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Ensure the Right to Fair and Impartial Judges

July 18, 2018

President Trump has issued an Executive Order allowing Administrative Law Judges (ALJs) to be selected by political appointees.  Currently, ALJs go through a competitive examination and selection process open to all applicants.  This process ensures that ALJs are qualified and experienced and safegards against potential partisan interference when making decisions.  President Trump's Executive Order means that the only requirement for a person to become an ALJ is that they are licensed to practice law.  Over 85 percent of ALJs in the federal government work at the Social Security Administration and many others work in Health and Human Services (which decides Medicare cases).  ALJs often determine whether individuals are entitled to benefits after they have been denied Social Security Disability Insurance or Supplemental Security Income benefits.  When ALJs are politically appointed or potentially inexperienced, it is possible that cases will be decided based on the preferences of a political party rather than the rule of law.

Find more information from Justice in Aging here and read a letter from the American Association for Justice here.

Contact your members of Congress and urge them to stop the Trump Administration's efforts and ensure people's right to fair and impartial decisions!

Contact Congress by:

  1.  Identifying your two Senators and your Congressperson.  If you don’t know who they are, go to: https://www.govtrack.us/congress/members, then use the drop down menu where it says, "Or select a state to list all senators and representatives from that state." As soon as you select your state, your members of Congress will pop up.

  2. Calling the Capitol switchboard at (202) 224‐3121.  Follow the prompts.

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New York Times Article Confirms Consumer Voice Concerns about Nursing Home Staffing Levels and Data

July 09, 2018

The New York Times article, 'It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years, substantiates Consumer Voice’s long-standing concern about the inaccuracy of previous staffing information based on self-reporting and what we have heard from residents, families, ombudsmen and other advocates for years – staffing is inadequate, particularly on the weekends.

The Consumer Voice advocated for a payroll-based staffing data collection system to increase the accuracy and reliability of staffing information and is pleased that it is now operational.  However, the fluctuations in staffing levels discussed in the article prevent consumers from getting a true picture of a nursing home’s available staff. While progress has been made in the government’s website, Nursing Home Compare, and five-star rating system, further refinements of the data must be made.

The article underscores the relationship between staffing levels and quality.  It demonstrates yet again the critical importance of adequate numbers of staff and speaks to the need for a staffing standard to ensure that residents in all facilities receive at least a minimum level of nursing care. Research and experience show the harm residents can suffer when there are not enough nursing staff to care for them.   

The article also demonstrates why Consumer Voice and other advocates are so concerned about CMS’s efforts to rollback nursing home regulations in order to give facilities more flexibility and to reduce “provider burden.”  The current regulations, which require only that staffing be “sufficient” to meet the needs of residents, already give nursing homes flexibility in staffing. The result?  The national average is 3.4 hours of combined direct care staff time (registered nurses, licensed nurses and certified nursing assistants) per resident per day, and 0.4 hours of registered nurse staff time per resident per day*.  A landmark federal study indicated that 4.1 hours of direct care staff is the minimum amount of nursing care residents need to prevent common quality of care problems and loss of the ability to do things independently, like eating.  According to the study at least 0.75 hours of registered nurse time is needed.
 
Consumers and the public must send a strong message to the Centers for Medicare & Medicaid Services (CMS), Congress, and state legislatures that stronger, not weaker standards are needed, and rolling back nursing home regulations to reduce the burden on nursing home providers is not acceptable.  The goal of government must be to protect consumers, not to make life easier for the regulated.

To achieve that goal, Consumer Voice calls on CMS to:

  • Address the issue of fluctuating staffing levels in its rating system so consumers are not misled
  • Use its staffing data to identify facilities that are not meeting minimum requirements for registered nurse staffing and enforce those regulations
  • Strengthen – not weaken – nursing home regulations, particularly those relating to staffing

*SNF Payroll-based journal daily nurse staffing 2017Q4

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Action Update

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Advocates Meet with Top CMS Official About Nursing Home Rule

June 27, 2018

On June 25, Consumer Voice staff, Lori Smetanka and Robyn Grant, joined several advocacy organizations in a meeting with CMS Administrator Seema Verma and two members of her team to discuss our recommendations for the nursing home Requirements of Participation (RoPs). CMS is revising the current rules with a goal of reducing provider burden.
 
When asked for written recommendations prior to the meeting, advocates submitted a statement calling on CMS to retain the RoPs as issued in October 2016 and indicating our disagreement with the premise that the rules needed to be revised to reduce provider burden.
 
During the meeting, advocates stressed that the regulations contain important resident protections and discussed why strong regulations are needed now more than ever.  They also refuted provider claims that the rules are excessive, unnecessary and/or onerous, by pointing out that the RoPs are already flexible, and that many of the so-called burdens are in fact resident protections.
 
The Administrator reported that CMS is going through a deliberative process in revising the rules and is reaching out to a number of groups to hear their thoughts and proposals. Advocates emphasized the need for agency staff to hear directly from residents and family members about their experiences and suggestions.
 
In addition to listening and asking questions, Administrator Verma solicited advocate recommendations for strengthening the RoPs.  At the top of the list was a minimum staffing standard and a 24-hour RN. Advocates also raised the need for stronger, more effective enforcement.

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Action Update

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Consumer Voice's Robyn Grant Speaks About the VA's "Secret" Nursing Home Ratings

June 18, 2018

Consumer Voice Director of Public Policy & Advocacy Robyn Grant was quoted in a recent article in USA Today about the VA's hidden nursing home ratings.  The agency tracks quality statistics on nursing homes but has been keeping them from the public.  Nearly half of VA nursing homes received the agency's lowest ranking as of December 2017.  Some of the ratings were made public last week after the VA received questions from the Globe and USA Today.  The agency has monitored care at its nursing facilities through quality indiciators, unannounced inspections and star rankings, but until now, all of these quality measures have been hidden from the public.  Federal regulations require private nursing homes to disclose data, and the federal government uses the data to calculate quality measures where are posted to a federal website.  These regulations do not apply to the VA.

The VA has “got this whole sort of parallel world out there that’s hidden,” said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care. “I still can’t get over that this information is not available to people who are looking for a veteran’s home. That’s just unacceptable.”

Read the article here.

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World Elder Abuse Awareness Day is June 15th

June 14, 2018

World Elder Abuse Awareness Day (WEAAD) was launched by the International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations. The purpose of WEAAD is to provide an opportunity for communities around the world to promote a better understanding of abuse and neglect of older persons by raising awareness of the cultural, social, economic and demographic processes affecting elder abuse and neglect.  Visit the website for resources, ways to take action and events going on near you.

Visit Consumer Voice's elder abuse issue page for more information on preventing elder abuse.

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Fighting the Rollback of Nursing Home Protections

June 14, 2018

Since January 2017, the health and safety of nursing home residents has become increasingly imperiled. Nursing home lobbyists have urged the Centers for Medicare & Medicaid Services (CMS) to eliminate or delay regulations and dramatically reduce enforcement of violations. Unfortunately, CMS has shown a disturbing willingness to follow these lobbyists’ recommendations.

For example, under regulations finalized by the prior administration, nursing homes were obligated by November 2017 to conduct prompt care planning and institute antibiotic stewardship programs. The administration complied with lobbyist requests to delay enforcement of these and other requirements, establishing a moratorium until May 2019 on money penalties, even though nursing homes have been on notice of these requirements since September 2016.

Similarly, nursing home lobbyists have attacked a regulation from the previous administration that had prevented nursing homes from obtaining arbitration agreements from residents during the admissions process. In response, the current administration has proposed to rescind that regulation and issue a new regulation that would authorize nursing homes to require arbitration agreements as a condition of being admitted.  

Justice in Aging, with Consumer Voice, and some of our close partners created a tracker of industry lobbying and resulting administrative actions, as well as a series of policy alerts providing more detail about the specific protections weakened or at risk of being weakened by industry lobbying. An online version of the tracker and policy alerts are available on our website. This page will be updated regularly to include future CMS actions.

Read the press release, in conjunction with World Elder Abuse Awareness Day.

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Action Update

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Consumer Voice's Lori Smetanka Interviewed on Benefits of Caregiving

June 13, 2018

Consumer Voice Executive Director Lori Smetanka spoke to caring.com about the benefits of being a caregiver for their aritlce "10 Surprising Benefits of Being a Caregiver."  Lori spoke about her experience caregiving for her grandmother.  "“Seeing the person you are caring for smile when you come into a room, or relax when you brush their hair, makes you, as the caregiver, feel like you are making a difference. And isn't that what many of us want? To make a difference?”

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Consumer Voice's Robyn Grant Speaks About Bed Rails on the Nursing Home Abuse Podcast

June 12, 2018

Consumer Voice Director of Publicy Policy Robyn Grant  was interviewed on The Nursing Home Abuse Podcast regarding bed rails in nursing homes.  She spoke with nursing home abuse attorneys Rob Schenk and Will Smith about the dangers of bed rails.  The discussion including information on how bed rails can cause entrapment, suffocation and falls; what to do if your loved one's bed has bed rails; alternatives to bed rails; and the regulations in place to protect residents.  Listen to the podcast/read the transcript here.  Find more information about the dangers of bed rails on the Consumer Voice issue page.

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Action Update

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Consumer Voice Opposes Florida’s Medicaid Wavier Amendment to Eliminate Retroactive Coverage

June 04, 2018

Consumer Voice sent a letter to the Centers for Medicare & Medicaid Services (CMS) opposing the State of Florida's proposal to waive the federal protection that provides up to three months of retroactive Medicaid coverage for Managed Medical Assistance (MMA) program recipients. Under the proposal, the MMA program could provide coverage only as far back as the first day of the month of application.  Retroactive coverage is vital to vulnerable long-term care consumers and protects older adults and their families who experience unexpected health care needs and may not be able to file a prompt Medicaid application.  The Medicaid application process often can take weeks or months.  This proposed waiver would leave Medicaid-eligibile consumers without coverage when they have health care needs, especially when those needs are unpredictable and necessary.

Read Consumer Voice's full letter here.

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17 Attorneys General Condemn Federal Action Rolling Back Protections for Nursing Home Residents

June 05, 2018

Last week, 17 Attorneys General submitted a letter to the Centers for Medicare and Medicaid Services condemning federal actions that would delay the enforcement of protections for Medicare and Medicaid beneficiaries who receive care in skilled nursing facilities.  Leading the coalition was California Attorney General Xavier Becerra who held a press conference highlighting their concerns.  The federal actions, including a memorandum to decrease the amounts of Civil Money Penalties imposed against a facility, and an 18-month moratorium on enforcement of certain requirements, in effect, weaken the 2016 CMS regulatory reforms that would improve the safety of nursing home residents by providing protections against abuse, neglect, and exploitation.  The letter was sent in anticipation of the June rule-making period that will revisit requirements deemed to be burdensome for facilities.  For more information, read the press release from the Office of the Attorney General.  See Consumer Voice's statement on the Attorneys General action. 

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ProPublica Updates Data and Online Tool Comparing Nursing Home Deficiencies and Penalties by State

June 01, 2018

ProPublica has published new data on deficiencies cited by regulators and the penalties imposed in the past three years on nursing homes.  The online tool< Nursing Home Inspect, compares nursing homes by state and includes over 60,000 nursing home inspection reports. The data includes information about federal sanctions against nursing homes, including fines and payment suspensions.

Access the tool here

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Action Update

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Consumer Voice Opposes Arizona’s Medicaid Prior Quarter Coverage Waiver Amendment

May 22, 2018

Consumer Voice sent a letter to the Centers for Medicare & Medicaid Services (CMS) opposing the State of Arizona's proposal to waive the federal protection that provides up to three months of retroactive Medicaid coverage for Arizona Health Care Cost Containment System (AHCCCS) members. Under the proposal, AHCCCS would provide coverage only as far back as the first day of the month of application.  Retroactive coverage is vital to vulnerable long-term care consumers and protects older adults and their families who experience unexpected health care needs and may not be able to file a prompt Medicaid application.  The Medicaid application process often can take weeks or months.  This proposed waiver would leave Medicaid-eligibile consumers without coverage when they have health care needs, especially when those needs are unpredictable and necessary.

Read Consumer Voice's full letter here.

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Action Update

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Consumer Voice Recommends Increased Funding for Long-Term Care Ombudsman Program

May 15, 2018

Consumer Voice sent a letter to the House Committee on Appropriations recommending an increase of $24.98 million in funding for the Long-Term Care Ombudsman Program.  The letter emphasized the long-term care ombudsmen's role in advocating for quality care for long-term care consumers.  The letter also demonstrated the ways ombudsmen promote quality care by resolving complaints, visiting residents in facilities, providing information about long-term care to individuals, and providing information, assistance and training to long-term care facility staff.  Consumer Voice supports increased funding for the Long-Term Care Ombudsman Program in order to provide residents with the advocacy, assistance, and support they need to obtain quality of care and quality of life.  The letter recommended funding for the Long-Term Care Ombudsman Program in the Elder Justice Act, level funding for federal fiscal year 2019 in Title VII, and new funding to create new ombudsman positions dedicated to assisted living, board and care, and similar community-based long-term care settings. 

Read the full letter here.

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Consumer Voice Leaders Participate in AARP Foundation Roundtable on Misuse of Antipsychotic Drugs

May 15, 2018

AARP Foundation held a roundtable last week on the misuse of antipsychotic drugs.  Consumer Voice Executive Director Lori Smetanka was a presenter and panelist at the event, and Consumer Voice Governing Board Member Dr. Jonathan Evans was a featured speaker and panelist.  The roundtable, entitled "Invisible People: The Misuse of Antipsychotic Drugs With Nursing Facility Residents Who Have Dementia" raised awareness about people with dementia in nursing homes who are inappropriately medicated with antipsychotic drugs and promoted the use of non-drug interventions.

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Quality NOW

April 26, 2018

Quality care, quality of life, protection of rights, empowerment of all individuals receiving care and services, NOW!

