A round-up of some of the most popular long-term care news headlines for the week of November 21 2008.

Facing Shortfalls, States Seek Emergency Aid From Washington

By Keith B. Richburg and Ashley Surdin. The Washington Post. Nov 16, 2008

Economic Crisis Boils Democratic Message down to Jobs

By Alec MacGillis. Washington Post. Nov 16, 2008

Health Care, Energy Still Part of Agenda

House may address stimulus package this week

McKnight’s Long-Term Care News & AssistedLiving. Nov 17, 2008

FMAP increase expected in state tax policy would be of little help to the flagging economy.

CO: Rebirth in care of elderly

By Michael Booth. Denver Post. Nov 15, 2008

Patient-centered efforts mean improved quality of life, medical treatment

A concerted effort by the nursing home industry, along with intensive oversight from CMS, has produced positive outcomes in the quality of patient care in Colorado’s nursing homes. Between 2004 and 2007 there was a 46 percent drop in chronic pain episodes, a 12 percent drop in the number of pressure ulcers, and a 17 percent drop in the use of physical restraints. Colorado’s new pay-for-performance plan is expected to further spur the transformation of nursing home culture change. “The message from the state of Colorado to the public is that the quality of a person’s life in a nursing home matters, and we’re willing to pay a little more for it,” said Jeff Jerebker, owner of Piñon Management, which oversees 15 nursing homes in Colorado. “This can put Colorado on the map in a pioneering effort.

CO: A burden for broad shoulders

By Michael Booth. Denver Post. Nov 15, 2008

Energetic Maxine Roby sets the standard for how nursing homes should be run.

People come to Rowan Community “to live, not to die,” says director Maxine Roby. A growing number of younger residents demands “a schedule packed with college courses, election debates, swim hours at the local gym, and a do-it-yourself laundry room.” Besides enjoying plenty of pizza and hamburgers, Rowan’s open kitchen policy allows residents to pick up sandwiches and snacks 24 hours a day. Commuters can often see Rowan residents scootering along in traffic, out for errands or entertainment.

CT: State of confusion

By Jamie Masonfrom The Deal.com. Reuters. Nov 14, 2008 8:36 PM EST

Low Medicaid reimbursement rates have caused the closure of dozens of nursing homes and hospitals, nationwide, in the past few years. In Connecticut, where the reimbursement rate is just 50 percent of cost, many providers have sought bankruptcy in the past year.

“Marathon and Affinity are standard Chapter 11 filings, with the hope and expectation that they can reorganize”, says Toni Fatone, vice president of the Connecticut Association of Health Care Facilities. But “Haven is in a league of its own. Haven is beyond the realm,” she says. So much havoc has been created by the state’s investigation of Haven that now “the state of Connecticut is trying to micromanage nursing homes,” says Fatone.

FL: Lauderhill’s dream of better living for retirees has become a nightmare neighborhood

By Jon Burstein. South Florida Sun-Sentinel. Nov 16, 2008

A zoning change intended to convert a crime-infested South Florida neighborhood into a pleasant community of assisted-living facilities for middle-class retirees, has become a nightmare twelve years after its inception. Wayward teenagers, living in group homes, mix with mentally ill and drug sellers on the decaying streets, while assisted living residents wander aimlessly in the mix. “It was basically like opening up Pandora’s Box,” said city planning director Earl Hahn.

NY: State could put county out of nursing home business

By Dave Canfield. Troy Record. Nov 17, 2008

“If the state does not want to see counties in the nursing home business, then that should be a conscious decision on its part,” said County Executive Kathleen Jimino. “It should answer the question: Who will provide care for all of the residents on Medicaid that may not be able to be absorbed by private nursing homes?”

OR: Assisted living group nears sale of 7 bankrupt properties

By Jeff Manning. The Oregonian. Nov 15, 2008

Carolina investors, who potentially could get nothing, are fighting the deal to sell to a Boston company

A Sunwest Management deal to sell seven bankrupt retirement communities to a Boston company for $40 million is a potential disaster for individual investors who poured more than $11 million into Carolina retirement homes and who would get absolutely nothing from the transaction. They are fighting the plan in U.S. Bankruptcy Court in Nashville, Tenn. Another 1,200 investors who put $400 million into various Sunwest-affiliated operations have stopped getting their monthly interest checks and stand to get nothing from the “Sunwest-7″ deal.

