Health and Disability

Health and Care Minister Ivan Lewis today (Monday 21 July) announced
the sites that will benefit from £80million of Government funding to
build extra care housing, enabling more older people and those with
dementia and long-term conditions to live in a home of their own. He
will today be presenting the successful Barnsley extra care housing
scheme with a cheque for £3.8 million together with Sir Michael
Parkinson.

People who are unable to continue to live in their own homes have
traditionally had their choices limited to care homes, creating a
number of problems including couples finding they can no longer live
together.

In the midst of all the political rhetoric and debate during this
presidential season, one critical issue seems to have been left out
-America's broken system for long-term care financing.

The current system, therefore, is simply unsustainable. So what is
the solution? The American Association of Homes and Services for the
Aging (AAHSA), of which St. Andrew's is a member, commissioned an
in-depth study to develop a workable plan for future financing of
long-term care. Their recommendation calls for a broad-based
national insurance trust into which all Americans would be enrolled.
Among its features are:

• Low overhead costs.

The insurance would be financed by premiums, not by general
tax revenues.

Individuals could pre-fund their long-term care needs.

Benefits should be available regardless of setting and
payable in cash.

The Commonwealth Fund and Brown University conducted a survey of long-term care leaders.
Over 1100 respondents, including consumer advocates, providers, public
officials, and policy experts, completed the survey between September
2007 and March 2008.

Among the findings, eighty-five percent ranked the workplace as one of
the top three challenges facing long-term care, followed by financing
(66%) and achieving quality (60%). More ranked nursing homes as fair or
poor (53%) than other service types, including hospices (6%). They
favored adopting savings incentives and adding a long-term care benefit
to Medicare. Few had faith in consumer report cards to help people make
informed choices. Read more by downloading the top-level findings.

A bill to amend title XVIII and XIX of
the Social Security Act to improve the transparency of information on
skilled nursing facilities and nursing facilities and to clarify and
improve the targeting of the enforcement of requirements with respect
to such facilities.

Other Bill Titles (2 more)Hide Other Bill Titles

2/14/2008--Introduced.
Nursing Home Transparency and Improvement
Act of 2008 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the
Social Security Act to direct skilled nursing facilities (SNFs) and
nursing facilities to make available, upon request, ownership and
affiliated parties
information to the Secretary of Health and Human Services and other
responsible parties. Outlines accountability requirements for such
institutions. Requires specified additional information to appear on
the Department of Health and Human Services Nursing Home Compare
Website. Requires SNFs to separately report expenditures for wages and
benefits for different levels of nursing staff. Directs the Secretary
to develop a standardized form for use by a resident (or a person
acting on the resident's behalf) in filing a complaint about a SNF with
a state survey and certification agency or long-term care ombudsman
program. Requires a state to establish a complaint resolution process.
Directs the Secretary to establish a program for SNFs to report
staffing information based on payroll data. Increases certain civil
monetary penalties for SNF violations. Requires the Comptroller General
to study and report to Congress on:
(1) the financial
status, resident care, and performance of SNFs and nursing facilities
in the Special Focus Facility (or a successor) program of the Centers
for Medicare & Medicaid Services relative to a comparable
sample of facilities outside such program; and
(2) best
practices for, and barriers to, the appointment of temporary management
for SNFs with a record of poor care. Directs the Secretary to provide
for an national independent monitoring program to oversee interstate
and large intrastate chains of SNFs. Requires a SNF administrator to
notify the Secretary and other responsible parties of an impending
closure of the facility. Directs the Secretary to conduct demonstration
projects on culture change and use of information technology in SNFs
and nursing facilities. Provides for dementia management training and
patient abuse prevention training. Directs the Secretary to study and
report to Congress on training for certified nurse aides and
supervisory staff of SNFs and nursing facilities.

... morehide bill summarySee Full Bill Text

Over
the next two weeks, the Democratic and Republican parties will be
forming their platforms. It’s essential that long-term care financing
reform is included in their platforms. That’s why we need your help.

