A ProPublica Report
By Marian Wang
ProPublica, March 3, 2011, 3:24 p.m.
NOTE: A few years ago, ProPublica published this essay. Has anything changed, since then?
About 5 percent of nursing home workers—or one out of every 20—had at least one conviction, according to the report, which took a random sample of 260 nursing homes certified by Medicare and ran FBI background checks on their workers.
State Rules
State rules differ regarding background checks: 43 states require nursing homes to perform background checks against state records, ten of those require an additional FBI background check, and eight states don’t require background checks at all.
The rules also differ on what types of crimes disqualify workers. The report noted that of the workers with convictions, 44 percent had committed property crimes such as theft, vandalism or writing bad checks. Some 16 percent had drug-related crimes, and 13 percent had committed crimes against people, including sexual offenses.
Federal Regulations
Federal regulations prohibit nursing homes from employing workers convicted of “abusing, neglecting, or mistreating residents,” but because FBI data do not show whether the victims of the crimes were nursing home residents, it’s unclear whether these rules were violated.
The New York Times noted [2] that the current system for background checks—which Wisconsin Democrat Sen. Herb Kohl criticized as “haphazard, inconsistent, and full of gaping holes [3]—has allowed people convicted of crimes in one state simply find jobs at nursing homes in another state.
We’ve noted a similar lack of oversight in the nursing field, which allowed problem nurses to cross state lines in order to keep working and avoid consequences [4]. A national database was created decades ago to prevent this from happening, but reporting failures at both the state [5] and federal level [6] have left the database riddled with gaps.
***
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CMS Over-Sight
The inspector general recommended that the federal government’s Centers for Medicare and Medicaid Services, or CMS, work with the states to develop background check procedures, including lists of convictions that would disqualify a potential hire.
CMS oversees nursing homes eligible for funding under Medicare and Medicaid. In a written response to the report, the agency agreed with the recommendation. CMS also runs Nursing Home Compare [7], a searchable database with ratings on nursing homes.
Assessment
For more, read the full report: http://www.propublica.org/blog/item/government-report-finds-92-percent-of-nursing-homes-employ-convicts
Conclusion
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Filed under: Alerts Sign-Up, Breaking News, Ethics, Health Law & Policy | Tagged: elder care, Marian Wang, Nursing Home Compare, nursing home workers, nursing homes, ProPublica, Sen. Herb Kohl, senior care |
CMS to Cut Skilled-Nursing Facility Pay
The CMS just announced in a final rule that it will cut Medicare skilled-nursing facility pay by 11.1%, or $3.87 billion, in fiscal 2012, a move strongly opposed by the SNF industry.
The CMS cut the payments to claw back estimated increased reimbursement in the current fiscal year that resulted from unintended changes in SNF Medicare billing for therapy, which had followed changes in how Medicare paid for therapy.
The CMS in the rule said that it has recalibrated its payment structure, enacted through what it calls resource utilization groups, or RUGs, to correct the incentives that led to billing for higher-cost therapies. CMS also tightened the rules for SNFs in the timing of allocating group therapy to also reduce future over-billing.
Source: Paul Barr, Modern Healthcare [7/29/11]
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Investigation finds chart falsification endemic in California nursing homes
In a two-part series (one | two) in The Sacramento Bee, Marjie Lundstrom reveals the results into the widespread falsification of patient records in California nursing homes.
http://www.healthjournalism.org/blog/2011/09/investigation-finds-chart-falsification-endemic-in-calif-nursing-homes/
Ann Miller RN MHA
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CDC Releases First National Survey on LTC, Non-Nursing Home Facilities
[Four in 10 residents use Medicaid to pay for expenses]
The Centers for Disease Control and Prevention released in December the “first nationally representative survey” of residential care facilities to provide an overview of their role in the long-term care industry.
“The ability to provide a comprehensive picture of the long-term care industry has been hampered by the lack of data on RCFs,” according to the report. “Previous estimates of the size of the RCF sector varied depending on how RCFs were defined.”
http://www.advisorone.com/2012/01/03/cdc-releases-first-national-survey-on-ltc-non-nurs?ref=hp
Diana
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10 Surprising Ways to Avoid Nursing Home Care
Most older adults would rather live out their lives in their own homes, rather than in a nursing home.
http://health.msn.com/health-topics/caregiving/10-surprising-ways-to-avoid-nursing-home-care
Learn how that may be possible and affordable. Why? I have never seen, or worked in, a NH where I would like to live?
Dr. David Edward Marcinko MBA
[Publisher-in-Chief]
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10 Questions To Ask Aging Parents About End-of-Life Care
1. Thinking about your death, what do you value most about your life?
2. If you were diagnosed with a terminal illness, would you want to pursue every possible cure?
3. Do you imagine wanting to stop curative efforts if they were unsuccessful?
4. What kinds of aggressive treatments would you want (or not want)?
5. Do you want to die at home?
6. How do you feel about an extended hospitalization?
7. How much pain is acceptable to you?
8. Do you want to be with your family when you die?
9. What decisions regarding care do you want to entrust to others?
10. What do you hope for most regarding your death?
Source: Hospice Foundation of America
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OMG
Nursing Home Workers Share Explicit Photos of Residents on Snapchat.
http://www.msn.com/en-us/news/us/nursing-home-workers-share-explicit-photos-of-residents-on-snapchat/ar-BBnMwxE?li=BBnbfcL&ocid=U348DHP
Brenda
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Nursing Facilities Account For 40% of COVID-19 Deaths
Kaiser Family Foundation recently released an analysis of racial disparities in COVID-19 deaths in nursing homes. Here are some key findings:
• Nursing facilities account for 8% of all coronavirus cases but more than 40% of deaths.
• 63% of nursing homes with a high share of Black residents reported COVID-19 deaths.
• 40% of nursing homes with a lower share of Black residents reported COVID-19 deaths.
• 55% of nursing homes with a high share of Hispanic residents reported COVID-19 deaths.
• 44% of nursing homes with a lower share of Hispanic residents reported COVID-19 deaths.
Source: Kaiser Family Foundation, October 27, 2020
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2021 Hospice Fraud
https://www.msn.com/en-us/news/us/ceo-henry-mcinnis-gets-15-years-for-lying-to-patients-about-how-long-they-would-live-in-fraud-scheme/ar-BB1doX3h?ocid=msedgdhp
Betty
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Nurshng Homes
I think this is a byproduct of continued cutting of pay. I’m a firm believer that if you want quality help, and by quality I mean qualified and educated with experience – then you are going to have to pay for it.
These facilities continue to have to do more and more for patients with less and less assistance from the government and a lot of people not carrying long-term care but the significant financial burden on these facilities where they can only afford to hire bottom of the barrel employees in some cases and what these statistics show is they’re hiring felons that likely can’t get work anywhere else.
This is very sad and disappointing seeing that a lot of our seniors are not getting the care they deserve or want in these facilities that are still very expensive.
JOE
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