Displaying items by tag: nursing home
Governor Cuomo Has Defended The State's Reporting Of Nursing Home Deaths
Amid allegations that New York coronavirus deaths in nursing homes were under reported, Governor Andrew Cuomo says they were only “delayed”.
Within hours of the report's release, the state came out with new data that showed an additional 3,800 deaths — nursing home residents who died in hospitals. More than 15,000 people have died from coronavirus in the state's nursing homes and long-term care facilities.
"All the deaths in the nursing homes and in the hospitals were always fully, publicly and accurately reported," Cuomo said. "The numbers were the numbers. Always."
How bad was the under-reporting? The New York Governor said Monday that everything reported was accurate though delayed. However the state attorney general last month said the death toll was much higher, possibly 50% higher.
Why The Delay In Reporting Nursing Home Deaths From Covid-19?
Governor Cuomo said Monday that the state had released the numbers it had immediate access to at the time. That delay was in part due to the state's dealing with a federal inquiry by the Department of Justice, Cuomo said. Health officials decided to focus on that data request before responding to state lawmakers' request for more information. The governor said, "We paused the state legislature's request while we were finishing the DOJ request".
A top aide to Cuomo, Melissa DeRosa, said to state lawmakers that "we froze" when asked for the true number of nursing home deaths, worrying they would be "used against us" by a hostile White House administration, the. The governor's office later confirmed that report.
"Everyone was busy…We're in the midst of managing a pandemic. There was a delay in providing the press and the public all that additional information." - Governor Andrew Cuomo
Other Nursing Home Reporting Issues Dogging Cuomo
Cuomo has also faced criticism in recent days after an Associated Press report found that, in the early days of the pandemic, New York sent more than 9,000 recovering coronavirus patients from hospitals back into nursing homes.
A report by the New York DOH (New York State Department of Health) seemed to defend the Governor claiming the readmissions did not contribute to the spread of coronavirus in nursing homes. "These patients could not have been responsible for introducing COVID into their nursing home, as they had COVID prior to going to the hospital for treatment and before being readmitted," the report said. Also in the report, a claim that "most patients" readmitted to nursing homes were likely no longer infectious at that point.
United States Department of Justice
New York State Department of Health
Living As A Senior in Michigan
The State of Michigan is blessed with the riches of unspoiled nature: the nation's longest freshwater coastline, world class beaches and the abundance of fresh produce straight from the farm. Here you will find more than 100 public beaches, sand dunes, two National Lakeshores and the only national marine sanctuary in the Great Lakes - the Thunder Bay National Marine Sanctuary in Lake Huron. Along the shoreline there are 129 lighthouses, numerous maritime museums, ten shipwreck-diving preserves and historic military fortifications.
And Michigan is a state of industry. From the ‘Big Three’ auto plants to lumber, pharmaceutical and mining industries. These have contributed to comfortable retirement for Michigan seniors. There is the world famous Henry Ford Museum, America's "Greatest History Attraction" and a thriving arts and culinary scene. And don’t forget the Mighty Mackinaw Bridge and Mackinaw Island where folks can visit life as it was in bygone eras.
Michigan has 19 million acres of forests. Lakes, campgrounds, wildlife refuges and 103 Michigan state parks and recreation areas create a wide variety of recreational pursuits.
Assisted Living in Michigan
The state of Michigan does not license or regulate assisted living facilities.
In Michigan, assisted living community staff will create a service plan, or care plan, for each resident. This is done as part of an initial screening of each resident and before the person moves into the facility. These plans are based on information provided by the resident or his or her legal representative.
As part of the plan, the resident's primary care doctor conducts a physical and mental health screening to make sure assisted living is the appropriate level of care for their needs. If signs of Alzheimer's or dementia are found, then memory care may be recommended. Most Michigan assisted living facilities to not accept residents needing this level of care. If a physical ailment is present that requires regular therapy or medication, skilled nursing or rehabilitation care are usually the right choices. For seniors who are capable of taking care of themselves, Michigan assisted living may be a good choice.
Licensed and Regulated Senior Homes in Michigan
Michigan does have a number of types of senior living that is Licensed, Regulated and Regularly Inspected by the State. These include:
- Adult Foster Care Family Homes
- Adult Foster Care Large Group Homes
- Adult Foster Care Medium Group Homes
- Adult Foster Care Small Group Homes
- Homes for the Aged
- Nursing Homes
Responsible for licensing such homes is the Michigan State Adult Foster Care and Homes for the Aged Licensing Division. There are Staffing Requirements and Staff Training Requirements to obtain and maintain a license. Also background checks for each staff member.
