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Bad Nursing Home Gets $14 Million Punishment

July 28, 2014 by Honey Leveen Leave a Comment

A July 25, 2014 story in McKnights, by Tim Mullaney, reports on a $14 million award ($12.5 million was awarded in punitive damages) to the family of a nursing home patient. This story was also covered in the Boston Globe on July 24, 2014.

Quoting from the Globe story, “Judge Krupp instructed the jury that while punitive damages can be awarded for a company’s bad behavior, they can also be used to dissuade other nursing homes from similar conduct…the judge explained that the whole purpose of the punitive award is to send a message that you can’t get away with this anymore.”

How wonderful if the problem could simply be fixed by a judge using the court system to “teach a lesson”!

Again, the 8,000 pound elephant in the room is being ignored.

Especially in Texas, but throughout the country, nursing homes get paid less per diem than it costs them to care for their patients. Medicaid, which pays for the majority of long-term care in the US, needs an overhaul.

There is no doubt in my mind that the nursing home sued accepted mostly Medicaid patients. Here are a couple of blogs I did about murders that occurred in Lexington Place nursing home in Houston. Lexington Place accepts mostly Medicaid paid patients.

When nursing homes do not get paid enough, there are not enough caregivers. This directly affects the quality of care nursing home patients receive.

Click here for several blogs I’ve done that explain why Medicaid paid nursing home care often leads to sad outcomes.

Those of us who own long-term care insurance (LTCi) are far more likely to have the money to avoid nursing homes and receive care at home or in an assisted living facility.

Finding Good Nursing Home Care Is Not Easy!

July 2, 2014 by Honey Leveen Leave a Comment

A 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.

Why Staff (Is All That) Matters in Choosing a Nursing Home (Not!)

May 14, 2014 by Honey Leveen Leave a Comment

In all of my 23 years specializing exclusively in long-term care insurance (LTCi), the Houston Chronicle has done scant reporting on LTCi and long-term care planning. They’ve done a story on how to financially plan for aging and left out mentioning LTCi altogether. On the rare occasion they’ve made mention of LTCi they’ve gotten vital facts wrong.

In a city as large as ours, I’m very embarrassed about the Houston Chronicle’s dearth of coverage of LTCi, a subject that would help its readers. I believe New York, Washington, DC, Chicago, and many smaller cities than Houston, have had good coverage of LTCi lately. Houston still hasn’t.

In her recent Houston Chronicle column, “Why Staff Matters in Choosing a Nursing Home”, reporter Cindy George advises using various online tools to help you “shop” for a facility that won’t neglect or abuse your loved one. She makes this task sound as easy as, say, researching a computer or vacation online.

If you do the proper research, her article implies, your loved one won’t be subject to neglect, abuse, or the murders or beatings that have recently occurred at two Houston nursing facilities. Or maybe your loved one will be subject to just some abuse and neglect, but not beatings or murders? To accomplish this just use the tools she provides; it’s that easy.

Here’s what I wrote to her on my Facebook page:

“Cindy George of the Houston Chronicle, I know you’re trying to help by offering advice on how to choose a functional nursing home, in light of the recent nursing home violence we’ve had in Houston. Your advice may make readers feel good in the short term by giving them the impression there are decent odds they might have any control over the quality of their care if they cannot afford to pay for it. I would like to help add depth to your reporting and hope you will accept my invite to lunch or coffee.”

The problem with stories like “Why Staff Matters in Choosing a Nursing Home” is that it lulls people into believing doing correct facility research and shopping is all they’ll need to access quality long-term care. Responsible long-term care planning is not necessary. The government is there and will be there to pay for quality long-term care.

Search on this blog for “Nursing Homes” to learn a lot about why the government can’t – and won’t – pay for meaningful, adequate long-term care.

Government financing for long-term care is decreasing. Nursing home failures, neglect, abuse, tragedies, are increasing.

Generation Warfare is Brewing

May 12, 2014 by Honey Leveen Leave a Comment

In her April 9, 2014 column, one of my heroines, Terry Savage, describes looming Generation Warfare.

In a nutshell, our government is spending far more than it takes in. Check out Truth in Accounting, a nonprofit that keeps track of both our current national debt and the burden of future government payment promises. We now have an “official” national debt of more than $17.4 Trillion. The ticking clock on their website shows that we have promised to pay a total of $76 trillion to future Social Security and Medicare recipients, not to mention interest on our debt, along with military retirement benefits, etc.

In other words, we owe a lot of money! More than the government can raise in taxes.

In the meantime, Washington is playing a shell game. Instead of figuring out how to grow the economic pie, they are obsessed with dividing up the existing pie.

Generational warfare is brewing. Young people are enticed to take out student loans at interest rates many times what the government pays to borrow — and then graduate into an economy that is not providing jobs so they can repay those loans.

Younger workers pay into a Social Security “trust fund” that is scheduled to move onto shaky ground long before they can expect to receive benefits. They’ll be supporting government retirement benefits for someone else’s parents and grandparents.

And from the seniors’ side, isn’t it generation warfare for the Fed to keep interest rates low (depriving seniors of the opportunity to earn interest in their retirement years), so that the government’s unprecedented borrowing (a burden on the young) can continue?

And isn’t it generation warfare to reduce the government’s support for Medicare Advantage plans and limit Medicare reimbursements to physicians and hospitals, just when seniors most need the care?

Here’s another article about oncoming Generation Warfare that came out about the same time Terry Savage’s column did. It echoes what Terry predicts.

My April 9, 2014 blog is about how astonishingly huge and unsustainable our national debt is. Tax collection doesn’t put a dent in it. Medicare and Medicaid, the primary ways long-term care is paid in the US, are on the firing line and already suffering cutbacks. The giant bulge of Baby Boomers, most of whom are wholly unprepared to pay for their long-term care, is just beginning to hit our system.

At age 65, there’s a 70% chance any of us will need long-term care during our lives. I urge you not to depend on the government to provide your long-term care.

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

May 1, 2014 by Honey Leveen Leave a Comment

With 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.

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Bad Nursing Home Gets $14 Million Punishment

Finding Good Nursing Home Care Is Not Easy!

Why Staff (Is All That) Matters in Choosing a Nursing Home (Not!)

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

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