WI: Fraud suit filed against state nursing home chain

By Ben Poston. Milwaukee Journal Sentinel. Nov 14, 2008

A class-action lawsuit filed against Extendicare Homes contends that the company fraudulently advertised its services and admitted too many patients with acute conditions without being sufficiently staffed to care for them.

Mexico’s growing assisted-living market targets U.S. retirees

By Laurence Iliff. Dallas Morning News. Nov 16, 2008

Mexican developers are creating a new industry, offering assisted-living to Americans in modern facilities, with a full range of services, in a warm climate, for as little as $1,100 a month.

No need for nursing home when PACE handles seniors’ care

By Andrea Pitzer, Special for USA TODAY. Nov 17, 2008

PACE’s emphasis on preventive care is designed to allow seniors to live independently for a longer period of time, keeping them away from costly hospitalizations. PACE centers provide day-care activities and the services of nutritionists, social workers, psychologists, nurses’ aides, nurse practitioners, doctors, and drivers who provide transportation to beneficiaries. “If we provide good care, we control costs,” says Shawn Bloom of the National PACE Association.

Seek advice, plan during long-term care month

By Susie Caspar. GateHouse News Service. MetroWest Daily News (MA).. Nov 17, 2008

Medicare coverage gap vexes patients, survey says

By Marley Seaman, Associated Press. Nov 18, 2008

Most Medicare Part D enrollees don’t understand the “donut hole” concept, according to a survey by Medco Health Solutions. “At this point the majority of members do know that there’s a gap in their coverage but they don’t understand how they arrive there, and there’s a few different points of confusion there,” said Woody Eisenberg, chief medical officer at Medco. “People know there’s a gap but there’s still lots of confusion about how they get there.”

FL: State collects $1.4M Medicaid rebate

Orlando Business Journal. Nov 17, 2008 2:42 PM EST

An investigation of billing procedures by the Florida Agency for Health Care Administration uncovered a difference between the billing procedures for medications dispensed at pharmacies and providers offices, resulting in a $1.4 million Medicaid rebate to the state.

MI: State Medicaid plans among slowest payers

By Patricia Anstett. Detroit Free Press. Nov 18, 2008

Michigan’s fee-for-service Medicaid insurance plans have the fourth worst payment lag: 88 days compared with 37 days for payment from commercial insurers, according to a new survey, published in the journal Health Affairs.

NH: Medicaid pits state against counties

By daniel Barrick. concord Monitor. Nov 18, 2008

The Supreme Court will rule on a lawsuit brought against the state by the N.H. Association of Counties, requiring county governments to cover what had previously been the state’s share of Medicaid expenses for nursing home and home-based-care patients.

SC: Medicaid cuts will affect thousands

By Liv Osby. GreenvilleOnline.com. Nov 17, 2008

“Our cut total equals $76.6 million in state funds,” said Jeff Stensland, spokesman for the Department of Health and Human Services. With the loss of federal matching funds, the total impact is $255 million, he said. “Like all other state agencies, we are having to tighten our belt.”

IA: State to tell public about nursing home inspectors’ role

By Clark Kauffman. Des Moines Register. Nov 18, 2008

In response to charges that the state nursing home inspection system is too punitive, the Iowa Department of Inspections and Appeals will hold a series of forums over the next two months. “We want people to know just who these inspectors are,” said Dean Lerner, director of the inspections department. “They are our registered-nurse neighbors, and they are pretty darn experienced and pretty darn caring.” Lerner said that Iowa’s nursing homes are among the best in the nation and most deliver high-quality care. Only a handful of facilities are performing poorly, he said.

OK: Number of Oklahoma Long-Term Care Monitors Falling

Nov 17, 2008 12:13 PM

State Health Department officials say that a significant cutback in the number of surveyors is causing inspections of Oklahoma’s long-term-care facilities to fall behind.

