No Ice Floes Handy?

According to legend, when their elderly became burdensome, Eskimos put them on ice floes and let them drift out to sea.

If I thought that Trump and his “best people” could read, I’d suspect they were emulating the Eskimos.

A week or so ago, a friend who no longer lives in Indianapolis was in town, and met my husband and me for breakfast. During the “catching up” talk that takes place when old friends haven’t seen each other for a while, we asked him what his wife was doing. He said she’d been working part-time as an advocate for nursing home patients–a position required as a condition of federal grants for nursing home care–but that the Trump Administration had eliminated the requirement, along with a number of other regulations intended to protect the sick and elderly residents of such institutions. So she was looking for another job.

I was pretty incredulous; why would even this benighted administration refuse to protect helpless old folks against the well-documented abuses encountered in numerous substandard nursing homes?

Turned out, however, our friend was right. I saw this article from The Hill not long after our conversation:

The Trump administration is reportedly rolling back the use of fines against nursing homes that have been cited for violations such as neglect or mistreatment.

The move comes after the nursing home industry requested the change in the Medicare program’s penalty protocols, The New York Times reported over the holiday weekend.

The American Health Care Association had argued that inspectors were too focused on finding wrongdoings at nursing homes instead of assisting the facilities.

A 2001 Congressional investigation uncovered reports of serious, physical, sexual and verbal abuse in a third of the nation’s nursing homes. That led to more monitoring and additional regulation. Since 2013, nearly 6,500 nursing homes have been cited  for one or more serious violations. Approximately two-thirds of those were fined by Medicare.

Nevertheless, the personnel installed by Trump at the Center for Medicare and Medicaid Services argued that the regulations and fines were counterproductive.

“Rather than spending quality time with their patients, the providers are spending time complying with regulations that get in the way of caring for their patients and doesn’t increase the quality of care they provide.”

A lawyer from the Center for Medicare Advocacy disagreed, observing that the revised regulations and diminished penalties have “pretty much emasculated enforcement, which was already weak.”

So let’s see….this administration wants tough penalties for street crime and drug use and illegal immigration, because Trump and Sessions say punishment is a deterrent to socially undesirable behaviors. But we don’t need to fine or otherwise punish the owners of nursing homes that mistreat their vulnerable inhabitants. (Sorry–I know the word “vulnerable” has been banned.) We can  gently suggest they desist, and maybe those bedsores will go away by themselves….

The regulations no longer being enforced weren’t imposed by some abstract, rule-happy big government bureaucrat; they were put in place because of evidence that far too many nursing homes were abusing and neglecting their elderly, incapacitated patients, and doing so with impunity.

Someone needs to explain to me just how forbidding elder abuse “gets in the way of quality care.”

Actually, ice floes might be more humane….

26 Comments

  1. This is SO appalling and dangerous. Thanks for the heads up. This administration seems determined to antagonize senior citizens. They have succeeded with this retiree.

  2. As absurd as so much of the actions of this administration are, some people refuse to believe the actions have occurred. After I expressed disgust at the Trump derriere-kissing of two weeks ago, two friends of mine dismissed it by saying, “The Democrats did the same with Obama.” I pressed for a time and place of the occurrence. One shrugged, the “they all do it” response. The other person was on the phone. We have to persevere. Until a “chunk”—I’ll come up with a percentage at some point—of those who voted for Trump realize what happened in the election, things will proceed like this. Nixon did not resign until a sizeable number of people (finally) believed what had happened in that “thing” described by the catch-all “Watergate.” We have to continue to explain to what seems like a bleak, gray wall because some of the blocks will eventually give way.

  3. This appears to be another instance where, along with lack of any attempt by Republicans to understand results of their cutting funds to anything, along with not caring about what little they do understand, they are also unaware of or uncaring that hundreds of thousands of Republican voters are housed in those facilities across this country. Just as there are Republican voters relying on Social Security, Disability, Medicare and Medicaid.

    Jane; thank you for your connection between these two issues.

  4. The phrase “nursing home industry” jumps out at me in this reading. It is yet just another capitalistic industry. It keeps lobbyists in Washington and every state capital paid for through some vague association. Using a pact the industry makes campaign contributions aka bribes to elected officials. To avoid competition the membership is kept on the same page of profit through regional meetings at resorts all paid for by monies drained out of Medicare and Medicaid ; and meanwhile board and management meetings are most often focused on how to eek out every bit of money from the “patients” who are really seen as “customers/suckers”.

    We are not failing as a society… we have already failed.

