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⭒ News & Notes Archive

September 2015

In this Issue

Nursing Homes Reap Billion Dollar Windfall by Exploiting Medicare Billing System for Therapy

On September 30, 2015, the Inspector General of the Department of Health and Human Services issued a new report on wasteful payments to skilled nursing facilities (SNFs) for therapy services. The report, The Medicare Payment System for Skilled Nursing Facilities Needs to be Reevaluated, stated that Medicare payments for therapy greatly exceed SNF’s costs for therapy.
Read More…

More Misery for the Poor – AB 139 Transfer on Death Deeds Signed into Law

AB 139 (Gatto) was recently signed by the Governor.  With a sunset date of January 1, 2021, AB 139 creates the revocable transfer on death deed (revocable TOD deed), which would transfer real property on the death of its owner without a probate proceeding. The bill would also provide that the deed, during the owner’s life, does not affect his or her ownership rights and, specifically, is part of the owner’s estate for the purpose of Medi-Cal eligibility and recovery.  The new law creates a statutory form – the  “SIMPLE Revocable Transfer on Death (TOD) Deed.”  Unfortunately, there is nothing simple about this 24-page poorly drafted new law.  Not only is it not simple, but it will surely complicate the lives of those it is aimed to assist, i.e., those who don’t wish to pay or can’t afford to pay attorneys fees.

CANHR strongly opposed this bill – and similar bills over the years – as we believe it would make many elders even more susceptible to undue influence and elder abuse.  These deeds are also subject to estate recovery, which means that those same low-income elders, who are likely to execute TODs will also be more likely to be on Medi-Cal and thus subject their estates to recovery.  Proposed as a low cost alternative for those seniors who cannot afford attorneys for trusts or other alternatives, AB 139 will undoubtedly cause more harm than good. As one organization opposed to the bill noted, these deeds “will become the new form of easy, convenient, and cheap elder abuse.”

CANHR will be discussing this bill at our Elder Law Conference and embarking on a legal services and consumer education campaign to try to blunt the impact of this unfortunate bill.

Click here for the text of the bill…

Medi-Cal Recovery Regulations Finalized

Final regulations affecting the Estate Recovery Regulations were filed with the Secretary of State on September 3, 2015 with an effective date of January 1, 2016.  The regulations amend sections 50961, 50962 and 50963 of the recovery regulations, primarily to apply the hardship regulations equally to married couples, registered domestic partners and legal unions performed in other jurisdictions.  The regulations also substantially revise the Application for Hardship Waiver, DHCS Form 6195.  The regulatory changes, as originally proposed, would have eliminated the 90 days timeline to act on hardship waiver requests, but this change was deleted and the 90 day timeline remains.

Some of the suggested amendments to the regulations as submitted by CANHR were adopted including retaining the 90 day timeline, but a number of substantive recommendations were rejected.

However, many of the changes to the Hardship Application were incorporated to make the application process more understandable to consumers and avoid the submission of unnecessary paperwork. 

Click here for background information, statement of reasons and final regulation package (DHCS-08-012 – Estate Recovery).

Heat Wave Turns Deadly; Nursing Homes Responsible for Resident Safety 

California’s deadly heat wave is a grave threat to the elderly, including nursing home residents who are supposed to be protected from the heat. In 2000, several residents of a Burlingame nursing home died due to the extreme heat, and many others have suffered because of unsafe temperatures within nursing homes. Additionally, residents are subject to transfer trauma caused by emergency evacuations from nursing homes due to air conditioning failures.
The suffering is preventable and should not occur. Nursing homes are obligated to protect their residents from the heat.
Read the factsheet…

FINRA Board Approves Rulemaking Item to Protect Seniors and Other Vulnerable Adults from Financial Exploitation 

FINRA Board Approves Rulemaking Item to Protect Seniors and Other Vulnerable Adults from Financial Exploitation.  The Financial Industry Regulatory Authority (FINRA) announced that its Board of Governors approved a rulemaking item to help firms better protect seniors and other vulnerable adults from financial exploitation. The proposal would allow a firm to place a temporary hold on a disbursement of funds or securities and notify a customer’s trusted contact when the firm has a reasonable belief that financial exploitation is occurring.
Read the press release…

America’s Most Admired Lawbreaker

Beginning on September 15th and continuing for the next 14 days, the Huffington Post and journalist Steven Brill published a remarkable 15-part “DocuSerial” that examines how drug giant Johnson & Johnson developed Risperdal, a powerful antipsychotic drug, promoted it illegally to children and the elderly, covered up the side effects and made billions of dollars. The groundbreaking series, America’s Most Admired Lawbreaker, is a must read for anyone concerned about the epidemic use of antipsychotic drugs like Risperdal to chemically restrain persons who have dementia. Mr. Brill provides a fascinating account of how J&J knowingly marketed Risperdal to doctors and long term care providers for use on persons with dementia despite explicit directions from the FDA not to do so. The series chronicles Alex Gorsky’s rise to the chairmanship of J&J despite his central role in these illegal activities and gives links to every document – court transcripts, internal emails, FDA staff memos – referred to in each chapter of the series.

CDC Advises Nursing Homes to Stop Misusing Antibiotics

On September 15, 2015, the Centers for Disease Control and Prevention (CDC) issued new recommendations to nursing homes aimed at reducing inappropriate use of antibiotics to protect residents from the consequences of antibiotic-resistant infections, or “superbugs,” such as C.diff. The CDC press release cites familiar but scary data. Antibiotics are the most frequently prescribed medication in nursing homes; about 70 percent of the 4 million people living in nursing homes receive at least one course of antibiotics each year; and up to 75 percent of antibiotics prescribed in nursing homes are given incorrectly.

The CDC is cracking down on indiscriminate use of antibiotics because unnecessary use is contributing to outbreaks of superbugs that are on the rise nationally. The CDC recommendations are found in a new resource, Core Elements of Antibiotic Stewardship for Nursing Homes. New fact sheets for residents and families and other resource materials are also posted on the CDC’s website.

CMS Extends Deadline for Comments on Proposed Nursing Home Requirements of Participation

On September 11, 2015, the Centers for Medicare and Medicaid Services (CMS) extended the deadline to submit comments on the proposed regulations to revise the federal Requirements of Participation for Nursing Homes. The new deadline for submitting comments is October 14, 2015. The proposed rules are the first major rewrite of the Requirements of Participation since they were published in 1991 to implement the Nursing Home Reform Act of 1987.

Upcoming Events


Health for Family Caregivers Workshop

A FREE conference for Spanish-speaking family and friends caring for someone with dementia, or an aging loved one.
Workshop topics include:

  • A healthy body for a healthy brain
  • Long Term Care: What is it and Who Pays for it?
  • Therapeutic Dance

October 3, 2015
8:30am – 12:30pm
Mission YMCA
4080 Mission St.
San Francisco, CA 94112

Click here to view the English Flyer
Click here to view the Spanish Flyer