A Huffington Post exposé in June, “Hospice, Inc.,” rekindled some thoughts I’ve long had about the split personality of the journalism on complex topics like aging.
One week, readers see richly reported news features, usually by health care or feature reporters, about the struggle of elders and their families caught in this country’s messy long-term care system. The next, readers get stories by political, economics reporters on bipartisan budget debates (how much to cut this year) or exposés that aim for accountability, but don’t help most families.
The Huffington Post project got me thinking – what’s the responsibility of an investigative team posting an approximately 7,000-word, six-month investigation? How can they get beyond house-of-horrors revelations? Continue reading
There is some good news coming out of the latest report from the Medicare Trustees. They predict that the trust fund that finances Medicare’s hospital insurance coverage will remain solvent until 2030, four years beyond last year’s projections. Per capita spending is expected to grow more slowly than the overall economy for the next few years, partially due to costs controls under the Affordable Care Act.
However, the report concludes, “notwithstanding recent favorable developments, both the projected baseline and current law projections indicate that Medicare still faces a substantial financial shortfall that will need to be addressed with further legislation.”
“Medicare Part A is moving in the right direction but the day of reckoning has merely been postponed to 2030,” said Rosemary Gibson, senior adviser at The Hastings Center and author of “Medicare Meltdown.” Unless something changes, by 2030 it will lack enough money to pay boomers’ hospital bills. “We’re not out of the woods.” Continue reading
The Center for Public Integrity’s series unearthing potential fraud and waste under the Medicare Advantage program had little help — and apparently little interest — from the Centers for Medicare & Medicaid Services. The insurance program, which Congress established to help control health care costs for older adults, could leave taxpayers on the hook for more than $36 billion, as AHCJ member Fred Schulte and the rest of the investigative team uncovered.
In this “How I did it” article, Schulte explains how the series follows up on CPI’s 2012 Medicare costs investigation, the extensive lengths taken to try to obtain CMS records, work-arounds and other sources the team used to piece together a puzzle that paints a clear picture of improper billing, missed opportunities by regulators, lack of oversight, and industry influence.
The Chicago Declaration on the Rights of Older Persons — a proposed international convention that aims to provide legal protections to older persons under international human rights law, was released last week after months of work by legal scholars, human rights advocates and policymakers from more than a dozen countries. Delegates will present the Declaration before the United Nations on August 1.
The Chicago Declaration addresses numerous issues facing the world’s older population, from medical decision-making to abuse. Participants say it is not meant to supersede or diminish any greater rights granted to older persons that may already exist in local, state or national law.
It calls upon nations to raise public awareness and educate older persons of their rights, as well as encourage programs that promote inter-generational relationships. The John Marshall Law School, Roosevelt University and East China University of Political Science and Law jointly supervised the work.
Untreated oral disease can have a devastating impact upon frail elders.
Yet significant financial and physical barriers prevent many from getting the care they need. (See related tip sheet, “Getting dental care to elders in nursing homes.”)
The lack of dental services is particularly acute for many of the 1.4 million seniors living in nursing homes, placing them at increased risk for everything from pain and tooth loss to poor nutrition and serious, even fatal infections.
“Brushing teeth becomes a life or death thing for many patients,” dentist Gregory Folse, D.D.S., told AHCJ members who joined a recent webinar dedicated to exploring the challenges of getting care to vulnerable nursing home residents.
Folse, whose innovative mobile dental practice is dedicated to getting care to more than two dozen Louisiana nursing homes, spends his days addressing those challenges.
It turns out his efforts are deeply appreciated in his community of Lafayette, La. Folse was recently named Dentist of the Year by a local nonprofit.
Bill Decker, community editor of The Advertiser in Lafayette used the award as a peg to create a feature story in words and video about Folse and the people he serves. Continue reading
Prevalence of chronic disease is on the rise, and the ability to afford nursing home care is declining among older adults, according to a new report from the U.S. Census Bureau commissioned by the National Institutes of Health.
The report, 65+ in the United States: 2010, highlights several trends among America’s older population. There are more than 40 million people over age 65. That figure is expected to more than double by mid-century, to 83.7 million people and one-fifth of the U.S. population by 2050. The report presents population trends among older adults, as well as data on life expectancy, how well they age, their financial and educational status, medical, long-term care and housing costs, where they live and with whom, and other factors important for aging and health.
