From Patricia McGinnis of the California Advocates for Nursing Home Reform.
A lack of federal funding for elderly healthcare could cause a nursing home abuse epidemic in San Clemente and across the country, a recent article in The New York Times suggests. While a vote on the Senate health care bill has been delayed, even an amended version of the bill that includes drastic cuts to Medicaid could have serious and even deadly consequences for seniors living in nursing homes and assisted-living facilities. As the article contends, if such a bill passes, introducing “Trumpcare” to California and to the rest of the country, it “is certain to produce drastic upheaval in the landscape of long-term care.” Medicaid is currently “by far the largest source of funding for nursing home stays,” providing the funding for almost two-thirds of all nursing home residents.
If funding ceases, the quality of care is likely to decline, as well. Such a cut to Medicaid would result, at best, in a rise in nursing home neglect cases, the article argues. Could changes to Medicaid funding really produce such damage to elderly nursing home residents’ care?
History of California Nursing Home Abuse and Neglect
If you have an elderly loved one at a nursing home or assisted-living facility in Temecula, or if your family is just beginning to think about skilled nursing options, it is important to learn more about proposed legislation designed to protect LGBT long-term residents of such facilities. Nursing home abuse and neglect are serious problems in California and across the country, and such incidents can sometimes involve discrimination against the patient.
The proposed law, SB 219, has been named the “Lesbian, Gay, Bisexual, and Transgender Long-Term Care Facility Resident’s Bill of Rights.” The bill is aimed at extending certain protection against discrimination based on sexual orientation and gender identity to seniors in nursing homes and other facilities in California.
Learning More About SB 219 and LGBT Protections in California Nursing Homes
According to a recent article in the Contra Costa Times, California Governor Jerry Brown recently signed into law a bill that will impact licensing requirements for residential care facilities for the elderly (RCFEs). Specifically, the law will require applicants seeking a license to run an RCFE to “disclose prior ownership of any type of facility in any state.” With this information, elder justice advocates hope that California can prevent the opening of RCFEs by persons who have been linked to accusations of elder neglect or nursing home abuse around California and in other parts of the country.
History and Requirements of the New Law
The law began as AB 601, and it was written by Assemblywoman Susan Eggman. The law is aimed at establishing “specific suitability requirements for all licensing applications,” which involves the following:
New Bill Raises Penalties for Elder Abuse and Neglect
Is the state of California taking seriously the problems with nursing home abuse and elder neglect at assisted-living facilities? According to a recent article in UT San Diego, Governor Jerry Brown just signed into law a bill that will impose “a 100-fold increase in the top fine for violations of state regulations at assisted-living homes for the elderly.” Before Governor Brown signed the bill, the highest fine for a violation that results in the death of a resident was only $150. Now, the top fine rose drastically to $15,000.
Fines for elder abuse and neglect resulting in the death of an older adult are not the only penalty increases. To be sure, the bill will also raise the maximum fine for “violations leading to serious injury or abuse from $150 to $10,000.” And the new law will not just apply to assisted-living facilities, as was originally proposed in the bill co-authored by Assemblyman Brian Maienschein of San Diego. It will “apply to all community care facilities in the state.”
For quite some time, elder-care advocates have encouraged federal legislation that would require certain long-term care measures for older adults. However, a recent article in the New York Times referred to this legislation—the Community Living Assistance Services and Supports (CLASS) Act—as a victim of the recent fiscal cliff deal in Congress. In short, the CLASS Act was repealed. What does this mean for nursing home and other residential care programs? Very likely, long-term care will remain available only through private long-term-care insurance in the near future. Are you considering long-term care insurance? Or do you have a loved one who may require nursing home or other residential care? You’ll want to have a clear idea of what the end of the CLASS Act means for you and your loved ones.
History of the CLASS Act
The CLASS Act was originally conceived by Senator Edward Kennedy in the mid-1990s. Elder Law Answers explains that Kennedy’s proposed long-term care plan would allow employees to pay a small premium, approximately $65 per month, which is much lower than the average cost of a private long-term care insurance plan. For participants who had contributed for at least five years and worked for at least three of those years, they would become eligible for benefits of at least $50 per day.
Assembly Bill 40 is a California law that took effect January 1, 2013. The bill is intended to expand reporting requirements related to elder abuse.
The Napa Valley Register reported in an article that the Napa County Health and Human Services department investigated 370 abuse and neglect cases in 2012. 295 of those involved seniors and the rest involved disabled adults. Reports of theft and embezzlement from the elderly have significantly increased over the last couple of years.
In light of this new bill, it is important to look at the increase in reported instances of abuse and neglect in different ways. A simplistic view of this increase indicates that elder abuse and neglect is on the rise. Whatever measures have been put in place to combat abuse over the last couple of years have failed.
Families with loved ones in adult care facilities are pushing for new legislation that will affect how the facilities handle missing patient situations according to a recent article in the Mercury News. The legislation is not up for a vote yet, but if enacted, the law will require care facilities to contact authorities immediately once a resident is discovered missing or has failed to return at a scheduled time.
The two incidents highlighted in the article involve situations where mentally impaired adults went missing for several hours from the facilities whose care they were under. The facilities did not act quickly in either case.
Yolanda Membreno was an 86-year-old mentally impaired woman under the care of Julia’s Home. She went missing from the home on September 30th of this year. According to Roy Roberto, the man who operates Julia’s Home, their established protocol is to conduct their own search before contacting the police. In Membreno’s case, the staff followed protocol but that meant waiting an hour before contacting the police. Membreno was found dead on a playground only 100 yards away from the entrance to the care facility just a few hours after she went missing.
A new data analysis reports that a colossal $65 billion in federal cuts will affect the nursing home sector over the next ten years. This staggering sum—calculated by Avalere Health—is a result of several different federal budgetary actions and regulatory changes made by Congress and the Centers for Medicare and Medicaid Services since 2009. Part of the reason for such drastic slashes in budgeting is that nursing homes, technically signified as “skilled nursing facilities” (SNFs), are the country’s second largest health facility employer, employing roughly 1.7 million Americans. Broken by The Sacramento Bee, the story projects $4 billion will be cut from 2013-2014.
Just behind Florida, California will be the second-most affected state from these massive SNF Medicare funding cuts. The Golden State is forecasted to lose $350 million. Now, many including the Alliance for Quality Nursing Home Care (AQNHC) are challenging these financial rollbacks, amid the already strenuous economic climate. AQNHC and others are arguing that such funding reductions will “undermine facility operations, disrupt staffing, and threaten seniors’ care amid the growing influx of older, higher acuity patients.” With the recent report from Operation Guardians, the environment of many California nursing homes is in sordid condition, and these cuts appear to be no help.
Here is an overview of the specific programs with their particular budgetary impacts:
The healthcare reform bill signed by President Obama this week will have an impact on nursing homes and long-term care. The most dramatic change will come in the form of long-term care insurance, and provision that was long championed by the Senator Edward Kennedy. Under the Community Living Assistance Services and Support Act (CLASS), all Americans will automatically be enrolled in a long-term care insurance program, but will have the option to opt out.
Under the Act, individuals will start paying a premium immediately, and will be able to use the benefit after five years of contribution to the program. The benefit, though, is not much, as it is expected to be about $50 per day to offset other long-term care costs.
The healthcare reform bill will also start to close the “donut hole” in Medicare Part D coverage for prescription drugs. Patients will immediately begin receiving a rebate for drug costs that fall into the gap, and drug manufacturers will be required to provide a discount on brand name drugs. Over time, the gap in coverage will be phased out entirely.