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January 13, 2015

Consumer Voice Submits Comments on CMS Proposed Home Health Conditions of Participation

On January 7, Consumer Voice submitted comments on the Center for Medicare and Medicaid Services’ proposed home health Conditions of Participation (CoPs - the regulations that Medicare-certified home health agencies must comply with in order to receive Medicare funding).  These comments were developed with the help and input of many members of the Consumer Voice Leadership Council and several State Long-Term Care Ombudsmen whose programs include advocacy in the home care setting.  
In our comments, we commended CMS for proposing to hold home health agencies (HHAs) to a higher standard of care by requiring them to attain and maintain a patient’s highest practicable functional capacity.  We also supported new provisions that focus on individualized and person-centered care, such as a patient- centered assessment and care planning process, as well as a more holistic and interdisciplinary approach to care. In addition,  we were pleased that the proposed rules called for greater consumer involvement, participation and engagement and included additional patient rights that better protect patient health and well-being.  
At the same time, Consumer Voice expressed two major concerns.  First, we opposed CMS’s proposal to eliminate “administrative process requirements” unless they are “predictive of either achieving clinically relevant outcomes for patients or preventing harmful outcomes for patients.” Consumer Voice believes that such an approach has resulted in the failure to include numerous patient rights regarding receipt of critical information in writing.  For example, the proposed rule does not require:

  • written notice to patients about payment for services,  services that are covered/not covered by Medicare, Medicaid, and charges for non-covered services;
  • written information to patients about the toll free state home health telephone hotline and the names, addresses, telephone numbers of consumer information, consumer protection and advocacy agencies.  
  • written notice to patients of a proposed transfer/discharge

Consumer advocates have found such information to be essential in protecting residents in the nursing home setting.  This information is even more important in the home care setting where the majority of patients do not have advocates such as the long term care ombudsman to help support their rights. 

Second, CV disagrees with CMS’s view that the current CoPs’ “problem-oriented, external, after the fact (occurrence) approach” must be replaced with the proposed Quality Assessment and Performance Improvement (QAPI) CoP that would require “proactive performance monitoring through an effective, ongoing, agency-wide, data-driven QAPI program.” From our perspective, both approaches are necessary - one to look “after the fact” at problems that have occurred and the other to work to avoid problems.  The two are not mutually exclusive.  While we support home health agencies having an internal quality improvement system, it is our view that CMS is relying too heavily on such a process to ensure quality care and not enough on regulatory oversight.
To read the Consumer Voice comments, click here.

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Consumer Voice Presents Congressional Leadership Award to Representative Henry A. Waxman

Representative Waxman delivering closing remarks at Consumer Voice's 2007 Annual Conference

Before he left office, Consumer Voice presented former Congressman Henry A. Waxman (D-CA) its first Congressional Leadership Award for outstanding Congressional achievements to improve the lives of nursing home residents. Representative Waxman retired at the end of the 113th Congress following forty years of public service in the House of Representatives.
A renowned champion of nursing home reform throughout his years in Congress, Waxman held hearings in 1986 in response to the Institute of Medicine study, “Improving the Quality of Care in Nursing Homes.” These hearings helped pave the way for the major reform of federal nursing home regulations, achieved through the Nursing Home Reform Act, which was introduced by Representative Waxman. In addition, Representative Waxman worked to prevent spousal impoverishment for individuals with spouses in nursing homes reliant on Medicaid coverage; prohibit nursing homes from evicting or transferring residents when they qualify for Medicaid coverage; and to obtain greater Medicare coverage of nursing home stays. He has also fought against efforts to repeal or weaken federal nursing home regulations, led efforts to protect and enhance the oversight and enforcement of nursing homes, and introduced legislation to establish minimum federal staffing standards for nursing homes.
Consumer Voice was honored to work with Representative Waxman and his office over the years on nursing home reform issues. The Congressional Leadership Award expresses our organization's deep admiration and respect for the Congressman's decades of work in Congress to improve the quality of life and quality of care for our nation's nursing home residents.

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Article Examines Utilitizing Online Tools to Increase Volunteer Ombudsman Presence

Greg K. Shelley and Carmen Castro from the Harris County Long-Term Care Ombudsman Program recently published an article entitled "Utilizing online tools to increase volunteer ombudsmen presence in long-term care."  The study examined the impact of internet-based communication on the recruitment and retention of volunteer long-term care ombudsmen. The results showed that the program's shift to internet-based recruitment and communication methods helped increase the number of volunteers by 50% and contributed to a positive shift in role perception and satisfaction. It concluded that the proliferation of internet and social media usage permits greater volunteer management opportunities than previously were available.  Read the entirety of the study here.

