Hawaii Gov. Neil Abercrombie (D)


Five-year SNF moratorium

INDIANA — State Sen. Patricia Miller (R-Indianapolis) knows how big an employer and tax revenue source the state’s nursing homes are but believes thousands of empty beds are a good reason to stop building new ones.

While the industry is among the top 10 job providers and funnels $300 million in state and local taxes each year, 13,000 unoccupied beds (a 74% occupancy rate) spurred Miller to introduce Senate Bill 173, which would create a five-year moratorium on new construction, beginning in June 2014. Assisted living and continuing care centers would be exempt, however. Miller noted the state has seen a marked decline in utilization of skilled nursing care.

Supporters have noted the bill would reduce the growth of the state Medicaid budget and bring additional stability to the long-term care sector.


Enhanced CON rules

FLORIDA— Lawmakers have introduced bills aimed at bolstering current certificate of need rules to revitalize the state’s long-term care infrastructure.

HB 287 and its Senate companion, SB 268, would preserve existing CON rules that promote cost containment and prevent unnecessary duplication of long-term care services while encouraging home- and community-based care, according to the Florida Health Care Association. But the bills also would encourage a more open and competitive bidding process that would allow renovation and new construction in areas where demand is the greatest. 

Officials said they believe such enhanced flexibility with the CON process would better serve the state’s growing elderly population.

‘Review panels’ proposed

KENTUCKY — Pending legislation aimed at mitigating malpractice claims against providers is the latest tort reform effort sharply dividing lawmakers here along party lines. Not surprisingly, seniors advocates such as AARP say such efforts would impede patients from seeking full remedies.

A group of providers, provider organizations and business interests, including LeadingAge Kentucky, formed the Care First Kentucky Coalition to push current reform efforts, which advocates say would decrease or eliminate “meritless” malpractice lawsuits.

Under the proposal, yet to be drafted in bill form, three-person panels of “medical experts” would review plaintiffs’ claims in a timely manner and render an opinion on whether standards of care were violated before plaintiffs are allowed to pursue legal action. 

While the panels’ findings would not be based on rule of law, they would be admissible in court.

Continued praise for SNFs

GEORGIA — The state’s nursing homes continue to garner high praise among residents and their families, as evidenced by the latest satisfaction survey results.

In fact, Georgia has the distinction of running the country’s oldest satisfaction measurement program, established in 2003. Results for 2013 revealed that 90% of residents and families gave “excellent” or “good” ratings for the homes in which they were cared for, according to National Research Corporation, which administered the results.

Data is collected under the auspices of the Georgia Quality Incentive Program, a collaborative quality measurement and improvement program for the state’s skilled nursing care centers. The information is tracked in conjunction with other “technical” quality measures. Over the past few years, the program has evolved into an incentive-based performance measurement program and today does impact Medicaid reimbursement levels, NRC noted.


Admins’ education rebuffed

SOUTH DAKOTA  — State nursing board officials have failed in their bid to relax the education requirements for nursing home administrators in an effort to attract more talent.

The State Board of Nursing Facility Administrators went before the state legislature’s Health and Human Services Committee to push the measure, which would lower the minimum requirement to two-year degrees. They cited a nurse with experience who wanted to be an administrator, but current law requires that she have at least a four-year degree.

A South Dakota Health Care Association representative, however, reportedly testified the association opposed the measure, given the complexity and high regulatory risks associated with administrators’ jobs.


Income tax shocker ahead? 

MAINE  — A measure capping deductions on personal tax returns slipped under the radar during budget talks last year. It could catch many nursing home residents by surprise during tax season.

The measure, which was reportedly rushed through the legislature while it struggled to bring the state into compliance with recent federal tax changes, even caught the Maine Health Care Association by surprise, as well as a number of lawmakers who are nursing home resident advocates, according to Portland Press-Herald columnist Bill Nemitz.

Prior to the current law, Maine residents could deduct an unlimited amount of medical care expenses (including costs related to nursing home care) on their state returns. Now, those deductions are capped at $27,500. 

Nurse residency program

NEW JERSEY — Rutgers University is taking aggressive steps to stem high turnover rates in skilled nursing facilities through an innovative one-year residency program.

Working with the New Jersey Action Coalition, Rutgers’ College of Nursing and School of Nursing faculty will use a $1.6 million CMS grant to develop the program, which has long been popular in hospitals and other acute care settings. 

Officials say the plan is designed to retain newly licensed nurses employed at federally certified long-term care facilities. Fifty nurses will be selected to train as residents over 30 months, beginning this spring.

Supporters of the plan say nurses are likely to remain on the job at places where they are better prepared to work as well as be nurtured in specific practice environments. The state’s nursing home industry is currently plagued by a 40% turnover rate. 

LTC policyholders vulnerable 

MASSACHUSETTS — Consumers may be protected from excessive costs for long-term care insurance, but more than 150,000 state residents holding such policies remain vulnerable to unwarranted claim denials and other pitfalls, a recent Boston Globe report found.

In 2012, the state legislature took aggressive measures to cap annual premium increases insurers could levy (about 10%) on new policies. Nationwide, such premiums have nearly doubled to about $3,700 per couple, the newspaper reported. The state insurance division reportedly missed a deadline, however, to put other consumer protections into place.

Meanwhile, existing policyholders in other states are staring at the prospect of premium hikes of between 6% and 25% this year alone. Massachusetts lawmakers remain unsure about whether stiff premium constraints would apply to such policies.

Adult briefs service funded 

CONNECTICUT — Medicare doesn’t cover the cost of adult briefs, and many elderly and disabled people on fixed incomes do without or do not have enough. This can lead to a host of issues, including pressure ulcers.

Thanks to a grassroots movement in the town of Bozrah, a group of caregivers now offers a mobile service delivering free adult briefs to those in need.

Sharon Gauthier, president of Patient Advocate for You, established Discreet Undergarment Banking for You (DUB4U) using the Bozrah Senior Center as a distribution hub, according to DUB4U’s Facebook page. 


Rapidly growing senior boom has Aloha State officials concerned

HAWAII — One of the most expensive states in the country for long-term care is staring down the barrel of dwindling budgets and a rapidly growing elderly population. Officials are taking proactive measures to ensure adequate funding and better engage aging residents. 

By 2034, more than a third of the state’s population will be over 60. Complicating the budget dilemma is that longevity runs high in the Aloha State, where the average life expectancy is 82. Private nursing homes are at least 50% more expensive than just about anywhere else, with an annual average per resident cost of about $145,000, Steve Tam, director of advocacy for AARP Hawaii, told Hawaii News Now.

But officials now realize that Kupuna Care, the state program that provides services for the elderly, will quickly lose its ability to meet growing demands. Gov. Neil Abercrombie (D) requested a 75% funding increase for the Executive Office of Aging to expand the state’s health care and social support resources in 2013. And in his State of the State address in January, the governor asked the legislature to increase the Kupuna Care budget by $4.2 million and make it permanent.