Wednesday, April 27, 2011

Now Playing at a Facility Near You

Look at the activity board for almost any nursing and assisted living facility in America today, and most likely, there is a movie being shown in the next week.

Going to the movies is a classic American pastime. Even during recessions and depressions, people are lining up to get a ticket to the next big show.

For those in long term care facilities, the same is still true. Whether timeless classics or the newest blockbusters, movies are a great way to bring residents together and socialize. However, showing a video at a nursing or assisted living facility isn’t as easy as popping in a DVD at home. For more than 20 years, the profession has had to negotiate video licensing fees with the Motion Picture Licensing Corporation (MPLC).

The latest negotiations between AHCA/NCAL and our friend LeadingAge with MPLC helped bring out an agreement allowing nursing and assisted living facilities to be exempt from video licensing fees.

With the last agreement expiring in 2000 and many facilities unsure about whether they needed to pay licensing fees, this is especially helpful in bringing clarity to the issue. It’s certainly a victory for the thousands of facilities that like we said before, show a video to residents almost every week.

While nursing and assisted living facilities are exempt, there are some exceptions within the agreement worth noting:
  • Any senior community or facility which has a closed circuit television system (such as an in-house channel) playing videos must obtain a license. 
  • Communities with independent living units, apartments or other similarly defined living quarters must acquire a license based on the number of independent apartments in the community. 
  • Since many long term care facilities incorporate a number of facets including nursing, assisted living, independent living and continuing care retirement communities, AHCA/NCAL and LeadingAge helped negotiate that member facilities can receive a 10 percent discount on all rates MPLC has applied to their facility.
So break out the popcorn, folks! It’s time to kick back and enjoy a good flick.

Thursday, April 21, 2011

Extra! Extra!

Governor Parkinson chats with reporters April 19, 2011
President & CEO of AHCA/NCAL, Governor Mark Parkinson, is making the news this week after holding a roundtable with some leading health policy reporters in the DC area on Tuesday.

Governor Parkinson kicked off the roundtable by talking about how long term and post-acute care could help be a part of the solution to the growing federal debt and deficit challenge. He offered three areas AHCA/NCAL is focused on and continues to advocate our involvement to policymakers:
  • Site-neutral payments – to focus on more patient-centered care;
  • Accountable Care Organizations (ACOs) – to help move towards an episodic payment system and streamline health care; and
  • Improve quality – take advantage of new technology that can help lower costs. 
The discussion also led towards how the profession feels about possible Medicaid block grants, upcoming cuts to Medicare and certain provisions of health care reform, including the Independent Payment Advisory Board (IPAB).

Check out the stories featuring or including Governor Parkinson following the roundtable:

A Blog post by Governor Parkinson: Keeping the Promise to America's Seniors 
On The Hill's Congress Blog
By Robert Pear, New York Times
By Phil Galewitz, Kaiser Health News
McKnight’s Long Term Care & Assisted Living
By Amy Lotven, Inside Health Policy  
Subscription required 
By Jim Berklan, McKnight’s Long Term Care & Assisted Living

Thursday, April 14, 2011

And They're Off!

President Obama gave his speech on the administration’s new fiscal policies yesterday, following the Republican’s proposed FY 2012 budget announcement last week – marking the beginning of what is sure to be a tumultuous debate.
The president’s plan aims to reduce the deficit by $4 trillion over the next 12 years or less; find a combination of spending cuts and tax reforms; eliminate the Bush tax cuts to the wealthiest Americans; and form a bipartisan, bicameral Congressional team to agree on a legislative framework for comprehensive deficit reduction.
AHCA/NCAL was especially encouraged to hear the president mention “nursing homes” twice in his speech to America, given the enormous task nursing and assisted living facilities face in providing care to our nation’s frail and elderly:
“And so we contribute to programs like Medicare and Social Security, which guarantee us health care and a measure of basic income after a lifetime of hard work; unemployment insurance, which protects us against unexpected job loss; and Medicaid, which provides care for millions of seniors in nursing homes, poor children, those with disabilities.”


