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2009 Annual
Convention &
"Key to Quality"
Awards Banquet

September 16-17, 2009 Kansas City,
Missouri
Nominate your outstanding
caregivers for a NAHCA 2009 "Key to Quality" Award
PRESS RELEASE

Nation’s Front Line Caregivers Mobilizing to Help Defeat Obama
Implementation of Damaging Medicare Regulation
$1.05 Billion FY 2010 Proposed Medicare Cut Weakens Key Health Care
Delivery System Reforms Now Benefitting Patients, Strengthening
Frontline Workforce
Joplin, MO (May 4, 2009) –
The
Coalition to Protect Senior Care (CPSC) today said it is mobilizing
to defeat a Medicare regulation put forward for implementation
Friday by the Centers for Medicare and Medicaid Services (CMS). The
proposed Medicare rule, a Coalition spokeswoman said, would cut
Medicare funding by $1.05 billion in FY 2010 and $5.6 billion over
five years, eliminate the key front line care jobs that make a
positive difference in patient outcomes, and significantly undercut
ongoing improvements in clinical infrastructure already underway now
benefitting patients.
“With so many good health care reform ideas coming from the new
Obama Administration, it is curious and distressing to see a
previously-discredited Medicare regulation appear on the policy
radar screen,” said Lisa Cantrell, a co-founder of the National
Association of Health Care Assistants, and a national spokesperson
for the Coalition to Protect Senior Care. “The new CMS directive is
enormously frustrating to America’s front line caregivers because
its net impact will be to reverse existing federal policy that is
currently benefitting elderly patients.”
Cantrell, pointing out that a bipartisan coalition of forty
Democratic and Republican U.S. Senators worked last year to derail
the same Bush Administration proposal, said that as the nature of
America’s skilled nursing facility (SNF) patient population
continues to evolve due to demographic and policy changes, the
federal government’s role should be to help facilities’ direct care
staff treat the high-acuity individuals increasingly seen in
facilities nationwide. Moreover, Cantrell warned, the direct care
staff that help make the key difference in quality outcomes will
also be significantly harmed by the CMS action.
“The Medicare funding cuts illogically put forward will further put
at risk a facility’s ability to sustain caregiver wage and benefit
packages that are already on the margin of being uncompetitive with
other service-oriented professions,” Cantrell warned. “This
regulation and its resulting sharp Medicare funding cut is bad news
across the board, and it is in need of swift correction based on
simple common sense and what is best for patients and caregivers. We
urge CMS to reconsider and reverse this new policy, and we will be
encouraging Congress to voice its strong, legitimate dissent.”
The
Coalition to Protect Senior Care
consists of:
The American Association
for Long Term Care Nursing (AALTCN)
The American College of Health Care Administrators (ACHCA)
The American Association of Nurse Assessment Coordinators (AANAC)
The National Rural Health Association (NRHA)
The American
Association of Nurse Executives (AANEX)
The American Occupational Therapy Association (AOTA)
The
American Physical Therapy Association (APTA)
The American Society of Health Care Administration Executives
(ASHCAE)
The American Health Care Association (AHCA)
The American Health Quality Association (AHQA)
The
National Association for the Support of Long Term Care (NASL)
The National Association of Health Care Assistants (NAHCA)
The Alliance for Quality Nursing Home Care; the Coalition of Women
in Long Term Care (COWL)
and The Senior Clinician Group.
McKnights
The Department of Health and Human Services this
week released official guidelines for the reduction of six common
hospital acquired infections (HAIs), including methicillin-resistant
Staphylococcus aureus and Clostridium difficile.
The agency released its infection-control
guidelines in hopes of significantly reducing occurrences of the
most common HAIs within five years. In addition to MRSA and C.
difficile, HHS has identified catheter-linked urinary infections,
surgical site infections, blood-stream infections from intravenous
lines and pneumonia from ventilators as the most common HAIs. The
American Hospital Association and the Joint Commission released
similar guidelines in October of 2008.
(McKnight's, 10/10/08)
Among HHS's infection-control recommendations:
adequate control of blood sugar among diabetic patients; more
prudent use of both ventilators and catheters; increased use of
sterile techniques, including sterile gloves, sterile gowns, masks
and caps when inserting central venous catheters. The HHS report
also warned against the improper use of catheters in nursing homes
for the management of incontinent patients.
The HHS plan can be found at
http://www.hhs.gov/ophs
Vaccinate healthcare workers first to stem
spread of influenza, Joint Commission says
The Joint Commission, an independent healthcare accreditation
and certification organization, on Wednesday released guidance for
increased healthcare worker influenza vaccinations.
The
Joint Commission's new guidance is designed to help reduce the
overall spread of seasonal influenza. [Note: It does not address
immunization strategies for H1N1, also known as the swine flu.]
