Last week, Illinois nursing home reform advocates and State Representative Kelly Cassidy (D-Chicago) proposed legislative reforms on the Illinois nursing home industry. House Bill 5668, outlined by State Rep. Cassidy, highlighted nursing home owner responsibility.

“As more residents are aging, nursing homes are a vital part of the care that seniors receive and their families rely on, and it is totally unacceptable that they have responded to our trust with not only incompetence, but life-threatening disregard for basic safety,” said Joan Stanley, a registered nurse assistant who works in a Chicago-area nursing home.

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The Federal Trade Commission said it would dismiss its lawsuit against the long-term care pharmacy giant Omnicare after Omnicare said it was abandoning plans to acquire PharMerica, the second-largest company providing pharmacy services to nursing homes. FTC Chairman Jon Leibowitz said the “deal would have harmed an especially vulnerable group of patients – those in long-term care facilities – as well as taxpayers, who foot much of the bill under Medicare, by raising the price of drugs for Medicare Part D consumers and others." The Consumer Voice had discussed its opposition to the takeover with the FTC.

For more information, read the Federal Trade Commission’s press release.

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Approximately 9 million low-income seniors and individual with disabilities are enrolled in both Medicare and Medicaid (often referred to as “duals”). At least 37 states and the District of Columbia are pursuing efforts to better coordinate care and potentially lower cost for this population, including 15 states which were awarded design contracts. Meaningful stakeholder engagement from aging and disability advocates is essential to the success of duals integration efforts.

Join Friday Morning Collaborative, a coalition of national aging and disability organizations, for a webinar which will highlight the experiences of advocates in two states that are among the first to move forward: Massachusetts and California. Advocates will share insights, strategies and examples of their focused advocacy in such key areas as enrollment and consumer choice, network adequacy, accessibility, care coordination, oversight and monitoring, appeals and grievances, and access to home and community-based services.

State Advocates Experiences and Engagement in Duals Integration
Friday, March 9 2:00pm-3:30pm EST

Space is limited, so please register early and share lines when possible. The webinar will also be recorded and made available for viewing following the event.

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In the 1980s, Swedish nursing homes became models for individualized care in the United States through the work of noted social worker Carter Catlett Williams. Williams’ presentations about Swedish nursing homes were influential in the development of OBRA’s language about homelike environment, resident choice, and freedom from restraints. Unfortunately, however, in recent years Swedish nursing homes, like their American counterparts, began to be sought out by private equity companies looking for profitable investments.

The takeover of Swedish nursing homes caught the attention of investigative journalist Erik Palm, who came to the United States to study the impact of private equity in this country. In the course of his research, he interviewed Consumer Voice policy director Janet Wells and Leadership Council Member Charlene Harrington, a leading reading researcher on nursing home corporations. The interviews took place during the months up to and after the passage of the Nursing Home Transparency and Improvement Act.

Last year, Palm produced a documentary on his research for Swedish television, and since then, privatization of nursing homes has been put on hold in Stockholm, he reports. 

“The nursing home chain Carema, partly owned by KKR, which we investigated, has since then been headlining the national news,” Palm said in an e-mail to the Consumer Voice. “Carema lost the contract for their largest nursing home due to systematic abuse. Several other cases of abuse were revealed afterwards, and they have lost more contracts.

“The inspections of homes, whistleblower protection and an analysis of the private companies vs. public ones will now be investigated by the government,” he added. “Also tax loopholes used by the private equity companies are being investigated by the government, and on the 16th of December, the parliament of Sweden had a hearing about Carema.”

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The U.S. Supreme Court has vacated a decision by the West Virginia Supreme Court that predispute arbitration agreements signed by plaintiffs in nursing home death cases are unenforceable. The decision involved suits against three nursing homes in which family members had signed agreements on behalf of residents that they would arbitrate any case that arose rather than sue the facility. (Two of the nursing homes’ contracts, however, allowed the facilities to sue family members over disputes about payment of residents’ bills.) All three cases involved claims that the nursing homes’ negligence had led to the death of the residents.

The state court had ruled that mandatory arbitration clauses in nursing home admissions contracts could not be enforced under West Virginia law. In an unsigned opinion, the U.S. Supreme Court disagreed that Congress did not intend the Federal Arbitration Act (FAA) to apply to personal injury or wrongful death cases. It reminded the lower court that it ruled last year (AT&T Mobility v. Concepcion) that when there is a conflict between state arbitration law and the FAA, the federal law prevails.

The West Virginia court was ordered to reconsider the cases in light of its ruling. See the court document.

A bill introduced in previous congresses, the Fairness in Nursing Home Arbitration Act, would amend the FAA to prevent enforcement of predispute arbitration clauses in nursing home and other long-term care facility contracts. Another bill, the Arbitration Fairness Act (S. 987, H.R. 1873), would make mandatory predispute arbitration agreements illegal in any consumer or employment contract. Nursing homes and numerous other businesses include mandatory arbitration in consumer contracts because the process usually favors businesses.

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The Consumer Product Safety Commission has notified the Consumer Voice and Consumer Voice Public Service Award recipient Gloria Black that it has “taken seriously” concerns about asphyxiation deaths of the elderly on bed rails. The Consumer Voice honored Black in 2011 for her advocacy to get federal agencies to take action to prevent accidents like the one that caused her mother’s death in a Washington state long-term care facility.

At a meeting last week that approved safety standards for portable children’s bed rails, Commissioner Robert A. Adler said that “a death is a death” and that his agency needs resources to look into data that suggest the elderly face the same hazards as children of being entrapped in bed rails.

Black has compiled reports of more than 500 deaths and serious injuries on bed rails, most involving frail elderly persons and children; recent reports show continued deaths. Last year, Black and the Consumer Voice filed comments on the CPSC’s proposed child bed rail regulations urging the agency to take similar action on adult bed rails.

The CPSC in the past has maintained that the Food and Drug Administration has jurisdiction over bed rails because they are medical devices. However, Black points out that they are sold to the public in retail stores and on the internet as safety devices without warnings about their danger to frail elderly users. The CPSC was aggressive in removing baby cribs from the market that caused several deaths.

In an e-mail to Black and the Consumer Voice, CPSC counsel Jason Levine said “we are hopeful that this issue is one that the Commission will explore in more depth in the near future.”

The children’s bed rail safety regulations were required by the 2008 Consumer Product Safety Improvement Act. For more information, visit this website.

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