Tag Archives for Medicare

Internet will soon be good source for information on nursing homes

Published in The Pawtucket Times, May 2003

A growing number of Americans are doing their shopping for products and services, via the Internet.  But if the federal government has its way consumers in five states will rely on Medicare and Medicaid programs and their family members, will be able to cruise the world wide web to find the best nursing facilities to meet their specific needs.

Rhode Island is among five states chosen by the Centers for Medicare and Medicaid Services (CMS) for a pilot project that will identify collect, and publish nursing home quality information on the Internet for easy access and comparison of facilities.

The other states are Colorado, Maryland, Ohio and Washington.  Eventually, this federally-funded initiative will be expanded nationwide.

People covered by Medicare and Medicaid have the power to choose the best care to meet their individual needs, but they have to have more reliable information to choose quality care, HHS Secretary Tommy G. Thompson, who oversees the Medicare and Medicaid programs. “Our efforts will help beneficiaries all across the country to compare the performance of their local nursing homes, and will provide the recognition that high-quality nursing homes deserve”.

In April 2002, the newly compiled performance information becomes available online at www.medicare.gov and will also be disseminated through Rhode Island Quality Partners, an agency contracted by the federal government to oversee the quality of health services provided to Rhode Island Medicare beneficiaries.

So what information can consumers find when shopping for the right nursing facility on the world wide web?

Currently, the CMS’s website provides nursing facility-specific information compiled from state annual surveys.

As a result of this five state pilot project, consumers will be able to see data culled from the Minimum Data Set (MDS), a standardized medical collection form that every nursing home is required to complete on every patient upon admission and on a regular schedule thereafter.

For those seeking a long-term placement, CMS will bring together comparative state-wide information that indicates quality care is being provided.  When shopping you will be able to find out how many residents are being physically restrained, how many have pressure sores, how many are taking anti-psychotic drugs without a psychiatric diagnosis, how many have lost weight, how many have acquired an infection, and finally how many residents can no longer take care of themselves.

For those seeking short-term stays after hospitalization, CMS will provide state-wide MDS data compiled from nursing facilities that can tell you how many residents are in pain, how many residents fail to recover from delirium, along with how many are re-hospitalized and improvement in walking.

Dr. David R. Gifford, principal clinical coordinator with Rhode Island Quality Partners, told All About Seniors that CMS chose Rhode Island for the pilot project because of the state’s interest in public reporting of consumer information.  He noted that CMS was aware of Lt. Gov. Charles Fogerty’s legislation, recently enacted that now requires reporting of nursing facility quality information.

“We’re very pleased to be involved in the pilot project because it allows us to help shape the national data dissemination effort,” Gifford adds.

How will consumers not computer savvy gain access CMS’s new quality measures?

Dr. Gifford notes that each state participating in the pilot project must develop other avenues for non-computer users to tap into the MDS data compiled on its website.

Roberta Hawkins, Executive Director of the Alliance for Better Long Term Care and the state’s ombudsman, applauds the new federal effort to help consumers in choosing nursing facilities.

However, Hawkins is concerned that the MDS does not always provide “insight into the personality of a nursing facility.”

“MDS won’t tell you if a facility’s staff are compassionate to residents.”  she says.  Additionally, the newly compiled CMSA information will not provide you with specifics about how some facilities specialize in taking care of ethnic populations.”  she added, specifically, if staff speak a foreign language, sever ethnic cuisine, or plan culturally-related activity programming.

Additionally, Hawkins notes that while CMS’s website may tell you how many persons have bed sores, a higher incidence of bed sores may only reflect that a newly admitted resident came to the facility with bed sores or that a facility specializes in taking care of that medical condition.

At best, internet information can only provide a snapshot of care being provided by facility staff, warns Hawkins.  “Today’s best nursing homes may become next weeks providers of poor care,” she adds, when key staff in leadership positions leave the facility.

Take advantage of CMS’s website to cull nursing facility specific information compiled from state annual surveys.

When in doubt, call the Alliance for Better Long-Term Care at 785-3340.

Bush’s “just guns, no butter” policy hurts senior programs

Published in the Pawtucket Times on March 31, 2003

President Lyndon B. Johnson’s “Guns and Butter” policy is not in fashion today.

In a recent Washington Aging Report, radio commentator Bill Benson predicted future federal funding of program and services for seniors will take a back seat to President Bush’s worldwide fight against tourism, the high-tech war against Iraq and tax breaks for the upper income Americans.

In his Marh 24 commentary, Benson, a former assistant secretary with the U.S. Administration on Aging and now a principal at Health Benefits ABC – sees tough times ahead for the federal funding of programs and services, especially the creation of a meaningful Medicare pharmaceutical assistance program.

“Guns and Butter” was coined nearly 40 years ago, describing President Lyndon B. Johnson’s two-front war. Back then, a large infusion of federal dollars allowed the Democratic president to fight a war abroad – in Vietnam – along with a war on the domestic front, against poverty and social ills, especially those facing the elderly.

“By the end of 1965, with Vietnam escalating, we had the Medicare program and the Older Americans Act,” noted Benson, adding Medicaid was also created at this time to help millions of low-income older people afford the cost of nursing home care.

Benson’s radio commentary charged the Bush administration and the Republican-controlled Congress are fully committed to funding the “guns” but not “butter” policy initiatives.

“It would be one thing if the commitment to guns over butter was for the president while we topple Saddam and occupy Iraq, and combat terrorism everywhere. “Instead, it looks like the Bush administration is committed to making butter a scarcer commodity for years to come,” said Benson.

According to Benson’s proposed budget for the next fiscal year suggests it won’t be both “guns and butter,” especially in light of the president’s efforts to pursue large tax cuts for upper-income Americans.

What about the spending for guns?

