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Finding Good Nursing Home Care Is Not Easy!

July 2, 2014 by Honey Leveen Leave a Comment

Good Nursing Home CareA newly published survey called “Raising Expectations” by AARP, The Commonwealth Fund and the SCAN Foundation, is a report card for nursing facilities across the country.

The news for us in Texas isn’t good, reports Howard Gleckman in this Forbes piece on this new study, published June 25, 2014. The research finds that on average the most affordable facilities are in Oklahoma, the District of Columbia, Utah, Kansas, Missouri, Georgia, Texas, Iowa, Louisiana, and Arkansas. But nearly half of those states—Oklahoma, Utah, Kansas, and Texas– rank in the bottom 10 for at least 2 of the study’s 3 quality measures. Texas and Oklahoma rank near the bottom for all three.

Most of Mr. Gleckman’s piece describes how unable most Americans are to pay for their own long-term care. I will concentrate instead the correlation between low cost and low quality care.

In Texas, Medicaid nursing home reimbursement is one of the lowest in the country.

Nursing homes are not where anyone with great wealth or long-term care insurance chooses to receive care.

Here in Houston, we’ve made headlines lately with a spate of nursing home murders.

If nursing homes are paid less than it costs them to actually provide care (as they are in Texas), the result is a cascade of problems, including but not limited to  insufficient, underpaid caregivers, inappropriate admissions (accepting extremely needful people in order to get the census up), increased safety and health hazards, patient negligence and warehousing, the list goes on.

The American Association for Long-Term Care Insurance (www.aaltci.org) states that approximately 80 percent of long-term care insurance (LTCi) claims are not for nursing home care. LTCi gives policyholders the ability to instead stay at home or access assisted living. My own experience is that very few of the approximately 300 LTCi client claims I’ve seen paid were for nursing home care.

Because a great many people choose to ignore the need for responsible long-term care planning and are therefore unprepared to pay when the need for care arises, the majority of long-term care in the US is paid for by Medicaid (Welfare). If you don’t plan and you don’t own LTCi, you are greatly increasing your odds of ending up in a nursing home.

Filed Under: Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: AARP, assisted living, Howard Gleckman, Lexington Place Nursing Facility, Medicaid, Nursing Homes, SCAN Foudantion, The Commonwealth Fund, www.forbes.com

Nursing Home Murders: Connecting the Dots with Medicaid-Paid LTC

May 1, 2014 by Honey Leveen Leave a Comment

Connecting The DotsWith permission from The Center for Long-Term Care Reform, I republish their Monday, April 28, 2014 post about my prior blog.

The reason I chose to cover the horrific nursing home murders still in the headlines here in Houston, is because there is a link between failing to plan responsibly for long-term care well in advance and tragic outcomes, whether or not they’re of the magnitude of the Lexington Place murders.

Many who can afford reasonably priced long-term care insurance simply won’t entertain it. They make excuses to avoid such conversations. It’s an uncomfortable conversation to have.

The horror and negligence that occurred at Lexington Place Nursing Home may be isolated (or maybe not since most of us choose to turn our heads away from this type of event). Even so, the importance of these posts is to understand that such events may be indicative of a widespread trend that’s just beginning.

I’ve chosen to cover these tragic murders because to me, they’re the tip of the iceberg. The industrialized warehousing of the indigent who need care will increase as our national debt grows, Medicaid and Medicare reimbursements continue to drop, and the partisan stalemate in Washington continues.  And this financial catastrophe is approaching at an increasingly rapid rate as government programs are deluged with unprepared Baby Boomers who need long-term care but did not plan for it when they were able to afford and obtain reasonably priced long-term care insurance (LTCi). Sadly, events like the Lexington Place murders may become more common.

This blog and the one before it are meant to educate. If these tragic posts help even one person wake up and decide to defer their purchase of a new flatscreen TV or more expensive car in favor of buying a reasonably priced LTCi policy, they’ll be worth it.

