Rough waters: rethinking bathing in long-term care

from McKnight's: 


To fully understand how the simple process of bathing affects long-term care facility residents it's important to walk—or more likely slip—in their shoes.

Just think about how this activity, one that able-bodied people require privacy to perform, becomes an exercise in embarrassment once a caregiver enters the picture.

That is why facility operators need to pay even closer attention to how this routine is carried out, and whether it is being done in a manner that minimizes the emotional dread that residents may experience, according to experts. 

Thankfully caregivers are becoming increasingly sensitive to the dignity issue, according to bathing and lift equipment vendors.

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/

Violations Reported at 94% of Nursing Homes

from NYTimes: 


WASHINGTON — More than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes, federal investigators say in a report issued on Monday.




About 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the Department of Health and Human Services.
Problems included infected bedsores, medication mix-ups, poor nutrition and abuse and neglect of patients.
Inspectors received 37,150 complaints about conditions in nursing homes last year, and they substantiated 39 percent of them, the report said. About one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients.


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/

Takeover will keep Metron nursing care home open

from Mlive.com: 


ALLEGAN -- A Southfield company has agreed to take over a nursing home that lost its Medicaid and Medicare funding and was facing possible revocation of its state license.



The tentative deal reached Wednesday averts the closing of Metron of Allegan, one of seven nursing homes owned by Cascade Township-based Metron Integrated Health Systems. The Allegan nursing home lost its government funding Sept. 11 because of 32 health and fire safety violations and was in danger of closing soon, a move that would have displaced 55 elderly residents

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/

AARP Solutions Forum Convenes Panel To Examine Medicaid Funding Of Long-Term Care

AARP will release a new report and convene a panel of experts to discuss Medicaid funding for long-term care (LTC) for older adults and adults with physical disabilities. The report analyzes the progress states are making shifting public funds and the people who rely on them from nursing homes to home and community based services.

Approximately 10 million older Americans need assistance with every day activities. Overwhelmingly, people (87 percent) prefer to receive this care in their homes or communities rather than in nursing homes. Few Americans have planned for the cost of LTC and by default Medicaid, which has an institutional bias towards nursing home care, is the primary payer.

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/

Long-Term Care Facilities Across America to Protect Residents with Full Sprinkler Systems

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/

Breaking the Cycle of Violence in Long-Term Care

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/

CMS TO RATE NURSING HOME QUALITY NEW FIVE-STAR SYSTEM TO BE ADDED TO NURSING HOME COMPARE SITE

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/

Nursing home operators lose 93% of appeals: report

The federal government won 66 of 71 appeals cases brought by nursing home providers last year according to a recent report from the Center for Medicare Advocacy. The Centers for Medicare & Medicaid Services won all 18 cases decided on the merits at the Appellate Division; it won 48 of 53 cases at the Civil Remedies Division.

The report author used the findings to call for stricter regulatory oversight of facilities. It is believed to be the first such examination of nursing home appeals findings in citations of poor care, she said.

"The study shows not only that problems in care are serious and that penalties are modest, but also that facilities choose to appeal these enforcement actions throughout he administrative appeals process. Almost always the facilities lose their cases," said report author Toby S. Edelman, a senior policy attorney for the Center for Medicare Advocacy.

She called for an upgrade of the regulatory system, including higher fines for deficiencies. Her analysis, "Nursing Home Decisions of the Department of Health and Human Services' Departmental Appeals Board, 2007," can be found at http://www.medicareadvocacy.org.

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/

Older Adults More Likely To Go Into A Nursing Home Just After Death Of Spouse

The chances of older adults being institutionalized, for instance in a nursing home, go up significantly immediately after the death of a spouse, according to new research from Finland.

The study was conducted by Elina Nihtila and Pekka Martikainen, sociology researchers at the University of Helsinki in Finland and was published online in the American Journal of Public Health yesterday, May 29th.

The researchers investigated the risk of an older adult entering long-term institutional care after the death of their spouse, compared with how long they lived after their loss. They also looked at whether level of education or household income had an effect.

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/

Center For Medicare Advocacy Issues New Report On Nursing Home Decisions

Nursing home decisions issued by the Department of Health and Human Services' Departmental Appeals Board (DAB) in 2007 highlight serious failures in care that cause residents to suffer unnecessary pain, injury, trauma, and death. "Despite the serious deficiencies reflected by these cases, the federal enforcement response is usually modest, at best," said Toby S. Edelman, Senior Policy Attorney with the Center for Medicare Advocacy and author of the just-released report,, an analysis of nursing home enforcement decisions issued by the DAB. "The federal government imposes only minor fines for these deficiencies," she continued, citing a case where a trivial $4050 fine was imposed when a resident strangled to death on her bedrail, after having fallen out of bed numerous times and been found caught by the bedrail in the same way a week before.

The Center for Medicare Advocacy's study of the 85 decisions is the first study ever made of the administrative appeals filed by nursing homes when federal remedies are actually imposed against them for poor care. "The study shows not only that the problems in care are serious and that penalties are modest, but also that facilities choose to appeal these enforcement actions through the administrative appeals process. Almost always, the facilities lose their cases," Edelman said. The government won 66 of the 71 cases that reached the merits of the appeals - a 93% success rate.

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/