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There have been multiple reports about insurance companies and for-profit hospital chains committing massive fraud all across the country.  The fraud is massive, endemic, and widespread.

On December 2, 2012 60 Minutes reported that Health Management Associates, the fourth-largest hospital chain in the country "relentlessly pressured its doctors to admit more and more patients -- regardless of medical need -- in order to increase revenues."

It is estimated that this type of fraud costs the country (taxpayers) $210 billion annually.

As these criminal health care cartels continue to bilk the taxpayers (with the help of bought off politicians of both major political parties), their actions are getting more brazen... As we enter a new era of rampant criminality and wrongdoing by increasingly powerful big business criminal cartels in the country, with little or no consequences, in effect creating an environment where the rich and powerful and well-connected can commit crimes with impunity, their actions become more and more sadistic, and predatory.

For the latest dastardly acts by the criminal health care cartel, check out the article by Bloomberg, "For-Profit Nursing Homes Lead in Overcharging While Care Suffers."

The reports are truly horrific:

At a nursing home in South Carolina owned by Life Care Centers of America Inc., an 80-year-old woman who couldn’t control her head or keep her eyes open was placed in a standing frame for 84 minutes of physical and occupational therapy just two days before she died...
Patients at the homes were left unattended for hours in soiled clothing, denied meals and baths and suffered infections and malnutrition, according to evidence in the class-action trial.
We need to remove the profit motive from health care; we need a single payer healthcare system.  The longer we delay in becoming a civilized country when it comes to health care, the worst it's going to get, with countless people victimized, brutalized, abused, tortured, by the scum-sucking criminal cartel that makes much of the for-profit health care system in this country.

Originally posted to Ray Pensador on Tue Jan 01, 2013 at 10:49 PM PST.

Also republished by KosAbility.

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Comment Preferences

  •  I'm all for single payer, but the horrors (22+ / 0-)

    you cite have occurred within the current single payer system that we have for the elderly -- Medicare. (I know there are glosses on that, but compared to what the rest of us have, it's close to single.) And, without knowing more details, it appears they stem from different problems within the system, one of which is that custodial care in nursing homes is not considered health care at all, and therefore is not covered by Medicare. (I'm setting aside the first part of your diary & 60 Minutes, which address hospitals, not nursing homes, and explicitly fraudulent activity, not just bad incentives.)

    The example of the PT/OT required for a near-death woman (though we don't know if that was clear to the facility) is probably a direct result of Medicare policies. Medicare only pays for a certain number of days in a skilled nursing facility after a qualifying hospital stay, and for most patients those payments end if the patient is not participating in therapy and making meaningful progress. Skip therapy sessions or plateau? Out you go. (Or move to private pay, which amounts to the same thing for most.) The Medicare leash is very short, and it does not matter if the patients are extremely ill, too weak to stand, in pain, or half out of their minds. It only matters that a therapist can check off a number of minutes, activities, and "progress." That's why they evaluate an admitted patient within hours of hospital discharge -- to establish a baseline that is as low as possible, to provide room to improve and thereby keep Medicare paying for the bed. Payment for the therapy is a nice byproduct, but the holy grail is the bed charge.

    That's an entirely different incentive structure from what causes the inadequate care problems (bedsores, malnutrition, etc.) -- those are overwhelmingly due to low reimbursement rates from Medicaid, which pays for some two-thirds of nursing home patients. Profit motives can exacerbate the problems of understaffing and lousy training, but there are some very, very nice for-profit nursing homes: they cater to rich people. So "for-profit" doesn't necessarily mean bad care.

    In short, the nursing home crisis is going to be a Medicaid crisis, not a crisis of single payer vs. other systems, unless we start treating the housing of the relatively healthy but frail & poor elderly as a health care issue -- which no one has planned for in gaming out Medicare budgets.

    All of this may be clear to you, but I find a fair amount of confusion on this site between Medicare and Medicaid and, in my view, an obsessive emphasis on avoiding the slightest change to Medicare while acquiescing to the certain deaths that slashing Medicaid will bring. How's that for a Happy New Year?

