At any given moment, there is a large group of citizens who want nothing more than to make absolutely certain that they are impoverished enough to qualify for Medicaid sooner rather than later. Someday, you might be one of them. Welcome to the (perfectly legal) world of Medicaid planning, the plain-vanilla term for the mini-industry of lawyers and others who help people arrange their financial lives so they don’t spend every last dime on a nursing home. Once properly impoverished under the law, then Medicaid, which gets funding both from your state and the federal government, picks up the tab.
SPRINGFIELD – The Illinois Department of Public Health (IDPH) today announced the following type “AA” and “A” violations of the Nursing Home Care Act processed during the first quarter of 2017. An “AA” violation is cited when there is a condition or occurrence at the facility that proximately caused a resident’s death. An “A” violation pertains to a condition in which there is a substantial probability that death or serious mental or physical harm will result, or has resulted. The Quarterly Report of Nursing Home Violators can be found on IDPH’s website and contains additional information about the violations.
Alice Jacobs, 90, once owned a factory and horses. She raised four children and buried two husbands. But years in an assisted living facility drained her savings, and now she relies on Medicaid to pay for her care at Dogwood Village, a nonprofit, county-owned nursing home here. "You think you've got enough money to last all your life, and here I am," Jacobs said. Medicaid pays for about two-thirds of the 1.4 million elderly people in nursing homes, like Jacobs. It covers 20% of all Americans and 40 percent of poor adults.
One of the biggest flash points in the debate over Republican legislation to repeal and replace the Affordable Care Act is the future of Medicaid. Here are some basic facts about the 52-year-old program. What is Medicaid? It’s a public health insurance program largely for low-income people, though some middle-class disabled and elderly people also qualify. States and the federal government share the cost. Whom does Medicaid cover? Nearly one in five Americans, 74 million people, are on Medicaid. Federal law guarantees Medicaid coverage to pregnant women, children, elderly and disabled people under certain income levels. It covers more than a third of the nation’s children and pays for half of all births. It also covers almost two-thirds of nursing home residents, including many who are middle class and spent of all their savings on care before becoming eligible.
Chicago's population is gradually getting older. In 2014, people over 65 made up 24 percent of the population in the Chicago region, up from just 18 percent in 1970, according to a report by the Chicago Metropolitan Agency for Planning. Although most seniors surveyed by AARP say they'd like to remain in their homes, the reality is that age-related physical limitations — difficulty climbing stairs and shoveling driveways — will make staying put difficult for many. All of this signals huge demand for senior housing in the years to come, and developers have been rushing to build or refurbish both rental and for-sale housing for the nation's 75 million baby boomers. Yet housing experts point to a mismatch between what's being built and what will be needed. Most construction has been aimed at the affluent luxury market, as developers have tried to lure active young seniors by emphasizing spalike amenities ranging from swimming pools to movie theaters. Not enough senior housing is being developed for middle-income retirees.
In 2016, the Centers for Medicare and Medicaid Services barred nursing homes from forcing their residents into accepting binding arbitration agreements that would move all legal claims into business-friendly fake courts where the proceedings are often secret, and where the presiding fake judges draw their pay from the companies that are accused of malfeasance. Naturally, the nursing home lobby sued to prevent this rule, and now, the Trump administration has announced that it won't fight the suit, and so the nursing home industry will be allowed to take away the foundational right of elderly people who've experienced harm at the hands of corporate care facilities to sue for redress of those harms.
Despite objections from senior advocates, Gov. Bruce Rauner’s administration is forging ahead with a cost-cutting plan to dramatically alter how older adults receive services intended to keep them from needing to go into nursing homes. Rauner’s team is projecting it can save $120 million a year by reducing the number of hours state-paid home care workers are needed in the homes of elderly individuals by substituting “flexible” alternatives. Opponents, including AARP, say the plan in reality is a reckless reduction of services that will result in higher costs to the state by forcing more Illinois residents into expensive nursing home care.
THE AMERICAN HEALTH CARE ACT, which squeaked through the House of Representatives on Thursday, is terrible for many Americans in many ways. But what’s gotten almost no attention is the horrendous effect it could have on Americans in nursing homes. Daniel Webster, a Republican representative from the 11th Congressional District in central Florida, acknowledged this when he announced he would vote for the AHCA. “I have been very concerned about Florida’s Medicaid-funded nursing home beds,” Webster said. “These are critical to the access some of our senior population has to our nursing homes.”
The potential repeal and replacement of the Affordable Care Act (ACA) is as much about municipal budgets and economics as it is about the individuals who rely on it for coverage. Federal Medicaid reimbursements, newly created preventive care grants, and financial incentives for neighborhood clinics have been a boon for Illinois hospitals and health centers. In a special 36 minute episode of The Aldercast, we take a deeper dive into this topic to explain what the healthcare landscape was like in Illinois before the ACA, how it changed, and what taxpayers, governments, and providers stand to lose from a potential repeal.
