Pennsylvania Nursing Home Abuse Lawyer Blog

Earlier this month, the Pennsylvania House and Senate passed House Bill 210, making changes to the state's Family Caregiver Support Program which helps families care for loved ones at home.
The bill which Gov. Corbett signed Dec. 22, is funded exclusively with state lottery dollars and federal monies and increases stipends from $200 to $500 for the Family Caregiver Support Program, which reimburses eligible families for out-of-pocket expenses relating to caring for an older adult at home.
"Making updates to this legislation so that more individuals can get the care they need while remaining in their homes has been a mission of mine for the past decade," said state Rep. Matt Baker, R-Bradford/Tioga. "This program provides financial support, counseling services and training programs for those who are giving care to another individual. As someone who served as a caregiver for a family member, I understand the many challenges caregivers face, which is why the services provided through this program are so important.
Baker said nursing and personal care homes are essential to many senior citizens but they are expensive and most seniors would rather be cared for at home.
The Family Caregiver Program allows families to stay together and care for their loved ones according to state Sen. Kim Ward, R-Westmoreland who sponsored a companion bill, S.B. 638.
There are more than 1.3 million Pennsylvanians caring for elderly parents or other family members at home according to Vicki Hoak, executive director of the Pennsylvania Homecare Association.
According to pahomecare.org, the program, administered by local Area Agencies on Aging, has not been updated since its creation in 1990 and eligibility requirements were so restrictive they led to more than $1 million in state lottery funding going unspent in 2009-2010
Hoak said in a news release passage of this legislation does not require additional state spending, but instead provides local Area Agencies on Aging the flexibility needed to serve more seniors and their families so they can remain in their homes.

Erie County Council accepted a $2.5 million offer from Millcreek Manor for the sale of 88 individual bed licenses as part of plans for a new, combined Pleasant Ridge Manor.

Pennsylvania Department of Health and the Pennsylvania Department of Public Welfare must sign off on the sale.

The bed licenses were sold to raise revenue to combine the 2 Pleasant Ridge facilities into a new 300-bed facility to be called Pleasant Ridge Manor. Plans including closing Pleasant Ridge Manor-East in Millcreek Township and moving its patients to Pleasant Ridge Manor-West in Fairview Township, creating a new, modern facility that could cost more than $60 million.

Millcreek Manor wants the bed licenses because it plans to expand as well, although there is no timetable for that expansion.

As we gather with our families to celebrate the holidays, Anthony Youn, M.D., reminds us in a blog posted this week on CNN.com: thank a nurse this Christmas.

Hospitals are one place that you can guarantee will be open for Christmas because medical care never takes a day off. And as a plastic surgeon in Metro Detroit, Dr. Youn knows that most physicians who work on Christmas make their rounds with patients in morning, so they can spend the rest of the day with their own families. But this is not the case for nurses and other hospital employees who often put in full or extended shifts over the holiday to make sure all patients are cared for.

In his blog, Dr. Youn points out that each Christmas, nurses and hospital support staff juggle their work schedules and sacrifice their time, giving up their own Christmases to accommodate the needs of patients. He offers this suggestion: since hospital food can be iffy and on Christmas day really iffy, try dropping off some food or sending some take-out to the nurses' station at your local hospital.

He adds, "We owe a great debt to the people who serve us and our country - our military, our teachers, police officers, fire fighters, mail carriers and others in civil service. I know that many people give generously to all those who keep us safe, educated and connected. But if you happen to have a little extra time or can space a few extra dollars, consider showing your appreciation to the nurses in your local hospital who are spending their Christmas caring for patients."

We applaud Dr. Youn for remembering nurses and hospital workers this Christmas. We hope you'll keep his suggestion in mind as you visit your loved ones in skilled nursing facilities this holiday season.

Merry Christmas to you from all of us at Michael J. O'Connor & Associates!

A Holiday Visit may be the perfect time to check up on Mom and Dad.
According to AARP, between the eating, drinking and gift-giving, make time to see how elderly relatives are managing.
Even if they say everything is ok, AARP recommends looking into four key areas to see if there is something needed, that maybe the relative doesn't even realize.
1. Look around their home to ensure it meets their needs. Check for loose rugs, clutter or fire hazards. Is the lighting sufficient? Can they manage the stairs? Is there a bathroom on the ground floor and could a room on the first floor be turned into a bedroom if necessary?
2. Monitor their ability to drive. Ride with an older relative and observe their behind the wheel skills. Are their dents in the car or garage? Do they drive to slow or miss traffic signs?
3. Keep up with changes in their health. Ask about new medications and how they make the relative feel when taken. Do they remember to take their medication and if not, would a pill organizer help? Give a reminder that Medicare open enrollment season until December 31 and see if they need to update their coverage.
4. Discuss finances. Although this may be difficult, ask the relative if all financial information is in one place. Check on mail to see if bills are stacking up. Are their late notices? Are they having trouble paying bills?
For more advice on steps you can take, visit www.aarp.org/caregiving.

According to the Pennsylvania Care Planning Council, caregivers often don't realize when they are in over their heads, or at a breaking point.
The PCPC states a typical pattern with an overloaded caregiver may unfold as follows:

> 1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.

>20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.

