Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Long-term care leaders criticize Washington Post article on reimbursements

Patti's Comments:  I do not think this is a beginning, I think the effort to limit therapy has been issue for a long time!!

Excerpt from McKnight's: (click for entire article)

A recent Washington Post analysis of the use of “ultra-high” reimbursement categories for nursing homes “paints a negative, incomplete picture of the growing role and tangible benefits associated with skilled nursing facility (SNF) patient care,” two leading long-term care advocates said.

In a letter to McKnight's (see letter attached), Alan G. Rosenbloom, President of the Alliance for Quality Nursing Home Care, and Bruce Yarwood, President and CEO of the American Health Care Association, denounced the Post article as “irresponsible and inaccurate.”

“The headline and premise of the story itself suggests so-called ‘up coding' is somehow a standard means of over-billing Medicare,” the two leaders wrote. “Facilities must use specific regulatory tools to provide patient assessment, which then reflects the level of reimbursement. Any suggestion that facilities are able to bill any way that they wish are simply false and misguided.”

New Health Care law will affect college students

Excerpt from The Signal: (click for entire article)

After over a year of heated debate, drafting and re-drafting, the health care legislation Obama campaigned on was passed through the House of Representatives on Mar. 21 and signed into law on Mar. 23.

The bill passed the house by a vote of 219-212, without a single Republican vote. However, three Democrats who had previously voted for the bill voted against it this time.

The act will  be costly, but it will also cut back on the costs of existing health care plans and reduce the size of the budget in the long run. The legislation expands Medicaid, reforms current laws and expands health coverage to 32 million currently uninsured Americans.

The law’s first major action is to create a federally-funded program in the next 90 days that will temporarily cover people with preexisting medical conditions.

Police release details of arrest of Stacey Lore

Patti's Comments:  I congratulate the advocates and parents involved in this victory!

It makes me sad when our success stories are about convicting folks for harming people with disabilities.  I want to celebrate folks accepting and befriending folks with disabilities.  I know, people say I am a dreamer, but I am not the only one. Right??

Excerpt from News Hound: (click for entire article)

On Monday afternoon, March 29th, 2010 Stacy A. Lore waived her extradition rights while in Putnam County Court in Carmel, N.Y.  On Tuesday, March 30th, 2010 at 11:15 a.m. Stacy A. Lore was picked up from the Putnam County Correctional Center by Norwalk Police Detectives Orr and Tolnay and transported to Norwalk Police Headquarters where she was charged with three separate arrest warrants. The arrests stem from her therapy services rendered to the Norwalk Public Schools and two families within the City of Norwalk.

The first warrant charges Lore with one count of Larceny in the First Degree, one count of Forgery in the Second Degree and one count of Criminal Impersonation in which the victim was the Norwalk Public School system.  Lore had billed the Norwalk Public Schools a total of $155,781.25 for services rendered in 2007 and 2008.  Lore is being held on a bond of $150,000.00 for this case.

The other two warrants also charge Lore with one count of Larceny in the First Degree, one count of Forgery in the Second Degree and one count of Criminal Impersonation respectively.  Local families, using their own funds, were the victims in these two cases in which Lore was paid $12,706.00 and $21,364.50 for services rendered.  Lore is being held on a bond of $25,000 for each of these cases.

Aging in Place Technology Watch March 2010 Newsletter

What begins with C? Caregiver, chronic disease, channel, consumer.  Traveling in March around the conference circuit of the HR-oriented Care Summit, the age-related specialists at the ASA Aging in America conference, walking among entrepreneurs at What's Next, and the electronics dealers at the Electronic House Expo -- it an interesting sequence. It pushed me to wonder: when does the market interest of a boomer overlap with that of a senior? When does an electronic house become a health-monitoring zone? When do health-related issues fully synch up with issues of aging? Is the caregiving task list different for someone with chronic disease, for an ill child, or for an elderly parent? And overall, who is the consumer/buyer? Together, we can all help answer these questions.

C's for chronic disease and patient care. With the Continua endorsement of e-Care, the concept of communicating health status information through broadband connections still seems to be confined to thinking about the recipient as patient. This (otherwise known as a person) has vital signs and conditions to be monitored:  if e-Care is enabled by greater broadband reach, maybe we won't have to drive or be driven to the doctor's office or hospital. But clearly, in the world of tech-enabled health, care means health-care, provided and delivered by the health-care industry.