Quality is what we seek for people receiving long-term care, no matter what the setting.  Advocating for quality is why the Consumer Voice (as NCCNHR) was created more than 40 years ago.  While strides have been made in the past 40 years, experiences shared by consumers who guide us, recent news stories, research, data, and reports indicate our work is not yet done.

The millions of individuals residing in nursing homes, assisted living facilities, and other care settings are too often out of sight and out of the minds of the rest of society instead of receiving the care and respect they deserve.  And this is why we need your help!

Please support our advocacy by making a donation today!   Learn more and leave us a message about why you support Consumer Voice on our webpage.

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New Consumer Voice and NORC On-Demand Training Center

April 16, 2018

Visit the Training Center

Consumer Voice and NORC have created a new online training center. This on-demand education platform allows you to delve into important topics through our online courses. Courses are available for consumers, representatives of long-term care Ombudsman programs, advocates, and family members through your computer or mobile device. 

There are separate courses created by Consumer Voice and NORC. Consumer Voice courses focus on understanding federal regulations, policies, and advocacy strategies. NORC courses focus on Ombudsman program practices and advocacy.

NORC created a continuing education course that Ombudsman programs can use for on-going education credits for their representatives. Individuals that complete the course will receive a certification of completion. Two continuing education courses are currently available, one regarding Abuse, Neglect, and Exploitation and another regarding Volunteer Management. Additional courses will be added to the Training Center over time. 

To enroll in a course you must create an account. Watch the video below for an overview of the Training Center. Step-by-step instructions for enrolling and navigating a course are available here.

If you have any questions or need assistance accessing the Training Center, email info@theconsumervoice.org or ombudcenter@theconsumervoice.org.

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New Training Materials on Abuse and Revised Nursing Home Regulations

April 10, 2018

Consumer Voice and NORC have created several new training materials on the topic of abuse, neglect, exploitation and misappropriation of property.  The materials are based on the revised nursing home regulations.

The new materials can be used together as an educational toolkit for training by and for Ombudsman program representatives, for members of resident and family councils, facility in-service training and community education.

  • Prezi - A Prezi is a visual storytelling alternative to a PowerPoint presentation.  The Abuse, Neglect, Exploitation and Misappropriation of Property Prezi uses the map-like layout to provide information on identifying, preventing and reporting abuse and knowing the signs of abuse.  The Prezi is available as a video with a voiceover or as a clickable presentation without the voiceover.  Use the script to follow along with the presentation and learn further details on each topic.

  • PowerPoint - This PowerPoint can be used for training purposes. The slides include presenter notes and are customizable for state and local information.

  • Fact Sheet - This updated fact sheet is an easy-to-use handout with information on the topic.

All materials are available on the Consumer Voice website here and on the NORC website here.

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New Nursing Home Discharge Fact Sheet

April 10, 2018

A new fact sheet on nursing home discharges is now available from Consumer Voice and NORC.  This fact sheet was developed for long-term care consumers to inform them about their rights regarding involuntary discharges. This fact sheet can also be used in training by and for Ombudsman program representatives, as well as for members of resident and family councils, facility-in-service training, and community education.

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CMS Releases Memo on Payroll-Based Journal Staffing Measures on Nursing Home Compare Tool

April 10, 2018

The Centers for Medicare & Medicaid Services (CMS) has released a memo regarding - Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five Star Quality Rating System.  The memo announced that beginning in April 2018, CMS will use PBJ data to determine each facility's staffing measure on the Nursing Home Compare tool and will calculate the staffing rating used in the Nursing Home Five Star Quality Rating System.  It also noted that nusing homes whose staffing data audit identified significant inaccuracies between the hours reported and the hours verified or facilities who have failed to submit data by the deadline will receive a one-star rating in the staffing domain.  Nursing homes will also receive a one-star rating in the staffing domain if they report seven or more days in a quarter with no RN hours.

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New Report on Nursing Home Deficiencies, Staffing and Resident/Facility Characteristics Released

April 10, 2018

A newly updated report is available from the University of California, San Francisco and the Kaiser Family Foundation - Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016.  This report analyzes nursing home data from 2009 to 2016, including rates of deficiencies, staffing levels as well as resident and facility characteristics. Charlene Harrington from the University of California, San Francisco has previously completed similar reports analyzing nursing home data in earlier years.  This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and Certification and Survey Provider Enhanced Reports (CASPER).  The information in the report is meant for policymakers and the general public to understand recent changes in nursing facility care and to highlight ongoing areas of interest.  Read the report here and view the supplemental tables.

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Action Update

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Spending Bill for Remainder of 2018: The Good and the Sad

March 27, 2018

Congress has passed and the President has signed a $1.3 trillion spending bill to fund the federal government through September 2018.
 
The good news is that the bill provides increased funding for Title VII of the Older Americans Act.  The Ombudsman Program and Elder Abuse Prevention would receive an additional $1 million, while there would be $2 million more for Adult Protective Services and the Elder Justice Initiative.  The OAA Title III B Home and Community-Based Supportive Services was the big winner with a gain of about $35 million. For more information, see NASUAD's FY18 Budget Chart: Key HHS Programs Serving Seniors and Persons with Disabilities.
 
Sadly, the Money Follows the Person Program was not included in the spending bill. This is a blow to many aging and disability rights organizations, and certainly for individuals in nursing facilities and institutions who would like to return to the community. Advocates will look for other legislative opportunities to extend and fund MFP.
 
Consumer Voice thanks all of you who joined us in telling members of Congress to increase funding for the Long-Term Care Ombudsman Program and continue MFP.  The fact that the LTCOP was given more money, not less, is a significant victory in this challenging environment.

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Tell Congress to Increase Funding for the Ombudsman Program

March 20, 2018

Congress will be making important budget decisions on March 23 when legislators vote on the Omnibus Appropriations Act. Consumer Voice has written a letter to the Chair and Ranking Member of the Senate and House Appropriations Committees and the Labor, Health and Human Services, Education and Related Agencies subcommittees requesting increased funding for the long-term care ombudsman program.

We urge you to contact your members of Congress to make a similar request by Friday, March 23.

By email:     Click here to use our online advocacy system to send a pre-crafted message.

By phone:    Call your members of Congress.  

  1. Identify your two Senators and your Congressperson.  If you don’t know who they are, go to: https://www.govtrack.us/congress/members, then use the drop down menu where it says, "Or select a state to list all senators and representatives from that state." As soon as you select your state, your members of Congress will pop up.

  2. Call the Capitol switchboard at (202) 224‐3121.  Follow the prompts. 

The Long-Term Care Ombudsman Program is a vital program that protects residents’ rights and helps ensure residents are receiving quality care and quality of life in their chosen long-term care setting.  It is the only program federally mandated to advocate on behalf of residents of long-term care facilities.  But despite its mandate, the LTCOP is currently unable to provide residents with the assistance they need and are entitled to due to insufficient funding.  Additional money for the LTCOP would mean that nursing home and assisted living facility residents who are among our nation’s most vulnerable citizens have someone on their side, at their side.

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Looking for a Few Good Candidates to Join Our Board!

March 07, 2018

Join Our Board and Help Us Grow the Consumer Voice!

As part of our annual recruitment process, the Consumer Voice is seeking candidates for open positions on our Governing Board.  The Governing Board is responsible for management and fiscal oversight of the organization, fund development, and strategic planning.

Service on the Governing Board is an opportunity to help drive the decisions of our highly-respected national organization and shape the future of consumer-directed long-term care in every setting. Be part of the decision-making process on the national level, driving the strategic goals of the organization.  This is an exciting time to join the Governing Board’s leadership and help us map our ambitious future.

We are looking for thoughtful leaders to join the Governing Board, and welcome applications from all interested candidates.  We are interested in applicants who can help us expand our influence and achieve goals, particularly in the areas of:

  • Fundraising
  • Public relations/communications
  • Nonprofit management/leadership/previous Board development experience

Candidates must meet a professional standard of excellence by demonstrating the following:

  • Robust fundraising capabilities and experience in the not-for-profit environment;
  • Strong social presence with ability to activate your professional network and advance Consumer Voice issues and agenda;
  • Hold active membership in the Consumer Voice;
  • Be willing to accept a leadership role for the future of our national, professional organization;
  • Be free of conflicts of interest (i.e., a LTC provider or affiliated with a provider association);
  • Have time to dedicate to fulfilling Board responsibilities.

RESIDENTS AND INDIVIDUALS RECEIVING CARE AND SERVICES: We are happy to help support your participation in meetings (in-person if feasible, but on the telephone at a minimum), so please do not let travel costs or other participation barriers stop you from applying - tell us how we can support your participation!

If you are interested in joining our Governing Board, please:

  1. Complete a brief application

  2. Submit a resume and 2 references to lsmetanka@theconsumervoice.org

APPLICATIONS ARE DUE BY APRIL 16, 2018

Please also share with others who you think would be a good fit for our Board.

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ACT NOW: Contact Congress Again to Fund MFP!

March 06, 2018

"MFP has allowed me to be independent and have a purpose for my life.  Because of MFP, I got a job once I moved out of the nursing home, and now I give back trying to get people on the same program.  It's very fulfilling."     

---Marvin Dawkins, MFP Program Participant

Your actions in early February to ask the Senate to fund the Money Follows the Person (MFP) program (#FundMFP) made a big impact.  Now it is time to go all out and make a big push to pass the EMPOWER Care Act!

The MFP program is a Medicaid program that has helped more than 75,000 long-term care consumers move from nursing homes and other institutions to the community.  But the MFP program has expired, and without additional funding, every state will stop transitioning new individuals THIS YEAR.  The March omnibus spending bill may be our last chance to pass the EMPOWER Care Act to extend this important program before funding runs out entirely.

Help long-term care consumers like Marvin continue to transition into the community by taking the following action steps below.


ACT NOW:

  1. Wednesday, March 7: Join in the national call-in day.  RSVP to this Facebook event.

  2. Thursday, March 8: Participate in the social media day to #FundMFP.  RSVP to this Facebook event.  Use the sample tweets and posts in this Social Media Toolkit when posting to Facebook and Twitter.

  3. Before Friday, March 9: Contact your members in Congress by sending a pre-crafted message.  Click here to send your message.  You can personalize your message with the following talking points:

    • The Money Follows the Person Program brings long-term care consumers back home to their communities.

    • The Money Follows the Person program gives consumers greater control over the lives.

    • It’s fiscally responsible! MFP improves the quality of life of individuals while saving states and the federal government Medicaid funding.

    • The program expired over a year ago. Without additional funding, states could scale back programs, potentially withdrawing long-term care services from people who need it.

    • Talk about why this is important for you or someone you know, and your state. MFP frees people! MFP keeps families together! MFP reduces waiting lists!  


Background materials on MFP, the EMPOWER Care Act, and our call-in day are all available at the links above and at https://medicaid.publicrep.org/feature/money-follows-the-person/.  Please spread the word widely to your grassroots and join in our #FundMFP advocacy this week.

By passing the EMPOWER Care Act and funding the Money Follows the Person program, Congress can help more long-term care consumers transition out of nursing homes and into the homes and communities of their choice

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Workgroup in Minnesota Publishes Report on Elder Abuse

February 06, 2018

A Consumer Workgroup in Minnesota, convened by AARP Minnesota at the request of the Governor, has published a report on elder abuse in long-term care settings.  The workgroup was created in response to a Minneapolis Star Tribune article which shed light on Minnesota's failure to protect older and vulnerable adults from abuse in nursing homes, assisted living settings and in thier homes.  The workgroup was also in response to a 2017 report from the Minesota Office of Health Facility Complaints (OHFC) which reported a 600% increase in maltreatment reports since 2010 and were only able to investigate 1%.  The report recommends policy and agency practice changes including:

  • Strengthening and expanding rights of older and vulnerable adults and their families;
  • Enhancing criminal and civil enforcement of rights;
  • Developing new licensure grameworks for assisted living and dementia care across residential settings; and
  • Improving Minnesota Department of Health licensing regulation, OHFC enforcement and investigative process and Minnesota Adult Abuse Reporting Center reporting.

Read the full report here.  Read the report from the State Ombudsman here.

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More Must Be Done To Protect Residents of Assisted Living Facilities

February 06, 2018

In response to yesterday’s release of the Government Accountability Office (GAO) report, Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare Is Needed, the National Consumer Voice for Quality Long-Term Care (Consumer Voice) is calling on states and the federal government to better protect assisted living facility residents.

According to the GAO findings, the Centers for Medicare and Medicaid Services and the majority of state Medicaid agencies are not effectively monitoring the abuse, neglect, exploitation, and other harm (referred to as critical incidents) occurring in assisted living facilities funded by Medicaid. In fact, not only is the government failing to protect these individuals from the most basic harm, it doesn’t even know the true extent of the problem.  In 2014, more than 330,000 beneficiaries received assisted living services through the Medicaid program.  In 22 states, nearly 23,000 critical incidents were reported.  Considering that more than one-half of the states surveyed by the GAO were unable to report the number of critical incidents and that abuse is generally underreported, this number is undoubtedly only the tip of the iceberg

Nationwide nearly one million residents live in assisted living facilities. Each year, billions of dollars are spent on these services. State and federal Medicaid funding for assisted living was about $10 billion in 2014, while the 2017 annual cost to a consumer paying out of their own pockets was $45,000. In the past, many of these individuals would have lived in a nursing home. Almost half need assistance with three tasks of daily living and over 40% have Alzheimer’s disease or other dementias. Given that a significant percentage of these individuals are highly vulnerable, the failure of both state and federal government to adequately protect them is unacceptable.

The GAO investigation is a step in the right direction, and Consumer Voice applauds Senators Collins, Hatch, McCaskill, and Warren for requesting this assisted living report. We support the GAO recommendations, including that states report critical incidents to CMS on an annual basis.

