Obama administration officials are offering to cut tens of billions of dollars from Medicare and Medicaid in negotiations to reduce the federal budget deficit, but the depth of the cuts depends on whether Republicans are willing to accept any increases in tax revenues.

Administration officials and Republican negotiators say the money can be taken from health care providers like hospitals and nursing homes without directly imposing new costs on needy beneficiaries or radically restructuring either program.

Before the talks led by Vice President Joseph R. Biden Jr.broke off 12 days ago, negotiators said, they had reached substantial agreement on many cuts in the growth of Medicare, which provides care to people 65 and older, and Medicaid, which covers lower-income people. Those proposals are still on the table when Congress reconvenes this week, aides said, and are serious options that Democrats could accept in exchange for Republican concessions that raise revenues.

“Congress smells blood,” said William L. Minnix Jr., the chief lobbyist for nonprofit nursing homes.

For more on the story, go to The New York Times

Pittsburgh Tribune-Review shares the story:

Carol Holland checked her hair in a hand-held mirror, draped a bag of lollipops over the side of her wheelchair and rolled out of her room to begin her daily routine of passing out candy to residents at Heritage Place, a Squirrel Hill nursing home.

“Good morning, dear,” she sang out to Agnes Mondry, who lives in a room on the third floor. “I’ve got a sucker for you. I’ll see you later, honey.”

For 23 years, Holland worked at a nursing home in East Liberty. Although she appears at ease in Heritage Place, a skilled nursing facility that traditionally houses the elderly, she hardly fits in: At age 48, Holland is the youngest resident here.

“I got used to taking care of people. Never thought I’d have to be taken care of,” said Holland, who came to Heritage Place in January after surgery. She is undergoing rehabilitation on her ankle.

In Pennsylvania and across the country, more younger people are ending up in nursing homes.

According to an analysis of statistics compiled by the Centers for Medicare and Medicaid Services, the percentage of under-65 residents in nursing facilities has risen steadily since 2002. That year, 11.7 percent of the nation’s nursing home population was younger than 65. In 2006, the number rose to 13.6 percent, and by the end of 2010 it was 14.9 percent, the statistics show.

Read more from Pittsburgh Tribune-Review

“Northampton County officials know something about wrestling with the multimillion-dollar, emotionally charged issues of a government-run nursing home.

As Erie County government ponders the future of its two nursing homes — known as Pleasant Ridge Manor — the proposed sale of Gracedale, a 725-bed, long-term care facility run by Northampton County, is currently the hottest political issue in eastern Pennsylvania’s Lehigh Valley.”

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During Cindy Cool’s almost daily visits to the nursing home, she would routinely find her Alzheimer’s-suffering father wearing urine-soaked clothes.

The Blue Lake, Calif. resident said it would take upwards of 20 minutes for the apparently short-handed staff of Eureka Healthcare and Rehabilitation to respond and help Cool clean her father. Other patients fared worse, she said.

“A lot of times I walked out of there crying because of the things I saw,” Cool said an interview.

She provided key testimony before a Humboldt County jury last month slammed the owners of her father’s nursing home with a $677 million verdict, sending shock waves through the industry and rekindling calls for tort reform.

The verdict as it stands is already thought to be the largest in the country this year and its ramifications are still being sorted out weeks after the jury surprised even the plantiffs’ lawyers with the size of their verdict. Tort reformers have seized on the verdict as the latest example of litigation abuse.

The company’s stock price has plunged on fears it will have to file bankruptcy. Cool, 58, was part of a class-action lawsuit representing 32,000 patients that blamed the nursing home staff shortage for the misery she encountered — echoing a common complaint across the country that for-profit nursing homes are too concerned with the bottom line.

After Wall Street investment firms went on a nursing home buying spree during the early years of the new century, critics charge that many companies drastically cut payroll expenses to prop up stock prices.

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Along with a growing elderly population, area nursing homes may face challenges in providing quality care as Medicare funding decreases and legislators propose more cuts.

In early October, the federal Centers for Medicare and Medicaid Services adjusted its Medicare rates, cutting approximately $12 billion nationwide over the next ten years.

Proposed Congressional bills could intensify the Medicare cuts by trimming additional funding to skilled nursing facilities over the same time period.

The leading House bill, HR 3200, would cut $2.1 billion to Medicare in Pennsylvania alone, according to a study by the American Health Care Association.

A bill sponsored by the Senate Finance Committee would cut $14 billion to skilled nursing facilities, said U.S. Rep. Glenn Thompson, R-Pa.

Thompson said that will be a major blow to nursing facilities that normally operate with a profit margin between 1 and 3 percent.

“Those operations are lean at this point,” said Thompson, who has spent 28 years in the health care industry.

He added it’s the governments responsibility to serve those who can’t help themselves.

George E. Leonhardt, president and chief executive officer of Bradford Regional Medical Center, said it’s unclear what cuts may or may not occur in health care reform.

