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

Low Obamacare Premiums to Soften Blow for Those Losing Medicaid

Ganny Belloni
March 16, 2023, 5:44 PM

CMS will take active role during Medicaid eligibility checks

All states required to take 14 months to complete checks

One-third of the millions of individuals expected to lose Medicaid coverage as eligibility checks resume this spring will qualify for Affordable Care Act coverage with low or no premiums, a top Medicaid official said.

The Department of Health and Human Services believes the majority of those whose Medicaid eligibility will be redetermined will remain eligible, and the government is actively collaborating with states to make sure beneficiaries don’t lose coverage because of administrative issues, Daniel Tsai, director of the federal Center for Medicaid and CHIP Services, said Thursday in an interview with reporters

see full article at :

https://news.bloomberglaw.com/health-law-and-business/low-obamacare-premiums-to-soften-blow-for-those-losing-medicaid

#AffordableCareAct #DepartmentofHealthandHumanServices #CenterforMedicaidandCHIPServices #DanielTsai #Medicaid #CMS

Insomnia predicts nursing home admission, study finds

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

 

Seniors who have insomnia are more likely to be admitted to a nursing home than those who experience quality sleep, according to a recently published study.

Researchers at the Johns Hopkins Bloomberg School of Public Health utilized the Health and Retirement Study, which is a biennial survey of more than 26,000 Americans who are 50 and older.

Respondents who had symptoms of insomnia in 2006 were more likely than other survey participants to be hospitalized, admitted to a nursing home or need home healthcare by 2008, the researchers found.

“A relationship was even found between insomnia symptoms and hospitalization as well as use of any of the three health services after accounting for common medical conditions and elevated depressive symptoms,” said lead author Christopher Kaufmann, MHS, a doctoral student with the Bloomberg School's Department of Mental Health.

Family members concerned about under-staffing of long-term care homes

Excerpt from: Global News (click for full article)

 

Sunset Extendicare admits they’ve had some short-staffing in the past that they’ve now dealt with and said they are providing more than adequate care to the 152 residents.

“Our professional staff here at the facility are doing an amazing job of providing care to our residents here,” said administrator Kevin Siebert.

Klassen and Seabourne disagree, saying that even if the facility is ‘fully staffed’, there simply aren’t enough workers.

Extendicare wasn’t forthcoming with an exact ratio of number of patients to a single care worker, but Klassen said they told her on average that ratio was around one care worker for every 9 patients and as many as 12 patients in the evenings. She says she’s worried about the stress load of frontline staff.

10 Surefire Ways To Make Enemies At A Nursing Home

Excerpt from: Huffington Post (click for full article)

 

The nurses, aides, activity directors and other long-term care facility employees spend a tremendous amount of time with your loved one. They are the ones who help shower, dress and feed residents who need assistance with these tasks. They provide entertainment and arrange for socialization. Most importantly they strive to promote the residents' overall well being by any means possible.

On occasion, however, there is friction between staff and family members. This is unfortunate because staff members typically become deeply attached and devoted to the residents for whom they care. Disagreements with the family cause distress for all involved.

Unfortunately, some people look down on the aides and other staff and think they are only there because they couldn't get better jobs. But most employees in long-term care facilities are there because they have chosen this as a profession of which they are proud and to which they are firmly dedicated.

The following list of things you should never do will help you avoid pitfalls that can occur when interacting with long-term care facility employees.

Automatic Sprinkler Systems Now Mandatory in Ontario’s Long-Term Care Facilities and Retirement Homes

Excerpt from: 570 News (click for full article)

 

Automatic sprinkler systems will be mandatory in long-term care facilities and retirement homes in the province.  The new regulations were announced Thursday morning but will not be implemented until January 1, 2014.  Currently only new facilities are required to have automatic systems.

Over one hundred facilities in Kitchener and 12 facilities in Waterloo will be impacted by the new provincial legislation.  Public Education Office with Waterloo Fire Rescue, John Percy tells 570 News that once the new regulations are implemented into the Ontario Fire Code, education for owners, operators and staff at facilities will start.

