In this Issue
- CANHR Calls for Radical Changes to Address Problems With California’s Long Term Care System
- CONSUMER ALERT: Treatment of Disaster Assistance and Insurance Payments for Medi-Cal Eligibility
- New Study: Money Motivates Nursing Home Discharge Decisions
- The CMS Campaign is Failing: Nursing Home Chemical Restraint Use Trending Upward Again
- Senate Report Finds that Nursing Home Residents Died Due to Poor Disaster Oversight
- What To Know Before You Go
CANHR Calls for Radical Changes to Address Problems With California’s Long Term Care System
San Francisco, CA – Calling for an overhaul in the Department of Public Health, the agency responsible for oversight of California’s nursing homes, California Advocates for Nursing Home Reform has released a white paper summarizing major problems in long term care in California and offering suggestions as to what needs to be done to improve nursing home and residential care for elders and persons with disabilities.
The paper, titled “California’s Broken Long Term Care System,” outlines the problems in oversight, enforcement and funding in nursing homes, residential care, home and community based services and elder abuse prevention and prosecution and offers recommendations for improvement. These include:
The need for replacing the leadership at the Department of Public Health and the Center for Health Care Quality with visionary consumer protection leaders who will reform the Department and directly address the crisis in care nursing home residents are facing.
Adequate funding for the Department of Social Services to meaningfully inspect and oversee California’s 7,200+ RCFEs which house over 152,000 frail elders, along with oversight of 66,000+ other facilities in California.
Increase availability and access to cost-saving home and community based alternatives for those who do not wish to die in a nursing home.
Increase remedies for victims of residents’ rights violations and elder abuse, including a private right of action.
CANHR calls on the new Governor and legislators to address this crisis in long term care and to create new models of care where the health and safety of residents takes priority and where elder abuse becomes a distant memory.
CONSUMER ALERT: Treatment of Disaster Assistance and Insurance Payments for Medi-Cal Eligibility
This alert is to inform those consumers who are on Medi-Cal — either traditional Medi-Cal or MAGI, the adult Medicaid expansion program through the Affordable Care Act — who were impacted by the recent fires.
This alert contains information about Medi-Cal beneficiaries’ rights regarding receipt of disaster assistance and insurance payments, as well as information on assistance available for those wishing to apply or recertify for Medi-Cal.
READ FULL ALERT
New Study: Money Motivates Nursing Home Discharge Decisions
A new study reviewing nursing home occupancy rates (census) and resident discharge rates finds that financial incentives significantly influence how aggressively nursing homes discharge residents. When facilities have a low census and less overall revenue, they discharge residents at much lower rates than facilities with a high census and few empty beds. The effort to maximize profit leads facilities with a high census to push out residents whose stay is paid for, in part, by Medicaid (Medi-Cal) in favor of other, higher-paying, residents. The reviewed data shows that when a facility’s census reaches about 90% of capacity, residents on Medicaid are suddenly discharged much more often, due to more “positive discharge effort” from the facility. The study provides good data backup for what we have long known: it’s not residents’ conditions that prompt nursing home discharges, it is the revenue they bring.
The CMS Campaign is Failing: Nursing Home Chemical Restraint Use Trending Upward Again
Some new data from CMS sadly shows the use of antipsychotic drugs to chemically restrain nursing home residents continues unabated. Twenty percent of California nursing home residents are drugged with antipsychotics in 2018, the same number as in 2015. There have also been no meaningful reductions in the use of other psychotropic drugs used to sedate nursing home residents. National numbers are similarly flat. In 2012, CMS initiated a national Partnership to Reduce the Use of Antipsychotics in Nursing Homes to great fanfare and for the next three years, antipsychotic use gradually diminished. In the last three years, CMS has reduced its already modest efforts and residents are again being drugged inappropriately, causing significant harm. The combination of rising drugging rates and pathetically weak regulatory enforcement were noted by the Long Term Care Community Coalition in an alert this week. Unless CMS acts, the drugging of nursing home residents is bound to rise once again to epidemic levels.
Senate Report Finds that Nursing Home Residents
Died Due to Poor Disaster Oversight
On November 2, 2018, the minority staff of the U.S. Senate Committee on Finance issued a report – Sheltering in Danger – that says flawed responses to Hurricanes Harvey and Irma placed nursing home and assisted living facility residents in dangerous conditions and, in the case of 12 residents in Florida, led to their deaths. The investigation, like others on earlier disasters, found that some nursing homes are not equipped to handle matters of basic safety during disasters and that public officials are not doing enough to prevent tragedies. Although hurricanes are not a common threat in California, many of the report’s recommendations are needed to improve the safety of California nursing home and assisted living facility residents during disasters that occur here.
Read related New York Times article, “Poor Disaster Oversight Imperiled Nursing Homes, Senate Report Finds”.
What To Know Before You Go
CANHR’s postcard guide to nursing home residents’ rights regarding discharge and eviction is now available for printing and distribution. The postcard provides important information in a simple and portable format to counter all of the nonsense nursing homes tell residents and their families when a resident’s Medicare rehabilitation benefit is ending.