Some of the victims can't speak. They rely on walkers and wheelchairs to leave their beds. They have been robbed of their memories. They come to nursing homes to be cared for. Instead, they are sexually assaulted. The unthinkable is happening at facilities throughout the country: Vulnerable seniors are being raped and sexually abused by the very people paid to care for them.[Article mentions Illinois further down]
Home health agencies will be required to become more responsive to patients and their caregivers under the first major overhaul of rules governing these organizations in almost 30 years. The federal regulations, published last month, specify the conditions under which 12,600 home health agencies can participate in Medicare and Medicaid, serving more than 5 million seniors and younger adults with disabilities through these government programs.
...Will the new requirements help improve care for the country’s 1.4 million nursing home residents — perhaps raise the report card grade to a solid B? “From our perspective, it’s a mixed bag,” Ms. Grant said. Residents and families will most likely appreciate some of these changes once they are in place. But the regulations disappointed nursing associations and many advocates by declining to set minimum staffing standards. And one key provision has already been stopped in its tracks by a lawsuit. A look at some particulars...
Dr. Anitha Rao has seen this problem firsthand: She's just one of 1,000 physicians in the world with specialized training in dementia and geriatric neurology. Rao is now launching a startup in hopes of improving dementia care through technology. Rao is the cofounder of Neurocern, a platform that uses proprietary algorithms to analyze symptoms in order to provide diagnostic guidance for doctors and a personalized care plan for patients. Rao hopes this solution will be particularly helpful to families without access to specialists and caregiving advice.
A Chicago appellate panel has affirmed a lower court finding that a suit lodged by scores of nursing homes, alleging Illinois state government excessively cut its Medicaid reimbursements to the nursing facilities, should be pursued in the Illinois Court of Claims rather than Cook County Circuit Court, because the state did not overstep its authority as to how it calculated the reductions.
At age 88, Elizabeth Fee looked pregnant, her belly swollen after days of intestinal ailments and nausea. A nurse heard a scream from Fee's room in a nursing home and found her retching "like a faucet" before she passed out. The facility where she died in 2012 was affiliated with a respected San Francisco hospital [...] Fee had just undergone hip surgery at the hospital, and her family, pleased with her care, said they chose the nursing home with the hospital's encouragement. Laura Rees, Fee's elder daughter, said she was never told that the nursing home had received Medicare's worst rating for quality - one star. Nor, she said, was she told that state inspectors had repeatedly cited the facility for substandard care, including delayed responses to calls for aid, disrespectful behavior toward patients and displaying insufficient interest in patients' pain.
Ald. Matt O’Shea (19th) is advising anyone with relatives or friends staying at a Morgan Park nursing home to check up on them after the staff there failed to report a resident’s allegations of abuse, according to an Illinois Department of Public Health report.
The son of a 63-year-old woman who died last year at a south suburban nursing home claims she was sexually assaulted at some point during her seven-week stay at the facility. The woman, who suffered from Alzheimer’s disease, was admitted Dec. 7, 2014, to GlenShire Nursing and Rehabilitation Centre [...] The suit claims the woman “developed a sexually transmitted disease as a result of being raped” while admitted, but does not specify when the alleged attack happened or who carried it out.
Newly elected Champaign County Board Chair C. Pius Weibel said last week that he wanted to review the numbers from the Nov. 8 vote on the quarter-cent increase in the county sales tax for facilities in advance of Tuesday's special board study session on the county nursing home. It shouldn't take long. Not only did the proposal lose countywide, 70 percent to 30 percent, but it lost in every part of the county — Champaign, Urbana, suburban areas, rural areas — and it lost in every precinct.
Hospitals have long been reluctant to share with patients their assessments of which nursing homes are best because of a Medicare requirement that patients' choices can't be restricted. [...] But hospitals' tight-lipped approach to sharing quality information may soon be changed. The Obama administration is rewriting those rules, not just for patients going to nursing homes but also those headed home or to another type of health facility.
State and federal health officials are seeking penalties totaling more than $100,000 from a North Side nursing home after five residents overdosed on heroin inside the facility in February, the Tribune has learned. The residents of Continental Nursing & Rehabilitation Center were hospitalized and recovered, but at least two used heroin again hours after they were returned to the facility, even though they were supposed to be on close watch, Illinois public health department inspectors allege. One of the two overdosed again.
For years, wealth and controversy have followed Chicago-based nursing home operators Morris Esformes and his son Philip Esformes, who was arrested in July in what prosecutors have called one of the largest health care bribery and kickback schemes in U.S. history. Their dozens of Illinois, Florida and Missouri nursing facilities have earned millions of Medicaid and Medicare dollars annually despite repeated federal law enforcement probes and Chicago Tribune investigations alleging substandard care and incidents when disabled patients were assaulted by fellow residents.