High-functioning seniors who may need help with bathing, dressing, meal preparation and other activities of daily living (ADLs) most often find themselves living in privately overseen residential care communities.
The Cost of Senior Living in Michigan
There are over 4,000 senior care homes of all types in Michigan. Genworth lists the average cost of a private, one bedroom unit in an assisted living community in Michigan as $4,084. This places Michigan on the higher end of the scale at about $100 over the national average, and about $200 lower than the median cost of assisted living in nearby states.
The state Medicaid program is known as Healthy Michigan, and can provide residents of the state with financial assistance. Qualifications to enroll include:
- Permanent residents of the state of Michigan
- Between 18 and 64 years old
- Not pregnant at the time of application
- Not currently enrolled in other Medicaid programs
- Not eligible for Medicare
Also Michigan has several government agencies and various nonprofits that assist aging citizens who need help with their transition into assisted living, as well as for those who could use a helping hand before or after they have gotten settled in. These services are typically provide free of charge.
A Wide Variety of Michigan Senior Living Options
Yes Michigan many senior living possibilities, both licensed and unlicensed. From what some refer to as assisted living to state regulated homes such as Adult Foster Care, Group Homes and more providing home like settings with trained staff and the companionship of other seniors.
The Law Will Require Development Of A Strategy To Recognize And Support Family Caregivers
In January, Congress passed and President Donald Trump signed the RAISE Family Caregivers Act. The law creates a strategy to support millions of people who help loved ones remain in their homes.
Here is what the new law will require.
- Require HHS to develop, maintain and update a National Family Caregiving Strategy, offering resources and education opportunities to family caregivers in the United States;
- Require HHS to convene a Family Caregiving Advisory Council to advise it on recognizing and support family caregivers;
- Promote greater adoption of person and family centered care in all health and long-term services and supports settings; and
- Ensure older adults with disabilities and illnesses receive high quality care in their homes.
Senators Susan Collins (R-Maine) and Tammy Baldwin (D-Wis.) and Representatives Greg Harper (R-Miss.) and Kathy Castor (D-Fla.) spearheaded the legislation.
The bill as it moved through congress was also backed by AARP. “Family caregivers are the backbone of our care system in America,” said Nancy A. LeaMond, AARP’s chief advocacy and engagement officer. “We need to make it easier for them to coordinate care for their loved ones, get information and resources and take a break so they can rest and recharge."
These family caregivers have a big job, but some basic support — and commonsense solutions — can help make their big responsibilities a little bit easier.
We are grateful to Congress and “This is forward progress, but it should not be the end of the journey. - Charles Fuschillo, Jr., President and CEO of the Alzheimer's Foundation of America
Across America, family caregivers help parents, spouses, children and adults with disabilities and other loved ones to live independently. They prepare meals, handle finances, manage medications, drive to doctors’ appointments, help with bathing and dressing, perform complex medical tasks and more — all so loved ones can live at home.
So What Will The RAISE Family Caregivers Act Really Do?
The RAISE Family Caregivers Act requires the U.S. Secretary of Health and Human Services (HHS) to develop, maintain and update an integrated national strategy to support family caregivers. According to the Act, HHS will create a national family caregiver strategy by bringing together federal agencies and representatives from the private and public sectors (like family caregivers, health care providers, employers and state and local officials) in public advisory council meetings designed to make recommendations. The agency will have 18 months to develop its initial strategy and then must provide annual updates.
So we can say that the aim of this new law is certainly needed, well intentioned and could be of great help to the 40 million family caregivers with an elder or disabled loved one at home. What could be wrong with that?
What We See Is Wrong With The RAISE Act
Funding, simply put. Implementing any national strategy will create a large cost that our polarized Congress is unlikely to fund. The RAISE Act is supposed to help family caregivers keep working outside the home. The question is: Who is going to pay for the replacement caregiver when the family caregiver goes back to work? Respite options are to be included as part of the Act. That means that the family caregiver gets time off to rest. And what happens to the elder or disabled person when the family caregiver is getting that break? Someone has to pay for the actual cost of placing the care recipient in a facility temporarily or paying someone by the hour to care for them temporarily. We have no such national programs now. Strategizing about programs is not the same as paying for programs.
