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January 10, 2016

This is a common scene in nursing homes.

My son Jacob was totally embarrassed by me at the Commerce of Lexington Public Policy luncheon because he said I was babbling about how the Medicare program should allow people who are discharged from the hospital following surgery to receive care and rehabilitation at medical adult day centers such as ours instead of in nursing homes.  Jacob said I was supposed to ask a question of Mitch McConnell instead of telling him what to do. But Mitch began his presentation by saying that the Medicare and Social Security programs were in grave danger of going away if something wasn’t done. Well, they could do something by saving millions by not paying $200+ plus per day (24 hours) in a nursing home for 20 days following a hospital discharge and instead pay $65 per day (10 and a half hours) plus $8 for a meal and $10 each way for transportation, if needed. Medicare also will currently pay a co-pay amount (which is much more than $65 per day) for an additional 80 days in a nursing home.  I wrote a letter to Mitch last year about how Medicare could save money by allowing people to go to a medical adult day center to recuperate instead of a nursing home (the nursing home often uses the opportunity to try to keep the patient indefinitely) but he did not reply. I wonder if he is being wooed by a nursing home lobbyist or two? Research shows that people recover much more quickly at home.

Medicare also pays for a nurse to visit a person at home after being discharged from the hospital, so they can have vitals checked, wounds dressed, etc. However, a caregiver must be available to take care of the patient at home for this Medicare benefit to work. What if that caregiver needs to work, or just isn’t capable of caring for a sick person? We can do all the care here at the club, and the person at home will just have to help the patient get ready for bed and get up in the morning, or a caregiver can be paid to do it. It would still be cheaper than a nursing home and the patient would recover more quickly.

I was disappointed to hear Mitch McConnell say he is for tort reform and establishing medical review boards which would prevent wronged patients and their families from suing the nursing homes until their accusations were brought before a panel of doctors and others to determine if the wrong that was done to them or a family member was worthy of a lawsuit. By the time they processed the accusation the case would grow cold. Do you know about the Civil Monetary Penalty (CMP) Fund? It is comprised of monies from fines against the nursing homes for violations found during government inspections. The fund had over $250 million in it back in 2011…and that was just Kentucky. I don’t know what the fund has in it now, but I know it is still growing. All that money in fines says to me that the nursing homes are not doing a good job. And if it wasn’t for the threat of a lawsuit they would be doing a lot worse. The nursing home industry probably just sees the fines as the cost of doing business, but the lawsuits hit them where it hurts more, because they cost them more.

The money in the fund is to be used in one of these ways, by writing a grant to request use of the funds to:

  • CMP funds must be used to support activities that benefit nursing home residents.
  • Support and protection of residents of a facility that closes either voluntarily or involuntarily, or, is decertified.
  • Projects that support resident and family councils in assuring quality care in facilities.
  • Projects that support consumer involvement in assuring quality care in facilities.
  • Projects that support facility improvement initiatives.

May you and yours have a blessed week!

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