IA- Hospice industry decries Medicare cuts

5-23-2009 Iowa:

The president of a group representing the nation's hospice care industry says one of Iowa's two senators is supporting a bid to rescind a rule that cuts federal payments to hospices.

Don Schumacher, president of the National Hospice and Palliative Care Organization, says last year the Bush Administration enacted a rule which cut payments to hospices for treatment of elderly patients who're on Medicare.

"We're trying to make consumers aware all around the country that hospice care, which is one of the most successful choices for care at the end of life, is experiencing some potential difficulty in that as the Bush Administration left office last year they instituted a regulation that's cutting hospice reimbursement by $2.2 billion," Schmacher says.

Specifically, Medicaid payments for hospice care were cut by just over four-and-a-half percent.

"We did an economic survey of our members over the last couple of months and it shows that even without this rate cut the economic picture right now has hospice programs struggling 'cause of the tremendous costs and the reimbursement really, essentially being on the low end as it is," Schmacher says, "and this is an additional cut to us which will cost us dramatically."

Congress reversed the reduction in Medicaid payment rates for hospice care for this year, but Schmacher's group is now lobbying congress to keep hospice care rates the same for the next two years. Iowa Senator Tom Harkin has signed onto a letter, urging the Obama Administration to make the move. Hospice groups are asking Iowa's other senator, Chuck Grassley, to join the effort to keep hospice care payments for Medicare patients the same for the next two years.

"It's quite a bit of change for programs to lose," Schmacher says.

According to Schmacher, it makes economic sense for Medicare patients to choose hospice care.

"A study came out of Duke University two years ago and it shows that for every patient admitted to hospice, we save the Medicare system about $2200 to $2500 when compared with patients of similar disease and life trajectory," Schmacher says. "...Everybody who goes through hospice, for the most part, feels as though they received the opportunity to say good-bye in the most appropriate way possible."

The Hospice and Palliative Care Association of Iowa represents 74 hospice agencies providing end-of-life care at 103 different facilities in Iowa. Schumacher leads the national group which represents about 80 percent of the hospices in the United States. ..Source.. by O.Kay Henderson

MI- Editorial: Protect patients at care facilities

5-8-2009 Michigan:


Congress should pass legislation to prevent criminals from securing jobs in long-term care fields. Those looking to abuse and steal from senior citizens should have to work harder at it than just filling out a job application at a nursing home. The bill would require a comprehensive nationwide program for background checks before a job could be given to anyone seeking elder-care employment. There is an unprecedented demand for long-term care housing because Americans are living longer. That has created more need for caregivers. More protection is needed to safeguard vulnerable residents from those who could do them harm.

While most states like Michigan require background checks for employees of long-term care facilities, there is no national or coordinated database that provides a thorough review of an applicant's criminal history. Too often predators, who frequently change states and jobs, have been able to evade detection because state-based background check systems, overall, are incomplete and inconsistent.

The bill introduced in Congress (HR 2223) by Rep. Joseph Sestak, D-PA and co-sponsored by Rep. Vernon Ehlers, R-Grand Rapids and Rep. Fred Upton, R-St. Joseph, calls for states to establish a cross-referencing system for national and state background checks of prospective employees. The checks would be applied to those people with direct access to patients in the long-term care facilities. Federal matching funds would be provided to help states pay for the system.

State information would be coordinated and applicants screened against the Federal Bureau of Investigation's criminal history database.

This legislation seeks to expand on a seven-state background check pilot program that included Michigan, operated between 2005 and 2007. Checks were done either statewide or for a few counties. As a result of that pilot, administered by the Centers for Medicare & Medicaid Services, more than 7,200 people with criminal histories of violence or abuse were prevented from working as caregivers.

Mr. Ehlers said the pilot has proved successful in Michigan, and he is dead-on about a national background system providing "safety and peace-of-mind to people staying in these facilities, and their families." There needs to be some faith that those entrusted to care for a person or his loved one is not going to kill, beat, rape or rob that person. This bill would be a big step in achieving that confidence. Kent County has 25 licensed long-term care facilities (2,560 beds) and Ottawa County has 14 facilities (908 beds).

There is a strong case for this measure. Besides the pilot program, a 2006 Health and Human Services (HHS) study points out several challenges of individual state registries. In addition, a 2004 national survey of State Adult Protective Services agencies identified more than 500,000 reports of elder abuse, including physical, sexual and financial exploitation.

