State News May 2014

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Sen. Patty Murray (D-WA)
Sen. Patty Murray (D-WA)


AG: Reinstate Risperdal suit

ARKANSAS – Attorney General Dustin McDaniel pledged to petition the Arkansas Supreme Court to overturn its recent ruling that reversed a lower court's $1.2 billion judgment against Johnson & Johnson and its Janssen pharmaceuticals subsidiary. The companies are accused of billing Medicaid for off-label use of the antipsychotic drug Risperdal.

Johnson & Johnson introduced Risperdal 20 years ago as a “second-generation” antipsychotic drug for treating schizophrenia, bipolar disorder and irritability in autism patients, according to Arkansas Business.

“We pursued this case based on the belief we continue to hold, which is that the General Assembly intended to give the Attorney General's Office the authority to pursue penalties against those that would enter our state and blatantly deceive the public,” McDaniel told the newspaper.

The high court, meanwhile, remanded a separate deceptive trade practices act decision back to the circuit court. That decision concerned a complaint that the firms misled physicians about the dangerous side effects of the drug.

In an unrelated matter brought by the Justice Department, Johnson & Johnson reportedly agreed to pay more than $2.2 billion to federal and state governments to settle criminal and civil allegations that the company promoted powerful psychiatric drugs, including Risperdal, for unapproved uses in children, seniors and disabled patients.

Social workers overused?

LOUISIANA — Nursing home social workers have greater responsibilities than ever before, yet widely disparate training programs and declining numbers of applicants could threaten patient care in the years to come, according to research published in the Journal of Contemporary Medical Education. The study looked specifically at social workers in Louisiana long-term care facilities. It found that mission creep might burn out social workers.

“It may not be snobbery of social workers to stay in their respective treatment silos, but downright fatigue,” wrote study author Priscilla Dawn Allen, an associate professor at Louisiana State University School of Social Work and a former long-term care ombudsman. “Social workers are often called to be marketers, admissions directors, discharge planners, room change technicians, grief and bereavement specialists, conflict resolution experts, advocates, counselors, Minimum Data Set coordinators, activities helpers, lost and found workers, and handlers of vast mountains of paperwork.”

‘Granny cam' bill tabled

SOUTH CAROLINA – Nursing home patient advocates will need to be a little more patient while the state Legislature reconsiders a bill that would allow residents to install personal video monitoring devices in their rooms.

The bill that would allow the so-called “granny cams” failed in committee and reportedly met stiff opposition from the nursing home industry, which claimed such devices would violate privacy rights of staff and other residents. The legislation would require residents to install and pay for the cameras, and would make it illegal for staff to tamper with or otherwise impede the devices. Lawmakers were asked to review additional evidence in states where granny cams are allowed, including Texas and Oklahoma.

State Sen. Paul Thurmond (R)is sponsoring the bill. 


Governor's race has SNF link

ILLINOIS – A candidate's affiliation with a huge operator charged with wrongful death and other alleged crimes is expected to make good political theater during the upcoming governor's race in November.

Political newcomer and multimillionaire Bruce Rauner handily defeated Republican rivals for the GOP nod during the March primaries after spending a fortune on folksy ads that deflected attacks on his relationship with Trans Healthcare Inc., a now shuttered firm getting hammered with a series of lawsuits alleging wrongful death and patient neglect. These include a $900 million judgement against one of the company's homes in Florida in 2009.

Rauner once was the chairman of a private equity firm that had significant investments in THI, which owned as many as 274 facilities in 21 states before falling into receivership in 2009. Rauner is not a defendant in any of the lawsuits. The firm at one time faced judgments exceeding $2 billion, some of which have been dismissed, and some of which were not actively defended because of bankruptcy filings.

PR issue for funding option

MINNESOTA – A long-term care funding awareness campaign has acknowledged reverse mortgages have an image problem among people seeking ways to pay for long-term care and daily expenses.

The news comes two years after the launch of the state's Own Your Future initiative, which was designed to advise lawmakers and private citizens on various ways to plan for and fund long-term care. One charge for the campaign was to identify more affordable and suitable long-term care products for middle-income households, according to Reverse Mortgage Daily, an information website.

In its recommendations to the state and the U.S. Congress, however, program administrators warn that many people believe alternative funding products such as reverse mortgages do not have adequate consumer protections. They also question their stability, safety and benefits.


