Saturday, November 21, 2009

Senate Bill, Long Term Care & PEU's

The Senate health reform bill has provisions related to long term care. Language includes:

Despite the Pepper Commission and Olmstead decision, the long-term care provided to our Nation‘s elderly and disabled has not improved. In fact, for many, it has gotten far worse.

The big change in long term care the last few decades? Private equity underwriters (PEU's) buying nursing homes. Congress approved The Carlyle Group's purchase of ManorCare in December 2007, despite concerns about PEU profits over quality. Carlyle had a clear track record of failure to LifeCare "long term acute care" (LTAC) hospital patients in a time of crisis.

Yet, Congress wants to do more than approve deals involving characters with questionable track records.:

SENSE OF THE SENATE.—It is the sense of the Senate that— (1) during the 111th session of Congress, Congress should address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals the care they need; and (2) long term services and supports should be made available in the community in addition to in institutions.

How else might the Senate help long term care? It will allow physician assistants (PA's) to order post hospital extended care services. Will this allow LTAC PA's, a lower cost provider, the same privilege?

The bill has $10 million for long term care worker training. It provides another $10 million for geriatric career education to "foster greater interest among a variety of health professionals in entering the field of geriatrics, long-term care, and chronic care management."

It refers to the Five Star rating system for nursing homes, but specifies a demonstration project for nursing home chains. Will this give large corporations, like ManorCare, a leg up on adjusting to the standards?

The bill supplies $160 million for required LTC worker background check programs, including fingerprinting of employees. How many background checks does ManorCare and LifeCare perform annually? How big are their savings with the feds footing the bill?

Few talk about these long term care provisions in health reform. Corporafornication likes back room deals. On that, the Reds & Blues are bipartisan.