Articles Posted in Nursing homes

Medicaid-300x225Republicans have long fumed about the federal government’s role in health care, ever since Medicare for the elderly and Medicaid for the poor were both passed in 1965. Now, though, we’re at a crossroads, where a frontal assault on Medicaid could cause big damage to both programs.

The temptation for too many Americans, as I’ve written before, may be to skip over the Medicaid-related parts of the GOP proposals to repeal and replace the Affordable Care Act, aka Obamacare. That would be wrong because those parts of the American Health Care Act, aka Trumpcare, may be the most radical and will be detrimental to the poor, working poor, children, sick, disabled, and seniors. They will hit many millions more middle-class Americans than might be thought.

Opponents also say that Trumpcare and its Medicaid and health insurance changes will harm Medicare, the linchpin of health care coverage for seniors.

goodlatte-300x256We all know how con artists work the streets. One might bump into you in a train or in a crosswalk, while the other grabs your wallet. Or one might smile and chat with a mom at a playground, while her partner nabs the purse.

Patients and consumers may want to watch carefully for the congressional version of the distraction scam, a series of stealth bills that aim to strip them of valuable legal rights and protections they’ll need if harmed by big hospitals, rich doctors, big insurance companies, or giant corporations. With so much commotion under way with the new administration, Republicans sneakily have launched a furious, multi-pronged so-called “tort reform” campaign. They’ve wanted it for a long time. They insist it is needed to curb excess and frivolous lawsuits, to save money for Uncle Sam (who often is a defendant), to make the economy work better, and to add jobs, and to make life in general more wonderful.

Their arguments are counter-factual and lacking in evidence.

elder-abuse-awareness-300x210It’s one of the more disturbing, revolting, and painful health care investigations put out by a news organization in recent times. It’s disheartening but it also demands action: So, what steps will federal, state, and local authorities take now that CNN has reported that thousands of sick, disabled, and defenseless patients, most of them women, have been sexually abused and assaulted in nursing homes in the last decade?

The broadcast network said that data, collected by the U.S. Health and Human Services Department’s Administration for Community Living, show 16,000 sexual abuse complaints have been filed since 2000 over conditions at long-term care facilities (both nursing homes and assisted living facilities). Experts say there may have been more cases because sexual assault and abuse, due to stigmatization, often is un- or under-reported.

CNN, which turned up more than 380 sexual assault allegations in Illinois and more than 250 in Texas between 2013 and 2016, said it had analyzed U.S data in the same period, finding that “the federal government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities … And nearly 100 of these facilities have been cited multiple times during the same period.”

prescription-bottles-1-300x170Some diligent, grown-up sons and daughters may want to check in on mom, dad, and grandma, grandpa, all the aunties and uncles, too. That’s because there’s yet another warning that too many doctors are whipping out their prescription pads all too readily and writing scripts for retirement-age Americans, who now take on average three psychiatric drugs without any mental health history.

Research published in the JAMA Internal Medicine shows that over-prescribing of powerful psychotropic drugs, including sleeping pills, painkillers, and anti-depressants may be more common than believed. The study was based on an analysis of data from a big number of doctors’ office visits, with researchers finding the number of “polypharmacy” incidents (cases in which seniors received scripts for multiple drugs) increased between 2004 and 2013 from 1.5 million to 3.68 million.

This doubling resulted from seniors’ greater openness in talking with their doctors about mental health issues, and, in instances where visits were related to “anxiety, insomnia, or depression,” the researchers write. But, in disturbing fashion, a high number of women and rural patients were involved in cases where multiple psychotropics were prescribed, and many of the prescriptions were for painkillers.

harlanYes, there can be progressive steps in health care—and with all the controversy and change going on in the sector it’s worth spotlighting some of these:

Patients should get access to own health records, researchers say

  • Three researchers—Dr. Harlan Krumholz of Yale Medical School (photo right), Connecticut lawyer Jennifer L. Cox, and Yale student Austin W. Jaspers—deserve credit for publishing a pointed opinion piece in the JAMA Internal Medicine detailing the costs and needless obstacles patients confront when they want copies of their own health records. As Krumholz told Reuters of the study’s message about excessive records fees charged by doctors and hospitals:  “Higher costs are a higher barrier for people to get their own information. Without that information it is not possible to correct errors in the record, get informed second opinions, donate your data to research – or share with others what is happening with your care.”  That’s spot on, doctor, as I have written recently and in my book,  The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Uncle Sam has stepped in and tried to make it easier and more affordable for patients to get their own records, which Krumholz and company point out should be even more available now that they are digitized (he’s working on software to help, too). But states aren’t doing enough to help, except for Kentucky, which requires a free first copy on request, he and his colleagues say. My firm’s site contains information that may be helpful to those struggling to get their records. Here’s hoping that doctors, hospitals, and other caregiving facilities read the Jaspers, Cox, and Krumholz viewpoint, and, because it appears in one of their publications and Krumholz is a physician-researcher of growing influence, they heed it more.

Just some quick updates on some topics that the blog has followed in recent days:

Big Soda, Big Pharma spending big to battle ballot measures

nursinghomeA 100-year-old woman is strangled by her roommate, but a lawsuit against the nursing home gets blocked from court. Another nursing home dodges a suit when a 94-year-old patient suffers an unexplained and fatal head wound. An Arizona facility manages to duck a negligence suit when an elderly Alzheimer’s patient endures two sexual assaults in two days in a nursing home. How can these and other similar efforts to seek justice for the aggrieved  fail to find their day in court?

Federal regulators, with oversight on 1.5 million nursing home residents and more than $1 trillion in Medicare and Medicare funding, finally have stepped in with new rules in answer. Nursing homes will now be barred from forcing arbitration onto their customers. That means that nursing homes will no longer be able to push significant problems involving negligence, elder abuse, sexual harassment, and even wrongful death, out of public view and the civil courts, and into the private system of arbitration.

This is a big win for consumers.

The events of recent days ─in Texas, Louisiana, and Minnesota─ have been so tragic that it’s easy to despair. Here are four health-related people stories worth reading to remind us of humanity’s enduring better side:

  • In the horrors of Syrian combat, medical Samaritans strive to maintain some kind of care

syriaFirst, let’s stipulate that there’s almost as much barbarous conduct as can be imagined in this recent New Yorker report about the struggle to maintain medical care in combat-ravaged Syria. President Assad’s predation on his own people has become an international abomination, including his forces unleashing snipers to maim emergency medical personnel, and their dropping barrel bombs, laden with lacerating shrapnel, on hospitals or known care-giving sites (February, 2016, photo of a bombed hospital from Doctors Without Borders/Medicins san Frontieres).

Flag_of_South_Dakota.svgSevere diabetics, the blind, and the mentally ill all too often get sent to sterile and restrictive group or nursing homes by South Dakota officials who can’t seem to find other care options because they discriminate against thousands of the disabled, the federal government says.

The Justice Department is investigating the state under federal laws affirmed by the U.S. Supreme Court. As the New York Times reports, the feds aim to protect the disabled from needless confinement in highly regimented group or nursing homes because:

[A] 1999 Supreme Court decision, Olmstead v. L.C. [held] that, unless a nursing home is medically necessary, people have a right under the Americans With Disabilities Act to receive care without being segregated from society. Advocates for the disabled have compared that ruling to Brown v. Board of Education, which declared racial segregation in schools unconstitutional.

CRE superbugExperts say antibiotic-resistant microbes may be spreading from hospitals to other health care facilities because of transferring patients’ dirty hands.

And new research in Southern California raises the concern that existing treatment municipal treatment plants may lack the sanitizing punch needed to kill superbugs (such as the CRE microbes shown) flushed from hospital and other health care facilities into sewer lines. The supposedly treated water, too frequently with flourishing super bug colonies, then gets dumped into oceans.

Patients’ infectious hands

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