    •  VR - great comment (8+ / 0-)

      "let's talk about that"

      by VClib on Wed Jan 02, 2013 at 01:13:53 AM PST

      [ Parent ]

    •  Well, everybody dies. The issue is whether or not (3+ / 0-)
      Recommended by:
      Rogneid, WakeUpNeo, NapaJulie

      the still living are abused.
      It is our misfortune, IMHO, that the obsession with death seems to distract us from the fact that abuse of all kinds gets tolerated with equanimity. Indeed, the practice of human husbandry is about our only expanding industry. Human husbandry comes in a variety of flavors and no age group is exempt. Nor does it have to be industrialized. Humans exploiting their own kind to their detriment is a long-standing practice.
      Establishments of religion do it.
      Educational institutions do it.
      Foster care systems do it.
      Apprentice programs do it.
      High tech medico/surgical treatment does it.
      Elder care providers do it.

      Not per force, but as a matter of convenience. And as a "lesser evil" -- a substitute for outright neglect and deprivation. Getting humans to do one's bidding provides a "high" that is difficult to resist and, for the addictive personality, addicting. Then too, taking the (good) intention for the act makes it possible to excuse much injury.

      We organize governments to deliver services and prevent abuse.

      by hannah on Wed Jan 02, 2013 at 03:05:59 AM PST

      [ Parent ]

      •  Too true I am afraid. (5+ / 0-)

        As I get older and more experienced, I frequently observe that private sector negotiations are oriented more toward one party's dominance of another party, rather than getting to outcomes that meet organization objectives.  

        The less regulation that we have, the more abuse engaged in by the private sector.  

        It gets on my nerves, and you know how I am about my nerves...

        by ciganka on Wed Jan 02, 2013 at 03:59:00 AM PST

        [ Parent ]

    •  All LTC providers always howl and moan about rates (4+ / 0-)

      and yes there are a few "good" for profit providers, but several studies and investigations point to much more egregious fraud, negligence and abuse at private for-profits than at other types of facilities.

      I have seen this first-hand and monitored media coverage about this matter for several years --- and have actually participated in some state and federal investigations related to this --- both with typical ("vanilla") nursing homes or "skilled nursing facilities" (SNF's) and in specialized "medical rehabilitation facilities," some of which charge astronomical daily or monthly rates, for sometimes (criminally) doing nothing "special," at all.

      Astronomical means, for example, $1000 or $2000 per BED per DAY. Those rates can add up to EACH of a facility's beds pulling in $300,000 to $500,000 annually. For this kind of money a patient and payors (we, often, as taxpayers) should obtain at least a safe, clean environment and a great deal of quality specialized "health care," wouldn't you think?

      There really is an astounding number of nursing home owners, group owners and administrators who are driving around in BMW's or Jaguars, flying private planes and sailing expensive yachts while refusing to hire and pay adequate staff to actually "provide" anything resembling quality care --- while often their "patients" suffer --- this does not make a convincing case that these owners and administrators really are trying to "provide" health care, or a safe place to live --- or even decent jobs for staff.  No, too often the true focus is solely on profits, investors, leverage and real estate values.

      Property swaps are a real hot item in the field. I have seen it play out time and time again; one operator (or investor group) buys up and for a number of years carefully "milks" a particular (often "failing") facility, or chain of facilities, for all they can (while neglecting "care" for the sake of profit) and when all the profit and depreciation has been sucked out (and/or they finally get "busted" for consistently providing inferior care) they declare bankruptcy, sell or swap it off, change names and start over. Licenses change hands, and the game proceeds at a new location(s).


      And too often when health and justice authorities do happen to catch and prosecute instances of fraud, abuse, negligence and poor care it is typically the poor line staff (who were commonly just doing what they were told to do by management to keep their jobs) who take the fall.

