CARING FOR A SICK OR DISABLED RELATIVE ON FRIEND?
The Adult Fan=mily Care Porgram pays family members and friends to provide are at home.
Receive up to $18,000 per year to provide care that prevents or delays Instituional care.
Sick or disabled individual must be 18 years or older and eliglbe for MaasHealth
CARING CHOICES
www.eldercare.org
CALL THE AGING INFORMATION CENTER AND ASK ABOUT ADULT FAMILY CARE
617-628-2601 EXT 3151
Saturday, July 10, 2010
Friday, April 23, 2010
Village to Village Network
Connect here with Villages that are sprouting up
in communities across the country. Because…together
we have the power and means to design our own futures
and keep control of our own lives.
The Village to Village (VtV) Network is a national peer
to peer network to help communities establish and
continuously improve management of their own Villages
whether in large metropolitan areas, rural towns, or
suburban settings alike.
The mission of the VtV Network is to enable communities
to establish, and effectively manage, aging in community
organizations initiated and inspired by their members.
in communities across the country. Because…together
we have the power and means to design our own futures
and keep control of our own lives.
The Village to Village (VtV) Network is a national peer
to peer network to help communities establish and
continuously improve management of their own Villages
whether in large metropolitan areas, rural towns, or
suburban settings alike.
The mission of the VtV Network is to enable communities
to establish, and effectively manage, aging in community
organizations initiated and inspired by their members.
Monday, April 5, 2010
CLASS ACT INFORMATION
--------------------------------------------------------------------------------
Article published Apr 3, 2010
New health care law has benefits for seniors
A clear goal of the new health care reform law: increased access to home-based care.
Last month's health care law contained some benefits for the nation's older population. It provided long-term care options to allow more seniors to stay in their current homes rather than seek institutionalized care, and called for more publicly available information about nursing homes.
Most seniors prefer to stay where they are than move into assisted living or a nursing home. AARP surveys show that roughly nine out of 10 senior adults prefer to "age in place." But, in many cases, health issues force a senior to seek out a facility where they receive individualized, round-the-clock care.
Parts of the new law help seniors and their families navigate such difficult situations.
The most high-profile provision related to long-term care in the new law is the Community Living Assistance Services and Supports act, or CLASS. It will allow adults with mobility problems to receive home care through a voluntary insurance plan. A handful of other programs will improve access to home and community-based services to complement CLASS, including one that provides matching federal dollars to states that expand their home care services.
And, the legislation requires that nursing homes report important information like staffing data, so families can make informed decisions about where to place their loved ones.
"The key thing to realize is the health care reform bill actually has probably a couple of dozen opportunities, all told, to think differently about aging successfully," said Dr. Bruce Chernof, president of The SCAN Foundation, a nonprofit proponent of long-term care for seniors funded by SCAN Health Plan, a Medicare Advantage plan.
The number of Americans over 65 will mushroom in the coming decade, as roughly 75 million Baby Boomers reach retirement age. Their long-term health care needs will strain the nation's collective wallet, stretching thin programs like Medicaid and Medicare.
AARP reports that it costs as much in Medicaid dollars to care for one person in a nursing home than it costs to care for three older adults and people with disabilities in home and community-based settings.
Meanwhile, more than 10 million Americans are currently in need of long-term services that help them function in their daily life, and that number is expected to rise to nearly 15 million by 2020, according to the National Council on Aging.
Enter the CLASS voluntary insurance program.
Under CLASS, working adults who need daily assistance would have at least $50 per day to pay for home care — more if the adult has a higher level of impairment. After five years of paying into the program, recipients could use the money to pay for a home health-care aide.
CLASS funds also can be used to pay for adult day care, transportation, and safety features like grab bars and handrails. They also can be used to help pay for assisted-living facilities and nursing homes.
Seniors who enroll in CLASS will have a better chance to remain independent and active in their communities. That provision also helps their caregivers, who in many cases are adult children who may feel they are spending too much time and money looking after their parents.
CLASS includes protections ensuring the program will be solvent for 75 years, and could result in Medicaid savings in the long haul.
Another benefit to seniors is a collection of programs that improve access to Medicaid's home- and community-based services but which aren't a voluntary insurance plan like CLASS.
For example, the Community First Choice program creates a state-based plan to keep people with disabilities who require an institutional level of care out of nursing homes by providing them with home-based attendant services. States will receive federal matching funds if they adopt this program.
Another program increases funding for Aging and Disability Resource Centers, which offer information and counseling about the various long-term health-care options available to seniors. And, another provision protects spouses from being forced to spend all the couple's assets to get access to home- and community-based care, similar to benefits already in place for nursing home residents covered under Medicaid.
These programs are meant to keep the senior at home. For those who have no alternative but to move into a nursing home, there's something for them, too.
Nursing homes will be required to submit ownership information, staffing data and other items to increase transparency and accountability. People will be able to search the Nursing Home Compare Web site (found at www.medicare.gov) and find information on quality of care, consumer rights, staffing and other issues to help them choose a nursing home.
The Obama administration's reform effort is not the definitive answer to seniors' health care needs. Just call it an important first step in providing long-term, home-based health care for America's older adults.
--------------------------------------------------------------------------------
Article published Apr 3, 2010
New health care law has benefits for seniors
A clear goal of the new health care reform law: increased access to home-based care.
Last month's health care law contained some benefits for the nation's older population. It provided long-term care options to allow more seniors to stay in their current homes rather than seek institutionalized care, and called for more publicly available information about nursing homes.
Most seniors prefer to stay where they are than move into assisted living or a nursing home. AARP surveys show that roughly nine out of 10 senior adults prefer to "age in place." But, in many cases, health issues force a senior to seek out a facility where they receive individualized, round-the-clock care.
Parts of the new law help seniors and their families navigate such difficult situations.
The most high-profile provision related to long-term care in the new law is the Community Living Assistance Services and Supports act, or CLASS. It will allow adults with mobility problems to receive home care through a voluntary insurance plan. A handful of other programs will improve access to home and community-based services to complement CLASS, including one that provides matching federal dollars to states that expand their home care services.
And, the legislation requires that nursing homes report important information like staffing data, so families can make informed decisions about where to place their loved ones.
"The key thing to realize is the health care reform bill actually has probably a couple of dozen opportunities, all told, to think differently about aging successfully," said Dr. Bruce Chernof, president of The SCAN Foundation, a nonprofit proponent of long-term care for seniors funded by SCAN Health Plan, a Medicare Advantage plan.
The number of Americans over 65 will mushroom in the coming decade, as roughly 75 million Baby Boomers reach retirement age. Their long-term health care needs will strain the nation's collective wallet, stretching thin programs like Medicaid and Medicare.
AARP reports that it costs as much in Medicaid dollars to care for one person in a nursing home than it costs to care for three older adults and people with disabilities in home and community-based settings.
Meanwhile, more than 10 million Americans are currently in need of long-term services that help them function in their daily life, and that number is expected to rise to nearly 15 million by 2020, according to the National Council on Aging.
Enter the CLASS voluntary insurance program.
Under CLASS, working adults who need daily assistance would have at least $50 per day to pay for home care — more if the adult has a higher level of impairment. After five years of paying into the program, recipients could use the money to pay for a home health-care aide.
CLASS funds also can be used to pay for adult day care, transportation, and safety features like grab bars and handrails. They also can be used to help pay for assisted-living facilities and nursing homes.
Seniors who enroll in CLASS will have a better chance to remain independent and active in their communities. That provision also helps their caregivers, who in many cases are adult children who may feel they are spending too much time and money looking after their parents.
CLASS includes protections ensuring the program will be solvent for 75 years, and could result in Medicaid savings in the long haul.
Another benefit to seniors is a collection of programs that improve access to Medicaid's home- and community-based services but which aren't a voluntary insurance plan like CLASS.
For example, the Community First Choice program creates a state-based plan to keep people with disabilities who require an institutional level of care out of nursing homes by providing them with home-based attendant services. States will receive federal matching funds if they adopt this program.