A federal district court in Mississippi has issued an injunction blocking a new rule that would preserve the right of patients and their families to sue nursing homes over quality-of-care disputes. The rule, announced in September by the Centers for Medicare & Medicaid Services, would ban so-called pre-dispute binding arbitration clauses in nursing home contracts, which require patients and families to settle any dispute over care through arbitration, rather than the court system.
An organization that advocates for better nursing homes has developed a series of online videos to help families choose nursing homes for loved ones. The organization, known as the Illinois Pioneer Coalition, advocates for “culture change” in nursing homes, including allowing residents to make more decisions about their day-to-day lives. The videos are available on YouTube.
Springfield – The Illinois Department on Aging (IDoA) today announced the U.S. Department of Health and Human Services, through the Administration for Community Living, has awarded the State of Illinois a $1 million grant. Through the grant, the Department will develop and pilot test person-centered supportive services that meet the needs of persons living with or those at risk of developing Alzheimer’s disease and related dementia, and their caregivers.
Attorney General Lisa Madigan yesterday joined with 44 other states, Washington, D.C. and the federal government to announce a $28 million settlement with Omnicare Inc. over allegations the company solicited and received kickbacks from Abbott Laboratories in exchange for recommending and purchasing the drug Depakote for the off-label use of controlling behavior disturbances in nursing home patients with dementia.
For the first time in 25 years, the Centers for Medicare & Medicaid Services (CMS) has issued revised rules to improve resident safety. An important one of them is that nursing homes can no longer force residents or their families to sign arbitration agreements in their contracts. This then allows a resident who suffers from serious harm in a nursing home to have their day in court, rather than try to get justice in a secret non-public arbitration.
Sometimes called elder orphans, seniors with no relatives available to help them manage aging and illness are a large and likely growing group, according to Dr. Maria Torroella Carney, chief of geriatrics and palliative medicine at Northwell Health in New Hyde Park, N.Y. Roughly 22 percent of adults over the age of 65 are elder orphans or are at risk of becoming elder orphans because they don't have spouses, children, or siblings who live nearby, according to an analysis by Carney and three co-authors that was presented at the American Geriatrics Society's 2015 annual meeting.
New nursing home ratings published on a Medicare-run consumer website don't answer questions about the system's accuracy, a Democratic senator told Bloomberg BNA Aug. 10. The Centers for Medicare & Medicaid Services changed the overall five-star quality ratings on its Nursing Home Compare website by including data from another five quality measures, an Aug. 10 fact sheet said.
Standing before the religious icons that line his Ukrainian Orthodox church in Humboldt Park, the Rev. Nicholas Chervyatiuk has ministered to followers who arrived in Chicago as refugees after surviving Nazi Germany's prison camps. Now the Cook County public guardian is accusing the priest of improperly taking more than $500,000 from the savings of one of those displaced persons, a 93-year-old former church secretary diagnosed with dementia.
In the years before Sacred Heart Hospital abruptly closed, a series of elderly nursing home patients were taken to the struggling West Side medical facility, where they were whisked directly into a room to be examined and tested. The reasons for admission were murky. The trips to Sacred Heart, situated in the Garfield Park area, often made little geographic sense. Many of the patients were mentally disabled and poor.
Three nursing homes have gone to court to stop two projects that would bring new competition to the western suburbs. Community Nursing and Rehabilitation Center in Naperville, The Springs at Monarch Landing in Naperville and Bria Health Services in Westmont filed two lawsuits last week challenging recent state approvals of proposals by a new rival, Transitional Care Management, to open facilities in Lisle and Aurora. The projects have been controversial in the nursing home industry because Transitional Care only wants to treat patients who were hospitalized but need short-term rehabilitative therapy before they go home.
In essence, the bill allows older adults to remain at home and in the community by providing them with necessary services to maintain their independence. The Older Americans Act also saves Medicaid and Medicare untold millions each year.
A "senior" version of "nanny cams" is about to hit Illinois nursing homes. As of Jan. 1 , a new state law, the Authorized Electronic Monitoring in Long-Term Care Facilities Act allows video or audio recording devices to be placed in Illinois nursing home rooms to monitor treatment.
The Government Accountability Office Nursing Home Quality Report found that the average number of consumer complaints reported per home increased by 21% from 2005-2014 [...] Conversely, the number of serious deficiencies identified per home with an on-site survey [...] decreased by 41% over the same period.
After years of frustration, authorities and advocates believed this spring represented their last and best opportunity to reform Illinois's troubled nursing homes. Still, it took tense negotiations and an eleventh-hour deal to strike a historic bill that aims to undo a half-century of failed policies and end a legacy of violence in which nursing home residents were raped, assaulted and murdered.