Medicare’s 5-Star Rating System Under Fire

Medicare’s star-rating system for nursing homes, dubbed Nursing Home Compare, is no stranger to controversy. On its launch in 2008, the long-term care community was up in arms, criticizing the system’s lack of quality metrics that play a key role in resident satisfaction. And a new report by a major newspaper has brought critiques of the system back into the forefront.

New criticisms emerge pointing to flawed ratings

According to a recent article in The New York Times, “The Medicare ratings, which have become the gold standard across the industry, are based in large part on self-reported data by the nursing homes that the government does not verify.”

The article points out that only one of the metrics used to determine a nursing home’s star rating comes from independent reviewers: state inspection data. Staffing ratios and quality measures are self-reported by skilled nursing facilities (SNFs), opening the door for potential abuse of the system.

Criticisms of Nursing Home Compare are nothing new; the program has faced them since its inception. But the content of the complaints has changed course over the years.

Early criticisms of Nursing Home Compare

The American Health Care Association (AHCA) denounced Nursing Home Compare in a public statement, voicing the view that the program “is premised upon a flawed survey system that does not measure quality, lacks the inclusion of other important quality elements that help consumers make informed decisions, and includes inaccurate data.”

The general consensus was that nursing homes could be unfairly portrayed or perceived as providing a lower quality of care, based on technicalities that resulted in deficiencies on state inspections. In other words, a lower five-star rating could be assigned to a skilled nursing community that provides exceptional care, and providers were concerned that they’d lose potential residents as a result of such inaccurate ratings.

Nursing Home Compare

 

Ratings lack critical state complaint data

What’s more, Nursing Home Compare does not take into account complaints filed by consumers with state agencies or fines and other enforcement actions by individual states, only federal actions. The Times points to one community, Rosewood Post-Acute Rehab, a nursing home in a Sacramento suburb, which has maintained a perfect five-star rating for five years, a distinction held by just one-fifth of all nursing homes in the U.S.

But what this rating doesn’t disclose to consumers is the fact that Rosewood was fined $100,000 in 2013, the highest penalty possible, for an accidental, and unfortunately fatal, overdose in 2006. It also doesn’t tell consumers that there have been more than 100 complaints filed in California against this particular nursing home between 2009 and 2013.

California Advocates for Nursing Home Reform, an organization which also tracks complaints, has documented 164 complaints for the same time frame against Rosewood. Officials from Rosewood point out that only a small portion of those complaints have ever been validated, but according to The New York Times, experts say that merely being the subject of that number of complaints is a sign of potential trouble.

But consumers need a clear metric for comparison

While there are some changes coming that will hopefully improve the validity of the Nursing Home Compare rating, such as the requirement that Medicare use payroll data to verify reported staffing levels (required under the Affordable Care Act), a process and system for doing so hasn’t yet been finalized. Best Senior Living Awards Winner Badge

Perhaps of major concern is the idea that a standard, industry-wide rating system is such a valuable metric for consumers. It provides a single point of comparison to help families wade through what can otherwise be a confusing and overwhelming decision-making process. That’s why SeniorHomes.com has created the Best Senior Living Awards, an independent, third-party rating system for assisted living, independent living, and retirement communities.

The Best Senior Living Awards rating system utilizes the opinions of independent senior living experts, along with reviews from residents, staff, and family members, and other quantifiable metrics like state inspection data, to calculate a standard score that consumers can use to easily compare their top communities. Additionally, written reviews are publicly available on SeniorHomes.com, providing consumers with in-depth opinions from others with real-world experience with these communities. Visit any community’s profile on SeniorHomes.com, such as Dunwoody Pines in the Greater Atlanta, Georgia metro area, and access reviews submitted by residents, family members, and staff. And, if you have experience with a senior living community and would like to share your opinion with seniors and their families searching for senior housing options, visit our Post a Senior Living Review page to search for the community and submit your review.