      The typically top-notch legal teams and pricey "health care consultants" for the owners regularly cut deals with regulators and prosecutors to make sure that everybody "seems" genuinely concerned, while making sure that "somebody" publically pays a price for their sins --- while the people at the top shamelessly keep on keeping on at the same old game, while nonchalantly hob-nobbing with their wealthy cronies, political benefactors and investors (often a very incestuous group).

      Much like Abu Gahraib actually, and unfortunately. Somebody in authority gave orders, and somebody else followed them, as part of just "doing the job" --- but guess who, if anyone, ever pays a substantial penalty?

      Indeed, much of the "long term care" industry is not about providing health care, at all --- but rather it has become about accumulating capital and profit through the uncaring commodification of many "old" people (and younger disabled people, too) as the key to filling "heads in beds" --- often very profitable beds, even at "lousy" reimbursement rates.

      (The REAL money is in the underlying REAL ESTATE --- don't let them fool you.  Just asks the banks, insurance companies and REITS that fund the front game, while operators simultaneously suck in as much of the nation's treasure, be it Medicare or Medicaid, or private insurance, as they can.)

      And be aware that the same types of operators described here are among the very wealthiest and powerful contributors to politicians, parties and lobbying organizations. In fact many prominent politicians (state and federal) have made fortunes actually in the long term care industry, and/or from the business owners and investors who "float their boats" (sometimes literally).

      LTC is very BIG BUSINESS with an enormous amount of waste and fraud endemic to the system; and seldom do we see any serious, lasting response to the kinds of terrible issues noted in the Bloomberg article shared above.

      Finally, and sadly, too often many originally competent, dedicated and genuinely caring professionals and non-professional workers get caught up by the "golden handcuffs" of what can seem to be inflated salaries and other perks and become just another "player" in the overall scheme. It is a shame, and far too common.

      So --- That's my comment on reimbursement rates.

      Mea culpa for carrying on so long --- probably should have written my own diary, and may in the future --- but somebody pressed a truly "hot" button for me.

      Ray Pensador, thank you your thoughtful lead, and especially for sharing the Bloomberg article on nursing home fraud. Another reporter, David Armstrong, has been covering a closely-related issue that you might also find interesting.

      I will not use any more of your space here, and should create a new diary (and hope to find time to do so) --- but here's a link for anyone who might care to see the excellent article, with video:

      Brain-Injured in Nursing Homes Without Care Giffords Had

      •  I obviously didn't spend time at the type of (2+ / 0-)
        Recommended by:
        WakeUpNeo, Villanova Rhodes

        place you're talking about.  Generic rates were more along the lines of $3200 a month, not a day, and $5200 a month for the alzheimer's unit, and that was the priciest of the places I was at.  Most places were close to spotless, with the only one that seemed on the grimy side actually being a hospital-type skilled nursing facility that used an awful lot of nurses who had fairly thick foreign accents.  That was also the place that wanted to tack on a 3-day wait period (and getting paid period) when we had a patient who wanted to check out so she could go home to die, which was ridiculous.

        Didn't see any required 'therapy' either, and the closest anyone came to torture while I was around was when I took their blood pressures - some of the alzheimers patients don't really understand any more, and interpret the pressure from the cuff as unpleasant and possibly dangerous, and require soothing.

        All of the places had been in operation for years, if not decades, and didn't seem to be anything to do with property deals either.

        •  Might that have been fraudulent on their part? (1+ / 0-)
          Recommended by:
          Villanova Rhodes
          Didn't see any required 'therapy' either
          Am sure their "rates" and state, federal and insurance contracts required a certain amount of daily therapy?

          (Probably not your department or responsibility; but I sense you already reached your own conclusion from the way you included that info with your comment?)

          And I'll bet your treatment of your patients was always anything but torture. We don't really know one another, but I've read enough from you to know I'd be pleased to have you as my caregiver.

          Thank you for your response.

          •  Once they get to a certain point (2+ / 0-)
            Recommended by:
            WakeUpNeo, Villanova Rhodes

            you can't really ever tell how much, if anything they understand of what you're trying to do, and I have to say, even I don't like how high the pressure gets on the wrist cuff, but it's still a lot less stressful for most folks than the arm cuff.

