Gov. Dannel Malloy

CONNECTICUT – Gov. Dannel P. Malloy (D) joined 700 striking nursing home workers after a National Labor Relations Board ruling found their employer violated labor laws.

The ruling came after months of failed negotiations between the workers and Parsippany, N.J.-based HealthBridge/Care One, which operates five facilities once manned by the striking workers. The NLRB ruled that HealthBridge/Care One had failed and refused to bargain in good faith with the union, making changes to employee wages, hours and other conditions, according to the San Francisco Chronicle.

HealthBridge/Care One disagreed, saying in a statement, the union “chose to abandon negotiations, jobs and our residents,” the newspaper reported.

Nearly 75 workers reportedly crossed the picket line. A Sept. 10 hearing is scheduled.

More insurance scrutiny
OREGON – A new law could make it harder for long-term care insurers to deny coverage for policyholders.

Until recently, only health insurance companies were subject to an external review or audit when they denied coverage, a provision that now also applies to long-term care insurers. Under a new state law, they will be required to process undisputed claims within 30 days and be subject to Oregon Insurance Division review if a coverage denial was based on a determination a policyholder isn’t sufficiently disabled for long-term care. Efforts to incorporate similar provisions under federal health care reform were derailed last year.

A spokesman for the Oregon Insurance Division said the office is experiencing an increase in consumer complaints about denied coverage with long-term care insurance policies. A spokesman for the American Association of Long Term Care Insurance told The Oregonian the new state law could discourage companies from underwriting new policies.

‘Duals’ project underway
CALIFORNIA – A novel pilot program designed to pool funding sources from the state’s Medi-Cal and Medicare programs will get underway in March.

Nearly 700,000 of the state’s dual eligibles are expected to be served initially under the demonstration project across eight counties. The plan is to move those individuals into the state’s Medi-Cal managed care plans. Officials hope the plan will better coordinate care, provide stronger case management and save money.

Officials still have to resolve a number of issues, such as opt-out options and whether to stagger enrollment periods.

Malpractice caps overturned
MISSOURI – The state Supreme Court has overturned a seven-year-old law that placed a $350,000 cap on non-economic jury awards for medical malpractice.

The 4-3 decision was the culmination of a long-standing court battle waged by the family of a child left brain-damaged after birth.

The high court ruled that the former cap was unconstitutional because it denied plaintiffs’ right to a fair trial by forcing lower courts to adjust jury damages exceeding the cap.

Reaction from both sides of the controversy was predictable; trial attorneys group lauded the decision while the state’s medical association wrote in a statement the decision “eviscerates” one of the country’s most successful tort reform laws.

According to the association, the number of lawsuits against physicians dropped 58% during the years the cap was in place.

Voter ID law worries
KANSAS – Nursing homes in the state are scrambling to help residents navigate recent changes in voter registration rules that now require photo identification and proof of citizenship.

Politicians who supported the change claim it will stem vote fraud while others fear it will suppress voting.

Meanwhile, the secretary of state’s office has pledged to help nursing homes assist their residents to obtain the needed documentation.

Some nursing homes told the Topeka Capital-Journal they are struggling under the new rules.

One facility’s officials said only nine of its 51 residents had the required photo ID. Residents who submit affidavits are eligible for free photo IDs if they can provide proof of identity and residence.

Safer patient lifting rules
ILLINOIS – A rapidly aging and increasingly overweight population is prompting the state to enact laws providing greater protection for nursing home residents and caregivers from lift- and transfer-related injuries.

Gov. Pat Quinn (D) is reviewing a recently passed law that would force long-term care workers to undergo training in safe lifting techniques and equipment, according to the Chicago Tribune.

A typical 100- to 200-bed nursing home reports 100 to 200 resident falls a year, according to the Centers for Disease Control and Prevention.

More than one-third of back injuries among nurses are attributed to handling patients, according to the Premier Safety Institute.