In 2005, Michigan Attorney General Mike Cox reported that 25 percent of residential care facility employees committing crimes against residents since 2002 had past criminal convictions. His statewide investigation revealed criminal histories that included homicides, armed robberies and criminal sexual conduct. This led to a law that took effect in April 2006, making it a crime not to conduct a criminal background check. The law mandates fingerprint checks and expands the number of crimes that can disqualify a job applicant, including drug and theft offenses. These are important safeguards, but the FBI screening and enhanced state-to-state information from a national database would bolster protections in the state.

America's baby boomers are beginning to turn 65. People who reach that age have a 40 percent chance of entering a nursing home, according to HHS. Those who do will stay there five years or more. According to the Census Bureau, 10.3 percent of Kent County's population was 65 or older in 2007, 10.7 percent of Ottawa County's and 12.7 percent statewide.

The bottom line is that the current background check system is not thorough enough, and allows criminals to slip through. Congress knows that. Now lawmakers need to do something about it so the elderly and disabled are not easy prey for shady characters. ..Source.. Opinion of Grand Rapids Press Editorial Board

OH- Proposed law would ensure nursing homes be informed when a sex offender moves in

This proposed law makes no sense because it puts the onus on law enforcement to do something (administrative clerical type work) that takes them away from law enforcement work. To take time to personally notify nursing homes when a registered sex offender moves into an address which is classified as a nursing home. Further, LE would have to keep track of every nursing home as well. It would be far easier and more cost justified if nursing homes would check the public registries on some regular basis for their new admissions, or on preadmission. If families of nursing home residents are concerned they can do the checking as well.

4-28-2009 Ohio:

You don't have to wait for a new Ohio law to pass to find out if a sex offender is living in the same nursing home where your mom or dad or other loved one lives.

You can find out right now.

The legislation, House Bill 98, introduced last month by State Rep. Courtney Combs, Republican of Hamilton, would require local sheriff's offices to notify nursing homes -- and other long-term care facilities -- when a sex offender moves in.

The facilities, in turn, would be required to tell patients and whoever looks out for them.

Combs introduced the law because an 18-year-old mentally retarded woman was raped by the man in the next room at a long-term care facility in his district. He doesn't want that to happen again.

The way the existing law is written, schools, day-care centers and homes -- but not long-term care facilities -- that are within 1,000 feet of where an offender lives are notified.

That means a sex offender could be sharing a room with Grandma or Grandpa and you'd never know it.

So how can you find out now? All you need is the address of the nursing home and a computer.

Go online to the Ohio attorney general's website and you can search for sex offenders. Type in the address of the nursing home. You'll get the name, photograph and address of each registered sex offender who lives within -- and you can choose this -- a quarter-mile, a half-mile, one or two miles.

Click on the offender's name, and you'll get a little more information on his or her crime.

The problem with the system, says John Saulitis, is that you have to keep checking back. A sex offender may not live in your mother's nursing home today, but he could move in next week. And that, Saulitis says, puts an unrealistic burden on nursing home residents and their families.

Saulitis runs the Youngstown office of Ohio's Long-Term Care Ombudsman Programs, part of a state and national system of people who look out for the rights and safety of those living in group homes, nursing homes and assisted-living centers, as well as those who receive in-home care.

He's also the guy who spent weeks combing through the registry to find out how many sex offenders live in Ohio's nursing homes.

It's a changing number. But when he finished his research on March 23, he'd discovered 107 offenders living in 47 nursing homes across the state.

Keeping tabs on them is a time-consuming process. That's one reason Saulitis wants to see the law changed.

He knows you can go to the attorney general's Web site listed above and sign up for an automatic e-mail alert whenever a sex offender moves close to any address -- including a nursing home's -- that you type into the site. The problem, he says, is that you get an alert whenever an offender moves into the surrounding area, not just the nursing home.

"The more notifications you get," Saulitis says, "the less you're going to pay attention to them."

And when you stop paying attention, what good is the notification?

That's another reason he's pushing for passage of House Bill 98 and urging all of us who have a loved one in long-term care to call our lawmakers.

"Contact your legislators," he says, "and say 'Look, there's a simple solution to this. It's called House Bill 98. We want to you support it.'

