Health and Disability

Earlier we blogged here about the long-term care financing forum at the University of Minnesota. One of the solutions put forward came from AARP. Here are highlights from Enid Kassner, director, Independent Living/Long-Term Care Public Policy Institute. Next we’ll share an approach from the American Association of Homes and Services for the Aging.

AARP’s Goal:

Create an affordable, consumer and caregiver-focused system providing coverage for, and access to, high quality long-term services and supports for independent living.

1. Promote - nationally and in the states - reform of delivery and financing for long-term services and supports.

2. REFOCUS reform debate on providing: long-term services and supports for independent living . . . rather than on “long-term care” or “Medicaid Reform.”

3. Include ALL populations, people with: developmental disabilities and physical disabilities . . . while improving services for seniors.

4. Defin “long-term services and support system” as FOUR separate, but related components:

1. Caregivers
2. Housing
3. Health Care
4. Long-Term and Community-Based Supportive Services

. . . . plus mechanisms to finance each component.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The authors showed that the quality of life of amyotrophic lateral sclerosis (ALS)patients does not depend on the severity of their physical restrictions. In contrast, it was found that patients who have to be given artificial respiration are more satisfied than patients for whom this is not necessary. Although an outside observer would have expected ALS patients to be depressed, as the disease is so serious, this was only the case for 10% of patients. This means that the proportion of depressive disorders is only slightly greater than in the overall population.

In view of the public discussion on euthanasia and assisted suicide, the authors think it essential that there should be a scientific investigation of the quality of life, as seen by the patient.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Image via WikipediaIt is estimated that almost one out of every 11 nursing homes do not contain a sprinkler system, between 20% and 30% do not have automatic sprinklers, and retrofitting will cost facilities roughly $850 million.

The Centers for Medicare and Medicaid Services said Wednesday that, within five years, all nursing homes will require full automatic sprinkler coverage to participate in Medicare. CMS also announced that the full financial burden of these upgrades will rest solely on the facility.

Reacting to the CMS rule, both the American Association of Homes and Services for the Aging and the American Health Care Association have said that they support the requirement, but would like to see some financial assistance to help facilities undertake the endeavor. The organizations support the Nursing Facility Fire-Sprinkler Act of 2007, which would create a framework for issuing low-interest loans to nursing homes.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The Supreme Court ruled for older workers Thursday in a closely watched age discrimination case, placing on employers the burden of proving that a layoff or other action that hurts older workers more than others was based not on age but on some other “reasonable factor.”

The 7-to-1 decision overturned a ruling by the federal appeals court in New York, which said employees had the burden of disproving an employer’s defense of reasonableness.

The case was brought by 28 employees who lost their jobs during cutbacks at a federal research laboratory in upstate New York. All but one of the employees who were laid off were at least 40, the age at which protections begin under the federal Age Discrimination in Employment Act.

The issue in the case, while technical, is important for the litigation of age discrimination cases in which an employer’s action or policy that appears neutral on its face has a disparate impact on older workers. David Certner, the chief legislative counsel for AARP, praised the decision and said it would prove “vital to the creation and maintenance of a workplace that is fair and free of age bias.”

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Published in June, 2008 by the Urban Institute, this report discusses the economic burden that Americans take on when they are no longer able to care for themselves as they age.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

June 20, 2008 -- Elderly women who maintain close friendships and strong family ties are less likely to develop dementia than women who are less sociable, according to new research funded by the National Institute on Aging.

The latest findings, published in this week's American Journal of Public Health, add to the growing body of evidence suggesting that strong social networks can protect against dementia.

Previous studies have showed that adults who live alone or who have no social ties have a much higher risk for cognitive impairment than those who have more social connections.

Dementia is a decline in cognitive (thinking) function that greatly affects one's day-to-day activities and relationships. Alzheimer's disease is the most common cause of dementia.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

CMS to Publish Final Rule

Long term care facilities such as nursing homes across America will, for the first time, have to protect their residents by installing sprinkler systems throughout their buildings if they wish to continue to serve Medicare and Medicaid beneficiaries, under a new regulation to be issued by the Centers for Medicare & Medicaid Services. Facilities will have a five-year phase-in period to be fully compliant with the new rule.

Approximately three million elderly and disabled Americans reside in the nation’s 16,000 nursing homes, all of which must have comprehensive sprinkler systems in place by 2013. To date, there has never been a multiple-fatality fire in a facility with a sprinkler system that meets the requirements of today’s rule.

“CMS is taking further action to protect the lives of our beneficiaries through a more comprehensive and effective approach to fire safety,” said Kerry Weems, acting administrator of CMS. “In the past, certain older facilities were exempt from having an automatic sprinkler system, but we now will hold all 16,000 nursing homes in the nation to this standard.”

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Nursing homes not only can but must change the way they operate, becoming better places to live and work. Only then will they be able to reduce the epidemic of violence that currently plagues them, according to an article in the Journal of Gerontological Nursing, Vol. 34 No. 3.

CNAs often experience “harassment, threats, and assaults” from residents, and the number of those incidents is probably “seriously underestimated,” according to “Policy Recommendations on the Prevention of Violence in Long-Term Care Facilities.” (The article is free to subscribers only; others must pay.)

Those attacks cause emotional distress, which can lead to more confrontations. “Frustrated and fearful, CNAs’ voices might be louder and their movements rougher, causing residents to respond in an aggressive manner,” notes the report. A vicious cycle of abuse can also occur when, “in retaliation, such aggressive behavior results in staff-to-resident abuse.”

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The Centers for Medicare & Medicaid Services today announced it will soon launch a ground-breaking ranking system of America’s nursing homes, giving each a “star” rating. CMS is requesting comments on the system designed to provide patients and their families an easy to understand assessment of nursing home quality, making meaningful distinctions between high performing and low performing homes.

The ratings will be posted on the agency’s Nursing Home Compare Web site by the end of this year. A sample screen shot of the proposed star ratings is available at www.cms.hhs.gov/PressContacts/10_PR_fivestar.asp. Medicare Compare can be found at www.medicare.gov.

“More than three million Americans rely on services provided by a nursing home at some point during the year. The new “five-star” rating system will provide a composite view of the quality and safety information currently on Nursing Home Compare to help beneficiaries, their families, and caregivers compare nursing homes more easily,” said Kerry Weems, CMS acting administrator.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/