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⭒ News & Notes Archive

October 2015

In this Issue

War on Poor Elders: House Committee Looking at Reducing Medicaid Home Equity Caps and Community Spouse Income

As if long term care consumers aren’t punished enough, the House Energy and Commerce Committee is now considering capping the Home equity limits back to the minimum ($500,000 plus inflation). No increases will be permitted by the states regardless of the property values in that state. Although the Deficit Reduction Act of 2005 (signed by President Bush) set a home equity limit of $500,000 above which persons would not be eligible for long term care Medicaid, it also allowed states the option to begin the equity limit at $750,000, which California did. With annual increases since 2006, the maximum home equity limit is now $828,000 in California. Given the property values in California, a limit of $500,000 would be devastating to many long term care consumers, forcing them to sell their homes and – what the reverse mortgage industry really wants – force them to take out predatory reverse mortgages that will end up eating up all the value of their homes.
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Shlomo Rechnitz Owned Nursing Homes Under Investigation Again

California’s largest nursing home operator, Shlomo Rechnitz, is back in the news yet again after the FBI raided his Alta Vista Healthcare & Wellness Centre in Riverside on October 22. The Sacramento Bee reported that FBI agents executed search warrants “seeking evidence in relation to alleged criminal activity.” Details of the investigation have not been released.

In the same article, the Bee revealed that the former administrator and director of nursing at another Rechnitz nursing home, the Mesa Verde Post Acute Care Center in Costa Mesa, are facing criminal charges in connection with the alleged abuse of two residents. In August 2015, the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse charged Joseph Munoz III, the administrator, and Milagros Victoria Soqueno, the director of nursing, with four misdemeanor counts each of inflicting injury on an elder adult and failing to report elder abuse. Reportedly, the charges stem from failure to report knowledge that a resident at the facility had been inappropriately touching other residents in 2014. Munoz and Soqueno will be arraigned in Orange County on December 10.

Governor Brown Signs Residential Care Ownership Suitability Law

Governor Jerry Brown signed AB 601 (Eggman) into law. This bill establishes specific suitability requirements and requires applicants who are seeking a license to run an assisted living/residential care facility for the elderly to submit information on ownership and prior ownership of any type of facility, in any state, including a history of compliance with applicable laws.
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CANHR Submits Extensive Comments to CMS about Nursing Home Rule Overhaul

CANHR has submitted two sets of comments to the Centers for Medicare and Medicaid Services (CMS) in response to the draft of its first major overhaul of federal nursing home regulations in 25 years. One set of comments extensively reviews the state of dementia care in nursing homes and criticizes the government’s enforcement efforts to stop the inappropriate use of chemical restraints. The other set of comments focuses on the remainder of regulatory issues such as facility staffing levels, resident rights, and quality of care concerns.

Click here to read CANHR’s comments on dementia care and chemical restraints.

Click here to read CANHR’s comments on the rest of the nursing home rules overhaul.

Ombudsman/Attorney Partnership Leads to Better-Late-Than-Never DPH Enforcement

In an extraordinary success for a unique “public-private partnership” of Ombudsman and attorneys, a couple of fruitless Department of Public Health (DPH) nursing home complaints were recently turned into high-level citations and fines.

In the first complaint, a female resident of Oakpark Healthcare Center of Tujunga was drugged with multiple psychotropic drugs to sedate her because she was crying out “help me.” The resident had a gangrenous bed sore that led to her death; nonetheless, the facility failed to investigate if the resident’s “help me” cries were related to the excruciating pain she must have felt. Instead, her cries were miscast as a psychiatric issue to be treated with chemical restraints. Faced with these facts, DPH initially issued a single trifling deficiency for failing to properly treat the resident’s bed sore. The deficiency was not accompanied by a monetary fine and the supportive findings do not mention the resident’s pain, her cries of “help me,” or the use of multiple drugs to chemically restrain her.
Click here to read the statement

The Medicare Payment System Needs to be Reevaluated

According to a new government agency report Medicare paid skilled nursing facilities (SNFs) $1.1 billion more than it needed to in fiscal years 2012 and 2013. This occurred because of “flawed payment incentives”. In the report, the Department of Health and Human Services Office of the Inspector General (OIG) found that Medicare payments for therapy “greatly exceeded” SNFs actual costs for therapy for the past decade. 
Click here to read the OIG’s Report

Why Do People Lapse Their Long Term Care Insurance?

Long-term care, including both nursing home and home health care is a substantial financial risk for most retired households. Yet, few individuals buy long-term care insurance, and many who do let their policy lapse even after holding them for years. Of those people 65 and older who have purchased policies, more than one third will let them lapse and forego all their benefits. The question as to why people let their long-term care insurance policies lapse was addressed in this recently released study.  
Click here to read the study

Can Nursing Homes Get 300,000 Dementia Patients Off Deadly Antipsychotics?

In another feature to its excellent reporting on failures in nursing home care, Al Jazeera’s “America Tonight” program examined more problematic elements of drugging dementia last week. The latest story focuses on one California woman’s experience of being drugged into a near “vegetative state” in a nursing home and her ultimate rebound when her family demanded the drugs be discontinued. Also featured are Helen Kales, author of a study connecting antipsychotics with death for elderly people with dementia, Thomas Hamilton, the director of the nursing home division of the Centers for Medicare and Medicaid Services, and Tony Chicotel, CANHR Staff Attorney.
Click here to read the story and watch part of the television feature