C is also for context. As with 'e-Care', caregiving is word viewed through the lens of the view. Topics and ideas originate from context -- and then shape frameworks, products, advice, and best practices.  At one event, context shocked: The speaker began describing a story with: "My husband and child were killed last year" and then paused and choked up. Sitting on the panel for the next session, I could see the audience collectively stop breathing. Eventually she would say how she has moved on with her life and appreciated that she had access to online resources to help her through the crisis. The overall topic? This context was about caregiving as an employer issue that requires flexibility and rich information support.

But C is also for consumer, channel, caregiving family members. Often just as crisis-driven, the search for information about elder care issues and solutions can be a consumer-oriented topic, shaping communities of interest into media businesses that attract advertisers seeking their consumer audiences -- evident at ASA and the Boomer Business What's Next symposium -- like Caring.com (elder care issues) VibrantNation.com (boomer women), Grandparents.com (exactly what it sounds like) and many others.  But does that mean that firms that address health-related issues like managing fall risk, monitoring chronic disease, or mitigating issues associated with dementia should target their offerings direct to consumer?  Or should they cultivate dealers, installers, service providers (like those at EHX) who go into the home and look around?

Please provide answers! And for more thoughts on these and other imponderable topics, here are three March blog posts:

Why do the same telehealth studies again to repeatedly prove the same benefits? One press release too many -- and I thought I was seeing things. YATS -- Yet Another Telehealth Study -- kicked off prove the effectiveness and savings home use of telehealth monitoring of seniors with chronic disease. Have we seen this movie before? And the comments about the readiness of the healthcare industry to change were better than the blog post -- especially "Don't expect turkeys to vote for Christmas!". See what I mean.

Senior housing trends for the next ten years -- has year one already happened? Ecumen's Eric Schubert offered predictions about trends in senior housing that indicate use of technology as standard practice. One wonders when an industry that slowed to a near-crawl during the housing and economic bust will see the use of technologies as standard practice, delivering competitive amenities -- not just in their own units, but broadening their reach into their surrounding communities.

Startups, new starts, new AgeTek association -- it's been a busy month.  This month saw the emergence of a brand new trade association for small tech vendors who see that a whole lot of energy is more than the sum of the parts.  AgeTek launched at ASA -- with a variety of membership options and ideas for how to accelerate growth of an emerging industry. Meanwhile Philips launched Lifeline with AutoAlert.  Also launched, BeClose Networks and Early Bird Alert.

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If you or your firm would like guidance in any of these areas, learn more about Aging in Place Technology Watch offers of retainer-based business services.

Remember, you can sign up for blog post notifications on www.ageinplacetech.com by putting your e-mail address into a Subscribe 'Feedburner' box on the left. (Of course within the posts you receive, you can unsubscribe as well.)  Registering on the site also enables free download of  2009 Market Overview and Health and Technology reports as well.

Hope to see you at future conferences -- listed on the home page!

All the best!

Laurie Orlov

Court revives $650K verdict in psychiatrist shooting

Excerpt from Freep.com: (click for entire article)

The Michigan Supreme Court has reinstated a $650,000 jury award to an Oakland County woman who was injured in a shooting at a Southfield psychiatrist’s office in 1999.

The court upheld the woman's claim that the psychiatrist, who was killed in the shooting, had a legal obligation to protect her.

In an opinion released this afternoon, the court found unanimously that a Michigan statute exempting doctors from harm done by patients unless they have specific knowledge of an impending threat does not cancel the doctor’s underlying duty to his or her patients.

The "John Cusack In The Rain" Montage (VIDEO)

Excerpt from The Huffington Post: (click for entire article)

In the end of his movies, John Cusack gets the girl. That's what John Cusack does. But before he can swoop the girl (who's supposedly too good for him) off her feet, it's essential that he has an emotional breakthrough (or breakdown) in the rain. That is the key to his success.

Cusack's been called an everyman. That's misleading. Not every man has a rain cloud continuously following him around.

Health Care Reform Will Impact Long-Term Care

Excerpt from AOL News: (click for entire article)

As health care reform became the law of the land this week, a huge bloc of Americans with a unique interest in the outcome sat watching on the sidelines.