Among the strategies laid out in the guidance is the notion that
healthcare workers should be inoculated soon after a vaccine become
available. The Joint Commission suggests that, while inoculations
among the general public tend to peak in November of each year,
healthcare workers should get vaccinated much earlier, ideally
before October.
In related news, recent reports show that
H1N1 is spreading among healthcare workers. The Centers for Disease
Control and Prevention announced last Thursday that as many as 81
healthcare workers have tested positive for swine flu. On Tuesday,
officials confirmed that a nursing home resident in the Canadian
province of Newfoundland and Labrador had contracted the disease.
Because nursing homes are typically closed settings, it is likely
that a visitor or a healthcare worker brought the disease into the
facility, according to Canadian health ministers.
More
information is available at
www.jointcommission.org
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Health Care News |
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McKnights 
The Congressional Budget Office has
estimated that a legislative proposal
for a disability insurance program would
save $59 billion between 2010 and 2019.
Also, if implemented, this program would
lead to savings of $2.5 billion for the
Medicaid program over that period, the
public analysis agency said late last
week.
The program, which is
known as the Community Living Assistance
Services and Supports (CLASS) Act, would
allow workers to pay a monthly average
of $65 into an "Independence Fund." The
fund, in turn, would offer a payout of
$50 a day for those who no longer can
perform at least two activities of daily
living. People would have to be vested
in the program for five years to receive
the cash benefit. The program is a part
of the Affordable Health Choices Act, a
bill proposed by the Senate Committee
for Health, Education, Labor and
Pensions (HELP). A preliminary CBO
estimate has placed the cost of the
universal healthcare portion of this
bill at $1 trillion over 10 years.
In response to the scoring, the
American Association of Homes and
Services for the Aging, which helped
craft the legislation, Friday released
the following statement:
"The
scoring issued today by the
Congressional Budget Office on Section
191 of the Affordable Health Choices Act
proves that our country can create a
national insurance trust for long-term
services and supports that is affordable
for average Americans and does not drain
government resources."
In a
background call about the scoring held
Friday, a senior democratic adviser on
the HELP committee noted that the
program is intended to work in tandem
with long-term care insurance products,
and not act as a replacement for them.
"This is not about competing
with the industry. It's about gloving
with them," she said.
The
10-year cost projection by the CBO is
based on the knowledge that, while
premium collections would begin in 2011,
no one would be receiving benefits until
2016. Also, it is based on an assumption
that premiums are set on average at $65
a month. But to be actuarially sound,
the CBO said that premiums would have to
exceed the average dollar amount of $65
set by the legislation by $35 to $45.
The adviser on the call noted that
the legislation allows for the secretary
of the Department of Health and Human
Services to change the premium and also
to project solvency for the program
based on the previous year, and over a
two-year, 50-year, and 75-year outlook.
If she determines that it would not be
solvent, she could stop enrollment. Two
populations would only have to pay $5
premiums: those whose incomes do not
exceed the poverty line, and students.
In response to a caller who
asked how Medicaid could save $2.5
billion over 10 years, the adviser said
she guessed it would be because the
program would be the payer of first
resort to Medicaid. Those who are
impoverished and on Medicaid would pay
into the program and thus receive cash
from the disability program first.
CMS nursing home
guidance focuses on resident quality of
life, environment and choice
McKnights
The
Centers for Medicare & Medicaid Services
on Friday issued new guidance for
nursing home surveyors emphasizing the
importance of resident quality of life
and homelike environments.
Nursing home surveys conducted after
June 12 will include a heightened focus
on areas such as care and service
choices, creating a homelike
environment, resident dignity and
accommodating environmental needs and
preferences, according to CMS. This new
guidance is intended to support current
efforts to create more homelike nursing
facilities and focus on
resident-centered care, CMS Acting
Administrator Charlene Frizzera said.
CMS also seeks to deinstitutionalize
nursing homes through the removal of
certain technology and mechanisms
associated with institutional
environments. Overhead paging systems,
alarms and large nursing stations, as
well as meals served on institutional
trays should be eliminated, according to
the guidance. Facilities should also pay
close attention to a resident's
preference for his or her own daily
schedule, CMS says.
More
information about the new guidance can
be found online at
http://www.cms.hhs.gov/transmittals/downloads/R48SOMA.pdf.
McKnights
By
refusing to review an Illinois appellate
court ruling, the U.S. Supreme Court has
tacitly agreed that a state law
nullifying nursing home arbitration
agreements supersedes the Federal
Arbitration Act, which favors
arbitration agreements, according to a
Bureau of National Affairs report.