Another program increases funding for Aging and Disability Resource Centers, which offer information and counseling about the various long-term health-care options available to seniors. And, another provision protects spouses from being forced to spend all the couple's assets to get access to home- and community-based care, similar to benefits already in place for nursing home residents covered under Medicaid.
These programs are meant to keep the senior at home. For those who have no alternative but to move into a nursing home, there's something for them, too.
Nursing homes will be required to submit ownership information, staffing data and other items to increase transparency and accountability. People will be able to search the Nursing Home Compare Web site (found at www.medicare.gov) and find information on quality of care, consumer rights, staffing and other issues to help them choose a nursing home.
The Obama administration's reform effort is not the definitive answer to seniors' health care needs. Just call it an important first step in providing long-term, home-based health care for America's older adults.
--------------------------------------------------------------------------------
Wednesday, March 31, 2010
Support for Caregivers in Health Care Reform
Support for Caregivers in Health Care Reform
Posted by Terrell McSweeny on March 29, 2010 at 11:12 AM EDT
As frequent readers of this blog know, the Middle Class Task Force developed a new Caregiver Initiative in the FY 2011 Budget to address the needs of the estimated 65 million Americans that provide unpaid care to seniors or people with disabilities. The historic health care legislation signed by the President last Tuesday will complement and enhance the Task Force’s Initiative. Let’s take a quick look at the ways in which health reform will help family caregivers and their loved ones.
First, the health reform legislation includes a provision called the CLASS Act, which establishes a new, voluntary long-term care insurance program for workers aimed at allowing them in the event of a disability to assist them in accomplishing life’s daily activities. After a 5-year vesting period, participants who experience a functional limitation would receive a cash benefit that could be used to purchase services and supports needed to maintain their independence at home or in the community including things like home modifications, assistive technology, accessible transportation, homemaker services, personal assistance services, home care aides, and nursing support. CLASS Act benefits can be used to compensate family caregivers, who often make huge financial sacrifices. And receiving benefits from this program would not have any effect on eligibility for other government programs.
Health reform will also provide much-needed support to Medicaid enrollees seeking home and community based services. Right now, there is a bias in the Medicaid program in favor of institutional rather than home and community-based care. Under the Community First Choice Option in the health reform legislation, States can elect to provide with enhanced Federal funding self-directed, home and community-based attendant services and supports to Medicaid beneficiaries. Additionally, the law provides additional funding for the Money Follows the Person program, which provides grants to states to help transition Medicaid-enrolled nursing home residents back into their communities.
The health reform legislation also creates a new Medicare pilot program aimed at helping patients and caregivers successfully negotiate the transition from a hospital stay to their homes or other care settings. And it provides new funding for Aging and Disability Resource Centers, which provide information and assistance to caregivers and people with long-term care needs.
Finally, the legislation establishes a nationwide system for States to run background check programs for employees of long-term care facilities and providers. This proposal builds on a successful pilot program, which operated in seven states and kept thousands of individuals who had disqualifying records out of the long-term care workforce. This new national system will give family members peace of mind by ensuring that all employees with direct access to patients have been screened.
As we have said on this blog before, the Middle Class Task Force’s Caregiver Initiative is just one modest step towards addressing the needs of caregivers. Health care reform marks another important step forward.
Terrell McSweeny is Domestic Policy Advisor to the Vice President
Posted by Terrell McSweeny on March 29, 2010 at 11:12 AM EDT
As frequent readers of this blog know, the Middle Class Task Force developed a new Caregiver Initiative in the FY 2011 Budget to address the needs of the estimated 65 million Americans that provide unpaid care to seniors or people with disabilities. The historic health care legislation signed by the President last Tuesday will complement and enhance the Task Force’s Initiative. Let’s take a quick look at the ways in which health reform will help family caregivers and their loved ones.
First, the health reform legislation includes a provision called the CLASS Act, which establishes a new, voluntary long-term care insurance program for workers aimed at allowing them in the event of a disability to assist them in accomplishing life’s daily activities. After a 5-year vesting period, participants who experience a functional limitation would receive a cash benefit that could be used to purchase services and supports needed to maintain their independence at home or in the community including things like home modifications, assistive technology, accessible transportation, homemaker services, personal assistance services, home care aides, and nursing support. CLASS Act benefits can be used to compensate family caregivers, who often make huge financial sacrifices. And receiving benefits from this program would not have any effect on eligibility for other government programs.
Health reform will also provide much-needed support to Medicaid enrollees seeking home and community based services. Right now, there is a bias in the Medicaid program in favor of institutional rather than home and community-based care. Under the Community First Choice Option in the health reform legislation, States can elect to provide with enhanced Federal funding self-directed, home and community-based attendant services and supports to Medicaid beneficiaries. Additionally, the law provides additional funding for the Money Follows the Person program, which provides grants to states to help transition Medicaid-enrolled nursing home residents back into their communities.
The health reform legislation also creates a new Medicare pilot program aimed at helping patients and caregivers successfully negotiate the transition from a hospital stay to their homes or other care settings. And it provides new funding for Aging and Disability Resource Centers, which provide information and assistance to caregivers and people with long-term care needs.
Finally, the legislation establishes a nationwide system for States to run background check programs for employees of long-term care facilities and providers. This proposal builds on a successful pilot program, which operated in seven states and kept thousands of individuals who had disqualifying records out of the long-term care workforce. This new national system will give family members peace of mind by ensuring that all employees with direct access to patients have been screened.
As we have said on this blog before, the Middle Class Task Force’s Caregiver Initiative is just one modest step towards addressing the needs of caregivers. Health care reform marks another important step forward.
Terrell McSweeny is Domestic Policy Advisor to the Vice President
Sunday, March 28, 2010
Nursing home comments
The Bay State nursing
home population is about 45,000.
The Herald’s findings come at a
time when the number of residents
in such homes is expected to
surge as baby boomers age
into their 80s.
Buzz up!Nearly 40 percent
of the state’s 437 nursing
homes received below-average
scores during their most recent
inspections due to a troubling
catalog of lapses and abuses
that are putting vulnerable
seniors at serious risk,
a Herald review has found.
Some of the care at nursing
homes in this state is a
disgrace. Big corporations
like Kindred have bought
up many nursing homes and
now put out terrible care.
In Massachusetts a hospital
or nursing home can only
be sued for only $20,000.00
under state law. No lawyer
today could afford to take
such a case. The hospitals
and nursing homes know this.
The Archdiocese of Boston's
Massachusetts Catholic
Conference lobbies heavily
on Beacon Hill to stop any
reforms in this law.
They are against holding
these so called non-profits
accountable because they
want to protect their assets
and properties from all
the sordid law suits.
Patients rights suffer
as a result. Our Attorney
General Coakley has one
of the worst records in
the nation for addressing
hospital or nursing home
abuses. Thank you Boston
Herald for writing this article.
Posted 11 hours ago Reply
Link Abusive
Dissociate ? +3 0
There needs to be more
elderly day cares.
Better to have elderly
parents taken care of
during the work hours
and later picked and
brought home to the family
rather than have them wither
away inside some nursing
home of horrids.
Posted 11 hours ago
Reply Link Abusive
GameChanger replying to
eastie ? +2 -2
And yet people push for
more tort reform as an
answer to everything.
Not understanding they
will not suddenly find
a conscience and began
to have a soul and suddenly
put patients ahead of profit.
It is just another way for
them to downsize care at
the expense of patients
and not be held accountable!
Posted 11 hours ago Reply
Link Abusive
gemini612 ? +3 0
How disgusting is this
nursing home situation
and getting worse.
I spent 15 days in a
nursing home rehab and
it was just awful.
Every day I wanted to go home,
the food was gross, and if
you were not ready when
they came around for you
to shower they just left
you until the next day,
disgusting, but when it
comes to being paid they
are all over you, money
talks with this group PERIOD.