"It simplifies the system incredibly for the families and relatives," Saulitis says. "It's just much more efficient."

If you want a more complete picture about the safety and quality of a nursing home, make sure you go to the Department of Aging's Long-Term Care Consumer Guide.

Follow the instructions and the site will tell you how people who live in nursing homes feel about each facility. You can see, for example, what percentage of patients actually said they liked the home and what percentage would recommend it to someone else.

Not only will you get that from the patient's perspective, you'll get it from the family's, too.

You'll also find more specific survey results about things like clothing getting lost, residents being treated with respect, and how satisfied people are with the food and medical care.

What's more revealing, though, are the inspection reports you'll find when you click on the "Inspections" tab. That will lead you to a description of what Medicare/Medicaid inspectors found when they stopped by the facility -- unannounced and sometimes at night or on weekends -- to visit.

From those reports you can learn, for example, if a nursing home was cited for not providing a safe, clean environment; for medication errors that caused harm; for allowing pressure sores to develop; or for failing to notify family members when a resident was injured.

The information is even more helpful, says Beverley Laubert, the state long-term care ombudsman who oversees Ohio's 12 offices, when you click on the date under "Most Recent Annual Survey" and see the details of what officials call the "deficiencies."

What the Web site doesn't provide, though, is what action the nursing home took to solve the problem.

Each home is required to have that on hand, in an easy-to-see spot, says Laubert. Look for it at the front desk, nurses station or on a bulletin board.

If it's not there, ask for it, says Laubert. If you're not comfortable doing that, contact the state ombudsman's office at 1-800-282-1206 and someone will put you in touch with the office closest to you.

But don't stop there.

Spend some time at the nursing home and check it out for yourself.

"Nothing beats going there and visiting," says Kathy Keller, spokeswoman for AARP Ohio.

"You need to see it, you need to get the feel for the institution, you need to be able to walk around and see what is going on, you need to smell it, you need to see if the residents there seem to be happy or if they're not very happy."

That's the only way you'll know for sure if it works for you and your loved one. ..Source.. by Diane Suchetka/Plain Dealer Reporter

WA- Bill targeting those who exploit vulnerable adults approved

4-21-2009 Washington:

Legislation may soon go to governor for her signature

A bill that would prevent those who exploit elderly or otherwise vulnerable persons from inheriting money or property from their victims has passed both the House and Senate and may soon be on its way to the governor's desk.

House Bill 1103, sponsored by Rep. Jim Moeller, is the latest in a series of bills the Vancouver Democrat has sponsored in recent years to protect vulnerable adults from exploitation. Moeller has worked closely with the Clark County Vulnerable Adults Task Force to develop the legislation.

"As we age, we become more dependent upon people close to us for taking care of our basic necessities," Moeller said in a statement. "Yet some of the people closest to us, sometimes even our own children, take advantage of the situation."

Nothing in existing state law prevents a person who is found guilty of committing financial exploitation from inheriting property from the victim if the perpetrator is named in the victim's will.

Vancouver attorney Jessica Dimitrov said the new law will have significant impacts.

She is a partner in Dimitrov & Senescu, a law firm that represents exploited and vulnerable adults and works to change state law.

"We are seeing an increase in financial exploitation of vulnerable adults, and given the current economic situation, we can expect it to get much worse before it ever stops happening," she said in an e-mail. "But this law seeks to serve as a very severe and tough deterrent to this type of activity."

Moeller said he expects the House to concur with an amendment to the bill added by the Senate and then send the bill to the governor for her signature. ..Source.. by KATHIE DURBIN, COLUMBIAN STAFF WRITER

IN-Indiana bill would allow alerts for missing seniors

4-20-2009 Indiana:

INDIANAPOLIS (AP) — Indiana residents could soon get public warnings similar to Amber Alerts when seniors with Alzheimer's disease or other endangered adults go missing.

A bill that won final legislative approval Monday would create silver alerts, which would be issued by police and broadcast by media outlets.

Bill supporters say the proposal could protect thousands of Indiana residents with Alzheimer's disease or other cognitive problems. But some were concerned that the system would result in so many alerts that the public would tune them out.


At least 10 states have notification systems for people with some form of mental impairments.

The bill now goes to Gov. Mitch Daniels for his consideration. ..Source.. by SOuth Bend Tribune