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Consumer Voice to Offer FREE Advocacy Skills Training Webinars

As part of our Consumers for Quality Care, No Matter Where initiative, Consumer Voice will be conducting four FREE advocacy skills training webinars throughout the year. We welcome anyone and everyone - long-term care consumers, family members, individual advocates, long-term care ombudsmen, members of consumer advocacy groups, family/caregiving groups, consumer alliances, and community and senior organizations - to register to receive these trainings. It doesn't matter how much or how little advocacy you've done in the past - all are welcome to register!

1. How to Craft an Effective Advocacy Message
February 12, 2015
2. Delivering Your Message in Person: The Nuts and Bolts of Meeting with a Key Decision Maker
April 30, 2015
3. Delivering Your Message: Utilizing Both Traditional Approaches and Social Media
June 30, 2015
4. How to Grow, Support, and Activate Your Network
August 27, 2015
What's next?

Save the dates and stay tuned! We'll be sending out more details about the trainings and how to register in upcoming weeks and as the new year unfolds.

*While the webinars are free, your contribution of $10 or more - or your membership in Consumer Voice - will help support our Public Policy and Advocacy programs. You can join the Consumer Voice here  or make a contribution here.

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Help Fight Efforts to Restrict Long-Term Care Consumers' Access to the Civil Justice System

In Georgia, legislation will soon be re-introduced in the General Assembly that, if enacted, would greatly hinder long-term care consumers’ access to the civil justice system. These two pieces of legislation would strengthen the power of nursing home arbitration agreements often signed during the admissions process, allowing for individuals with no legal authority to make decisions for a resident to enter into these agreements on the resident's behalf, and restrict consumers and their loved ones from using a nursing home's failure to meet federal or state regulations governing quality of care and quality of life to make a legal case of negligence against a nursing home.

Unfortunately, these types of bills that would restrict consumers’ access to the civil justice system are likely to be introduced not only in Georgia but in many other states as well. We ask for members in our network across the country to keep alert of your state legislative proceedings and to be on the lookout for any problematic legislation that may arise that would limit or bar consumers’ access to legal action against facilities, deny consumers their constitutional right to a trial by jury, limit the ability of judges and juries to do their jobs or limit the levels of compensation consumers or their loved ones can receive in legal actions against facilities. To read the full article detailing the soon-to-be introduced legislation in Georgia as well why protecting consumers' access to the civil justice system is important and what you can do to advocate against efforts to limit such access, click here.

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Consumer Voice Board Holds First Meeting of 2015

The Consumer Voice governing board began the New Year with a two-day meeting last weekend.  The Board includes five new directors and is at the maximum size permitted by the organization’s bylaws.  The meeting featured a transfer of the President’s gavel from Bill Lamb to Michael Koenig, who had been President-elect.  Senior assistant dean at the University Of Virginia Darden School Of Business, Koenig grew up surrounded by long-term care concerns as the son of Jackie Koenig, a state ombudsman and former NCCNHR staff member. Michael is dedicated to using his pursuits, abilities and relationships to enable Consumer Voice to optimize its advocacy for long-term care consumers.

Joining Michael as officers are former NCCNHR staff member Gail MacInnes, Secretary, who is government affairs manager at PHI, an organization that focuses on the wellbeing of paid care providers; as Treasurer, retired businessman and family caregiver from Michigan, Paul Van Westrienen; and former North Carolina Health and Human Services official, Bill Lamb, now Immediate Past President.  The officers form CV’s executive committee and will be joined by Tom Fonseca, Chairman of The Fenwick Foundation and CEO of The Aristone Group. Tom is a new member who will chair the Consumer Voice Development Committee.

Other new members include Jonathan Evans, MD, a physician practicing and teaching in long-term care; Iris Gonzalez, JD, a senior litigator for the AARP Foundation; Peter Reed, PhD, director of the Sanford Center for Aging at University of Nevada - Reno; and Joshua Wiener, PhD, Distinguished Fellow – Aging, Disability and Long-Term Care at RTI International, an independent research institute.  They join continuing directors, Hanna Fink, a nonprofit executive who in retirement became a volunteer LTC ombudsman; Yvette Greene, a long-term care consumer and activist; Mary Ellen Jacobs, RN, a certified care manager and owner of Graceful Seniors, LLC in New Jersey; and Lori Walsh, a program manager at the Center for Advocacy for the Rights and Interests of the Elderly (CARIE) in Philadelphia.  Also participating in CV board meetings is the current chair of the organization’s Leadership Council; the current chair is Brian Capshaw.

