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Specialized Information for:
Long-Term Care ConsumersFamily MembersAdvocatesCOVID-19
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Specialized Information for:
Long-Term Care ConsumersFamily MembersAdvocatesCOVID-19
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Renaissance Arlington Capital View Hotel
2800 South Potomac Avenue, Arlington, VA 22202
November 4-7, 2015
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Wednesday, November 4 |
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1:00pm – 4:00
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Intensives 1. Managing Challenging Behaviors Without Drugs Presenters: Jonathan Evans, MD; Morris Kaplan, J.D., Gwynedd Square Nursing Center Powerpoint Presentation (Kaplan) 2. Advocacy Strategies and Appeals – Involuntary Discharge from Nursing Homes and Assisted Living Presenters: Eric Carlson, J.D. Justice in Aging; Joshua Casper, J.D., Casper Law, LLC |
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9:00am – 10:30am |
Opening Plenary – Listening Session with CMS – The Survey and Enforcement System: Experiences from the Field Presenters: Toby Edelman, Center for Medicare Advocacy; Mitzi McFatrich, Executive Director, Kansas Advocates for Better Care; Sarah Slocum, Michigan State LTC Ombudsman CMS Officials: Karen Tritz, Director, Division of Nursing Homes in the Survey and Certification Group, Centers for Medicare and Medicaid Services; Evan Shulman |
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Thursday, November 5 |
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11:00am – 12:15 pm |
Workshops
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Combating the Excessive and Illegal Use of Atypical Antipsychotic Drugs in People with Dementia (LEGAL TRACK) Presenters: Iris Gonzalez, Senior Attorney, AARP Foundation Litigation, Kelly Bagby, Senior Attorney, AARP Foundation Litigation; Jonathan Evans, M.D. Powerpoint Presentation (Evans) Powerpoint Presentation (Bagby & Gonzalez) |
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Advocacy Strategies Through Managed Care Presenters: Heather Bruemmer, State LTC Ombudsman, Wisconsin; Gwen Orlowski, J.D. Legal Services of New Jersey |
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Family Advocacy Presenters: Kathy Bradley, My Mother’s Voice; Addie O’Connell, Family Council Member, VA |
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Unlicensed Care Homes and The Dangers to Residents Presenters: Catherine Hawes, Regents Professor Emeritus, Texas A&M, School of Public Health; Douglas Anders, Senior Policy Officer, City of Houston, TX; Dean Lerner, Esq., Health Care Fraud Consultant to USAttorney, Northern District of Iowa; Attorney Consultant, Disability Rights Iowa; former Director, Iowa Department of Inspections and Appeals |
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12:15pm – 2:00pm |
Resident Empowerment Luncheon
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2:15pm – 3:30pm |
Workshops
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Protecting Residents’ Rights from Arbitration (LEGAL TRACK) Presenter: Joseph Musso, Esq. Ashcraft & Gerel, LLC |
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Challenges with Nursing Home Enforcement Presenters: Toby Edelman, Center for Medicare Advocacy; Richard Mollot, Long-Term Care Community Coalition; Pam Walz, Community Legal Services
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The QIO-QIN Network Presenters: Tara Cooke, Outreach Specialist, KEPRO ; Pam Meador |
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Addressing the Care Needs of Younger Residents Presenters: Nancy Overstreet, Brian Capshaw, Yvette Green |
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4:00pm – 5:15pm |
Workshops
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Issues in Assisted Living Litigation (LEGAL TRACK) Presenters: Joshua Casper, J.D., Casper Law LLC; Victoria Nugent, J.D. Cohen Milstein Sellers & Toll Powerpoint Presentation (Casper) Powerpoint Presentation - Legal Theories for Addressing Deceptive and Fraudulent Business Practices |
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Journey to Culture Change Presenters: Nancy Kusmaul, Assistant Professor, Baccalaureate Social Work Program, University of Maryland, Baltimore County; Karen Schoeneman, Owner, Karen Schoeneman Consulting, LLC; Patricia Hagen, Director of Memory Care, Charles E. Smith Life Community, Chairperson, Maryland Culture Change Coalition; Eileen Bennett, Director, Montgomery County (MD) LTC Ombudsman Program |
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Protecting Residents from Financial Exploitation Presenters: Naomi Karp, Senior Policy Analyst, Consumer Financial Protection Bureau; Iris Freeman, Adjunct Professor of Elder Justice and Policy, William Mitchell College of Law. |