Imagine Obamacare in
this state with the
one party rule facilitating
this mess. What a scary thought!
So much for the golden years!
Posted 10 hours ago Reply
Link Abusive
enoughBS ? +2 0
My daddy was in a nursing home
for under 3 weeks & died
They had no clue how to
take care of him but
told us they did & we
believed them.....
My mom, myself & my bro
were taking care of him
@ home for 9 years after
his brain aneurysm left
him totally disabled, up
until my mom had to go in
for a total hip replacement.
So my daddy went from home
to a nursing "facility".
His Dr. was from the
NE Siani Hospital in
Stoughton & we begged
them to take him in for
3-4 weeks till'
my mom was able to be
home & function after
the operation & his
Dr. fought it & told us
he couldn't take him.
We went to some place
on 138 in Canton I can't
remember the name.
The guy told us they
could take care of him
in his current condition,
well, they couldn't
he died there within 3 weeks.
All we needed was help
for 3-4 weeks & they killed him.
They couldn't take care
of him in his current
condition & they knew
it but took him anyway
to BILL MEDICARE.
The first week he was
there I went in town
to see my mom & my bro
went to see my daddy,
he was dehydrated &
had bruises on his hands.
He had respiratory issues
also & they had NO clue as
to address them. If you can
NEVER put a loved one in a
facility if you can take
care of them at home.
It may be inconvenient
but too bad their family
& if you want them to live
as long as they may
YOU are their only safeguard.
God bless........
“The average score is
just the average score.
People shouldn’t give
it more weight than it has.
” Hartstein said.
“Just because (a home)
is below the average
score doesn’t necessarily
mean they are not a good
nursing home.”
ARE YOU KIDDING ME??
Now there are many good
nursing homes so this
shouldn't besmirch them all.
..but what bothers me is
the attitude of the Mass.
government oversight.
Laissez faire? Is that
appropriate?
P
I think Mr. Riley would
have been more bothered
if he had to provide
the care for his mother
in hos own home at his
own expense.
I did not realize taxpayers
owed each citizen the 24 hour
care necessary for the last
5 to 10 years of their life
to assure they die
peacefully in their sleep.
An unfortunate reality is
that if you take a walk
through a nursing home,
a majority of staff are
less than competent,
lazy, etc. The good staff
are becoming far and few between.
My comments are based upon the
fact I have relatives who's
career requires them to visit
patients in nursing home
settings and the stories
they tell me about how the
staff responds when asked
to do something for a patient,
either demonstrate an
unwillingness or refuse.
And when it comes time for
the staff to take their breaks,
they'll take their breaks,
leaving you to assist a
200lb patient with ambulatory
issues by yourself.
The truth (and no I'm not
being racial) is that a
good majority of the staff
who demonstrate this lazy
work ethic are the non-Caucasians.
My mother was in a nursing
home for over two years.
One day, she called me at
my job and asked if I was
going to visit her that
night, then she started
crying. She explained that
"a man had come into her
room last night". This was
the first time I had heard
about it. After many calls
to the nursing home
supervisors/nursing
directors and after
a couple of screaming
sessions, I found out
that a man with dementia
came into my mother's room,
and sat on the bed with her.
(She was immobile.)
It took 20 minutes
to get help into the room.
Two CNA's came in, but
had difficulty removing
the man.
Finally, the nursing
supervisor (who had
20 years of experience)
came into the room to
get things in order.
My mother was so scared,
it took 45 minutes to calm her down.
At NO TIME did the nursing
supervisor believe that this
was a serious incident,
so no notes were made,
and no phone calls were
made to our family.
Instead of being fired,
this supervisor was
given an "in service" day.
BUT, if I was ever late with
a payment, I would hear about
it the next day! Sometimes,
I think people who work in
nursing homes shouldn't be
there because they have no
common sense and no feelings
for what goes through
the mind of the resident's family.
i don\'t know your point because
you made no point. in fact,
I am in favor of both
government regulation
AND privatization. Govt.
needs to overee this
entities and post as
much info about them
as possible on line and
in other ways, so the
public can see that info.
private companies need
to figure out a model
that makes this system
work efficiently.
If the govt. wants
to run nursing homes,
it needs to prove that
it can do so capably.
There is no \"pro\" and
\"con\" thing here.
It should all be \"pro\"
better care.
Posted 3 hours ago
Why isn't Massachusetts,
the state that is
sooooo cutting edge
in terms of medical
care doing more to
police nursing homes.
Why force people to
keep their fingers
crossed hoping their
loved one will be
properly cared for,
then be forced to sue
and give a large percentage
of their damages to some loyer
like Hoey? Like being
victimized twice!!!!!
Posted 3 hours ago Reply
Link Abusive
EV10 replying to TrailorHitch ? 0 0
Privatization,
A republican scam!
why does someone have to die
before these places follow
the rules?
When are people going
to learn these nursing
homes are a scam.
These privately owned homes
are in it together with the
insurance companies and they
combine their death panels.
They keep you alive just
long enough to suck all your
life savings from you and
then who cares what happens
to you.
Anyone who does not realize
that insurance companies and
nursing homes have their own
death panels are fooling
themselves
If you have any property
or a Life insurance policy
they try
to get their hands in it!
This is not Government run
institutions.. you idiot.
These are private entities
and are usually major
corporations!
That overcharge the government
for services they provide
Medicare recipiants!. Why
do you think Medicare is
going bankrupt?
We;re all going to be
Soylent Green.
there are many private
sector industries that
do bad jobs...and many
of them have some sort
of govt connection/support.
but regardless, to use this
in defense of the always
inefficient and corrupt
government is pure nonsense.
one has nothing to do with
the other.
there is nothing more terrifying
than the thought of govt employees
running our 'emergency services
personnel'. imagine the likes of
the DMV running an emergency
room....you might as well kill
anyone showing up with a
broken bone.
Medicare is on the skids
due-in major part-to the
fraud committed against it
by private parties who set
up phoney medial supply
companies and over-inflated
pricing by healthcare facilities.
NOT by the governmental agency
we know as Medicare, folks.
In Florida alone the amount of
medicare fraud committed by
medical supply companies was
over $600 Billion
(that's with a 'B").
"Fly-by-night outfits
who set up store-front
businesses, bill medicare
for such things as power
wheel chairs for
non-existent patients
or simply others "in on the scam".
They would pay them a stipend
for using their name, SS# and
other necessary info and submit
a claim. A LOT OF CLAIMS.
The wheel chair was never
delivered, of course.
Just the money paid.
Of course you're probably
asking yourselves:
"How come the medicare
office "let" them do it?
" How come they didn't
stop them?" "It's THEIR
fault for allowing it to
happen". Actually, it's not.
Have you ever visited or
worked in a Medicare office?
Talk about under-staffed!
Picture, if you will:
You're a claims worker.
You are trained to
look for certain key
factors in a claim.
Mainly, certain medical
billing codes which
mean and are attributed
to different ailments
and conditions. If the
coding data is correct,
the "patients'" personal
data "jives", the proper
clinicians' signatures
and a mountain of paperwork
appears accurate.
(Yes even doctors are
in on the scam),
you-as the claims
person-input the data
and voila! a check is sent.
Now multiply this process
by thousands upon thousands
of claims being processedin
one regional office alone.
How do the fraudulent ones
finally come to the surface
you wonder? When-periodically-all
this data is regurgitated and
sorted by different parameters.
That's when the same doctor's
name pops up. The same medical
device company name pops
up etc...However, by the time
any government enforcement agency
is able to go VISIT these sites,
the perps have moved on. Usually
to another location under a
different name. And it starts
all over again.
It's so bad that there are
many such scum out there
who were ONCE illegal drug
dealers who now do THIS
"for a living". They say
it's far more lucrative and,
when caught, the punishment
has far less of a stigma than
dealing drugs. Don't believe it?
Just Google "medicare fraud,
Florida" and see for yourself.