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Congress Highlights the 50th Anniversary of Medicare and Medicaid

Senator Wyden delivers statement recognizing the 50th anniversary of Medicare and Medicaid

Last week, forty-six members of the U.S. Senate introduced a resolution commemorating the 50th anniversary of the Medicare and Medicaid programs. Senator Wyden (D-OR), along with other colleagues, delivered a statement on the Senate floor Thursday, January 8th, recognizing the 50th anniversary of President Lyndon B. Johnson's historic message to Congress, Advancing the Nation's Health, which called on Congress to establish what would become the Medicare and Medicaid programs. In his message, President Lyndon B. Johnson stated that the United States must "assure the availability of and accessibility to the best health care for all Americans, regardless of age or geography or economic status." The establishment of Medicare and Medicaid has played a crucial role in expanding Americans' access to health care.

Today, the Medicaid and Medicare programs are the primary payers of long-term care in our nation, providing for roughly 40% and 21% of all long-term care spending. These programs provide access to long-term care for individuals that would otherwise not be able to afford such services. Senator Wyden's statement can be read here and viewed here. To read the text of the Senate resolution commemorating the 50th anniversary of these programs and view the resolution's co-sponsors, click here.

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In this Issue

Consumer Voice Submits Comments on CMS Proposed Home Health Conditions of Participation

Consumer Voice Presents Congressional Leadership Award to Representative Henry A. Waxman

Article Examines Utilizing Online Tools to Increase Volunteer Ombudsman Presence

Consumer Voice to Offer FREE Advocacy Skills Training Webinars

Help Fight Efforts to Restrict Long-Term Care Consumers' Access to the Civil Justice System

Consumer Voice Board Holds First Meeting of 2015

Congress Highlights the 50th Anniversary of Medicare and Medicaid

4.1 It CAN Be Done!

As part of our nursing home staffing campaign, Better Staffing: The Key to Better Care, Consumer Voice is advocating for a minimum of 4.1 hours of nursing care per resident per day.  To show your support of this campaign, individuals can send us a photo with the slogan "4.1 - It CAN Be Done" by tweeting us pictures @ConsumerVoices, posting on our Facebook or emailing your photos to info@theconsumervoice.org.  Get the word out and encourage consumers to participate by sending in their photos too! 

You can join the Better Staffing: The Key to Better Care campaign, learn more about the campaign's goals, access the campaign advocacy toolkit, and take action at: www.theconsumervoice.org/betterstaffing

Calendar of Events

Thursday, January 15: Moving Past the 3Bs of a Traditional Activities Calendar, 2:00pm EST, Webinar from the Pioneer Network

Thursday, January 22: Abuse in Later Life: An Overview, 2:00pm EST, Module One of a five-part webinar series

Thursday, February 5: Forming the Relationship with Your Client: Client communication, interview skills, and confidentiality/mandatory reporting concerns, 2:00pm EST, Module Two of a five-part webinar series

Thursday, February 12: How to Craft an Effective Advocacy Message, Advocacy skills training webinar from the Consumer Voice

Thursday, April 30: Delivering Your Message in Person: The Nuts and Bolts of Meeting with a Key Decision Maker, Advocacy skills training webinar from the Consumer Voice

Tuesday, June 30: Delivering Your Message: Utilizing Both Traditional Approaches and Social Media, Advocacy skills training webinar from the Consumer Voice

Thursday, August 27: How to Grow, Support, and Activate Your Network, Advocacy skills training webinar from the Consumer Voice

Resident to Resident Aggression: New Brochure and Fact Sheet Available from Consumer Voice

Aggression between residents of long-term care facilities is a serious yet hidden problem. All residents have the right to be free from all forms of abuse, neglect, and exploitation, and have rights if they have been subjected to mistreatment. 

Newly released from the National Consumer Voice for Quality Long-Term Care and the National Center on Elder Abuse, this brochure (and large print fact sheet) identifies mistreatment, shares information about an individual’s rights, and offers resources where they can go for help.  The brochure and fact sheet can be downloaded for free. Hard copy will be available for purchase from the Consumer Voice. Contact us at info@theconsumervoice.org for more information.