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Transcending Tragedy: Promoting the Rights of Residents with Dementia Presenters: Jennifer Carson, Chief Learning Officer, Alzheimer’s Resource Center; Peter Reed |
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Friday, November 6 |
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9:00am – 10:30am |
Plenary – Advocating for Real Reform Through the New Federal HCBS Regulations Presenters: Melissa Harris, Deputy Director, Disabled and Elderly Health Programs Group, Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services; Eric Carlson, Directing Attorney, Justice in Aging; Becky Kurtz, Director, Long-Term Care Ombudsman Program, Administration for Community Living |
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11:00am – 12:30pm |
Workshops
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Consumer Centered End of Life Care: Doing Better in LTC Facilities Presenters: Kimberly Callinan, Chief Program Officer, Compassion and Choices; Brian Lindberg, Executive Director, Consumer Coalition for Quality Health Care; Pamela Edgar, End-of-Life Manager, Compassion and Choices |
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Long-Term Care Ombudsmen and Legal Services: Collaborations in Advocacy Presenters: Alison Hirschel, Michigan Elder Justice Initiative; Pam Walz, Community Legal Services
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Grassroots Advocacy – Successes in the Field Presenters: Mitzi McFatrich, Executive Director, Kansas Advocates for Nursing Home Reform; Patricia Hunter, Washington State LTC Ombudsman; Joseph Rodrigues, California State LTC Ombudsman |
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Advocacy by Numbers: Using Data to Make Your Case Presenters: Louise Ryan, Administration for Community Living; Richard Mollot, Long-Term Care Community Coalition |
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12:30pm – 2:30pm |
Awards Luncheon |
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3:00pm – 4:30pm |
Workshops
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How the New Ombudsman Rule Supports Person-Centered Advocacy Presenter: Becky Kurtz, Director, Office of Long-Term Care Ombudsman Programs, Administration for Community Living; Greg Shelley, Volunteer Coordinator/Staff Ombudsman, Harris County LTC Ombudsman Program; Sara Hunt, Long-Term Care Ombudsman Resource Center PowerPoint Presentation (Kurtz) |
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Barriers to Successful Transitions and What to Do About It Presenters: Jeni Coyne, Consumer Voice; Cynthia Rudder, Long-Term Care Consultant; Dan Timmel, CMS Powerpoint Presentation (Coyne) |
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Achieving Staff Stability Presenters: Barbara Frank, B&F Consulting; Cathie Brady, B&F Consulting |
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Meeting Health Needs in Assisted Living Presenters: Eric Carlson, Justice in Aging; Cindy Eggleston, Registered Nurse, Regional Director of Health & Wellness, Brightview Senior Living |
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7:30pm – 9:00pm |
Friday night at the movies - Alive Inside: The Story of Music & Memory
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Saturday, November 7 |
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8:30am – 10:00am |
Plenary - Palliative Care for Persons Living w Advanced Dementia: Why Comfort Matters Presenters: Tena Alonzo, Director of Education & Research, Beatitudes Campus; Ann Wyatt, Coordinator, Palliative Care Project, Alzheimer’s Association NYC Chapter |
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10:30am – 12:00pm |
Closing Plenary – The Power of Advocacy: How Do We Get Where We’re Going? Panelists: Elma Holder; Barbara Frank; Alice Hedt; Patty Ducayet; Sarah Burger; Moderator: Diane Menio |
We know that higher levels of staffing lead to better care, but the federal government does not require nursing homes to have at least a minimum number of staff on duty. As a result, every day across the country there are nursing home residents who aren’t getting the care they need because there aren’t enough aides and nurses. Understaffing harms nursing home residents and can lead to pressure ulcers (bedsores), infections, malnutrition, dehydration and injuries from falls.
Nursing home resident experiences and more than 100 studies, articles and government documents have identified the important relationship between staffing and quality of care. Even the best nurses and nurse aides can’t deliver quality care if there aren’t enough of them.
