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The National Consumer Voice for Quality Long-Term Care

March 27, 2012

GAO Report Says CMS Should Set Goals & Timelines to Improve 5-Star Ratings

The Government Accountability Office says the Centers for Medicare & Medicaid Services plans to improve the Five-Star Nursing Home Quality Rating System but has taken “only limited steps to determine whether or to what extent the Five-Star System is achieving the primary goal of providing consumers with understandable and useful information on nursing home care.” CMS agreed with the GAO that it should establish milestones for improvements and said it will develop a mechanism to receive regular input from consumers and other stakeholders.

CMS plans to launch a revised Nursing Home Compare website in July. In responding to the GAO, it identified several efforts planned to improve the rating system and Nursing Home Compare:

•             Detailed consumer testing, a survey of long-term care stakeholders, and a web-based pop-up survey.

•             Distinguishing whether facilities specialize in certain types of care (e.g., long-stay or short-stay rehab care).

•             Including other types of staff, such as therapists, in the staffing measure. (CMS said it “would like” to include some non-nursing staff in the measure by next January if feasible.)

•             Identifying additional measures for the quality measure component of the ratings as CMS completes the transition to the new MDS 3.0 reporting system.

CMS told the GAO it will be three to five years before it complies with the Affordable Care Act requirement to collect staffing data from facility payroll records and report the information on Nursing Home Compare.

The study was required by the Affordable Care Act. It contains explanations of how CMS arrives at individual ratings that advocates may find useful.

Nursing Homes: CMS Needs Milestones and Timelines to Ensure Goals for the Five-Star Quality Rating System Are Met. GAO-12-390, March 23.

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House Passes Limit on Lawsuit Damages

H.R. 5, a bill that would limit noneconomic damages and place other restrictions on civil lawsuits, passed the House of Representatives 223-181 on March 22.

“I would like to thank the approximately 200 members of the Consumer Voice network who responded to our request for constituents to e-mail their House members and ask them to vote against H.R. 5,” said Consumer Voice Executive Director Sarah Wells. “Working together with our members, we convinced a number of Representatives that by capping damages for pain and suffering, this bill would deny nursing home residents the ability to sue for neglect and abuse.”

H.R. 5 would also have repealed a Medicare cost-control board established in the Affordable Care Act. Also known as the HEALTH Act, the bill is not expected to pass the Democratic-controlled Senate this year.

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Consumer Voice Submits Comments on Proposed Rule Regarding Home Care Workers

The comment period for the Department of Labor’s proposed rule regarding home care workers ended on March 21, 2012. The rule would change the definition of “companionship” so that home care workers, such as home care aides and personal care attendants, would qualify for minimum wage, overtime and other protections under the Fair Labor Standards Act. The Consumer Voice supported the proposed change and mobilized advocates from around the country to speak out. Over 100 individual comments were submitted through the Consumer Voice network and 56 organizations signed onto the Consumer Voice’s comments.

The proposed rule generated a great deal of controversy. This was evident at a hearing held on March 20 by the U.S. Workforce Protections Subcommittee of the U.S. House of Representatives Education and Workforce Committee. At the hearing, Committee Chair Tim Walberg praised home care workers, while stating that the proposed rule would increase health care costs and negatively impact the home care industry, workers and consumers. Ranking Member Lynn Woolsey responded by noting that the home care industry is “booming” and that the “bottom line” is to “bill twice what the worker receives.” She also pointed out that the services provided by today’s home care workers far exceed the companionship the Fair Labor Standards Act intended to exempt.

The Department of Labor will now review the comments and decide if revisions will be made. A final rule may be released this summer.

Source: Quality Care Through Quality Jobs, March 22, 2012

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NCPEA Requests Updated Listings of Elder Justice Coalitions

The National Committee for the Prevention of Elder Abuse (NCPEA) is updating the National Center on Elder Abuse (NCEA)’s website listing and map of local and state elder justice coalitions and other examples of multi-disciplinary collaboration around elder abuse and protection of vulnerable adults.

If you are aware of a coalition or network focused on elder abuse prevention or intervention operating in your area, please send the contact information to Beth Rosenthal, Executive Director, at brosenthal@preventelderabuse.org by April 15th. NCPEA requests that you use this form to enter contact information.

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Bill Would Limit Awards in Elder Abuse Suits

A bill making its way through the legislature would limit awards of attorney fees in abuse cases involving the elderly and vulnerable adults. House Bill 2560, sponsored by Republican Ted Vogt out of Tucson, removes the ability for the court to order the payment of attorney fees in civil claims related to the care of vulnerable adults.

Read this article for more information.

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NAPSRC Releases Research to Practice Brief on Sexual Abuse in Care Facilities

The National Adult Protective Services Resource Center (NAPSRC) has posted its latest Research to Practice (R2P) brief entitled Sexual Abuse of Vulnerable Adults in Care Facilities. The R2P Series contains single page briefs that link research to daily practice in adult protective services.

Read this brief on NAPSRC’s website.

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AARP Releases Report on Person- and Family- Centered Care

AARP Public Policy Institute has released a report entitled Moving Toward Person- and Family- Centered Care. Person- and family-centered care (PFCC) has gained attention in recent years as a mechanism for transforming health care and long-term services and supports (LTSS). Although research shows that PFCC improves quality of care and quality of life, it has not yet been fully integrated across health care and LTSS as an essential part of all care and support. This report defines PFCC, highlights the importance of the family in a PFCC approach, and describes the key elements of PFCC in practice.

Read the full report on AARP’s website.

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Senate Approves New Approach to Elder Abuse

A bill recently passed by the Missouri state senate aims to make it easier to prosecute people who use undue influence to move money and other assets out of the estates of older people.

Read this article for more information.

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About The Gazette

The Gazette is a weekly e-newsletter, published by the National Consumer Voice for Quality Long-Term Care and the National Long-Term Care Ombudsman Resource Center. If you do not wish to continue receiving this publication, please unsubscribe. Your contributions and comments are welcome and should be sent to swells@theconsumervoice.org. Copyright © 2011.

The Consumer Voice is the leading national voice representing consumers in issues related to long-term care, helping to ensure that consumers are empowered to advocate for themselves. We are a primary source of information and tools for consumers, families, caregivers, advocates and ombudsmen to help ensure quality care for the individual. The Consumer Voice's mission is to represent consumers at the national level for quality long-term care, services and supports.

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