Tag Archives for Nursing Homes

LCAO Calls for Fourth Stimulus Bill to Protect the Health and Well-Being of Seniors

Published in the Wooonsocket Call on April 19, 2020

As part of the Economic Impact Payment provision in the recently enacted $ 2.2 trillion stimulus bill, at press time about 80 million Americans have already received their $ 1,200 stimulus check ($2,400 for joint filers) through direct deposit. But for those 70 million Americans waiting for this payment by paper check, this Congressional handout may not be delivered to their mail box by early May, predict a Democratic Senator.

While the U.S. Treasury Department denies that embossing President Donald Trump’s signature on the “memo” section of the check will delay the delivery of paper checks, Senate Finance Committee Ranking Member Ron Wyden, (D-Ore.) disagrees.

A Break in Protocol

In an April 15 statement, Wyden stated: “Donald Trump is further delaying cash payments to millions of Americans struggling to pay the rent and put food on the table to feed his ego. Only this president would try to make a pandemic and economic catastrophe all about him.”

According to an article published in the Washington Post on April 14, “It will be the first time a president’s name appears on an IRS disbursement, whether a routine refund or one of the handful of checks the government has issued to taxpayers in recent decades either to stimulate a down economy or share the dividends of a strong one.”

The Washington Post article, penned by Reporter Lisa Rein, reported that Trump had initially approached Treasury Secretary Steven Mnuchin, who oversees the Internal Revenue Service, to be allowed to sign the checks. “But the president is not an authorized signer for legal disbursements by the U.S. Treasury. It is standard practice for a civil servant to sign checks issued by the Treasury Department to ensure that government payments are nonpartisan,” says the article.

Political insiders say that we can expect to see a fourth stimulus package hammered out between the Democratic-controlled House, the GOP-led Senate and Trump, to pump billions to jumpstart the nation’s sputtering economy. A second round of cash payments may well be part of this economic stimulus package, they say.

“We could very well do a second round,” said President Donald Trump at a White House news conference held over a week ago. “It is absolutely under serious consideration,” he said.

Last week’s commentary publicized Max Richtman, president and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, call to Congress to protect seniors in a fourth stimulus package (go to https://herbweiss.blog/2020/04/12/congress-must-protect-seniors-in-phase-four-stimulus-package/).

The continuing political battle over crafting the fourth stimulus bill has been put on hold for now with Democratic and WRepublican congressional leaders extending recess. After conferring with public health experts, the House and Senate will not come back into session until, Monday, May 4th.

Calling on Congress to Protect Seniors During the COVID-19 Pandemic

In an April 8 letter, the Washington, DC-based Leadership Council on Aging Organizations (LCAO), representing 69 national nonprofit organizations, urged Congressional lawmakers to ensure that a fourth stimulus package will protect the health and wellbeing of seniors and their families. LCAO’s 19-page communication provides over 50 recommendations (in the areas of housing services, income security and health and community resources) that are key to helping and providing the needed support to assist seniors cope with the raging COVID-19 pandemic.

Specially, LCAO calls on Congress to put funding for affordable housing in a fourth stimulus bill, by funding $ 1.4 billion for federally assisted housing supports to make up for vacancies along with decreased rents from HUD-and USDA-assisted older adult residents, and for emergency housing assistance. Investing $1 billion for new Section 202 Homes would result in short-and long-term jobs as well as 3,800 affordable homes becoming available with service coordinators, says LCAO. Congress was also requested to allocate $450 million in emergency assistance for HUD-assisted senior housing communities, too.

LCAO opposes any attempts to weaken the nation’s Social Security and Medicare programs. The aging group strongly resists any efforts to include a provision in the stimulus bill that would eliminate the payroll contributions to these programs and pushes for the expansion of Social Security and Supplemental (SSI) benefits to enhance the income security of America’s retirees.

Over 10 million workers and retirees have earned benefits under multiemployer pension plans, says LCAO, urging Congress in their letter to allocate sufficient funds to protect the “hard-earned benefits” of these retirees.

With a growing number of the nation’s seniors relying on the support of caregivers, LCAO calls for support of older adult caregivers and children through the expansion of the refundable tax credit for “other dependents.”

Within the next five years, 25 percent of the workforce will be age 55 and over, says LCAO, noting that it becomes crucial to provide adequate funding to the Senior Community Service Employee Program for workforce training.

It’s important to protect seniors from confusing and unfair billing hospitals and payment scams. This can be accomplished by establishing standards for billing that will help seniors manage the aftermath of health care costs due to the pandemic.

