The New York Times reported the investigation into pharmacist’s mistakes and fraud at nursing homes. Pharmacists responsible for reviewing the medication of patients in California nursing homes routinely allowed inappropriate and potentially lethal prescriptions of antipsychotic medications, and failed to correct other potentially dangerous drug irregularities, according to recent state investigations.
In reports obtained by The Bay Citizen, the department found that in 18 of the 32 investigations conducted in California nursing homes between May 2010 and June 2011 — 17 of the 32 were in the Bay Area — pharmacists failed to red-flag cases in which residents were inappropriately prescribed powerful antipsychotic medications like Seroquel, a drug used to treat schizophrenia. Pharmacists also overlooked or approved cases in which medications were prescribed at questionable levels or in unsafe combinations that could put patients at risk of seizures, accidents or even death, according to the public health department.
The state investigations also showed a “probable correlation” between the inadequate review of nursing home patients’ medications by pharmacists and the failure of those nursing homes to pay a fair market rate for the pharmacists’ services. A 1982 anti-kickback law requires nursing homes to pay a fair rate for pharmacy services to discourage consulting pharmacists from endorsing or extending the prescriptions of expensive, and potentially dangerous, drugs. A majority of the nursing homes where the state found patients who were inappropriately prescribed antipsychotic medications were paying below-average fees for pharmacy services. The state anti-kickback law bans nursing homes from accepting below-market rates “from any pharmacist or pharmacy as compensation or inducement for referral of business to any pharmacy.”
“The consultant pharmacists’ review, which is intended to identify unnecessary or potentially inappropriate drugs among nursing home residents, is defective in the state of California,” said Dr. Jonathan Evans, a geriatrician and the vice president of the American Medical Directors Association. He called the problem “widespread.”
A report last year by the United States Department of Health and Human Services Article source: http://feeds.lexblog.com/~r/SouthCarolinaNursingHomeBlog/~3/uHQS_0q7-qE/
In Kentucky a death of a resident in a nursing home resulted in two lawmakers filing bills that would require people to be screened before being admitted to one of the facilities. This is a positive outcome of a bad situation. This type of bill can help protect thousands of residents in the future.
Many nursing homes provide long-term care for people who do not need full-time nursing care but need some assistance. Some patients who reside in nursing homes suffer from mental illness or they are mentally disabled. A man who was schizophrenic, bipolar and diabetic, suddenly went missing from his personal care home and was later found dead near the banks near a river about four weeks later.The week later, the state representative introduced legislation in his memory. If the House bill 307 is approved by the General Assembly it will be known as Larry’s Law and it would require an individual to be examined and assessed by a medical official before they were admitted to a personal care home. It would measure the degree of disability of an individual before being considered for placement. Another state representative filed Senate Bill 115, which would require and evaluation by a qualified mental health professional before someone enters a personal care home. The state would end up paying for the assessments because individual care home could not afford them. This can be a positive step for families who are seeking a nursing home for their loved ones who suffer from mental illnesses. These extra assessments can provide your family with more peace of mind that they are placing their loved one in an environment that can care for them.
Article source: http://feeds.lexblog.com/~r/TheGuardianBlog/~3/qXey0RnsDzI/
Many disabled folk are in need wheelchairs in The United States and simply cannot afford them. It's actually possible to get a wheelchair thru a mixture of coverage by Medicare and Medicaid at no charge to the receiver, it's not guaranteed . A method to get a wheelchair, powerchair or scooter is thru the Medicare / Medicaid insurance plans. The Medicaid Programme : Medicaid is an executive funded health care programme built to aid folks who fall into the low-income class to get sufficient health care by providing supplemental cover to Medicare, the main central authority sponsored insurer. You'll be given a physical address, a telephone number and any links to web sites that are generally available. You may also have accessibility to downloadable application forms. The state will have stern tenets and wants that must definitely be met for an individual to be given consideration for any of the advantages linked with Medicaid.
Medicaid Waiver Programs State Line-Up As of publication, there aren't any decisive lists that outline states with Medicaid waiver programs for controlled living facilities. To sign up for Medicaid online you first ought to get the PDF form that may be downloaded thru your state contact web site. At the very best the governing body ( through the Centres of Medicare and Medicaid Services ) has made an internet list of all Medicaid waiver programs, meaning visitors have to pass some time finding the required info. Though I have released the states that do accept Medicaid waiver programs, certain obstacles could be in place to securing a Medicaid-covered bed in a controlled living facility. I. As usual, determine suitability wants with the Centres for Medicare and Medicaid Services.