Age Related Illness and Disease
Alzheimer’s disease and Dementia are affecting seniors in growing numbers. The result is literally millions of people become family caregivers and are quitting their jobs to care for their loved ones part time or full time. Passing a law requiring an integrated strategy is fine, however funding research to find a cure for the sixth leading cause of death in the U.S., Alzheimer’s disease, is hugely important. Caregiving for a loved one with Alzheimer's can last 20 years.
The RAISE Act is an important step toward more fully recognizing the impending crisis in caregiving as the aging population continues to grow. As improved guidelines and policies develop from the legislation, funding will be required to relieve the 2015 AARP estimate of $470 billion in unpaid care and the 2016 AARP estimate of $7,000 in out-of-pocket expenses provided annually by family caregivers. - Kathleen Kelly, Executive Director - Family Caregiver Alliance
We have not seen as part of this new law, any mechanism for Funding caregiver relief, disease research, housing assistance for seniors or any other important caregiver related need. Referring this lack of funding, Charles Fuschillo, Jr., President and CEO of the Alzheimer's Foundation of America is quoted in a press release from GlobeNewswire: “We are grateful to Congress and “This is forward progress, but it should not be the end of the journey.”...This encouraging development is only the tip of the iceberg. A dire need remains for the federal government to pass a Fiscal Year (FY) 2018 budget which includes $2 billion—up from the current amount of $1.4 billion—for Alzheimer’s disease research at the NIH." (National Institutes of Health).
Caregiver Training, Medical Assistance And Financial Relief
According to AARP, family caregivers “commonly experience emotional strain and mental health problems, especially depression, and have poorer physical health than non-caregivers.” And they rarely receive training in providing care.
And 78% of them incur out-of-pocket costs due to caregiving, spending $6,954 a year, on average, according to AARP. That’s estimate of $470 billion in unpaid care each year. Recognizing and strategizing about this with a new law is not the same as funding a solution.
What Concerns Me Is What’s Missing In This Law
To be effective and not just a list Advisory Councils, Strategies, and Unfunded Departments, I see several main things that could be put in place rather quickly and which would provide much needed help for families faced with a senior caregiving situation. Consider the following:
- Allow family caregivers an amount stipulated on their tax return that funds their lost wages in regards to social security. In other words fill those gap years in their ss earnings with a stipend so they do not lose benefits they will need when they themselves retire.
- Congress needs to pass a law allowing Medicaid funds to be used to pay for Adult Foster Care Homes and not just nursing homes. These homes cost on average ½ of the cost of a nursing home, which is the only option open to those whose funds have run out. The care in these homes as good and many times proven to be better than traditional nursing homes. The smaller environment can be a great benefit to patients with forms of dementia and Alzheimer’s disease and the staff to patient ratio usually much better. Just ask, me I am a huge advocate for these homes.
- Allow family caregivers who leave work to care for a loved one to draw a caregiver wage from the government if they meet certain income requirements. If a person cannot financially leave a job to care for someone, that person ends up in a nursing home and that cost the government and the economy on average 8-10,000 per month per resident! Again you could pay a family caregiver a fraction of that, save money and the patient gets better care! It’s a win win solution.
Senior Homes - What are the Options in Your State
In your search for a place for yourself or a place for mom or dad to live, you are seeing so many different names and terms for various types of senior homes and senior living. These terms and names have changed over the years and what we may have at one time called a 'Nursing Home' or 'Old Folks Home' are now called many other things. At one time thoughts of white-walled, institutional settings we we’re hesitant to visit are now independent and assisted living options offering a wide range of appealing amenities, features and socializations.
Assisted Living, Adult Foster Care, Nursing Home, Board and Care Homes.
The different levels of care available today will depend on you or your loved one's needs, and various options, depending on a senior's health, age and financial status.
What is very important however, is that most if not every state in the U.S. has it's own definitions - descriptions and usually licensing requirements for senior living options. This is where we provide you with an important and useful resource for finding what your states options are.
To discover what senior living options are offered in your state:
Information updated regularly.
What You Should Do When Searching For Senior Living
When it comes time to choose a home for you or your senior Loved One, you may discover it is a difficult task. Your goal is to find the best home possible yet you may be looking at many, even dozens of homes on a list. How will you make the right decision?