The Federal government has found that nursing homes that do not meet a recommended level of 4.1 hours per day of total nursing time per resident may be putting their residents at risk. This is an issue that affects all of us; more than 40% of Americans who reach the age of 65 will spend some time in a nursing home during their remaining years.
Our Nursing Home Staffing Campaign educated the public and policymakers about the need for stronger nursing home staffing laws at both the state and federal levels and advocated for such laws to be passed.
On Tuesday, June 24, 2013, we held a soft launch of our campaign through a virtual kickoff. To view the slides from the presentation, click here.
Supporters for the Better Staffing: the Key to Better Care campaign sent us photos saying “4.1 It CAN Be Done!” We wshared these pictures of support with our network through Twitter, Facebook and this website!
In your community:
Speak to organizations, community groups, service clubs, faith communities – any group - about the need for more staff in nursing homes and about our Staffing Campaign. Use our ready-to-go PowerPoint presentation. Hand out the consumer fact sheet. Distribute postcards, collect signed cards and mail them to us.*
Ask your members of Congress to support increased nursing home staffing.Visit one or more of your members of Congress in their district. Give them the Staffing Issue Brief. If you need guidance and help arranging and conducting this visit, contact the Consumer Voice (info@theconsumervoice.org or 202-332-2275).
Send a letter to the editor to your local newspaper. Use our sample letter.
In facilities:
Talk to as many residents and family members as possible about the Staffing Campaign!
Hand out the consumer fact sheet.
Ask residents and families to sign the postcard to send a message to their members of Congress about the need for more staff – nurses and nurse aides - in nursing homes.
Interview one or more residents using our resident interview materials (see Toolkit below). Everything is outlined for you. It only takes 10 minutes!
Video record or audio tape residents who have specific stories to tell and who are willing to be recorded.
Speak to resident councils and family councils about the Staffing Campaign. Use our ready-to-go PowerPoint presentation. Hand out the consumer fact sheet. Distribute postcards.
Contact Congress:
We've put together the following resources to make your advocacy for more staffing as easy as possible. Click on the links below to access these resources:
Research and Reports
The Need for Higher Minimum Staffing Standards (2016)
This report eviews how nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. The report by Charlene Harrington, John F. Schnelle, Margaret McGregor and Sandra F. Simmons discusses the relationship between nursin ghome quality and staffing and the barriers to staffing reform. Multiple studies have demonstrated a need for higher minimum nurse staffing standards in nursing homes as it is shown to have a positive relationship with nursing home quality. Yet, many barriers prevent the implementation of higher staffing standards like concerns about cost and enforcement and strong nursing home industry political opposition.
Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2005 Through 2010 by Charlene Harrington, Ph.D., et al. The October 2011 edition of this book shows trends in U.S. nursing homes by state for 2005 through 2010. The data are from the federal On-Line Survey and Certification System (OSCAR) reports that are completed at the time of the annual nursing home surveys by state Licensing and Certification programs for the U.S. Centers for Medicare and Medicaid Services. Book sections include: Introduction; Facility Characteristics; Resident Characteristics and Services Provided; Staffing Levels; Facility Deficiencies from State Survey Evaluations; Summary; References; and Technical Notes.
The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes (Abstract) This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a four-year period.To view the full study, you must be a subscriber to the database.
Nursing Home Staffing Guide (second edition 2002) The Consumer Voice for Quality Long-Term Care guide for residents, families, friends, and caregivers
Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes - Report to Congress: Phase II Overview: Background, Study Approach, Findings, and Conclusions This purpose of this report is to complete the Report to Congress that was mandated by Public Law 101-508 which required the Secretary to report to the Congress on the appropriateness of establishing minimum caregiver ratios for Medicare and Medicaid certified nursing homes. A Phase I report of preliminary findings was delivered to Congress in July 2000.
Nurse Staffing Standards Recommended by Consumer Voice: In 1998, Consumer Voice's members approved what are widely known as the Consumer Voice Minimum Staffing Standards for nursing homes.