Sprinkler laws hinder SNFs

MICHIGAN – Detroit nursing homes are dwindling in number despite urgent demands for more, and recent fire protection mandates aren’t helping, according to a new study by a leading senior group.

More than half of the city’s remaining 32 nursing homes must install new sprinkler systems or upgrade existing ones — both costly options — before they obtain certification to remain open and receive much-needed Medicaid dollars, according to the Detroit Free Press.

The city has lost 16 nursing homes in 13 years, and more than half of the city’s remaining nursing homes are struggling to remain open, the newspaper reported.

Facility operators complain the sprinkler improvements take more than two years to be reimbursed, a situation that puts many into financial jeopardy.

Rate cuts, citations link eyed
OHIO – Ohio Health Care Association officials say it’s unclear whether declining reimbursements and increasing care citations among the state’s nursing homes are related.

That’s because from 2007 to 2008, a record 51 immediate-jeopardy citations were issued to the state’s nursing homes in a year when reimbursement rates were higher than they are now.

Still, officials are scratching their heads over the 41 citations issued during the current fiscal year that ended June 30.

That’s nearly twice as many as the year before and coincides with Medicaid and Medicare rate cuts.

According to the Columbus Dispatch, complaints about staffing shortages actually declined during the past fiscal year even as citations rose.

DOJ: Move the disabled
NORTH CAROLINA – The Department of Justice and state health and human services department are locking horns over enforcement of a federal mandate to transfer mentally ill patients out of adult care homes.

Following a year-long investigation, the Justice Department recently instructed the state to find suitable housing in the community for those patients in order to comply with the Americans with Disabilities Act, and a Supreme Court decision that calls for housing to integrate people with disabilities into the community.

The state has agreed to comply but was opposed to a formal enforcement procedure, according to the North Carolina Health News website.

State lawmakers allocated nearly $11 million this year for creating housing for about half of the 6,000 mentally disabled residents currently living in adult care homes and have committed about $70 million for the process over the next eight years.

Pearl Harbor vet eviction
FLORIDA – Paperwork delays at the Veterans’ Administration were threatening to lead an Army veteran who survived Pearl Harbor to an eviction from a Port Orange long-term care facility he moved into last March.

According to Florida television station WFTV, 92-year-old Arthur Fusco Sr. has been waiting for the Veteran’s Affairs Administration to approve his application for assistance.

The VA told the news station the process could take months.

Fusco, who retired after eight years as a bombardier in the United States Army Air Corps, called the delay “unfair.”

Better dementia training
MASSACHUSETTS – State health officials say next year will bring stronger regulations regarding Alzheimer’s patient care in nursing homes. The development follows a new state law mandating minimum care standards and training for personnel who care for dementia patients in nursing homes.

The state Department of Public Health, which pledged to work with the Alzheimer’s Association of Massachusetts and New Hampshire on the regulations, said the new rules would build upon the law’s requirement that nursing homes and special-care units provide dementia-specific training for direct-care workers, activity directors and supervisors.

The regulations also will go far in instilling confidence among family members seeking skilled care for their loved ones, according to the Patriot Ledger.

Tighter SNF eligibility

TENNESSEE – Low-income seniors needing care deemed below grade in nursing homes will find it more difficult to qualify for Medicaid assistance in the future. That’s because of a plan designed to save the state’s TennCare program $47 million a year while opening up beds for an expected wave of aging baby boomers.

Those seniors instead will be given a $15,000 annual allowance to seek an equivalent level of care in settings such as home- or community-based services.

Under an earlier successful plan to reduce red ink in the TennCare program in 2009, existing nursing home residents and new long-term care enrollees were given the option to seek such alternatives, a plan that has seen the nursing home occupancy rate among Medicaid recipients drop 20%.

Today, 34% of Medicaid-eligible seniors are receiving care outside of nursing homes.

One provision of the new TennCare eligibility rules replaces the activities of daily living (ADL) metric with a complicated and more restrictive point system.

Opponents say the $15,000 annual stipend will fall far short of actual expenses.