How Not To Fix Nursing Homes -- Budge...

How Not To Fix Nursing Homes -- Budgets and Budgeting

There are 52 comments on the Hartford Courant story from Apr 7, 2008, titled How Not To Fix Nursing Homes -- Budgets and Budgeting. In it, Hartford Courant reports that:

Everybody wants to fix Connecticut's nursing homes. The problem is, the fix elected officials have in mind is empty rhetoric, and it could do more damage than good.

Join the discussion below, or Read more at Hartford Courant.

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CT no longer

Haverhill, MA

#1 Apr 7, 2008
It's about time that the Association has voiced something. I am a licensed administrator who has worked for CT Facilities including Haven and have to say that the real issues has little to do with the companies that are brave enough to be in this business.
As a business I have no clue why anyone would want to pursue ownership of a facility when the return is so minimal, the regulatory environment so extreem, the family lawyers preying on the families acceptance/denail of their loved ones conditions, making every change in their condition a potential abuse issue.
The Courant has done a fine job in further attempting to disgrace a profession that seams to constantly battle for a positive image. I challenge the Courant to try something different and really look at what goes on inside. The positive work and challenges that the profession really is up against.
It really does seam that the system is broken in CT and as a very talented Administrator I can honestly say that there are way too many other options than to work in CT as mentioned in Toni's article.
Maybe Blumenthal and the State should purchase Haven at the bankruptcy auctions and make History with a socialized model where profits or meeting bills doesn't effect care just the tax payers pockets. How would they do? Not well I am sure.
Just really too bad that my commute has been lengthened as I am not leaving long term care, it is too rewarding to work with the elderly. Other States that border Connecticut just seam to have their act together.
Maybe the press and the state should stop bashing Connecticut providers and look to our neighbors for some guidance and solutions.
Good luck to all those in the trenches here in CT hopefully the press bashing and DSS's avoidance of responsibility for their part of the broken system will end soon. Our residents deserve much better than the current stigma of their homes and healthcare providers.
The Fat One

Plainville, CT

#2 Apr 7, 2008
Earle is the VP of CAHCF and Toni is the Executive Director. Why would any facility pay dues to this organization. The larger facilities have left her and she cannot help anyone. Why pay an association that brags it can help but is incompetent in everything it does. The only one who benefits is Toni
Paul Johnson

New London, CT

#3 Apr 7, 2008
I couldn't agree more with Ms. Fatone. As usual, we have legislators pandering for votes by telling their constituents that they are going to "fix" the nursing home problems. At the same time, the other side of their mouth is telling nursing homes that the state is not going to pay for the "fix". It only sets nursing homes up to fail. It is time for everyone to sit down, study the problems and come up with some reasonable, financially sound solutions, as opposed to the typical knee jerk reaction that is being seen now.
a patient family

New York, NY

#4 Apr 7, 2008
There seems to be a feeding frenzy at the capitol. All the legislators are worrying that they need to do something to "correct" the situation that allowed a Haven to occur. AND SO they're willing to destroy the system that cares for our parents, and destroy the potential for them to continue to receive the excellent care that most do receive. AND WHY? So the politicains can say they did something!
Let's have our legislators really do something and fix the system by providing the money necessary to care for our parents.

New London, CT

#5 Apr 7, 2008
Do the right thing - find the money to pay the nursing homes for the additional staffing.
NH Pro

New London, CT

#6 Apr 7, 2008
For the Fat Man,
Your comments are very self serving and of little importance or use to anyone. I suggest that if you would take care of your own business properly, all nursing homes would be better off.
Cindy in Plainfield

Jewett City, CT

#7 Apr 7, 2008
Love the article - VERY acurate. However, high levels of staffing do not necessarily translate to good care, strong involved management translate to good care. Most nursing homes run very close to the bottom line each month. One bad month can tip a small facility into the red, I can't imagine what will happen with a 1% or ZERO increase. Wages account for about 70% of a facility cost, the remainder goes to physical plant and energy costs. Staff already are in serious trouble due to transportation increases. It is a very critical time for nursing care!
Linda Garcia