Consumer Perspective on Quality Care (Executive Summary) This 1985 document is still a seminal study of quality care as defined by the experts -- nursing home residents themselves. It recounts the research, discussions and findings of a Consumer Voice survey of 400 residents in 15 cities and shows their strong endorsement of nurse staffing as the most important component of care.
State Resources, Regulations & Proposed Staffing Legislation
Nursing Home Staffing Standards in State Statutes and Regulations (December 2010) A compilation of nursing care requirements in all states.
Analyses on Outcomes of Increased Nurse Staffing Policies in Florida Nursing Homes: Staffing Levels, Quality and Costs (2002-2007) Section 6 of House Bill (HB) 5003 requires the Agency for Health Care Administration (AHCA) to “study the effects of the minimum nursing home staffing ratios found in s. 400.23(3), Florida Statutes, and the relationship to Medicaid reimbursement and the quality of care provided to residents. The agency shall report its findings to the Governor, the President of the Senate and the Speaker of the House of Representatives by February 1, 2009.” Researchers from the University of South Florida’s Florida Policy Exchange Center on Aging, the University of Florida’s College of Health Professions and Texas A&M contracted with the Agency for Health Care Administration to prepare a preliminary report in March. This final report provides some additional analysis using data on quality measures. Finally, this report builds on research supported by earlier grants from the Commonwealth Fund and the Administration on Aging.
Kansas Legislation Proposed to Increase State Minimum Staffing Standard
Improving the Quality of Care - Increase Nursing Staffing Minimum Hours in Kansas Nursing Facilities (January 2011) Prepared by AARP-Kansas & Kansas Advocates for Better Care
Archived Resources
Consumer Voice Press Release 2/18/02 on Federal Nurse Staffing Ratio Study
Consumer Voice Statement on Proposed Nurse Staffing Quality Measures
Long-Term Care Issues & Resources
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Please click on the links below to find resources to assist family members and loved ones of long-term care consumers in advocating for quality care.
Click the links below for resources for consumers on how to achieve quality long-term care.
You’ve been told to leave…now what?
Resources for ConsumersConsumer Voice submitted comments to the Center for Medicare & Medicaid Services (CMS) in response to their Notice of Proposed Rule Making (NPRM) that included requests for information regarding the implementation of a minimum staffing standard in nursing homes and input on measuring health disparities in resident outcomes. Consumer Voice's comments strongly supported CMS's proposal to implement a minimum staffing standard.
Linking Investors and Nursing Home Quality (LINHQ) Act would bring transparency into nursing home ownership and financial activity by requiring nursing homes and parties with ownership interests to disclose ownership and financial information each year.
Infrastructure Modernization Project Related to the Overall Enhancement of Nursing Homes Act (IMPROVE Nursing Homes Act) would provide funding for resident-centered nursing homes by creating a grant program to convert traditional nursing homes into small-house nursing homes with person-centered cultures.
Essential Caregivers Act would permit designated essential caregivers to enter long-term care facilities to provide care and support during a public health emergency.
The Nursing Home Improvement and Accountability Act of 2021 would increase transparency, accountability, and oversight in nursing homes, improve staffing, and support innovation in the structure and culture of these facilities.
The Elder Justice Reauthorization and Modernization Act of 2021 would increase funding for the long-term care Ombudsman program; provide funding for long-term care workforce development; and provide grants and training for community-based organizations.
The Consumer Voice recognizes the value of a team made up of highly-skilled people from a variety of backgrounds.
If you are interested in interning with the Consumer Voice, please inquire whether we have any open internship positions by emailing kohearn@theconsumervoice.org. If so, send a cover letter and resume to kohearn@theconsumervoice.org. A general description of our offered internship positions and application deadlines are below. Before applying, please read the Consumer Voice internship requirements.
Application Deadlines:
Internship Position:
The Consumer Voice relies on the generous time and expertise that volunteers provide the organization. We encourage and welcome your interest in volunteering with the Consumer Voice!
Volunteers can assist the staff on projects including: marketing and communications, research, fundraising, public policy and administration. To apply, please send us a note explaining your interests and availability, along with a resume, to: info@theconsumervoice.org. **No Calls, please.
Thank you for your interest in the National Consumer Voice for Quality Long-Term Care.
