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Advancing Long-Term Services & Supports (Health Affairs Journal - January 2010)
This issue focuses on long-term care and related services, including the CLASS Act and the need to develop a competent, paid workforce to deliver needed services and supports.

Details on the Class Act - Part 1 (New York Times - 4/29/10)
The New Old Age has been following the Class Act, the first national plan for long-term care insurance, since last summer, but the late Senator Edward M. Kennedy and his staff began working on the current version of this plan in 2003.

Details on the Class Act - Part 2 (New York Times - 5/3/10)
Posting about the new federal Class Act invariably brings at least two kinds of responses from New Old Age readers: questions about how it will operate and who will be able to participate, and a tide of gloomy predictions, often from insurance agents and industry spokesman, of spiking premiums and eventual insolvency.

Patti's letter to Senators in Support of HCSCE (3/9/09)
..."The Act will exempt dually eligible individuals living in home and community settings from prescription drug co-payments. Currently, under Medicare Part D, only individuals living in skilled nursing homes are exempt from prescription drug co-payments. This change is necessary, as assisted living is one of the fastest growing long-term care options for the elderly and disabled."

More Info:

ALFA Commends Senator Bill Nelson's Commitment to Co-pay Equity for Home and Community Based Seniors (MedicalNewsToday - 3/6/09)

10 Questions That Make Sure the Elderly are Treated with Dignity and Respect (MailOnline - 3/15/09)
A checklist for patients and carers includes ten questions to ensure basic needs are met and people are treated with respect.
Patti's Comment: I can tell you that I honestly did not feel that I was treated with dignity and respect while I was in the hospital. Anyone who is being treated or receiving support or care giving services should be asked these questions.

An Overview on Medicaid Eligibility for Nursing Home Care and Payment (Helium.com)
For starters, Medicare requires that a patient spend three midnights in the hospital before being admitted to a skilled nursing facility. With the push to get people in and out of hospitals, some doctors may be reluctant to keep the patient this long, so be prepared to play hardball.

At Many Homes, More Profit and Less Nursing (New York Times - Sept. 23, 2007)
Some families of residents say structures unjustly protect investors who profit while care declines.

Even Older Americans Get Failing Grade on Their Knowledge About Long-Term Care (Senior Journal - 10/28/09)
Older Americans are really not very knowledgeable about long-term care. Most know what long-term care is and how much it costs, but their scores fall short regarding how many people will need it and how they will pay for it.

Facing Up to the Costs of Long-Term Care (CNN Money - Oct. 2007)
No matter how well you plan your retirement, the catastrophic expense of long-term care could ruin it all. Insurance looks like the obvious solution. Turns out it's anything but.

Fighting Bedsores With a Team Approach (New York Times - Feb. 19, 2008)
Bedsores: an area of skin breakdown that occurs when sustained pressure cuts off blood circulation - usually in patients confined to their beds in hospitals and nursing homes - a bedsore can result in a wound so deep and painful that some patients require narcotics. If a bedsore becomes infected, the complications can be fatal.

Foot Health and Amputation Prevention for the Long-Term Care Resident (McKnight's - 3/24/09)
Older adults in nursing homes and long-term care facilities often have multiple health problems. With medical advances in the treatment of diabetes, aging Americans are living longer with the disease. Foot health and amputation prevention programs for geriatric patients with diabetes are crucial to allowing the elderly to remain functional and independent. Patients with healthy feet can continue to walk and exercise. With proper foot care, falls and fractures can often be prevented.
Patti's Comment: I really like this doctor's goals!

How to Deduct Assisted Living Facility Costs (Robert C. Anderson, LL.M. Taxation, CELA)
The IRS provides an income tax deduction for medical expenses which include "qualified long-term services." This is a helpful article written by one of our friends on important tax considerations for folks who live in an assisted living facility!

How to Fight a Nursing Home Discharge (Elder Law Answers)
Nursing homes are required to follow certain procedures before discharging a resident, but a facility may occasionally attempt to "dump" an undesirable resident by transferring the resident to a hospital and then refusing to let the him or her back in. However, residents can fight back and challenge such discharges.

Housing Options for the Older Client (Probate & Property - Nov/Dec. 2008)
On reaching retirement age, many people think about changing their housing accommodations. Here issues are considered that are too often ignored.

Imprisoning the Aged in Long Term Care Settings (AC - 3/9/09)
After 20 years of working in long term care facilities as a Certified Activity Director, I have become disenchanted and frustrated with the lack of respect for the democratic resident rights of our ill and aging senior citizens.

