Tag Archives for Senator Bob Casey

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.”

Senators Collins, Casey, Pushing for Reauthorization of Older Americans Act

Published in Woonsocket Call on May 19, 2019

With the Older Americans Act (OAA) scheduled to expire on September 30, 2019, the U.S. Special Senate Committee on Aging puts the spotlight on the importance of this critical law to older American’s, calling for its reauthorization.

Enacted in 1965, the OAA helps more than 11 million seniors age in their communities by funding programs that support grandparents raising grandchildren, reduce social isolation, provide congregate or home-delivered meals and offer respite care among other services.
OAA was last reauthorized in 2016 for a period of three years.

Bipartisan Push in Senate to Reauthorize OAA

While the Senate Aging Committee does not have legislative jurisdiction over OAA, the panel traditionally has put attention on the OAA by holding hearings or special events at the start of any reauthorization process. And the Chair and Ranking Member of the Senate Aging Committee – Senators Susan Collins (R-Maine) and Robert Casey (D-Pa.)—have taken an especially keen interest in this year’s OAA reauthorization process. The Senators are leading a bipartisan coalition of Senators pushing for reauthorization, which includes Senate HELP Committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wa) as well as Senators Mike Enlzi (R-Wyo.) and Bernie Sanders (I-Vt.).

In Collin’s opening statement, she pledged to “get across the finish line, on time, a robust and bipartisan Older Americans Act that will strengthen support for its bread and butter programs, while providing more flexibility for states to meet local needs.”

At the Senate Aging hearing, Collins says she plans to focus on five priority areas in the reauthorization of OOA, specifically family caregivers, nutrition, social isolation, transportation and elder justice. “By enriching the lives of seniors, the Older Americans Act improves the lives of all Americans,” says the Maine Senator, kicking off the two hour and 26-minute hearing, aptly titled, “The Older Americans Act: Protecting and Supporting Seniors as they Age.”

“The Older Americans Act is a shining example of a federal policy that works. Every $1 invested into the Older Americans Act generates $3 to help seniors stay at home through low cost, community-based services,” says Collins.

“The Older Americans Act reminds us who we are as a country. It represents our commitment to the generations who made us who we are today. And, it lifts up the seniors who need our help the most, added Casey in his opening statement.

Before the May 18 hearing, Casey noted that he had reached out to 34 Area Agencies on Aging, representing 60 percent of the counties in his home state, for their feedback about OAA’s effectiveness in delivering services to older Pennsylvanians. He asked these two questions: “How is the OAA currently working?” and “How should this important law be strengthened?”

“In every city and every town, the aging network said that there is no match for the high-quality services that senior centers and Area Agencies on Aging provide to older Pennsylvanians. The OAA programs support Pennsylvanians and their caregivers by providing meals, respite and protection from fraud and abuse. And importantly, the OAA also helps seniors age in the location of their choice, which of course is most often their homes and communities.”

Senate Panel Witnesses Give Thumbs-up to OAA

Larry Gross, the chief executive officer of the Southern Maine Agency on Aging shared with the attending Senators his more than four decades of experience serving seniors in both urban and rural areas. He explained how OAA bolsters nutrition programs, supports family caregivers, reduces social isolation and addresses elder justice. He highlighted a partnership with Maine Medical Center showing that home-delivered meals reduce hospital readmissions, and discussed innovations that he has led to improve senior nutrition and build community.

Faith Lewis, a great-grandparent from Simpson, Pennsylvania, shared her personal experience raising her 5-year-old great-granddaughter and the importance of OAA program support that assist grand families like hers. She receives support through the National Family Caregiver Support Program and regularly attends a support group for grandparents raising grandchildren that is hosted by her local Area Agency on Aging.

Lance Robertson, the Administrator & Assistant Secretary for Aging at the administration for Community Living, gave an overview of OAA, including its history, sustainability, and variability across states and communities. He shared background and data on how OAA has helped millions of seniors to age in their local communities. He also discussed his agency’s mission to connect people to resources, protect rights and prevent abuse, expand employment opportunities, support family caregivers and strengthen aging networks.

Finally, Richard Prudom, the Secretary of Florida’s Department of Elder Affairs, Mr. Prudom talked about his work with his state’s 11 Area Agencies on Aging. He offered a state perspective on interfacing both with the administration for Community Living as well as with the Area Agencies on Aging to develop programs that meet the needs of communities. He focused on priorities in supporting family caregivers, advancing senior nutrition, combating elder abuse and addressing disaster preparedness.

AARP Talks About Impact of OAA Programs

Wendy Fox-Grage, Senior Strategic Policy adviser at the Washington, DC-based AARP, in a Feb 19 blog posting, says that despite “woeful inadequacy of current funding, OAA enables 11 million older Americans to live independently. Recent evaluations confirm the positive impact on the Act’s nutrition and family caregiver program, she says.

As to evaluating the impact of OAA’s nutrition programs, Grage says that forty-two percent of congregate meal participants and 61 percent of home delivered meal participants would skip meals or eat less in the absence of these programs. Congregate meal participants are also less likely to be admitted to nursing homes, and congregate meal participants who live alone are less likely to be admitted to hospital than nonparticipant, she says.

As to caregiving, Grage noted that family caregivers received four hours or more of respite care per week reported a decline in burden over time and those who received at least one education/training, counseling, or support group session experienced an increase in self-reported confidence over time.

