A round-up of this week’s long-term care news, including information on Medicare, Medicaid, generic drugs and nursing home information.

Long-term power outages snag rehearsed plan for frail residents
By Lise Olsen. Houston Chronicle. Sep 20, 2008
In Texas, 58 nursing homes and 71 assisted living centers are still struggling with the after-effects of Hurricane Ike. Many are still without power and are having to operate without air conditioning or adequate lighting. Manual techniques are being used to operate oxygen tanks, and to feed those reliant on feeding tubes.

For most, Medicare premiums won’t rise in 2009
By Victoria Colliver. San Francisco Chronicle. Sep 20, 2008
For the first time in nine years, Medicare premiums will not go up for most beneficiaries. Over recent years, premiums have been raised to help build up Medicare’s reserves. The reserve is now at an acceptable level, and the government recently discovered an accounting error that will work in favor of the 2009 rates.

Household Eligibility and Application Process of the Coupon Program for Individuals Residing in Nursing Homes, Intermediate Care Facilities, Assisted Living Facilities and Households that Utilize Post Office Boxes;
Department of Commerce; National Telecommunications and Information Administration. Federal Register. Sep 19, 2008, Vol. 73, No. 183
The Digital Television Transition and Public Safety Act of 2005 (the Act), among other things, authorized NTIA to create a Digital-to-Analog Converter Box Coupon Program (Coupon Program) to assist consumers to continue receiving broadcast programming over the air using analog-only televisions not connected to cable or satellite service after the February 17, 2009 deadline for full power stations that convert to digital-only transmissions.\1\ Specifically, section 3005 of the Act directed NTIA to implement and administer a program through which eligible U.S. households may obtain via the United States Postal Service a maximum of two coupons of $40 each to be applied
towards the purchase of Coupon-Eligible Converter Boxes (CECB).

Aggression among nursing home patients widespread
Reuters Health. Sep 19, 2008 8:43 PM
A study released by Weill Medical College at Cornell University in New York City is one of a number of studies to conclude that aggression among nursing home residents is a wide-spread problem. Researcher Tony Rosen and his colleagues found that the largest number of incidents of aggression centered around territoriality and conflicts among roommates. The team concluded that keeping residents with dementia in separate areas from those without, and allowing residents greater control of their daily lives may help minimize aggression issues.

September 21 - 27, 2008 is National Adult Immunization Awareness Week.

This annual health observance is a great opportunity to promote the importance of adult immunizations. CMS reminds health care professionals that Medicare Part B reimburses health care providers who accept the Medicare-approved payment amount for influenza, pneumococcal, and hepatitis B vaccines and their administration. All adults 65 and older should get influenza and pneumococcal shots. People with Medicare who are under 65 but have chronic illness, including heart disease, lung disease, diabetes or end-stage renal disease should get a flu shot. People at medium to high risk for hepatitis B should get hepatitis B shots.
You can help by talking with your Medicare patients about their risk for these vaccine-preventable diseases covered by Medicare and the steps they can take to help reduce their risk of contracting these diseases, including getting vaccinated. And don’t forget, health care workers also need to protect themselves. Get Your Flu Shot. - Not the Flu.
For information about National Adult Immunization Awareness Week, please visit the National Foundation for Infectious Diseases at http://www.nfid.org/.

Long-term care Rights Week slated
Worcester Telegram (MA). Sep 21, 2008
The week of October 5-11 has been designated Long-Term Care Rights Week. This year’s theme is “Recipe for Home: Defining and Creating Home in Long Term Care Facilities.”

Medicaid long-term care lawsuit erupts in Florida
By Matt Sedensky, Associated Press. Miama Herald. Sep 19, 2008
A group of Florida Medicaid patients is challenging the state, saying they are being illegally forced to live in nursing homes in order to receive Medicaid benefits. A federal class-action suit has been filed on behalf of 8,500 Florida residents who would rather live under the care of relatives or friends than in the nursing homes where they currently reside. In many cases, the costs of allowing patients to live in the community are lower than those of keeping them in nursing facilities, but in many states getting Medicaid-supported services at home is much more difficult and requires a longer wait. There are also concerns over how to determine which residents are truly capable of living outside of a nursing facility, and the safety issues involved. AHCA spokeswoman Susan Feeney noted, “You don’t want to be there (in a nursing facility) but sometimes for health reasons beyond your control, you have to be.”