“It’s a vision that says up to 50 million Americans have to lose their health insurance in order for us to reduce the deficit. Who are these 50 million Americans? Many are somebody’s grandparents -- may be one of yours -- who wouldn’t be able to afford nursing home care without Medicaid.”
Since we gave you a briefing of how the Republican’s budget related to the long term care profession, we thought we’d give the president the same courtesy. Here are some quick highlights:
  • Strengthening the Independent Payment Advisory Board (IPAB) Seeks to “bend the long-term cost curve” by setting a target for Medicare cost growth per beneficiary to “GDP per capita plus 0.5%” starting in 2018 by bolstering IPAB. The intent is for IPAB to serve as the last line of defense though additional authority, and to improve quality of care and cost reductions without placing additional financial burdens on seniors.
  • Increase Scrutiny of Providers using Higher-risk Banking Arrangements to receive Medicare Payment To prevent fraud and abuse, providers would have to report the use of "sweep accounts" (accounts that automatically transfer funds to separate accounts) for receipt of Medicare payments, so that those accounts could be targeted for enhanced scrutiny.
  • Making Medicaid More Flexible, Efficient, and Accountable The framework uses the Patient Protection and Accountable Care Act as a foundation and seeks to save no less than $100 billion over 10 years, without employing block grants, eliminating the Federal-state partnership, or “reducing health care coverage for seniors in nursing homes, the most economically vulnerable and people with disabilities.” Further goals include better quality of care, additional fraud and abuse protections, as well as enhanced efficiency and accountability measures.
  • Provider Taxes The framework would “clamp down on states’ use of provider taxes to lower their own spending while not providing additional health services through Medicaid”.
As is the case with the President’s FY 2012 Budget, this framework only serves as a recommendation to Congress. Although the House and Senate are certain to consider the President’s recommendations, neither chamber is required to include any of the framework concepts in legislation.
Find out more about President Obama’s fiscal framework through his fact sheet.

Tuesday, April 12, 2011

State Watch: Backing the Buckeyes

April 12, 2011

Vernell Moore, who calls Medicaid "the best insurance in Ohio," fears what
changes may come if Gov. John Kasich overhauls the system.
Photo by Gus Chan, The Plain Dealer.
After Ohio Governor John Kasich recently announced his plan to cut Medicaid services to skilled nursing facilities, our friend and colleague at the Ohio Health Care Association wrote a winning column this weekend detailing how such cuts would damage care to the frail elderly.

Peter Van Runkle, Executive Director of the OHCA, skillfully explains that while Gov. Kasich attempts to allow more seniors to stay at home, instead of turning to nursing care, many elderly require round-the-clock care that only a nursing facility can provide.

“[The governor’s budget] simply drains resources for caring for the sickest of the sick, who need to be in skilled nursing facilities — Ohioans who temporarily or permanently cannot stay at home.”

Van Runkle also points out the significant economic impact Medicaid cuts would have on nursing facilities, with the potential for more than 7,000 job losses across the state. What happens to seniors’ nursing care when these Ohio care givers are let go? The quality of care that these facilities provide is threatened.

“Call lights will not be answered as quickly. Patients will not get medication as soon as they need it. They will not be turned and repositioned as often. Their basic care will be delayed, and significant, measurable quality improvements that Ohio's skilled nursing facilities have achieved will be reversed.”

What’s more, Kasich wants to expand the eligibility for the state’s home and community-based program for long-term care, Passport, but cut the funding.

“The plan calls for cutting monthly per member funding for Passport by $33.4 million in 2012 and $65.4 million in 2013, according to a study by the Cleveland-based Center for Community Solutions.”

States around the country face a real challenge in making their budgets balance, but it shouldn’t be on the backs of our nation’s seniors. Props to our good friends at the Ohio Health Care Association for speaking up for Ohio’s frail elderly and individuals with disabilities who deserve nothing but the utmost care.