            There may have been therapy in some places, but as you might have guessed from the fact that I was there with a hospice nurse, most of these people were not folks who were actually expecting to 'improve'.  They were places in which people were largely 'waiting for God', and being provided a safe environment to do so.

            •  Yes, hospice is a different situation. (2+ / 0-)

              My main complaint is about folks who are generally healthy otherwise but who are too often just, plain and simply, warehoused.

              Sometimes for many years, without the types of therapies (OT, PT, Speech, etc.) that could help them maintain or sometimes even improve function.

              The article I linked above contains a short video about just such an individual, who soon lost his ability to walk after arriving at what is now his "home." It is a shame, and inhumane, and much too common.

              And expensive, no matter what the rate!

      •  Hmm. You seem to think there is something (1+ / 0-)
        Recommended by:

        in your comment with which I would disagree. There isn't. And I wish you would create a whole diary on the subject. It's a recurring need on the site, not just in terms of what policy to pursue but what to do with suddenly ailing parents, etc., although these topics might be better pursued in multiple diaries.

        I was addressing one major point the diarist seemed to be making, not the entire economic structure of the industry. His point seemed to be "nursing home abuse is because we don't have single payer and therefore we need single payer." My point is: there are different kinds of what we call abuse, they do not stem from the same factors, and single payer is no panacea. In fact, Medicare's vaunted "low overhead" has its costs as well.

        As a non-wealthy person, I would always look for nonprofit rather than for-profit care homes because the data are clear overall about where your chances for good care are better. But in the individual case, it simply isn't true, as the diarist implies, that for-profit is necessarily bad and not-for-profit is necessarily good, if only because, as you elucidate, there's plenty of $ to be gained in the non-for-profit biz as well by delivering minimum service & quality for maximum cost, no matter who pays. Don't confuse that with my defending the for-profit structure -- that's a macro question on which I would happily say dump it -- but there are often readers here who are facing the question right now -- where do I put my relative? Perhaps it's because that just happened over the weekend in another diary that it's on my mind.

        Anyway, thanks for your broader insights -- I look forward to your diary.

    •  I knew two business partners who owned (1+ / 0-)
      Recommended by:
      Villanova Rhodes

      several skilled nursing facilities, and they had matching vanity license plates for their luxury cars:

      One's spelled "MEDICARE" and the other, "MEDICAID."

      Gave the impression they liked the money, okay.

      They also had a long record of rulings made against them by the National Labor Relations Board, state and federal health care "surveillance" teams, and the New York State Attorney General --- including an undercover camera sting to document extensive abuse and neglect. And they drew attention from news media across the state.

      But they were treated, pretty much, as "too big to fail" job creators, in favor with certain politicians. Typically, "negotiated settlements" and "plans of correction" followed --- no major penalties.

      I think our problems in long term care have much more to do with greed, than any policy disincentives. If anything, the system now is too lax, and some segment of "providers" get away with murder (sometimes literally) as a result.

      •  Yes, I could always tell which parking space (1+ / 0-)
        Recommended by:

        was for the owner, which for the administrator, and which for the director of nursing (when those were different) by (a) how often & what time the spaces were filled, and (b) what kind of cars parked there. And all three of them were always very pricey. Most of them weren't as Romneyesque to make it clear in a vanity plate, but one was. If you think I was poor-mouthing for these folks, you misread me. And don't get me started on the doc-owned ones that have their hospital discharge planners (allegedly social workers) feeding the pipeline regardless of suitability of placement.


        •  Yes, "feeding the pipeline" sounds familiar, too: (2+ / 0-)
          Recommended by:
          Ray Pensador, Villanova Rhodes

          Check this out:

          Treating of Severe Brain Injuries Is Profitable, but Not for Patients  

          By PETER KERR | The New York Times | March 16, 1992

          ...Ms. Vanderpool also said that New Medico had given "research grants" to trauma and neurosurgery units at several hospitals and that the hospitals gathered information on their brain-injured patients and sent it by computer to the company. At Albany Medical Center, one employee -- a registered nurse whose salary is paid from a New Medico grant -- worked as a "discharge coordinator," and advised families on where to send their relatives for rehabilitation. The state investigator described the arrangement as a conflict of interest.