And unless and until individual
human beings stop being greedy,
trying to make a "fast buck"
and a myirad of other human
failings, it will continue.
If you are the kind of person
who sees nothing wrong with
providing your personal
information KNOWING it's for
illegal and fraudulent
purposes and think so little
of yourself as to prostitute
yourself for a measley stipend
then you're part of the problem.
And, regrettably, there are too
many out there who will and do.
In good economic times AND bad.
Some people are really schizo-
you complain about Government
health expenses and taxes,
yet gripe about nursing homes
doing bad jobs largely in
part due to low Medicaid
reinbursement. (Yes Medicaid,
not Medicare, which funds most
longterm nursing home stays.)
You want less government and
lower taxes, but you expect
nursing home care to be yet
another government based senior
entitlement benefit? You can't
have it both ways. You want
lower taxes and less government-
keep Grandma at home and take
care of her your damned selves!!!
As for even legitmate
health facilities? It
happens there too. If
I might, a personal case
in point:
A few monhs ago my spouse
spent 3 days (just three,
folks) in a North Shore Hospital.
(note: My spose is disabled
(yes, truly he is) and is on
Medicare. The bill was over $19,000.
Medicare paid just less than $18,000. We can't afford supplimental insurance so the remaining balance-his co-pay as it's called) is his to pay. So when the hospital called-3 months alter-he set up a payment arrangement. When he mentioned the call and the arrangement to me, I asked to see a copy of the itemized bill. A detail explaining the entire $19,000. It arrived a few days later.
How many of you have ACTUALLY
reviewed (or even asked) for an
itemized statement? You should.
It;s quite an eye-opener. Anyway,
as I viewed each line item,
I came across an item for
$1,116 labeled "respitory therapy".
For the live of me-and my
spouse-we couldn't figure
out what that charge was for.
So I called the hospital.
After being transferred
3-4 times, I finally asked
to speak to the mdeical
billing coder who coded this
charge. It as then I remembered;
Aha! my spouse had the USE of
a sleep apnea machine for
those three days. However,
he had made it known after
the first night he'd used it,
that it was an older model
than what he had at home and
didn't work right for him.
So he didn't use it for
the next two nights.
HOWEVER, they wouldn't
allow him to have his
own machine while he was
there either. Yet Medicare
was billed for the whole
$1,116 cost.
It's really quite "interesting"
to see the reaction one gets
when they ask for the medical
billing coder.
When I fianlly reached
this person,
she ahemed and stuttered
and put me on hold for
the longest time.
She finally told me
she didn't know about
this charge because she didn't
"do" respatory therapy coding!
(She coded everything else!
Right down to each and every
medicine he had been given
(which is another peeve I have)
during his stay.
Anyway, she transferred me
to a patient laison. a very
nice person who, when
I questioned the validity
of this $1,116, she said she
would research it.
But it would take 3-4 weeks.
But she ALSO made a point
(that a couple of others had
during my phone tag session)
that-even if the charge was
wrong-it would make a difference
in the bottom line amount yet
to to paid; for THAT amount was
my spouse;s co-pay, as it were.
I told her I acknoledged that
and had no issue with it. I also
proceeded to remind her that
it was STILL a charge they had
billed Medicare for that-in
our opinion-WASN'T valid and
they should NOT have been
paid for it. (Yes, I also
made a couple or comments
about Medicare abuse etc...
either be accident or design).
Admittedly, i am as tenacious
as a pit bull. So I WILL call
her back in 3-4 weeks
cont'd.... And I will
keep calling her until
the issue is resolved.
It may only be $1,116.
But multiply that by
thousands of other such
cases and it's a healthy
hunk of change. Don't you think?
The point is, we ALL have
to become tenacious pit bulls.
ALL OF US! Otherwise we shall
all be guilty of dubious
medicare claims. And the
cost will just keep rising
and our grandchildren will
be having this same conversation!
Don't worry under OBAMACARE,
we won't even end up in run
down nursing homes
...we'll have the death
panels to put us out of
our misery as soon as we
are no longer "useful"
to the Dear leader !
replying to HarryTaint
You said: "Thae Flatley Co.
owns a ton of these places
and puts profit way,
way, way, way, way
above the actual care
form the elderly"
I knew a guy who was
married to a Flatley
and he later divorced her
(being truthful he was a
haughty guy). The story
I heard is that the Flatley
family had sold their souls
for money.
:
If you have any property
or a Life insurance
policy they try to get
thier hands in it!
This is not Government
run institutions.. you idiot.
These are private entities
and are usually major
corporations!
That overcharge the government
for services they provide
Medicare recipiants!. Why
do you think Medicare is
going bankrupt?
Where is the link to the list
of nursing homes and the grades?
Medicare is on the skids
due-in major part-to the
fraud committed against
it by private parties
who set up phoney medial
supply companies and
over-inflated pricing
by healthcare facilities.
NOT by the governmental
agency we know as Medicare,
folks.
In Florida alone the amount
of medicare fraud committed
by medical supply companies
was over $600 Billion
(that's with a 'B").
"Fly-by-night outfits
who set up store-front
businesses, bill medicare
for such things as power
wheel chairs for
non-existent patients
or simply others "in on the scam".
They would pay them a stipend for
using their name, SS# and other
necessary info and submit a claim.
A LOT OF CLAIMS. The wheel chair
was never delivered, of course.
Just the money paid.
Of course you're probably
asking yourselves:
"How come the medicare
office "let" them do it?
" How come they didn't stop them?"
"It's THEIR fault for allowing
it to happen".
Actually, it's not.
Have you ever visited
or worked in a Medicare
office? Talk about
under-staffed! Picture,
if you will: You're a
claims worker. You are
trained to look for certain
key factors in a claim.
Mainly, certain medical
billing codes which mean
and are attributed to
different ailments and
conditions.
If the coding data is correct,
the "patients'" personal data
"jives", the proper clinicians'
signatures and a mountain of
paperwork appears accurate.
(Yes even doctors are in on
the scam), you-as the claims
person-input the data and voila!
a check is sent. Now multiply
this process by thousands upon
thousands of claims being
processedin one regional
office alone.
How do the fraudulent ones
finally come to the surface
you wonder? When-periodically-all
this data is regurgitated and
sorted by different parameters.
That's when the same doctor's
name pops up. The same medical
device company name pops up etc
...However, by the time any
government enforcement agency
is able to go VISIT these sites,
the perps have moved on.
Usually to another location
under a different name.
And it starts all over again.
It's so bad that there are
many such scum out there who
were ONCE illegal drug dealers
who now do THIS "for a living".
They say it's far more lucrative
and, when caught, the punishment
has far less of a stigma than
dealing drugs. Don't believe it?
Just Google "medicare fraud,
Florida" and see for yourself.
And unless and until individual
human beings stop being greedy,
trying to make a "fast buck"
and a myirad of other human
failings, it will continue.
If you are the kind of person
who sees nothing wrong with
providing your personal
information KNOWING it's
for illegal and fraudulent
purposes and think so little
of yourself as to prostitute
yourself for a measley stipend
then you're part of the problem.
And, regrettably, there are
too many out there who will
and do. In good economic times
AND bad.
Some people are really
schizo- you complain
about Government health
expenses and taxes, yet
gripe about nursing homes
doing bad jobs largely
in part due to low Medicaid
reinbursement. (Yes Medicaid,
not Medicare, which funds
most longterm nursing home stays.)
You want less government and
lower taxes, but you expect
nursing home care to be yet
another government based senior
entitlement benefit?
You can't have it both ways.
You want lower taxes and
less government-
keep Grandma at home
and take care of her
your damned selves!!!
As for even legitmate
health facilities?
It happens there too.
If I might, a personal
case in point:
A few monhs ago my spouse
spent 3 days (just three,
folks) in a North Shore
Hospital.
(note:
My spose is disabled
(yes, truly he is) and
is on Medicare.
The bill was over $19,000.