AAHSA recently developed platform statements to share with both parties on the Long-term Care Solution. Please share you own versions of the following platform statements by July 25.

Whatever your political affiliation, please consider submitting information to both parties.

Thanks to Barbara La Valleur, who directs a local block nurse program in St. Paul: . She wrote this letter to the editor in today’s Minneapolis Star Tribune about
how her organization’s work is keeping people at home longer, at a much
lower cost than institutional care . . . and outlines the opportunity
we have to radically change how we fund local solutions to helping
people live the way they desire . . .

Your July 9 editorial about reaching out to help seniors
live at home and the challenges of Meals on Wheels programs is a drop
in the tidal wave bucket before the inevitable Aging Tsunami crashing
our way.

Latest figures show that more and more seniors are living longer and
most have the same goal: to remain in their homes for as long as
possible. Meals on Wheels is a valuable service that supports their
goal. That’s also what the Living at Home/Block Nurse Programs
(LAH/BNPs) do for Minnesota seniors.

The False Claims Correction Act (H.R. 4854) Wednesday made its way to
the House Judiciary Committee for deliberation and a markup.

Nursing-home and long-term care advocates are opposed to this
legislation (Duh!)because of the perceived burdens it would place on the
long-term care industry, according to a June letter sent to the House
by more than 20 healthcare advocates. Overpayments from Medicare or
Medicaid would be grounds for legal action under the new law. The bill
also would provide legal protection and financial reward to
whistleblowers in these instances. This could seriously disrupt many
government programs, advocates argue, as any payment records would have
to be meticulous to avoid potential lawsuits from those seeking to gain
from minor oversights.

This is a video of a Brookings panel on LTC. It is broken down into 4 sections:

• Welcome
• Improving Quality
• Financing
• Political Prospects
  

Objective. To analyze
corporate governance arrangements and quality and financial performance
outcomes among large multi-facility nursing home corporations (chains)
that pursue stakeholder value (profit maximization) strategies.

Study Design. To
establish a foundation of knowledge about the focal phenomenon and
processes, we conducted an historical (1993–2005) case study of one of
the largest chains (Sun Helathcare Inc.) that triangulated qualitative
and quantitative data sources.

Data Sources. Two main
sets of information were compared: (1) corporate sources including
Sun's Security Exchange Commission (SEC) Form 10-K annual reports,
industry financial reports, and the business press; and (2) external
sources including, legal documents, press reports, and publicly
available California facility cost reports and quality data.

Principal Findings. Shareholder
value was pursued at Sun through three inter-linked strategies: (1)
rapid growth through debt-financed mergers; (2) labor cost constraint
through low nurse staffing levels; and (3) a model of corporate
governance that views sanctions for fraud and poor quality as a cost of
business.

Conclusions. Study
findings and evidence from other large nursing home chains underscore
calls from the Institute of Medicine and other bodies for extended
oversight of the corporate governance and performance of large nursing
home chains.

Redesigning the regulatory survey of nursing homes would help determine
how far current resources can be stretched to improve quality,
according to a panelist who participated in a long-term care reform
conference held on Friday.

Speaking at the event, hosted by the Brookings Institution, Mary Jane
Koren of The Commonwealth Fund, Susan Reinhard of AARP and John
Schnelle of Vanderbilt University discussed improving quality and
efficiency in the nation's long-term care sector. Providers do not view
the current regulatory survey of nursing homes as consistent, fair or
objective, and the system doesn't make it clear whether or not quality
improvements can be made using available resources, Schnelle said.

Sen. Ron Wyden (D-OR) proposed including job-training programs in
healthcare reform as a way to ensure healthcare workers are prepared to
deal with any emerging long-term care needs. Rep. Jim McCrery (R-LA)
suggested a tax benefit for family members who take care of elderly
relatives at home, suggesting that that may be a way to fill some of
the gap in the healthcare workforce.