Collect Nursing Home Campaign Staffing Postcards!

The deadline for our contest to see who can collect the most nursing home campaign staffing postcards has been extended to January 31, 2015.  While we will continue to collect staffing postcards after that date, the contest will end.  So this is your chance to win a $100 gift card!

The Nursing Home Staffing Campaign postcards feature brief information on why nursing homes need more staff and federal law that needs to be changed.  Advocates, consumers, family members, staff, and volunteers can fill out the backside of the postcard to add their voice to the cause.

You can obtain staffing postcards from the Consumer Voice office by contacting Amanda Celentano at acelentano@theconsumervoice.org or at 202-332-2275, ext. 204, or by going online at  http://theconsumervoice.org/uploads/files/issues/Staffing-Campaign-Postcard.pdf.  Postcards are free, but there is a shipping charge (100 postcards -  shipping $10; 300 postcards - shipping $13; 500 postcards - shipping $13).  

Staffing postcards will be hand delivered by Consumer Voice and sorted by Congressional staff.

Help us tell Congress that nursing homes need more staff!

Now is a Great Time to Join the Consumer Voice

Here are a few reasons why you should join as a member:

  1. Most organizations are raising their membership fees, but we have either kept ours very low or we have reduced them for seniors and for long-term care professionals.  We want you to join us!
  2. We are enhancing our benefits and will make special members-only offers throughout the year.
  3. We also have special offers for only a small added contribution.
But most of all, we are making progress in advocating for the rights and well-being of all long-term care consumers.  This is occurring despite great political and economic pressures.  The source of our capabilities is the membership and support of people like you and many partner organizations.

By purchasing a membership now, you support Consumer Voice and the movement advocating for the rights and well-being of everyone who now or in the future depends upon long-term care.

Support Consumer Voice While You Shop Online

You can now support Consumer Voice while shopping on Amazon.  Consumer Voice is now listed as a part of AmazonSmile, an easy and automatic way to support Consumer Voice every time you shop, at no cost to you.  The Consumer Voice receives a donation of a portion of the purchase price every time you make a purchase.  All Amazon purchases cost the same as they normally would.  

To shop at AmazonSmile, click this link or go to smile.amazon.com and input "NCCNHR" as your charity of choice.  For simpler shopping, you can install a one-touch button on your browser, so you can easily return to AmazonSmile to shop and support the Consumer Voice. For more information about AmazonSmile, click here.  Begin shopping now at smile.amazon.com!

Did You Know?

If you make a tribute contribution in honor of an individual or organization, or in memory of a person, we will send the appropriate contact an acknowledgment recognizing your contribution (but not the amount).  All you have to do is supply their mailing address.  And you will also receive a donation receipt, too.

A Gift of Stock is a Win-Win for the Donor and for Consumer Voice

It is great when the value of an asset increases, but when such assets are owned outside of a retirement plan people are subject to capital gains tax on the asset’s appreciation or increase in value.  Making a gift of the asset – often a stock or other security – to Consumer Voice eliminates the capital gains tax on the holding.  Additionally, the gift may be recognized as a charitable donation and may result in a tax deduction for the full appreciated value of the asset. 

So, the donor wins in two ways – by avoiding capital gains tax and receiving a charitable gift deduction.  And Consumer Voice wins by obtaining your contribution and using it to support our programs of long-term care advocacy and education. If you would like to make a gift of stock or other security, contact rgelula@theconsumervoice.org.

Join the conversation and follow us on social media!

Last Week's Most Popular Post:

Wednesday, January 7:
New fact sheet and brochure available on Resident to Resident Mistreatment

Last Week's Most Popular Tweet:

Wednesday, January 7
Today is the 50th anniversary of President Lyndon B. Johnson's historic message to Congress, Advancing the Nation's Health #50moreyears

Long-Term Care Resources & News

Read past issues of The Gazette here.

Sponsor the Gazette - Consumer Voice is now accepting sponsorship for each weekly issue of The Gazette.  As a benefit of sponsorship, the contributor may honor, remember, or thank an individual or organization.  For more information, contact Richard Gelula at rgelula@theconsumervoice.org

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 below. Your contributions and comments are welcome and should be sent to info@theconsumervoice.org. Copyright © 2015.

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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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