United States

#8 Apr 7, 2008
Ms. Fatone's article is factual and addresses the concerns that I have as a healthcare provider. My costs in the area of electricity, prescription drugs, laboratory fees and nursing wages and benefits have increased by 15% or more from last year at this time. At the same time the acuity level of the people we are caring for has worsened. People do not come to stay in skilled nursing facilities unless they are too ill to return home. The type of person we care for now truly requires 24 hour nursing care due to multiple complex medical issues. We staff well above the CT public healtch code requirements and still have vacancies for licensed nurses. These vacancies can be very difficult to fill due to qualified staff availability. More staff is great, but we need the revenue to pay for them, and the ability to find them! A 1% increase is totally unrealistic to meet the costs of doing business in CT.

United States

#9 Apr 7, 2008
This editorial was difficult to read because, as a licensed Administrator for the last 25 years, I have found Toni Fatone's comments to be true. Our State's leadership is using politics to direct and manage Connecicut's health care policy. I have never met a politician who didn't say that they supported good health care programs for the frail and elderly. However, there are a rare few who will take the time to come to understand the REAL issues at hand. Fewer still are those who will engage in a dialogue regarding REAL solutions. The idea of putting additional regulations into place without a way to fund them reaffirms for me that our State's leadership is saying what they believe people want to hear, not seeking real solutions.
Concerned in Canaan

New London, CT

#10 Apr 7, 2008
I would invite any legislator to spend a day "walking in the shoes" of a Certified Nursing Assistant in a Nursing Home. In spite of being underpaid and overworked, they give excellent care day after day. Come in and talk with them and then tell us that you can only find enough money in the budget for a 1% increase. We are lucky to have someone like Toni Fatone championing our cause.
Meghan Lerner

United States

#11 Apr 7, 2008
To the Fat One: sadly it seems to me that you are nothing more than a simple minded ignorant soul.
This article is very honest and very accurate. Thank you Ms. Fatone!!!!
Richard A Schafer

Minneapolis, MN

#12 Apr 7, 2008
Bottom line, it is unreasonable for government to demand care quality that exceeds what it's willing to finance.

Even if you plant armed guards or NFL linebackers in every nursing home in the country, you will not solve the quality problem as long as nurses aides can make more money working with fresh vegetables and soda pop at a Taco Bell than they can make working in blood and feces at a nursing home.

The truth is that the nursing home industry provides an extraordinarily high level of compassionate, professional care for a huge number of mostly Medicaid residents in spite of the welfare program's grossly inadequate levels of reimbursement. If nursing homes sometimes fall below that standard, the responsibility--indeed the guilt--lies principally with public policy. However well-intentioned that policy may have been, it created the quality problem by crowding out private financing of long-term care and trapping most people in institutional care inadequately financed by Medicaid.
Richard A Schafer

Minneapolis, MN

#13 Apr 7, 2008
The goal of long-term care public policy is rightly to encourage a broad spectrum of LTC services, support home and community-based care, discourage institutional bias, and empower consumers to pick and choose the kind and quality of long-term care they prefer.

The other side of the sword, however, is that when government makes Medicaid-financed long-term care services more attractive than ever before without targeting those benefits effectively to the poor, it invites more Medicaid planning and discourages private LTC financing through insurance and reverse mortgages.