The best way can be to make sure you are informed about each home you are considering. First it is great to have access to the internet so you may gather details about homes in your area, their basic information, rates, amenities, history, even photos of the homes and their surroundings. Also you will want to make a list so that you can collect that information about each home you are looking at and have it available when finally making that important choice. You can fill out the list from the facts you gather on the web, but also take it along when you visit the homes in your search. Obviously it is very important to visit each home you are considering.
So here are some tips on conducting your search and suggestions for some of the information you will want to collect.
1. Determine The Needs Of You Or Your Loved One
What are the needs which must be provided by the home? This is a question that should be answered first. If a home does not meet those needs it will not be placed on a list of homes you will consider. Needs may depend on your loved ones level of independence, health care needs, even budget and payment option requirements. Many of these questions are answered on websites such as Senior Home Search. But do not neglect calling the homes as well.
To determine needs you may ask some questions: Does your loved one require help with Activities of Daily Living - ADLs? Do they need help with dressing themselves, taking a shower, and going to the bathroom, preparing meals, taking their medications, etc.? Are there memory issues – dementia or Alzheimers disease? Some homes will not accept someone with memory issues while others specialize in and/or are licensed for memory care.
2. Make a List of Homes
Once you have determined what needs must be provided by a prospective home, make a list of all of the homes that address those needs and are in a location that will be as convenient as possible to as many of those as will be regular visitors or responsible for monitoring your loved ones care. This will no doubt include family and also friends who are active in their care.
How many homes will be on this list depends on you, as you will be doing quite a bit of homework in order to find the best possible fit. Many people will work with a list of at least 3 or 4 homes that fill their needs. As discussed these needs will include 1) Location 2) Budget and 3) Required Care.
3. Visit Each Home / Facility on Your List
Most if not all of us would never consider buying a home or renting an apartment without first visiting. Likewise, each home on your list should be visited, allowing sufficient time to get a thorough understanding of the home, its staff and how it is operated. In many cases, especially with smaller homes, you will be meeting with the owner. Be sure to have your checklist and questions handy on your visits.
4. Ask the Right Questions
Whether during your visit or on the phone, you should be prepared with the right questions to ask about the home. This is important to ensure your search for the best possible home and environment for your loved one is a success. Your questions should be designed to help you understand clearly the services, programs and processes the care home has in place. Your questions may include:
What is the ratio of caregivers to residents on every shift?
Does the staff undergo a background check before employment?
How will you meet my loved ones needs?
How often are visitors allowed? Are visitors allowed anytime?
Is the staff provided with ongoing training? Is the staff monitored to assure proper behavior and job performance?
What are the state requirements and the homes requirements to be hired to provide care?
What safety guidelines are in place at the home?
These are just a few examples of questions that should be answered clearly and in a detailed manor by the home/facility operator. You will no doubt want to add others you feel are important. And do not be afraid to write down the answers provided while on your visit.
5. Be Thorough When Visiting Each Home
When you visit each care home, make sure you inspect the facility thoroughly noting things that are good about it, and also any red flags which may turn up. Does the home or facility make you feel welcomed? Does it smell good like it was just cleaned or does it smell like urine?
Do you see licensing certificates posted in plain view? Do they have photos of the residents’ celebrations? Do they visibly display their food menu or schedule of activities? Are the residents just sleeping in their room during the day or are they staying active? Are the bathrooms and inside the refrigerators clean? Does it look like they pay attention to detail at the facility?
You can see that a very thorough inspection will take some time, but is extremely important. Your loved one may be living there one day!
6. Talk to the Residents
Are the residents living in the home sociable? How do they interact with one another? Do they look well groomed? Are they happy? Are their alert levels similar to that of your Loved One? In case the residents are not alert, it does not mean the care facility is a bad home. It could mean that the particular home or community specializes in dementia residents. Make sure to find out from the staff and owner the condition of the residents before you visit to help save you time. And it is important to talk to the residents and try to determine if they would get along with your Loved One.
7. Talk to the Owner and the Caregivers
Does the Owner and each Caregiver at the home during your visit seem friendly and welcoming? Do they rush you off or do they take time to answer your questions. Do they seem to want to understand your Loved One’s needs? How do the staff and caregivers interact with the residents? Do they seem like they care? Observe them and do not hesitate to take notes.
