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The National Consumer Voice for Quality Long-Term Care

February 5, 2013

Consumer Voice Requests Update on CMS' Review of the Nursing Home Requirements of Participation

On January 25th, 2013, the Consumer Voice wrote to Dr. Patrick Conway, the Director of the Office of Clinical Standards and Quality (OCSQ) at the Centers for Medicare and Medicaid Services (CMS), requesting an update on the Office’s review of the nursing home requirements of participation. These requirements were promulgated to implement the landmark Nursing Home Reform Law of 1987 and are regulations that long-term care facilities must meet in order to begin or continue participating in the Medicare and Medicaid programs. Last year, OCSQ announced that it was conducting a review of these regulations. At the request of this Office, the Consumer Voice submitted recommendations on ways that these regulations could be strengthened and improved. Since submitting these recommendations in July of 2012, the Consumer Voice has received no information about the status of CMS’s review. 

 In addition to asking for an update on the requirements of participation, the Consumer Voice asked where OCSQ was in developing regulations to implement the nursing home provisions under the Affordable Care Act (ACA). In a response on January 28, 2013, Dr. Conway stated. “We have continued to work on both the ACA provisions and updating nursing home requirements of participation.” He also indicated that his office would draft a more formal response to the Consumer Voice to provide more detail about the status of this work. We will update our network when this additional response from CMS is received. To read the Consumer Voice letter, click here.

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Alice Bonner Steps Down as Director of the Division of Nursing Homes at CMS

The Consumer Voice is sad to learn that Alice Bonner will be stepping down from her position as Director of the Division of Nursing Homes at the Centers for Medicare and Medicaid Services (CMS).    Alice has shown an extraordinary dedication, commitment and passion for improving the lives of nursing homes residents across the country and has accomplished a great deal over the past two years. She produced a number of surveyor training programs, worked to develop new guidance in a number of important clinical areas, established a new triage team to research and analyze questions from around the country and implemented various sections of the Affordable Care Act. Alice has also provided great leadership with the National Partnership to Improve Dementia Care – CMS’s initiative to reduce the use of antipsychotic medication in nursing homes and improve the care of residents with dementia. In his announcement about Alice’s departure, Thomas Hamilton, Director of the Survey and Certification group at CMS, wrote, “One of Alice’s great aptitudes is really an attitude - an attitude of partnership, and she has capably engaged with consumer groups, advocacy organizations, nursing homes, and many others to move the quality agenda forward.” Alice has always been eager and willing to listen, and she consistently sought and valued the views and ideas of advocates and consumers.

 Alice will continue in her role as director for the next few months. We at the Consumer Voice wish her the best in this next phase of her life and know whatever Alice chooses to do; she will continue to make a difference in the lives of nursing home residents.

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NSCLC Executive Director Paul Nathanson Retires; Search Begins to Fill Position

Paul Nathanson, Executive Director of the National Senior Citizens Law Center (NSCLC), has announced his retirement. He served NSCLC in various capacities – twice as Executive Director and also as a board member – for forty years.

Read Paul’s retirement letter.

NSCLC is now conducting a search for a new Executive Director. They seek a person with “a sophisticated level of fundraising and management skills” who can “demonstrate a collegial leadership style, a passion for justice, and the ability to garner resources effectively, think creatively and plan strategically.”

To find out more about the position and how to apply, visit NSCLC’s website.

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AoA Provides Materials for the Year of Elder Abuse Prevention

The Administration on Aging is sponsoring the Year of Elder Abuse Prevention to encourage organizations to protect seniors and raise awareness about elder abuse, neglect and exploitation. AoA has provided information, tools and resources to raise public awareness about elder abuse and shed light on the importance of preventing, identifying and responding to this serious problem.

Visit AoA’s website for toolkits, outreach guides, fact sheets, logos, and more.