William Phelan: Medicaid relief must be in any stimulus bill

Tallahassee Democrat. Nov 19, 2008

“With our slowing state and national economies causing declines in projected state revenue, rising unemployment and an increased demand for Medicaid-funded care and services, it is more important than ever for Congress and President George W. Bush to pass in the remaining weeks of 2008 an economic stimulus bill that includes state Medicaid relief.”

Clinton Takes the Lead — on Health Insurance Reform

By Ceci Connolly. The Washington Post. Nov 19, 2008

Senator Ted Kennedy yesterday asked Hillary Clinton to run a special Senate “committee working group” on health insurance reform. Sen. Tom Harkin (D-Iowa) will head a sub-group on prevention and public health, and Sen. Barbara Mikulski (D-Md.) will head up a task force on improving the quality of health care. Clinton has not said whether she will accept the position.

GE, Mayo Clinic, others develop health record tech

By The Associated Press.. Seattle Post-Intelligencer. Nov 19, 2008

GE’s health care unit will invest $200 million over the next five years in a partnership initiative to develop electronic systems to enable the storage and sharing of medical information and patient records. Its partners in the effort are the Mayo Clinic, Intermountain Healthcare, Montefiore, and the University of California at San Francisco Medical. All of these institutions have  already developed electronic records systems.

Research by K-State Aging Experts Is Helping Nursing Home Staff Become More Comfortable Dealing With Residents’ Sexual Expression

Fox News. Nov 19, 2008

Researchers at Kansas State University have been developing ways for nursing homes to educate staff on the taboo topic and provide accommodations for the elderly that shield privacy. “Even though we advocate for residents’ rights, there are things that are inappropriate,” said Gayle Doll, director of KSU’s Center on Aging. “But staff must be able handle this without residents feeling embarrassed. Inappropriate behavior can just come from people needing relationships, not necessarily sexual

Medicare rules may force many to switch plans or lose free drug coverage

By Bob LaMendola. south Florida Sun-Sentinel. Nov 19, 2008

Twenty-five percent of low-income Medicare recipients in the U.S. must change prescription drug plans next year or pay more for coverage. Medicare gives free coverage to low-income people so long as premiums are under about $21 per month. Many plans that offered affordable coverage this year will not do so in 2009, and many seniors are unaware of the changes or are confused, standing to lose coverage altogether.

NY: Governor, Legislature fail to act on deficit

Delay shifts focus to bid for federal aid

By Tom Precious. Buffalo News. Nov 19, 2008

Facing a serious budget deficit, New York lawmakers spent a futile day in Albany yesterday, finally throwing up their hands and departing without any agreement. Gov. David A. Paterson is leading a delegation to Washington today to try to get federal funds to help close the gap.

Daschle reportedly offered top spot at HHS, providers pleased

McKnight’s Long-Term Care News & AssistedLiving. Nov 20, 2008

“I believe President-elect Obama could not have made a better choice than former Majority, Minority Leader Tom Daschle,” South Dakota Health Care Association Executive Director Mark Deak told McKnight’s. AHCA President and CEO Bruce Yarwood agreed. “Senator Daschle is a pragmatic problem-solver well versed in elder care issues and policy,” he said.

Health Insurers Offer to Accept All Applicants, on Condition

By Robert Pear. New York Times. Nov 20, 2008

America’s Health Insurance Plans and the Blue Cross and Blue Shield Association both said yesterday that they would support reform legislation requiring insurers to accept people with pre-existing and traumatic conditions so long as all Americans, including the healthy, are required to have and maintain insurance policies.

Adult Children, Aging Parents and the Law

By Jane Gross. New York Times. Nov 20, 2008

Few people are aware that there are statutes in 30 states making adult children legally responsible for payment of expenses for indigent parents. These unenforced filial responsibility laws, modeled on the Elizabethan Poor Laws of 1601, were intended to preserve public assistance as a last-resort funding source. Perhaps if these statutes were resurrected and enforced, families would be forced to engage in serious financial planning for long-term care.

DONs most stressed over staff issues, long-term care survey suggests

McKnight’s Long-Term Care News & AssistedLiving. Nov 20, 2008

Staff recruitment and retention issues, excessive stress, and long work hours head the list of frustrations of directors of nursing in the U.S., according to a new survey.