          Don't mean to "get you going," on docs who do the same; but the play is nothing new, and the gaming certainly continues. "Heads for Beds."

          Well, when I manage to get a diary together on this, you'll have a pretty good idea of where I am coming from. It may be a day or two in coming, given that so much attention right now is centered on multiple other dysfunctions within our government. (Just heard about Cantor calling Gov. Christie last night to tell him the Speaker would not act on Sandy relief funds --- that's one really pissed of Jersey boy. Me, too.)

          Thank you for your thoughtful responses.

  •  Also, dollars are a good measure of relative value (1+ / 0-)
    Recommended by:

    However, because the availability of dollars is irrationally rationed, basing decisions on cost is particularly bad, albeit convenient. Bad decisions based on not having enough money are easier to excuse than admitting that deprivation is the result of negligence and ill-will. Money has come to serve as a convenient "middle man" or instrument, available to be blamed for all sorts of malfeasance. Which is one of the reasons why keeping it scarce is not more strongly resisted. Even though, if there's on thing whose supply is unlimited, it's a figment of our imagination. Dollars, especially now that they are made of electronic bits, need never run out; just like the script we use to record our words, thoughts and other figments of our imagination.

    We organize governments to deliver services and prevent abuse.

    by hannah on Wed Jan 02, 2013 at 03:15:15 AM PST

  •  I spent time in some for-profit nursing homes (7+ / 0-)

    during my hospice rotation.  They varied in quality of care and environment, with some of the best being cash on the barrelhead types, and the worst being ones that had crosses hanging all over the place.  I agree that 'for-profit' is a bad part of the equation for economic reasons, but I don't think it's directly correlated to crappy care or 'torture'.

  •  I'm curious what a move to (2+ / 0-)
    Recommended by:
    WakeUpNeo, Villanova Rhodes

    Single payer would do to mitigate this problem, given that these abuses occurred within the framework of our existing single payer system (Medicare)...

  •  Higher pay for better nursing home workers. (3+ / 0-)

    People who want to keep their job instead of people who hate their job would help a lot.

    Yes the profit should be taken from those who don't actually fetch the water and chop the wood.  But those who do should make a great living.

    At least that's what I think as that's where I'm headed.

    •  The nursing home bosses vs. their own workers (5+ / 0-)

      I agree. The working people at the horrendous Golden Living Center I describe above were uniformly kind and caring but there were so few of them that they couldn't do a good job. Many had limited English and seem to have been paid minimum wage. Typically, one RN - also with limited English - covered nights and weekends. One orderly, a man about 65 himself, also had another job and complained that GLC kept switching his hours. That trick, along with keeping many workers on part time status, made it difficult for workers and patients to form relationships. The food, needless to say, was almost inedible compared to the decent food at the non-profit Burke Center. GLC ran its physical therapy through a separate for-profit subsidiary, Aegis Therapies,  and again, the physical and occupational therapists were good people. One young woman was particularly good with my uncle but confided that she and her equally young colleagues planned to move on to better-paying jobs once they gained some experience at GLC.

      If my soldiers were to begin to think, not one would remain in the ranks. -Frederick the Great

      by Valatius on Wed Jan 02, 2013 at 07:00:39 AM PST

      [ Parent ]

      •  Being a baby boomer, I went through the school (3+ / 0-)
        Recommended by:
        jabney, NapaJulie, Villanova Rhodes

        system and now expect the same thing on this end of my life.

        What to do, maybe like they said in a John Wayne movie, pick the biggest meanest one and spit right in their eye.  That way it would be quick at least.