According to the Washington Post, Bush’s proposal for the fiscal year begins on Oct. 1, calls for defense spending that is 16 percent more than the combined total of all other discretionary spending excluding what he would spend on homeland security.

And that figure does not take into account the cost of the war in Iraq, nor expenditures to combat terrorism, Benson says.

Meanwhile, Benson said the Washington Post noted secretary of defense Donald Rumford has proposed a $20 billion increase for defense for each of the next six years, would follow what have been six straight years of real increases in defense spending. The result by 2010 would be annual spending for defense of more than half a trillion dollars.

Combine increased defense with the cost of the Iraq war.

Benson noted the White House estimated the cost for Iraq and related matters will be nearly $75 billion over the next six months.

Benson said that by 2011, the first baby boomer s will turn age 65, and will begin placing huge demands up on Medicare, Social Security and other services for the elderly.

“President Bush’s FY 2004 budget calls for $ 400 billion spread over 10 years for a prescription drug plan for senior,” said Benson.

On the other hand, the Congressional Budget Office estimates Medicare beneficiaries will in fact spend more than $1.8 trillion over the same 10 years for prescription drugs.

That means, said Benson, the president’s plan would cover only a bit more than 20 percent of wat seniors will actually spend. And that is if the $ 400 billion actually goes for drug coverage when there will be many other demands for additional Medicare dollars.

Bush also purposes to cut funding for the Older Americans Act – a federal program that supports such services as Meals on Wheels, transportation for the elderly and ombudsmen to investigate problems in nursing homes -by $24 billion, Benson said.

With a worldwide war on  terrorism combined with the ongoing war in Iraq, the debate regarding “guns and butter” spending must begin in earnest.

Hard choices must be made in times of war, but seniors must continue to press both the Bush administration and Congress for adequate federal funding to create a meaningful Medicare pharmaceutical assistance program, and to shore up the ailing Medicare, Medicaid and Social Security programs.

In this new era of huge defense spending, the Bush administration and Congress will have to make very painful choices in allocating its limited discretionary funds to support a wide variety of domestic policy initiatives.

Only an intense lobby of aging advocates and seniors will keep programs and services benefiting the nation’s elderly on the radar screens of federal officials and lawmakers.

The Best Of…Former Sen. Moss’ Advocacy Commitment Will Be Missed

Published on February 3, 2003

            Last Wednesday evening, former U.S. Sen. Frank Moss of Utah died.

            After he received his law degree in 1937 from Washington, DC-based George Washington University, Moss briefly worked on the legal staff of the U.S. Securities and Exchange Commission.

           Throughout his legal career, he would sharpen his legal skills by working in a variety of settings.  Initially, clerking at the Utah Supreme Court, he would ultimately win an election putting him on the bench of the Salt Lake City Municipal Court in 1940.

         During the World War II, he would serve on the Judge Advocate General’s staff of the U.S. Armory Corps in England.  After the war, Moss would be elected in 1950, reelected in 1954, to serve as Salt Lake County attorney.

         Two years after his unsuccessful bid for Utah Governor, in 1956, Moss would run for Senate and win, by less than 40 percent of the vote.

         Obituaries in newspapers stated that the liberal three-term Senate Democrat was best known for his environmental work that included the establishment of national parks and recreational areas in Utah.  Moss was also recognized for drafting a series of bill protecting consumers, ranging from mandating labeling on cigarette packages about the health hazards of smoking, banning cigarette advertising on radio and television, to developing minimum safety requirements for automobiles.

           But for me and many of my colleagues in the field of aging, we will always remember Moss as being a true advocate for the nation’s elderly.

           Moss worked closely with President Kennedy, Vice President Lyndon Johnson, who would later become President, Hubert Humphrey and Claude Pepper getting Medicare and Medicaid enacted into law.

          Moreover, Moss will always be remembered for being the driving force behind the establishment of the Senate Special Committee on Aging in 1961.

          He also played a major role in establishing the House Committee on Aging with the late Rep. Claude Pepper.  The two special committees would later put the spotlight on aging policy issues, generating both the public and political will to bring about the needed policy changes.

          Throughout his Senate Career, in addition to authoring legislation that would require federal minimum standards for nursing homes and helping to create  the Medicare and Medicaid home health care benefits. Moss held the first hearing on hospice care and introduced legislation authorizing payment for hospice care.

           More than 40 years ago, the Special Committee on Aging, chaired by Moss, began to hold a series of hearing s on nursing homes.  It became extremely clear to his committee through its hearings, generating 1,300 pages of testimony, that both nursing home standards and enforcement by state regulatory agencies varied drastically.  Moss noted that these hearings helped to shape the Medicare and Medicaid programs, and that they also lead to series of reforms in 1967.

         Ultimately, a series of 30 hearings held between 1969 and 1976 eventually lead to the publication of a 12-volume report, entitled “Nursing Home Care in the United States: Failure in Public Policy.”

        In 1977, Moss, with coauthor Val Halmandaris (who at the time was responsible for research of the Subcommittee of Long-Term Care, but now serves as executive director of the National Association of Home Care) wrote “Too Old, Too Sick, Too Bad: Nursing Homes in America,” detailing the plight of America’s elderly.

       More than 10 years later, in a 1998 speech to the National Council on Aging, Moss expressed his concerns that American’s elderly were losing ground from all the gains they had achieved in the late 1960s and 1970s.  Congress has yet to enact a pharmaceutical drug program to put the brakes on spiraling drug costs.  Elder abuse is still running rampant throughout the nation.  Medicare expenditures are being slashed to nursing homes, home and hospice care.

        It is now time for Congress to get serious about tackling the multitude of problems thrust upon the nation by an aging society.  Moss’ advocacy comment to the nation’s elderly will be sorely missed, and his shoes will be hard to fill.

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