NH news notes – Frontlines

NH news notes – Frontlines – Brief Article

Douglas J. Edwards

CMS’s Scully a Purveyor of “Tough Love”?

When you run a regulation-loaded agency like the Centers for Medicare and Medicaid Services (CMS), it takes guts to stand in front of a room of stressed long-term care providers and declare that nursing homes are over-reimbursed by Medicare. But that was the message Thomas A. Scully, CMS administrator, delivered during the American Association of Homes and Services for the Aging’s (AAHSA) spring conference.

Scully said that the perception of nursing home quality is horrible, claiming that people from around the country tell him that nursing homes are “killing” their loved ones. He said the public will not support deregulation until facilities improve their quality and emerge from “a death spiral” where people blame all the problems on the nursing homes.

Two weeks later, though, this seemed to have been an exercise in tough love. Health and Human Services Secretary Tommy Thompson announced that $1 billion of that dreaded $3 billion “cliff” of Medicare cuts threatening nursing homes this October will be retained to reimburse facilities, as CMS continues to work on refining RUG classifications for the Prospective Payment System. The remaining funds are still in question pending congressional action. At the AAHSA meeting, Scully pointed Out that the add-on funds had been intended to help the industry cope with the nursing home chains’ bankruptcies during the 1990s. Facilities that “stuck to their knitting” and did not enter ancillary services were the ones that survived, he said, and noted that the add-ons were not meant to be permanent.

Ergonomics “Partnership” Stirs Controversy

Nursing homes are number one in the Occupational Safety and Health Administration’s (OSHA) eyes–the first industry, that is, that will be expected to implement voluntary guidelines to reduce ergonomic-related injuries and illnesses among employees. In developing the guidelines, expected to be ready for public comment later this year, OSHA is working with industry associations such as the American Health Care Association (AHCA) and AAHSA.

“With the nursing shortage and other issues confronting this industry, it makes sound business sense for the stakeholders involved to be the first to tackle ergonomic problems in their industry,” John L. Henshaw, assistant secretary of labor for occupational safety and health, said in a release.

Suzanne M. Weiss, AAHSA’s senior vice-president for advocacy, agreed. “With caregivers in short supply, long-term care providers have more incentive than ever to prevent lost workdays due to injury,” she said in a release.

The Bush administration’s decision to create voluntary guidelines for industries has been controversial. At the Senate Health, Education, Labor and Pensions Committee Hearing on Ergonomics, Sen. Edward M. Kennedy (D-Mass.) said, “[the administration’s plans] rely on toothless voluntary guidelines that most corporations will simply ignore.”

The American Public Health Association (APHA) also expressed concern about the administration’s stance. “It is very clear that American workers need a real ergonomics standard, that there are scientific data supporting a standard and that [Labor] Secretary Chao has chosen to ignore this information in favor of big business interests,” said Richard Levinson, MD, DPA, associate executive director of API-IA, in a release. “We were dismayed at the repeal of OSHA’s standard last year and remain committed to the development and implementation of a national and enforceable ergonomics standard.”

Taking a different view, Charles H. Roadman II, MD, president and CEO of AHCA, called OSHA’s plan “an excellent beginning,” and both AAHSA’s Weiss and Dr. Roadman affirmed their organizations’ commitment to workplace safety.

Study Finds Wide Disparity in Nursing Home Room Rates

Location matters when it comes to the cost of a private nursing home room, according to a recent study by the MetLife Mature Market Institute. The study found that facilities in Stamford, Connecticut, have the costliest average rate at $347 per day; the room rate average is lowest in Shreveport, Louisiana ($88 per day). The national average is $168 per day.

The study also found that the wages of a home healthcare aide averaged $18 per hour across the nation, with such care being most expensive in Anchorage, Alaska ($27 per hour), and least expensive in Montgomery, Alabama ($12 per hour).

Staffed by gerontologists, the MetLife Mature Market Institute is MetLife’s resource center for information on aging, retirement, long-term care and mature market issues.

COPYRIGHT 2002 Medquest Communications, LLC

COPYRIGHT 2002 Gale Group