Please contact us at:
Consumer Voice
1025 Connecticut Avenue, NW, Suite 1000
Washington, DC 20036
202.332.2275 (phone)
866.230.9789 (fax)
Media Relations Contacts:
To learn more about the Consumer Voice and its work with long-term care consumers, please contact:
Lori Smetanka, Executive Director
lsmetanka@theconsumervoice.org
Sam Brooks, Director of Public Policy
sbrooks@theconsumervoice.org
Lori. O. Smetanka, Executive Director
Sam Brooks, Director, Public Policy
Amity Overall Laib, Director, National Ombudsman Resource Center,
Jocelyn Bogdan, Senior Program & Policy Specialist
Katie Kohler, Manager, Program & Outreach
Libby Laubert, Program Specialist
Alejandra Ona, Manager, Finance & Operations
Carol Scott, Manager, LTC Ombudsman Program & Policy
Tina Steier, Manager, Communications, Membership & Events
Jamie Freschi, Consultant
Maria Greene, Consultant
To learn more about the Consumer Voice and its work with long-term care consumers, please contact:
Lori Smetanka, Executive Director
lsmetanka@theconsumervoice.org
Robyn Grant, Director of Public Policy and Advocacy
rgrant@theconsumervoice.org
For up-to-date information on Consumer Voice's most recent activities, read the weekly e-newsletter, The Voice.
The National Consumer Voice for Quality Long-Term Care was formed as NCCNHR (National Citizens’ Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice is the outgrowth of work first achieved by advocates working for Ralph Nader and later for the National Gray Panthers. Elma Holder, NCCNHR founder, was working with The Long-Term Care Action Project of the Gray Panthers when she organized a group meeting of advocates from across the country to attend a nursing home industry conference in Washington, DC. At that meeting, representatives of 12 citizen action groups spoke collectively to the industry about the need for serious reform in nursing home conditions.
The consumer attendees were inspired to develop a platform of common concerns and motivated to form a new organization to represent the consumer voice at the national level. Most of the original members had witnessed and endured personal experiences with substandard nursing home conditions.
1975
The National Consumer Voice for Quality Long-Term Care (formerly known as the National Citizens' Coalition for Nursing Home Reform) is formed when various citizen groups and long-term care ombudsman programs, convened by the National Gray Panthers' LTC Action Project, gather in Washington, DC, in June. Prior to attending a conference sponsored by the American Health Care Association, the groups meet to become acquainted and to develop recommendations to present at the conference in a united consumer voice.
The Consumer Voice holds its first press conference, attended by Dr. Arthur Flemming, Commissioner on Aging.
1978
The Consumer Voice issues its first paper, The Plight of the Nurse Aide in America's Nursing Homes. A preliminary report on nursing home costs issues also is released. Both are circulated widely to health-care professionals, state and national organizations, state government agencies and nursing homes.
During the Consumer Voice's second annual meeting, reaction and comments are issued on proposed changes federal nursing home rules. Also that day, Rep. Claude Pepper, chair of the House Select Committee on Aging, addresses Consumer Voice.
The Consumer Voice receives a three-year grant from Volunteers in Service to America (VISTA) to recruit, train and place 40 volunteers in 13 project sites, strengthening local and state member groups toward a stronger national network.
1981
The Consumer Voice Information Clearinghouse expands to include board and care issues. The Clearinghouse thrives thanks to a grant from the Administration on Aging. Today, it receives major support from the AARP.
The Consumer Voice conducts a national survey on Medicaid discrimination, issuing a report on the scope of the problem and avenues for resolution. A Citizens' Action Guide to Reimbursement Issues also is published, introducing consumers to reimbursement principles and strategies for promoting quality through the reimbursement system.
1983
The Consumer Voice issues, with 43 national organizations and individuals, A Consumer Statement of Principles for the Nursing Home Regulatory System, following the 1982 release of proposed federal regulations that threatened to severely weaken nursing home monitoring.
Responding to the Consumer Voice's statement and congressional directives, the Institute of Medicine (IOM) launches a study of nursing home regulations. IOM study committee members invite the Consumer Voice to several briefings and work sessions, and commission two Consumer Voice papers on resident and consumer participation.