Each year, Medicare loses $60 billion to fraud and abuse. LCAO also requests $20 million for the Senior Medicare Patrol to educate Medicare beneficiaries on combating fraud and abuse scams.

LCAO’s letter also asked Congress for adequate funding of mass testing for COVID-19, data collection and accelerate Medicare enrollment to provide seniors and people with disabilities with access to needed medical treatment, two populations with the highest risk for being afflicted by the devastating virus. Congress must also ensure access and affordability to prescription drugs, says the Washington, DC-based aging advocacy group.

LCAO urged Congress to give states sufficient Medicaid funding to keep hundreds of thousands of Medicaid recipients from losing health coverage, which would increase the risk of these individuals spreading the COVID-19 virus.

The need to social distancing may force day care centers to close. LCAO says that a fourth stimulus bill package might add language within the Medicare and Medicaid Home and Community Based Service funding to authorize states to apply retainer payments to adult day care centers for the purpose of providing services to seniors outside the physical center.

LCAO also made a recommendation to prevent the unnecessary transfers of seniors to hospitals and nursing homes and support those recovering from COVID-19 by increasing beneficiary access to home health care by eliminating Medicare’s requirement that they be home bound to quality for this benefit.

LCAO’s letter supported the expanded access to hospice care by allowing physician assistants to certify need and to create a federal fund to identify and set up alternative care sites to nursing homes that meet the same minimum federal standards of care.

LCAO pushed for an additional $50 million to fund the Medicare State Health Insurance Program, a program providing unbiased, free and personalized information to assist seniors to chooses Medicare products, to help seniors understand their specific health care coverage needs under this COVID emergency.

The fourth stimulus bill, says LCAO, must also include funding to ensure providers in health care facilities and at community-based programs, be given personal protective equipment. These providers should be provided free child care and sick leaved during this crisis, too.

Considered “a frontline resource in the battling the pandemic,” LCAO calls for the adequate funding to Geriatric Workforce Enhancement Program, administered by the Health Resources Administration.

LCAO, noting the importance of federal programs that assist seniors to stay at home (including the Older Americans Act that directly serve seniors and caregivers, and the Supplemental Nutrition Assistance Program, the largest federal nutrition program), asks Congress to increase funding, benefits and streamline the application process to these programs to address healthcare and food needs during this pandemic.

With the COVID-19 virus spreading throughout the nation’s nursing homes and assisted living facilities, LCAO calls for more funding to the nation’s long-term care ombudsman program for remote online training and education of nursing facility staff and volunteers, and to the National Ombudsman Resource Center for training materials.

With elder abuse and neglect cases in the community reaching 63,000 in 2018 and an expected surge in incidences due to the pandemic, LCAO calls for funding of $ 120 million for the nation’s state and local Adult Protective Services programs in the next stimulus bill. Also, allocating $4.1 billion for the Social Service Block Grant Program can provide critical services to vulnerable seniors through adult protective services, adult day care and in-home support services, congregate and home delivered meals, case management programs.

Finally, in a fourth economic response package, LCAO calls on lawmakers to include $15 million for the Retired Senior Volunteer Program and $10 million for the Senior Companion program to provide volunteer opportunities for seniors in their communities during the pandemic crisis. Congress might also consider “easing or suspending the current age requirements for participation,” to allow younger seniors to participate.

Remember Your Older Constituents

With the Trump Administration and GOP lawmakers pushing to put billions of dollars into the fourth stimulus bill to support the nation’s large corporations and small businesses, during the COVID-19 pandemic, it is important for Congress to not forget the needs of the nation’s seniors. If you run into your Congressman or Senator, make sure you urge them to seriously consider the needs of their older constituents.

To get a copy of LCAO’s letter to Congress, go to https://www.lcao.org/files/2020/04/LCAO-April-2020-Letter-for-COVID-19-Package-4-FINAL.docx.pdf .

Senators Seek to Identify Subpar Nursing Homes

Published in the Woonsocket Call on July 14, 2019

Last month, U.S. Senators Bob Casey (D-PA) and Pat Toomey (R-PA) succeeded in prodding the Centers for Medicare and Medicaid Services (CMS) to publicly release the April listing of underperforming nursing homes across the nation that require closer regulatory scrutiny but are not receiving any. Before CMS released the listing of candidates to the Special Focus Facility (SFF) program, the federal agency, charged with overseeing the care and quality in nursing homes, had not publicly identified these troubled facilities.