>38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

The PCPC states it is often at this final stage that help may be needed finding other solutions for care including respite care, hiring home health aides or putting the disabled loved one in a facility.
Without intervention, the caregiver may become a candidate for long term care as well.
During the holidays, caregivers may feel even more stress planning, shopping and participating in holiday activities. The PCPC states this is a perfect time for family and friends to step up and give the gift of respite time and caregiving help.
An article in "Today's Caregiver" states about one in four caregivers of people with dementia, including Alzheimer's disease, provide 40 hours a week or more of care, and would appreciate the gift of cleaning the house, preparing a meal, mowing the lawn, or shoveling the driveway, that allow the caregiver time off to focus on his or her needs. 
Another idea is to hire professionals such as a financial planner, reverse mortgage specialist, or care manager to guide the patient and caregiver through long term care issues.

An article in the PoconoRecord.com, reminds seniors that the deadline for the 2010 Property Tax/Rent Rebate is quickly approaching.

Renters and property owners have until Dec. 31 to apply for a rebate for taxes/rent paid in 2010.

You qualify for this rebate if you owned and occupied your home as your primary residence only, or rented and occupie a home, apartment, nursing home, boarding home, or similar residence in Pennsylvania.

To quality, you must also meet one of the following three categories:

You or your spouse were 65 years or older as of Dec., 31, 2010.

Or you were a widow or widower during all or part of 2010 and were 50 years or older as of Dec. 31, 2010.

Or you were permanently disabled all or part of 2010, and you were 18 years of age or older during 2010, and you were unable to work because of your medically determined physical or mental disability, and your disability is expected to continue indefinitely.

Also, the total eligible annual household income, including the income of your spouse who lives with you, was $15,000 or less in 2010 for renters and $35,000 or less in 2010 for property owners. You may exclude 50 percent of your Social Security benefits and 50 percent of any Railroad Retirement benefits when calculating your total eligible annual household income.

If you have any questions, or would like an application, contact your local Area Agency on Aging. Or, you can print a form at www.revenue.state.pa.us.

According to the University of Pittsburgh's Institute on Aging, an average of 226,000 people are hospitalized annually with flu-related symptoms and the rate is higher for the elderly with 560 hospitalizations per 100,000 people. The highest rate of death from flu related symptoms is in those seniors 85 years old and older.
A study done by the university states vaccination is the still the most effective way to prevent influenza from stiking older adults.
The Centers for Disease Control offers the following suggestions for keeping the flu from having a major impact on long term health care facilities:
Promote and administer seasonal influenza vaccine
Take steps to minimize potential exposures
Monitor and manage ill healthcare personnel
Adhere to standard precautions
Adhere to droplet precautions
Use caution when performing aerosol-generating procedures
Manage visitor access and movement within the facility
Monitor influenza activity
Implement environmental infection control
Implement engineering controls
Train and educate healthcare personnel
Administer antiviral treatment and chemoprophylaxis of patients and healthcare personnel when appropriate
The university study suggestes that multiple sources claim vaccinating health care workers against the flu not only reduces their risk of contracting the flu, but also reduces the mortality rate of nursing home residents, regardless of whether the residents have been vacinated.
The CDC categorizes healthcare workers as all employees, contractors, attending physicians, and volunteers with patient contact including housekeepers, dietary staff, chaplains, hospice workers, and candy stripers.
It is also recommended that visitors alert facility personnel if they have any respiratory symptoms and to take precautions such as wearing masks if symptoms are present or limiting visits until symptoms clear. It is suggested long term care facilities provide masks and/or hand hygiene supplies to visitors during peak flu season.

Skilled nursing facilities can expect another 2 percent cut in Medicare rates beginning January 2013 and this cut comes on the heels of an 11 percent cut to Medicare last month.
The failure of the Super Committee to agree on a way to trim $1.2 trillion from the federal deficit is being blamed for the cut.
According to the Pennsylvania Health Care Association, nursing homes were hit with the almost $200 million cut in October under the new rule by the Centers for Medicare and Medicaid Services. This cut along with other provisions included in the rule could reduce Medicare rates by as much as 18 percent, or $18 million, PHCA said in a recent news release.
Two-thirds of all nursing home residents are on Medicaid. Medicaid payments to Pennsylvania nursing homes fall short of the cost of care and facilities are absorbing an average of $7,000 for each Medicaid resident each year.
The PHCA said a national survey released in November found nursing homes across the country are laying off workers, freezing or reducing wages, changing benefit plans, and delaying renovations because of reduced revenue.

The appointment of Marilyn Tavenner to replace Donald Berwick, M.D. as administrator for the Centers for Medicare & Medicaid (CMS) is getting strong support from nursing home groups, according to an article on McKnights.com.

In the article, Alan G. Rosenbloom, president of the Alliance for Quality Nursing Home Care, said that Tavenner "developed invaluable experience" while working with skilled nursing providers as Virginia's Secretary of Health and Human Resources.

He added, "Marilyn Tavenner is a strong choice to lead CMS because of her reputaion as a smart, competent administrator, and because she has a strong working knowledge of how Medicare and Medicaid funding adequacy are both integral to the ongoing ability of SNFs to provide high quality long-term and post-acute care to U.S. seniors."

Officials with the Obama administration confirmed last week that Tavenner, who served as Berwick's principal deputy at CMS, has been appointed to replace him.