There’s so much information out there about senior living options, yet the choice isn’t an easy one for seniors or their families. There’s a clear need for an independent, third-party rating system that provides a clear, straightforward rating taking into account both quality and compliance, quantitative and qualitative data. And that’s precisely what SeniorHomes.com aims to achieve.

Nursing Home Compare screenshot via Medicare.gov

Celebrate National Assisted Living Week with SeniorHomes.com!

By 2020, there will be an estimated 21 million seniors who are 75 and older in the United States. Behind this number will be families grappling with how to care for loved ones. When a family member needs support, it is instinctive to turn inward, for families to support each other and find the solution within the family. Yet that is often overlooking the support an outside partner can play in lessening the burden for all involved and making life a bit easier.

Many people still think that assisted living communities are nursing homes—and this could not be more wrong. Assisted living communities are filled with seniors National Assisted Living Week - Logo
in their 80s, 90s, and some even celebrating the century mark, who are still active and living independent lives. They visit zoos, attend plays and even kayak down a local river. The only difference which sets these seniors apart from their younger 60s and 70s counterparts is the need of supportive assistance to retain their independence.

This is why SeniorHomes.com is proud to recognize National Assisted Living Week, which runs from Sept. 7-13. The National Center for Assisted Living started National Assisted Living Week in 1995 to celebrate and honor relationships between residents, families and the dedicated staff members who provide person-centered care each and every day.

Every week we work with more than 1,000 consumers, answering their questions about what is assisted living and matching them to communities which deliver this person-centered care. And we partner with the most reputable senior living companies across the nation so families have options that will fit every budget and every state.

“We are proud of the role we play in helping seniors and families find the best community possible,” says Chris Rodde, CEO of SeniorHomes.com. “Our care advisors take the time to know each consumer and learn what type of support and lifestyle is wanted. Every week we receive a ‘thank you,’ whether from a senior or their family, for the help we provided in matching them to a community. Many never knew how rewarding life could be after moving into a community.”

We invite you to join SeniorHomes.com in recognizing National Assisted Living Week.

Joan’s Journey: Senior Living Lights Up Life

A Joan’s Journey riddle: How many seniors does it take to hang a wall lamp?Joan London and her new lamp

A) Three

B) Two

C) One

D) None

If you guessed “D,” you are correct. How does a wall lamp get mounted in a senior residence, if no senior hangs it?

Simple! At Holiday Villa East (HVE), a senior housing community in beautiful Santa Monica, Calif.—and my new home—the capable and consistently available maintenance men hang lamps, arrange furniture, fix ceiling fans and assist with every maintenance task under the sunny beach-area sun. In addition, housekeepers, aides, front-desk and kitchen staff cheerfully provide residents with comfortable, homelike amenities. Whether eating with companions in the attractive dining room or enjoying breakfast, lunch or dinner in one’s own space, an easy, relaxed lifestyle abounds.

To read the rest of Joan’s post, and to get a glimpse into her living quarters, visit the latest installment of Joan’s Journey, “Part 21: Senior Living Lights Up Life.”

Joan London, a former Houston Chronicle newspaper correspondent, is a freelance medical and social service writer. London recently moved from Baltimore to a senior housing residence in Santa Monica, Calif., where she is closer to her children and grandchildren. Follow her series, Joan’s Journey, on SeniorHomes.com.

 

Older Adult Bullying is On the Rise: How to Cope

Bullying isn’t a problem isolated to kids and teenagers. It’s an issue that spans every age demographic, but as the population ages, it’s becoming an increasingly common problem among senior citizens—particularly those living in communal living settings such as assisted living or independent living.Older adult bullying

Older adult bullying can take many different forms, from offensive jokes to whispering when the victim enters a room, isolating an individual by reserving seats in the dining room and excluding one or more people intentionally, and even actual physical violence. Seniors are sometimes already suffering from depression or feelings of isolation, or perhaps grieving the loss of a spouse or loved one, making older adult bullying a particularly concerning problem.