8. Get All the Facts
Preferably before your visit, you should check on the Facility’s Licensing Records and get testimonials from the other residents’ families that are staying there now or that have stayed there in the past. Check with the neighbors to see if there have been any reported problems inside or outside of the home or facility.
If you want a thorough report, a great place to start checking on the care facility is with State Licensing board or department. Each care home and community is licensed by the State and they keep on file all of the write-ups or citations each facility has received since it opened.
Minor citations are common such as administration write-ups. However, major citations noted by the State inspector are something worth learning more about in detail. If a care facility has a major citation, it is worth getting more information from the State and even bringing it to the attention of the care homeowner or management staff for an explanation. It may turn out to be a reason to remove that home from your list.
You may also check to see if the home is rated online at sites other than the States website. Do your research and check online reviews and ratings for the facilities you are considering. Be sure to also check the Better Business Bureau rating and look for complaints and even compliments from the residents or their families.
9. Take All The Time You Need!
The more time you have to research each home on your list, the better it is for you and your Loved One. The home you and your family choose should be the best you can find. This is a most important decision and deserves as much time as needed.
Keep in mind that good, excelling care homes and communities will many times stay full with no vacancies. When a vacancy does become available, due to their popularity and reputation, they fill their opening up very quickly.
It can be difficult lining up a good care home just when it has an opening And it is the time when your Loved One is in need of care. If you already visited homes but your Loved One is not ready, it might be a good idea to see if you can go on the care facilities wait lists.
Summary and Conclusion:
Selecting the right senior care home for you or your Loved One is a very important task. A good – well thought out choice is important in order to avoid having to move your Loved One from one care facility to another due to unforeseen problems or issues. Such moves can be very difficult for your Loved One and place them under a lot of stress.
The initial move to an assisted living care home or community is already going to be a big adjustment so you want to make sure that you choose carefully. You can use these tips to help increase your chances of success in finding the right home.
Across the country, thousands of nursing home residents face this situation every year:
"You had to go to the hospital, and when it came time to return home, to your nursing home, you were told you couldn't move back in"
This news is according to an article on the website NPR – National Public Radio.
I was on the forums these past few days and one of the threads was talking about how many days are covered by Medicare in a Nursing Home or Rehab after a hospital stay. The answers were all over the map and quite confusing I must confess, so I thought I would do a post about it to clear things up. I have always told my readers I am no expert, but when it comes to this subject I know it all to well. You see my mom has been in and out of rehab 3 times in the past 2 years so we know the rules by heart.
According to Medicare rules a person must have a qualifying hospital stay of at least 3 days, ( 24 hours) and be in need of further skilled nursing or rehab care in order for them to pay for the stay. The doctor and the physical therapy department at the hospital must agree that the patient would benefit from continued care or therapy at a nursing home or rehab facility.
It is important to note at this point that the patient needs to be an inpatient at the hospital for 3 days, and time spent in observation or the ER does not count. They have to be admitted to the hospital. This is very important!
Insurance companies and Medicare are putting increased pressure on doctors so that they do not admit patients. They have narrowed the guidelines for admittance and now many patients are ending up in observation for 1, 2 or 3 nights and then they do not qualify to go to rehab under Medicare.
If a person has a qualifying stay of 3 days then Medicare will pay for nursing home or rehab as follows:
1. Day 1-20 Covered 100%
2. Day 21-100 partial coverage with a 161.00 a day co-pay
3. Day 101 and beyond no coverage
Many Medicare supplement policies like the one my mother has will cover the copay on days 21-100 so there is no out of pocket for the patient. However this is something you should look into ahead of time so you know your coverage should you or a loved one be in this situation.
During the time in rehab the patient must continue to show that the services provided are helping them to improve. So if at anytime during their stay the team feels they have done all they can for the patient the team is obligated to discharge them, even if they have days left.
Now there is something to be said about having days left over. If the patient leaves rehab or nursing care and they need to be readmitted to the facility within 30 days and have days remaining they will have coverage through Medicare. If they use up all their days then they would have to wait 60 days and have another qualifying hospital stay of 3 days before Medicare would pay for skilled nursing care or rehab again. This would start their 100 day benefit period over again.
I am providing a link here that goes to the Medicare.gov site for skilled nursing care. It has more information for you.
I do hope this information helps you understand the process a bit better. If you have any questions or comments please feel free to contact me or leave a comment at the bottom. We always love to hear from you. Remember you are not on this journey alone.