Wisconsin hospitals and nursing homes achieve high levels of employee influenza immunization
WKOWTV.com, Madison. Sep 23, 2008
In Wisconsin, 107 health care facilities succeeded in getting at least 80 percent of employees immunized against influenza last year.”Reaching an 80 percent immunization rate is a tremendous accomplishment, and we want to recognize such dedication to patient safety,” said State Health Department secretary Karen Timberlake.  “We also want to encourage more health care staff to get immunized.  Sick health care workers can be a serious threat to patients, and immunization of hospital and nursing home workers against influenza reduces the risk of illness, even death, for their patients.”

NY: Health alliance formed to assist elderly
By Tracey Drury, Business First (Buffalo). Sep 23, 2008
Renowned geriatrician, William Thomas, was the featured speaker at the September 19 launch of the Western New York Alliance for Person-Centered Care. The first-of-its-kind initiative, comprised of long-term-care providers, government regulators, academics, and the Pioneer Network is focused on effecting change “through a community-based strategic plan to introduce, refine, and promote person-centered care through education and mentoring.”

MS: Residents to be in convention spotlight
Clarion Ledger. Sep 23, 2008
About 500 residents of Mississippi long-term care facilities will participate in events and contests at the Mississippi Health Care Association’s Residents’ Convention on Wednesday at the Mississippi Trade Mart.

OR: On-site nurse practitioners help with health of nursing home residents
By Tom Adams. KVAL.com. Sep 23, 2008
“It appears that we’re having fewer hospitalizations with our patients,” said Trillium CEO Terry W. Coplin. “These are highly qualified nurse practitioners that can address the needs of our patients in a routine daily manner. We’re getting very good feedback from families as well as patients.”

Oregon one of seven states to test nursing home alternatives
Thelma Guerrero-Huston. Statesman Journal. Sep 23, 2008

The Doctor’s Hands Are Germ-Free. The Scrubs Too?
By Tara Parker-Pope. New York Times. Sep 23, 2008

Behavior: As People Age, the Thrill Is (Almost) Gone
By Eric Nagourney. New York Times. Sep 23, 2008
As people age, the response of their brains to dopamine, a naturally occurring chemical messenger that plays a central role in the reward system, undergoes change, according to  Dr. Karen Faith Berman of the National Institutes of Health, author of a new study. “It may explain anecdotal evidence that people are mellower,” she said, “that they may not get the same highs from certain experiences, but they may not get the same lows, either.”

Michigan House approves bills to soften Carlyle Group takeover of Michigan nursing homes
By Todd Spencer. Sep 19, 2008 1:44 PM
The Michigan house passed an eight-bill package to simplify the process for patients, families of patients and government regulators to lodge complaints or obtain answers about the care provided in Michigan nursing homes. This move comes nine months after the highly publicized acquisition of 28 nursing homes by the Carlyle Group, a major private equity firm.

NY home health aides fight for higher wages
By Marcus Franklin, Associated Press. Newsday. Sep 21, 2008
About 3,500 New York home health aides are threatening to strike next week after an unsuccessful four-year battle to gain union representation. Many of these agency-employed aides, including some who have been working in the healthcare industry for more than a decade, are paid only minimum wage, have no health insurance and no paid holidays or sick days. Though agencies get an average of $22 per hour for healthcare aides in Medicare-certified cases, the money goes towards many other things such as training, screening potential employees, supervisor pay, liability insurance, accreditation and more. There is little left over to pay the aides providing the services.

PA: Nursing home residents flee plant fire
By The Associated Press. The Times Online. Sep 19, 2008 10:20 PM
Residents of the Silver Oaks nursing facility were evacuated to Jameson Hospital and the Scottish Rite Cathedral after a fire broke out in a nearby hazardous waste plant on Thursday. No injuries from the fire or the evacuation were reported.

