New Federal Data Released on Staffing Levels in U.S. Nursing Home

Contact: Richard Mollot – 212-385-0356, richard@ltccc.org

New York, NY, November 1, 2017—This week marks the official release by the U.S. Centers for Medicare and Medicaid Services (CMS) of new data on staffing levels in U.S. nursing homes. Staffing is key to the quality of care and safety provided by a nursing home. Though the critical need for sufficient staffing is widely acknowledged, too many nursing homes fail to have enough staff to ensure that residents receive decent care and are able to live with dignity. With over half of Americans who reach age 60 expected to need nursing home care at some point, accurate staffing information is important to the public and to state and federal policymakers (who are responsible for overseeing both public safety and the appropriate use of Medicaid and Medicare funds, which pay for the majority of nursing home services).

Following is information on the new data released by CMS.

What’s New?: CMS has released, for the first time, information on nursing home staffing that is based on payroll or other auditable data sources. Up until now, public information on nursing home staffing levels has been based on data that are self-reported by facilities. Also, up until now, there has been no mechanism in place to ensure that facilities are accurately reporting this vital information.

Why?: The new reporting system was developed because the self-reported data have long been considered by many to be suspect (i.e., that there is a strong potential for facilities to overstate their staffing levels with impunity). Under the new, payroll-based journal (PBJ) reporting system, facilities are required to report verifiable staffing data that distinguishes between staff who were assigned to resident care and those with administrative duties.

Where?: The new data are available in large files at https://data.cms.gov/. To facilitate public access to the information which we have identified as most important to resident safety, LTCCC has published facility data on our website at http://nursinghome411.org/nursing-home-staffing-2017q2/.

The data provided on www.nursinghome411.org include: resident census, RN, LPN and CNA care staffing for every facility (as reported on the CMS database). We used those data to compute hours per resident day (HPRD) for both all care staff and for RNs. To facilitate ease of use, we separated the data into individual state files and inserted sorting (arrow) icons at the top of each column so that the state files can be sorted by criteria such as RN HPRD.

How Is This Important To The Public?: Direct care staffing levels, especially those of Registered Nurses (RNs) are one of the most important indictors of a nursing home’s quality and safety. Thus, it is essential that the information on staffing levels is accurate and accessible.

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LTCCC is a non-profit organization dedicated to improving care and quality of life for residents in nursing homes and other residential care settings. Visit www.nursinghome411.org for more information about nursing home quality and compliance with minimum safety standards as well as our free resources for LTC consumers.

After 20 hard-charging years in banking and portfolio management, Todd Sensing realized something was missing. So he changed careers and became a financial planner.

Sensing, 45, launched FamilyVest, his financial advisory firm, in 2016. Focusing on family finances made business sense, but his deeper motivation hit closer to home.

Raising two sons on the autism spectrum led Sensing to appreciate the challenges that families with special needs face. Aside from long-range financial planning, they confront social, psychological and practical difficulties just getting through each day.

“Your kids look normal but they don’t act normal,” Sensing said. “That can create a lot of anxiety about going out in public.”

Sensing’s sons were born in 2001 and 2003. They were diagnosed at a young age, and Sensing initially maintained his self-described “Type A investment manager” personality. He even started and ran a hedge fund in 2007 called the Aardvark Market Neutral Fund.

Once his sons reached their teen years, Sensing wrestled with the mounting dissatisfaction of his working life. He wanted to apply his experience and knowledge as a parent with special needs children to help others in a similar situation.

“When you’re raising kids with autism, even thinking about long-term financial planning is tough,” said Sensing, a certified financial planner in Miramar Beach, Fla. “You’ve got a full plate. There’s lots of room for error.”

When he was a number-crunching asset manager, Sensing mastered financial instruments but admits that he had little use for “the softer side like communication and empathy.” His perspective changed as his young sons struggled and he developed patience and listening skills, “since planning for a child with special needs isn’t just about numbers.”

As a guest on the “Your Money” radio show hosted by Kent Smetters, Sensing fielded a call from a father who was raising children on the autism spectrum. Sensing suggested financial tools such as ABLE accounts (tax-advantaged savings accounts for families with disabilities) and shared other tax strategies.

“I started to sense what I was saying wasn’t aligned with what the caller was asking,” Sensing recalled. “He was speaking as a stressed parent worried about what was going to happen to his child after he was gone. He didn’t want to know about possible tax savings because that’s not where he was yet.”

Reflecting on the call, Sensing wishes he had said, “You’re not alone. There are ways to solve the problems you face, protect your children’s future and help them achieve the goals and dreams you have for them.”

Upon launching his advisory firm, Sensing set out to understand each client’s plight. From experience, he knew that parents with special-needs children benefit by confiding in attentive, caring experts who listen intently rather than rush to dish out advice.

“I used to jump to a conclusion instead of listening with a clean slate,” he said. “You want to show off your technical expertise. But now I’m more focused on helping people move forward by understanding them first and speaking their language.”

That’s particularly important when he meets parents dealing with autism at home. He knows it’s tempting to become a recluse because of the social anxiety that can arise when the family dines out or shops at the mall.