It’s only then that Medicaid picks up the bill itself. That ‘spend-down ‘ suggests that your assets will pay for the costs Medicaid spends for you till you are down to $2000. That is due to the fact that Medicaid was meant to provide medicare for the poor. Perhaps! Medicaid forecasts you may do this. So to impede this ‘Medicaid Planning ‘, the govt now demands that all asset transfers be finished five years ( called the ‘look-back ‘ period ) before trying for Medicaid. To try to rule in costs, Congress is working on a bill which will make it harder to be accepted for Medicaid. Anything you transfer in the five year look-back period will penalise you from straight away collecting free Medicaid benefits. The ‘look back ‘ period for the moving of assets will be elongated to five years. States are given more space in reducing what they pay and limiting advantages for certain enrollees. Certain allowances formerly set up to shield assets from Medicaid would now have to name Medicaid as the beneficiary, with the remainder going to Medicaid after death. The goal of this legislation is to keep folks from ‘gaming ‘ the system.
Many residents remain completely unfamiliar with most aspects of New York elder care until the need for skilled long-term treatment is thrust upon them by a loved one’s sudden health decline. For one thing, the high costs of the service catch most community members completely off-guard. Coming up with over $10,000 a month (or more) for this care is simply impossible for most areas families that have not planned ahead of time. On top of that, our New York elder law attorneys know that many are also surprised by the challenge of simply finding a suitable facility in the first place, regardless of the costs.
One peculiar aspect of the process, for example, is that men have a harder time finding a bed in nursing homes than women do. The situation was discussed last week in a post at the New York Times’ “The New Old Age” blog.
It was explained that the problem has to do with nursing home demographics. A 2010 CMS Report noted what most intuitively suspect: two-thirds of all nursing home residents are female. In some specific areas, the rate of female use of these facilities is much higher. As our New York Medicaid lawyers often explain to clients, Medicaid–which pays for most nursing home care–only covers “semiprivate” rooms. These rooms usually house at least two residents with privacy provided, as in a hospital, by a curtain. Only residents of the same gender can live in each room.
That is where the demographic problem comes in.
Men who are seeking to enter these facilities cannot be put into a room where a woman already resides–even if there are open beds. Therefore, the man is forced to wait until there is a bed available in a room with another man. Considering the skewed demographics, there are a lot fewer male rooms, and the wait can last longer than many expect.
The financial demands on these skilled long term care facilities also play a role. For example,
Article source: http://rss.justia.com/~r/NewYorkElderLawAttorneyBlogCom/~3/fUGxMgKuBm0/men-find-it-harder-to-get-a-be.html
ProPublica’s Charles Ornstein and Tracy Weber report that Iowa Republican Sen. Charles Grassley is asking 34 states what steps they are taking to investigate doctors who are prescribing antipsychotics, anti-anxiety drugs and painkillers to Medicaid patients at levels far higher than their peers.
For instance, in his letter to Ohio, Grassley notes, “that the top prescriber of the anti-psychotic Abilify wrote 13,825 prescriptions in 2009 – about 54 prescriptions per weekday. Ohio paid $6.7 million for those prescriptions….The biggest prescriber of another anti-psychotic, Seroquel, wrote 18,890 scripts at a cost of $5.7 million. Grassley wrote the tally would amount to nine prescriptions per hour.” Grassley went on to explain to Ohio officials that he had concerns about the oversight and enforcement of Medicaid abuse in the state and that the numbers presented to him were “quite shocking.”
Grassley has asked state officials to tell him by Feb. 13 what action, if any, “they have taken against top prescribers, whether those doctors are still eligible to bill Medicaid, whether any of the doctors were referred to their state medical boards for investigation, and what systems have been set up to track possibly excessive prescribing, among others.”
“These types of drugs have addictive properties, and the potential for fraud and abuse by prescribers and patients is extremely high,” Grassley wrote in Monday’s letters. “When these drugs are prescribed to Medicaid patients, it is the American people who pay the price for over-prescription, abuse, and fraud.”
