Waves of new fund cuts imperil US nursing homes by AP

My comments were not to start an arguement between the parties. The initial withdrawal of the Social Securtiy Funds was taked my Mr. Clinton. And he did not 'pay off the deficit' just significantly reduce it by taking these funds in order to get reelected. This done, with the promise to pay it back. Elkhart if you reread what I said, you will note that not any of the Presidents after him, paid it back (from either party), but just continued what he started and used this money in a numbers game at the polls to make them appear to be better managers of our money.

Now, the nursing homes making so much money? Eliminate the for-profits? I hadn't realized that there were so many non-for -profits willing to run through all of the hoops that the government has set-up in order to own and operate nursing homes. While 'some' of what the gov has asked the nursing homes to do is reasonable and I give them credit, the small amount that they pay is ridiculous. Do they make a profit, sure they do...the ones that have a nice blend of private pay, insurance holders and medicare recipients although even medicare has severly cut their rates. The nursing homes that were unable to 'scramble' fast enough to put the programs together and train their already overburdened staff when yet another medicare rule changed, but even after providing all the basics, plus medications, plus the therapies, and the documentation, got their money taken back by medicare because they didn't document it in the 'new way'! If you worked in this sector of the industry and had to go throught the nightmare of Medicare Part A with all of the rule changes often three times a week just to give a medication. A simple medication may be 'covered' on Moday. Wednesday, medicare would change their mind and not cover that medication any longer, soooo the nurse would call the doc, then the pharmacy and wait for it to arrive. Then come Friday, that medication would no longer be covered and the whole thing would start again!

As for medicaid recipients, with a base pay that low, you can't seriously think that an institution could stay viable. And that is why so many of these homes have significantly decreased the number of medicaid recipients than they did in the past. If that makes them greedy for wanting to remain in opporation, what does it make our government for taking their money? Social Security was never meant to be used as a 'bank' for the government but was put their to accrue interest and remain a self-funded program for retirees.

According to the article, 'many nursing homes may have to close their doors' and/or 'cut more nursing hours', well as usual, the reporters are a bit behind the times. They have already stopped hiring, have cut out OT altogether and are looking at ways to give the cna's a $2/hour raise, train them to be medication administration 'techs' and have them pass meds under the supervision of an RN. Now, how does that sound? Safe??? In the nursing homes it is tough enough to rely that your cna is actually feeding the resident or transfers a new 'hip' properly and then actually reapplies the O2 when they are returned to bed, now add on taking the responsibility of their med errors? Trusting that the big $2hour and 3 month class will make them suddenly more responsible and knowledgeable seems like another nail in the coffin so-to-speak.

I will agree, the for-profits have to make money to stay open. One of the biggest expensed is nursing salaries. If medicare is cut even further than it already is, they will not close but will try to push the medication administation position more. And when thinking about healthcare reform, these postitions and others like it, will have to be considered. Or, actually going through with putting the $20,000 or so cap on nursing salaries. And like KittyKatty has written if we remain 'asleep at the wheel' this is a very real possibility! For all of the supporters of the 'changes' that our country is going through, get ready for this one. And not just in the nursing homes, the hospitals are doing the same now with limiting hours, increasing nurse-patient ratios and stopped hiring. As nurses, we all know who are the actual front-line workers, us. And we know that without us, none of these institutions could remain open. And if we do not come together like the auto industry, the financial industry, and even for petes-sakes GE, to change legislation or to stop this from happening (like the docs are doing with their march on Washington) we may just wake up from our slumber and cry, how could they do this to us? When the answer is, we let them.

As for increasing 'homecare'. Seniors are affected by this economy as much as the rest of us. Even if their homes are paid off there are so many municipalities that have doubled or worse taxes that their homes could be sold at auction just to pay these taxes. We are looking at the huge burden of all of these baby boomers becoming senior citizens,most of whom are on Social Security and will not get a cost of living raise until 2011 and only will get little more than a 1% increase. 1%, while virtually the price of every single thing that we use on a daily bases has gone up waay more than that. If we close the nursing homes, and take their homes for taxes and then don't give them COLA, how will they live? Where will they live? How will they get that med at $50 a pill? What will they eat? Who will tend to their wounds?

Who knows, any church folks out their thinking about opening up a non-for-profit to care for our elders?

Elkhart, I am not at odds with you and respect your opinions. I do follow you but this is just another aspect of health care reform that scares the heck out of me. I don't have the answers so I post here. I am hoping not for derision but for comradery. I am looking for others that are following closely with what is being decided on for OUR future. Our, not just mine. I am just tired of being scared and want to do something, just not sure what or where to start. But one thing I do not want to do is start a fight with other nurses that I care so much about, but want to hear what do you think of the possiblility of this happening? What are any of you doing or what have you done to have your voice heard?