Less than 6 percent (88 facilities) out of more than 15,700 nursing homes nationwide are participants of the SFF program. CMS publicly identifies these facilities to the public. But an additional 2.5 percent (or approximately 400 facilities) qualify as candidates for the program because of having a “persistent record of poor care” but are not selected because of limited resources at CMS, according to a 26-page report, “Families’ and Resident’s Right to Know: Uncovering poor care in America’s Nursing Homes,” released in June 2019 by Pennsylvania’s two U. S. senators.

Nursing homes that are part of the SFF program have 12 to 18 months to correct any deficiencies and have two clean CMS surveys. If a facility fails to meet that target, it is are subject to increased regulatory enforcement, including being dropped from the Medicare and Medicaid programs.

Calls for Transparency

On March 4, 2019, Casey and Toomey wrote to CMS requesting information on its oversight of nursing homes in the SFF program. In that letter, the Senators requested the federal agency to provide the names of the 400 SFF candidates, calling for details about programs operations, scope and overall effectiveness. On May 3, 2019, CMS provided a written response and two weeks later, on May 14, the Senators received the listing of SFF candidates for April 2019. The names of these SFF candidates were not made public until Cassy and Toomey forced the issue by releasing this information in their report on June 5.

In CMS administrator Seema Verna’s May 14 letter to the two senators, Rhode Island-based participants and candidates in the SFF program were identified. They are: Charlesgate Nursing Center (SFF Candidate); Hebert Nursing Home (SFF Candidate); Oak Hill & Rehabilitation Center (SFF); St. Elizabeth Manor East Bay (SFF Candidate); and Tockwotton on the Waterfront (SFF Candidate).

In responding to the senators, Verma said that regardless of whether a nursing home is part of the SFF program, “any facility that performs poorly on surveys and continues to jeopardize residents’ health and safety will be subject to CMS enforcement,” which includes civil money penalties, denial of payment for new admissions or termination from the Medicare and Medicaid programs. Verma also stressed that in addition to her agency’s regulatory oversight, its Nursing Home Compare website has been improved to include “new, more reliable sources for obtaining staffing and resident census data, as well as including more claims-based quality measures.”

“Regardless of participation in the SFF program, any facility that performs poorly on surveys and continues to jeopardize residents’ health and safety will be subject to CMS enforcement remedies, such as civil money penalties, denial of payment f-or new admissions, or termination,” adds Verma.

Casey and Toomey believe that the list of SFF candidates is information that must be publicly available to individuals and families seeking nursing care for their loved ones. For that reason, the Senators have released the April 2019 list of SFF candidates and are continuing to work with CMS to make future lists public.

Through the release of the SFF candidate list and the Senate report, which details preliminary findings from surveys and public information about these candidate facilities, the Senators aim to provide Americans and their families with the transparency and information needed to choose a nursing home that would provide quality care to a loved one.

CMS Inquiry Identifies Issues

Casey and Toomey’s CMS inquiry into the SFF program put the spotlight on several issues. It became apparent to the two senators that a nursing home’s participation in the SFF program was not easily understandable to the public or would-be residents and their families. It became clear that CMS’s Nursing Home Compare, the agency’s online website, was not consistently updated to reflect any changes in the SFF program. “For example, in March 2019, the small icon used to indicate that a facility is an SFF participant was not on the webpage of five of the 17 newly-added SFF participants,” noted the Senate report. Most important, CMS’ website did not identify SFF candidates.

According to the released Senate report, only CMS and the state regulatory agency in which the nursing home is located and the facility itself, had knowledge of who is an SFF candidate. While CMS requires every nursing home to notify residents and its community of its regulatory SFF participant designation, these requirements do not apply to SFF candidates.

Aside from CMS recently updating its Nursing Home Compare webpage to more clearly indicate which nursing homes are SFF participants, it lacks details about the SFF program. There is no information explaining the reason for a facility’s participation in the program, the length of time it has been in the program or whether it has fixed the care issue. Most important, CMS does not include information on facilities that routinely cycle in and out of the SFF program, says the Senate report.

“There are few decisions more serious or life-altering than that of choosing a nursing home. I am pleased that CMS has taken the work that I have done with Senator Toomey seriously and is heeding our call to release the list of nursing facilities that are nominated to the Special Focus Facility program,” said Casey. “Our bipartisan work will ensure that families have all the information at their fingertips when choosing a nursing home. Now we must work in a bipartisan fashion to ensure the SFF program is working properly and that CMS has the funding it needs to improve underperforming nursing homes nationwide,” he says.