But more needs to be done.  The Consumer Voice has long been concerned about the safety and well-being of all assisted living facility residents.  Reports of abuse and neglect have been growing; between 2010 and 2015 complaints of abuse, gross neglect and exploitation reported by the long-term care ombudsman program grew by 22%.   

This is hardly surprising. State regulations vary enormously and are frequently inadequate.  At the federal level, there are a few very limited requirements for Medicaid-funded facilities, but none that address staffing, training, medication management or other critical areas. Weak, ineffective and often infrequent inspections and enforcement further undermine resident health and welfare by failing to ensure compliance.

As our population ages and residents’ acuity levels increase, stronger assisted living standards and more robust oversight and monitoring at both the state and national levels are needed more than ever.  Our goal must be for each resident, no matter where they live or how they pay for their care, to receive quality services, live free from abuse, and to be treated with dignity and respect. 

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GAO Report Finds Large Gaps in Regulation of Assisted Living Facilities

February 05, 2018

The U.S. Government Accountability Office (GAO) issued a report finding large gaps in the regulation of assisted living facilities.  The report found that states are spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries.  But, very little federal and state standards regulate the industry. The GAO report found that the federal government does not have basic information about the assisted living services being provided.  More than half of states were unable to provide information on the number and nature of cases involving the abuse, neglect exploitation or unexplained death of Medicaid beneficiaries in assisted living facilities.  Only 22 states were able to provide information on "critical incidents - cases of potential or actual harm," and in one year the states reported more than 22,900 incidents. 

Read the full GAO report, and find more information in the New York Times article.

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Human Rights Watch Publishes Report on Use of Antipsychotic Drugs in Nursing Homes

February 05, 2018

Human Rights Watch has issued a report today on US nursing homes over-medicating residents with dementia.

The report states, "In an average week, nursing facilities in the United States administer antipsychotic drugs to over 179,000 people who do not have diagnoses for which the drugs are approved. The drugs are often given without free and informed consent..."  Studies show that the use of antipsychotic drugs nearly doubles the risk of death among older people with dementia. And too often, the drugs are used for their sedative effect rather than any medical benefit.

Federal law and some state laws require patients be informed about their treatment. The Human Rights Watch report found that non-consensual use of the drugs is "inconsistent with human rights norms," and the use of antipsychotic drugs as a chemical restraint "could constitute abuse under domestic law and cruel, inhuman, and degrading treatment under international law."

The report continues, "US authorities, in particular the Centers for Medicare & Medicaid Services (CMS) within the US Department of Health and Human Services, are failing in their duty to protect some of the nation’s most at-risk older people. On paper, nursing home residents have strong legal protections of their rights, but in practice, enforcement is often lacking. Although the federal government has initiated programs to reduce nursing homes’ use of antipsychotic medications and the prevalence of antipsychotic drug use has decreased in recent years, the ongoing forced and medically inappropriate use of antipsychotic drugs continues to violate the rights of vast numbers of residents of nursing facilities. The US government should use its full authority to enforce longstanding laws, including by penalizing noncompliance to a degree sufficient to act as an effective deterrent, to end this practice."

The Human Rights Watch report offers specific recommendations to CMS, Congress, US Department of Justice, State Governments and State Long-Term Care Ombudsman Programs.

Read the full report here.

Learn more about the misuse of antipsychotic drugs on our issue page.

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Urge Congress to continue the Money Follows the Person Program!

January 30, 2018

The future of the Money Follows the Person (MFP) program is at risk.  Enacted in 2005, the MFP program is one of the longest running, most successful Medicaid demonstrations.  MFP has assisted more than 75,000 long-term care consumers with moving into a setting of their choice, and has helped 44 states improve access to home and community-based services.  In addition, the MFP program provides an important quality framework and data collection and reporting requirements to build a solid state HCBS infrastructure.

MFP improves the lives of long-term care consumers and does so in a more cost-effective way than other settings.  MFP is a program where everyone wins: individuals regain their independence, and state and federal governments save money because it costs less to provide services and supports in the community rather than in an institution.  That's why nearly every state has participated in the program!

Independent evaluations have proven MFP improves the quality of life for individuals, and reduced Medicaid and Medicare expenditures by approximately 23%. Unfortunately, MFP expired September 30, 2016, and states are running out of funding.  For more information on the MFP program, please click here.

As a result, states are scaling back their programs, reducing dedicated staff and crucial resources. Last year was the first time that the number of people transitioned to the community declined. Without action NOW, the program will lose progress.

Senators Portman (R-OH) and Cantwell (D-WA) have introduced bipartisan legislation (EMPOWER Care Act - S. 2227) to improve and extend the program for five years.  For more information on the EMPOWER Care Act, please click here.


Urge your Senators to co-sponsor the bill!  Take action by following the steps and talking points below:

  1. Action #1: National Call-In Day, Thursday February 1, 2018

    • Call Your Senators: Call the Capitol Switchboard at (202) 224-3121 or (202) 224-3091 (TTY) and ask to be connected to your Senators.  Ask your Senator to co-sponsors the EMPOWER Care Act S. 2227 to extend the MFP program and pass it immediately (see talking points below).

    • RSVP to this Facebook event, which contains information on how to call your Senators.  View Center for Public Representation's page for more information on the call-in day.

  2. Action #2: National Social Media Day, Friday February 2, 2018

    • Tweet and Post on Facebook:

  3. Action #3: Email Your Senators before February 8, 2018

    • Click here to send a pre-crafted email to your Senators.  You're invited to personalize your message if you wish. 

    • Be sure to tell Congress to consider MFP during negotiations on the budget and other extensions of health-related programs in the coming weeks.  An extension of the MFP program must be included. 

  4. Talking Points

    • ​​The Money Follows the Person Program brings long-term care consumers back home to their communities.

    • The Money Follows the Person program gives consumers greater control over the lives.

    • It’s fiscally responsible! MFP improves the quality of life of individuals while saving states and the federal government Medicaid funding.

    • The program expired over a year ago. Without additional funding, states could scale back programs, potentially withdrawing long-term care services from people who need it.

    • Talk about why this is important for you or someone you know, and your state. MFP frees people! MFP keeps families together! MFP reduces waiting lists! 

Questions?  Contact us at info@theconsumervoice.org.

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New York Times Article Reveals How Nursing Homes Feed Money into Corporate Webs

January 03, 2018

A New York Times article published January 2nd uncovers the practice of nursing home owners outsourcing goods and services to companies that they also control or have a financial interest.  Nursing home owners say that these so-called "related party transactions" are an efficient way of running their businesses and help minimize taxes.  However, these arrangements allow owners to put together advantageous contracts in which their nursing homes pay higher rates and the owners pocket the higher profits, which aren't recorded on the nursing home's accounts.  Plus, these complicated arrangements make it more difficult for injured residents or their families to collect money from the related companies when they sue the nursing home. 

An analysis from Kaiser Health News revealed that "nursing homes that outsource to related organizations tend to have significant shortcomings: They have fewer nurses and aides per patient, they have higher rates of patient injuries and unsafe practices, and they are the subject of complaints almost twice as often as independent homes."

Read the article here.

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Emergency Preparedness Legislation Introduced in Congress

December 21, 2017

Legislation to improve emergency preparedness in nursing homes was introduced  in the House by Congresswoman Wasserman Schultz (FL) and Congressman Tim Walberg (MI) yesterday.  

The bill would:

  • Require nursing homes to have alternative sources of energy capable of heating, cooling and ventilation for at least 4 days;
  • Require measures under the Public Health Service Act to prioritize nursing homes in the same manner as hospitals with respect to health emergency preparedness; and
  • Authorize civil monetary penalties up to $100,000 for non-compliance resulting in a resident’s death.

Consumer Voice is pleased to have assisted Congresswoman Wasserman Schultz in considering policy options. 

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40 Organizations Send Letter to Senate Opposing Tax Cuts

November 29, 2017

Consumer Voice has joined 40 organizations in a letter to the US Senate opposing tax cuts that would jeopardize health care for older adults and people with disabilities. The tax bills under consideration in the House and Senate would increase the national debt by $1.5 trillion.  In doing so, there would be a revenue shortfall and programs like Medicaid, Medicare and Social Security could see cuts.  The Senate tax plan would repeal the individual mandate in the Affordable Care Act (ACA), leaving 13 million people uninsured.  Repealing the mandate would raise the costs of insurance for people with preexisting and chronic conditions.

For more information, read the press release.

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Major Changes in Nursing Home Regulatory Arena Go Into Effect Today

November 28, 2017

November 28 is a big day in the world of nursing home regulations:  Phase 2 regulations go into effect, along with a new survey process, the “freezing” of health inspection ratings,  and revised interpretive guidelines. At the same time, an 18-month  moratorium on full enforcement of certain Phase 2 requirements begins.

Phase 2 Regulations
Today, nursing home requirements categorized as “Phase 2” become effective. The implementation timeframe includes three phases:  Phase 1- November 28 2016; Phase 2- November 28, 2017;  and Phase 3- November 28, 2019.  In response to provider concerns about insufficient time to come into compliance with the revised regulations, CMS decided to phase in the requirements and gave nursing homes up to three years to comply.

Even with this additional time, the nursing home industry lobbied hard for a delay of Phase 2, including asking many members of both the House and Senate to sign a letter to CMS requesting this delay. Consumer Voice and other advocacy organizations strongly opposed postponing Phase 2 implementation. In a letter signed by 240 national, state and local organizations and more than 950 individuals, Consumer Voice wrote, “Residents should not have to wait any longer for these - and other - protections. Stronger regulations and timely implementation are needed now more than ever.”  Advocates achieved a major victory when CMS decided not to grant an extension of time.

Phase 2 requirements include reporting suspicion of a crime to law enforcement, appropriate treatment and services for residents with dementia, a facility assessment, a baseline care plan, an antibiotic stewardship program, policies regarding loss and replacement of dentures; and more.

Consumer Voice will soon be issuing a "Summary of Key Changes" for Phase 2.

Moratorium on full enforcement of specific Phase 2 standards
Today is also the day that a moratorium on the use of certain enforcement remedies for a number of Phase 2 regulations is imposed.  For a period of 18 months, a directed plan of correction or a directed in-service training are the only remedies that can be imposed on the following regulations:

  • F655 (Baseline Care Plan); §483.21(a)(1)-(a)(3)
  • F740 (Behavioral Health Services); §483.40
  • F741 (Sufficient/Competent Direct Care/Access Staff-Behavioral Health); §483.40(a)(1)-(a)(2)
  • F758 (Psychotropic Medications) related to PRN Limitations §483.45(e)(3)-(e)(5)
  • F838 (Facility Assessment); §483.70(e)
  • F881 (Antibiotic Stewardship Program); §483.80(a)(3)
  • F865 (QAPI Program and Plan) related to the development of the QAPI Plan; §483.75(a)(2) and,
  • F926 (Smoking Policies); §483.90(i)(5)

No civil money penalties (CMPs), discretionary denials of payment for new admissions (DPNAs) and discretionary termination can be issued for deficiencies of any of these Ftags.  Note: the moratorium does not include remedies that are required by federal law such as the Denial of Payment for New Admissions (DPNA) if the facility has not achieved compliance within 3 months of the finding; Termination after 23 days for immediate jeopardy; and Termination after 6 months for non-immediate jeopardy noncompliance.

CMS states that the purpose of this delay is to educate facilities about specific Phase 2 standards. Consumer Voice and other advocacy groups fought this moratorium because it will likely impact full implementation of these requirements.

To read the memo issued by CMS on this moratorium, go to: http://theconsumervoice.org/uploads/files/issues/Survey-and-Cert-Letter-18-04.pdf.

Survey Process
Beginning today, CMS is launching a new survey process referred to as LTCSP (Long-Term Care Survey Process).  According to CMS, the LTCSP combines “the best” of both the Traditional and Quality Indicator Survey processes into a single nationwide survey process. The process will be computer-based.  To learn more about this new process, go to:

  1. CMS’ website at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes.html and click on "New Long-term Care Survey Process - Slide Deck and Speaker Notes

  2. The Integrated Surveyor Training Website (https://surveyortraining.cms.hhs.gov/index.aspx)

In the past, the survey protocol was laid out in Appendix P of the State Operations Manual.  CMS has replaced Appendix P with a LTCSP procedure guide which will be what surveyors will follow when conducting a standard survey. To access the LTCSP Procedure Guide and Survey Resources, go to: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes.html.

Health inspection five-star rating
Because the protocol is different under the new survey process, CMS decided that consumers and others would not be comparing “apples to apples” if facilities surveyed under the new process were compared to those surveyed under the prior process. As a result, CMS will be holding constant, or “freezing,” the health inspection star rating for health inspection surveys and complaint investigations conducted on or after November 28, 2017.  Consumer Voice will provide more information about changes to Nursing Home Compare and the five-star rating system soon.

Interpretive Guidelines
Lastly, revised interpretive guidelines for the federal regulations are effective today. The purpose of the guidelines is to interpret and clarify the regulations; the guidance helps explain the regulations and what the facility should be doing if it is in compliance. To access the regulations with the revised guidance, go to: http://theconsumervoice.org/uploads/files/issues/Revised_Interpretive_Guidelines_with_Clickable_TOC.pdf.

 

Consumer Voice is developing materials and resources to help advocates understand the changes and apply this new information to their advocacy and consumer education.

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New Issue Brief on Key Issues in LTSS Quality

November 21, 2017

A new issue brief from the Kaiser Family Foundation focuses on "Key Issues in Long-Term Services and Supports Quality."  As 2017 is the 30th anniversary of the passage of the Nursing Home Reform Act, which substantially strengthened federal standards and enforcement of nursing home quality, the brief discusses where progress has been made as well as where there is still room for improvement. The brief also acknowledges the shift in the last several decades to home care and other community-based services and the need for quality measures in those settings.   This issue brief discusses four key issues related to long-term services and supports (LTSS) including institutional and home and community-based services (HCBS) quality, highlighting major legislative and policy changes over the last 30 years. The four key issues identified are:

  • How is long-term services and supports quality regulated?
  • What is the state of long-term services and supports quality today?
  • What is not known about long-term services and supports quality?
  • What are the current challenges in long-term services and supports quality oversight?