TN: ‘Cultural shift’ sparks region’s senior housing building boom
By Linda Bryant. Nashville Business Journal. Sep 19, 2008

Vitamin C Might Help Lower Hypertension
By Alan Mozes, Health Day Reporter. The Washington Post. Sep 19, 2008
An Italian study has found that vitamin C works to calm overactive nervous systems, thereby lowering blood pressure.

Mending Medicare to be painful
By Darla Mercado. Investment News. Sep 22, 2008

Congress backs parity in coverage of illnesses
By Robert Pear. New York Times. Sept 24, 2008
By an overwhelming majority, both the Senate and House yesterday approved a bill that would require equivalent health coverage for both mental and physical illnesses. “This bill provides mental health parity for about 113 million Americans who work for employers with 50 employees or more,” said Sen. Pete Domenici (R-NM), who has a daughter with schizophrenia. “No longer will people with mental illness have their mental health coverage treated differently than their coverage for other illnesses like cancer, heart disease and diabetes.”

Congress approves mental health bill
Private Insurers Would Provide More Benefits
By Lyndsey Layton. Washington Post. Sept 24, 2008; A02

Report: Medicare spending billions on suspicious claims
By Julie Appleby. USA Today. Sept 24, 2008
Congressional investigators have found that Medicare pays millions each year for unwarranted medical supplies. “Since when did doctors start prescribing blood-glucose test strips for the bubonic plague? It seems like a no-brainer that Medicare should check the diagnosis before paying for expensive medical equipment,” asks Sen. Norm Coleman of Minnesota, top Republican on the Senate Permanent Subcommittee.

McKnight’s offers video from NIC conference
Want to hear directly from industry leaders on market trends and capital availability? McKnight’s has posted a dozen short videos from the recently-held National Investment Center for the Seniors Housing & Care Industry conference in Chicago.

California Budget Is Signed, 85 Days Late and Despised
ByJennifer Steinhauer. New York Times. Sept. 24, 2008
“This record-setting budget stalemate has been an enormous burden on so many small businesses and health care providers who care for our most vulnerable Californians: the sick, elderly, disabled and children,” said State Controller John Chiang in a statement. “I will quickly pay all (80,000) backlogged claims, and I am asking state agencies for their assistance to ensure that we get payments into the hands of those who most desperately need them as quickly as possible.” The first checks to be written,
as early as Friday, will go to nursing homes and other health care providers so hard-hit during the stand-off.

IN: Elders’ lawyers slam planned Ind. Medicaid changes
By Ken Kusmer. Associated Press. Chicago Tribune 4:18 PM CDT, September 23, 2008
I don’t think many people realize how devastating these proposed rules might be,” said Robert Smith, attorney who helps nursing homes get Medicaid or other payments for their patients. “This thing is coming through like a runaway freight train.”

Feds target Minneapolis Veterans Home in new probe
By Warren Wolfe. Star Tribune. September 23, 2008
The federal Justice Department is investigating medical care at the troubled Minneapolis Veterans Home, and has requested access to medical records of all residents of the home for the past two years — as many as 500 veterans or their spouses. However, the state is refusing access to those records, which are private under Minnesota law.

TX: 8 hospice patients die far from home
The Cherokeean Herald, Sept. 24, 2008. Front Page
After 23 hospice patients from Beaumont found a safe and welcoming haven at a little nursing home in Wells during Hurricane Ike, power lines were severed in 18 locations between Hillside Plaza Rehabilitation Services and the nearest source. Although the Cherokee County emergency management coordinator made it a priority to help Hillside Plaza get power back quickly and was able to get all 18 breaks repaired, eight of the 23 patients died during the first 48 hours. Although the average patient succumbs within 10 days of entering hospice, caregivers and residents at Hillside Plaza were profoundly affected by the loss of their new friends.

Many trial reports on FDA-approved drugs go unpublished
HealthDay News. Washington Post. Sept. 23, 2008
Researchers at the University of California, San Francisco, have found that more than half of all supporting clinical trials for FDA-approved drugs remain unpublished five years after the drugs are approved for sale.