During client meetings, Sensing has learned to paraphrase what he hears to confirm he’s captured the message accurately. He also weaves in his experience — the fears, frustrations and joys of raising his sons — to strengthen his connection with clients.

“My boys,” he said, “have taught me more about patience and love than anyone could.”

By Shaun Heasley via Disability Scoop

Housing prices across the country are far outpacing the monthly benefits provided by Supplemental Security Income, according to a new report, forcing many people with disabilities into homelessness or costly institutional care.

The national average rent for a one-bedroom apartment in 2016 exceeded the entire typical SSI check of $763 per month, while a studio or efficiency unit accounted for 99 percent of that payment.

What’s more, in the 13 states and Washington, D.C. where housing prices are highest, individuals with disabilities could not even cover the average cost of the smallest apartments with their SSI benefits.

The findings come from a report out this week from the Technical Assistance Collaborative and the Consortium for Citizens with Disabilities’ Housing Task Force. It’s based on U.S. Department of Housing and Urban Development data on rental costs for 2016 and information from the Social Security Administration on SSI benefits.

“Housing is a challenge for most of us; it’s a crisis for individuals on SSI,” said Kevin Martone, executive director of the Technical Assistance Collaborative. “Nowhere in the United States can people with disabilities receiving SSI afford a safe, decent place to live.”

About 4.8 million adults with disabilities received SSI in 2016. With these benefits falling short of housing prices, an estimated 87,000 people with significant disabilities were homeless and between 200,000 and 300,000 people with disabilities were living in institutions, nursing facilities and other segregated environments, the report found.

Meanwhile, over 870,000 people with developmental disabilities were estimated to be residing with caregivers age 60 or older.

“Taxpayer resources are spent exponentially on the costs associated with institutionalization and homelessness even though proven, cost-effective solutions exist,” Martone said. “We need our policymakers to finally confront this issue and work in a bipartisan fashion to address this form of discrimination against those who are the most vulnerable.”

FOR IMMEDIATE RELEASE
December 20, 2017

Contact:

Center for Medicare Advocacy – Matt Shepard: 860-456-7790, mshepard@MedicareAdvocacy.org
Medicare Rights Center – Mitchell Clark: 212-204-6286, mclark@medicarerights.org

Statement from
The Center for Medicare Advocacy and The Medicare Rights Center On Passage of Devastating Tax Bill

Washington, DC – Today’s passage of the Tax Cut bill puts the 57 million older adults and people with disabilities who rely on Medicare, and their families, at risk.

Medicare faces both short, and longer-term, threats as a result of this Bill. Almost immediately, budget rules triggered by the tax bill will require automatic and ongoing cuts to Medicare, starting with $25 billion in 2018 alone. While Congress may prevent this from happening, such action won’t “fix” this catastrophically damaging bill. The massive tax give-away will still result in a gaping revenue shortfall of $1.5 trillion or more, putting Medicaid, Medicare, and Social Security directly in the cross-hairs of policy-makers seeking to pay for the tax cuts.

Congressional leaders have been clear – after passing a costly tax bill that drives up deficits, they will use these higher deficits to justify cuts to programs like Medicare. As organizations concerned about access to affordable, quality health care and long-term services and supports for older people, people with disabilities, and their families, we will continue to fight for Medicare and the health and well-being of everyday Americans.

Congress: We, and the tens of millions of people we represent, are watching. We will hold you accountable.

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The Center for Medicare Advocacy (http://www.medicareadvocacy.org) is a national, nonprofit, non-partisan law organization that works to advance access to comprehensive Medicare coverage and quality health care for older people and people with disabilities through legal analysis, education, and advocacy.

The Medicare Rights Center (www.medicarerights.org) is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.

Courtesy of the Center for Medicare Advocacy

A New Jersey appeals court upholds the state’s denial of Medicaid benefits to an applicant because the applicant did not provide the necessary verifications, rejecting the administrative law judge’s decision that the case must be decided on its merits. P.B. v. Division of Medical Assistance and Health Services (N.J. Super. Ct., App. Div., No. A-5405-15T2, Dec. 8, 2017).

P.B.’s daughter filed a Medicaid application on her behalf. The Medicaid agency requested additional information about P.B.’s bank accounts, life insurance, and housing. P.B.’s daughter did not provide this information, and the Medicaid agency denied P.B. benefits.

P.B.’s daughter appealed on P.B.’s behalf. After a hearing, the administrative law judge (ALJ) remanded the case to the Medicaid agency to work on getting the required information, ruling that the case must be decided on the merits unless P.B.’s daughter failed to cooperate without good cause. The state rejected the ALJ’s decision and upheld the decision to deny benefits. P.B.’s daughter appealed to court, arguing that the Medicaid agency failed to assist her with the application.

The New Jersey Superior Court, Appellate Division, affirms the state’s denial of Medicaid benefits. According to the court, P.B.’s daughter did not provide any evidence to show why she couldn’t comply with the state’s request for additional verifications, so the state properly denied P.B. benefits.

For the full text of this decision, go to: http://www.njcourts.gov/attorneys/assets/opinions/appellate/unpublished/a5405-15.pdf