Read the issue brief here.

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Congratulations to the 2017 Consumer Voice Leadership Award Winners!

November 16, 2017

The Consumer Voice is proud to announce the following recipients of its annual leadership awards.  Each of these individuals and organizations has worked tirelessly to improve quality in long-term care and preserve the rights of individuals receiving care and services.  Congratulations to this year's award winners!

The winners are:

Janet Tulloch Memorial Advocacy Award

Thomas Fonseca, Founder, The Fenwick Foundation

This award honors a citizen advocate, family caregiver or long-term care consumer who has worked directly with and for consumers to improve the lives of long-term care consumers.


 

Howard Hinds Memorial Award

Elaine Wilson, Ombudsman, SOWEGA Council on Aging

This award honors an individual who has effectively advocated for long-term care consumers on the local level.

 

Cernoria Johnson Memorial Advocacy Award

Nancy Shaffer, Connecticut State Long-Term Care Ombudsman

This award is presented to someone whose work has had a national impact or is a model for national excellence and who exemplifies accomplishments in his or her chosen field.


 

Janet Wells Public Policy Leadership Award

Justice in Aging

This award recognizes an individual or organization that has provided exemplary leadership in the public policy field in advancing quality of care and quality of life for residents receiving long-term care services.

 

 

Toby S. Edelman Legal Justice Award

Erica Wood, Assistant Director, American Bar Association Commission on Law and Aging

This award honors those who work through or with the legal system and go to extraordinary lengths to achieve justice for long-term care consumers.


 

Elma Holder Founder's Award

Diane Menio, Executive Director, Center for Advocacy for the Rights and Interests of the Elderly (CARIE)

This lifetime achievement award honors a person whose life work exemplifies leadership in the field of long-term care reform.

 

 

Special Lifetime Advocacy Award

Judith Mangum, Consumer Advocate

This award recognizes a special individual who has dedicated his/her life to advocated for quality care and quality of life for long-term care consumers.


 

Public Service Award

Melanie Hicken and Blake Ellis, Journalists, CNN

This award recognizes an individual or organization whose work has profoundly expanded coverage and public understanding of long-term care issues.

 

Congratulations to all the winners!

For more information about the award recipients, review the 2017 Consumer Voice Conference program and read the press release.

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Oppose Efforts to Rollback and Delay the Nursing Home Rules; Sign a Letter to CMS!

October 31, 2017

Since their release in October 2016, there have been multiple efforts to undermine, repeal, and delay the recently revised federal nursing home regulations – the requirements of participation.  These efforts continue to gain momentum.  The rules provide important new protections for residents and need to be preserved.  Support and protect residents by signing onto a Consumer Voice letter urging CMS to retain the requirements and implement them without delay.

To sign on, click here if you represent a group/organization/program.  Click here if you are an individual.  Sign-ons are due by November 15.

These updated, stronger regulations include a greater focus on person-centered care; improved protections against abuse, neglect and exploitation; improved staff training; notice to the ombudsman of proposed transfers/discharges; required infection prevention, and much more.  Residents should not have to wait any longer for these – and other – rights and protections.  With increasing needs of residents, and continued documentation of poor care in too many facilities, timely implementation of these regulations is needed now.

To learn more about the regulations and efforts to weaken or eliminate the standards, click here.

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New Guide on HCBS Settings Rule

October 20, 2017

Consumer Voice has created a new guide - "Understanding and Advocating for Effective Implementation of the Home and Community-Based Services Settings Rule."  In March 2014, the Centers for Medicare and Medicaid Services (CMS) published the first ever regulations establishing standards for the settings in which HCBS are provided. These regulations will impact the services, quality of life, and rights of HCBS care recipients, as well as the environment in which they receive those services. Each state must develop and implement a plan for how it will come into compliance with the HCBS rules. The involvement of advocates, including elder law attorneys, in influencing the plan and monitoring its implementation is critical.

This guide is designed to provide elder law attorneys with a better understanding of the HCBS settings rule and how they can advocate for a strong, effective system that achieves the spirit and intent of the rule.  The guide includes an overview of the rule, a process for states to comply with the HCBS Rule, opportunities for advocacy to promote your clients' best interests, and a review of special issues including dementia care and evictions. Development of this guide was supported by NAELA Foundation.

Read the guide here.

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House Passes Elder Abuse Prevention and Prosecution Act

October 04, 2017

After passing the Senate in August, yesterday the House passed the Grassley-Blumenthal “Elder Abuse Prevention and Prosecution Act”.  The bill will now go to the President's desk for signature.  The Elder Abuse Prevention and Prosecution Act  would improve the nation’s response to elder abuse and financial exploitation of seniors. It does so by encouraging the investigation and prosecution of perpetrators who prey upon seniors, enhancing data collection, and supporting robust elder abuse prevention programs. 

Read the bill here.

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Consumer Voice Calls on CMS to Immediately Implement Recommendations in OIG's Early Alert

September 26, 2017

Consumer Voice, along with other organizations, has sent a letter to the Centers for Medicare & Medicaid Services (CMS) to urge them to immediately implement the recommendations in the Department of Health and Human Services Office of Inspector General's (OIG) Early Alert and to institute prompt enforcement of the reporting requirements instituted in the Social Security Act.  In August, OIG issued an Early Alert regarding the reporting of abuse and neglect of nursing home residents, finding that many incidents of potential abuse or neglect are not reported to law enforcement.  The OIG alert concluded that CMS procedures are not adequate to ensure incidents of potential abuse or neglect are identified and reported, and OIG recommended that CMS take a number of immediate actions to protect vulnerable nursing home residents.  Consumer Voice, and other organizations, are urging CNS to implement the recommendations now.  Unreported abuse cannot continue with impunity.  Nursing home residents cannot wait any longer for the requirements to report to law enforcement to be fully implemented and enforced.  Read the full letter to CMS here.

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More Needs to Be Done to Protect LTC Residents in Disaster Situations

September 20, 2017

The death of nine nursing home residents in Florida in the wake of Hurricane Irma is tragic and sad.  As the events in Hollywood and North Miami Beach unfold, it is a reminder of the vulnerability of long-term care facility residents, and older adults needing care and services in their own homes.   This situation provides a hard lesson about what it means to be prepared for an emergency, and the need to be vigilant about monitoring the adequacy of those plans.  

We know that elders are particularly susceptible to dehydration and heat, and they are acutely vulnerable in times of disaster.  As Florida officials investigate this terrible situation, we call on all communities to reassess their preparedness for, and ability to respond to, emergency situations.  From the Centers for Medicare and Medicaid Services, to state and local officials, power and energy companies, and long-term care providers themselves, there is an urgent need to reassess standards and procedures for both prevention and response to emergencies.

Our staff will continue to stay in close contact with our network in impacted states, and follow the reports on investigations and recovery to identify best practices and lessons learned in order to improve the emergency preparedness process to ensure the safety of all long-term care consumers.  For more information about emergency preparedness, visit our issue page.

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No Caps to Medicaid!

September 18, 2017

Right now, the Senate is working on its own bill to repeal and replace the Affordable Care Act (ACA).  This bill, referred to as the Graham-Cassidy Bill, converts Medicaid into a per capita cap system.  A per capita cap means that states will receive a fixed amount of money per beneficiary, which will likely not include adjusments for the rising cost of health care or needs of the population.

Call your Senators & Governors and tell them, NO CAPS to MEDICAID!

You can call your Senators by dialing the Capitol Switchboard at (202) 224-3121.  You can find the number for your Governor by clicking here.  When calling, you can discuss the following talking points:

  • Medicaid is the largest single payer of long-term care in our nation.
  • Medicaid is the ONLY way most people can afford long-term care.
  • Medicaid allows long-term care consumers to stay in their homes.

For nursing home residents and other long-term care consumers, caps to Medicaid would result in cuts to available care and services and would make it harder to qualify for care.

To learn more about per capita caps and how they can hurt nursing home residents, other long-term care consumers and their families, go to our webpage on preserving Medicaid.

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ACL Develops Principles for Person-Directed Services and Supports

September 05, 2017

The Administration for Community Living (ACL) has developed Principles for Person-directed Services and Supports during Serious Illness. ACL will use these principles to inform policy discussions and enhance existing programs related to serious illness among older adults and individuals with disabilities. The principles focus on every person's right to make choices and control their own decisions regardless of age, disability, or stage of illness.

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OIG Investigation Finds Nursing Home Abuse Often Not Reported

August 29, 2017

The Department of Health and Human Services Office of Inspector General (OIG) released an early alert on Monday about potential abuse or neglect at skilled nursing facilities (SNFs). OIG's investigation has found that more than one-quarter of serious cases of nursing home abuse are not reported to law enforcement, despite state and federal law requiring it.  OIG is conducting an ongoing review into nursing home neglect and abuse, and their early alert was issued in order to prompt immediate actions to ensure better protection of individuals in SNFs.  The investigation reviewed records from 2015 and 2016 and found 134 cases of abuse severe enough to require emergency treatment; 28% of these cases were not reported to the police.  The alert determined that CMS has inadequate procedures to ensure that incidents of potential abuse are identified and reported, and it suggests immediate actions for CMS to protect vulnerable residents in SNFs.  Read the alert here.  Read the story from NPR here.

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Lance Robertson Confirmed as New ACL Administrator

August 11, 2017

On August 3, the Senate Health, Education, Labor, and Pensions (HELP) Committee confirmed nominee Lance Robertson as the new Assistant Secretary on Aging and the Administrator of the Administration for Community Living (ACL). During his nomination hearing, Robertson laid out on his four-pronged strategy that he plans to implement during his tenure as the Assistant Secretary:

  • Improve access to information about LTC services and supports that are available both with publicly-funded and private-sector resources;
  • Promote vouchers, seek evidence-based solutions, and build support systems for working caregivers;
  • Strengthen elder justice; and
  • Increase the network’s business acumen, specifically in non-profit aging and disability community-based organizations.

To read Administrator Robertson’s opening statement to the HELP Committee, click here.

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Consumer Voice & Public Citizen Op-Ed on Forced Arbitration Agreements in Nursing Homes

August 02, 2017

Consumer Voice and Public Citizen have teamed up to shed light on forced arbitration agreements in nursing home admissions contracts.  Both organizations reiterate that a forced arbitration agreement "holds residents hostage - they must agree to give up their rights in order to have essential care and a place to live."  Read the full op-ed by clicking here.

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Oppose Pre-Dispute Arbitration in Nursing Homes: Sign on to a letter to CMS! Send comments!

July 25, 2017

As you’ve heard, CMS has issued a proposed rule to roll back its ban on nursing home pre-dispute arbitration agreements and to allow nursing homes to require residents to sign them in order to be admitted.  This rule is unfair to residents and their families and would harm residents’ rights, safety, and quality of care. 

CMS needs to hear from all of us that this proposed regulation is not acceptable!  Below are some very simple and fast actions you can take to tell CMS to withdraw the rule and restore the ban: 

  1. Sign on to a comment letter that Consumer Voice, along with many other organizations, has prepared. To sign on, click here if you represent a group/organization/program.  Click here if you are an individual.  Please sign on by August 4.

  2. Send in your own comment letter.  We are providing sample comments for organizations to submit or use to create their own comments. These sample group comments can be easily adapted for use by individuals.

    Click here to access a short version of a comment letter.
    Click here to access a longer version.

    Comments are due by 5:00 PM ET on August 7, 2017.

    The best way to submit comments is electronically.  Go to www.regulations.gov.  Within the search bar, enter the Regulation Identifier Number associated with this regulation - 
    0938–AT18 - and then click on the "Comment Now" box.

  3. Do BOTH – sign on and send in comments. 

 

Additional Information:

  • Read the proposed rule here.
  • To learn more about the proposed rule, click here.
  • To learn more about arbitration, visit our website.  


Questions?  Contact us at info@theconsumervoice.org.

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New Information Released by CMS: Revised Interpretive Guidelines, New F-Tags and More!

July 06, 2017

The Centers for Medicare and Medicaid Services (CMS) issued a Survey & Certification Memo announcing the release of several new documents related to the revised federal nursing home regulations, and information about the new survey process and training resources. In the memo, CMS also revealed it will impose a one-year restriction of enforcement remedies for specific Phase 2 requirements and hold constant for one year the Nursing Home Compare health inspection rating for any surveys conducted after November 28, 2017.

Consumer Voice will provide advocates with more information about the Interpretive Guidelines once we have completed our review and analysis. Additional information about the new survey process will be coming as well.

Below is a summary of the Survey & Certification Memo:

Revised Interpretive Guidelines. These are contained in Revised State Operations Manual (SOM) Appendix PP.  The guidelines are effective November 28, 2017.  They include clarification to existing unchanged requirements, guidance for new requirements implemented in Phase 1, as well as guidance for the new Phase 2 regulations. CMS notes that it has added a section in some areas to the Interpretive Guidance titled “Key Elements of Noncompliance.” This is intended to provide guidance about the key behaviors and practices identified in the regulation.  Note that Appendix PP uses newly designated F-Tags (see below).

A Crosswalk of Old F-Tags to New F-Tags.  Since the regulatory sections in the revised rules were re-structured, CMS renumbered the F-Tags. Some tags were combined, and some tags were split into multiple subparts.  These new F-Tags will be used after November 28, 2017.  The crosswalk shows you old F-Tags and the corresponding new F-Tag(s).

Survey Process. CMS is launching a new, computer-based Long Term Care survey system at the same time that Phase 2 is implemented. Information about the survey process is available here, which includes a slide deck outlining the survey process.

