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Nursing Home Infections Are Increasing…Surprise (Not!)

October 17, 2014 by Honey Leveen Leave a Comment

Here’s an October 9, 2014 article from McKnight’s LTC News describing recently published findings that show across the board infection rates in nursing homes have surged during the past five years.

Quoting from the article, “The prevalence of viral hepatitis in nursing homes increased 48% between 2006 and 2010, the investigators determined. MDRO prevalence increased by 18% and pneumonia by 11%. The rates of urinary tract infections, septicemia and wound infections also rose.”

Here are several additional blogs I’ve done about Medicaid’s shortcomings. Because most long-term patients in nursing homes are on Medicaid (a form of Welfare), and because Medicaid’s reimbursement to nursing homes is actually less than the cost of caring for such patients, many nursing homes are unprofitable. We all agree that the most important employees in nursing homes are the custodial caregivers. These are the lowest paid people on the economic totem pole. Counter-intuitively, these critical frontline caregivers are often the first place nursing homes fire to cut expenses.

My opinion is that because of inadequate care in many Medicaid-funded nursing homes, corners are cut. Quality of care suffers. Sad outcomes then occur. This is what is causing the rapid rise of nursing home infections. It is not hard to connect the dots on this one.

Many nursing home patients end up in such facilities because they do not have money to access better care. People who own long-term care insurance (LTCi) are far less likely to wind up in Medicaid-funded nursing homes. They are far more likely to end up in preferable, far nicer assisted-living facilities.

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.

Take Responsibility, Folks!

December 2, 2013 by Honey Leveen Leave a Comment

Thank you again, Dear Abby, for providing fodder for this blog.

When I read this recent column, written by a daughter whose mother is evidently in a Medicaid-paid nursing home and receiving less than respectful care, I said to myself, “grow up; face the truth and don’t pawn the blame off on others.” The daughter’s sugary sweet letter smacks of the misguided denial I often see. It is cloaked in the daughter’s dysfunctional view of reality. The daughter aims her complaints at her mother’s caregivers, who are simply the most visible, yet non-responsible, cause.

As usual, Abby does not address the actual problem, which is the public’s widespread avoidance of conversation and responsible planning for long-term care, well in advance. However, she did give a correct answer to the letter writer, which is, “don’t blame the messenger”! Abby also correctly noted that the caregiver is the lowest ranked, lowest-paid, least respected, and in the most understaffed area at the nursing home. These caregivers do their best. They often work two or more jobs, and really must have heart and soul to want to do this type of work. Don’t blame the caregiver for the low quality care you are nearly certain to receive in Medicaid-funded nursing homes.

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Nursing Home Infections Are Increasing…Surprise (Not!)

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!)

Take Responsibility, Folks!

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