  5. Is there an Indiana connection to the elimination of this regulation? Let us remember that Seema Verma was placed in a high level position at CMS by pence. She is all about the indigent and poor needing to pull themselves up by their bootstraps to pay their own way. She surely sees those people in the nursing homes as unproductive drags on society that should not be allowed to just sit/lay there in a nursing home and take money from hard working Americans like herself. Can you tell that I have absolutely no respect for Seema Verma?

  6. The phrase “ whatever you do to the least of these you do to me”. Comes to mind, the Christian Right seems bound and determine to abandon “the least of these” in every sphere!

  7. This is not a regulatory issue. It is a civil rights issue. Our job is to demand that the new AG appointed by the next administration treats it as such.

  8. Once again, the Republicans reveal their masters’ voices in their ears. When we cast aside the regulations that protect our citizens from capitalism’s abuses, we become a fascist nation.

    I had a conversation with my neighbor who was terribly disheartened at what happened to her Republican/conservative party…and how quickly they jumped the tracks.

    November 8, 2018. Remember that date. Vote like your country depends on it. We can’t vote out Ben Carson, but we can put in a Congress that will stop Trump’s utter disregard for the American people.

  9. Theresa; these word go straight to the core of this administration’s problems, it is their deliberately chosen direction with dreams of building their own private empire. Organization and structure, strengthened by determination to turn the current “Trumpism” society to reality.
    “We are not failing as a society… we have already failed.”

    Patrick; this is the solution but it is a solution with no power to “demand” before the self-destruction by the current administration, upheld by Congress. Look at the degree of “deconstruction” they have accomplished in less than one year; they will double their efforts and continue succeeding over the coming year as they remain in power UNLESS we can remove them…hope is dwindling along with our loss of civil rights. Is Robert Mueller our salvation? No guarantees Trump will not or can not fire him and his team of investigators; any more than there is any document to protect us from him pressing that nuclear button.
    “This is not a regulatory issue. It is a civil rights issue. Our job is to demand that the new AG appointed by the next administration treats it as such.”

  10. For many nursing home operators, the quality of care or lack thereof becomes secondary to their goal for maximum profit. Thus, it becomes necessary for relatives and friends to monitor the care of those so housed, call in the authorities when necessary and/or sue the operators of the substandard nursing homes into bankruptcy. That outta work in the absence of strong regulations.

  11. So let’s count the blessings for nursing home owners. They can still bilk Medicare for care not delivered. They can still bilk Medicaid for care not offered. They will no longer have to worry about penalties. They have a huge tax break coming their way. It’s good to be them, right now.

    Seriously, if any of you have loved ones in a nursing home, the best way to protect them is to show up and ask questions. It has always been that way and now, even more so. Sad!

  12. A nursing faclitiy antedotal story regarding a nursing home rehabilitation facility in Indiana. Had a friend experience being banned from a nursing home here in IN after complaining (and proving via hospital blood testing) that her mother was being inappropriately medicated with not prescribed drugs (i.e. drugged) in a nursing home while there for rehab. When picking mother up to take her to a planned & scheduled medical appointment, daughter/legal guardian found her mother incoherent in a wheel chair at nursing home facility. After calling ambulance (against nursing facility wishes) and having mother treated at a hosptal e-room, nursing home wold bot allow mother to return, and had her blackballed from all nursing homes in the same county. This was verbally verified by a Director of one of the other nursing home facilities. Mother and legal guardian were not allowed to return (not that they wanted to do so). But guardian decided to appeal through IN state administratve process. Catch-22: An appeal requesting return was denied because mother was no longer in the facility. Lesson: Nursing home advocates are needed and valuable. Be vigilant and watchful should you have a family member, loved one, or friend in a nursing facility.

  13. still think this admin isnt quite like hitlers get rid of the sick etc? call it like it is,and get it done..

  14. The Koch brothers the American Legislative Exchange Council (ALEC) to provide an opportunity for CEOs and lawmakers to meet in private. ALEC became a bill mill where they’d produce boilerplate bills to be passed around to legislators to add their state and individual names to the bills. They are the wish lists of CEOs.

    Since the Koch’s contribute to over 150 universities, including Ball State, they teach young minds that the sole purpose of a business is to “maximize profits for the owners”. Period.

    Let’s be clear, we warehouse old people. Feeding them to sea creatures would be more humane.

    The private sector should have never been allowed to operate nursing homes or hospitals. Their sole purpose goes against the needs of patients. The free market might work for consumer goods and services but should not have any responsibility for social services and public goods.

