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Solving Problems in Long Term Care |
Newsletter November
2007 1.
Please join us at our next statewide meeting on Saturday,
November 17, 2007 from 10:30-2:30 at the Library of Michigan Lake
Superior Room, 717 West Allegan, Lansing.
We love to welcome new members and see old friends!
If you plan to attend the November meeting, please RSVP to Alison
Hirschel at hirschel@umich.edu
or 517-324-5754 by November 14, 2007. We
will be discussing important issues including how we can assist in advocacy
efforts to prevent declining care at Manor Care facilities (see # 4 below),
support a proposal that the state considers a nursing home chain’s history
of quality care when it decides whether to permit the chain to expand,
on-going advocacy efforts to expand home and community based care as an
alternative to nursing home care, and much, much more.
We need you to be part of these
important plans and discussions! Join
us!
3.
Another way to help the Campaign–receive our newsletter
electronically and help us save printing and postage! –Many of
our members receive our newsletter electronically, thus saving us printing and
postage costs. If you have access
to email and are willing to receive newsletters electronically instead of by
mail, please contact our secretary, Carole Newburry, at cjnewb@mei.net.
Thanks!!
4. Campaign joins effort to stop private equity firm from purchasing 27 Michigan HCR Manor Care nursing homes–-Advocates across the country are joining forces with SEIU Healthcare (a union representing direct care workers) to fight the proposed purchase of HCR Manor Care by the Carlyle Group, one of the world’s largest private investment firms. Advocates’ concerns arise because the buy-outs are designed to create greater profits, not improved care or quality of life for Manor Care residents. In fact, the experience of other nursing home chains that have been purchased in recent years by private investment companies sounds a deeply troubling warning. On September 23, 2007, the New York Times ran a front page article entitled, “At Many Homes, More Profits and Less Nursing.” According to this meticulously researched report:
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Private equity firms over the
last six years have acquired nursing homes and then routinely cut costs by
reducing staffing and budgets for supplies and resident activities;
!
Residents at homes
acquired by large private investors generally suffer more often from depression,
loss of mobility, and loss of ability to engage in activities of daily living
than residents of other nursing homes;
!
Many homes that performed above the national average on issues like
skin breakdown, preventable infections, and restraint usage before their
acquisition by private investors scored below the
national average after their acquisition;
!
At 60 percent of the homes acquired by private equity firms between
2000 and 2006, clinical registered nurses were cut and, on average, homes
owned by private investors offered residents 35% fewer hours of care by
registered nurses than the national average; ! Serious quality of care deficiencies rose at every large nursing home chain after it was acquired by a private investment group from 2000-2006. The typical number of serious health deficiencies at homes owned by large investment companies was almost 20 percent higher than at other nursing homes. Moreover,
the Carlyle Group’s own experience in healthcare raises concerns.
Carlyle owns LifeCare Hospital group, the defendant in a class action
lawsuit that alleges a LifeCare hospital was understaffed and poorly prepared
during Hurricane Katrina, resulting in the deaths of 24 patients who were
awaiting evacuation. But
the bad news does not end there. When
private investment firms buy nursing home chains, the corporate structure
becomes increasingly complex and hard to track, shielding those firms from
liability in lawsuits concerning abuse and neglect of residents and making
regulation of the chains more difficult.
In addition, according to research by SEIU Healthcare, the buy-out will
make HCR Manor Care more fragile financially and load it down with huge debt.
And the buy-out is likely to result in extraordinary windfalls for Manor
Care’s executives and advisors. For
more information on the Carlyle Group buy-out effort, go to
carlylefixmanorcarenow.org. Before
the Carlyle Group can assume responsibility for Michigan’s 27 Manor Care
homes, the state must approve both certificates of need and a change of
ownership. Advocates have urged Janet Olszewski, the Director of the
Michigan Department of Community Health, to deny these requests and urged
policy makers to hold hearings on this issue.
If the state does approve the requests, the Campaign has asked Ms.
Olszewski to assure that no Manor Care facility reduces staffing after the
change of ownership; that the facilities staff at the level of 4.1
hours/resident/day which is recommended by a federal study as the minimum
required to meet residents’ needs; that facilities do not reduce any
training or orientation for staff; that facilities engage in sincere and
significant efforts at culture change to create more homelike and progressive
environments; and that all beds in Manor Care facilities become and remain
dually certified for Medicare and Medicaid.
