Tag Archives for RIHCA

Nursing Assistant Recognized for Providing 31 Years of Quality of Care   

Published in the Pawtucket Times on February 4, 2002

At the age of 32 in 1963, Adele Lubera had already raised a daughter. Now it was time for her to go to work to bring money into the household.

But after holding very brief jobs at two mills in Central Falls, the former homemaker realized the mill jobs were not her cup of tea. As a foot press operator who manufactured sunglasses, Lubera could not stand the loud, repetitive noise and clatter of machines, nor did she end up liking the tediousness of inspecting baby clothes.

Be it fate, destiny or just being in the right place at the right time, Lubera eventually fell into a fulfilling lifelong career that has spanned more than three decades. A tip from a friend led the frustrated mill worker to seek employment as a nursing assistant at the Cumberland-based  Grandview Nursing Home. Lubera was one of the facility’s first hires for nursing assistants.  In time, she would take several other positions, including one at Manchester Nursing Home in Pawtucket, which ultimately would lead her to her current position as a certified nursing assistant at Harris Health Care North in Central Falls.

Last week, more than 300 people from Rhode Island’s nursing home industry, gathered for a breakfast to recognize their own, as well as state officials, politicians, and community volunteers who bring quality of care to the state’s 106 nursing homes.

Along with other award recipients, Lubera received her 15 minutes of fame that day. She was recognized by the Rhode Island Health Care Association (RIHCA) as recipient of the group’s First Annual Quality Award. “The President’s Award,” for her 31 years of providing quality of care to residents in her current position. The RIHCA award is given to a dedicated certified nursing assistant who exhibits caring and compassion while delivering quality of care.

When presenting the prestigious award to Lubera, Jimmy Flanagan, RIHCA’s past president, told the packed banquet room that in 31 years at her current position, Lubera had never called in sick or even arrived late to work.  Quite a track record.

Being an advocate for long-term care, Lubera has always been three to reassure families. She goes the extra mile for resident’s too, Flanagan said.

“Lubera is a wonderful role model for other workers,” he added, noting that she has led by example and displays loyalty, caring, and consideration for her fellow 13 workers.

Later that afternoon, at a party organized by Harris Health Care North, Central Falls Mayor Lee M. Matthews, quickly popped into the facility to shake hands and exchange greetings with: Luber; Michael, her husband of 51 years; daughter Dera DiBenedetto and her three children Dana, Ashley, and Drew; friends; facility staff and residents.

The mayor left behind a mayoral proclamation, celebrating the certified nursing assistant’s achievement by declaring the day to be “Adele Lubera Day” in Central Falls.

At the facility gathering, Lubera, holding her engraved plaque, reflected on her long career as a nursing assistant.

The time just by so fast, she said.

“It is hard work, but I enjoy every day,” she said. “The residents are like family to me.”

Resident Anna Golembeski, 89, who has resided in the facility for 38 years, describes Luera as helpful, kind and caring.

“She has been so good to her residents that it is about time she was recognized for her efforts,” Golembeski said.

Adds Elizabeth Daily, 88, a resident in the facility for six years, “There isn’t a person here who doesn’t love Adele.”

Administrator Elizabeth A. Sarro, of Harris Health Care North, calls Lubera the unofficial Mayor of Central Falls. Lubera knows almost everyone in the one-mile radius community, Sarro says.

“Everyone in Central Falls knows of Adele’s loving work,” she said. “She is pretty close to being a saint.”

Charley Harris, who owns Harris Health Care North and two other skilled nursing facilities, believes that certified nursing assistants are the backbone of the care delivery in any nursing facility.

“It is time that certified nursing assistants are finally getting the recognition they deserve<” he said.

“Nursing facilities are having tremendous problems staffing their facilities, particularly with front-line caregivers,” RIHCA Executive Vice President Alfred Santos stated. “With turnover rates estimated to be as high as 100 percent, people like Adele – whose commitment to her residents remains strong year after year are worth their weight in gold.

“It is great to see her receive recognition for her dedication,” says Santos.

Adequate Medicaid Payments Can Bring High Quality Health Care

Published in the Pawtucket Times on January 21, 2002

Like clockwork each year, Robert Hawkins, the state’s best-known consumer advocate for quality nursing home care and the state’s nursing facility industry, came to Smith Hill, calling on the General Assembly to adequately fund long-term care.

While representing different constituencies, both Hawkins and the nursing home industry were on the same page regarding this policy issue. Both groups strongly urged the Rhode Island General Assembly to adequately fund the state’s Medicaid program. For its Medicaid dollars, the Rhode Island Department of Human Services got: 24-hour nursing care; three meals per day with dietary supplements; other care services like grooming, personal care, bathing and assistance with eating; medical supplies, such as beds and wheelchairs; social services and activities.

