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The National Consumer Voice for Quality Long-Term Care

December 11, 2012

Consumer Voice Issues Memo on Filial Responsibility

Back in September, the case of Health Care & Retirement Corporation of America v. Pittas, (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012) drew the attention of some of our members when the court ruled in favor of Health Care & Retirement Corp on the grounds of filial responsibility. Filial responsibility statutes obligate adult children to pay for their parents’ food, clothing, shelter, and medical needs. After the court issued its decision, we did some researching on what filial responsibility statutes are, who can be held responsible, and if there are any exceptions to the law. We’ve written a memorandum on our findings, which you can read here.

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Facebook First Friday Focuses on the 25th Anniversary of Nursing Home Reform Law

On December 7th the Consumer Voice hosted their annual Facebook First Friday series. The theme for our December Facebook chat was on the 25th anniversary of the Nursing Home Reform Law (NHRL). We discussed the various provisions of the law, how it has affected lives, and the places we still need to go. There was a lot of great discussion and dialogue throughout the day. Someone commented that the most significant change they have personally experienced since the NHRL was passed was that it brought about the right to be free of unnecessary and inappropriate physical and chemical restraints. This person said “I think it changed the dynamic of seeing nursing homes as warehouses where they could overmedicate residents in order to minimize work while filling beds to collect reimbursement... it brought a demand of individual rights, respect and dignity back to those who had been neglected because it was easier to drug than care.” 

With regard to what people feel the strengths of the NHRL are, one person responded “I think a big one is the right for residents to organize resident groups, and for family members to organize family groups. These groups provide important ways for folks to come together, (there's strength in numbers!) to work to address concerns, recognize things that are going well, and bring about important change and improvements in residents' care and quality of life!” Another commented “We definitely appreciate the formation of the ombudsmen programs in each state. And, I am thankful that many facilities do a good job of bringing us in on issues early in the problem-solving process, and many do in good faith include us in care planning in order to make sure the resident and family knows their rights and feels additional empowerment from having us represent their interests.”

An additional great comment was regarding the passage/implementation of the NHRL in 1987. This person stated “In our own way we ALL were, and continue to be involved in the implementation of OBRA '87. The process may be 25 years old, but if we are to continue the good work of the pioneers who made the law a reality, the process is ongoing.” 

During Facebook First Friday, we also shared this moving video of a Regional Ombudsman Coordinator sharing her personal experiences with the Nursing Home Reform Law. Click here to view.

And don’t forget, we’re continuing to honor the 25th Anniversary of the Nursing Home Reform Law with a virtual anniversary party! Have you registered yet? The celebration will take place Friday, December 14th, from 1:00-2:30pm ET. Click here to register today!

Many Ohio Facilities Skirt Charges in Nursing Home Abuse Cases

A recent article on Vindy.com recounted how in 2011, the Ohio Department of Health cited Ohio nursing homes 198 times for failing to adequately report abuse or neglect, or hiring someone with a history of abusing or neglecting patients. Also, facilities were cited 46 times for failing to keep patients free of “verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion.” Even in cases where the police do get involved, investigations often don’t lead to criminal charges.

Local ombudsman John Saulitis said, “Sometimes you see violations that are so serious that – not just as an ombudsman but as a member of the public – you look at that [and ask], ‘Why didn’t someone pay or have to face consequences for this particular activity?’”

For more information, read the full article.

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National Council on Aging Holds Webinar on Development of the Home and Community Based Services Experience Survey

The National Council on Aging is holding a webinar entitled Development of the Home and Community Based Services Experience Survey. The webinar is part of a series aimed at promoting dialogue and building the capacity of the advocates on quality and reporting measures in Medicaid managed long-term services and supports programs.   It will highlight the development of a new Home and Community Based Services Experience Survey, a survey being designed to align with the Agency for Health Care Research (AHRQ) Consumer Assessment of Healthcare Provides and Systems (CAHPS) project.