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Interactive Course on Assessing the Capacity of Older Adults

The Rush University Medical Center and the ABA Commission on Law and Aging are holding an interactive educational curriculum on assessing the capacity of older adults. The course is aimed at physicians, but it will be useful for other health care clinicians and students as well. The curriculum will feature six modules including the importance of evaluating patients’ capacities; key principles and practices; the evaluation process and content and more.

The course will be open starting March 18th. For more information, visit Rush University Medical Center’s website.

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MI Ombudsman Program Releases Document About Decision-Making in Nursing Homes

Michigan State Long-Term Care Ombudsman Program developed a document that strives to clarify the law in the area of informed consent, advanced directives and guardianship. The purpose of the document is to offer Michigan nursing homes a comprehensive, understandable presentation of the law of surrogate decision-making in health care.

Read the document on NORC's website.

New Resources Available from NORC

New resources are available from NORC. The PowerPoint slides, recording, scenarios and discussion questions from the Working with Families: Tips for Effective Communication and Strategies for Challenging Situations webinar (held Wednesday, January 30th) are available on our website. The skills training paper that was used to develop the content of this webinar is under final review and we will let you know when it is available.

Access the materials.

Also, check out these new and updated resources on the NORC website:

NEW! Licensing and Certification Issue Page
Each state has an Office of Licensure and Certification that works to ensure that the quality of healthcare delivered by providers is safe, cost effective and compliant with all state and federal laws. Nursing homes must be licensed to operate according to their state’s licensure requirements. Get resources and information related to the licensing and certification of long-term care facilities.

UPDATED Flu and Other Health Issues
With the 2012-13 flu season underway, ombudsmen, residents and their families can stay up to date with the latest health recommendations for long-term care facilities through published items on this site.

UPDATED Older Americans Act Reauthorization
This page contains resources and information on the
reauthorization of the Older Americans Act.

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Nursing Home Operators Turn to the FHA

A recent article in the Wall Street Journal provided insight on how the Federal Housing Administration has come to the rescue of nursing home operators who are having a difficult time getting traditional financing for mortgage loans. Big banks are becoming more tentative about making loans to nursing homes because of the uncertain health-care environment. Lenders are concerned that nursing-home companies may have a problem repaying the loans in the future if they are struck with cutbacks by state governments or the federal Medicare program. To get by, nursing-home operators are trying to get FHA-secured loans, mostly to refinance existing mortgages. But that is increasing the chance that taxpayers may be on the hook if the nursing homes fail to pay these loans at a much higher rate.

For more information, read the article in the Wall Street Journal.

Pioneer Network Holding Webinars on Teams of Practitioners Achieving Better Outcomes

As a part of Webinar Series Five of their National Learning Collaborative, the Pioneer Network is holding two webinars – It Takes a Team to Prevent and Heal Pressure Ulcers on March 23th and It Takes a Team to Provide High Quality Individualized Care on May 7th. During the webinar, teams of practitioners will share how they have achieved better outcomes through key systems for relational coordination – consistent assignment, huddles, CNAs involvement in care planning, and Quality Improvement huddles among staff closest to the residents.

For more information and to register, visit the Pioneer Network’s website.

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Institute of Medicine Conducting Project on Transforming End of Life Care

The National Academy of Sciences convened an Institute of Medicine Committee on Transforming End-of-life Care that will undertake an 18 month project to address the current state of care that patients and their families receive at the end of life.

For more information on this project, visit the Institute of Medicine’s website.

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CMS Identifies Healthcare Centers to Be a Part of Bundled Payments for Care Improvement Initiative

The Centers for Medicare & Medicaid Services has identified more than 500 healthcare centers, including many skilled nursing facilities, that will be a part of the Bundled Payments for Care Improvement initiative (BPCI). Created as part of the Affordable Care Act, the BPCI will test four models of bundled payments. The initiative is part of an effort to improve outcomes and reduce costs by coordinating care among hospitals, physicians, nursing homes and other post-acute care providers.

For more information, read the article in McKnight’s.

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 © 2013.

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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