Federal Penalties Coming to Middle South Nursing Homes for Care Failures

New Orleans       There are few lobbies as powerful as the nursing home owners’ groups in Louisiana, Arkansas, and Mississippi.  All of which makes the intervention of federal rules extending some of the same accountability standards that hospitals now face, welcome news.  The fact that the penalties go right to their pocketbooks is even better news.

Here’s the deal on the new rules hitting nursing homes across the country now.  Penalties – or incentives for those doing better – will be meted out to nursing homes based on the frequency of readmission of elderly Medicare patients that are returned to hospitals within thirty days of leaving a skilled nursing home.  The financial penalty can reach up to 2% of the individual Medicare reimbursement rate per patient.  Hospitals already have to measure up to this standard and in recent months nursing homes came under the same regime.

Will this affect many homes?  Yes, indeed!

Kaiser Health News reported an analysis of homes in Louisiana and found that 85% of the 277 skilled nursing facilities in the state would be subject to a penalty based on data from 2015 through 2017.  Not that Louisiana was by itself since the figures for nursing homes in Arkansas and Mississippi was almost exactly the same.  Bottom line:  the vast majority of nursing homes in the three-state area are facing penalties.  The Advocate reports that in New Orleans for example, a dozen facilities will face a penalty and only two will receive small bonuses for doing right.  These are not just problems with for-profit providers.  The three homes overseen by the Catholic Archdiocese of New Orleans will each receive almost the maximum penalty for each new admission at 1.98% of the possible 2%.

The question of how nursing homes can provide better care to patients, often elderly, sick, and frail, is a constant concern for families and appropriately for public policy.  Reading the comments from administrators of homes that got the good grades under the new rule, they cite getting more thorough information from the hospitals about incoming and prospective patients is key as well as offering preventive care on site.

All of that sounds right, but given the long experience that Local 100, United Labor Unions, has had in representing nursing home workers and observing care conditions firsthand, it will be difficult to fundamentally improve care until staffing levels are adequate to the significant health demands of patients as a first priority.  Being able to retain professional caregivers also means compensating workers commensurate to the value of the service they provide to families and patients.  In the thirty or more years that we have been involved with nursing homes we still see a conflict faced by many home owners and operators between seeing the facilities as real estate developments with a sideline in healthcare as opposed to healthcare facilities that happen to be built on real estate.

We’ve got a long way to go still, but hopefully the application of this new rule will bring some change now that owners will feel the pain of nonperformance in dollars and cents.

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Congressman Al Green is Serious About Trump Impeachment

New Orleans   Before you say anything, let me be clear. We’re big Al Green fans. Huge, simply, huge! Houston’s Democratic Congressman Al Green has been our go-to-guy for the last dozen years, whenever Local 100 United Labor Unions or ACORN needed help on anything, anytime. When there was a resolution in Congress to ban ACORN, Al Green wasn’t voting for it, even as many of our friends folded like cheap suits. When ACORN International wanted a delegation of Korean mayors and legislators to meet a Congressman, who do you think agreed to meet them? Al Green, that’s who. When Local 100 has a leadership conference anywhere within shouting of Houston, and sometimes even in New Orleans, who has keynoted unfailingly? Yes, Al Green. When we needed help to fight for better remittance policies and against payday lending, Green took our cause to the House Financial Services Committee. He brought us to his office to discuss a national living wage bill and an increase in the federal minimum wage. He represents Houston, but was born and raised in New Orleans. Don’t ever tell me that we don’t support Congressman Al Green.

So, were we surprised when Al Green took the floor of the House of Representatives and formally offered Articles of Impeachment against President Donald Trump? Heck no, he had told us last June in Houston that he was going to ask that Trump be impeached then. It was just a matter of time, and the time had obviously come. Al Green had had enough.

The Washington Post catches the weight and drama of Green’s move:

Rep. Al Green (D-Tex.) came to the House floor at 12:13 p.m… to offer articles of impeachment under special House rules requiring a floor vote; he returned to the floor at 1:34 to force that vote. House Majority Leader Kevin McCarthy (R-Calif.) offered a motion to table the resolution, which was adopted on a 364 to 58 vote. Every lawmaker who opposed the motion was a Democrat, as were four others who voted present.

The top two House Democrats both voted to table the resolution after coming out against Green’s effort shortly before the House voted.

House Minority Leader Nancy Pelosi (D-Calif.) and Minority Whip Steny H. Hoyer (D-Md.) issued a joint statement opposed Green’s push, though they stopped short of calling on Democrats to vote to kill it.

 

The leadership’s argument was to keep working hard to oppose Trump initiatives and to let the special counsel proceed with investigations into Russian collusion in Trump’s election. They had made the argument before, and Green was not to be dissuaded this time.

So, sure, it’s also not a surprise that he got beaten, but he got 57 other recorded votes besides his own for articles of impeachment, and that’s something, even if 12% is a long way from a majority. Don’t tell me that Mister Hypersensitive in the White House didn’t notice that as well. Win or lose, it’s not a good day in the West Wing when there’s a vote to impeach you for malfeasance in office.

Notice has been served, and, we know Congressman Al Green, so trust us, this is serious, and he’s not going away, so someone in the White House better straighten their act up and do it ASAP.

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