In the case of SSC Odin Operating
Co. v. Carter, Sue Carter originally
sued SSC Odin Operating Co. over the
alleged wrongful death of Joyce Gott, a
former resident of Odin Healthcare
Center in Odin, IL. According to a state
appellate court ruling, two provisions
of the Illinois Nursing Home Care Act
prohibit the facility from enforcing an
arbitration agreement signed by Gott at
the time of her admission. Most notably,
the NHCA provisions apply to all
contracts involving nursing home
residents, not just arbitration clauses,
and therefore can be applied to the
arbitration agreement signed by Gott,
the Appellate Court of Illinois ruled.
The nursing home operator argued
that the Federal Arbitration Act should
overrule any state law governing
arbitration agreements, especially in
light of the fact that the NHCA applies
to nursing home contracts in a broad and
more generalized way, rather than
specifically singling out arbitration
agreements. The Appellate Court of
Illinois, however, shot down that
argument in April 2008, saying instead
that it is because the NHCA applies so
generally to all nursing home contracts
that it can be applied in this case. The
Illinois Supreme Court refused to review
the decision in October of last year.
With its June 1 rejection of the case,
the U.S. Supreme Court has let the lower
court's ruling stand, thereby setting a
precedent under which other states' laws
might trump the Federal Arbitration Act.
MRSA thriving
among one-quarter of nursing home
residents, study results show
McKnights
Nearly one in
every four nursing home residents has
been colonized by methicillin-resistant
Staphylococcus aureus (MRSA), according
to a recently published report from
Queen's University Belfast.
After taking
samples from 1,111 residents and 553
staff members at 45 nursing homes in
Ireland, researchers discovered that
roughly 24% of residents and 7% of staff
carry the tough-to-treat disease.
According to report authors, 24% is the
median rate of colonization, with
individual nursing home results running
the gamut: three nursing homes were
entirely free of MRSA, while at least
one had a 73% rate of resident
colonization. Similarly, staff members
at only 28 of the nursing homes that
were tested were found to carry the
disease; the highest rate of
colonization was 28%.
In the first week
of 2009, the Department of Health and
Human Services released infection
control guidelines designed to stem the
spread of certain hospital-acquired
infections, including MRSA (McKnight's,
1/8). The Queen's University Belfast
report appears in the latest issue of
the Journal of the American Geriatric
Society.
McKnights,
The
recently released Department of Health
and Human Services survey of long-term
care nursing assistants (CNAs), and a
forthcoming survey of home health
workers, reflects the department's
commitment to the needs of the long-term
care workforce, Secretary Kathleen
Sebelius says.
HHS has been
conducting these surveys in an effort to
increase job satisfaction and
recruitment, and reduce turnover rates
in the long-term care industry, Sebelius
says. Sebelius called CNAs and home
health workers "the backbone of our
long-term care system" in a letter to
the editor published in Monday's
Washington Post.
The results of
the recently released CNA survey show
that more than half of CNAs working in
nursing homes were injured on the job
last year, and that many are unable to
afford employer sponsored healthcare.
HHS is "wrapping up" the survey of home
health aides, Sebelius said, though she
did not give a release date
AAHSA report: Americans think
healthcare reform should include
long-term care
McKnights,
Most
Americans believe that long-term care
services and supports should be a part
of any upcoming healthcare reform,
according to the results of a new survey
from the American Association of Homes
and Services for the Aging.
A total of 85% of
those surveyed said that long-term care
services and supports should be included
in reform. More than half said that no
healthcare reform package would be
complete without them, the AAHSA report
said. The results of the survey show
that age, gender, region and income are
not factors in this debate. Large
majorities in all demographics endorse
long-term care supports and services. A
mere 13% said those services and
supports should not be covered. The
Mellman Group conducted the survey on
behalf of AAHSA.
"These results
prove once again that Americans do not
draw the artificial line between acute
care and long-term services and supports
that policy makers use to exclude
long-term services and supports from
health care reform discussions," said
AAHSA CEO Larry Minnix.
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McKnights,
The
Senate Special Committee on Aging met
Wednesday to address the importance of
emergency and disaster planning and the
need for improved coordination between
policy makers and long-term care
providers.
"More than 70% of the
people who died in Louisiana as a result
of Hurricane Katrina were older than age
60," Dr. Richard Besser, director of the
Coordinating Office for Terrorism,
Preparedness and Emergency Response at
the Centers for Disease Control and
Prevention, told the committee. Many of
those people died either at home or in a
nursing home, he continued.
Nursing homes were not given the same
guidance during the 2005 hurricane
season that hospitals were given,
according to another witness, LuMarie
Polivka-West, senior vice president of
policy at the Florida Health Care
Association. What's more, "utility
services did not understand the special
needs of the frail elderly and those
with disabilities in nursing homes and
assisted living communities, leaving
them without electricity and telephone
services," she said.
Committee
Chairman Sen. Herb Kohl (D-WI) pointed
out that, although efforts have been
made to strengthen emergency response
preparedness since Hurricane Katrina,
much work still remains. Of particular
concern to the committee was how to
protect seniors in the event of a
pandemic, such as the current H1N1
influenza outbreak. For transcripts of
witness testimony, visit
www.aging.senate.gov.