Lung drugs might be taking a toll on the heart
By Rita Rubin. USA Today. Sept 24, 2008
Researchers have found that patients given tiotropium (Spiriva) or ipratropium (Atrovent) - drugs widely used for COP - raise the risk of heart attacks, strokes and death from heart disease.

House Passes Stopgap Spending Bill, Delaying Major Decisions
By Carl Hulse and Robert Pear. New York Times. Sep 25, 2008
In hopes of getting a better domestic spending deal from the next occupant of the White House, the House yesterday passed a $630 billion stopgap spending measure that would keep the federal government operating through March 6. The bill includes nearly $23 billion in hurricane and flood relief.

Health insurance premiums increase moderately as coverage gets skimpier, report says
The 5% rise was similar to last year’s uptick, according to the Kaiser Family Foundation and Health Research and Educational Trust.
By The Associated Press. Los Angeles Times. Sep 25, 2008
Health insurance premiums rose to $12,680 for a family and to $4,704 for single coverage, according to the Kaiser Family Foundation and the Health Research and Educational Trust. Employers, who pay about 75 percent of that cost, are increasingly offering high-deductible coverage that requires their workers to pay more of their own medical expenses before the insurance kicks in.

Health Care Costs Increase Strain, Studies Find
By Reed Abelson. New York Times. Sep 25, 2008
The average family now pays $3,354 in health care insurance premiums, which is more than double the amount they paid in 1999. More than half of families surveyed  said they borrowed money to pay medical expenses last year, and nearly 20 percent of those considered declaring bankruptcy due to their medical bills.

Study: Seniors not quite embracing generic drugs
By Matthew Perrone, Associated Press. Sep 25, 2008
A majority of Medicare beneficiaries choose name-brand drugs while Medicare is footing the bill. When they hit the donut hole, these beneficiaries become acutely aware of the price factor and most switch to generics. When coverage resumes, 59 percent switch back to name-brands, boosting the costs paid by the federal government.

Drug Maker to Report Fees to Doctors
By Benedict Carey. New York Times. Sep 25, 2008
Eli Lily & Co. announced yesterday that it will post all payments to doctors for speaking and consulting services in an online database. Merck & Co. followed suit, saying it will post fees paid to doctors for speaking engagements in 2009.
Senator Charles e. Grassley (R-IA) responded to the announcement by saying, “Disclosing information about financial relationships between industry and doctors is a good thing, and this announcement contributes to transparency. My effort for broad-based transparency and accountability will continue because a uniform reporting requirement is needed to get the full picture.” Several states, including Minnesota and Vermont, currently keep records of those payments.

CA: Independent nursing homes eagerly await money from state
By Cynthia Hubert. Sacramento Bee. Sep 25, 2008
Betsy Hite of the California Association of Health Facilities said that, with 85 percent of nursing home residents depending on Medi-Cal, the state’s nursing homes “were on the brink of disaster. The Legislature puts them in this position year after year. Our people are used to it. But 85 days without getting paid? Come on. People were panicking. Many administrators lost staffers to more secure jobs. ”

IL: Nursing home deaths not about mercy, report indicates
By Charles Keeshan. Chicago Daily Herald. Sep 25, 2008
The 2006 deaths of six nursing home patients were likely purposely caused by a nurse who dosed patients she found troublesome or believed had lived long enough, according to an investigatory report from the Illinois Department of Public Health.

Ohio: Programs for Poor Face $80 Million in Budget Cuts
By The Associated Press. New York Times. Sep 25, 2008
In order to comply with an order by Gov. Ted Strickland to cut 4.75 percent from state agency budgets, the Ohio Department of Job and Family Services, is cutting $80 million from the state’s welfare program, adoption services, Medicaid fraud detection and the state’s child support program.
Not included in the cuts are $9.3 billion the state sets aside to provide Medicaid to Ohioans until receiving a federal reimbursement, and $25 million for disability assistance.

UT: Medicaid funds on chopping block
By Lisa Rosetta. Salt Lake Tribune. Sep 24, 2008
Just as more Utahans are lining up for Medicaid benefits, Medicaid director Michael Hales is preparing to present two budget-cutting scenarios to lawmakers.

