Tag Archives for Iraq

World issues pushed nursing home reform to the side in State of the Union. But it’s there

Published on March 7, 2022 in Rhode Island News Today

More than a week ago, President Joe Biden, with Vice President Kamala Harris and House Speaker Nancy Pelosi, sitting behind him in the House Chamber in the United States Capitol, delivered his first State of the Union Address. Harris and Pelosi made history marking the first time two women have been on the dais during a presidential address before the joint session and the American people

According to C-SPAN, Biden’s speech was the fourth-longest of the seven most recent presidents’ speeches, beating out Presidents George H.W. Bush, George H. Bush and Ronald Reagan. Amid frequent applause breaks, chanting from both sides of the aisle and heckling, Biden’s prepared remarks delivered Tuesday, March 1, 2022, totaled around 7,762 words, lasting over one hour and two minutes.

Biden spoke mostly on-script with his prepared remarks on a wide range of topics before lawmakers, Supreme Court Justices, guests, many waving small blue and yellow Ukraine flags or wearing the country’s colors to show solidarity with the people of Ukraine. While the first half touched on the Russian invasion of Ukraine and the need for a global coalition to respond, the second half addressed inflation, COVID-19 and the “new normal,” increasing domestic manufacturing, health care, prescription drugs, energy and taxes, voting rights legislation, and the nomination of Judge Ketanji Brown Jackson to the Supreme Court. 

Biden concluded his speech by proposing a “Unity agenda” calling for a fight against the opioid epidemic, pushing Congress to pass a mental health package, supporting Veterans returning from the battlegrounds of Iraq and Afghanistan and finding a cure for cancer.

The State of the Union and nursing homes

While Biden’s speech briefly touched on the quality of care in the nation’s nursing homes, his Administration is clearly making this a major domestic issue.  During the address, Biden expressed strong concerns about Wall Street firms that were taking over many nations’ nursing homes. “Quality in those homes has gone down and costs have gone up. That ends on my watch,” he told the packed chamber. “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect and [they’ll be] looked at closely,” he said.

A day before the State of the Union address, the White house released a detailed document, entitled, “Fact Sheet: Protecting Seniors and People with Disabilities by Improving Safety and Quality of Care in the Nation’s Nursing Homes,” outlining dozens of proposed changes on how U.S. nursing homes are regulated and operate, including a vow to adopt federal minimum staffing requirements for facilities, step up enforcement of regulations and to eliminate overcrowded patient rooms.

Amid the ongoing COVID-19 pandemic that continues to wreak havoc on the nation’s nursing homes, where 200,000 residents and workers have died from COVID-19, nearly a quarter of all COVID-19 deaths in the United States, the Biden Administration says that staffing shortages are getting worse, reducing the quality of care provided to residents

Poorly performing facilities will be held accountable for improper and unsafe care and must immediately improve their services or will be cut off from tax payor dollars. Biden calls for better information to be provided to the public to assist them in better understanding the conditions they will find in each facility and to assist them in choosing the best care options available.  

Centers for Medicare & Medicaid Services (CMS) will begin to explore ways to reduce resident room crowding in nursing homes by phasing out rooms with three or more residents and promoting private, single occupancy rooms. Multi-occupancy rooms increase the risk of the spread of infectious diseases, including COVID-19.  The agency will also establish a minimum nursing home staffing requirement, the adequacy of staffing is closely linked to quality of care provided.

Meanwhile, CMS also plans to strengthen the Medicare Skilled Nursing Facility Value-Based Purchasing Program and base payment on staffing adequacy (including over weekends) and retention and the resident experience.  Although the nation has seen a dramatic decrease in the use of antipsychotic drugs in nursing homes in recent years, CMS will continue its efforts to identify problematic diagnoses and bring down “inappropriate use” of such drugs.

Enhancing accountability and oversight

The Biden Administration calls for the enhancing and accountability and oversight of the nation’s nursing homes by adequately funding inspection activities, beefing up scrutiny on more of the poorest facility performers, expanding financial penalties and other enforcement sanctions, and increasing the accountability for chain owners whose facilities provide substandard care. CMS will work with nursing homes to improve care by providing technical assistance.

