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Denver Hospital Adds Separate ER for the Elderly

Another sign of our growing aging population: Denver's Exempla Lutheran Medical Center has converted a pediatric emergency room into an emergency room for seniors, and made a lot of changes to address their specific needs.

A hushed atmosphere, softer lighting, no-slip floors and staffers trained to screen for dementia, drug interactions and other elderly risks are sample features of the Lutheran Senior ER, launched this week. ..."This is where our market is going," said Bev White, a registered nurse who directs Lutheran's emergency trauma services.

This is a great idea. The screening helps those who don't need hospitalization get to the right place, and identifies those who do have major problems and need inpatient care. The noise of a regular ER really is disconcerting for the elderly. Here's the hospital's webpage for the senior ER. Love the graphic.

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About the Long Term Care Benefits in the Health Care Bill

(Warning: This post is going to be controversial and expresses my views only.)

Both the House and Senate bills would create a voluntary federal program to provide long-term care insurance that pays small cash benefits to people with severe cognitive or physical disabilities. Like the elderly.

I don't think most people understand what long term care insurance covers. It covers nursing homes, assisted living facilities, and for the cognitively or physically disabled, some home health care costs in lieu of going to a facility. This isn't medical coverage but coverage that assists those who can't feed, clothe, toilet or bathe themselves. You aren't eligible until you can't do at least two of the above. The payments cover a fraction of the actual cost of the services. In other words, you have to be basically physically or mentally dysfunctional to qualify for what is a paltry amount of benefits. [More...]

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Hillary and Harkin Introduce Bill to Force Disclosure of Names of Worst Nursing Homes

As someone with a parent in a nursing home, I am very glad to learn that Hillary Clinton and Tom Harkin (D-IA) have introduced a bill "that would force a federal agency to make public its list of the nation's worst nursing homes."

The U.S. Centers for Medicare and Medicaid Services has compiled a list of 128 nursing homes that have repeatedly fallen in and out of compliance with government health and safety regulations and caused harm to their residents. Those so-called "special-focus facilities" are now subject to more frequent government inspections.

Two weeks ago, the agency released an abbreviated, public version of the list that identified only 52 of the facilities. The agency refused to release the full list of 128 homes, even though it had already provided the full list to nursing home association lobbyists at the American Health Care Association.

The lobbying group that got the full list is the Alliance for Quality Nursing Home Care. [More...]

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Feds to Hospice Patients: Die Faster, Please

The Government is going after hospices to repay Medicare when their patients don't die fast enough.

The result: Many hospices will go broke and have to close.

A perverse interim measure: Some hospices are trolling nursing homes looking for more patients. That way they can use the new money to pay Medicare back for the old patients who didn't die fast enough.

[Ms. Youngstown, a] Hometown Hospice nurse, said that after she visited her charges — doling out their pills, and turning the sweet potatoes in their ovens — she trolled for new patients at nursing homes and senior centers.

At the small hospital here, she said, the nurses joke about her “marketing” forays: “They’ll say, ‘Here comes Nurse Kevorkian. She has no shame.’ And I’ll say, ‘Look, I have to have a paycheck, too.’”

Something is seriously wrong with this picture.

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Private Capital Groups Buying Up Nursing Homes, Reducing Care

The New York Times has a long expose today on how private capital groups are buying up the large chains of nursing home and cutting staff and care. If you have a loved one in a nursing, you should read it. It's very frightenting. First, what the Times did:

The Times examined more than 1,200 nursing homes purchased by large private investment groups since 2000, and more than 14,000 other homes. The analysis compared investor-owned homes against national averages in multiple categories, including complaints received by regulators, health and safety violations cited by regulators, fines levied by state and federal authorities, the performance of homes as reported in a national database known as the Minimum Data Set Repository and the performance of homes as reported in the Online Survey, Certification and Reporting database.

What it found:

As such investors have acquired nursing homes, they have often reduced costs, increased profits and quickly resold facilities for significant gains. But by many regulatory benchmarks, residents at those nursing homes are worse off, on average, than they were under previous owners, according to an analysis by The New York Times of data collected by government agencies from 2000 to 2006.

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