Advocacy
has already been effective at the federal level, since the buy-out affects
Manor Care facilities in a number of states.
Rep. John Dingell, D-(Dearborn) MI, chairman of the House Energy and
Commerce Committee, and Rep. Barney Frank, D-Mass., chairman of the House
Financial Services Committee, announced they will hold hearings in their
respective committees to examine the proposed buy-out.
In addition, U.S. Senate Finance Committee Chairman Max Baucus
(D-Mont.) and the committee’s ranking Republican member, Sen. Charles E.
Grassley (R-IA), sent letters to Carlyle and four other private-equity firms
asking for information related to their ownership and management of nursing
homes. The committee will likely hold hearings on the issue and may introduce
legislation. Senators Baucus and Grassley also sent a letter to the Centers
for Medicare and Medicaid Services, the federal agency responsible for
overseeing nursing home inspections, asking it to account for a report of
higher health and safety violations in nursing homes that have been bought by
private-equity investors. As
a result of all the pressure and attention, the Carlyle Group has issued a
pledge to provide quality care to residents and to provide adequate training
for staff but many health care experts do not have much faith in the Carlyle
promise. In Michigan, SEIU Healthcare,
the Campaign, State Ombudsman Sarah Slocum and a number of other groups
including the Michigan Disability Rights Coalition; the ARC Michigan; the
Michigan Association for Justice; the Area Agencies on Aging Association of
Michigan; and numerous Michigan lawmakers will continue their advocacy to
assure the safety of residents of Manor Care facilities. What
you can do to stop the Carlyle Group takeover of Manor Care facilities and
fight declines in care and staffing:
Contact Michigan Department of Community Health Director Janet
Olszewski (olszewskiJD@michigan.gov
or write to her at: Capitol View Building, 201 Townsend Street Lansing,
Michigan 48913) and Governor Granholm (go to www.michigan.gov/gov and
click on “contact the Governor” or write to: Governor Jennifer M. Granholm,
P.O. Box 30013, Lansing, Michigan 48909 or call (517) 373_3400) as well as your
state and federal legislators to express your concern over the Carlyle
Group’s proposed purchase of HCR Manor Care.
5.
New law requires estate recovery; state will seek to recover funds
spent to provide Medicaid funded nursing home and MiChoice services from the
estates of some individuals–-Under
federal law, states are required to attempt to recoup some of the Medicaid funds
spent to provide care and services to nursing home residents and home and
community based care participants after their deaths. Although Michigan had long avoided this federal mandate–and
was the only state not to enact estate recovery–a new law, Public Act 74, was
enacted on September 30, 2007 that creates a limited estate recovery program for
the state. Due to the advocacy of
elder law attorneys and others, the law is far less aggressive than we
previously feared although a number of questions remain regarding how it will be
implemented. The new law will not
apply to individuals who received Medicaid funded nursing home care or MiChoice
services before October 1, 2007 and may not apply to individuals who begin
receiving services for some period after that date. It applies only to assets
that remain in the individual’s probate estate although many individuals have
assets that do not pass through probate. In
addition, the law appears to exempt 50 percent of the average value of a home in
the county in which the recipient’s home was located, family farms and
businesses, and homes in which certain relatives reside.
The Department of Community Health is required to provide written
information to individuals who will be affected by this new law.
Recipients and their families may wish to seek guidance from attorneys
with expertise in this area to determine whether and how the new law will affect
the estates of Medicaid recipients in nursing homes or MiChoice. 6.
Campaign awards Second Annual Courage and Heart Awards–On
October 11, the Campaign was proud to present this year’s Courage and Heart
awards during the annual conference of the Elder Law and Disability Rights
section of the State Bar. The
recipients were: elder law attorney Doug Chalgian for his on-going
support of the Campaign and his outstanding service on the Ombudsman Advisory
Group, the Nursing Home Standards Advisory Committee of the Certificate of Needs
Commission, and the Alzheimer’s Association board; Assistant State Long Term
Care Ombudsman Brad Geller for his lifelong commitment to and expertise
in championing the rights of individuals in the guardianship system and other
vulnerable individuals; and RoAnne Chaney for her outstanding leadership
on the Governor’s Medicaid Long Term Care Task Force, her ability to bring
advocates for the elderly and advocates for people with disabilities together,
and her brilliant and effective advocacy
for long term care consumers.
For information on NCCNHR
and to tap its many resources for consumers, go to www.nccnhr.org.
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