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Sen. Julie Denton (R-Louisville)
Sen. Julie Denton (R-Louisville)


KENTUCKY — A four-person review panel would have to approve civil malpractice lawsuits against long-term care providers before the claims could go to court, under a bill that recently passed the state Senate.

The panel would be composed of three physicians and an attorney chairman. The chairman would not vote on the merits of the complaint but would advise the doctors on legal questions. The review panel would have six months to determine whether cases could proceed, based on evidence such as non-privileged medical records and witness depositions.

Panelists would be charged with identifying and throwing out frivolous complaints, said the bill's sponsor, Sen. Julie Denton (R-Louisville). Reducing litigation costs would free up money to be spent on resident care, she said.

The bill was sent to the House Health and Welfare Committee, where it faces opposition from committee chairman Tom Burch (D-Louisville). Burch said the review panel would simply create red tape.

Medicaid bill in the works

FLORIDA — State lawmakers and officials with the Department of Children and Families are working together on a bill to close what they say is a Medicaid loophole allowing wealthy people to get government funding for nursing home care.

To qualify for Medicaid, some nursing home residents are paying family members advance wages for caregiving tasks such as hairstyling. By paying years' worth of advance wages, residents deplete their assets and qualify for Medicaid. While this is not illegal, DCF officials describe this as a loophole allowing for unfair payments and improper use of taxpayer funds, according to The Associated Press.

A person also can sign over his or her spouse's financial support to the state. Even if the healthy husband or wife is still living in the couple's home and possesses substantial assets, the other spouse would then qualify for Medicaid. 

A Florida House committee and Senate committee both rejected the idea of expanding Medicaid under the Affordable Care Act in March. Gov. Rick Scott (R) had reluctantly supported expanding the rolls, since it's estimated the state would have received $50 million to $60 million in federal funds.


Payment rates may rise

MINNESOTA — Lawmakers from both sides of the aisle are seeking to increase funding for long-term care facilities by 5% for each of the next two years.

House and Senate members recently introduced legislation that would boost reimbursements to nursing homes by about $56 million. Payments to providers would be contingent on meeting certain quality standards. The state's Medicaid program would begin making the additional payouts in July if the bill passes. About 75% of the new money would be allocated for worker compensations.

The bill goes further than the proposed budget from Gov. Mark Dayton (D). Under his plan, long-term care providers would see reimbursement rates go up 2.2% over two years, starting in July 2015.

SNF rooms for rent

MISSOURI — Senior citizens living in rural counties would be able to lease unused nursing home rooms as apartments, if a recently introduced Senate bill becomes law.

Introduced by Sen. Brian Munzlinger (R-Lewistown),
SB 89 says nursing homes that at a minimum provide housing, food services and emergency call buttons to residents may lease unused rooms to seniors at fair market rent, as defined by the U.S. Department of Housing and Urban Development. No nursing services would be provided to these seniors, and the emergency call buttons would be disabled in their rooms.

The bill applies to nursing homes in 89 of Missouri's 114 counties.

Munzlinger says seniors in these counties may want to lease a nursing home room rather than live in isolated houses that are hard to keep up and may be cut off during bad weather, according to local reports.

ACO seeks nursing homes

OHIO — In a high-profile example of how long-term care providers are playing more prominent roles in multi-payer healthcare groups, The Ohio State University's Wexner Medical Center is seeking candidates to take part in an accountable care organization.

The hospital system recently solicited responses from interested skilled nursing facilities and other senior care and post-acute care providers as it continues to develop plans for an ACO.

The ACO planning is being spearheaded by the OSU medical center's former chief financial officer. It is expected to roll out in a pilot program in the spring.


Multilayer review needed

CALIFORNIA — The state's department of public health is not comprehensively reviewing proposed acquisitions of skilled nursing facilities as mandated by law, according to a lawsuit recently filed by California Advocates for Nursing Home Reform.

State officials are reviewing facility operators and the next-highest level of corporate ownership in acquisitions involving a 5% or greater stake in a SNF, but this is not going far enough, CANHR says. The advocacy group alleges nursing home owners and investors are creating multi-level, complex corporate structures to evade review. As a result, the state is not effectively monitoring who is running and profiting from SNFs, according to the lawsuit.

CANHR is asking the court to mandate that the state thoroughly review the corporate structure of entities involved in a potential SNF acquisition.

Group shapes LTC policy

OREGON — A recently released report compiled input from the state's care providers and consumers, gathered in an ongoing project to develop long-term care policy recommendations.

The “Listening and Visioning Project on Long-Term Care” began in 2011, and is being undertaken by the Oregon Association of Area Agencies on Aging and Disabilities, with funding from the Meyer Memorial Trust and the Oregon Community Association. It has significant stakeholder buy-in from various groups, including government agencies, workers unions, advocacy groups and healthcare systems.

The project leaders formulated 2013 legislative policy recommendations based on the provider and consumer input summarized in the new report. These recommendations include expanded options counseling for families and better coordinated prescription management to cut down on unnecessary hospitalizations.


Bill to slow SNF growth

WYOMING — The House of Representatives recently defeated a bill to keep people with complex health conditions in assisted living longer.

Introduced by Sen. Charles Scott (R-Casper) and passed by the Senate before falling 44-11 in the House, the bill said it is in the best interest of the state that people stay in assisted living “as long as possible” before transferring to a “more expensive” skilled nursing facility.

Under the bill, assisted living staff or contractors would have been able to care for residents with open skin lesions, catheter or ostomy bag needs and supplemental oxygen needs.

Steve Bahmer, executive director of LeadingAge Wyoming, was a critic of the proposed measure. 

Bahmer is serving on a committee convened by the Wyoming Department of Public Health to review assisted living rules and regulations. This bill was premature as it “jumped the gun” on the work of the advisory committee, Bahmer told McKnight's