The 49 million people who care for older family members were hidden in plain sight, as usual, quietly shouldering a burden that so often takes a heavy toll on their finances and their physical and emotional well-being. Many of them -- I know a few -- are opposed to the new health care law, even though it includes one of the most important steps ever taken to improve caregivers' lot, especially those of the middle-class persuasion. Of course, hardly any of them are aware of that.

The Community Living Assistance Services and Supports Act, otherwise known as CLASS, provides for a national insurance program to help cover the cost of long-term care -- something 70 percent of people over 65 will need at some point along the way. The premiums will be much lower than those for private plans, and you won't get screened out because you've already had some health problems. Once vested after five years, enrollees unable to care for themselves will be able to claim cash benefits for as long as needed.

Gov. Perdue Kicks Off Campaign to Crack Down on Medicaid Fraud, Waste and Abuse

Excerpt from the Office of Governor Perdue: (click for entire article)

Gov. Bev Perdue today announced a series of aggressive measures to set government straight by cracking down on Medicaid fraud, waste and abuse that costs taxpayers millions of dollars each year.  The steps include stronger investigation and prosecution of potential abusers, including new Medicaid SWAT teams, better use of technology to detect and prevent abuse, and a campaign to encourage the public and providers to report suspected abuse.

“In these tough times, when Medicaid enrollment is growing even as we face deep budget shortfalls, we must do more to root out waste and crack down on folks who are abusing or defrauding Medicaid,” said Perdue.  “Tens of millions of taxpayer dollars each year are wasted on Medicaid fraud, waste and abuse.  It’s got to stop and we will not allow it to continue.”

A new software system in DHHS will bring the detection of potential Medicaid fraud into the 21st century, by quickly analyzing thousands of Medicaid claims and flagging suspicious cases. Once identified, the most egregious cases will go to newly created Medicaid SWAT teams, specially trained investigators who will quickly deploy to investigate providers or consumers identified as potential abusers of the system.

Gov. Perdue also called for toughening North Carolina’s anti-fraud laws by stopping kickbacks to providers that refer patients for Medicaid services and ending the practice of soliciting patients for services they don’t need.

Gov. Perdue announced these new initiatives at a press conference at Rex Hospital in Raleigh. She also called for doubling the staff size of the Attorney General’s Medicaid Investigations Unit and an aggressive awareness campaign to encourage individuals and providers to report Medicaid fraud, waste and abuse when they suspect it.

“Medicaid fraud hurts our state’s most vulnerable residents and robs taxpayers,” said Attorney General Roy Cooper, whose Medicaid Investigations Unit handles criminal and civil cases. “Adding more investigators and ways to detect fraud is the right direction to go to stop those who abuse the system.”

Information About Bladder Cancer

Excerpt from Medicaid Health Insurance: (click for entire article)
 
Obtaining cancer information about the bladder first requires understanding that the bladder s function is important for overall health. Knowing what the bladder does will demonstrate the threat that cancer to the bladder is. The bladder is a reservoir for the urine in our bodies working as a storage unit. Prior to entering the bladder our kidneys will filter waste from blood & afterwards the urine goes through two tubes called ureters. After the release urine will go into a tube called the urethra.

Bladder cancer refers to any of several types of malignant growth of the urinary bladder. It is a disease in which abnormal cells multiply without control in the bladder. The greatest risk factor for bladder cancer is genetic predisposition (a genetic effect that influences the phenotype of an organism but which can be modified by the environmental conditions); it can also be linked with smoking & occupational exposure to aniline-based dyes (such as textile factory) as well as with petrol & other chemicals.

Feds accuse group home owner and his sister of Medicaid, tax fraud

Excerpt from al.com: (click for entire article)
 
The owner of a Mobile-area group home and his sister have been indicted on allegations that they bilked Alabama's Medicaid by inflating their payroll.

An indictment issued this week by a federal grand jury in Mobile charges Charles Williams and Veleta Williams with five criminal counts of aggravated identity theft and conspiracy to commit health care fraud and tax fraud.

Veleta Williams also faces three counts of lying on her own tax returns.

The indictment seeks $671,227 from the Williamses in connection with the health care fraud charges.

Neither Charles Williams nor his sister could be reached for comment Friday.

Charles Williams, according to the allegations, incorporated Williams Group Homes Inc. in 2003 for the purpose of providing residential group home care to mentally disabled people in the Mobile area.

He employed 30 workers, including Veleta Williams, who served as the company's accountant and business manager.