Training Resources. CMS is providing several training resources on its website and on an MLN Connect call on July 25, 2017 from 1:30 to 3:00pm EST.

Enforcement and Nursing Home Compare Considerations.  CMS states that to address concerns related to the scope and timing of the changes, it will provide limited enforcement remedies for certain Phase 2 provisions and will be holding constant the Nursing Home Compare health inspection rating for one year.

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Residents' Rights Posters Available For Pre-Order

June 30, 2017

Residents’ Rights are guaranteed by the federal 1987 Nursing Home Reform Law. The law requires nursing homes to “promote and protect the rights of each resident” and places a strong emphasis on individual dignity and self-determination.  This easy-to-read poster provides important information for all staff, volunteers, residents and advocates.  

Posters are printed on sturdy, glossy paper.  Choose the horizontal or vertical layout and 11"x17" or 18"x24" sizes depending on your needs.  Display these posters in facilities, resident rooms, or offices of advocates as a reminder of the important rights to which all residents are entitled.

Residents' Rights Posters are currently available for pre-sale and will be shipped beginning August 1st.  

Place your order now to ensure you get a copy of this must-have item for all advocates, facilities and residents!

Pre-order a 11" x 17" and 18" x 24" poster today!

Remember: Consumer Voice members receive 10% off all items in the online store. Join or renew your membership here.  Email info@theconsumervoice.org for the discount code.

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It's National Call-In Day to Save Our Health Care: Call Your Senator Today!

June 20, 2017

Today is a national call-in day to save our health care as we know it.  Call your Senator today!

  1. Call the Capitol switchboard at (202) 224‐3121.   If you can’t get through when you call, please keep trying. The switchboard is going to be extremely busy!

  2. Follow the prompts. Press “1” to indicate you want to speak with your Senator, then say your state and press “1”to indicate that the state is correct. Finally, press “1” to connect to your first Senator’s office.

  3. A staff person or machine will answer the phone. You can leave the message below.  Try to personalize the message if possible. 

    Hello, my name is (name).  I am a constituent of Senator (name) from (hometown).  I am calling to urge Senator NAME to vote against the American Health Care Act.  The bill would result in devasting cuts to Medicaid.  Medicaid is the only way most people can pay for long-term care, but these cuts would mean those in need of services and supports wouldn't get them. 

    Please tell Senator NAME to say "NO" to Medicaid cuts and caps and protect the care of all those needing long-term care in NAME OF YOUR STATE and the country.

  4. Repeat to call your second Senator and leave the same message.

Your advocacy matters!

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CMS needs to hear from you! Submit comments by June 26

June 19, 2017

As you may know, the Centers for Medicare and Medicaid Services (CMS) is requesting comments on several items. These items include:

  • Modification or elimination of three (3) parts of the revised federal nursing home regulations- discharge notices to ombudsmen; the grievance process; and the Quality Assurance and Performance Improvement process.
  • Changes to Medicare reimbursement for skilled nursing facilities that would significantly change the financial incentives to facilities for providing therapy. 
  • Ideas for changes to eliminate unnecessary burdens for providers and patients. This solicitation of ideas can be used to advocate for changes related to how hospital time is counted to qualify for Medicare coverage of a skilled nursing facility stay (observation status).

We are providing sample comments for organizations to submit or use to create their own comments. These sample organizational comments can be easily adapted for use by individuals.

Click here to access the sample comments, or go to our website.

Comments are due by 5:00 PM ET on June 26, 2017.

The best way to submit comments is electronically.  Go to www.regulations.gov.  Within the search bar, enter the Regulation Identifier Number associated with this regulation - 0938-AS96 - and then click on the "Comment Now" box.

 

Additional Information:

  • To read the full text regarding the feedback CMS is seeking on the grievance process, QAPI, and discharge notices, go to the Federal Register, Vol. 82, No. 85, Thursday, May 4, 2017, pp.21088, or click here.
  • The revised regulations can be found here. Refer to the following sections: discharge notices to ombudsmen - 483.15(c)(3)(i); grievance process - 483.10(j); QAPI - 483.75.  
  • To learn about the proposed therapy changes, see the Center for Medicare Advocacy's Alert at CMA Alert, May 17, 2017.
  • For more information about observation status, click here and scroll down to the bottom of the page where it says, “Observation Status Resources and Links.”

Questions?  Contact us at info@theconsumervoice.org.

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It's World Elder Abuse Awareness Day

June 15, 2017

Today, events are being held all over the world  to highlight the growing tragic issue of elder abuse.  As many as 1 in 10 older Americans are abused or neglected each year. Older adults are contributing members of American society and their abuse or neglect diminishes all of us. Elder abuse can be prevented if everyone would treat older Americans with respect and care. Let us use today as a call-to-action to raise awareness about abuse, neglect, and exploitation of elders.

Be a part of WEAAD today by participating in an event near you or taking part in the "Finish this Sentence" social media campaign with this template and using #WEAAD

Learn more about WEAAD

Find resources about identifying, preventing and reporting elder abuse on the NORC and Consumer Voice websites.

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Congress Wants to Limit Access to Justice

June 12, 2017

The House of Representatives will be voting on legislation, H.R. 1215, the Protecting Access to Care Act, which will significantly strip away an individual’s right to justice through the courts in the event they are harmed or killed by a health care provider, including nursing homes, assisted living facilities, rehabilitation facilities, doctors, hospitals, and pharmaceutical companies.  Act now and contact your representative in Congress.

Mr. H, father, grandfather, decorated U.S. Army veteran, suffered from a misplaced feeding tube which resulted in horrific pain for over 21 hours.  His family got justice from the Court and held the providers accountable when no one else would.

H.R. 1215 would have made it more difficult, if not prohibitive, for Mr. H's family to hold the negligent parties responsible for their actions.  This bill is bad for consumers because it:

  • Caps pain and suffering compensation (also known as non-economic damages*) at $250,000, even in states where such a cap is unconstitutional
  • Mandates that damages over $50,000 must be paid out periodically instead of in a lump sum, leaving long-term care consumers without the necessary resources to access care
  • Provides immunity to any health care provider who negligently prescribed or administered a prescription drug
  • Limits a consumer’s ability to bring one lawsuit against all responsible parties, instead forcing them to spend more time and money bringing individual suits against each responsible party
  • Mandates a more restrictive time period (statute of limitations) for the consumer to file the lawsuit
  • Severely limits attorney’s fees, which will cause even fewer attorneys to take these time-consuming cases

The House of Representatives will be voting on this legislation as early as Thursday, June 15, 2017.  Click here to tell your representative in Congress to VOTE NO to H.R. 1215.

To view our fact sheet on H.R. 1215, click here.  To take more actions, visit our website.

*Damages are any sum of money awarded in compensation for a loss or injury.  Non-economic damages include awards compensating the loss of enjoyment of life, mental anguish, anxiety, pain and suffering.

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Now Accepting Nominations for the 2017 Consumer Voice Leadership Awards!

June 09, 2017

Based on your nominations, Consumer Voice recognizes people who have demonstrated an exceptional commitment to improving the lives of long-term care consumers. Individuals and organizations may nominate people for an award. Awards will be presented at our 41st Annual Conference, November 5-8, 2017, in Arlington, Virginia.

There are 3 easy steps to submit a nomination!

  1. Review the award categories and criteria.

  2. Complete the nomination form via SurveyMonkey

  3. Submit a letter of recommendation.

Click here to learn more about submitting your nomination.

Click here for a PDF of the nomination form.

Questions? Contact us at info@theconsumervoice.org.

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CMS Reverses Course on Pre-Dispute Arbitration

June 06, 2017

Eight months after publishing a final rule on the Revised Requirements of Participation for Nursing Facilities banning pre-dispute arbitration agreements for nursing home residents and family members, CMS is issuing new proposed rules that rescind resident protections against these unfair provisions.

According to CMS, it “now believe[s] that an outright ban on pre-dispute arbitration agreements and the further restrictions on post-dispute arbitration agreements do not strike the best policy balance,” and also that “a ban on pre-dispute arbitration agreements would likely impose unnecessary or excessive costs on providers.”  The proposed rule was placed on Public Inspection at the Office of the Federal Register on Monday, June 5, and is scheduled to be officially published in the Federal Register on Thursday, June 8, 2017.

In the proposed rule, CMS removes the requirement preventing facilities from entering into pre-dispute arbitration agreements, and also removes the provision banning facilities from requiring these agreements as a condition of admission.

Instead, CMS requires that an agreement for binding arbitration be explained to the resident and his/her representative in a manner that s/he understands, and that the resident acknowledges that s/he understands the agreement.   The agreement may not prohibit or discourage the resident or anyone else from communicating with federal, state, or local officials, including the survey agency and the long-term care ombudsman program.  CMS kept the provision that when a dispute is settled through arbitration, a copy of the signed agreement for binding arbitration, as well as the arbitrator’s final decision must be kept by the facility for 5 years and be available for inspection upon request by CMS or its designee.

Additionally, CMS requires that the arbitration agreement be in plain language; and if it is a condition of admission, that it be in plain writing in the admission contract.  Lastly, CMS is proposing that facilities be required to post a notice describing its policy on the use of agreements for binding arbitration in an area that is visible to residents and visitors.

Gone from the rule is not only language banning pre-dispute arbitration as a condition of admission, but also requirements from the 2016 final rule for post-dispute binding arbitration that the agreement be entered into voluntarily by the resident, that a neutral arbitrator be mutually agreed upon, and that the venue for arbitration be convenient to both parties.  

Shortly after publication of the final rule in October 2016, the American Health Care Association and affiliated nursing homes filed a lawsuit against CMS seeking an order stopping enforcement of the provision.  The district court concluded that the rule was likely in conflict with the Federal Arbitration Act and ordered the preliminary injunction.  On June 5, 2017, the government filed a notice with the court that they will seek a stay of the injunction, pending the completion of the rule making process.

Comments on this forthcoming proposed rule will be due 60 days from the date of publication in the federal register, or on or about August 7, 2017. 

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Webinar Covers How AHCA Would Affect Medicaid

May 30, 2017

On May 24th, the Alliance for Health Reform held a webinar focused on how the American Health Care Act would impact states and Medicaid beneficiaries, how a system of per capita caps would work, what was learned from the Medicaid expansion under the Affordable Care Act, and how states might respond to new waiver flexibility from the Centers for Medicare & Medicaid Services.  Find the webinar recording, transcript and speaker presentations here.

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NPR Publishes Story on States Efforts to Crack Down on Involuntary Discharge

May 30, 2017

A recent story by NPR covers several states' attempts to crack down on involuntary discharge from nursing homes.  Maryland is suing nursing home chain Neiswanger Management Services (NMS) for Medicaid fraud.  Maryland's State Attorney General Brian Frosh stated that more than half of all involuntary discharges in Maryland come from nursing homes run by NMS.  The lawsuit alleges that NMS charged the state for discharge planning services it didn't deliver.  Nursing homes are obligated to ensure that discharged residents go somewhere safe.  Yet, NMS has sent residents to homeless shelters and unlicensed board and care homes. Frosh asserts that NMS was discharging residents for its own financial gain.  Medicare payments for long-term care only last for 100 days; NMS evicted residents just as they were transitioning from Medicare. 

Other states are also fighting unfair involuntary discharges.  In Illinois, according to the last five years of data, nursing home discharges have more than doubled. State lawmakers have proposed legislation which aims to crack down on improperly discharging residents, ensuring that residents won't get discharged for complaining too much or requiring too much staff time.  Read more on NPR.

Involuntary transfer and discharge is the #1 complaint reported to the Long-Term Care Ombudsman Program.  For additional information and resources, visit the Consumer Voice webpage and the National LTC Ombudsman Resource Center webpage.

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CMS Provides Update on Special Focus Facility Initiative

May 26, 2017

The Centers for Medicare & Medicaid Services (CMS) has provided an update on the Special Focus Facility (SFF) Initiative.  The update provides a list of nursing homes that have had a history of serious quality issues and are included in a special program to encourage improvements.  CMS provides tables with facilities in five different categories 1.) New Additions; 2.) Not Improved; 3.) Improving; 4.) Recently Graduated and 5.) No Longer in Medicare and Medicaid.  The website is part of an effort from CMS to address the problem of chronically under-performing nursing homes.  

Read the update here.

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CMS Announces Extension for Compliance with Home- and Community-Based Settings Rule

May 24, 2017

The Centers for Medicare & Medicaid Services (CMS) announced a three-year extension for state Medicaid programs to meet the Home- and Community-Based settings requirements. States now have until March 17, 2022, to comply with the final rule. For more information, see the informational bulletin from CMS.

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We’re fighting the good fight … and we need your help!

May 09, 2017

Dear Friends,
We’re fighting the good fight … and we need your help!

During these past few months, there has been an unprecedented assault on the policies that support access to quality long-term care and protect the rights of long-term care consumers.  We are fighting back.

  • We are fighting proposed cuts to and changes* in the long-term care safety net program, Medicaid, that will mean:
    • Less access to nursing homes and home and community based care,
    • Tougher eligibility standards to qualify for Medicaid,
    • Saddling older adults and individuals with disabilities and their families on limited incomes with the added burden of paying for nursing home care - $82,000 per year for a semi-private room, and
    • Weakened oversight of long-term care facilities.
  • We are fighting harsh restrictions on consumers’ access to the justice system if they have been harmed by negligent or abusive health care providers. The proposed restrictions would:
    • Leave victims without rights or recourse for justice,
    • Protect those who are negligent or abusive, and
    • Perpetuate poor practices that lead to serious injury and death.
  • We were successful in fighting threats to roll back newly revised nursing home regulations that enhance protections from evictions, abuse, and neglect.

Consumer Voice staff have been working tirelessly to battle attacks that will turn the clock on long-term care and consumer rights back 40 years!  Will you join us?