Medicare paid just less
than $18,000. We can't
afford supplimental
insurance so the
remaining balance-his
co-pay as it's called)
is his to pay.
So when the hospital
called-3 months alter-he
set up a payment arrangement.
When he mentioned the call
and the arrangement to me,
I asked to see a copy of the
itemized bill. A detail
explaining the entire $19,000.
It arrived a few days later.
How many of you have ACTUALLY
reviewed (or even asked) for
an itemized statement?
You should. It;s quite
an eye-opener. Anyway,
as I viewed each line item,
I came across an item for
$1,116 labeled "respitory therapy".
For the live of me-and my
spouse-we couldn't figure
out what that charge was for.
So I called the hospital.
After being transferred 3-4 times,
I finally asked to speak to
the mdeical billing coder who
coded this charge. It as then
I remembered;
Aha! my spouse had
the USE of a sleep
apnea machine for those
three days. However,
he had made it known
after the first night
he'd used it, that it
was an older model
than what he had at home
and didn't work right for him.
So he didn't use it for the
next two nights. HOWEVER,
they wouldn't allow him to
have his own machine while
he was there either.
Yet Medicare was billed
for the whole $1,116 cost.
It's really quite "interesting"
to see the reaction one gets
when they ask for the medical
billing coder. When I fianlly
reached this person, she
ahemed and stuttered and put
me on hold for the longest
time. She finally told me
she didn't know about this
charge because she didn't "do"
respatory therapy coding!
(She coded everything else!
Right down to each and every
medicine he had been given
(which is another peeve I have)
during his stay.
Anyway, she transferred me
to a patient laison. a very
nice person who, when I
questioned the validity
of this $1,116, she said
she would research it.
But it would take 3-4 weeks.
But she ALSO made a point
(that a couple of others
had during my phone tag session)
that-even if the charge was
wrong-it would make a
difference in the bottom
line amount yet to to paid;
for THAT amount was my
spouse;s co-pay, as it were.
I told her I acknoledged
that and had no issue with
it. I also proceeded to
remind her that it was STILL
a charge they had billed
Medicare for that-in our
opinion-WASN'T valid and
they should NOT have been
paid for it. (Yes, I also
made a couple or comments
about Medicare abuse etc...
either be accident or design).
Admittedly, i am as tenacious
as a pit bull. So I WILL
call her back in 3-4 weeks
cont'd.... And I will
keep calling her until
the issue is resolved.
It may only be $1,116.
But multiply that by
thousands of other such
cases and it's a healthy
hunk of change. Don't you think?
T
Don't worry under OBAMACARE,
we won't even end up in
run down nursing homes
...we'll have the death
panels to put us out of
our misery as soon as we
are no longer "useful" to
the Dear leader !
Posted 9 hours ago Reply
Link Abusive
Dissociate replying to HarryTaint ? +2 0
You said: "Thae Flatley Co. owns
a ton of these places and puts profit way, way, way, way, way above the actual care form the elderly"
I knew a guy who was married to
a Flatley and he later divorced
her (being truthful he was a haughty guy). The story I heard is that the Flatley family had sold their souls for money.
Posted 9 hours ago
home population is about 45,000.
The Herald’s findings come at a
time when the number of residents
in such homes is expected to
surge as baby boomers age
into their 80s.
Buzz up!Nearly 40 percent
of the state’s 437 nursing
homes received below-average
scores during their most recent
inspections due to a troubling
catalog of lapses and abuses
that are putting vulnerable
seniors at serious risk,
a Herald review has found.
Some of the care at nursing
homes in this state is a
disgrace. Big corporations
like Kindred have bought
up many nursing homes and
now put out terrible care.
In Massachusetts a hospital
or nursing home can only
be sued for only $20,000.00
under state law. No lawyer
today could afford to take
such a case. The hospitals
and nursing homes know this.
The Archdiocese of Boston's
Massachusetts Catholic
Conference lobbies heavily
on Beacon Hill to stop any
reforms in this law.
They are against holding
these so called non-profits
accountable because they
want to protect their assets
and properties from all
the sordid law suits.
Patients rights suffer
as a result. Our Attorney
General Coakley has one
of the worst records in
the nation for addressing
hospital or nursing home
abuses. Thank you Boston
Herald for writing this article.
Posted 11 hours ago Reply
Link Abusive
Dissociate ? +3 0
There needs to be more
elderly day cares.
Better to have elderly
parents taken care of
during the work hours
and later picked and
brought home to the family
rather than have them wither
away inside some nursing
home of horrids.
Posted 11 hours ago
Reply Link Abusive
GameChanger replying to
eastie ? +2 -2
And yet people push for
more tort reform as an
answer to everything.
Not understanding they
will not suddenly find
a conscience and began
to have a soul and suddenly
put patients ahead of profit.
It is just another way for
them to downsize care at
the expense of patients
and not be held accountable!
Posted 11 hours ago Reply
Link Abusive
gemini612 ? +3 0
How disgusting is this
nursing home situation
and getting worse.
I spent 15 days in a
nursing home rehab and
it was just awful.
Every day I wanted to go home,
the food was gross, and if
you were not ready when
they came around for you
to shower they just left
you until the next day,
disgusting, but when it
comes to being paid they
are all over you, money
talks with this group PERIOD.
Imagine Obamacare in
this state with the
one party rule facilitating
this mess. What a scary thought!
So much for the golden years!
Posted 10 hours ago Reply
Link Abusive
enoughBS ? +2 0
My daddy was in a nursing home
for under 3 weeks & died
They had no clue how to
take care of him but
told us they did & we
believed them.....
My mom, myself & my bro
were taking care of him
@ home for 9 years after
his brain aneurysm left
him totally disabled, up
until my mom had to go in
for a total hip replacement.
So my daddy went from home
to a nursing "facility".
His Dr. was from the
NE Siani Hospital in
Stoughton & we begged
them to take him in for
3-4 weeks till'
my mom was able to be
home & function after
the operation & his
Dr. fought it & told us
he couldn't take him.
We went to some place
on 138 in Canton I can't
remember the name.
The guy told us they
could take care of him
in his current condition,
well, they couldn't
he died there within 3 weeks.
All we needed was help
for 3-4 weeks & they killed him.
They couldn't take care
of him in his current
condition & they knew
it but took him anyway
to BILL MEDICARE.
The first week he was
there I went in town
to see my mom & my bro
went to see my daddy,
he was dehydrated &
had bruises on his hands.
He had respiratory issues
also & they had NO clue as
to address them. If you can
NEVER put a loved one in a
facility if you can take
care of them at home.
It may be inconvenient
but too bad their family
& if you want them to live
as long as they may
YOU are their only safeguard.
God bless........
“The average score is
just the average score.
People shouldn’t give
it more weight than it has.
” Hartstein said.
“Just because (a home)
is below the average
score doesn’t necessarily
mean they are not a good
nursing home.”
ARE YOU KIDDING ME??
Now there are many good
nursing homes so this
shouldn't besmirch them all.
..but what bothers me is
the attitude of the Mass.
government oversight.
Laissez faire? Is that
appropriate?
P
I think Mr. Riley would
have been more bothered
if he had to provide
the care for his mother
in hos own home at his
own expense.
I did not realize taxpayers
owed each citizen the 24 hour
care necessary for the last
5 to 10 years of their life
to assure they die
peacefully in their sleep.
An unfortunate reality is
that if you take a walk
through a nursing home,
a majority of staff are
less than competent,
lazy, etc. The good staff
are becoming far and few between.
My comments are based upon the
fact I have relatives who's
career requires them to visit
patients in nursing home
settings and the stories
they tell me about how the
staff responds when asked
to do something for a patient,
either demonstrate an
unwillingness or refuse.
And when it comes time for
the staff to take their breaks,
they'll take their breaks,
leaving you to assist a
200lb patient with ambulatory
issues by yourself.
The truth (and no I'm not
being racial) is that a
good majority of the staff
who demonstrate this lazy
work ethic are the non-Caucasians.