    Through ALEC, they are introducing bills to privatize our educational system because those “damn libtards” are ruining everything. It doesn’t have anything to do with the billions spent of education in this country. [sarcasm intended]

    This privatizing the public realm is the goal of the Koch’s Libertarian beliefs. It’s why they spend a billion dollars a year on their political agenda. Pence is a Koch puppet and is behind all the anti-regulation agenda in Washington. It’s also referred to as Neoliberalism and has been the agenda since the 1980’s with Reagan/Thatcher running the show. Both political parties support Neoliberalism. With Trump/Pence, it’s now on steroids.

  15. About 25 years ago, my Aunt Mildred was in a small nursing home in New Port Richey, FL, her brother (my Dad) visited frequently and I had visited the month before she died. She was legally blind and suffered from some internal ailment and weak heart. She had taken both of us to her small bedroom which she shared with another patient; very low twin beds and they shared one dresser and small closet. I was executor of her pitiful will, the nursing home forwarded to me the Medicare bills for “her” hospital bed; the bill covered several months. She never had a hospital bed; it took many letters and phone calls over a few months to finally resolve the problem with Medicare. They then investigated the nursing home and it was shut down.

    My friend Maria was in a Catholic nursing/assisted living facility on South Meridian Street; for over a year the place was infested with bedbugs. Staff sprayed bug spray occasionally; Maria slept in a chair for months and wouldn’t let anyone visit to prevent them carrying bedbugs home on their clothing or shoes. She contacted public health several times before they took action. Incidentally; she was at the time, legally blind, suffering brittle diabetes and crippled with degenerative arthritis. In November 2012, she managed to make her way downtown to the City-County Building on a city bus to vote early for President Obama. She is now in a full care nursing home in Franklin, IN, totally blind and her initial roommate was hearing impaired and kept the television volume at top level; she couldn’t even hear her audio book using earphones. To resolve this problem the staff moved Maria to another room; her roommate speaks only Spanish and tries to communicate with her. The facility is basically clean, some medical care is provided when and how it is prescribed and the food “isn’t too bad”. This is vastly improved over her previous care…at least till the funding cut goes into action at her facility.

  16. iowa’s Terry Braindead did all this in iowa years ago. Even brought in a Nursing Home operator from out of state to run things. Got rid of monetary penalties in favor of voluntary compliance. You know, all the protections the residents depend on were now gone. Profits went up.

  17. This type of of deregulation reveals the extent of the Republican Party’s separation. We have on one finger the deregulation group. No government rules are best according to them. I suppose taking it to an extreme we should have no stop signs, stop lights or speed limits as these controls could impede the delivery of products and services and are a burden on the free market.

    The other finger of the Republican Party has the social control bible thumping theocracy. They want to control education – none of that evolution science. The origin of the universe is contained in the bible. The Bible Thumpers want to control a woman’s body.

    Bottom line is we the people get the middle finger.

    I read recently where the conservative wing of the Republican was concerned Trump may have been an East Coast Liberal during the Republican nomination process. (He was at one time friendly with the Clinton’s, at least in public.) The conservatives are now delighted to find that the Trumpet – aka – Agent Orange – is following the path of massive deregulation. Do not count on the Republican Party to abandon the Trumpet aka – Agent Orange – he is delivering what they desire.

    The latest attack lurking in the weeds is – The Trump administration’s plan to shrink four land-based national monuments has provoked howls of anguish from environmental groups, Native American tribes and some businesses, such as the outdoors company Patagonia. Accompanying changes (reductions) to protected monuments in the oceans – vastly larger areas than their land-based counterparts – have received less attention, but could have major consequences for the livelihoods and ecosystems dependent upon the marine environment.

    https://www.theguardian.com/environment/2018/jan/02/us-ocean-monuments-environment-trump

  18. Actually, I’m not surprised by this. My Mother has seen the writing on the wall and made other arrangements. She’s 86 now and living in an independent place in northern Indiana. I saw her in November. She has a DNR and advertises it to everyone she meets…DO NOT RESUSCITATE. When she goes into heart failure or has a stroke, she wants to die, right then and there. She does not want to live in a nursing home. She lived in one already. In 2000, she broke her ankle and had to live in one for about 6 weeks. She had a non-weight baring injury so she couldn’t even walk on it. She saw what those FOR PROFIT places were like and luckily had excellent insurance (and still does) but this is her last wish. Do not put her in one of those awful places ever again. (She would be an excellent candidate for assisted suicide if she has other life changing health scares).