Grassley, the senior Republican on the Senate Judiciary Committee, has long argued for greater transparency in health care. The painkillers and mental health drugs Grassley is inquiring about are among the top drivers of Medicaid drug spending.
Ornstein and Weber had previously reported that Florida allowed at least three physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct.
A number of the top-prescribing Medicaid doctors around the country are listed in ProPublica’s Dollars for Docs database of payments
Article source: http://feeds.lexblog.com/~r/SouthCarolinaNursingHomeBlog/~3/xC0MqxPNDBM/
The New York Times reported that the Obama Administration will require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment. Under the new standards, if a company has just one product covered by Medicare or Medicaid, it will have to disclose all its payments to doctors other than its own employees. The federal government will post the payment data on a Web site where it will be available to the public. Companies will be subject to a penalty up to $10,000 for each payment they fail to report. A company that knowingly fails to report payments will be subject to a penalty up to $100,000 for each violation, up to a total of $1 million a year.
Critics and researchers have found evidence that such payments influence doctors’ treatment decisions and contribute to higher costs by encouraging the use of more expensive drugs and medical devices. Consumer advocates agree that disclosures increased the likelihood that doctors would make decisions in the best interests of patients, without regard to the doctors’ financial interests.
Large numbers of doctors receive payments from drug and device companies every year — sometimes into the hundreds of thousands or millions of dollars — in exchange for “providing advice and giving lectures”. The Times has found that doctors who take money from drug makers often practice medicine differently from those who do not and that they are more willing to prescribe drugs in risky and unapproved ways, such as prescribing powerful antipsychotic medicines for children.
Medicare and Medicaid, the programs for older Americans, the disabled and the poor, spend more than $100 billion a year on drugs and devices.
Tags: Advocacy, conflict, devices, docotrs, drugs, interest, of, prescription, regulations, rules, transparency
Article source: http://feeds.lexblog.com/~r/SouthCarolinaNursingHomeBlog/~3/uNF41vLt178/
The Kaiser Health News reported the potential for a shortage of nursing homes for the babyboomers. The first baby boomers hit age 65 last year. By 2030, 20 percent of the U.S. population will be at least 65, up from 13 percent today. In that same period, the number of 85-year-olds will increase more than 50 percent and the number of 100-year-olds nearly triple. But the number of nursing homes dropped almost 9 percent from 2000 to 2009.
However, many babyboomers will stay at home and will be healthy enough to avoid the need for skilled care. Less construction of new nursing homes and the aging baby boom generation may cause full occupancy at many nursing homes.
Several trends are cutting into the number of nursing homes. Many homes were constructed during the 1960s under Lyndon Johnson’s Great Society programs. Often those homes are closed because they are old or, with their long hallways and large, multi-resident rooms, don’t fit what current residents want, says Robert Kramer of the National Investment Center for the Seniors Housing and Care Industry. From 2007 to 2011, the number of under-construction nursing home units (the sections of a facility that provide only nursing care) declined by a third.
Residing at a nursing home is not cheap. The median annual cost of a private U.S. nursing home room rose to $77,745 in 2011; up almost 30 percent from 2005. People without chronic conditions have less costly options;it takes about $43,500 yearly to pay for a home health care aide who doesn’t have specialized medical skills, and $39,000 to live in an assisted living facility that provides help with activities of daily life like cooking, but doesn’t necessarily offer health care services.
If nursing homes continue to be squeezed, they may need to continue to understaff. A November 2011 report by the University of California-San Francisco concluded that poor quality of care is already endemic in many nursing homes, especially the largest for-profit chains where staffing levels have been Article source: http://feeds.lexblog.com/~r/SouthCarolinaNursingHomeBlog/~3/MQ5ybULLYt4/
Oklahoma’s Aden Evening News on Officer.com reported that thousands of pain pills are missing from Calloway Nursing Home. Police have launched an investigation. Between 2,000 and 3,000 Lortab pills were discovered missing during a routine state audit. Why didn’t the nursing home know it was missing the narcotics?
Several employees are suspected of stealing and distributing the drug, but no employees have been arrested.
Article source: http://feeds.lexblog.com/~r/SouthCarolinaNursingHomeBlog/~3/FfQ8fKUelLM/