Myths About Long Term Care (Rocklin Today - 1/31/10)
Long-term care has been in the news often these days. But there is also a lot of conflicting, and even mistaken, information.

New Nursing Homes are Delightful (Smart Money - Feb. 28, 2008)
Slowly but surely, far-flung revolutionaries are upending the nursing-home industry by transforming the culture of nursing homes themselves.

Next Steps: Start Long-Term-Care Planning Now (Pittsburg Post Gazette - 5/26/09)
Q&A with things to think about when facing this process.

No Need for Nursing Home if PACE Handles Senior Care (USA Today - 11/17/08)
"Families are feeling like we're failing our elders... so PACE tries to keep people who are eligible for nursing home care living independently in the community."

Nursing Home Suits Face New Litigation Hurdles (Lawyers USA - 10/9/08)
Plaintiffs' lawyers seeking to bring negligence cliams against nursing homes are seeing a number of new obstacles.

Nursing Homes Undertreat Dementia Patients' Pain (Reuters - April 30, 2008)
Nursing home residents with dementia appear to be less likely to receive pain medication than other residents, even though they have just as many painful health conditions, a new study suggests.

Options to Integrate Health and Long-Term Care for Dual Eligibles (PR Newswire)
The SCAN Foundation released a policy options document by the Center for Health Care Strategies, Inc. (CHCS) summarizing four options to integrate care for dual eligibles, the nearly 9 million seniors and adults with disabilities who qualify for both Medicare and Medicaid.

Policy Recommendations for Future of Long-Term Care (Spectrum Online)
Georgetown University researchers have released four distinct policy options for including long-term care support and services as part of a nationwide health care reform package following on the heels of a survey showing strong public support for improved coverage for long-term care services.

Resident Rights in a Nursing Home
In 1987, Congress enacted the Nursing Home Reform Law that has been incorporated into the Medicare and Medicaid regulations. The law gives residents a number of specific rights, outlined here.

Senior Citizens Fear Nursing Home, Loss of Independence More than Death (Senior Journal - Oct. 2007)
Results of a very enlightening research study that examines the attitudes and anxieties of the nation's elderly population and the baby boomers who care for them.

Selecting a Nursing Home - Creativity Can Make a World of Difference for Dementia Patients (Yakima Herald - 11/1/09)
Picking a long-term care facility for an elderly parent or relative is a complicated consumer project, experts say. While there's plenty of advice and information to help with the decision, the work comes with wading through it all and advocating for your family member.

The Side Effects of Antipsychotics in Nursing Homes (KALW News - 5/10)
In nursing homes across the country, men and women with dementia are struggling not only with memory loss, but with symptoms of the disease that cause them to act out, sometimes violently, threatening the safety of staff and other residents. One of the most common ways doctors treat the symptoms is with antipsychotics, a group of drugs originally developed to treat hallucinations and delusions in psychiatric patients. Today, nearly a quarter of nursing home residents are on antipsychotics, and some say the drugs are being overprescribed and misused.

Violent Nursing Home Attacks are on the Rise (Wisconsin Law Journal - 4/3/09)
Criminal offenders and mentally ill residents are fueling an increase in patient-to-patient assaults at nursing homes, according to experts.

America's Best Nursing Homes
As the American population ages at an unprecedented rate, the U.S. News Best Nursing Homes guide is a valuable resource for families facing the difficult process of looking for a nursing home.

Assisted Living Facilities Improperly Discriminating Against Medicaid-Eligible Residents (NSCLC)
The National Senior Citizens Law Center (NSCLC) recently published an issue brief focusing on Medicaid payment for assisted living. One concern is the unfair way in which Medicaid-eligible residents are sometimes treated by assisted living facilities that are certified to accept Medicaid reimbursement.

Examining the Role of Private Long-Term Care Insurance in the Financing of Long-Term Care (The Henry J. Kaiser Family Foundation)
As the long-standing gap between Americans’ need for long-term care services and the public and private funding available to pay for them grows ever wider, this policy brief examines the fundamentals of private long-term care insurance.

Guide to Choosing a Nursing Home (Asiaing.com - 8/22/09)
Designed to help you make informed decisions about nursing home care, whether you’re planning ahead or need to make an unexpected decision.

Long Term Care Legal Resource Manual (Michigan State Long Term Care Ombudsman Program)
Several years ago, Kelly Quardukus and Elder Law of Michigan undertook a project to compile federal and state law and regulations relating to long term care. It was recently reformatted and renamed Federal and State Regulation of Nursing Homes. Note: this is a 946 page pdf document, so may take some time to download.