Adds, Toomey, “Ensuring that families have all the information they need about a nursing home will improve the quality of care at facilities across the country.”

Rhode Islanders Will Benefit for Long-Term Care Improvements

Published in Pawtucket times on April 5, 2004

An AARP membership application just arrived last week, inviting me to join the nation’s largest senior advocacy group.

AARP’s invitation to join clearly announces my major milestone in my life, when my June birthday officially pushes me into my 50s.

Celebrating my 50th birthday is no problem for me on a personal level, especially with my philosophy that, as with wine, one gets better with age.

But, as a writer on health care and aging issues, I see problems as to how I might access needed home and community-based services or nursing hoe care in my later years, especially if the state does not fix its problematic long-term care deliverly system.

The graying of Rhode Island’s population is taxing the state’s existing long-term care delivery system and will continue to do so for years to come. In response, state policymakers have taken a Band-Aid approach in trying to fix the fragmented system.

Already the Ocean State’s senior population, ages 60 and over, comprises more than 18 percent of the state’s total population. Gov. Don Carcieri and state lawmakers should be very concerned that Rhode Island’s population continues to age at the same time its long-term care delivery system needs an immediate overhaul.

Everyone knows it is extremely difficult for caregivers and seniors to negative the Ocean State’s long-term care system. Just ask any aging baby boomer (persons born between 1946 and 1964), and many will say that it is extremely difficult to find the needed programs and services to k eep mom and dad at home.

Today, many adult children who are juggling careers and raising children are also shouldering additional caregiving responsibilities to their olde parents. Even if their parents have been able to put a little money aside for their retirement, their children see their inheritance quickly being whittled down by thousands of dollars a month, all spent on costly pharmaceuticals and long-term care services.

Money can buy you anything in life, including home and community-based care and nursing home services.  Staying independent at home is still difficult for may moderate-income Ocean State seniors who cannot pay or find providers , especially with the Department of Elderly Affair’s (DEA) co-pay program not being fully-funded.

DEA’s co-pay program aids more that 1,500 frail seniors who do not qualify for the state’s Medicaid program, but who require ongoing services to remain in their homes. This funding helps pay for certified nursing assistants, who assist seniors with bathing, meals, shopping, laundry and light house keeping. DEA’s co-pay program slso provides subsidies for adult day care.

Last October, DEA’s freeze on new admissions to its co-pay program left more than 200 frail seniors on a waiting list for home and community based services.

While Gov. Carcieri recently gave an additional $ 200,000 in funding to DEA’s co-pay program in his 2005 budget, senior advocates have warned this amount is not enough. It is estimated this additional funding will serve 60 to 80 seniors out of the 200 persons currently on the waiting list.

Meanwhile, DEA has even put a freeze on new admissions to its respite program, which enables caregivers to take a break from the grueling physical and psychological demands of taking care of a frail elderly family resident.  This freeze will continue for the rest of this fiscal year, and nobody is sure how long the freeze for this initiative will last.

Hugh Hall, chair of the R.I. Health Care Association, tells All About Seniors that nursing homes will also be especially hit hard as state funding continues to diminish at the same time as  the cost of services and regulatory requirements increases.

“The state’s budget crisis is causing the governor to not meet a commitment in restructuring an antiquated Medicaid reimbursement system that pays for the care provided to 75 percent of the 10,000 frail residents in nursing homes,” said Hall.

This year, Carcieri, citing budgetary constraints, did not keep his promise to move forward with Part Two of the Medicaid reimbursement restricting, said Hall.

“This will have serious effects on the financial viability and quality of care provided in more than 70 small nursing homes throughout the state,” he said.

The huge budget deficient will continue to force Carcieri’s and state lawmakers hacking of many worthy programs and services previously funded in the state budget.  However, the state’s 2005 budget must adequately fund DEA’s co-pay and respite initiatives that keep frail seniors at home in their communities through the use of less costly home and community-based services.

The state must also keep its promise to adequately fund the state’s nursing homes for providing the needed medical care to those who are too sick to stay at home.

Hopefully, in 15 years, when I reach my next milestone – turning 65 – the state policy makers will have hammered out a much improved long-term care delivery system.

A commitment by Carcieri and state lawmakers to fix today’s fragmented long-term care delivery system will have long-range consequences, ultimately beneiting aging baby boomers, their children, and their children’s children.

Indeed, all future generations in this state will ultimately benefit from sound long-term care policy.