        Personally I would like to just stay home and know I could do it with a tube of nitrous oxide to ease the pain.  I don't think they sell nitrous oxide on the street and I am not in good with any dentists.  But you never know I still have a few years to score one.

  •  Golden Living Centers (5+ / 0-)

    Our family recently came to know an outfit called Golden Living Centers, a national chain of for-profit nursing homes. My 75 year old uncle, who lives alone 400 miles from me, suffered some fractures in an auto accident and went from the hospital to a GLC, ostensibly for the physical therapy he needed. The place was so understaffed that every shortcut was taken - he was soon bedridden, on oxygen, and then developed pneumonia, the typical downward slope toward death in these hell holes. The nursing home doc told me the pneumonia had been cured but in fact it recurred the day after I left. My uncle ended up back in the hospital after somehow suffering broken ribs and a concussion. (Golden Living never offered any explanation for these injuries and by now my uncle was incoherent) The hospital doc told me he might last a few more days and said he was in dementia.

    Now, three months later, he is alive and well, back at home with no dementia. The difference: good hospital care and the amazingly caring and dedicated staff at the non-profit Burke Rehabilitation. Like Golden Living, Burke was a nursing home offering physical therapy but did not need to skimp on services in order to funnel profits to the owners.

    And my uncle was on Medicare both places.

    If my soldiers were to begin to think, not one would remain in the ranks. -Frederick the Great

    by Valatius on Wed Jan 02, 2013 at 06:31:11 AM PST

  •  It's more than that... (4+ / 0-)

    In my area, there is a nursing home/rehab facility where my mom has been since late 2010 (had various other stays due to bleeding from coumaidn and a broken leg, probably 3-4 in all). Medicare paid only until December 2010, when we were on our own, paying over $10,000 a month out of pocket. Mom had a retirement fund that covered 13 months, that was it. I then had to get her qualified for MASS Health (Romney Care, like Medicaid). That took most of the past year. Of course, during that time we weren't paying. So now I'm looking at a bill that is in the neighborhood of $47,000.
    Further, care at this facility, while adequate, is nowhere near what we could be doing for seniors. Rehab stops once medicare stops paying. So those committed get NO rehab whatsoever. Nothing to keep them moving what little they can, nothing to keep them engaged. There are activities for those who still have all (or most of) their marbles, but no plans for those suffering from dementia.
    The facility my mom is in is run by Kindred. And they have been trying to change from nursing to rehab, which is more lucrative. When my mom needed to stay, I was told to find someplace else as they were no longer taking long term care patients. I looked around, but everything was just as expensive (or more so) and farther away. I later found out that they had no right to tell me I had to find someplace else as they are a licensed as a long term/skilled nursing facility - what they told me is against the law. But I'm sure they told others anyway.
    As they were trying to make the change, I saw new carpeting going in, all new TV's in the rooms; taking the social "Pub" and turning it into a leisure room with Internet access and a flat screen TV, and taking the lounge on the second floor and turning it into a second rehab gym. Of the three wings of patients, two are strictly rehab only. The number of long term patients has dwindled to one wing.
    Finally, another problem with these places is over-medication. This particular facility, on one of my mom's earlier stays in 2009, administered both Risperdal and Seroquel to her. They did it because she was refusing rehab, a little belligerent. But the two drugs? They are anti-psychotic medications. My mother was hardly psychotic. Further, both medications contain a "black box warning" (the most severe of the long list of complications with pharmaceuticals) stating that they should NEVER be given to elderly patients with dementia as they can cause death.  While on the two, my mom had an episode of bradycardia, where her heart beat got dangerously low - 40 beats a minute. She had to be rushed to the hospital for a stay of a few days, then back to rehab. [note: I don't know if it's possible, but I'm going to use this as leverage - I could have sued but didn't].
    The Boston Globe has several articles they've done on the subject of overuse of anti-psychotics, one of which mentions the home my mom is in.
    Finally, if we want our loved ones to be treated well, getting all the care they need, we need to ensure that those workers caring for them are both properly trained and fairly compensated. The facility my mom is in just got a new director (they canned the last one) who looks like a former drill Sargent. While I was there the other day, helping feed my mom her lunch, he was giving another woman a tour. When he opened the fridge in the lunchroom he saw lunches and food that staff had put in there. He took it all out and tossed it in the garbage - plates, bags, utensils and all. I don't know where he thinks they can put stuff. And the fridge is not used for storing medications. I think he's just a rod-up-his-ass, going-to-get-ahead kind of guy. But the staff there is clearly not happy. And that isn't good for patient care.
    I could go on, but think I have so too much already. Just be sure you investigate thoroughly any facility you consider for a loved one. They're not in the care business, they're in the money-making business. That's the bottom line.

