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.


Time to Lend a Hand in Mississippi?

New Orleans     The midterm elections in the United States are almost over, but there’s one race still pending.  It’s a longshot, but cries out for people of conscience, regardless of their politics, to take a stand and be counted.  There’s a cry for help, but it’s unclear how many will hear it.

Mississippi to many is a lost cause.  What’s the chance that Mike Espy, an African-American former Congressman from the state and Secretary of Agriculture during the Clinton Administration could be elected in this deep red state facing Cindy Hyde-Smith, the Republican Senator appointed recently to the seat?  He managed to make it to the runoff coming up on Tuesday, November 27th, so that’s something, but most wrote him off.

Maybe he still doesn’t have a chance, but recent polls have him only 5% behind with a week left before the election.  Maybe it shouldn’t matter?

The race has tightened up because of scandalously racist comment made by his opponent at a rally recently.  As the Washington Post describes the situation:

Republican Sen. Cindy Hyde-Smith stumbled recently when, in praise of a supporter, she spoke of her willingness to sit in the front row of a public hanging if he invited her — words that, in the South, evoked images of lynchings. She has struggled to grapple with the fallout, baffling members of her party and causing even faithful Republicans to consider voting for her opponent, former congressman Mike Espy.

She can’t seem to bring herself to apologize and has spent the time since the remark not making amends, but trying to shore up her support with donors and traditionalists, who are perhaps the people who understood her dog whistle message the best over the threat of an African-American in the US Senate from Mississippi.  President Trump certainly heard it loud and clear and is now going to hold two rallies to support her on the eve of the election.

Maybe it’s time for us to step up and go to Mississippi to stand at the front row condemning her comment?  Maybe we should get ourselves over to Mississippi, not at a Trump rally, but on the doors talking to people about why their votes matter and the importance of opposing attempts to bring back the old Mississippi.

We might not win, but if you remember Doug Jones being elected in Alabama, despite Trump and an army of opponents, then we also know anything is possible.

Win, lose, or draw, I can remember how people crossed the border to help us defeat David Duke in Louisiana, and that was for Edwin Edwards, who was a harder swallow for many that Mike Espy.  Arkansas, Louisiana, Tennessee, and Alabama are all hugging the borders of Mississippi.  It wouldn’t be a long haul to get on the ground.

Nancy Griffith has a famous song, “Come on Up, Mississippi,” asking the state to rise from the bottom.  Here’s a chance to sing with her, lend a hand up, and provide some push from the grassroots against the racism of the past.