There is lots of quiet speculation in Washington about the fate of the CLASS Act in the wake of the huge Republican 2010 election day victory. Will CLASS be repealed? Will it be changed in any major way? My best guess is that CLASS--the national voluntary long-term care insurance program passed as part of the 2010 health reform law--will neither be repealed nor fundamentally [...]
After my mother-in-law died suddenly, my wife and I found ourselves caring for my father-in-law. There was so much we didn't know. One area where we were flying blind: We had no idea what financial resources he had, what banks and mutual funds he used, or how to access the funds he needed to pay for his home health aides and, later, assisted living [...]
It is an article of faith among many in the elder and disability advocacy communities that aging in place is always the best alternative for someone who needs personal care. I don't believe it, and I recently heard an important panel discussion that confirmed that view. The panel, sponsored by Washington Grantmakers, was especially interesting because the participants were all supporters of [...]
More than half of long-term care residents in skilled nursing facilities made at least one emergency room visit in 2006. A quarter had two or more. Even more troubling, 38 percent were admitted to the hospital at least once that year, and nearly half were admitted twice or more. In all, one-quarter of all hospitalizations for nursing home residents were potentially preventable. These very [...]
The other day, Josh Wiener, who is one of the nation's experts on long-term care, presented three papers on certified nursing assistants (CNAs) in nursing homes. Josh and his colleagues at the consulting firm RTI International looked at quality of care, immigration, and injuries. And some of what they found may surprise you. The papers are available here (some may require [...]
Medicaid, which funds more long-term care supports and services than any other payer--$115 billion in 2008--is about to crash. Like a head-on train wreck, we can see it coming. The question is: What are we going to do about it? The Kaiser Family Foundation, in an extensive new survey of all 50 state Medicaid programs, tells the grim story. Medicaid is [...]
In an important new study, Lynne P. Snyder and Christopher Baker show the importance of energy assistance for elders living at home. The paper, Affordable Home Energy and Health: Making the Connections, was published by AARP. It is another example of why it is not enough for states to provide Medicaid waiver programs to help people receive long-term care at home. Without additional [...]
Among the great challenges we all face as we age is where to live. We may be a bit too frail to stay in our suburban colonial, but are not nearly ready for assisted living, to say nothing of a nursing home. We could move to a traditional large retirement community such as a Leisure World, but that would mean moving to a [...]
Instead of admitting patients, hospitals are increasingly keeping them under "observation status." This decision results in lower Medicare payments to the hospitals and more out-of- pocket costs for patients. But it also means that Medicare is no longer paying for some admissions to nursing homes, and is instead shifting those expenses to residents and their families. What's going on? It is complicated. But here is [...]
I spent yesterday with more than a hundred elder care professionals at the Seven Acres senior care campus in Houston. For a while they listened to me, but for much of the time I had the opportunity to listen to them. And what I heard was striking, and an important addition to the HSC Foundation's recently published study based on listening to family caregivers. We [...]