To enhance transparency, CMS will create a new database that will track and identify owners and operators across states to highlight previous problems with promoting resident health and safety.  The agency will also collect and publicly report data on corporate nursing home ownership and will enhance the Nursing Home Care website. Finally, CMS will examine the role that private equity investors play in the nursing home sector.

Biden’s nursing home reforms will ensure that every nursing home has a sufficient number of adequately trained staff to provide care to the 1.4 million residents residing in over 15,500 Medicare and Medicaid facilities across the nation.  Nursing home staff turnover can be reduced by creating pathways to good-paying jobs along with ensuring staff to join a union.  CMS calls for lowering financial barriers to Nurse Assistant Training, adequate compensation and access to a realistic career ladder. The agency launches a National Nursing Career Pathways Campaign with partners including the Department of Labor.

Finally, Biden puts together his strategy to ensure emergency preparedness in nursing homes during the ongoing pandemic.  He calls for continued COVID-19 testing in nursing homes and continued COVID-19 vaccinations and boosters to be provided to residents and staff. CMS will strengthen requirements for on-site infection prevention, and make changes to its emergency preparedness requirements,   Finally, the agency will take what it has learned during the pandemic and integrate new lessons on standards of care into nursing home requirements around fire safety, infection control, and other areas, using an equity lens.

Point/Counter Point

In a released statement after Biden’s State of the Union address, AARP CEO Jo Ann Jenkins stated: “We were also encouraged to hear the President describe new actions to ensure that residents in nursing homes will receive the safe, high-quality care they deserve. For years, AARP and AARP Foundation have sounded the alarm about problems in America’s nursing homes. The COVID-19 pandemic exposed the chronic, ongoing issues with our long-term care system and emphasized the need for reform. It is a national disgrace that more than 200,000 residents and staff in nursing homes and other long-term care facilities died. AARP urges the federal government to act swiftly to ensure minimum staffing standards, increase transparency, and hold nursing homes accountable when they do not provide quality care.”

On the other hand, the nursing home industry had its views as to Biden’s call for nursing home reforms.  “The nursing home profession has always been committed to improving the quality of care our residents receive, and we appreciate the Biden Administration joining us in this ongoing effort. Over the last decade and prior to the pandemic, the sector made dramatic improvements. Fewer people were returning to the hospital, staff were providing more one-on-one care than ever before, and the unnecessary use of antipsychotic medications significantly declined,” said Mark Parkinson president and CEO of AHCA, in a released statement.

“Those who continue to criticize the nursing home sector are the same people who refuse to prioritize our residents and staff for resources that will help save and improve lives,” noted Parkinson, whose Washington, DC-based nonprofit organization represents more than 14,000 nursing homes and long-term care facilities across the nation. “Additional oversight without corresponding assistance will not improve resident care. To make real improvements, we need policymakers to prioritize investing in this chronically underfunded health care sector and support providers’ improvement on the metrics that matter for residents,” he said.

“It’s time to stop blaming nursing homes for a once-in-a-century pandemic that uniquely targeted our residents and vilifying the heroic caregivers who did everything they could to protect the residents they have come to know as family,” said Parkinson. ““Long term care was already dealing with a workforce shortage prior to COVID, and the pandemic exacerbated the crisis. We would love to hire more nurses and nurse aides to support the increasing needs of our residents. However, we cannot meet additional staffing requirements when we can’t find people to fill the open positions nor when we don’t have the resources to compete against other employers,” he said.  

To read the White House Fact Sheet to improving the quality of care in the nation’s nursing homes, go to:

https://www.whitehouse.gov/briefing-room/statements-releases/2022/02/28/fact-sheet-protecting-seniors-and-people-with-disabilities-by-improving-safety-and-quality-of-care-in-the-nations-nursing-homes/

On Monday, March 7th at 9am, AARP Rhode Island and US Senators Reed and Whitehouse will speak on the need for lower prescription drug prices in a virtual press conference.

AARP Rhode Island State Director Catherine Taylor, Volunteer State President Marcus Mitchell and Volunteer Lead Federal Liaison Dr. Phil Zarlengo will join Rhode Island US Senators Jack Reed and Sheldon Whitehouse for a virtual news conference highlighting the need for Congress to lower prescription drug prices. AARP Rhode Island will present the Senators with a petition signed by more than16,000 Rhode Islanders calling for Congress to act now and stop unfair drug prices.