My mother was in a nursing
home for over two years.
One day, she called me at
my job and asked if I was
going to visit her that
night, then she started
crying. She explained that
"a man had come into her
room last night". This was
the first time I had heard
about it. After many calls
to the nursing home
supervisors/nursing
directors and after
a couple of screaming
sessions, I found out
that a man with dementia
came into my mother's room,
and sat on the bed with her.
(She was immobile.)
It took 20 minutes
to get help into the room.
Two CNA's came in, but
had difficulty removing
the man.
Finally, the nursing
supervisor (who had
20 years of experience)
came into the room to
get things in order.
My mother was so scared,
it took 45 minutes to calm her down.
At NO TIME did the nursing
supervisor believe that this
was a serious incident,
so no notes were made,
and no phone calls were
made to our family.
Instead of being fired,
this supervisor was
given an "in service" day.
BUT, if I was ever late with
a payment, I would hear about
it the next day! Sometimes,
I think people who work in
nursing homes shouldn't be
there because they have no
common sense and no feelings
for what goes through
the mind of the resident's family.
i don\'t know your point because
you made no point. in fact,
I am in favor of both
government regulation
AND privatization. Govt.
needs to overee this
entities and post as
much info about them
as possible on line and
in other ways, so the
public can see that info.
private companies need
to figure out a model
that makes this system
work efficiently.
If the govt. wants
to run nursing homes,
it needs to prove that
it can do so capably.
There is no \"pro\" and
\"con\" thing here.
It should all be \"pro\"
better care.
Posted 3 hours ago
Why isn't Massachusetts,
the state that is
sooooo cutting edge
in terms of medical
care doing more to
police nursing homes.
Why force people to
keep their fingers
crossed hoping their
loved one will be
properly cared for,
then be forced to sue
and give a large percentage
of their damages to some loyer
like Hoey? Like being
victimized twice!!!!!
Posted 3 hours ago Reply
Link Abusive
EV10 replying to TrailorHitch ? 0 0
Privatization,
A republican scam!
why does someone have to die
before these places follow
the rules?
When are people going
to learn these nursing
homes are a scam.
These privately owned homes
are in it together with the
insurance companies and they
combine their death panels.
They keep you alive just
long enough to suck all your
life savings from you and
then who cares what happens
to you.
Anyone who does not realize
that insurance companies and
nursing homes have their own
death panels are fooling
themselves
If you have any property
or a Life insurance policy
they try
to get their hands in it!
This is not Government run
institutions.. you idiot.
These are private entities
and are usually major
corporations!
That overcharge the government
for services they provide
Medicare recipiants!. Why
do you think Medicare is
going bankrupt?
We;re all going to be
Soylent Green.
there are many private
sector industries that
do bad jobs...and many
of them have some sort
of govt connection/support.
but regardless, to use this
in defense of the always
inefficient and corrupt
government is pure nonsense.
one has nothing to do with
the other.
there is nothing more terrifying
than the thought of govt employees
running our 'emergency services
personnel'. imagine the likes of
the DMV running an emergency
room....you might as well kill
anyone showing up with a
broken bone.
Medicare is on the skids
due-in major part-to the
fraud committed against it
by private parties who set
up phoney medial supply
companies and over-inflated
pricing by healthcare facilities.
NOT by the governmental agency
we know as Medicare, folks.
In Florida alone the amount of
medicare fraud committed by
medical supply companies was
over $600 Billion
(that's with a 'B").
"Fly-by-night outfits
who set up store-front
businesses, bill medicare
for such things as power
wheel chairs for
non-existent patients
or simply others "in on the scam".
They would pay them a stipend
for using their name, SS# and
other necessary info and submit
a claim. A LOT OF CLAIMS.
The wheel chair was never
delivered, of course.
Just the money paid.
Of course you're probably
asking yourselves:
"How come the medicare
office "let" them do it?
" How come they didn't
stop them?" "It's THEIR
fault for allowing it to
happen". Actually, it's not.
Have you ever visited or
worked in a Medicare office?
Talk about under-staffed!
Picture, if you will:
You're a claims worker.
You are trained to
look for certain key
factors in a claim.
Mainly, certain medical
billing codes which
mean and are attributed
to different ailments
and conditions. If the
coding data is correct,
the "patients'" personal
data "jives", the proper
clinicians' signatures
and a mountain of paperwork
appears accurate.
(Yes even doctors are
in on the scam),
you-as the claims
person-input the data
and voila! a check is sent.
Now multiply this process
by thousands upon thousands
of claims being processedin
one regional office alone.
How do the fraudulent ones
finally come to the surface
you wonder? When-periodically-all
this data is regurgitated and
sorted by different parameters.
That's when the same doctor's
name pops up. The same medical
device company name pops
up etc...However, by the time
any government enforcement agency
is able to go VISIT these sites,
the perps have moved on. Usually
to another location under a
different name. And it starts
all over again.
It's so bad that there are
many such scum out there
who were ONCE illegal drug
dealers who now do THIS
"for a living". They say
it's far more lucrative and,
when caught, the punishment
has far less of a stigma than
dealing drugs. Don't believe it?
Just Google "medicare fraud,
Florida" and see for yourself.
And unless and until individual
human beings stop being greedy,
trying to make a "fast buck"
and a myirad of other human
failings, it will continue.
If you are the kind of person
who sees nothing wrong with
providing your personal
information KNOWING it's for
illegal and fraudulent
purposes and think so little
of yourself as to prostitute
yourself for a measley stipend
then you're part of the problem.
And, regrettably, there are too
many out there who will and do.
In good economic times AND bad.
Some people are really schizo-
you complain about Government
health expenses and taxes,
yet gripe about nursing homes
doing bad jobs largely in
part due to low Medicaid
reinbursement. (Yes Medicaid,
not Medicare, which funds most
longterm nursing home stays.)
You want less government and
lower taxes, but you expect
nursing home care to be yet
another government based senior
entitlement benefit? You can't
have it both ways. You want
lower taxes and less government-
keep Grandma at home and take
care of her your damned selves!!!
As for even legitmate
health facilities? It
happens there too. If
I might, a personal case
in point:
A few monhs ago my spouse
spent 3 days (just three,
folks) in a North Shore Hospital.
(note: My spose is disabled
(yes, truly he is) and is on
Medicare. The bill was over $19,000.
Medicare paid just less than $18,000. We can't afford supplimental insurance so the remaining balance-his co-pay as it's called) is his to pay. So when the hospital called-3 months alter-he set up a payment arrangement. When he mentioned the call and the arrangement to me, I asked to see a copy of the itemized bill. A detail explaining the entire $19,000. It arrived a few days later.
How many of you have ACTUALLY
reviewed (or even asked) for an
itemized statement? You should.
It;s quite an eye-opener. Anyway,
as I viewed each line item,
I came across an item for
$1,116 labeled "respitory therapy".
For the live of me-and my
spouse-we couldn't figure
out what that charge was for.
So I called the hospital.
After being transferred
3-4 times, I finally asked
to speak to the mdeical
billing coder who coded this
charge. It as then I remembered;
Aha! my spouse had the USE of
a sleep apnea machine for
those three days. However,
he had made it known after
the first night he'd used it,
that it was an older model
than what he had at home and
didn't work right for him.
So he didn't use it for
the next two nights.
HOWEVER, they wouldn't
allow him to have his
own machine while he was
there either. Yet Medicare
was billed for the whole
$1,116 cost.
It's really quite "interesting"
to see the reaction one gets
when they ask for the medical
billing coder.
When I fianlly reached
this person,
she ahemed and stuttered
and put me on hold for
the longest time.
She finally told me
she didn't know about
this charge because she didn't
"do" respatory therapy coding!
(She coded everything else!
Right down to each and every
medicine he had been given
(which is another peeve I have)
during his stay.