PA: State officials say they hope to avoid cuts in Medicaid

By Margaret Smykla. Pittsburgh Post-Gazette. Nov 20, 2008

“It would be one of the worst areas you can cut funds from,” said state Rep. Chelsa Wagner of the possibility that state budget cuts could affect Medicaid. The state’s $14.8 billion Medicaid program serves about 1.9 million aged, disabled and low-income residents. Medicaid cuts are still possible as the state faces a possible deficit of $1 billion to $3 billion for 2009. Sen. Wayne Fontana, D-Brookline said, “It is still vague on what will happen and too soon to say there will be cuts, but it looks to me they’re trying to save money through the providers.”

FL: Medicaid growth may bust budget

By Phil Galewitz. Palm Beach Post. Nov 19, 2008

As the economy grows worse, more Florida residents are turning to Medicaid to cover health expenses. So far there are about 100,000 more enrollees in the program than anticipated for the year, requiring approximately $144 million above the approved budget. This is causing added concern about Florida’s nursing home care, as 63 percent of this care is covered by Medicaid.

MA: Nursing home items sold at auction

By Peter Goonan. The Republican. Nov 20, 2008

After the closing of the 127-bed Marathon nursing home facility in Springfield, Massachusetts, the home’s furnishings, electric hospital beds, wall prints, televisions, computers, wheelchairs and more were sold at auction on Wednesday. Buyers paid as little as $5 for items. The Marathon Healthcare Group continues to operate six facilities in Connecticut, following Chapter 11 filings.

Legislation To Support Health Care Workforce

Hudson Valley Press. Nov 20, 2008

The Health Professional and Primary Care Reinvestment Act, proposed by Senator Hillary Rodham Clinton, would expand health care training and improve recruitment and retention efforts, especially in underserved areas. “A stronger health workforce and a greater focus on prevention will help provide more Americans with access to necessary health care.  We need to encourage more people from disadvantaged areas to join the health workforce while providing incentives for health professionals to bring primary care services to underserved communities.  This bill will improve medical services in the areas that need them most and is a step in our ongoing effort to ensure that every single American has quality, affordable health care,” said Senator Clinton.

Obama administration unlikely to enact pending Medicaid rules, panel says

McKnight’s Long-Term Care News & AssistedLiving. Nov 21, 2008

Elder suicide risk persists in long-term care

By Joene Hendry. Reuters. Nov 21, 2008

Though there was a notable decline between 1990 and 2005 in the suicide rates of elderly people living in community settings, suicide rates have stayed the same for elderly residents of long-term care facilities. According to researcher Dr. Briana Mezuk of the University of Michigan in Ann Arbor, “suicide prevention strategies aimed at older adults living in the community are either not reaching or are not effective at reducing suicide risk in long-term care settings. Factors that predict admission to long-term care facilities and nursing homes, such as social isolation, depression, functional limitations, and cognitive impairment, are also associated with suicide.”

ID: Idaho audit: Medicaid database still has problems

By Rebecca Boone. Fort Mill Times. Nov 20, 2008

State auditors say that the Idaho Department of Health and Welfare’s Medicaid eligibility computer system still has thousands of errors, delaying Medicaid access for some. Data between two intricate computer programs still has not been combined, and auditors worry that the state has not placed a high enough priority on reconciling these computer programs to streamline access to important information.

NY: Sea change in elder care

By Henry L. Davis. The Buffalo News. Nov 21, 2008

Western New York Alliance for Person-Centered Care

The Western New York Alliance for Person-Centered Care, will attempt to be the first region-wide attempt to transform nursing home culture on a grand scale. “If we continue to provide care and treat staff the way we currently do, we will have a crisis,” said Robert Meiss, chief executive of Beechwood Continuing Care in Getzville.

NY: 54 Nursing Homes Sanctioned For Poor Care

North Country Gazette. Nov 20, 2008

Top Medicare Drug Plan Premium Hikes

U.S. News & World Report. Nov 20, 2008 11:20 AM

List of premium hikes for top ten plans.