“There will be a little bit of an education and awareness process for each fire department across the province to work with their facilities to first make them aware of the changes…and then adopting that and then the implementation period will be the next one [step].”

Medicaid Spend Down

Excerpt from: caring.com (click for full article)

 

The cost of nursing home care is extraordinarily expensive, and Medicaid won't help pay if you have more than $2,500 in "countable" assets. Sometimes people decide to "spend down" their excess assets to qualify for Medicaid benefits. But this can be risky. If the Medicaid agency thinks you're bending the rules, you risk losing eligibility for five years. And current crackdowns by Medicaid are much more common than in years past.

Nice Piece on Olmstead, Budget Cuts, and Nursing Homes

Excerpt from: Disability Law (click for full article)

 

By contrast, here's a nice piece on Olmstead issues, which uses the M.R. case as a lens to examine the various questions.

New Owners of Nursing Home Can’t Discriminate Against Union

Excerpt from: Lawyers.com (click for full article)

 

The 3rd U.S. Circuit Court of Appeals on Apr. 5 ruled that the new owners of a Pennsylvania nursing home must recognize and bargain with a union that began representing employees at the home when it was owned by the county.

Privately-owned Grane Healthcare Co. bought the nursing home from Cambria County in 2010. Employees at the home had previously organized under two recognized unions: the nurses under the Service Employees International Union, and the nonprofessional employees under Local 1305 of the Laborers International Union Of North America.

But Grane wasn’t so into the unions. While it hired most of the employees from the home to continue working at the newly named facility, Cambria Care Center, it refused to hire several union rep-employees who’d been agitators against the government’s sale of the home to Grane.

In addition, Grane refused to recognize the unions, claiming that because they’d been recognized by the home when it was a public employer, Grane as a private employer didn’t have to honor the “successorship” of the unions. It also tried to argue it shouldn’t be considered a “single employer” for liability purposes with Cambria Care Center.

As Session Enters Home Stretch, THCA Urges BudgeConferees to Prioritize Funding for Texas Seniors' Medicaid Nursing Home Care

Excerpt from: Wall Street Journal (click for full article)

 

With Senate and House Conferees now named to help guide, shape and direct the final state budget towards ultimate passage, the Texas Health Care Association (THCA) encouraged the lawmakers to ensure Texas nursing homes and the vulnerable patients under their care receive the priority required to help cope with the operational instability caused by 2011's $58 million state Medicaid cut and the new $51 million federal Medicare cut, now in effect.

"As we enter the home stretch of the legislative session, we believe the most significant piece of unfinished business is ensuring Texas' most vulnerable frail, elderly and disabled Medicaid-dependent nursing home patients can continue to access the quality care they deserve by making sure state nursing homes remain operationally stable in the face of deep Medicaid and Medicare cuts," said Tim Graves, President of THCA.

"We look forward to working with Conferees in a constructive, positive manner to ensure they are appropriately aware how their local facilities are increasingly struggling with shrinking resources in the face of growing numbers of patients requiring the type of 24/7/365 care that can only be found in their local skilled nursing facility," the THCA leader continued.

Care workers raises in Minn. House health budget

Excerpt from: Yahoo! News (click for full article)

 

Minnesota's nursing home and long-term care workers would get small salary increases in a health spending bill up for debate Monday in the state House, but some lawmakers question whether the increases are enough for financial challenged facilities in rural areas.

The Democratic-sponsored, $7 billion health and human services budget includes a 3-percent pay hike for nursing home workers and 2 percent for long-term care workers. The bill's sponsors said it would give about 600,000 additional Minnesotans access to some form of health insurance in the next two years, though some of those costs would be covered by federal and not state funds. The bill also steers new money to expanding access to mental health treatment for students.

The bill includes several new ways for the state to raise money for health programs. It would increase a state surcharge on hospital budgets from 1.56 percent to 2.63 percent, a move that's likely to be felt mostly at Mayo Clinic and suburban hospitals that serve fewer medical assistance patients. The measure also would collect about $50 million by making HMOs return excess operating reserves fed by government insurance programs.