Tag Archives for Nursing Homes

Senior Agenda Coalition of RI unveils its 2025 legislative priorities at forum,

Published in RINewsToday on March 17, 2025

On March 14, 2025, hundreds of older Rhode Islanders, aging network providers, state officials, and lawmakers gathered at the Senior Agenda Coalition of Rhode Island (SACRI)’s 2025 legislative forum, “United Voices for Meaningful Advocacy” at the Crowne Plaza in Warwick. With the RI House deliberating the FY 2025 budget and key legislation impacting older adults, SACRI announced its legislative priorities.

SACRI Board Chair Kathy McKeon gave welcoming remarks, giving recognition to major sponsor Delta Dental.  Serving as master of ceremonies, Executive Director Carol Anne E. Costa kept the three hour Legislative Forum on track.

SACRI Policy Advisor Maureen Maigret gave an overview and highlighted the growing influence of Rhode Island’s aging population.

“We’re 200,000 strong and growing,” she said, noting that within five years, one in four Rhode Islanders will be 65 or older. In 21 of the state’s 39 cities and towns, older adults now make up at least 20% of the population, with some communities reaching over 30%.

The Economic Impact of Older Adults

Maigret noted that 21% of older Rhode Islanders still work, many are caregivers for loved ones, and vote in higher numbers than any other age group. About 12% are veterans, and many volunteer at senior centers, Meals on Wheels, RSVP, and The Village Common of RI.

Older adults also contribute significantly to the economy. According to AARP’s Longevity Economic Outlook report, those aged 50 and older generate 40% of the nation’s GDP. In Rhode Island, retirees inject $4 billion into the economy through Social Security benefits.

However, many older adults struggle financially. “The ‘forgotten middle’ falls through the cracks,” Maigret said, referring to those with low incomes who don’t qualify for Medicaid or other public benefits. Long-term care costs are rising, and even with home equity many middle-income adults will not be able to pay for long-term.

Census data reveals that one in four Rhode Island households headed by someone 65 or older  have incomes less than $25,000 annually, and nearly half have  less than $50,000. The average Social Security benefit is $23,995, with men receiving $26,372 and women $23,565.

Shaping SACRI’s 2025 Legislative Agenda

Survey results from SACRI’s October 2024 Conference guided this year’s priorities. Among 241 respondents (42% aged 75 and older), top concerns included healthcare costs and access, economic security, housing, and community supports.

SACRI’s top priority is expanding the state’s Medicare Savings Program (MSP) by increasing income and asset limits. “Expanding MSP eligibility would provide an extra $185 monthly, or $2,200 annually, to thousands of older adults,” Maigret said. The federal government would cover the cost of those newly eligible. This extra income could help with food, utility bills, or rent and a boon to the state’s economy, she said.

With primary care practices closing due to retirement and low reimbursements, SACRI is pushing for a rate review to ensure competitive payments.

Though fewer than 5% of older Rhode Islanders live in nursing homes, Maigret stressed the importance of addressing the industry’s staffing shortages,  and substandard care, SACRI supports increasing wages for direct care staff, rewarding high-performing nursing homes, ensuring financial transparency, and preventing Medicaid cuts.

To address the housing crisis, SACRI advocates for fair allocation of state housing funds for housing for older adults and persons with disabilities. With public housing waitlists up to five years long, this is essential. SACRI is also pushing to expand income eligibility for the property tax relief program to $50,000 and mandating accessibility features in new developments.

Aging in place is another priority. SACRI calls for adding $600,000 ($10 per person age 65 and older) to the state budget to support community senior centers and enacting a caregiver tax credit to assist Rhode Island’s 112,000 caregivers, who spend an average of $7,000 out of pocket annually.

SACRI also seeks to increase Medicaid’s asset limit from $4,000 to $12,000 to help older adults on Medicaid remain at home. Additional funding for volunteer programs and continuing the “Ride to Anywhere Pilot” are also on SACRI’s agenda.

Maigret also noted SACRI is in close contact with the state’s Congressional delegation to oppose any harmful Medicaid cuts or changes in Social Security.”

Lawmakers Respond

Bringing greetings from House Speaker Joe Shekarchi, Rep. Lauren Carson (D-Dist. 75, Newport), who chairs the Special Legislative Commission on Services and Programs for Older Rhode Islanders, acknowledged the political power of older voters. “In the 2024 primary, 87% of voters were over age 85. I paid close attention to that,” she said.