For senior living communities tasked with providing a warm, comfortable, home-like environment for residents, older adult bullying situations can lead to awkwardness and tension that impacts the well-being of every resident, including those not directly involved in bullying as a victim or perpetrator.

Experts like Dr. Linda Rhodes, a former Secretary of Aging and author of “The Essential Guide for Caring for Aging Parents,”suggest a proactive approach to managing bullying, having residents sign standards of conduct agreements and setting clear expectations regarding bullying behaviors. Senior living communities should also conduct periodic needs assessments to pinpoint potential problem areas before situations escalate, and staff should engage in ongoing discussion to identify concerning behaviors to intervene before they lead to bullying.

If you suspect that your loved one is being bullied, or if your loved one expresses feelings of isolation or discomfort due to the actions of others in her community or social circles, there are some coping strategies for you, as well. Visit our article, Coping with Older Adult Bullying in Senior Living Communities, to learn more about older adult bullying and what you can do as a staff member in a senior living community or  a family member of an aging loved one.

Team SeniorHomes.com Joins In the Ice Bucket Challenge in Support of the ALS Foundation

You can’t visit social media these days without seeing images of people everywhere dumping buckets of ice water over their heads.

SeniorHomes.com takes the Ice Bucket Challenge

Team SeniorHomes.com takes the Ice Bucket Challenge!

What’s with all this ice-bucket madness? The Ice Bucket Challenge has gone viral and taken the Internet by storm in support of the ALS Association, with good-natured friends and supporters choosing to subject themselves to freezing-cold water and challenging their friends and loved ones to do the same by nominating them in their own ice water-dumping videos.

The idea is that you can donate to the ALS Association as a means to opt-out of the ice water stunt, but it turns out that there are thousands of people up for a good challenge who are also charitable: Many participants do both.

Ice Bucket Challenge raises millions for ALS Association

Not only is the Ice Bucket Challenge raising awareness of ALS, but it’s produced millions of dollars in donations for the ALS Association — as of August 21, 2014, the total topped $41.8 million, nearly a 25 percent increase from just 24 hours before ($31.5 million as of August 20, 2014).

Last year at this time, the Association had received about $1.9 million in donations, marking a substantial increase in funds that can be used to further research and search for a cure for this devastating disease.

What exactly is ALS?

The U.C. San Diego School of Medicine estimates that about 30,000 people in the U.S. are living with ALS (Amyotrophic Lateral Sclerosis) at any given time. You may be more familiar with “Lou Gehrig’s Disease,” a moniker commonly used to refer to ALS, which is a “progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord,” according to the ALS Association. About 5,600 people are newly diagnosed with the disease each year.

ALS is a progressive disease, with many patients becoming paralyzed as motor neurons degenerate, resulting in the loss of the brain’s ability to control and coordinate muscle movement. ALS is a devastating, fatal disease, and there is currently no cure.  The average life expectancy for a person newly diagnosed with ALS is two to five years, although it is a variable disease. Life expectancy actually ranges from two to 20 years, sometimes even more:

  • More than half of those diagnosed with ALS will live for three years or more.
  • 20% of people diagnosed with ALS will live five years or longer.
  • Up to 10% will survive for more than 10 years.
  • 5% will live 20 years.

The ALS Association also points out that, “There are people in whom ALS has stopped progressing and a small number of people in whom the symptoms of ALS reversed.” While this provides a glimmer of hope, it’s not enough. That’s the driving force behind the Ice Bucket Challenge: More research can identify better treatments, increase the life expectancy of a larger proportion of ALS patients, and ultimately, produce a cure.

SeniorHomes.com joins the fight and takes the Challenge!

SeniorHomes.com CEO, Chris Rodde

SeniorHomes.com CEO, Chris Rodde

And that’s the reason why Team SeniorHomes.com has joined the fight by participating in the Ice Bucket Challenge. Our COO, Jay Goldstein, was nominated by a friend and dumped a big bucket of ice-cold water over his head and, in turn, nominated our CEO, Chris Rodde. From there, it became a team effort — captured, of course, on video for your viewing pleasure.