Anyway, she transferred me
to a patient laison. a very
nice person who, when
I questioned the validity
of this $1,116, she said she
would research it.
But it would take 3-4 weeks.
But she ALSO made a point
(that a couple of others had
during my phone tag session)
that-even if the charge was
wrong-it would make a difference
in the bottom line amount yet
to to paid; for THAT amount was
my spouse;s co-pay, as it were.
I told her I acknoledged that
and had no issue with it. I also
proceeded to remind her that
it was STILL a charge they had
billed Medicare for that-in
our opinion-WASN'T valid and
they should NOT have been
paid for it. (Yes, I also
made a couple or comments
about Medicare abuse etc...
either be accident or design).
Admittedly, i am as tenacious
as a pit bull. So I WILL call
her back in 3-4 weeks
cont'd.... And I will
keep calling her until
the issue is resolved.
It may only be $1,116.
But multiply that by
thousands of other such
cases and it's a healthy
hunk of change. Don't you think?
The point is, we ALL have
to become tenacious pit bulls.
ALL OF US! Otherwise we shall
all be guilty of dubious
medicare claims. And the
cost will just keep rising
and our grandchildren will
be having this same conversation!
Don't worry under OBAMACARE,
we won't even end up in run
down nursing homes
...we'll have the death
panels to put us out of
our misery as soon as we
are no longer "useful"
to the Dear leader !
replying to HarryTaint
You said: "Thae Flatley Co.
owns a ton of these places
and puts profit way,
way, way, way, way
above the actual care
form the elderly"
I knew a guy who was
married to a Flatley
and he later divorced her
(being truthful he was a
haughty guy). The story
I heard is that the Flatley
family had sold their souls
for money.
:
If you have any property
or a Life insurance
policy they try to get
thier hands in it!
This is not Government
run institutions.. you idiot.
These are private entities
and are usually major
corporations!
That overcharge the government
for services they provide
Medicare recipiants!. Why
do you think Medicare is
going bankrupt?
Where is the link to the list
of nursing homes and the grades?
Medicare is on the skids
due-in major part-to the
fraud committed against
it by private parties
who set up phoney medial
supply companies and
over-inflated pricing
by healthcare facilities.
NOT by the governmental
agency we know as Medicare,
folks.
In Florida alone the amount
of medicare fraud committed
by medical supply companies
was over $600 Billion
(that's with a 'B").
"Fly-by-night outfits
who set up store-front
businesses, bill medicare
for such things as power
wheel chairs for
non-existent patients
or simply others "in on the scam".
They would pay them a stipend for
using their name, SS# and other
necessary info and submit a claim.
A LOT OF CLAIMS. The wheel chair
was never delivered, of course.
Just the money paid.
Of course you're probably
asking yourselves:
"How come the medicare
office "let" them do it?
" How come they didn't stop them?"
"It's THEIR fault for allowing
it to happen".
Actually, it's not.
Have you ever visited
or worked in a Medicare
office? Talk about
under-staffed! Picture,
if you will: You're a
claims worker. You are
trained to look for certain
key factors in a claim.
Mainly, certain medical
billing codes which mean
and are attributed to
different ailments and
conditions.
If the coding data is correct,
the "patients'" personal data
"jives", the proper clinicians'
signatures and a mountain of
paperwork appears accurate.
(Yes even doctors are in on
the scam), you-as the claims
person-input the data and voila!
a check is sent. Now multiply
this process by thousands upon
thousands of claims being
processedin one regional
office alone.
How do the fraudulent ones
finally come to the surface
you wonder? When-periodically-all
this data is regurgitated and
sorted by different parameters.
That's when the same doctor's
name pops up. The same medical
device company name pops up etc
...However, by the time any
government enforcement agency
is able to go VISIT these sites,
the perps have moved on.
Usually to another location
under a different name.
And it starts all over again.
It's so bad that there are
many such scum out there who
were ONCE illegal drug dealers
who now do THIS "for a living".
They say it's far more lucrative
and, when caught, the punishment
has far less of a stigma than
dealing drugs. Don't believe it?
Just Google "medicare fraud,
Florida" and see for yourself.
And unless and until individual
human beings stop being greedy,
trying to make a "fast buck"
and a myirad of other human
failings, it will continue.
If you are the kind of person
who sees nothing wrong with
providing your personal
information KNOWING it's
for illegal and fraudulent
purposes and think so little
of yourself as to prostitute
yourself for a measley stipend
then you're part of the problem.
And, regrettably, there are
too many out there who will
and do. In good economic times
AND bad.
Some people are really
schizo- you complain
about Government health
expenses and taxes, yet
gripe about nursing homes
doing bad jobs largely
in part due to low Medicaid
reinbursement. (Yes Medicaid,
not Medicare, which funds
most longterm nursing home stays.)
You want less government and
lower taxes, but you expect
nursing home care to be yet
another government based senior
entitlement benefit?
You can't have it both ways.
You want lower taxes and
less government-
keep Grandma at home
and take care of her
your damned selves!!!
As for even legitmate
health facilities?
It happens there too.
If I might, a personal
case in point:
A few monhs ago my spouse
spent 3 days (just three,
folks) in a North Shore
Hospital.
(note:
My spose is disabled
(yes, truly he is) and
is on Medicare.
The bill was over $19,000.
Medicare paid just less
than $18,000. We can't
afford supplimental
insurance so the
remaining balance-his
co-pay as it's called)
is his to pay.
So when the hospital
called-3 months alter-he
set up a payment arrangement.
When he mentioned the call
and the arrangement to me,
I asked to see a copy of the
itemized bill. A detail
explaining the entire $19,000.
It arrived a few days later.
How many of you have ACTUALLY
reviewed (or even asked) for
an itemized statement?
You should. It;s quite
an eye-opener. Anyway,
as I viewed each line item,
I came across an item for
$1,116 labeled "respitory therapy".
For the live of me-and my
spouse-we couldn't figure
out what that charge was for.
So I called the hospital.
After being transferred 3-4 times,
I finally asked to speak to
the mdeical billing coder who
coded this charge. It as then
I remembered;
Aha! my spouse had
the USE of a sleep
apnea machine for those
three days. However,
he had made it known
after the first night
he'd used it, that it
was an older model
than what he had at home
and didn't work right for him.
So he didn't use it for the
next two nights. HOWEVER,
they wouldn't allow him to
have his own machine while
he was there either.
Yet Medicare was billed
for the whole $1,116 cost.
It's really quite "interesting"
to see the reaction one gets
when they ask for the medical
billing coder. When I fianlly
reached this person, she
ahemed and stuttered and put
me on hold for the longest
time. She finally told me
she didn't know about this
charge because she didn't "do"
respatory therapy coding!
(She coded everything else!
Right down to each and every
medicine he had been given
(which is another peeve I have)
during his stay.
Anyway, she transferred me
to a patient laison. a very
nice person who, when I
questioned the validity
of this $1,116, she said
she would research it.
But it would take 3-4 weeks.
But she ALSO made a point
(that a couple of others
had during my phone tag session)
that-even if the charge was
wrong-it would make a
difference in the bottom
line amount yet to to paid;
for THAT amount was my
spouse;s co-pay, as it were.
I told her I acknoledged
that and had no issue with
it. I also proceeded to
remind her that it was STILL
a charge they had billed
Medicare for that-in our
opinion-WASN'T valid and
they should NOT have been
paid for it. (Yes, I also
made a couple or comments
about Medicare abuse etc...
either be accident or design).
Admittedly, i am as tenacious
as a pit bull. So I WILL
call her back in 3-4 weeks
cont'd.... And I will
keep calling her until
the issue is resolved.
It may only be $1,116.
But multiply that by
thousands of other such
cases and it's a healthy
hunk of change. Don't you think?
T
Don't worry under OBAMACARE,
we won't even end up in
run down nursing homes
...we'll have the death
panels to put us out of
our misery as soon as we
are no longer "useful" to
the Dear leader !