    For 45 to do this doesn’t even surprise me anymore. It’s like he wakes up everyday and wonders how he can F* over the rest of us, but wait! No, I’m putting the blame in the wrong place. It’s not 45, IT’S CONGRESS. Congress makes the laws, he only signs them. We’re all doomed.

  19. This group saw this coming Election Day yet much of the train wreck since has been out of the light of the news. It’s not Congressional action. Their only “accomplishment” was the wealth redistribution bill. This is Executive Branch malfeasance. Why no reporting? Tweets. A squirrel a day to keep the hounds busy.

    Strategically our pathway is clear. Get every voter out on Election Day and primed to vote nothing but Ds because qualification isn’t as important right now as prevention and messaging. The destruction of America, at a time when the rebuilding of America is necessary, will have to be undone first.

    We absolutely need the Legislative Branch to shut down the Executive Branch for two years when then democracy can undo its failure in 2016. We screwed up then and now have to atone for our failure.

    It’s not complicated. Turn out and all Ds. Even the old and feeble being put on ice flows can manage a parting shot. Absentee ballot, all Ds.

    Some will be bought off with the few hundred dollar bribe on this years taxes which goes on the federal credit card for them to pay later. Maybe we can convince them maybe not but can certainly out vote them.

    To the barricades.

  20. Bingo, Jane Cook! Happy New Year, everyone! Work for change and by all means…VOTE like your life depends on it. (It does!)

  21. Betty; you are so right, our lives do depend on the votes in November – the Primaries and the Election in November. Here is an example just in my family of what/who we are up against. On Christmas day, during a live picture phone conversation (whatever the technical name is) with my grandson who is a paramedic in the Navy, stationed in San Diego, I saw him wearing a bright red T-shirt with large white letters “MAKE AMERICA GREAT AGAIN”. I gave him two thumbs down on he shirt; too upset to question it. Had a Facebook conversation with his wife today; she bought them the T-shirts because she loves that slogan and was impressed with Trump’s dedication to the military. She then said she was aware he hasn’t actually done anything for them. A few months ago my grandson had to decide whether to reenlist or not; she said they opted to reenlist to maintain their health care. Then stated it isn’t very good. She is also aware that the current government is only about money and not about caring for people. This is typical of Trump supporters. We will be fighting them again throughout 2018 and into 2020. We need to be prepared for the unexpected – we were afraid Trump could win in 2016 but we were not prepared for it to actually happen. Yet, here we are. I won’t ask who my grandson and his wife will vote for in upcoming elections; I was unprepared for the unexpected disappointment I saw on Christmas day.

  22. I would recommend setting up voter registration centers in all elder-care facilities across the country. Now. And enlist their shuttle buses with volunteer drivers to get these seniors to the polls THIS November, just over 10 months from now.

  23. The investors, who are the ones charged with figuring out compliance with regulations, weak as they are, aren’t the ones spending time with patient care. To even make such an asinine argument displays the extent of the willful ignorance of fatso’s administration. Nursing home requirements are already very low–they have the least amount possible of actual nurses–that is, people holding a nursing license who actually went to a nursing school, as opposed to CNA’s–who attended a 6-week course and obtained a certificate. Of course, the millionaires in Congress can afford quality care by real nurses for their aged relatives, who won’t die from infected bedsores or urinary tract infections or dehydration or malnutrition, and everyone else can go to hell.

  24. Betty,

    “Work for change and by all means…VOTE like your life depends on it. (It does!)”

    Why should a WHITE MAN [or woman]vote for CHANGE and not vote for the Republican Party?

    An important part of my education as an attorney was defining the issue. I strongly suggest our biggest problem is…… OUR EDUCATED, REPUBLICAN, WHITE FRIENDS don’t like Donald Trump, but that doesn’t mean they will vote for a MULTI-CULTURAL FUTURE.

    Why should they? That’s the $64,000 question. WE better find a good answer to that question and PRONTO.

  25. These posts sound like readers can do what I have been doing for years or Pete recommends: vote “D” or anything but GOP.
    Don’t believe the trashing of our social systems by the GOP.
    Read these posts.
    Vote to prevent tinkering with our social support system. Improve it!
    Old Age Security, Universal Healthcare, Regulation of Food and Water, Tertiary Education, Infrastructure.
    Yes, and an acceptable tax code to gather needed revenue from those who can best afford it.
    Be suspicious of “privatization”; does it provide for the common good?
    Let’s replace this Congress in November, let’s add Term Limits.

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