But there’s one more video we think you should watch. It’s this one. Why? Because we could never convey the real purpose and the value behind all of this in the same way that this man has. It’s both hilarious and moving — so watch, learn, and share.

SeniorHomes.com Ranks In the Top 1,000 Companies in the Inc. 5000

SeniorHomes.com is thrilled to announce that the company has been recognized in the prestigious Inc. 5000 fastest-growing companies list for 2014. To qualify for inclusion, companies must have been founded and generating revenue by March 31, 2010, and rankings are based on revenue growth from 2013 as compared to 2010 revenue. SeniorHomes.com lands at No. 678, representing a growth of 670 percent in the three-year period between 2010 and 2013.Inc. 5000 logo

This is an exciting accomplishment, as the Inc. 5000 is a widely-respected and recognized ranking of privately-owned companies that has catapulted many brands to widespread success in the past. Brands that are now household names, such as Domino’s Pizza, Dell, Yelp and many others, were recognized in the Inc. 5000 while they were still startups with tons of potential.

There are a few factors contributing to this success. First, a growing elderly population and increasing numbers of family caregivers mean there are more people navigating the at-times-confusing landscape of senior housing and senior care. Companies like SeniorHomes.com provide a valuable, free service to these families who aren’t sure where to turn for help or how to begin their search. Second, SeniorHomes.com has worked hard to cultivate and maintain a positive, supportive company culture throughout phases of rapid growth and the inevitable challenges that statups face along the path to success.

“When people talk about the Inc. 5000, they talk about innovation,” says Chris Rodde, CEO of SeniorHomes.com. “At SeniorHomes.com, we emphasize a company culture that motivates our already-exceptional team to reach higher and achieve more. We try to cultivate an environment in which our team feels empowered to develop and pursue ideas that drive our company forward – a difficult thing to achieve in the modern business world – and that’s where true innovation lies, in the power of the collective.”

Our exceptional team is comprised of: compassionate and talented Care Advisors working with seniors and caregivers every day; expert writers who provide valuable content to help seniors and their families understand the many complexities of senior housing, senior care and aging; developers who work tirelessly to build and maintain the comprehensive national database and community rating system; and the many supporting staff members who handle various important tasks day in and day out. We all work together in a supportive and collaborative environment to ensure that SeniorHomes.com provides the best possible resources and services for the aging population.

All of this, of course, works in tandem to further the mission and realize the vision of our executive leadership team, who are responsible for cultivating a culture in which every employee feels valued and empowered to thrive. So far, it’s proven to be a winning combination, and we look forward to many more successes in the future as we continue to implement new ideas and find more innovative ways to provide valuable services to seniors and their loved ones.

Thank you to everyone who has contributed to the success of SeniorHomes.com!

The Last Stop: With Technology, We Try

I think our grands and great-grands find current technology easier than using a knife, fork or spoon. We marvel at them. Technology is not a challenge for children and teenagers; it's a way of life.

In contrast, my age-mates and I find new technology an ongoing struggle. We end up cursing at our smartphones and comp

uters and wish for the olden days.

I find that at my retirement community, computer frustration is a regular part of dinner conversation.

Read more about Margery’s efforts to become more tech-savvy—and why some of her friends choose not to embrace technology—in “Part 10: With Technology, We Try.”

This post was written by Margery Fridstein, an author and retired psychotherapist who lives in a CCRC outside of Denver, CO. She is chronicling her experience in the monthly series, “The Last Stop With Margery Fridstein.”

Marijuana Laws Throw a Monkey Wrench in Senior Living Operations

The legalization of marijuana for medicinal use has created some interesting challenges for the senior living industry, only further complicated by the recent legalization of marijuana for recreational purposes in Colorado and Washington State.