Your donation will help our staff:

  • Educate members of Congress about the impact of these harmful proposals on residents and families;
  • Analyze the new proposals that are being released weekly to determine their impact on residents and other long-term care consumers;
  • Mobilize advocates from across the country – including residents, individuals receiving long-term care and services in home and community based settings, and their family members – to tell their representatives in Congress how these policies will affect them.

In addition, your support will help continue the work of our wonderful Consumer Advisory Council, made up of current and former residents of nursing homes and assisted living facilities.  Last year, your donations helped us launch the Council. As active, vocal advocates, the Council members have already accomplished the following:

  • Conducted three conference call meetings.
  • Participated on Consumer Voice work groups, including work groups developing comments on new regulatory guidance, and planning Residents’ Rights Month.
  • Attended two four-day Stakeholder Sessions hosted by CMS earlier this year and provided input on the development of revised Interpretive Guidelines.

In 2017, we will expand the Council to include additional members, and involve them in even more policy issues.  If you know a resident who might be interested in joining our Consumer Advisory Council, let me know!

Every dollar helps!  Consider a monthly donation, which keeps these activities going year-round!  Make a donation now.

Thank you for being a strong supporter of Consumer Voice!

Sincerely,

 
Lori Smetanka
Executive Director
 

*Congress’ first recent attempt to change Medicaid failed, but another bill is up for a vote soon!

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Toolkit To Reduce CAUTI and Other HAIs in Long-Term Care Facilities

May 09, 2017

The Agency for Healthcare Research and Quality (AHRQ) released a Toolkit to Reduce CAUTI and Other HAIs in Long-Term Care Facilities.  Consumer Voice was a partner on this project. The toolkit is based on the experiences of 450 nursing homes that participated in the AHRQ Safety Program for Long-Term Care: Healthcare Associated Infections (HAIs)/Catheter-Associated Urinary Tract Infections (CAUTIs).  The toolkit combines clinical interventions and best practices for infection prevention with behavior change elements that promote leadership involvement, improvement in safety culture, teamwork, and communication, and sustainability. Its user-friendly educational modules, guides, and tools can help facilities advance from the "what to do" to the "how to do it.”  They include: Using the Comprehensive Long-Term Care Safety Toolkit; Senior Leader Engagement; Staff Empowerment; Teamwork and Communication; Resident and Family Engagement; Sustainability; Indwelling Urinary Catheter Use and Care; and Urine Culturing and Antibiotic Stewardship.

For more information on infection prevention, visit Consumer Voice's issue page on the topic.

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Join the Resident's Voice Challenge

April 25, 2017

Creative writing and artistic expression are meaningful and compelling ways to highlight the importance of residents’ rights and how these rights can be carried out in all long-term care settings.   For this year’s Resident’s Voice Challenge, residents are encouraged to pick up their pens, dust off their type writers or use a computer to display their writing or artistic skills by submitting essays, poems, artwork, drawings, or videos related to the theme for Residents' Rights Month 2017 "It’s All About Me: My Life, My Care, My Choices".  Learn more here.

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Call for Medicaid Stories

April 23, 2017

Click here for more information.

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Consumer Voice Issues Joint Statement on Abuse and Neglect in Nursing Homes

April 12, 2017

Consumer Voice, with the Long Term Care Community Coalition, Center for Medicare Advocacy, and California Advocates for Nursing Home Reform, issued a joint statement in response to the recent reports exposing abuse and neglect in nursing homes across the country.  The statement urges that more - not less - accountability is needed to ensure the safety and dignity of vulnerable nursing home residents. A substantial body of evidence shows the need for stronger accountability for nursing home resident safety.  Read the statement here.

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Revised Nursing Home Regulations Are Safe!

March 31, 2017

The revised nursing facility regulations were subject to repeal under the Congressional Review Act (CRA)*.  However, the deadline for introducing resolutions of disapproval under the CRA passed yesterday, Thursday, March 30.  Since no resolution had been introduced to repeal the revised nursing facility regulations by the deadline, they are safe from repeal.

These vital regulations increase quality of care and quality of life for nursing home residents by requiring:

  • greater emphasis on a resident's individual needs and preferences
  • prompt development of a care plan
  • more comprehensive care
  • improved training
  • improved protections against abuse, neglect and exploitation
  • better protection of resident property
  • increased visitation rights
  • protection against evictions
  • a limitation of nursing facilities' ability to "dump" a resident at the hospital

With these regulations, nursing home residents across the country will experience a higher quality of care and life.

To view more information, including Rule Resources and webinars, on the revised federal nursing facility regulations, click here.

*The CRA is a law passed in 1996 that allows Congress to repeal or prevent a regulation issued by a federal agency from taking effect.  The CRA states that all regulations passed in the last 60 legislative days under the previous administration are subject to repeal.  The revised federal nursing home regulations were issued by the Centers for Medicare & Medicaid Services (CMS) and became effective on October 4, 2016.  Since the revised regulations became effective in the last 60 legislative days of the previous administration, they were subject to repeal through the CRA.

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Announcing Residents' Rights Month 2017

March 28, 2017

October is “Residents’ Rights Month,” an annual event designated by Consumer Voice to honor residents living in all long-term care facilities. It is an opportunity to focus on and celebrate awareness of dignity, respect and the rights of each resident.

The theme for this year's Residents' Rights Month, "It's All About Me: My Life, My Care, My Choices," focuses on the respect and dignity of every resident.  The theme highlights residents’ rights to choose their own schedule and activities, communicate how and with whom they choose, be free from abuse and unsafe environments, and be treated as an individual with unique wants and needs.  Residents’ Rights Month is a time for staff, families, ombudsmen, residents and other advocates to focus on resident-directed care and emphasizing the self-determination, choice, and quality of life of each resident.

Find more information about 2017 Residents' Rights Month click here.

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New Issue Brief on Admissions in Revised Federal Nursing Home Regulations

March 15, 2017

Consumer Voice, in partnership with Justice in Aging and the Center for Medicare Advocacy, is developing a series of briefs entitled "A Closer Look at the Revised Nursing Facility Regulations."  This new brief in the series explains the changes in admission, bedhold and return regulations, which include broadly prohibiting facilities from using admission agreements or other documents that waive a resident's rights.  The revised regulations also prohibit pre-dispute arbitration agreements, but this consumer protection is currently blocked by a court order.  Read the brief here.

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Save Medicaid & Protect All Long-Term Care Consumers: Oppose Medicaid Per Capita Caps!

March 13, 2017

Medicaid is a lifeline for nursing home residents and other long-term care consumers.  But that lifeline may be taken away. The US House of Representatives has just issued a proposal to change the Medicaid program by going to a system of per capita caps.   The proposal is part of a  plan to replace the Affordable Care Act.  These changes to Medicaid would be devastating to nursing home residents and other long-term care consumers. Tell your members of congress to oppose per capita caps!

Here’s why per capita caps are so harmful:
 
They only give states a fixed amount of money per Medicaid beneficiary. The amount doesn’t change over time, so the result is a massive cut in Medicaid funding.  For long-term care consumers, this means:

  • Services/coverage would be drastically reduced or eliminated.
  • Eligibility standards would be tightened, making it harder to get into a nursing home or receive home and community-based services.
  • The personal needs allowance for nursing home residents could be slashed to the federally required minimum of $30 per month, leaving residents with even less money for items like clothing or hair cuts.

Nursing home quality care would decline because nursing homes would cut staff and there would be fewer nursing home inspectors (surveyors).To learn more about per capita caps and how they can hurt nursing home residents, other long-term care consumers and their families, go to our webpage on preserving Medicaid.

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Senator Franken Reintroduces Arbitration Fairness Act

March 03, 2017

Consumer Voice sent a letter to Senator Al Franken in support of his reintroduction of the Arbitration Fairness Act. Consumer Voice opposes pre-dispute arbitration clauses in nursing home admissions contracts as they prevent residents from obtaining justice in many instances of negligence, abuse or violations of residents' rights. Read the full letter to Senator Franken here.

For more information on how forced arbitration agreements harm long-term care consumers, visit our issue page.

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Consumer Voice Issues Statement on American Health Care Act

March 10, 2017

The American Health Care Act
Harmful for Long-Term Care Consumers and Those Who Care for Them

The National Consumer Voice for Quality Long-Term Care (Consumer Voice) issued the following statement on the American Health Care Act:

The American Health Care Act is detrimental for long-term care consumers and those who care for them.  Proposed changes to Medicaid, the primary payer of long-term care in this country, to a capped payment system would result in cuts to the amount of money states receive, impacting the services provided to beneficiaries.  Inevitable cuts will mean that states will likely change Medicaid eligibility requirements, and reduce services being offered, including access to long-term care.

Medicaid pays for more than half of all long-term care in the United States, and nearly 50% of all nursing home costs. The annual cost of a shared room in a nursing home is more than $82,000 per year.  Few individuals or families can afford that for an extended period. These proposed changes would impose tremendous financial burdens on individuals needing long-term care and their families.

Additionally, the American Health Care Act will make it harder for caregivers to obtain affordable health insurance.  Many direct care workers receive minimum wage, but are not provided with health benefits through their employer.  The Affordable Care Act was instrumental in providing affordable health care for many direct care workers, including through the expansion of Medicaid to individuals who live below 138 percent of the federal poverty level.  The proposal in the American Health Care Act to eliminate the Medicaid expansion, now implemented by 31 states, will put at risk the health care of hundreds of thousands of direct care workers.

Congress must reject the American Health Care Act because it is harmful to those who most need access to care. 

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Groups - Sign onto the letter opposing H.R. 1215

March 03, 2017

Earlier this week, the U.S. House Judiciary Committee passed out of committee a bill that would be extremely harmful to consumers - the “Protecting Access to Care Act of 2017” (H.R. 1215) - which would limit the ability to hold all healthcare providers accountable.  The bill’s sweeping scope covers not only cases involving medical malpractice, but also cases involving unsafe drugs and nursing home abuse and neglect.  We are very concerned about this bill's far-reaching effects for those receiving care in the community and nursing homes.  Here is a link to the issue brief about the bill.
 
Advocacy is needed right away because the bill is expected to go to the House floor for a vote in the next couple of weeks.
 
If you are part of a state or national group, please take action by signing your organization on to a letter opposing the bill that the Center for Justice and Democracy is circulating. Here is the link to the letter.

Your organization’s signature will help show Congress that a broad group of community, consumer, health, and public interest organizations strongly oppose H.R. 1215. The letter will be sent to the House prior to the floor vote.
 
Groups can sign on by emailing info@theconsumervoice.org and letting us know the name of your organization. If you are a state group, please indicate your state.  Signatures are due COB Thursday, March 9.
 
If you need additional information or have any questions, please email Alisha Lineswala at alineswala@theconsumervoice.org or Robyn Grant at rgrant@theconsumervoice.org.
 
Thank you in advance for your advocacy!

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Sexual Abuse in Nursing Homes - Joint Statement from CV, NCEA, and NOVA

February 24, 2017

Wednesday’s report by CNN, Sick, Dying and Raped in America’s Nursing Homes[1] is a shocking reminder that abuse, including sexual abuse, of nursing home residents continues to be a very real problem.  Residents and families need to have confidence that when they turn to a long-term care facility, that every possible step will be taken to protect them from such horrific acts.  

Too often, frail, vulnerable residents, including those living with dementia, are targeted by abusers who use fear and intimidation, or even a resident’s cognitive impairments to try to avoid prosecution[2].

Federal regulations[3] state that all residents have the right to be free from abuse.  Additionally, nursing homes must ensure that they have written policies and procedures to prevent abuse, to investigate any allegations, and to ensure that any allegations of abuse are reported immediately to the appropriate agencies.
 
What are signs that a nursing home resident is being sexually abused?

Physical indicators of sexual abuse include[4]:

  • Bruises around inner thighs, the genital area or breasts
  • Unexplained genital infections or venereal disease
  • Unexplained vaginal or anal bleeding, pain or irritation
  • New difficulty sitting or walking
  • Torn, stained or bloodied underclothing
  • An elder’s report of being sexually assaulted or raped

Social indicators of sexual abuse include[5]:

  • Extreme agitation
  • Withdrawal from social interactions
  • Panic attacks or emerging post-traumatic stress disorder (PTSD) symptoms
  • Suicide attempts
  • Unusual behavior between the victim and the elder sexual abuse suspect

Victims of dementia will exhibit anxiety or excessive fear around the person providing or tending to their care. They may also engage in more aggressive behaviors.[6]
 
Getting Help

Once a person has suspicions of, or has identified, that a resident is being sexually abused, get help immediately.  

Call:

  • 911 or the local police
  • State Licensing and Certification Agency. This is the agency that inspects nursing homes and investigates complaints.
  • Adult Protective Services (APS).  In some states, APS investigates reported suspicions about abuse of nursing home residents.
  • The Long-Term Care Ombudsman Program.  The local long-term care ombudsman is an advocate for nursing home residents and can assist the resident in getting the help needed.
  • Report the abuse to the nursing home administrator.

Contact information for the Long-Term Care Ombudsman, Adult Protective Services, or the State Survey and Certification Agency can be found at www.theconsumervoice.org.
 
For more information, go to:
 
National Center on Elder Abuse – https://ncea.acl.gov/
 
National Consumer Voice for Quality Long-Term Care – www.theconsumervoice.org
 
National Long-Term Care Ombudsman Resource Center – www.ltcombudsman.org
 
National Organization for Victim Assitance – http://www.trynova.org/



[1] See “Sick, Dying and Raped in America’s Nursing Homes” at http://www.cnn.com/interactive/2017/02/health/nursing-home-sex-abuse-investigation/.
[2] See “Challenges When Investigating Elder Sexual Abuse” at http://www.ncall.us/sites/ncall.us/files/H_07%20Sexual%20Assault.pdf.
[3] 42 CFR 483.12(c )
[4] See “Elder Sexual Abuse” at http://nursinghomeabuseguide.com/elder-abuse/sexual-abuse/.
[5] See “Elder Sexual Abuse” at http://nursinghomeabuseguide.com/elder-abuse/sexual-abuse/.
[6] See “Abuse” at https://www.alz.org/care/alzheimers-dementia-elder-abuse.asp.