Food for thought:
A few extra pounds can prolong life
McKnights
A pair of new studies analyzes the
effects of food on longevity and aging.
While one finds that healthy eating
helps to extend life, another finds that
having a few extra pounds is not a bad
idea either.
First on the menu,
researchers at Queens College of the
City University of New York provided
some concrete proof that eating well
helps you live longer. They looked at
the dietary habits and other information
of more than 350,000 older adults, and
compared what they found to the 2005
USDA Dietary Guidelines for Americans to
see if there was any correlation between
good eating and early dying. As it turns
out, the old advice is true: Over a
10-year follow-up, those who ate healthy
were between 20% and 25% less likely to
die than those whose diets were less
than adequate.
Meanwhile, a
study from Portland State University
also offers another finding: Being
overweight actually increases your
likelihood of living longer. Using the
Body Mass Index scale, researchers
compared the likelihood of death among
underweight, overweight and obese people
compared to normal weight people over
the course of 12 years. While
underweight and obese people were at an
increased risk of death—70% and 36%
greater, respectively—people with only a
few extra pounds were 17% less likely to
die. While researchers suggest it's
possible that the extra weight can help
seniors as their health declines in old
age, they don't recommend packing on the
pounds, and maintain that a healthy
lifestyle is still the best way to grow
old.
The Queens College study
appears in the July issue of the journal
Nutrition, while the Portland State
study appears online in the June 18
edition of the journal Obesity
McKnights,

Instances of deadly
pneumonia associated with methicillin-resistant
Staphylococcus aureus (MRSA) infection
are on the rise. While the majority of
cases still occur in nursing homes and
hospitals, the super bug now appears to
be thriving in the community at large,
according to new reports.
Community-acquired MRSA pneumonia
commonly manifests after a flu-like
illness, according to researchers at the
Emory University School of Medicine.
Study authors are concerned that the
recent outbreak of H1N1 influenza will
spur the rates of MRSA pneumonia even
higher. Though the community-acquired
strain is less resilient against
antibiotics than its facility-dwelling
counterpart, it still may have a
more-than-50% mortality rate, according
to the report.
Researchers are
as yet uncertain why the
community-acquired MRSA pneumonia is so
lethal, or which course of treatment is
best. In January, the Department of
Health and Human Services released
updated guidelines for the reduction of
hospital-acquired infections (HAIs). (McKnight's,
1/8) The HHS plan can be found at
http://www.hhs.gov/ophs.
Satisfaction among
nursing home consumers, employees
continues to rise, survey finds
McKnights
Nursing home consumers are more
satisfied than they have been since
2005. Meanwhile, workforce satisfaction
is at its highest level since 2006. That
is according to a new survey by the
research firm My InnerView.
A
majority (85%) of consumers report their
satisfaction as either "excellent" or
"good." Among employees, a total of 66%
recommend their facility as a place to
work as either "excellent" or "good,"
the survey found. The report includes
responses from more than 223,000
employees, more than 54,000 residents
and nearly 147,000 family members in
5,075 nursing facilities across the
United States. The research firm began
conducting research on these trends in
2005.
The report finds that
workers most directly involved in
patient care are the least satisfied
employees. Also, leaders would be wise
to address job stress to improve nurse
and nursing assistants' satisfaction,
the report suggests. Meeting choices and
preferences is one of the top priority
items for improving resident and family
satisfaction, according to the survey.
Copies of the "2008 National
Survey of Consumer and Workforce
Satisfaction in Nursing Homes" is
available for download at
www.myinnerview.com.
McKnights
Despite
indications that the national economy is
starting to rebound, the National
Governors Association is warning that
states' economies are still suffering,
and that another bout of budget cuts
could be on the horizon.
As many
as 42 states are predicting revenue
declines of 12% in January and February
of 2010, with some states estimating
decreases of up to 40%, according to the
recently released May 2009 NGA State
Budget Update. As a result of those dire
predictions, states across the country
are considering additional budget cuts
before fiscal year 2009 ends in June,
which traditionally includes cuts to
Medicare and Medicaid services.
This news comes as lawmakers in
Washington continue work on the federal
FY 2010 budget. Some nursing home
advocates are trying to alert
legislators to the potential dangers of
cutting federal Medicare and Medicaid
funding at a time when states are also
considering additional cuts. A statement
from the American Health Care
Association suggests that "any federal
cut to seniors' Medicare Part A nursing
home benefit in the months ahead will
intensify the negative impact of state
Medicaid cuts already jeopardizing older
Americans' ongoing access to quality
long term care and services."
The Alliance for Quality Nursing Home
Care fears the loss of thousands of
healthcare jobs as a result of any state
and federal budget cuts. The NGA budget
report is available for review at
www.nga.org.
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