With state and federal laws clashing in states which have legalized marijuana for medicinal or recreational use, senior living operators in these states must carefully craft policies to minimize legal risk. And that, it seems, is no simple matter. Medical marijuana challenges assisted living

While the Obama Administration has taken the stance that the federal government will not—and federal prosecutors should not—penalize prescribing physicians or approved patients or caregivers in states which have passed laws legalizing marijuana, it’s unclear what the future holds and presently, the government still classifies marijuana as a Schedule I Controlled Substance. That means it’s deemed to have a high potential for addiction and has “no currently accepted medical use.”

Senior living providers are taking approaches ranging across the spectrum, with some permitting the use of medicinal marijuana but not centrally storing or dispensing it as they would another prescription medication. In this case, residents using marijuana for medicinal purposes must have a caregiver who can assist and obtain it via a third-party, outpatient provider — but these circumstances aren’t free of obstacles, either.

For some providers, the risk is too great to take, and they opt to prohibit the use of medical marijuana within their communities altogether to play it safe.It’s an interesting landscape that’s sure to change in the coming years, and will likely be a heavily-debated issue in the next presidential election. Until then, the policies of individual senior living providers are the determining factor in whether it’s possible to use marijuana for medical purposes as a resident in a senior living community.

For more on this widely-debated issue and where the current regulations stand, check out our article on the impacts of the legalization of marijuana on the senior living industry.

 

 

 

 

Addiction Doesn’t Discriminate: Misuse and Abuse of Prescription Drugs in the Elderly a Growing Concern

You’ve probably heard devastating news stories about teens with promising futures dying of drug overdoses. No one likes to hear these stories, yet they’re becoming all-too common in society today.

What we don’t hear about is prescription drug abuse and other illicit drug use among senior citizens, yet it’s a growing problem that shouldn’t be ignored. Prescription Drug Abuse in the Elderly

In fact, the misuse of prescription medications can be even more dangerous in the elderly due to physiological and psychological changes that occur with aging that make seniors more vulnerable to overdoses. A slower metabolism and lower body water content, for example, mean higher concentrations of substances in the body, which can lead to an overdose even with lower doses of medication than what typically leads to an overdose.

A recent article in USA Today shed light on what is a problematic practice in the healthcare community with dangerous consequences: Many seniors suffer from chronic pain, anxiety, and other age-related issues, and physicians readily — perhaps too readily — prescribe narcotics and anti-anxiety medications to provide symptomatic relief. But when multiple doctors begin prescribing painkillers, and seniors develop a tolerance to their medications, self-medicating with higher doses to achieve the same symptomatic relief is an easy solution to the immediate problem. What many seniors don’t realize, however, is that they’re creating a dangerous physical and even psychological dependence on prescription drugs.

Faced with the choice between suffering and the possibility of easy relief, most of us would choose the latter. For more information about the rising incidence of prescription drug misuse in older adults, what to look for if you suspect a loved one is misusing prescription medications, and why seniors are sometimes more likely to develop an addiction, read our article, “Prescription Drug and Substance Abuse Among Seniors on the Rise.”

Four Smart Strategies from Derek Zoolander that Can Help You Prevent Senior Dehydration

As Derek, the title character in “Zoolander,” said, “Moisture is the essence of wetness, and wetness is the essence of beauty.” His words were silly, but his intentions were not.

Proper hydration is essential to life. More than half of our bodies are water. Water helps us digest food, keeps joints working properly and maintains blood pressure and body temperature. But many Americans—and many seniors—still do not drink enough water. Elderly dehydration is common both in assisted living or aging-in-place scenarios.

In this post, we’ll discuss dehydration matters and why seniors are at such great risk. Then, you’ll learn four smart strategies from Derek Zoolander to help prevent senior dehydration.

“I’m a hot little potato right now!”

Dehydration is a major problem for seniors and a leading contributor to elderly
hospitalizations. Thirsty seniors have higher risks of falling and more cognitive difficulty. Also, dehydrated seniors face medical conditions like urinary tract
'Zoolander' star Ben Stillerinfections, kidney stones or constipation. Taken to extremes, severe water loss leads to heat stroke or even death.