Development of the Home and Community Based Services Experience Survey
Tuesday, December 18, 2012
2:00pm EST

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OIG Makes Recommendations to CMS to Reduce Fraud in Medicaid Personal Care Services Programs

HHS released a report in which they made five recommendations to CMS to reduce fraud in Medicaid personal care services programs. The report included six years of OIG investigations and 23 reports.

For more information, read the overview of the report and the full report.

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KCMU Releases Report on Medicaid Home and Community-Based Services Program Data

The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released a report that examines the latest data regarding efforts to expand community-based alternatives to institutional long term care for low-income seniors and people with disabilities within Medicaid. Medicaid Home and Community-Based Service Programs: 2009 Data Update summarizes trends in three main HCBS programs: mandatory home health services state plan benefit, the optional personal care services state plan benefit, and optional 1915(c) HCBS waivers services.

Read the report.

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NHPF Held Panel on Assisted Living Facilities and Their Growing Role in LTSS

On November 30, 2012, The National Health Policy Forum (NHPF) hosted a panel discussion on Assisted Living Facilities and Their Growing Role in Long-Term Services and Supports (LTSS) on November 30, 2012. Speakers were Peter Kemper, PhD, Deputy Assistant Secretary, Office of Disability, Aging, and Long-Term Care Policy, ASPE; Heather Bruemmer, State LTC Ombudsman and Executive Director, Wisconsin Board on Aging and Long-Term Care; Josh Allen, RN, President and CEO, Care and Compliance Group, Inc.; and Mauro Hernandez, PhD, CEO, Concepts in Community Living, Inc. (http://www.nhpf.org/library/details.cfm/2909)

Panelists raised several issues including the place of ALFs in policies to “rebalance” long-term care options; the increasing frailty and health needs of individuals living in these facilities and the need for protections and quality oversight. Lack of training and significant turnover among ALF leadership are sources of concern as to whether ALFs can actually meet the care needs of their residents. There are still few licensed staff onsite, and use of medication aides is widespread. Panelists discussed concerns with Medicaid payment adequacy and stability as a barrier to quality and access. Transitions between care options need to be better managed. Wide variations exist across states in terms of terminology, regulation, size, amenities, and residents served.

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December 15th Marks One Year Anniversary of Proposed Worker Regs

Currently about 1.7 million home care workers are not eligible to receive minimum wage and overtime protections because they are not covered by regulations under the Fair Labor Standards Act (FLSA) which gives workers important wage protections.

 Right now, the Fair Labor Standards Act regulations give minimum wage and overtime protections to domestic service employees - people who work in a private home. However, these protections do not apply to “companionship services” provided to an older adult or person with disabilities who can’t care for themselves. The intent of Congress when it passed the Fair Labor Standards Act was to exclude someone who was providing company to a consumer and watching out for their safety while doing so.   However, the term “companionship” has been applied very broadly to include home health aides and personal care aides/attendants.

 December 15th will mark the one year anniversary since the Department of Labor proposed a rule to extend minimum wage and overtime to home care workers. Unfortunately, these regulations have yet to be finalized.

 While writing our recently released report, Consumer Perspectives on Quality Home Care, we heard over and over again that consumers think home care workers deserve better pay and benefits and that increased compensation would mean better care (less turnover, a more educated/trained workforce, etc.). Because of this, one of our policy recommendations is to enact policies that increase training, wages and benefits for home care workers. In our report we noted “increasing wages for home care workers is an important step toward improving the quality of the job. Consumers themselves believe that improving the quality of the job attracts better people to the work, decreases turnover and makes the workers' lives better by increasing job satisfaction, and improving morale - all which mean better care for individuals.” You can view the entire report here

 On this anniversary of the proposal of the stalled regulations, we again call on the Department of Labor to finalize the regulations.

 To learn more about the proposed regulations, go to the Consumer Voice Website.

Click here to take action supporting minimum wage and overtime protections for home care workers.

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Protect the Elderly from Dangerous Bed Rails

THANK YOU to those individuals and groups who have signed our petition which calls for safety standards for adult bed rails. Haven’t signed yet? Please take the time to do so today by clicking here. We have a goal of 1,000 signatures and we need your help to reach that goal!

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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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