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Consumer Voice Issues Statement on CNN Report on Sexual Abuse in Nursing Homes

February 23, 2017

We at the National Consumer Voice for Quality Long-Term Care (Consumer Voice) express outrage and horror in response to the findings of the CNN investigative report on sexual abuse in nursing homes, Sick, Dying and Raped in America’s Nursing Homes.

“We have been advocating for quality care for more than four decades, yet the findings of the CNN investigation are among the most shocking and frightening we have ever encountered," said Executive Director Lori Smetanka. "The sexual abuse of defenseless, vulnerable residents who can’t remove themselves from harm, often can’t communicate what has happened, and are frequently not believed even when they do, is reprehensible.”

The cases highlighted in the CNN report represent a complete breakdown at every level of the system designed to protect nursing home residents.  There are many contributing factors –including insufficient staff and training, inadequate background checks, failure to report allegations, inadequate investigations, and lack of prosecution.

The issue of sexual abuse is complex and change needs to occur at many different levels in order to address it. “But, we know that stronger nursing home regulations, more effective enforcement and increased staff in nursing homes are critical, and that we can’t begin to solve this problem without those three elements,” said Smetanka.  The federal government recently released revised rules that mandate better abuse protections, including reporting requirements. However, these rules could be rolled back by Congress under a rarely used federal law.  Consumer Voice advocated for these stronger nursing home protections and is fighting against repeal.  “Clearly, vast improvements are needed in the response to abuse, but the CNN investigation shows that greater protections are needed, not less.” said Smetanka.

In addition to more stringent rules and enforcement, there are steps that consumers can take to better protect themselves or their loved ones in nursing homes. Current and prospective residents and their families can educate themselves about warning signs and how to report suspected sexual abuse.  They can also contact the long-term care ombudsman program (www.ltcombudsman.org) if they have concerns. And they should immediately report any suspicions of abuse to the police and the state agencies that oversee nursing homes.  For more information and resources, go to www.theconsumervoice.org.

It is unacceptable that anyone should have to live in fear of sexual abuse at the hands of those paid to care for them. “There should be no facility in the country where such abuse takes place,” said Smetanka.  “We all, nursing homes, regulators, advocates, staff, and law enforcement need to commit to a zero tolerance policy and ensure swift action and accountability when such situations occur.”


Find resources on sexual abuse in nursing homes and many relevant resources on other types of elder abuse on the Consumer Voice issue page.

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New Issue Brief on Nursing Services

February 21, 2017

The new issue brief looks specifically at nursing services.  The regulations failed to include a numerical minimum staffing standard, instead maintaining the previous requirement that “sufficient staff ” be available. The regulations do, however, place a greater emphasis on establishing minimum competencies and skill sets for all nursing personnel. Facilities must assess their resident population and resources to determine both the number and competencies of staff needed to care for residents.

In addition, the regulations have increased requirements for in-service training of nursing personnel. Finally, the revised regulations require that the resident and resident representative be notified of any waivers of nursing staff requirements.

Visit the Consumer Voice website for the other issue briefs in the series.  

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Oppose the Repeal of the ACA and Changes to Medicaid

February 17, 2017

The ACA didn’t just expand coverage for millions of Americans, it was the first law in many years to adddress the quality of care in nursing homes that receive Medicare and Medicaid funding. The ACA provides more accountability, improved training, and makes prevention of elder abuse a national priority.

The ACA also improves access to home care services, which keep people at home and help nursing home residents move back into the community.

Repeal of the ACA could eliminate these protections, improvements, and services.

At the same time, proposals to replace the ACA include significant changes to Medicaid.  These plans would impose spending caps per enrollee or convert Medicaid into block grants - resulting in Medicaid cuts.  In addition, federal nursing home quality standards could be eliminated because states would receive federal monies with relatively few requirements.  These changes to Medicaid put long-term care consumers at risk.

Please contact your members of Congress now and urge them to vote to keep Medicaid as it is AND to vote against repeal of the Affordable Care Act without adequate replacement!  Click here to send your message.

Thank you for taking action!

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Article - "Long-Term Care Ombudsman Program Offers Trust and Solutions"

February 14, 2017

Director of the Office of Long-Term Care Ombudsman Programs within the Administration for Community Living Becky A. Kurtz recently wrote an article in the Society of Certified Senior Advisors Journal.  In the article, titled "Long-Term Care Ombudsman Program Offers Trust and Solutions", she explains how and why the Long-Term Care Ombudsman programs exist, and the kinds of benefits they’ve provided for long-term care residents for decades. This article presents how Ombudsmen frequently assist older Americans who’ve been inappropriately discharged or evicted from their nursing homes. According to the article, 74% of complaints handled by Ombudsmen in 2015 were resolved to the satisfaction of the resident. LTC Ombudsmen and the residents they work with build strong bonds that allow residents to feel comfortable, leading to greater satisfaction with their communities.

Read the article here.

Reposted with permission from the CSA Journal. Society of Certified Senior Advisors. All rights reserved. www.csa.us.

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New Fact Sheets on Revised Federal Nursing Home Regulations

February 08, 2017

Consumer Voice, along with Justice in Aging and Center for Medicare Advocacy, have released new issue briefs in our series on the revised federal nursing facility regulations.  The fact sheets can help residents, family members and advocates better understand how the regulations, which went into effect November 28, 2017.  New fact sheets cover:

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Fight the Repeal of the Revised Nursing Home Regulations!

January 27, 2017

On January 30, 2017 from 3-4 PM ET, tweet your members of Congress to not repeal the revised federal nursing home regulations through the CRA.  Send as many tweets as possible during that hour!  By doing so, you'll be tweeting with others nationwide in a "twitter storm."  Continue tweeting afterwards at least once a day until February 11, 2017.

Click here to view our communications toolkit that includes information on the CRA and what it means for nursing home residents if the revised nursing home regulations are repealed.

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Family Caregivers Speak at Senate Forum

January 19, 2017

Senators including, Senator Debbie Stabenow (D-MI), Senator Elizabeth Warren (D-MA), Senator Patty Murray (D-WA), and Senator Bernie Sanders (I-VT), held a forum featuring testimony from Americans who would be hurt by the policies of Tom Price, the nominee to lead the Department of Health and Human Services.  Testifiers, including family caregivers, told their stories of how they have benefitted from the Affordable Care Act, Medicare and Medicaid.  Watch the forum here.

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Consumer Voice Releases Report on Nursing Home Closures

November 08, 2016

Successful Transitions: Reducing the Negative Impact of Nursing Home Closures, a new report released by Consumer Voice, examines reasons why nursing home residents may suffer harm when their nursing home closes and identifies ways to reduce or eliminate such harm. The study found that major obstacles to a successful transition include lack of appropriate and nearby placements or providers who do not want to take a specific resident; poor discharge planning; and lack of communication and time to find new placements for residents. These are serious barriers, but innovative strategies and practices in several states appear to have the potential to address these issues. The report discusses these practices and recommends actions that the Centers for Medicare and Medicaid Services (CMS), state agencies and State Long- Term Care Ombudsman Programs can take to better protect nursing home residents facing relocation.

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Part II of Summary of Key Changes Now Available

December 22, 2016

This summary presents an overview of key changes in the revised federal nursing home regulations for the sections on Resident Assessment (§483.20) – Training Requirements (§483.95).  It is designed to highlight what is different between the prior rule and the final rule and includes only those parts of the rule that went into effect in Phase 1 on November 28, 2016.

Part II, combined with Part I, cover all sections of the regulations.

For more information about the nursing home requirements and to access Summary of Key Changes - Part I, click here.

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New Fact Sheet on Importance of Revised Nursing Home Regulations for Nursing Home Residents

December 20, 2016

Consumer Voice and Justice in Aging have released a new fact sheet entitled "Why the Recently-Revised Nursing Home Regulations are Vital for Nursing Home Residents."  After four years of work from the Centers for Medicare & Medicaid Services (CMS), newly revised federal nursing facility regulations were released in September, and most provisions went into effect on November 28.  These revised regulations provide critical consumer protections.  This fact sheet provides an overview of some important new revisions and how they protect long-term care consumers.  Stakeholders and policymakers can use the fact sheet to better understand the role the revised regulations have in improving nursing care, including an increased focus on addressing a resident's needs and preferences.  Read the fact sheet here.

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Tell Congress Not to Repeal the Affordable Care Act!

December 20, 2016

Congressional Leaders have promised, as a first order of business in January, to repeal the Affordable Care Act (ACA).   This could harm nursing home residents and other long-term care consumers, their families, the workers who care for them and many others. Tell your Senators and Representative NO!

  • Repealing the ACA without a comparable replacement plan that would go into effect immediately would leave millions without healthcare coverage and raise costs for millions more.
  • Nursing home residents could lose important protections that are part of the ACA. These include: 
    • A system for collecting more accurate data about staffing in nursing homes
    • Dementia and abuse prevention training
    • Support for state programs for national criminal background checks
    • Mandatory reporting of suspected crimes against residents to law enforcement
  • Programs that improve access to home care services could be eliminated - forcing people into nursing homes, costing taxpayers more money, and breaking up families.  Losing these programs could also stop nursing home residents from transitioning back into the community.

Ask your Senators and Representative to oppose repealing the ACA without replacing it by clicking here.

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New Fact Sheet on Assessment, Care Planning, and Discharge Planning

December 05, 2016

Consumer Voice, Center for Medicare Advocacy and Justice in Aging released a brief "A Closer Look at the Revised Nursing Facility Regulations: Assessment, Care Planning, and Discharge Planning."  The brief covers how the revised nursing facility regulations broadly affect facility practices, including assessment, care planning and discharge planning.  The revised assessment process places greater emphasis on a resident's preferences, goals, and life history.  The brief highlights regulations on assessments, baseline care plans, comprehensive care plans - including the care planning process and care plan contents, and discharge plans.  It also gives information on effective dates. how to find the regulations and specific tips for residents and advocates.

This brief is the first of a series explaining important provisions of the revised regulations.

View the brief here.

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New Guides on How New HCBS Rules Affect Adult Day Services and Assisted Living

November 23, 2016

Consumer Voice and Justice in Aging created two guides on how the Medicaid Home and Community-Based Services (HCBS) rules can be used to improve services for older persons. These guides are meant to assist state advocates as they develop "transition plans" to implement new federal rules and set policy in that state for 2019 and into the future. "Medicaid’s New Rule to Promote Independence and Choice for Persons Receiving HCBS" provides an overview of the rule, with a focus on HCBS for older persons. "Applying the New Federal HCBS Rules to Adult Day Centers" examines how the HCBS rules can improve services provided in those settings.

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New Fact Sheet on the Long-Term Care Ombudsman Program

November 15, 2016

Consumer Voice and the National Center on Elder Abuse created a helpful fact sheet providing an overview of the long-term care ombudsman program.  This resource walks readers through what the long-term care ombudsman program is, what the Ombudsman program does and does not do, links to information on residents’ rights, and some helpful FAQs.

View the fact sheet here.

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Webinar Recording Available for "Piecing Together Quality Long-Term Care"

October 12, 2016

Most of us will, at some point in our lives, need assistance with the tasks of everyday life. What are the options available?  Where can you go for information and assistance? What types of things should be considered? This webinar will walk you through the different pieces you, or your client, need to consider to obtain quality long-term services and supports.  Presenter Robyn Grant provides can't-miss tools and information for navigating the complicated world of long-term care.  Purchase the webinar via our online store.

Other webinar recordings for sale include - "Preventing Avoidable Hospitalizations" and "Obtaining Quality Care for Residents with Dementia."  Find more information here.

Purchase all three webinars for a discounted price.

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CMS Prohibits Pre-Dispute Arbitration in Newly Released Federal Nursing Home Regulations

September 30, 2016

The Centers for Medicare & Medicaid Services (CMS) has just released a comprehensive revision of federal nursing facility regulations.   The regulations and explanatory material (over 700 pages total) are available here. Currently, many nursing facility admission agreements include provisions obligating the resident to have disputes adjudicated through private arbitration.  Such “pre-dispute” arbitration agreements now will be prohibited.  Arbitration agreements will be allowed only when the events at issue occurred before the arbitration agreement was signed.

The prohibition of such agreements comes after Consumer Voice's efforts to urge CMS to include such a provision.

For more information, read the New York Times article.  For Consumer Voice's breakdown of other provisions included in the nursing home regulations, click here.

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Consumer Voice Sends Comments to CMS on Special Focus Facilities

September 15, 2016

On September 15th, Consumer Voice sent a letter to the Centers for Medicare and Medicaid Services (CMS) in support of the Special Focus Facility (SFF) program as a way to bring nursing facilities with a history of persistently poor care into compliance.  The letter provided comments on the proposed SFF memo on the following issues:

  • Consumer Voice agrees with with the Long-Term Care Community Coalition (LTCCC) that the number of SFF slots per state should be increased to the pre-sequestration level and that CMS should establish a plan to ultimately include all the nursing homes on the candidate list.   If a nursing home’s performance is bad enough to qualify the facility for the candidate list, it should be designated a SFF. 
  • We encourage CMS to require that the State Long-Term Care Ombudsman have input into the selection of the SFF.
  • We recommend the following agencies/entities/programs also receive written notification of the SFF selection:  Adult Protective Services, guardianship programs, the QIO-QIN, the state Medicaid agency, the state nursing home administrator licensing board (a board might consider review of an administrator’s license based on the facility’s poor performance), and hospitals in the areas surrounding the SFF.   
  • We are concerned that although a facility may show improvement between two consecutive surveys, i.e. no deficiencies at a scope and severity of “F” or greater (or “G” or greater for LSC deficiencies) and no complaints substantiated with deficiencies at “F” or greater (or “G” or greater for LSC deficiencies), this time period is too short to indicate that sustainable improvement has been made.  To better ensure that facilities have attained and maintained improvement over time prior to graduation, Consumer Voice proposes that homes that have completed two consecutive standard surveys with no deficiencies at a scope and severity of “F” or greater (or “G” or greater for LSC deficiencies) and no complaints substantiated with deficiencies at “F” or greater (or “G” or greater for LSC deficiencies), be required to remain in the SFF program.
  • We recommend that at least 25% of the surveys be conducted on a weekend and/or after business hours. This would better ensure that surveyors are getting an accurate picture of conditions in the facility.
  • We are pleased to see that remedies must be imposed with increasing severity, but are concerned that there is not sufficient guidance on what increasing severity means.

