest group to forecast “an unprecedented senior tsunami” led by 65- to 84-year-old baby boomers, whose nursing home ranks will more than double in just over 15 years.

The findings by the UC-Berkeley study paint a dire picture in the state by 2030, when the state's Medi-Cal long-term care costs are expected to soar to $12.4 billion annually, an 88% increase from current government spending for institutional long-term care. It doesn't help that rising levels of obesity are expected to exacerbate seniors' health problems, reported the Sacramento Business Journal.

But the biggest burden may fall on the shoulders of family caregivers, whose provision of mental and physical care largely is uncompensated, the study concluded, leading to greater financial strains, loss of productivity and higher levels of absenteeism in the workplace.

NORTHEAST 

Bed-hold plan pushed

MASSACHUSETTS – Long-term care advocates are hoping to make permanent a MassHealth program that pays nursing homes to hold the beds of residents who have to temporarily leave for medical or personal reasons. 

They also are seeking to extend an existing personal leave provision from 10 to 15 days. State Rep. James O'Day (D-West Boylston), who chairs the Elder Affairs Committee, said he is considering the idea.

The nursing home bed hold program is a part of the fiscal 2013 budget. MassHealth pays nursing homes a minimum of $30 per day for up to 10 days to hold a bed during a resident's leave of absence.

The program's goal is to protect nursing home residents, especially those with dementia, from the confusion and trauma that might result if they were forced to move to a new room and a new bed after a short absence. 

State audits will target resident funds theft

NEW JERSEY – Untold amounts of money have been pilfered from nursing home residents' funds by those entrusted to protect them, and little government oversight exists to prevent it. This is one reason the state decided to intervene under a new law requiring the New Jersey Health Commissioner to routinely audit residents' accounts, officials said.

The bill, introduced in late November 2013 by Assembly Republican Ron Dancer, mandates annual reviews of at least 10% of nursing home residents' records and quarterly statements, and provides for “cause of action” against individuals and the facility if misappropriations are uncovered.

Dancer acknowledged that his bill was partly influenced by “media reports” of financial abuse, including 28 cases in the state. A recent USA Today investigation of data from the Centers for Medicare & Medicaid Services found more than 1,500 cases of facility citations nationwide by state and federal regulators. In many cases, employees or administrators were found to siphon funds. Facilities often didn't account for their holdings or carry adequate insurance to protect the money from loss or theft, the newspaper investigation found.

Medicare and Medicaid rules do not currently mandate the kind of audits that would uncover resident fund misappropriation. 

MIDWEST

Survivors might pay less

WISCONSIN – Survivors and estates of deceased nursing home Medicaid recipients may eventually be on the hook for less of their share of settling the final facility bills under a state Senate-approved bill. The State Assembly had postponed voting on the measure at press time.

Gov. Scott Walker (R) had reportedly asked for these parties to pay a larger share during budget talks in June 2013, but the proposal was scaled back. Walker said his plan would save the state in excess of $4.5 million through June 2015, according to the Milwaukee Journal-Sentinel.

Background checks gaps

MINNESOTA – An extensive newspaper investigation revealed nearly 300 active licensed nursing home employees had criminal backgrounds that could have precluded them from direct patient care jobs, exposing gaps in the way the state agency charged with reviewing their qualifications performs background checks.

As many as 107 nurses will be barred. The state Department of Health acknowledged that it relied on employment references or probation reports without doing criminal background checks on about a third of those individuals on the newspaper's list, many of whom had convictions ranging from criminal sexual conduct, assault and fraud. 

DHS officials admitted their existing procedures were inadequate after the gaps were exposed, and agreed to begin using the Minnesota Court Information System, which reportedly keeps the most thorough and current records.

The state nursing board took action against 31 nurses on the newspaper's original list. Until recently, the board did not do criminal background checks on nurses. It became required to do so on new applicants beginning in 2014. Existing, actively employed nurses are exempt from formal background checks, the newspaper reported, but state licensing boards must devise a plan for them by 2017.

Incontinence-only center

MISSOURI – Principals of the St. Louis Incontinence Institute say it is the first ambulatory surgery center of its kind in the nation and the first facility dedicated to a condition that afflicts more than 25 million Americans.

Three St. Louis area physicians, in partnership with the St. Louis Women's Surgery Center and Symbion Healthcare, have come together in a collaboration. The new facility will focus exclusively on bladder and bowel incontinence treatments and solutions.

SOUTHEAST

Exposé targets LTC

LOUISIANA – The state's nursing home industry has come under fire from a group of news organizations that allege there are convincing connections between the industry's long history of political contributions and a favorable payment system that has defied an otherwise terrible budget climate.

Citing CMS documents, the joint report by NOLA.com, Times-Picayune and WVUE Fox 8 News claims Louisiana nursing homes are “among the worst ranked facilities in the country,” yet have benefitted from increased funding (from $738 million in 2009 to $796 million in 2012) while other healthcare sectors such as hospitals and physicians have not.

The industry was criticized for cutting deeply into a trust fund earmarked for elderly care and shoring up nursing home payments even in the face of sagging demand that led to higher numbers of empty beds, for which the state paid facilities about $23 million in 2010 alone.

SOUTHWEST

Ombudsman fines operator 

NEW MEXICO – A nursing home management company acknowledged that it obstructed efforts by the state long-term care ombudsman to gather information about complaints on a timely basis, and took remedial action to correct statements made by a facility administrative staff member the ombudsman deemed as derogatory. 

Preferred Care Partners Management Group, which operates two Santa Fe homes, also agreed to pay a $3,500 fine.

Sondra Everhart, state long-term care ombudsman, said she had initially fined the business $23,500 but reduced it because the company responded quickly.

Family council litigates

TEXAS – A small family council at a southeast Texas nursing home recently sued the facility, saying its concerns about resident care were ignored.

The suit claims Grace Care Center of Cypress violated Texas family council law by failing to address the council's concerns, which included cleanliness issues, undue waiting periods for meals, medication dispensing and staff training, said MyFoxHouston.com. n



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