1985
The Consumer Voice publishes A Consumer Perspective on Quality Care: The Residents' Point of View. For this seminal report, the Coalition convened small groups of residents in 15 states, who described their vision of quality nursing-home care.
A Consumer Perspective is released during a National Symposium on Quality Care in Clearwater Beach, Florida. Seventeen of the participating residents join researchers, educators, advocates, practitioners and public officials to respond to residents' views and chart ways to achieve quality care.
1986
In response to the IOM report, Improving the Quality of Care in Nursing Homes, Elma Holder launches the Campaign for Quality Care (CBC), bringing together national groups representing various health professions, workers, providers and consumers, to develop consensus positions to recommend to Congress in a forum hosted by Sen. John Heinz. Some 10 years later, CBC continues to meet monthly to find common ground on a range of long-term care issues.
The Consumer Voice begins publishing the Quality Care Advocate.
1987
The Consumer Voice presents the Campaign for Quality Care's views to Congress during a session hosted by Sen. David Pryor, who helped craft landmark nursing home reforms. The Coalition steers a national movement for passage of the 1987 Nursing Home Reform Act, comprised of amendments in the federal budget bill, the Omnibus Reconciliation Act of 1987 (OBRA '87). Congressional sponsors Sen. George Mitchell and Reps. John Dingell, Pete Stark and Henry Waxman hold hearings, where national organizations testify in support of the Campaign's consensus positions.
With bipartisan support, Congress passes the Nursing Home Reform Act on December 22. Elma Holder and Barbara Frank call it "a tremendous victory for residents and for all those groups who worked so hard for so long."
1990
The Consumer Voice helps persuade a federal district court to rule that limited Medicaid-bed certification violates the U.S. Civil Rights Act.
1993
The Administration on Aging (AoA) awards the Consumer Voice a three-year grant to operate the National Long-Term Care Ombudsman Resource Center (NORC).
The Consumer Voice publishes Avoiding Physical Restraint Use, followed by the companion guide, Avoiding Drugs Used as Chemical Restraints.
1995
The Consumer Voice kicks off a campaign to save the Nursing Home Reform Act with a Washington press conference endorsed by Senators William Cohen and David Pryor and Representatives Pete Stark and Henry Waxman. Groups like AARP, the Alzheimer’s Association, the National Committee to Preserve Social Security and Medicare and the Service Employees International Union also commit to the Consumer Voice’s fight.
1996
The Consumer Voice publishes and begins national distribution of new book for consumers, Nursing Homes: Getting Good Care There. Authors are Burger, Hunt, Fraser and Frank.
1999
In conjunction with the Consumer Voice Annual Meeting, Senate Special Committee on Aging holds educational forum on Nursing Home Staffing.
2002
AoA celebrates the 30th Anniversary of the Ombudsman Program. Pilot project started in six states for ombudsman involvement in CMS Nursing Home Quality Initiative.
2003
AoA awards the Consumer Voice another three-year agreement to house NORC.
2005
Residents, family members, citizen advocacy group members, ombudsmen, workers and others speak passionately about the need for quality long-term care at official WHCOA event sponsored by Consumer Voice -- Giving Voice of Quality: A Consumer Dialogue on Facility Based Long-Term Care.
2005
The Consumer Voice celebrates its 30th anniversary by examining the past to build strategies for the future under the theme, “Working Together for Quality Long-Term Care.”
2007
NCCNHR added a tagline to its name becoming NCCNHR: National Consumer Voice for Quality Long-Term Care
The Consumer Voice testifies at May 2, 2007, hearing on OBRA ‘87, addresses enforcement, staffing and the need for transparency.
2009
Former Kansas Long-Term Care Ombudsman Kathy Greenlee sworn in as U.S. Assistant Secretary for Aging.
2010
The Consumer Voice celebrates its 35th anniversary.
NCCNHR: National Consumer Voice for Quality Long-Term Care begins doing business as The National Consumer Voice for Quality Long-Term Care with "Consumer Voice" as its shortened name.
2014
For up-to-date information on Consumer Voice's activities, read the weekly e-newsletter the Consumer Voice Gazette.