Carson emphasized the importance of protecting Social Security, Medicare, and Medicaid. “Social Security is a promise. We paid into it. We can’t lose that program,” she said.

She highlighted legislative victories from 2024, including a $10 million investment to stabilize nursing homes, raising the pension exemption from $20,000 to $50,000, and launching the “Digital Age” initiative to bridge the digital divide. However, she stressed that more work remains.

Carson is also leading efforts to eliminate ageist language from state statutes, replacing terms like “elderly” and “senior citizen” with “older adults.” “We’re living diverse lifestyles beyond age 60, and our language should reflect that,” she said.

Representing Senate President Dominick J. Ruggerio (D-Dist. 4, North Providence, Providence) Senator Jacob E. Bissaillon (D-Dist. 1, Providence), chair of the Senate Committee on Housing & Municipal Government, echoed Carson’s concerns. He warned that state lawmakers must protect hard-won progress in light of potential federal cuts and a $250 million state budget shortfall.

Bissaillon called for addressing the housing crisis. “There are 150,000 Rhode Island households paying over 33% of their income on housing. We need 20,000 more affordable units and 2,000 permanent supportive housing units,” he said. He also supports eliminating the state income tax on Social Security and pointed to the Senate’s newly established Artificial Intelligence and Emerging Technologies Committee noting it is important aims to protect older adults from cyber scams. “It’s critical that Rhode Island keeps pace with technology,” Bissaillon said “We have our work cut out for us,” he concluded.

Following the legislative priorities session, Carlson called to order a meeting of the Special Legislative Commission on Services and Programs for Older Rhode Islanders.

At this time, Elizabeth Dugan, PhD from the University of Massachusetts Gerontology Institute presented highlights from the 2025 RI Healthy Aging Data Report scheduled for full release on May 1st.

A Final Note…

It was obvious today that older voices must be heard,” said Director Mary Lou Moran of the City of Pawtucket’s Division of Senior Services, emphasizing the importance of SACRI’s Legislative Forum . She noted that the event provided a valuable opportunity for seniors, aging advocates, and organizations to gather and share the latest information, resources and more importantly hear from the State’s legislative leaders.

Moran expressed her support for SACRI’s  advocacy for the State to allocate $10 per person aged 65 and over to communities  to fund senior centers and senior programs. “Senior centers play a vital role in helping older Rhode Islanders age in place within their communities and offer innumerable opportunities for social engagement, healthy living opportunities, and act as a reliable resource for not only them but for their families and their caregivers” she explained.

Moran also strongly supports SACRI’s efforts to increase the income eligibility for the state’s Medicare Savings Program (MSP). By participating in MSP, individuals can have their Part B Medicare premium covered, and for some low-income participants, the program also helps with prescription drug costs. “Reducing the cost of Part B premiums and, for some[]  who are income eligible, covering  prescription drug expenses allows older adults to redirect those savings toward essentials like rent,  utilities, and food,” she added. 

To watch SACRI’s Leadership Forum held on March 14, 2025, go to:                                                                https://capitoltvri.cablecast.tv/show/10954?site=1.    

To view Larson’s  Special Legislative Commission on Services and Programs for Older Rhode                                                            Islanders held at SARCI’s Leadership Forum, go to:                                                                          https://capitoltvri.cablecast.tv/show/10955?site=1.

To learn more about SACRI, go to https://senioragendari.org/

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.

AARP’s new COVID-19 Dashboard for national/local Nursing Home Data

Published in RINewsToday.com on October 26, 2020

While public health experts are predicting a second spike of the COVID-19 virus, expecting it to hit the nation as early as – now – and reaching its peak in December, AARP releases its Nursing Home COVID-19 Dashboard created to provide four-week snapshots detailing the infiltration of the virus into the nation’s nursing homes and its impact on residents and staff.  AARP’s latest Public Policy Institute analysis is the result of the Washington, DC-based aging advocacy group’s successful efforts to push for the public reporting of nursing home COVID-19 cases and deaths.

Using data collected by the Centers for Medicare & Medicaid Services—which is self-reported by nursing homes—the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff. The first release of the dashboard on October 14 reveals that nursing homes in every state reported shortages of PPE, ranging from 8 percent of facilities in the best-performing states, to 60 percent in the lowest-performing state. The dashboard also compared state and national data on COVID-19 cases and deaths, staff cases and staffing shortages.

