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Articles and Publications About Long Term Elder Care

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Articles

A checklist for patients and carers includes ten questions to ensure basic needs are met and people are treated with respect.
Patti's Comment: I can tell you that I honestly did not feel that I was treated with dignity and respect while I was in the hospital. Anyone who is being treated or receiving support or care giving services should be asked these questions.

Making a sound decision about whether to opt for long-term care insurance involves weighing the probabilities. Is it worth it to pay the premiums for many years–and risk premium increases or benefit cutbacks along the way–in exchange for the peace of mind that your nest egg won't be wiped out to pay for your care at the end of your life? What if you never need long-term care, or only need it for a limited time?  

The Centers for Medicare & Medicaid Services (CMS) issued a final rule to make major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in the Medicare and Medicaid programs.

Bedsores: an area of skin breakdown that occurs when sustained pressure cuts off blood circulation – usually in patients confined to their beds in hospitals and nursing homes – a bedsore can result in a wound so deep and painful that some patients require narcotics. If a bedsore becomes infected, the complications can be fatal.

Older adults in nursing homes and long-term care facilities often have multiple health problems. With medical advances in the treatment of diabetes, aging Americans are living longer with the disease. Foot health and amputation prevention programs for geriatric patients with diabetes are crucial to allowing the elderly to remain functional and independent. Patients with healthy feet can continue to walk and exercise. With proper foot care, falls and fractures can often be prevented.
Patti's Comment: I really like this doctor's goals!

In 2011, the largest generation in history – the baby boomers – began turning 65. The U.S. population is also living longer, often with chronic illness and disabling conditions. Given these demographic trends, we can anticipate significant growth in the demand for longterm care.  This fact sheet describes trends that contribute to the growing demand for longterm care among Americans. All the references accessed to produce this fact sheet are provided for further review.

Three stories about how elder law attorneys assisted three families with dealing with their long-term care issues.

All over the world, people are living longer than ever before and posing caregiving challenges that span the globe. We think of this phenomenon as particularly true of wealthy “first world” countries like the United States. But it’s not.

Navigating your way through the individual-care maze and determining how you will pay for eldercare can be daunting.

Ltc insurance is the traditional way of paying for long-term care. But due to the increase in premiums and fears that rates will continue to rise, the insurance industry came up with a new product that attempts to solve the issues of traditional ltc insurance, which is life insurance with ltc rider or hybrid insurance.

Q&A with things to think about when facing this process.

The SCAN Foundation released a policy options document by the Center for Health Care Strategies, Inc. (CHCS) summarizing four options to integrate care for dual eligibles, the nearly 9 million seniors and adults with disabilities who qualify for both Medicare and Medicaid.

The IMPACT Act of 2014 modified the Social Security Act requiring that Skilled Nursing Facilities be required to submit data for public reporting. In response, CMS established the Skilled Nursing Quality Reporting Program (SNF QRP) and authorized the Secretary to report quality measures that relate to care provided by SNFs on a CMS website. The SNF QRP data will be publicly reported on NH Compare.

This is the fourth post in my continuing series on addressing the threat of ruinous long-term care expenses. The first three posts provided an overview of the threat, assessed the risks we face, and summarized the various long-term care services you can choose.

The cost of LTSS and how these services are delivered is going to be an increasingly important question in the years to come. The “big shift” is the move from providing services in institutions to providing services in the community.

Long-term care insurance provides money for care when you're too old or sick to  wash yourself and cook, though few American use it. Many who do have found that some insurance companies are slow to pay up or deny payments completely. 

Contemplating who will care for a family member with an intellectual or developmental disability after the parents die is daunting. Planning wisely—and early—can help.

 

Publications About Long Term Elder Care

In passing the Patient Protections and Affordable Care Act (ACA) in 2010, Congress took arguably its most aggressive action toward rebalancing Medicaid long term services and supports (LTSS) spending in nearly three decades. However, since then, many states under budget pressure have put many Medicaid home and community-based care programs (HCBS) at risk. This new guide offers advocates a primer on the law that impacts Medicaid-funded HCBS. It also explains the different programs states can use to provide HCBS, including those created by the ACA. The guide highlights key resources and tools to use when advocating to expand and preserve Medicaid coverage of crucial LTSS services in individual states.

Nursing homes used to be the only choice for older or disabled persons who needed help caring for themselves. Today there may be the choice to stay in your home or a community setting, but you or a family member may need assistance in doing so.

Every month, the federal Centers for Medicare & Medicaid Services (CMS) identifies nursing homes with an extremely poor record of resident care for inclusion in the Special Focus Facility (SFF) program for enhanced oversight. Though there are thousands of nursing homes with a record of health and dignity violations, due to limited resources, CMS currently caps the SFF program to just 88 facilities nationwide. However, a June 2019 report by U.S. Senators Bob Casey and Pat Toomey found that CMS identifies an additional 2.5 percent of all certified nursing homes (about 400 facilities) as SFF candidates based on their “persistent record of poor care.

Accessing physical therapy and other skilled services can be a challenge for nursing home residents and the families, and advocates who work with them. CMA sued the federal government to fight the practice of denying skilled nursing or therapy care to Medicare beneficiaries because they were identified as not improving and, therefore, ineligible for these services. CMS has issued clarifications to relevant providers of Medicare services.

Are you concerned about taking care of yourself and continuing to live in your own home?  Are you eligible for Medicaid?  This program may let you hire someone to help you with your essential daily activities.

Information on the Institute's latest report, "Retooling for an Aging America: Building the Health Care Workforce."

Services and payment sources as part of the long term care continuum.

Several years ago, Kelly Quardukus and Elder Law of Michigan undertook a project to compile federal and state law and regulations relating to long term care. It was recently reformatted and renamed Federal and State Regulation of Nursing Homes. Note: this is a 946 page pdf document, so may take some time to download.

In January 2010, the Seattle Times began the first comprehensive accounting of adult family homes in Washington State. The six-part series, titled “Seniors for Sale,” reported that “[a]dult family homes in the state are seen as a national model, and in King County alone, they’ve become more plentiful than Starbucks stores. But the explosive growth, fueled by profiteers and a lack of careful state regulation, is leaving thousands of people vulnerable to harm.” By September, the Times reported that it had uncovered at least 236 deaths indicating neglect or abuse.

The 2016 market survey of nursing home, assisted living, adult day services and home care costs.

Ombudsmen advocate for the resident in the facilities, guided by the wishes of the resident.  All services are provided under strict confidentiality.   Ombudsmen cannot share information about the resident or the resident’s concerns without the resident’s permission. The program also aims to improve the long term care system, speaking for passage of laws, regulations and policies benefiting over 100,000 Michigan long term care residents.

How comprehensive care coordination, community connections, and person-directed care can make a difference.

Consumers want to remain in their homes as they age and/or as disability requires them to seek assistance, and they believe increased funding for in-home services and better pay and benefits for direct care workers are necessary to make that possible. These are among the findings of a report released today.

Long-term services and supports (LTSS) refers to the types of assistance provided to people with functional or cognitive limitations to help them perform routine daily activities.

Many states are undergoing or are about to undergo a dizzying array of long-term services and supports (LTSS) transformations.

The Centers for Medicare and Medicaid Services (CMS) published the first ever regulations establishing standards for the settings in which HCBS are provided.

Long-term care services can be provided in a variety of settings including institutional settings, in residential settings, or in one's home or community.  The term "home- and community-based services" refers collectively to those services that are provided outside of institutions. This fact sheet describes the settings where long-term care is provided across the U.S.