Posted 9 hours ago Reply
Link Abusive
Dissociate replying to HarryTaint ? +2 0
You said: "Thae Flatley Co. owns
a ton of these places and puts profit way, way, way, way, way above the actual care form the elderly"
I knew a guy who was married to
a Flatley and he later divorced
her (being truthful he was a haughty guy). The story I heard is that the Flatley family had sold their souls for money.
Posted 9 hours ago
Monday, February 1, 2010
Caring for Caregivers
Posted by Terrell McSweeny on January 28, 2010 at 06:35 PM EST
This week the Middle Class Task Force unveiled a series of initiatives in the President's FY 11 budget that are aimed at helping families with soaring child care costs, balancing work with caring for elderly relatives or people with disabilities, paying for college, and saving for retirement. These are costs that – along with health care – have risen dramatically for families at a time when their incomes haven't. Some people call this "squeeze" because of the pressure these costs put on family budgets. But for many families it just seems like it is impossible to get ahead.
This is particularly true for the so-called "sandwich generation" – people who are caring for children (or grandchildren or adult children who are struggling financially) and their parents. The Vice President often speaks very personally about his experience caring for his parents and in-laws. And almost all of us know someone who has juggled caring for a parent or relative who can’t get along completely on their own. Millions of Americans provide unpaid care to aging relatives – including approximately 23 million caregivers with jobs and 12 million who are also caring for their own children. That's why the Middle Class Task Force’s "squeeze" initiative includes help for family caregivers.
These caregivers play a vital role in helping seniors stay in their communities or at home. But too often they don’t have the support they need to balance caregiving with work and family responsibilities. As Elinor Ginzler of AARP put it:
"AARP is grateful that the Middle Class Task Force has drawn attention to an issue that is deeply important to our members—the critical role of family caregivers and what we should be doing to help them. Approximately 65 million Americans provide care to a loved one, giving more than $375 billion worth of unpaid care each year—often at their own financial and emotional expense. Increasing support to these invaluable individuals would be an important step to help those who do so much to help others."
The nearly $103 million investment proposed by the Middle Class Task Force will support more respite care, counseling, training, referrals, and adult day care. As Sandy Markwood, CEO of National Association for Area Agencies on Aging explained:
"Vice President Biden’s Middle Class Task Force’s recommendation to increase funding for the National Family Caregiver Support Program and Lifespan Respite, along with strengthening supportive services through Title III-B of the Older Americans Act, represents a huge investment in community-based programs that support the independence of older Americans and their caregivers. These funds will enable them to access and get the critical services that they need while avoiding unnecessary and more expensive institutional care or spending down to Medicaid. We applaud the work that has been done by the Administration that serves to strengthen long term living options through home and community-based services."
The extra funding proposed by the Task Force will allow nearly 200,000 additional caregivers to be served and 3 million more hours of respite care to be provided. It adds funding to programs that provide transportation help, adult day care, and in-home services including aides to help bathe and cook. Some have said these things are modest. And, to some extent, they are. But sometimes it is these small things that add up to make all the difference.
Eric Hall, President and Chief Executive Officer of the Alzheimers Foundation of America is well aware of the vital help these services give families:
"Family caregivers who struggle each day with practical and financial challenges have been anxiously waiting for this issue to be brought to the national stage and for relief in their own homes and communities. For these families, assistance at any level can help delay nursing home placement and enhance caregiver well being. The proposed initiatives represent a welcome change in direction, from minimal or flatlined funding to amounts that will make a difference for hundreds of thousands of American families."
And here’s what Gail Hunt, CEO of the National Alliance for Caregiving who represents family caregivers said:
"The National Alliance for Caregiving is proud to support the Middle Class Task Force and their efforts to support family caregivers. This is a wonderful addition to the National Family Caregiver Support Program and it is a perfect way to recognize these caregivers who on average spend 18 hours a week providing care. The funding for transportation, adult day care and other services under Title III b will also help family caregivers by assisting the older adult they are caring for. We are grateful to the Middle Class Task Force for bringing much needed public awareness to the family caregiver."
The caregiver initiative won’t magically alleviate all the strain on caregivers and their families – but it is an important first step toward providing more support for families and caregivers and the vital services they are performing.
Terrell McSweeny is Domestic Policy Advisor to the Vice President
This week the Middle Class Task Force unveiled a series of initiatives in the President's FY 11 budget that are aimed at helping families with soaring child care costs, balancing work with caring for elderly relatives or people with disabilities, paying for college, and saving for retirement. These are costs that – along with health care – have risen dramatically for families at a time when their incomes haven't. Some people call this "squeeze" because of the pressure these costs put on family budgets. But for many families it just seems like it is impossible to get ahead.
This is particularly true for the so-called "sandwich generation" – people who are caring for children (or grandchildren or adult children who are struggling financially) and their parents. The Vice President often speaks very personally about his experience caring for his parents and in-laws. And almost all of us know someone who has juggled caring for a parent or relative who can’t get along completely on their own. Millions of Americans provide unpaid care to aging relatives – including approximately 23 million caregivers with jobs and 12 million who are also caring for their own children. That's why the Middle Class Task Force’s "squeeze" initiative includes help for family caregivers.
These caregivers play a vital role in helping seniors stay in their communities or at home. But too often they don’t have the support they need to balance caregiving with work and family responsibilities. As Elinor Ginzler of AARP put it:
"AARP is grateful that the Middle Class Task Force has drawn attention to an issue that is deeply important to our members—the critical role of family caregivers and what we should be doing to help them. Approximately 65 million Americans provide care to a loved one, giving more than $375 billion worth of unpaid care each year—often at their own financial and emotional expense. Increasing support to these invaluable individuals would be an important step to help those who do so much to help others."
The nearly $103 million investment proposed by the Middle Class Task Force will support more respite care, counseling, training, referrals, and adult day care. As Sandy Markwood, CEO of National Association for Area Agencies on Aging explained:
"Vice President Biden’s Middle Class Task Force’s recommendation to increase funding for the National Family Caregiver Support Program and Lifespan Respite, along with strengthening supportive services through Title III-B of the Older Americans Act, represents a huge investment in community-based programs that support the independence of older Americans and their caregivers. These funds will enable them to access and get the critical services that they need while avoiding unnecessary and more expensive institutional care or spending down to Medicaid. We applaud the work that has been done by the Administration that serves to strengthen long term living options through home and community-based services."
The extra funding proposed by the Task Force will allow nearly 200,000 additional caregivers to be served and 3 million more hours of respite care to be provided. It adds funding to programs that provide transportation help, adult day care, and in-home services including aides to help bathe and cook. Some have said these things are modest. And, to some extent, they are. But sometimes it is these small things that add up to make all the difference.
Eric Hall, President and Chief Executive Officer of the Alzheimers Foundation of America is well aware of the vital help these services give families:
"Family caregivers who struggle each day with practical and financial challenges have been anxiously waiting for this issue to be brought to the national stage and for relief in their own homes and communities. For these families, assistance at any level can help delay nursing home placement and enhance caregiver well being. The proposed initiatives represent a welcome change in direction, from minimal or flatlined funding to amounts that will make a difference for hundreds of thousands of American families."
And here’s what Gail Hunt, CEO of the National Alliance for Caregiving who represents family caregivers said:
"The National Alliance for Caregiving is proud to support the Middle Class Task Force and their efforts to support family caregivers. This is a wonderful addition to the National Family Caregiver Support Program and it is a perfect way to recognize these caregivers who on average spend 18 hours a week providing care. The funding for transportation, adult day care and other services under Title III b will also help family caregivers by assisting the older adult they are caring for. We are grateful to the Middle Class Task Force for bringing much needed public awareness to the family caregiver."
The caregiver initiative won’t magically alleviate all the strain on caregivers and their families – but it is an important first step toward providing more support for families and caregivers and the vital services they are performing.
Terrell McSweeny is Domestic Policy Advisor to the Vice President
Subscribe to:
Comments (Atom)