Man, 86, uses wheelchair to kill nursing home resident
By The Associated Press. Canadian Press. Sep 25, 2008
A wheelchair became a weapon when an early-Alzheimer’s patient banged a sleeping fellow nursing home resident in the face with the footrest, killing him. The incident occurred in Puerto Rico.

Medicare officials advise seniors to shop around
By Kevin Freking. The Associated Press.. Sep 26, 2008
Costs of the 10 most popular Medicare drug plans will increase in 2009 from between 8 percent to 64 percent, according to an analysis by Avalere Health. While Medicae beneficiaries will have access to plans at the same cost as they are paying this year, they will need to shop around, said Kerry Weems. “The engine behind Part D is choice and competition,” he said.

Medicaid: Kaiser Daily Health Policy Report Highlights Medicaid Developments in Three States
Kaiser Daily Health Policy Report. Sep 25, 2008
Recent news coverage about Medicaid programs in Indiana, Maryland and Utah:
Indiana: A proposed rule, intended to stop fraudulent use of Medicaid funds, would restrict Medicaid coverage of nursing home care for people who shift their assets to meet income eligibility thresholds.
Maryland: A Medicaid expansion raised the annual income eligibility threshold for parents in the Medicaid program from 40% of the federal poverty level to 116% of the poverty level.
Utah: Facing a $274.4 million state budget deficit, Utah Medicaid Director Michael Hales yesterday presented two budget proposals that would cut Medicaid: One would cut Medicaid funding by 3%, or $10 million in general funds and $25 million in federal matching funds. The other would reduce funding by 5%, or $16.8 million in general funds and $40 million in federal matching funds

FL: Elder Care Cuts and Growth
By Bobbie O’Brien. Public Broadcasting. WUSF. Sep 25, 2008
“As I age, I want to be able to stay in my house with my wife,” stated 68-year-old Ed Lee, at an AARP-sponsored budget forum. “How are you going to ensure that services are available so that my wife and I may remain together and independent?”

FL: Nursing home death ruled homicide, but no charges
Pensacola News Journal. Sep 26, 2008
No charges will be filed in the case of an 83-year old nursing home patient with Alzheimer’s, who pushed her 84-year-old roommate to the floor, contributing to her cause of death.

ID: Remember the rights of long term care residents
The Latah Eagle. Sep 25, 2008
Across the country, Residents’ Rights Week will be celebrated in long-term care facilities during the week of October 5-11. This year’s theme “Recipe for Home: Defining and Creating Home in Long-Term Care Facilities” emphasizes the importance of empowering residents to define what home means to them and to honor their choices.

IL: McHenry County nursing home fined nearly $360,000
By Jeff Long and Carolyn Starks. Chicago Tribune. Sep 26, 2008
The McHenry County nursing home has been fined nearly $360,000 after regulators alleged that an employee used drug cocktails to ensure residents “would not be bothering her during her shift.” The nurse in question told a co-worker in 2006, “She won’t make it through the day. I made sure of that.”

OH: Bomb threat forces evacuation 81 nursing home patients and 15 health care workers
By JC Reindl. Toledo Blade. Sep 26, 2008
Residents of the Swanton Health Care and Retirement Center were moved to shelter at the Swanton High School after the threat was reported at about 7:30 p.m.

SD: Senior Art show looking for submissions
The Daily Republic. Sep 25, 2008
Artists 60 and older are invited to take part in the South Dakota Health Care Association (SDHCA) MasterWorks Senior Art Show, to be held Oct. 27-28 at the Good Samaritan Society in Sioux Falls. Categories include watercolor, oils, acrylic, drawing/pastels, photography, sculpture and wood carving. More information on the exhibit, go to www.sdhca.org.

Scientists find way to regress adult cells to embryonic state
By Rob Stein. Washington Post. Page A17. Sep 26, 2008
“This is a huge step forward — it could be the breakthrough we’ve been looking for,” said Robert Lanza, a stem cell researcher at Advanced Cell Technology in Worcester, Mass.