LTC E-Alert #14-014:  The Nursing Home Murders and LTC News and Comment

Monday, April 28, 2014

Seattle –

LTC Comment:  Did you see the news coverage last week about two nursing home residents bludgeoned to death by their roommate in Houston?  We opted not to cover it then, but the story does illustrate an important point.  Nursing homes, especially those in poorer areas, are heavily dependent on Medicaid which pays them less than the cost of providing the care.  Generous Medicare reimbursements help to make up part of the shortfall (at least for now), but the nursing homes most heavily dependent on Medicaid resort to cutting caregiver staff to a minimum and paying extremely low wages in order to operate.

So what?  Well, Honey Leveen, the self-proclaimed “Queen of Long-Term Care” and the Center’s Regional Representative in Houston, draws out the ramifications in her recent blog post here.  We encourage you to read it and to follow her links to more of the background.  Honey points out that the nursing home in which the murders occurred has “nearly all” Medicaid residents.  She opines that inadequate revenue led to dysfunctional management which resulted in poor care and finally in this awful crime.  She links to an earlier article she wrote for LifeHealthPRO questioning the value of “Partnership” policies that leave people dependent on Medicaid’s mostly nursing-home based care.

This is sad stuff, but information all LTCI producers should consider as they advise clients on long-term care planning.

Filed Under: Denial, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Center for Long-Term Care Reform, Honey Leveen, Lexington Place Nursing Facility, Long Term Care insurance, LTCi, Medicaid, Steve Moses, www.honeyleveen.com

“Police Say Nursing Home Resident Killed 2 With Arm of Wheelchair”

April 26, 2014 by Honey Leveen Leave a Comment

Wheel ChairThe breaking news that immediately seized my eye on the front page of the April 23, 2014 Houston Chronicle was,  “Police say nursing home resident killed 2 with arm of wheelchair.”

The murders took place at Lexington Place nursing facility.

This is an article I wrote about Lexington Place. I’ve been there a few times and have toured it. The article was published in an insurance trade magazine in August, 2011.

What’s interesting is that hardly anyone ever comments on my blogs or online articles. This had been the case with all the articles I wrote for this magazine, except for this one, which described a few aspects of life inside Lexington Place. This particular article motivated many peers from all over the country to comment, all in positive ways. They all thanked me for telling the story straight.

According to my source, almost all of Lexington Place’s residents were/are Medicaid recipients. That means that Lexington Place was/is in a particularly precarious situation. Medicaid reimburses at rates that are beneath what it actually costs to provide care for nursing home patients.

If you search this website for “nursing homes”, you’ll find much factual information on why nursing homes are suffering. Essentially, most Medicaid-funded nursing facilities are the red and continue to suffer funding cuts.

Here, I opine: there is something about money being in short supply that causes businesses to panic. Then fear sets in. Then dysfunctional management occurs. This is what I believe occurred at Lexington Place.

I believe Lexington Place admitted people it probably shouldn’t have, in hopes of keeping its census high. If funding gets cut, a volume approach is often the remedy, whether this makes sense in the big picture, or not.

I believe, based on information I was given by a trustworthy former employee there, that Lexington Place is also woefully understaffed. That is what I was told, that’s what I reported in my August, 2011 story.

My question remains: if people complained about the murderer’s violent tendencies, why was his behavior not dealt with in a more reasonable manner?

The murderer bludgeoned his victims with the arm of a wheelchair. I presume the deaths were not sudden, but rather, drawn out in a process involving screaming, for quite a while. Where were the caregivers?

I think the answer to the above question must be screaming similar to that of the murder victims is a normal occurrence at Lexington Place.

 

Filed Under: Elephant in the Room, Information About LTC, Medicaid Planning Tagged With: Honey Leveen, Houston Chronicle, Lexington Place Nursing Facility, Medicaid, Nursing home, www.honeyleveen.com, www.lifehealthpro.com

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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

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Honey Leveen, LUTCF, CLTC, LTCP
“The Queen, by Self-Proclamation, of Long-Term Care Insurance (LTCi)”
404 Royal Bonnet
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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

Email: honey@honeyleveen.com

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