Grants support home care

CONNECTICUT – $9 million in free money could go a long way toward allowing some seniors in the state to stay in their homes instead of needing more expensive nursing home care.

Gov. Dannel Malloy's (D) office said it awarded the grants to seven facilities in the state under a new program designed to diversify long-term care services and provide citizens with more options than skilled nursing home care. A total of 35 of the state's nursing homes have closed since January 2001 because of census declines.

The grants will go to facilities that offer proposals to do things like expand geriatric care management and education programs, repurpose SNF floors into transitional living wings, undertake hospital outreach, and leverage a facility's home-maker companion agency to increase the supply of direct-care workers. 

The next request for proposals is expected by summer, with possible additional grants of up to $25 million. Federal and state Medicaid funding, as well as state bond funds, support the initiative. 

Managed care exemption

NEW JERSEY — Existing nursing home residents across the state will have two years to get used to a new managed care funding mechanism going live July 1.

The state decided to grandfather existing facility residents over the period following a groundswell of concerns that many would be deemed ineligible for funding. In Bergen County alone, an independent survey of peer-group financed services revealed nearly 130 residents would not qualify for Medicaid services under the new system. The decision means 11 counties that provide nursing home services will gain more than $23 million this year under the current fee-for-service model, according to published reports.

Under the new funding plan, Medicaid managed care contracts will be administered by for-profit insurance companies, which will coordinate acute, physician and nursing home care. The plan is designed to consolidate home health aides, adult day care, assisted living and caregiver respite into one program.

Pay guarantee eliminated

NEW YORK — One of the state's most powerful unions failed to lock in pay guarantees for nursing home employees after lawmakers deleted the proposal before passing the $138 billion state budget.

Service Employees International Union local 1199 lobbied the Legislature heavily to include a passage setting a “standard wage” for nursing home workers. The Democratic Governor and Democrat-controlled Assembly approved the plan, which was later nixed by the Senate, according to Newsday.

Family sues over stripper

NEW YORK — The son of a nursing home resident is suing East Neck Nursing & Rehabilitation Center in West Bablyon, NY, after learning that strippers visited the facility.

Resident Bernice Youngblood, 86, has dementia and was unable to consent to the activity, according to a March lawsuit filed by her and her son, Franklin Youngblood, against the center's owner, Cassena Care. The event took place in late 2012 or early 2013.

An attorney representing the facility told CBS New York that residents voted to have the strippers and that the nursing home paid the $250 fee. He also has said a family member brought Youngblood to the event.


Complaint backlog bill

CALIFORNIA – Thousands of old nursing home complaints have received attention of the Assembly's Committee on Health, which unanimously approved a measure that would speed the investigation and resolution process.

The bill (AB 1816) stems from an onslaught of reports about the backlog, which then stirred a comprehensive audit spearheaded by Assembly Member Mariko Yamada (D).

State health officials first reported the backlog consisted of about 700 complaints. But Patricia McGinnis, executive director of California Advocates for Nursing Home Reform, told committee members she was aware of more than 10,000 backlogged investigations.

AB 1816 would require the state to complete investigations within 40 days and has received support from patient advocates and nursing home groups. The bill moved on to the Assembly Committee on Appropriations after being approved by the health committee. 

State presses VA to honor plans for vet nursing home

WASHINGTON – A proposal for a sorely needed veteran's nursing home in Walla Walla remains mired in red tape and declining federal funding while elected officials continue pushing the Veterans Administration for answers.

Sen. Patty Murray (D-WA), a senior member of the Senate Committee on Veterans' Affairs, recently questioned two high-level VA administrators why a once-committed $22 million in funding now seems jeopardized for the planned Washington State Veterans Home at the Wainwright Memorial VA Medical Center.

The project would add 93 jobs and serve more than 50,000 veterans across 10 counties. Included in the plans are a complex of small houses on the medical center campus, as well as an 80-bed skilled nursing facility. A bill authorizing the facility passed unanimously in the Senate but remains in limbo in the House, which reportedly killed a similar measure last year. Efforts to build the home also have been stymied by a huge influx of similar requests from other states.

Murray also recently introduced a bill to expand benefits for caregivers of veterans. The measure would make the benefit known as Special Compensation for Assistance with Activities of Daily Living tax-exempt, and it would increase federal support for those providing care for a vet with menal health challenges.