ADVANCE Perspective: LTC : Legal

ALFA-Backed Amendment Passes Senate Finance Committee

Heather Simons — Wed, 23 Sep 2009 17:11:00 GMT

A press release from ALFA today announces that the Senate Finance Committee accepted an amendment by Senator Bill Nelson to Senator Max Baucus' health care reform legislation that would eliminate prescription drug co-payments under the Medicare Part D Prescription Drug Program for all dual eligible residents in assisted living waiver programs. This legislation could benefit up to 650,000 low-income seniors nationwide, 75,000 of whom reside in assisted living communities.

ALFA will continue to work very closely with Senator Nelson's office to eliminate co-payments for all dual-eligible residents in assisted living and other home and community-based settings. We thank Senator Nelson for his leadership on this issue and will continue to work with him and other members of Congress on this and other critical issues on behalf of America's seniors.

Click here to read the full release. Then leave us a comment and let us know what you think.

Congressional Call-In Day - May 13

Liz Rosto — Thu, 07 May 2009 18:09:00 GMT

AAHSA is hosting a Congressional Call-In Day on May 13, 2009, from 8 a.m. to 6 p.m. in an effort to get more senators on board with including long-term services in any upcoming health care reform measures. They are encouraging all providers to call your senators and representatives.

More information, including a phone script, can be found at www.aahsa.org/callcongress.aspx

Worst Nursing Home List Released

Maureen McAndrews — Tue, 19 Feb 2008 15:43:00 GMT

A week ago, the Bush administration published the names of 131 nursing homes with poor inspection records and said some were already showing signs of improvement, according to the Associated Press.

The list, released by the Centers for Medicare and Medicaid Services, represents troubled facilities cited as a "special focus facility," a term used to identify those that merit more oversight. For these homes, states conduct inspections at six-month intervals rather than annually.

CMS will update its list of troubled nursing homes on a quarterly basis, with its next release scheduled for April.

The list released last week shows 52 nursing homes as not showing improvement after they were cited as a higher-risk nursing home, while another 52 did show some improvement. Twenty-seven nursing homes were added to the list in the last six months.

Out of the 54 nursing homes initially disclosed as poor performers last November, 21 have shown improvement, CMS said, adding that publicity about the problems might have played a factor.

While most nursing homes have some deficiencies, with the average being six to seven deficiencies per survey, the special focus facilities typically have about twice that number, and continue to have problems over a long period of time. However, the states determine which nursing homes should get the designation, and inspection standards vary among the states.

The offenses typically involve unnecessary use of medication for elderly residents, or inadequate safeguards to protect residents such as those with Alzheimer's from day-to-day hazards in the nursing home, the Associated Press reports.

What do you think of the publication of this list? We'd love to hear your thoughts.

The Value of an Apology

Maureen McAndrews — Fri, 01 Feb 2008 15:49:00 GMT

Over the summer I made a major purchase at a home improvement retailer. To make a long story short, the vendor: lost my order data due to a computer power failure, delayed product delivery, ordered the wrong size product, forgot to collect payment from me while I was in the store (which meant I had to make an extra trip to the store), allowed the product installer to cancel several appointments that I’d rearranged my schedule to accommodate and ultimately sent me a product that was drastically different from the one I’d seen in the store and ordered.

Throughout this entire process, which went on for several months, no one from the store ever once apologized. In fact, during one of my visits to the store, after I learned from the representative that the product measurements were inaccurate, I became very exasperated and said something to the effect of "This entire process has been such a hassle. I don’t know if I can keep going like this." The rep simply stared back at me and offered no apology. At that point, that store should’ve lost my business, but I elected to keep going because I didn’t want to forfeit my deposit and start all over again with another retailer.

But it would’ve made a difference if someone had said just once that they were sorry. Since my experience was with a retailer, it was simply a hassle. But when facility managers make mistakes, there are often far greater consequences. Even though the stakes are higher, an apology can still make a difference. As Loretta G. LeBar, JD, CHC, writes in her September/October 2007 article "Saying You're Sorry," "Today's culture discourages apologizing to victims and their families for fear of it being seen as an admission of guilt. We need to change this."

If you’re concerned about the legal ramifications of an apology, ask your attorney for more information on how you can effectively communicate when something goes wrong. If nothing else, at least start a conversation about the value of an apology. If the "carefully planned apology can prevent litigation, restore trust and build stronger employee infrastructure centered on quality of care for the residents," as Le Bar writes, wouldn’t it be well worth it?

Tax-Evading Medicaid Providers

Adkins-Ali Carrie — Wed, 14 Nov 2007 13:18:00 GMT

The Associated Press reported this morning that a Senate panel is looking to collect unpaid taxes from more than 30,000 Medicaid providers who receive federal payments for their services despite owing at least $1 billion in back taxes.

AP specifically mentioned a nursing home provider in the report:

"The GAO highlighted several egregious cases, including a Medicaid provider who had been convicted for failing to pay taxes owed by several nursing homes. While the nursing homes owed $14 million in unpaid taxes, the report said, its owner had purchased a 10,000-square foot home now valued at more than $2 million - and spent tens of thousands of dollars furnishing it with crystal chandeliers, a 132-piece set of Haviland Bavarian porcelain china and oriental rugs."

Sen. Norm Coleman, R-Minn., said he plans to press the IRS and CMS officials to find a way to recoup that money. But CMS spokesman Jeff Nelligan told the Associated Press that the CMS is not in a position to review provider tax records. CMS acting administrator Kerry Weems added that the "implication is that there is some direct correlation between owing taxes and being a Medicaid provider."

Read the story here and tell us what you think. Should Medicaid payments be affected by individual tax status? Should CMS monitor personal taxes? And if they did, how do you think it would affect the industry?