You can listen in via ZOOM at:  

https://aarp-org.zoom.us/j/98668832992?pwd=bktuTjJBMUZhUDRaVDkvN2dCSXZqUT09

Passcode: 618357

Participants will respond to on-topic media questions posted in chat.

More information about AARP’s Fair Drug Prices campaign can be found at aarp.org/rx.

Returning Veterans Need a Helping Hand from Employers

Published November 30, 2012, Pawtucket Times

When the time came to end his seven month tour of duty in Afghanistan, Michael Cremin envisioned a future with the military.  With his tour of duty now behind him, this Staff Sergeant in the United State Marine Corps Reserves had well-laid out plans to re-enlist and become a full-time Marine.  The ambitious Quincy, Massachusetts resident did the calculations – he would first reenlist, then attend Officer Candidate School and ultimately become a Marine Corps Officer.   However, in a New York second, at the age of 32, this reservist was dealt a harsh blow that left dreams shattered forever.

Last April, Cremin entered a medical facility to treat a nagging back problem that  doctors diagnosed as being caused by the strenuous work endured over those months of  active combat – jumping in and out of military convoy vehicles carrying either heavy gear or injured Marines away to safety from blown up vehicles.    He welcomed the responsibility and at a relatively young age, was charged with overseeing convoys of over 90 vehicles carrying over 100 military personnel, whose mission was to bring needed food, parts, and fuel from Camp Leather Neck, Afghanistan to the various forward operating bases. However, heavy pain caused by three bad disks resulting in nerve disorders would medically-drum Cremin out of military service.  “This medical problem will affect me for the rest of my life,” he said.

Being medically retired was bittersweet for Cremin.  He loved being a Marine but his back injuries would be exacerbated if he stayed in the military.   His doctor’s would later say,  that he might have difficulty moving as he aged and the effects would be life-altering. On the other hand, being officially retired has many benefits, specifically for his 27 year old wife, Carol, an administrator for a staffing agency, who would now be eligible to receive health benefits for life.

Military in His Blood

In 1986 at the age 6, Cremin immigrated to America from Cork City, Ireland with his mother and younger brother to join their father, who had left Ireland earlier to come to the United States to escape an economic recession at home.  For the father, America offered promise and hope with a better way to support a family. With the family together, both parents would ultimately work 90 hours a week to keep their family together.

As a young child, Cremin had always wanted to join the Marines.  He recalls as a youngster, the first poster on his bedroom wall was a Marine recruiting poster, instead rather than the typical sports teams poster you might expect to see.

“Why not be a Marine?,”  he asked.  Military service spanned generations in Cremin’s family tree, stretching to his grandfather’s enlistment in the Irish army early in the century.  Uncles would serve under the United Nation’s flag in Lebanon, Cyprus, the Congo and even Yugoslavia.

In 2003, during Operation Iraqi Freedom, Cremin would enlist in his beloved Marine Corps.  For all active duty recruits who lived east of the Mississippi, the young Marine’s basic training took place at Parris Island, South Carolina.  This would be followed by combat training in at Camp Lejuene, North Carolina where he was then sent to Amphibious Assault School, Camp Pendleton in California.

Until 2007 Cremin would be stationed in 29 Palms, California in the hot Mojave Desert.  From the West coast military base, he would be deployed for a 9 month tour in Iraq, serve on the 31st Marine Expeditionary Unit on amphibious LSD for ten months and take a 10 month tour of South East Asia.  Leaving active duty in 2007 he returned to Quincy, Massachusetts, where he would take care of family business.  Missing the ‘esprit de corps’ of belonging to the Marine Corps, he would reenlist in the reserves in less than 1 year, which would bring him back to war in Afghanistan in 2011.

The New Year Brings Retirement

Over his decade long military career, Cremin has also found time to volunteer in the community.   When he was stationed in California, he began to do volunteer work in the Marine Corps’ “Toys for Tots” initiative.  In 2010 he decided to step forward to volunteer running the state’s Toys for Toys initiative. When he came back to the east coast after his Afghanistan tour, he would again volunteer to take the reins and oversee Rhode Island’s efforts to collect toys for the needy OceanState children.