Institute of Medicine Report Recommends Improving Direct-Care Jobs (PHI Press Release)
Information on the Institute's latest report, "Retooling for an Aging America: Building the Health Care Workforce."

Let Elders Age Independently and With Dignity (Clearinghouse Review - Sept./Oct. 2008)
Assisted-living and nursing home providers may reject certain people because "we can't meet your needs." But is this legal? The Fair Housing Act is a powerful tool to ensure that people with disabilities (including dementia) are treated equally and as individuals who have choices in their housing.

Long Term Care Accommodations (Compiled by Tri-Care Office on Aging)
Services and payment sources as part of the long term care continuum.

Malnutrition and Dehydration in Nursing Homes (Nat'l Citizens' Coalition for Nursing Home Reform - June, 2000)
Researchers in the United States have found that malnutrition is epidemic in the elderly population in America.

Market Survey of Long-Term Care Costs (MetLife)
The 2009 market survey of nursing home, assisted living, adult day services and home care costs.

New Medicare Regulations Regarding Pressure Ulcers in the Nursing Home (Medical Advisors, Inc.)
Centers for Medicare and Medicaid Services has published new guidelines regarding pressure sores (decubitus ulcers).

Nursing Home List - Here's a list of all the nursing homes and the type of payment (medicare/medicaid) they accept and number of beds for each. This is really helpful information for folks looking to secure placement in a particular nursing home and they need to wait for a medicaid bed to open up.

SourceBook - Your Guide to Retirement Living
A resource for consumers and professionals alike. From active adult communities to assisted living facilities, the goal is to provide the most complete presentation of otpions for an aging public.

Supporting Culture Change: Working Toward Smarter State Nursing Home Regulation
The traditional nursing home regulatory approach, which uses survey and enforcement to achieve performance improvement, has created tensions between providers and surveyors. It has had limited success in improving quality overall and not necessarily allowed innovation to flourish. To move toward a new model of nursing home regulation, the states and federal government must strike a balance between the traditional regulatory approach to weed out substandard facilities and a partnership model aimed at promoting high performance. This issue brief highlights the importance of how such a model is structured, as well as the need to adequately train and educate regulatory staff and providers about culture change. Regulators, providers, consumer groups, residents, and their families also will need to commit to the principles of person-centered care to ensure the success of the new collaborative approach.

Assisted Living Consumer Alliance
A national collaboration of groups and individuals working together to promote consumer safety, choice, and rights in assisted living.

HCR Manor Care
More than 500 locations in 32 states - a leading provider of short and long term medical and rehabilitation care.

National Consumer Voice for Quality Long-Term Care (formerly Citizens' Coalition for Nursing Home Reform)
Organizied to represent the consumer voice at the national level because of public concern about substandard care in nursing homes.

Reports on Long-Term Care (Long Term Care FocUS.org)
An interactive database incorporating information from a number of government sources. It allows the user to create a chart comparing all nursing homes in a state with a broad range of variables from which to choose.

CareMinds.com
Resource for nursing homes, assisted living, home care, hospice and geriatric care managers.

ElderCare Link
A site that simplifies the process of connecting with qualified assisted living providers anywhere in the U.S.

How to Choose a Good Nursing Home (Elder Law Corner blog)
How do you go about finding a good nursing home, one which will properly care for the emotional as well as physical and medical needs of your family member?

NAELA Newsletter - subscriber question: "Nursing home resident with dementia and a well-documented history of falls, fell against bed frame breaking several ribs. Medical director examined resident but did not send him to ER. Resident died 16 hours later from his injuries at nursing home. The history of falls was well documented. A "Fall Risk Assessment" was done every few months. The Assessment sheet states that if the resident scores 10 or more points, "prevention protocol should be initiated immediately and documented in the care plan." The resident scored consistently between 10 and 16 on the four Assessments before his death, yet none of the Care Plans contain any mention of fall prevention protocols. Are there written standards for these protocols and, if so, where might these be found?" See Fall Prevention: Definitions and Measurements.

Senior Decision.com
A free website offering consumer reviews and ratings for nursing homes, retirement homes, assisted living facilities and home health agencies. Seniors and caregivers with first-hand experiences they want to share are invited to submit reviews to the site.

Senior Housing (NAELA - 11/2008)
An online navigational tool designed to help you and your clients find senior housing anywhere in the nation faster and easier.