“Proposed Medicare cuts to hospitals, skilled-care nursing homes and other health care providers can only be addressed and planned for when they occur,” Leonhardt said.

Read more at the Bradford Era.

A surprising number of frail, elderly Americans in nursing homes are suffering from futile care at the end of their lives, two new federally funded studies reveal.

One found that putting nursing home residents with failing kidneys on dialysis didn’t improve their quality of life and may even push them into further decline. The other showed many with advanced dementia will die within six months and perhaps should have hospice care instead of aggressive treatment.

Medical experts say the new research emphasizes the need for doctors, caregivers and families to consider making the feeble elderly who are near death comfortable rather than treating them as if a cure were possible — more like the palliative care given to terminally ill cancer patients.

“We probably need to be offering a palliative care option to many more patients to make the last days of their lives as comfortable as possible,” said Dr. Mark Zeidel of the Beth Israel Deaconess Medical Center in Boston, who was not involved in the studies.

Palliative care focuses on managing symptoms of a disease and a main goal is to relieve pain at the end of life.

End-of-life care became a divisive issue in the national health care reform debate this summer after one proposal included Medicare reimbursement for doctors who consult with patients on end-of-life counseling. Critics called the counseling “death panels” and a step toward euthanasia. The Obama administration denied those claims, yet has signaled the Medicare benefit will be dropped.

The new studies are published in Thursday’s New England Journal of Medicine.

Find out more at WGAL.

Federal and state governments, as well as private organizations, recognize it costs significantly more to care for someone in a nursing home than it does to pay for the services for someone to remain at home. They also know Pennsylvania’s rapidly graying population makes the current system, which focuses the bulk of resources on nursing-home care, unsustainable.

”If we don’t start to take these steps toward getting more care at home, it’s going to be unaffordable to us as a state,” said Ray Landis, advocacy manager for AARP Pennsylvania.

Pennsylvania’s overall population is expected to grow only modestly in the coming decades, according to projections from the U.S. Census Bureau.

The baby boomers are expected to wallop the state, though, with the number of Pennsylvanians who are 65 or older expected to jump to almost 2.9 million in 2030 from 1.9 million in 2000 — a spike of nearly 50 percent.

The expense of paying for so many people who are retiring and on the cusp of increasingly costly health problems is daunting.

Nursing homes get about 80 percent of the money Pennsylvania spends to help people who are too old or disabled to care for themselves, said Secretary of Aging John Michael Hall. In 2003 nursing homes were getting as much as 92 percent of the funds, with only about 8 percent going to home care and other services.

…

Adult day care programs, at-home care and senior housing complexes are some of the most effective programs for keeping seniors at home while giving them all the care they need, he said.

”We’re not saying to people that nursing homes shouldn’t be an option,” Hall said. ”But our position has been, and the policy we’ve been pursuing is, that it shouldn’t be the only choice.”

Find out more at the Morning Call.

Businesses that launched new products in late 2007 could start their own survivor’s club today, with monthly meetings convened around a mid-sized dining table.

In that elite club, one seat should be reserved for a company which—counter to the economic times—saw its sales more than triple last year.

Vocollect Healthcare Systems is based in Wilkins, about 10 miles east of Pittsburgh. The company’s product is a voice-assisted care device that, to an outsider, looks a lot like the headsets worn by the counter help at fast food restaurants.

But Vocollect’s device, called AccuNurse, is more—a voice-activated portable system that provides nursing home aides with information on their residents as they work while also capturing data to ensure the nursing home gets proper reimbursement.

When it debuted, AccuNurse was sold in two states. Now it is available in 23.

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…AccuNurse has a number of benefits: It helps ensure nursing home residents get proper care at the proper time; it streamlines the work day for aides, who no longer have to keep handwritten records or sit through shift-change meetings; and it makes sure the nursing home captures the full reimbursement.

Read more at the Lebanon Daily News.

PANPHA writes:

“The federal stimulus is more than building roads and repairing bridges – it provides Pennsylvania an unprecedented opportunity to build a strong bridge for senior care that can be used by all for generations to come. We have an opportunity – and obligation – to ensure our seniors have access to the care services they need. While many in Pennsylvania have talked about providing this system, they haven’t invested in it. Now, we can without raising a single extra dollar through taxes. The proper system – which includes care in the home, community, or in a nursing home – will see all care options as equally important.” Investing stimulus dollars into creating such a system will also yield long-term economic benefits to Pennsylvania taxpayers by helping providers rebalance their services to meet the needs of seniors.”

Proper use of the stimulus dollars can help maintain quality of care, which is being stretched to the breaking point. Due to Medicaid rates that have failed to cover the actual cost of care, providers have been slashing budgets for years and in many cases, increasing costs to those who can afford to pay. That means some are seeing their life savings disappear. Meanwhile, dedicated healthcare workers are seeing their salaries and benefits lag as providers try to make ends meet.