Families Need Help Coping With Mild Cognitive Impairment

The age related memory condition known as mild cognitive impairment (MCI) is more disruptive of day-to-day life and relationships than once believed, gerontology researchers at Virginia Tech have discovered.

Funded by the Alzheimer's Association, Karen Roberto, director of the Center for Gerontology at Virginia Tech, and Rosemary Blieszner, associate director, set out to determine the issues and needs of families responding to MCI. After interviews with 99 families, the researchers reported, "Primary family members reported that their relatives were experiencing memory-related changes that interfere with their daily activities and responsibilities, decision-making processes, and relationships."

Senator Grassley Introduces Nursing Home Transparency and Improvement Act of 2008

On February 14, 2008, Senator Charles Grassley and Senator Herb Kohl introduced the Nursing Home Transparency and Improvement Act of 2008 (S.2641). According to a related Press Release, S.2641 aims to bring more transparency to consumers regarding nursing home quality, improve enforcement, and strengthen nursing home staff training requirements.

Among other things, S.2641 would reportedly require that "special focus facility" designations be placed on the Nursing Home Compare website. S.2641 would also require that CMS develop a standardized complaint form and require more uniform reporting of nursing staff levels so that comparisons can be made across nursing homes. S.2641 would also strengthen the available penalties. For instance, S.2641 would reportedly allow the Secretary to impose civil monetary penalties of up to $100,000 for a deficiency resulting in death, $3,000-$25,000 for deficiencies at the level of actual harm or immediate jeopardy, and not more than $3,000 for other deficiencies. Finally, S.2641 would attempt to improve staff training by including dementia management and abuse prevention training as part of pre-employment training.

CMS to Hold Skilled Nursing Facility/Long-Term Care Open Door Forum

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will hold the next Skilled Nursing Facility/Long-Term Care Open Door Forum at 3:30 p.m. (EST) on February 27, 2008.

To participate by telephone, one must dial 1-800-837-1935 and reference conference ID 18796437. To participate in person, one must RSVP by 2:00 p.m. (EST) on February 25, 2008 to SNF_LTCODF-L@cms.hhs.gov, and include your name, organization, phone number, and “SNF/LTC” in the subject line. The Open Door Forum will take place at the Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. CMS asks that attendees arrive no later than 3:00 p.m. (EST).

MRSA infection

Risk factors for hospital-acquired (HA) MRSA include:

Residing in a long-term care facility. MRSA is far more prevalent in these facilities than it is in hospitals. Carriers of MRSA have the ability to spread it, even if they're not sick themselves.

Absence Of Cancer Diagnosis And Treatment In Elderly Medicaid-Insured Nursing Home Residents

UroToday.com- A study in the January 2008 issue of the Journal of the National Cancer Institute suggests that Medicaid patients in nursing home care receive limited cancer services. While the prevalence of cancer in nursing home patients is 1 in 10, according to Dr. Bradley and coauthors this population has received little attention in outcomes research.

In the U.S, Medicaid is the predominant payer for long-term residential nursing home care. These patients often have low income, frail, and more than 30% of them require assistance to perform 3 or more activities of daily living. It is reported that nursing home staff may not effectively recognize and treat cancer. The researchers used statewide Medicaid and Medicare data merged with the Michigan Tumor Registry to identify a study sample of patients with a first primary cancer diagnosis. Tumor registry patients were matched to the state Medicare Denominator file for the years 1996-2000 and all claims for inpatient, outpatient, physician, and hospice services were identified. Those with at least one year of claims history before the month of diagnosis were selected, as this permitted an estimate of patients' comorbidity burden. The researchers calculated odds ratios for late or invasive but unknown stage of cancer, death within 3 months of diagnosis, receipt of hospice services, and receipt of cancer-directed surgery.

CMS Takes Next Step To Improve Quality In Nation's Nursing Homes, USA

The Centers for Medicare & Medicaid Services (CMS) built upon historic action it took last November by making public more names of underperforming nursing homes across the country.

On November 29, 2007, the agency began publishing the names of Special Focus Facility (SFF) nursing homes that had failed to improve significantly after being given the opportunity to do so.

Once a facility is selected as an SFF, state survey agencies are responsible for conducting twice the number of standard surveys and will apply progressive enforcement until the nursing home either (a) significantly improves and is no longer identified as an SFF, (b) is granted additional time due to promising developments, or (c) is terminated from Medicare and/or Medicaid.

NAD And DSA Launch Senior Resources Listing, USA

The National Association of the Deaf (NAD) and its Senior Citizens Section together with the Deaf Seniors of America (DSA) have jointly launched a resources listing of, by, and for older deaf Americans.

With the title of 'Senior Resources', this first-ever and comprehensive listing contains items of interest to older deaf persons and their families or caregivers. The first half provides useful names, addresses, phone numbers, and websites for various types of senior housing facilities (e.g., independent/retirement, assisted living, nursing, and others of a specialized nature). The second half focuses on senior clubs having gatherings of a recurring nature, which is of particular interest to deaf seniors who travel extensively.

Half-Million Dollar Surety Bond Requirement Would Put Many Small Durable Medical Equipment Providers Out Of Business

A Senate bill introduced last week would impose a $500,000 surety bond requirement on providers of durable medical equipment (DME) under Medicare and would put thousands of small homecare companies out of business, says the American Association for Homecare.

A law passed in 1997 requires a $50,000 surety bond for DME providers as a deterrent to fraud and abuse. However, the federal government has never actually implemented the surety bond requirement for the DME sector. The Centers for Medicare and Medicaid Services has proposed that the amount increase to $65,000.

The bill introduced last week, S. 2603, called the "Medicare Fraud Prevention Act of 2008," would increase the $50,000 surety bond requirement by a factor of ten. The bill would also increase civil and criminal fines for Medicare fraud and abuse. The bill is sponsored by Senators Mel Martinez (R-Fla.), John Cornyn (R-Texas), Norm Coleman (R-Minn.), Lamar Alexander (R-Tenn.), David Vitter (R-La.) and Jim DeMint (R-S.C.).

"The impact of a half-million dollar surety bond requirement would be devastating on law-abiding small providers,"

Poor Outcomes For Nursing Home Residents Underscore Need For Nurse Staffing Ratios And Stronger Enforcement

Last week the Centers for Medicare & Medicaid Services publicly identified over 4000 nursing homes - more than 25% of facilities nationwide - whose residents are physically restrained, or have pressure sores, or both, in excessive numbers. This should be a call to action to both Congress and the Centers for Medicare & Medicaid Services.

"What's needed to avoid pressure ulcers and physical restraints is a sufficient number of well-trained certified nurse assistants, accompanied and supervised by a sufficient number of registered nurses," said Senior Policy Attorney Toby S. Edelman with the Center for Medicare Advocacy. "With CMS reporting that more than 90% of nursing homes do not have sufficient staff to meet residents' needs, it is time for Congress to enact legislation mandating comprehensive and meaningful nurse staffing ratios," continued Edelman. "For its part, CMS needs to take stronger enforcement action whenever it finds facilities short-changing their residents and providing them with less care than they need."

Effects of Cash and Counseling on Personal Care and Well-Being

Medicaid beneficiaries who have disabilities and receive traditional support services from Medicaid agencies often have little control over their care. Cash and Counseling is a flexible, consumer-driven program that gives Medicaid beneficiaries a monthly allowance. With this allowance they can purchase goods and services that facilitate independence, and they can hire whomever they like as caregivers, including family members and friends. This paper examines the effects of Cash and Counseling on the types and amount of personal assistance services Medicaid beneficiaries received, on the beneficiaries’ satisfaction with their care, and on their overall well-being.