Friday, April 8, 2011

Top 5 Stories in Long Term Care

April 8, 2011

In case you missed them, below are the top 5 news articles and/or blog posts in long term care for the week of April 4, 2011:

1) Long-term care facilities added 17,400 jobs in first quarter of 2011

2) Providers hail nursing home eligibility in ACOs

3) Federal departments lay out plans in the event of a government shutdown

4) House Republicans release proposed reforms to Medicare & Medicaid

5) Senate votes to repeal health-care law’s 1099 tax-reporting provision, sending bill to Obama

What did we miss? Share an article or two with us in the comments section.

Thursday, April 7, 2011

House Republicans release proposed reforms to Medicare & Medicaid

April 7, 2011

After months of rumors and speculations, House Republicans unveiled their budget proposal this week, which cuts federal spending by $6.2 trillion over the next 10 years, rewrites the tax code and overhauls major entitlement programs - Medicare and Medicaid.

The plan is led by the chair of the House Budget Committee, Representative Paul Ryan, R-Wisconsin. His proposal makes sweeping changes to Medicare and Medicaid:

“People who retire after 2021 would no longer have access to Medicare, the government-run fee-for-service health-insurance program. Instead, Medicare for them would be converted into a "premium support" system, meaning beneficiaries would choose from an array of private insurance plans, with government helping pay the premium. People 55 and older would not be affected.

“Medicaid would be converted into a block grant for the states. The GOP budget estimates it would save $771 billion on Medicaid over the next 10 years.”[1]

However, as The New York Times points out, the proposal requires subsequent legislation to meet the spending targets put forth by the GOP:

“The budget resolution is not a binding law even if approved by Congress; if adopted, it would direct the relevant Congressional committees to draft spending legislation putting in place its dictates.”

Following the announcement by the House Republicans, AHCA/NCAL President & CEO Governor Mark Parkinson issued the following statement:

“AHCA/NCAL understands the importance of addressing our nation’s growing debt and deficit and appreciates the challenges lawmakers face in reducing both. Still, our first responsibility is to ensure that America’s seniors who rely on Medicaid can continue to receive the long term care they need. 

“A healthy economy means a healthy Medicaid program. Further, we must ensure that the 3.1 million Americans working in long term care facilities today can continue providing for the medically frail elderly and individuals with disabilities. 

“We look forward to working with Chairman Ryan, the committees of jurisdiction and other Congressional leaders in the coming weeks to protect our commitment to the Greatest Generation today, and for generations to come.”

AHCA/NCAL is keeping apprised of the budget process and will continue to keep members in the loop as events unfold.

For excerpts from the GOP FY 2012 budget proposal regarding Medicaid and Medicare, Kaiser Health News has compiled the sections. Or read a summary of the budget plan or the entire proposal (pdf).

Wednesday, April 6, 2011

Start Spreading the News

 April 6, 2011
Courtesy of Roll Call

This morning was probably like any other for DC’ers – hitting the alarm button two, three times; making a hot cup of Joe; turning on your favorite morning cable news show; and scrolling through your daily edition of Roll or CQ. But what’s this? An ad about jobs in long term care?

AHCA/NCAL’s new ad campaign features what we in the profession have known for quite some time – that we are an essential element of our nation’s economy. As Congress begins hashing out budgets and possibly revamping federal health programs, making the Hill aware of this fact is exactly what we aim to do.

Besides the millions of jobs in long term facilities, the 63,000 additional jobs created in 2010, and the tens of billions of dollars in tax revenue by our facilities, long term facilities are also:
  • the 10th largest employer in the nation, 
  • supporting $529 billion in economic activity, and
  • directly contributing to 1.3% of the nation’s GDP.
AHCA/NCAL will be running the ad for the next couple of weeks, including in Politico, and we will continue to push forth the economic benefits of the long term care profession for the inevitable future.

Learn more about the economic impact of long term care facilities throughout the country and in each state.