Read the full letter here.

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Consumer Voice Featured in Philanthropy Journal News

September 09, 2016

Consumer Voice Executive Director Lori Smetanka wrote about Consumer Voice's many policy initiatives and programs in a feature in the Philanthropy Journal News.  Consumer Voice was highlighted as being the leading national organization representing consumers on issues related to long-term care and services.  The article features Consumer Voice's key value - including the voice of the consumer - as one of the reasons for our success.  Consumer Voice includes residents and consumers of long-term services and supports in our organization leadership as well as creating opportunities to bring consumers to the policy table.  Also highlighted was Consumer Voice's annual Residents' Rights Month, held every October, and the importance of this year's theme "My Vote Matters."  The Resident's Voice activity gives consumers an opportunity to share their thoughts on the year's theme and to engage in the political conversation.

From the article: "Consumer Voice works closely with a dedicated network of consumer advocates and long-term care ombudsmen across the country on these important issues. The strength of their advocacy is rooted not only in their collaborative efforts, but also in keeping the resident/consumer experience at the forefront of their efforts. Residents’ voices are their compass, and as new policies and practices are introduced and considered in the delivery and financing of long-term care and services, Consumer Voice continues to ask, 'What does this mean for the person receiving those services?'"

Read the full article here.

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CFPB Releases Report and Resource Guide on How Community Partnerships Can Help Fight Elder Financial Abuse

August 24, 2016

The Consumer Financial Protection Bureau released a report about counties around the country who have developed community-based efforts to prevent, detect and respond to elder financial exploitation.  Strong collaboration among community stakeholders - like financial institutions, adult protective services, and law enforcement - can be an effective way to protect older residents from financial exploitation.  CFPB's Director Ricard Cordray said, "Hundreds of counties have developed a community-based approach to protect their seniors and retirees from financial exploitation. We’ve learned that an ‘all hands on deck’ strategy can be very effective to fight elder financial fraud. Our new guide and recommendations can help more community stakeholders build these very helpful networks to pool information, expertise, and resources in addressing this growing crisis.”

Read the report here.

In addition to the report, CFPB also created a resource guide and best practices to help other communities create their own protection partnerships to fight elder financial abuse.  View the resource guide here.

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ACL Awards $2.2 Million to Adult Protective Services Systems

August 23, 2016

The Administration for Community Living's (ACL) Administration on Aging has announced $2.2 million in grants to assist 13 state Adult Protective Services (APS) systems in addressing the abuse, neglect, and exploitation of older adults and individuals with disabilities.  States awarded grants are: Arizona, California, Delaware, Hawaii, Idaho, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nevada, Ohio, and Tennessee.  The two-year grants will be used to enhance statewide APS systems, improve practices and data collection, and interface with ACL's National Adult Maltreatment Reporting System (NAMRS).  For more information, read the announcement from ACL.

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Urge Congress to Continue the Money Follows the Person Program

August 22, 2016

"I’m free!"  This is what many people of all ages say when they move out of an institutional setting or nursing facility and back to the community under the federal Money Follows the Person (MFP) demonstration program.  MFP gives people the right to decide where they live and receive home and community services and supports. It provides assistance, support and funding to help individuals with intellectual and developmental disabilities, individuals with physical disabilities, and older adults who want to transition out of an institution or facility to their own home or a community residence.

Since 2005, MFP has assisted more than 51,000 people with moving into a setting of their choice, and has helped 44 states improve access to home and community-based services. In addition, the MFP program provides an important quality framework and data collection and reporting requirements to build a solid state HCBS infrastructure. 

MFP is a program where everyone wins: individuals regain their independence, and state and federal governments save money because it costs less to provide services and supports in the community rather than in an institution.

Yet despite strong bi-partisan support, this crucial program is about to DISAPPEAR. Unless Congress takes action, the MFP program will end on Sept 30, 2016.  This means that fewer people will be able to move back into the community, and state progress and momentum to shift systems from institutional to more cost-effective home and community-based settings will be slowed.  

Tell your members of Congress to continue the Money Follows the Person program.  Send a message by clicking here.  Freedom should be for everyone!

Thank you for your advocacy!

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CFPB Creates Placemats to Help Prevent Elder Fraud

August 18, 2016

The Consumer Financial Protection Bureau (CFPB) has created placemats to be placed on meal trays across the country to help prevent elder fraud and exploitation.  The placemats provide tips for avoiding scams and can be distributed to a senior center, meal program, or to loved ones.

The placemats are available in English and Spanish and can be ordered for free here.  For more information, read CFPB's blog.

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Infographic About Detecting and Preventing Bullying Among Older Adults

August 17, 2016

Sadly, residents are not always treated with respect nor do they always get the care they need. This infographic was developed by the Health Professionals Press and talks about the factors that lead to bullying, the outcomes of resident-to-resident mistreatment, and how to prevent and respond to these incidents.

   

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CMS Adds New Quality Measures to Nursing Home Compare

August 16, 2016

The Centers for Medicare & Medicaid Services updated the Nursing Home Compare Five-Star Quality Ratings to incorporate new measures that look at successful discharges, emergency visits, and re-hospitalizations. The five new measures include:

  1. Percentage of short-stay residents who were successfully discharged to the community (Medicare claims- and Minimum Data Set (MDS)-based)

  2. Percentage of short-stay residents who have had an outpatient emergency department visit (Medicare claims- and MDS-based)

  3. Percentage of short-stay residents who were rehospitalized after a nursing home admission (Medicare claims- and MDS-based)

  4. Percentage of short-stay residents who made improvements in function (MDS-based)

  5. Percentage of long-stay residents whose ability to move independently worsened (MDS-based)

For more information, visit CMS' website.

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Action Update

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Thank You to Those Who Signed Our Letter to CMS on Arbitration

August 05, 2016

On July 25, the New York Times published a powerful editorial calling on CMS to ban pre-dispute arbitration clauses in nursing home contracts in its final nursing home rules.  These are clauses that require residents to agree to arbitration and sign away their right to a jury trial in the event they suffer injury or abuse while in the facility. The editorial gives us another great opportunity to advocate for strong nursing home regulations. Thank you to all the individuals and organizations who signed onto our letter to CMS calling for the agency to ban pre-dispute arbitration clauses in nursing home agreements once and for all.

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Tell CMS to Ban Pre-Dispute Arbitration in the Final Nursing Home Regulations

July 28, 2016

On July 25, the New York Times published a powerful editorial calling on CMS to ban pre-dispute arbitration clauses in nursing home contracts in its final nursing home rules.  These are clauses that require residents to agree to arbitration and sign away their right to a jury trial in the event they suffer injury or abuse while in the facility. The editorial gives us another great opportunity to advocate for strong nursing home regulations. Please sign on to our letter to CMS calling for the agency to ban pre-dispute arbitration clauses in nursing home agreements once and for all.

Anyone can sign on – local, state, national organizations AND individuals.  Enter your information and submit to us by 5:00 PM ET this Friday, July 29.

For individual sign-ons, click here.

For group sign-ons, click here

Help us send a strong message to CMS that this practice is unfair to consumers and must end now.

Thank you for your advocacy!

What is Pre-dispute Arbitration?

Arbitration is a process in which a dispute – such as a dispute regarding poor care, abuse or neglect – is settled by one or more arbitrators who decide the outcome instead of a jury made up of members of the community. “Pre-dispute” arbitration means that the consumer must agree to arbitration before any dispute arises. 

Pre-dispute arbitration agreements force individuals to make a decision without any information at all about the dispute. This decision must be made at the time of admission, a very stressful time for consumers and their families, when it is difficult to anticipate or even imagine the occurrence of serious harm or poor care. Once signed, pre-dispute, forced arbitration agreements strip individuals of their constitutional right to a trial by jury.

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Participate in the 2016 Consumer Voice Webinar Series!

July 11, 2016

Consumer Voice is hosting an exciting three-part webinar series featuring expert speakers, and important skills, strategies, and advocacy tips on important issues facing long-term care consumers! 

Register for one, two or get a discount when you register for all three webinars!

Webinar #1 – Preventing Avoidable Hospitalizations: A Primer for Consumer Advocates
Tuesday, August 9, 2:00pm – 3:00pm ET
Presenters: Marcia K. Flesner, PhD, RN, Sinclair School of Nursing, University of Missouri and Barbara Frank, B&F Consulting

Webinar #2 – Obtaining Quality Care for Residents with Dementia
Tuesday, September 13, 2:00pm – 3:00pm ET
Presenter: Jonathan Evans, MD

Webinar #3 – Piecing Together Quality Long-Term Care
Tuesday, October 11, 2:00pm – 3:00pm ET
Presenter: Robyn Grant, MSW

Each webinar is $65 and includes the live webinar and webinar recording that can be watched/shown as many times as you'd like.  Register for all three webinars in the series for the discounted price of $175.

Consumer Voice members receive a 10% discount on all webinars.  Email info@theconsumervoice.org for the discount code.

Read descriptions for each webinar and register here.

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Prevent and Protect Residents from Financial Exploitation

June 29, 2016

Many older adults and individuals with disabilities can be targets for financial exploitation, a growing form of abuse.  The resources below provide information, tips and guidance on how to create awareness for this important issue and how to protect residents.

Today, the Senate Judiciary Committee held a hearing on Protecting Older Americans from Financial Exploitation.  Connecticut State Ombudsman Nancy Shaffer testified.

 

Protecting Residents from Financial Exploitation: How Ombudsmen Can Use the New CFPB Guide in Their Work  
Tuesday, August 26, 2014

This webinar discusses the Consumer Financial Protection Bureau's new guide for assisted living and nursing facilities entitled Protecting Residents From Financial Exploitation.  The guide was developed to help operators and staff of nursing facilities and assisted living facilities protect residents from financial exploitation through prevention and early intervention, and outlines ways to create awareness, policies and practices to protect residents. In addition to enhancing LTCO advocacy skills regarding the warning signs of financial exploitation and learning about effective strategies to prevent and respond to such abuse, LTCO can share these tips and the guide with facility staff
 
Naomi Karp, Policy Advisor, Consumer Fraud Protection Bureau (CFPB) Office of Older Americans provides background on CFPB and the new guide and detail how long-term care ombudsmen can use this new resource to work with facilities to combat financial exploitation.  Iris Freeman, MSW, William Mitchell College of Law details how one state, Minnesota, developed a state-specific manual in 2010 and will provide tips how to replicate that process in your state.

Tips and Tools for Preventing and Responding to Financial Exploitation in Long-Term Care Facilities 
Wednesday, March 5, 2014, 3:00-4:30 ET

This webinar discusses financial exploitation in long-term care facilities and provides tips and resources for preventing, detecting and reporting financial abuse. Naomi Karp, Policy Advisor, Consumer Financial Protection Bureau (CFPB) Office of Older Americans, explains CFPB’s role in the financial protection and education of older adults and shares new resources attendees can use with residents, family members and providers to increase financial literacy and prevent financial exploitation. Ann-Maria Beard, Deputy Director, Office of Supplemental Security Income and Representative Payment Policy of the Social Security Administration discusses the Representative Payee Program, providing an overview of the responsibilities and oversight of representative payees and how attendees can support the rights of Social Security and Supplemental Security Income (SSI) beneficiaries and report suspicion of misuse of benefits by a representative payee. Additionally, webinar participants discussed a scenario involving potential financial exploitation and shared challenges and best practices related to responding to allegations of financial exploitation. New consumer facts sheets regarding the prevention, detection and reporting of financial exploitation in nursing home and assisted living facilities produced by the National Consumer Voice for Quality Long-Term Care (Consumer Voice) for the National Center on Elder Abuse (NCEA) were introduced.

NEW Consumer Voice Fact Sheets

Consumer Factsheets on Financial Exploitation (February 2014)
Developed in part through a grant from the Administration on Aging for the National Center on Elder Abuse (NCEA), these fact sheets discuss the prevention, detection and reporting of financial exploitation in assisted living and nursing homes. There are separate fact sheets for residents of assisted living facilities and nursing homes and their family members. The consumer fact sheets provide an overview of residents’ rights and facility responsibilities related to resident finances, tips for protecting themselves and how to report incidents of financial abuse. The fact sheets for family and friends of residents also review residents’ rights and facility responsibilities, highlight warning signs and how to report incidents of financial exploitation.

Assisted Living Facilities

Nursing Homes

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Tell Your Congressperson to Save State Health Insurance Assistance Programs

June 21, 2016

The Senate Appropriations Committee recently passed a Senate Labor-HHS measure which would eliminate State Health Insurance Assistance Programs (SHIP).  SHIPs provide millions of people with support comparing coverage options, appealing denials, applying for financial assistance and navigating complex Medicare benefits.  The House Labor-HHS Appropriations Committee hasn't finalized their spending plan, but may do so after July 4th.  Take action now to ensure that the House does not follow the Senate's lead and remove SHIPs.  Tell your member of Congres to oppose the Senate Appropriations Committee's SHIP funding recommendation!  Fill out this easy-to-use form from n4a and Medicare Rights Center to help save this vital program.  For more background on SHIPs, click here.

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