Two weeks ago, Cremin officially found out that he would was being retired from the Marine Corps, and his retirement would come at the beginning of 2013. Before this last combat tour, his Associate Degree in Criminal Justice that he earned at QuincyCollege might just have been a stepping stone to a law enforcement career if he was not to stay in the military.   However, his current medical disability would reduce the probability that he could enter that career. Not knowing where he will ultimately live, or work, makes it difficult for Cremin to choose a University to complete his bachelor’s degree.

“Things are up in the air now,” Cremin says, noting that with the economic downturn in Rhode Island, the young war veteran is not sure where he will ultimately end up. Five of his fellow Marines volunteering their time to work on this toy collection project, all who were injured in Afghanistan, will also be looking for work, too.  .

But for now, before he joins the rank and file of unemployed veterans with his five fellow Marines, he will concentrate on overseeing the completion of this year’s Toy’s for Tot’s Campaign. It keeps his mind off the uncertainly of not knowing where his next pay check will come from. “I really don’t want to think about the future.”

Reaching Out to Unemployed Veteran

           According to the U.S. Bureau of Labor Statistics, the employment rate for all Veterans nationwide fell to 6.3 percent last month —well below the national employment average of 7.9 percent.  However, for post-9/11 veterans, America’s newest veterans, the rate reached 10 percent.

However, “the picture is even worse in the Ocean State”, notes Consultant Dan Cahill.  “In our work we found the unemployment rate among veterans was higher than the general population,” says Cahill, who coauthored a report released in November 2011, entitled Initial Needs Assessment and AmeriCorps State Service Plan.  Funded by Serve Rhode Island, Cahill noted that issues of unemployment are predominant in the veteran population between 35 to 54 years of age. “Approximately 13 percent of veterans in this group are unemployed, compared with a 9 percent unemployment rate among non-veterans in this cohort,” he says.

Cremin and the growing number of unemployed Rhode Island veterans now can turn to a Department of Defense (DOD) program that will assist these individual’s find work.

According to Rebecca Sanderson, Rhode Island’s  H2H Hero to Hire                  Employment Transition Coordinator, this program unveiled in 2011, offers valuable resources for military veterans members by way of hiring fairs, job training, career assessment and military skills translation.  With more than 400 Hiring Our Heroes job fair events, Sanderson noted that one was recently held in the Ocean State to assist current service members, retirees and veterans find civilian jobs.

Sanderson stated that 64 employers came to CCRI in Warwick, on November 9, 2012, to meet the 176 job seekers who attend this event. During the day, company’s received 526 resumes with 103 interviews being conducted.  Seventeen job offers were made that day, she noted.

“We expect more job offers to be made by companies who attended the job fair as they sort through the resumes they collected and finish their interview process of the participants,” says Sanderson. Rhode Island usually hosts two Hirer Our Heroes (HoH) job fairs per year, one in the fall and one in the spring. (Information on these job fairs, including dates and locations can be found by following the links for live hiring fairs on www.H2H.jobs,  the organization’s website).  “At this internet site employers can post jobs, and service members, post resumes and make a job connection,” she says.

One of the biggest challenges that veterans face in finding jobs after returning from active military service involves the translating of their military skills into terms that civilian employers will understand, says Sanderson.  “Service members return with many “soft” skills such as leadership, problem solving, and team work, but may not have the training in the “hard” skills the employers are looking for,” she says.

Sanderson continues to work hard toward creating better networking opportunities that will allow military veterans from active duty and reservists to better interact with employers to break down barriers to communication which will allow businesses to better recognize the value of those who have served in the nation’s military.

Hopefully, Rhode Island companies will see the value of hiring Cremin, a war veteran who could bring his military leadership skills, problem-solving and expertise in organizing large scale events, to their operation.

Veterans fought  for our nation’s freedom.  May be its time for employers to give them a break, by easing them into civilian life and giving them decent employment.  If this happens, everyone becomes a winner.

For more info about the H2H Program, contact Rebecca Sanderson, Employment Transition Coordinator at 401 275-4359; Rebecca.Sanderson@us.army.mil.

Herb Weiss, LRI ’12, is a Pawtucket-based freelance writer who covers aging, medical and health care issues.  He can be reached at hweissri@aol.com.