Some years were better than others, especially last year. Responding to a serious statewide nursing assistant shortage, Rhode Island lawmakers gave an additional $9 million to pay for nursing facility direct care staff. However, the Rhode Island Health Care Association said that those funds did not cover the spiraling costs of operating a facility.

Liability insurance has doubled, energy costs have risen by approximately 25 percent and Providence-based facilities have been hit with tax increases with some facilities being assessed close to $ 100,000, noted the state’s largest nursing facility trade group.

Now, a recently released national study supports nursing facility and consumer concerns that the Rhode Island Medicaid program has not paid the “real” cost of providing care to Medicaid patients.

According to an independent analysis of the nation’s Medicaid pr.0ogram by the accounting firm of BDO Seidman, the Ocean State’s Medicaid program underfunds its nursing facility industry by more than $25 million annually or about $10.04 per patient day.

According to the national study, most states fail to adequately account for escalating Medicaid costs. They do this by using cost inflators that are not reflective of actual nursing facility cost increases and by using extremely outdated data.

For instance, Rhode Island uses data using 1991 costs in setting rates for most nursing facilities.

“The most disturbing finding of this study is that the state is reimbursing senior’s long-term care for substantially less than the acknowledge cost of that care,” says Alfred Santos, executive vice president of the Rhode Island Health Care Association (RIHCA). “Medicaid pays just slightly more than $4 per hour per patient, less than most people pay a teenage babysitter,” Santos charges.

Adds Hugh Hall, administrator of the Cherry Hill Manor, the cost of care in his facility is higher than most because of the acuity of his residents. Being under paid by Medicaid by $40 dollars per day significantly impacts the operation of his Johnston-based 172-bed skilled nursing facility, Hall says, noting that it forces the facility to look for other sources of payment to compensate for the state’s shortfall.

Hall called for a national commitment to adequately pay for care provided to the elderly and the younger subacute care population coming in nursing facilities.

“In Rhode Island, we’re working to educate the General Assembly so they understand the shortfall of the current Medicaid system, says Hall, specifically noting that the negative impact of not keeping up with annual cost changes affecting nursing facilities and not recognizing more immediately the capital costs required to maintaining a physical plant.

Hawkins, executive director of the Alliance for Better Long-Term Care and the state’s ombudsman brings the Medicaid payment issue down to a personal level: “How would any person like to have their salary level based on 1991 costs?”

“As a society, all of us are responsible for the care being provided to nursing facility residents. IF we don’t provide the best of care, we are partially responsible for that care not being provided,” says Hawkins.

“While we are demanding the highest quality of care to be delivered in Rhode Island facilities, we are not ensuring that the facility is being paid adequately to reach the quality that we are demanding from them,” adds Hawkins.

“While there may be areas where a facility can save money, it should certainly not come from a facility’s budget to ensure appropriate staffing levels or to pay for qualified nursing staff,” notes Hawkins.

“Nursing facilities are between a rock and a hard shell because they cannot recruit staff because of low wages that result from the current Medicaid reimbursement system, and they cannot hire additional staff either,” says Hawkins.

Lt. Governor Charles J. Fogarty, who heads the state’s Long-Term Care Coordinating Council, states that the General Assembly is now working to address the concerns of consumers and providers over the state’s inadequate Medicaid reimbursement policy.

Fogarty stated that he serves on a work group, administered by the state’s Department of Human Services with members from the House and Senate, to review the state’s current reimbursement Principles for Nursing Homes and other components of the long-term care system. The state-level work group has been meeting for several months and came into existence as a result of lawmakers confronting the severe certified nursing assistance shortage in nursing facilities, the Lt. Governor said.

Fogarty states the work group is in the process of considering the hiring of a consultant to ultimately shape the state reimbursement policy on Medicaid.

“This issue will not go away,” he said, noting the state’s growing aging population. “Nursing facility residents are now sicker and require more intensive care than they did 14 or 20 years ago, noted Fogarty.

Jane Haywood, director of the state’s Department of Human Services, says that her agency recognizes there is a myriad of issues relating to nursing facilities and the long-term care continuum the state must address. The legislatively mandated workgroup is expected to develop proposals of reforming the state’s Medicaid system and entire long-term care system by spring, Hayward adds.

When something is broke fix it.

No Rhode Island company can not survive for long with their revenues not covering their operating costs.

Now it is time for the state to follow this longtime sound business principle when it revamps its ailing Medicaid program. With adequate state funding, Rhode Island regulators can rightfully better demand quality from nursing facilities. With more money in their coffers, facilities had better produce that quality of care, too.

The message should be clear to the nursing home industry – it’s now time to get the gang for the buck.