    Isn’t it ironic to think that man might determine his own future by something so seemingly trivial as the choice of an insect spray. ~ Rachel Carson, Silent Spring ~

    by MA Liberal on Wed Jan 02, 2013 at 08:33:51 AM PST

    •  Thank you for sharing your story; it is very (4+ / 0-)

      illustrative of how dysfunctional this industry is.  The bottom line is that for-profit health care is an oxymoron.  The profit motive needs to be removed from health care delivery.

    •  IMO, you nailed it with this: (4+ / 0-)
      They're not in the care business, they're in the money-making business. That's the bottom line.
      Might even suggest, "money-sucking" business.

      There are good facilities, but families must be vigilant about what's happening, even at the "good" ones.

      For what we spend at nursing homes, we could support an awful lot of people in their own homes; many studies suggest with better health outcomes, too.

      •  If they could have paid even half of what I paid (1+ / 0-)
        Recommended by:

        the nursing home, per month, I might have been able to keep my mom home. They charge $350/day. I'm sure I could have found enough coverage for each day with that kind of money. But Medicaid (MassHealth in our case) won't pay me for that. But I'd sure rather have my mom here than there.

        Isn’t it ironic to think that man might determine his own future by something so seemingly trivial as the choice of an insect spray. ~ Rachel Carson, Silent Spring ~

        by MA Liberal on Wed Jan 02, 2013 at 10:34:20 PM PST

        [ Parent ]

        •  I hear you loud and clear. (0+ / 0-)

          We have a way to go before we finally overcome the "institutional bias" in  our payment systems that basically forces people into poverty, and nursing homes. It is unfair, and costly. But we've made some inroads in some areas, and the ACA bodes well for additional progress.

          You might appreciate this, from ADAPT:

          ADAPT's End of Year Message

  •  Become an Ombudsman! (2+ / 0-)
    Recommended by:
    WakeUpNeo, Villanova Rhodes

    My husband and I are just finishing our last two classes.  What we have learned, what we are expecting to deal with has been a real eye-opener.  He is a retired FF/Paramedic and promised himself that when he had the time, he'd try to make a difference.  Good old Arnold slashed the ENTIRE budget for support for the program here in Calif.  He saw the word "volunteer" and lined it out with a big fat blue pencil.  Our learning materials are outdated VHS tapes, and we have no way to view them.  Our directors have to make copies at our local copy store. The most shocking fact we have discovered is that skilled nursing facilities are inspected by the state once a year.  Once.  Residential facilities...once every FIVE years.  Sigh.  We're not going in looking for problems, and we can't help a resident without their permission, but anything we can do to make a difference will help us sleep at night.  
    Rule #1. Don't get sick.  Rule #2.  Don't run out of money.  
    It is cheaper to place a person on a cruise ship 365 days a year than to pay for long term care...and that's just not right.

    "I'm Grandma-delicious because his mom is so nutritious..."

    by NapaJulie on Wed Jan 02, 2013 at 10:35:01 AM PST

    •  Inspections once a year, or once every five years (1+ / 0-)
      Recommended by:
      Villanova Rhodes

      and they usually know when to spruce up the grounds and fluff up staffing levels (just before the inspectors get there) --- only to lapse back to status quo when no one is looking...

      I hear your sigh, and raise you a double-sheesh!

      Bless you and your husband for your efforts.

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