AARP joins Senators Collins and Casey’s call on Congress to reauthorize the Older Americans Act before the end of September. OAA’s 11 million beneficiaries, 700,000 caregivers, and providers in the nation’s aging network — consisting of the federal Administration on Aging, State Units on Aging, local Area Agencies on Aging, and local service providers – also wait for Congress to make its move and reauthorize the Act.

Government Shutdown Hurts Seniors, Too

Published in Pawtucket Times on January 21, 2019

At press time, the federal government has been partially shut down for over 29 days because of Democrats and Republicans being at odds over President Trump’s ask for $5.7 billion to be included in continuing spending resolutions for the Oct. 1 start of the new federal fiscal year. Trump calls for billions of dollars to build a border wall along the 234 miles of the nation’s southern border.

The partial shutdown began on Dec. 22 because Congress had not passed legislation, signed by the President, to fund nine federal departments, so these departments do not have funding to operate. The department’s include Agriculture (USDA), Commerce, Justice, Homeland Security, Housing and Urban Development (HUD), Interior, State, Transportation and Treasury.

During the partial government shutdown, Trump has so refused to retreat from his request for funding to build a wall. With strong Democratic opposition the political standoff has made this partial shutdown the longest one of its kind in the nation’s history. There have been 21 shutdowns since 1976.

Local media has widely reported that this shutdown has left 800,000 federal workers furloughed without pay, as well as those working in several federal agencies. But half of these employees are still working, being recalled but without being pay. But Trump has signed legislation this week to pay these employees retroactively once a funding bill is enacted.

What About Aging Programs and Services?

According to AARP’s Senior Writer Dena Bunis in a Jan. 18th web article, “Essential Services Stay in Place Despite Massive Federal Employee Furloughs,” the government shutdown does not impact major domestic programs, like Medicare, Medicaid and Social Security but other programs and services for seniors are affected.
Medicare, Medicaid and Social Security will continue operating and not be disrupted by the shutdown because these programs are funded by an advance appropriations and Social Security [ an earned benefit] is separately funded, says Bunis.

Bunis adds, even with the shutdown aging veterans will still have access to VA hospitals, medical centers and clinics because the Department of Veterans Affairs is funded.

Retirees will find many of the nation’s 400 national parks open but having limited services. Park rangers are furloughed and volunteers are stepping up to help where needed, says Bunis, noting that with employees not reporting for work, bathrooms and other facilities remain unattended with trash piling up and vandalism reports are increasing.

Although flights are not affected and air traffic controllers remain working, Transportation Security Administration’s airport security screeners are calling in sick in large numbers, increasing waiting times, notes Bunis. She says that Federal Aviation Administration has brought back thousands of safety inspectors and engineers to keep the planes in the air flying safely.

Seniors receiving SNAP (formerly called food stamps) from the USDA can expect getting their February benefits, says Bunis, but Meals on Wheels and the Commodity Supplemental Food Program food-box deliveries will be available through March.

Bunis notes that the U.S. Food and Drug Administration has brought back nearly 150 furloughed employees without pay “to resume safety inspections on certain drugs, medical devices and high-risk foods, such as cheese, fruits and vegetables, and infant formula.”

The current government shutdown has closed the Equal Employment Opportunity Commission (EEOC). Those workers age 40 and over who file age discrimination claims may experience difficulties in applying and getting these claims processed, says Bunis.

USDA loans for low- and moderate-income Americans who live in rural areas have stopped because of the shutdown, says Bunis. “The Federal Housing Administration is not issuing the needed paperwork for reverse mortgages to get approved. More than 1,000 contracts between HUD and landlords who provide rental assistance to low-income tenants have expired, and hundreds more will expire in February,” she notes.

Meanwhile, USDA has recalled 2,500 Farm Service Agency employees to temporarily assist agricultural producers with existing farm loan payments to ensure they get the tax documents necessary to file their returns, says Bunis.

It’s tax season…Bunis says that although the Internal Revenue Service is affected by the shutdown because it is part of the Treasury Department, over 46,000 furloughed employees have been called back to work to process income-tax returns and refunds. Filing season officially begins on Jan. 28.

Casey Calls on Trump to Reopen Government

Last week, U.S. Senator Bob Casey (D-PA), Ranking Member of the U.S. Senate Special Committee on Aging, urged Trump to end the partial shutdown charging that the federal government’s closing jeopardizes the transportation, housing, and nutrition needs of older Americans and people with disabilities.

“I am particularly concerned about the adverse impact of the shutdown on seniors, people with disabilities and their families,” stated in Jan 15 correspondence to the President. Food assistance programs administered through the UDSA, rental assistance payments from HUD, transportation services through the Department of Transportation (DOT), and frauds and scams investigations and enforcement by the Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are all negatively impacted during the shutdown, said Casey.

“Elected and appointed officials in Washington have a sacred responsibility of ensuring seniors can age with dignity and people with disabilities can live independently. I request you direct the USDA, HUD, DOT, FTC and FCC to provide additional information to Congress on the steps they will take to mitigate the harmful impact this shutdown will have on seniors and people with disabilities. And, I urge you to reopen the government so that the health and financial security of our aging loved ones are no longer put in jeopardy,” Casey adds.

For a copy of Casey’s correspondence, go to http://www.aging.senate.gov/press-releases/casey-to-trump-the-shutdown-hurts-seniors_.