Now, the worse news: The natural process of aging makes seniors even more susceptible to dehydration. As we age, our bodies hold less water and we are less aware of body temperature changes. This makes seniors less likely to take in fluids to self-regulate temperature.

Complicating matters, many seniors have difficulty swallowing, so drinking water becomes a painful chore. Further, some seniors restrict their water consumption because of fears of age-related incontinence. Finally, many medications that seniors take cause diuresis, sweating or reduced thirst.

Taken altogether, we’ve got a recipe for a perfect storm for dehydrated seniors. Let’s see what lessons we can learn from international male model Derek Zoolander.

1. The “How can we be expected to teach children to learn how to read … if they can’t even fit inside the building?” technique

Derek rejected the school because it was too small for children to fit. But many seniors face the opposite problem. How can we be expected to make sure our seniors drink if they can’t even hold the cups?

Know that your seniors also have a certain set of skills, but those are different than they used to be. The 50-ounce Big Gulp that appeals to a 20-something may look like a Crock-Pot to a 70-something. Help them out by focusing on small amounts first.

Make sure your loved ones have appropriately sized cups, utensils and cutlery. Cups with handles or lids or straws may help them drink in a comfortable manner.

Bonus tip: Place small water bottles around the home for seniors to carry around and keep near their bed. This helps seniors with mobility or memory issues get easy access to water.

2. The “Orange Mocha Frappuccino” technique

Derek’s friends helped him sort through important issues over a few Orange Mocha Frappuccinos. Derek and company knew they could get fluids from non-water sources as well.

Ignore the old “eight glasses of water” rule. Savvy seniors consume fluids in many variations. Add lemon or fruit to water as a hydration hack to make water taste better. One note of caution, though: Seniors should steer clear of alcohol and sugary sports beverages. The former has diuretic effects and the latter may aggravate diabetes.

Seniors can also add fluids by having soup with every meal. Opt for water or broth based soups rather than cream based soups.

Also, many plant-based foods have high water content. Melons, grapefruit, strawberries and raw tomatoes are great natural sources. Throw in raw vegetables and you have a nutritious and hydrating combination.

3. The “Listen to your friend Billy Zane, he’s a cool dude!” technique

When Zoolander needed help, his friend, actor Billy Zane, was there. Be like Billy, and be a friend to a senior in need.

Tell your senior to check his weight daily. Weight loss may be an early sign of dehydration. If he is down a pound, make sure he drinks it up. Also, ask your senior to check his urine color. Make sure his urine is lemonade colored or lighter.

Not everyone lives close enough to their senior to provide daily hydration reminders. Remote caregivers should consider a medical reminder service. Medical reminder services check in with your senior at the same time(s) every day. These systems help make sure he/she remembers to drink enough water (or take proper medications) every day.

4. The “You can read minds?” technique

In one of the most memorable scenes in the film, Zoolander mistakes Matilda for a clairvoyant.

Well, Matilda couldn’t read minds and neither can you.

Rather than try to intuit how much water your senior is drinking, find out for sure. Option number one is to ask on a weekly basis. Let’s try option number two.

Home water delivery services can help seniors get enough water. If you deliver two bottles of water each month, you can use the delivery amounts to ensure your senior is consuming enough water. If the bottles aren’t moving fast, then your senior isn’t drinking enough.

Conclusion

Derek Zoolander only had one skill, “being really, really, really good looking.” Perhaps you don’t have chiseled abs and perfect cheek bones. But, you can use the four techniques above and keep your senior “mer-man” safe and hydrated.

Shayne Fitz-Coy is an NAHB Certified Aging In Place Expert and has a Bachelor’s degree in Psychology from Harvard as well as a Master’s in Business Administration from the Stanford Graduate School of Business. Shayne hails from Maryland, and now calls the Bay Area home. As the Co-CEO and President of Alert-1, an aging-in-place technology company, Shayne writes about issues that matter to seniors and those that care about them.