Key Findings of AARP’s First Dashboard

The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time.  Here are some observations about AARP’s first Dashboard (using data from August 24 to September 20, in which 95 percent of the nation’s 15,366 nursing homes submitted data for this time period):

According to the database, in every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.

The researchers note that while considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.

Finally, there is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.

Looking at Rhode Island, AARP’s first dashboard detailed the following: 

·         2.2 COVID cases per 100 residents

·         0.2 COVID deaths per 100 residents

·         1.7 staff cases per 100 residents

·         19.7 percent of nursing homes without a 1-week supply of PPE

·         28.9 percent of nursing homes with staffing shortages

AARP’s dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.

As Others See It – in Rhode Island

“We have been very clear in our messaging: No state has done a good enough job to protect nursing home residents and staff,” said AARP Rhode Island State Director Kathleen Connell. “That said, it is good to see that in the first round of data postings on the AARP Nursing Home COVID Dashboard shows Rhode Island in better-than average shape compared to other states. But to our point, anyone in Rhode Island with a loved one in a nursing home expects – hopes and prays – for more than ‘better than average.”

“As we see daily reports of increased cases and deaths, safety concerns for nursing home residents and staff should be increasing as well. The pandemic is far from over and among many complicated aspects of dealing with it is transparency. The COVD Dashboard provides the public with a benchmark and tracks monthly changes; people need to pay attention and demand action at all levels to make nursing homes safer. These aren’t just numbers. These are lives,” says Connell.

On the other hand, the Rhode Island Department of Health questions the accuracy of AARP Nursing Home COVID-19 Dashboard as it relates to its Rhode Island findings. “The data don’t accurately reflect the Rhode Island reality in part because of how the questions are phrased,” says Joseph Wendelken, RIDOH’s Public Information Officer, specifically related to PPE data. “The question asks about PPE in the nursing homes. Nursing homes receive a weekly supply of PPE from their corporate warehouses. The question asks about one point in time. On occasion, reporting happens shortly before facilities receive their re-supply,” he says.

“RIDOH has taken several steps to protect nursing home residents, says Wendelken, noting that his department has built Congregate Setting Support Teams to conduct targeted to facilities regarding infection control, PPE, testing, and staffing. 

“We have weekly contact with facilities. We’ve worked with facilities to develop creative plans for reopening. We have implemented regular testing of staff every 10 to 14 days. We will take the lessons and experience we’ve gained from these past seven months and apply them to the increase in cases we see today,” adds Wendelken. 

According to Scott Fraser, President/CEO, of the Rhode Island Health Care Association (RIHCA), the AARP analysis shows what his organization has been saying in the last few weeks and months—that COVID-19 cases in nursing homes continue to drop. “Rhode Island is below the national average in all categories measured for this dashboard,” he says, stressing that the number of cases in nursing homes is dropping as is the number of deaths,” notes Fraser.  

The successful efforts to protect nursing home residents and staff can be directly linked to the measures the facilities have taken since the pandemic first hit, notes Fraser. “We are stocking up on PPE. We initially suspended visitation.  We are testing staff regularly and residents when necessary.  We are carefully monitoring visitors and vendors who come into our homes.  We isolate and quarantine anyone who tests positive or any new resident who moves into our facilities,” he says. 

Fraser says that RIHCA continues to advocate for regular testing of vendors who come into the state’s nursing homes, including ambulance drivers, lab technicians, and hospice workers.  RIHCA continues to call on RIDOH to renew the policy of having two negative tests before a hospital patient can be released to a nursing home and to allow those certified nursing assistants who received temporary emergency certifications to obtain their permanent licenses.

A Call to Action

More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation’s most recent analysis released on Oct. 8. Yet in its statement announcing the release of its Dashboard, AARP charges that federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. 

According to AARP, policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 casers and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done, says the nation’s largest aging advocacy group in its statement urging elected officials “to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.”

COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus, says AARP promising to “continue to shine a light on what’s happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable.”

AARP has called for the enactment of the following five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:

·         Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.

·         Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.

·         Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.

·         Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.

·         Reject immunity for long-term care facilities related to COVID-19.

To see AARP Nursing Home COVID 19 Dashboard, go to:

www.aarp.org/content/dam/aarp/ppi/pdf/2020/10/rhodeisland-nursing-home-dashboard-october-2020-aarp.pdf