According to the NIA, a key aspect of the report is the effect that the aging of the baby boom generation will have on the U.S. population and on society in general. Baby boomers began to reach age 65 in 2011; between 2010 and 2020, the older generation is projected to grow more rapidly than in any other decade since 1900.
The report points out some critical health-related issues: Continue reading
Cardiovascular disease (CVD) is the leading cause of death in the U.S. As with many other chronic conditions, age is the greatest risk factor. In 2013, someone in the U.S. died from cardiovascular disease every 40 seconds.
The average annual rates for first cardiovascular event rise drastically with age – from three per 1,000 men from 33 to 44 years old, to 74 per 1,000 men in the 85-to-94 age group. For women, comparable rate rises occur 10 years later than men.
Of the estimated 82.6 million Americans who have one or more types of cardiovascular disease, the American Heart Association says about 40 million are age 60 or older.
Many of the problems older people have with their heart and blood vessels are really caused by disease, not by aging. For example, an older heart can normally pump blood as strong as a younger heart; less ability to pump blood is caused by disease. But, changes that happen with age may increase a person’s risk of heart disease.
Get more facts, stats and resources for your reporting on heart disease.
Image by Enrique Bosquet via flickr.
A new study from the RAND Corporation calls on policymakers to improve long-term services and supports (LTSS) for the growing number of people diagnosed with Alzheimer’s and other dementias and their caregivers. The report focuses on policy options at the intersection of dementia and LTSS.
An estimated 15 percent of Americans over age 70 suffer from dementia, but the number of seniors with Alzheimer’s disease is projected to triple by 2050, affecting as many as 14 million in the United States. This will place an unsustainable demand on dementia-related long-term services and supports, according to the report.
The estimated annual costs of dementia care are between $159 billion and $215 billion, which could more than double by 2040 if the age-specific prevalence rate of the disease remains constant as the nation’s population grows older. U.S. policymakers have made funding for clinical responses to dementia a priority. Continue reading
Every year, the Centers for Medicare & Medicaid issues a list of troubled nursing homes as part of its Special Focus Facility Initiative. CMS released an updated list on June 19 as a PDF and AHCJ has posted the list as a series of web pages and has made them available to download as Excel spreadsheets.
The initiative is intended to address nursing homes that cycle in and out of compliance. Homes in this program are visited by survey teams twice as frequently as other nursing homes. This list includes nursing homes added to the SFF initiative and updates the status of homes already in the program.
This year, 15 homes in 14 states were added to the list. Sixteen others were found to have “failed to show significant improvement,” 23 were deemed to have shown improvement, 33 have “graduated” from the program and four are no longer participating in Medicare/Medicaid.
Angelo Fichera of The Philadelphia Inquirer recently reported on one nursing home that will likely close after spending three years in the SFF Initiative, noting that CMS has not seen an improvement in care:
CMS expects that after two years on the watch list, nursing homes will either improve and “graduate” from the program; have funding terminated; or be granted an extension to improve because of “promising progress,” according to the agency.
To round out your reporting on nursing homes, AHCJ just updated its version of CMS’s Nursing Home Compare database, which includes details of the most severe deficiencies found during nursing home inspections for the past three years. AHCJ posted separate files covering the star ratings for nursing homes – from 1 to 5 – based on quality, inspection results, staffing and overall ratings.
AARP, The Commonwealth Fund and The SCAN Foundation have released their second long term care scorecard, a state-by-state breakdown of performance of long-term services and supports that help older adults, adults with disabilities and their family caregivers. The rankings looked at 26 performance indicators within five dimensions of care for each of the 50 states, plus the District of Columbia and classifies them against each other.
Minnesota led the way among all states in all dimensions – affordability and access, choice of setting and provider, quality of life and quality of care, support for family caregivers, and effective transitions. It was the only state to rank in the top quartile for all five dimensions.
“The scorecard underscores value and importance and of state leadership and state policy,” said Melinda Abrams, vice president for health care delivery system reform, The Commonwealth Fund in a telephone press briefing. “Leading states have implemented laws and policies that build stronger Medicaid programs, and support the family caregiver.”
Policymaking at the state level sets the stage for a high performance system, she said. Indicators such as strong paid sick leave policies for caregivers and more funding of home- and community-based services help older adults age in place longer, or keep them out of nursing homes all together. Continue reading