So, step one to solve the LTC financing crisis is to give Medicaid back to the poor. Create a real spend down requirement that puts home equity at risk for long-term care. Do those two things and the public will finally see long-term care as a personal responsibility. They'll take out reverse mortgages to fund home care and if they're still young, healthy and affluent enough, they'll start buying LTC insurance. Medicaid will have fewer recipients so it will be able to provide better access, higher quality, and more reasonable provider reimbursements.
The Skinny One

Shelton, CT

#14 Apr 7, 2008
So now that the state got caught with their pants down with Haven Health they need to prove their worth by harassing legitment companies who are making a difference in this world. It’s unfortunate that the tax payers of this state fund ridiculous investigations such as this. My mother was in one Marathon’s facilities and she was always a priority to the staff and I was always amazed at the level a quality care that Marathon provided. The state needs to help companies like Marathon to make a difference in people lives not try to take them down because their system is a mess!!

New York, NY

#15 Apr 7, 2008
Nursing homes exist because they provide a cost effective alternative to acute care hospitals for persons requiring 24 hour per day skilled nursing care and rehabilitation services. This reason, and the fact that there are not nearly enough hospital beds available, is the reason hospitals are eager to discharge to nursing homes.

The Governor and our legislators seem to believe that home health care is the holy grail of healthcare. The fact is that if someone attempted to replicate the equipment, services, and personnel found in a nursing home to their personal residence, the cost per day would be far higher than a nursing home. This is why only very wealthy people can afford to stay at home and import these services. Home health care has a place to provide help to people who need assistance with activities of daily living, but that is distinctly different than the level and intensity of services provided in a nursing home.

Our legislators are urged to listen and understand the issues. Being punitive against the industry because of the misdeeds of an individual threatens the entire health care continuum in our state.


#16 Apr 7, 2008
Right on Ms. Fatone!
Our very wealthy state of CT. is treating the very people who helped build this nation as second class citizens. Our GOVERNOR, senators and legislators NEED to work WITH nursing home providers and listen to their needs to help benefit our residents. A 1% increase is absolutely ABSURD!
Susan Macdonald

Killingworth, CT

#17 Apr 7, 2008
I am the administrator and owner of a 60 bed nursing facility. Our employees deserve more than a 1% increase for they are hard working and go above and beyond to render care. In addition, rates for medical supplies, utilities and insurances have increased more than the 4% increase that we are requesting from the legislature. Since 80% of our funding comes from the State of Connecticut for state aided residents, and there are delays in approvals and payments many of our vendors may not be paid within 90 days.


#18 Apr 7, 2008
Finally , Someone is speaking out! What have they been waiting for? I am a therapist and its time the Skilled Nursing Facilities be allowed to do a good job! Current reimbursment has nearly toppled all the facilities I have worked in. Wake up Rell!
Andy Tarutis - Hamden Ct

Beacon, NY

#19 Apr 7, 2008
House Bill 5864's proposal to increase staffing in Connecticut Nursing Homes would cost the system well over $130 million dollars. But the State only has $10 set aside for this. The numbers just don't add up and our legislators should take note of this catestrophic shortfall. If there is no way to fund this legislation, how can it realistically be proposed?
I have worked in the Nursing Home Industry all my life. All of us would be open to more help if it were economically possible - and practical in terms of available personnel. But the $10 million dollars to increase staffing won't do it. Those monies would be better spent towards a fair increase in our overall budgets.
Our State's leaders must recognize that there are many dedicated care givers and professionals in this industry and that we all should not be denegrated or overregulated because one company's challenges.
Decent respectable care to our elderly cannot be accomplished without our care givers and the good operations that serve them. Accordingly we need to support the nursing home industry's continued existence and viability. A 1% is a giant shortfall in doing so, and in no way enables us to keep up with higher electricity, gas, food & other costs, and to give our staff a decent wage increase.
Our industry needs responsible support!
Big Mike

New London, CT

#20 Apr 7, 2008
Ms. Fatone is right on target. Once again, the legislators are acting as if they are going to "fix" nursing homes bu tin truth, they have no plans to spend one extra dime to do it. Their hope is that their constituents remember what they said, not what they did.

When voters finally smarten up, then the politicians will not get away with just rhetoric. they will actuall have to take concise, thoughtful, responsible action. but until then, they will continue to play games.

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