Category Archive

Watch out, Washington.  Everyone’s favorite domestic diva/lifestyle mogul is coming to town. And she isn’t her to share a new recipe or helpful housekeeping hint. She’s here to tell Congress why we must support those who care for our nation’s most vulnerable citizens.

Martha will join noted aging experts, including Dr. Robyn Stone from our Institute for the Future of Aging Services, at a Senate Special Committee on Aging Hearing entitled, “Caring for Seniors: How Can We Support Those on Our Frontlines?”

During the hearing, the committee will review a major Institute of Medicine report that features major recommendations for improving and expanding the skills and preparedness of the long-term care workforce.

Martha’s no stranger to caregiving. She care d for her beloved mother, “Big Martha,” until her death last year. That experience inspired the corporate giant to establish the Martha Stewart Center for Living at Mount Siani Hospital in New York in 2007. The clinic services as a model for coordinating outpatient geriatric care services for seniors across the city.

The hearing will be held at 3 p.m.  on Wednesday in the Dirksen Senate Office Building. Be sure to catch the Webcast if you can.

From from baking perfect pies to transforming our workforce. Is there anything Martha can’t do?!?!

When most people think of Congressional meetings, they picture policy debates or panel discussions, not computerized “brain fitness” games  or “smart” canes.

But those are just some of the products our Center for Aging Services Technologies (CAST) and the Senate’s Special Committee on Aging and Medical Technology Caucus set up in a Senate office building last week. The reasons? To give a “hands-on” look at how public policy could unleash technology’s potential to transform the way we age.

Take Honor Hacker. She’s a former teacher who now lives in a community where automatic sensors are installed to monitor her health without interrupting her routine and games help keep her memory strong.  She even told members of Congress about the growing “brain game” rivalry between her and her sister, a retired nun. That’s certainly sounds like a strong competition to me!

Experts also testified about how a law the Senate’s considering could help more seniors like Honor benefit from technology now and in the future.  It would bring together the experts and use their knowledge to develop a plan for taking aging-services technology to the next level.

 I don’t know about you, but passing that law means I may get a prescription to play video games in 60 years, I’m all for it!

Remember the New York Times story about private equity nursing homes? Well, members of Congress didn’t take it lightly. In fact, they held two hearings about the issue addressed in it last week.

At a Ways and Means Health Subcomittee hearing, scrutiny was the name of the game. Chairman Pete Stark (D-Calif.) even called for a Government Accountability Office report on nursing home ownership’s impact on the critical elements of quality: adequate staffing and transparency. And none of nursing-home-chain owners were there to argue against it.

Then came an analysis on the Senate side. That’s where the support comes in.  Don’t get me wrong, there was some scrutiny, but Committee members also talked about the work nursing homes were already doing to make their facilities more transparent and accountable to the public.

That work includes participating in the Advancing Excellence in America’s Nursing Homes., which hundreds of AAHSA members are doing now.  Sen.  Charles Grassley (R-Iowa) even said it was “vital” that more nursing homes participate in the campaign.

The Committee also hear from Denise Zabel. She’s an AAHSA member, and the  daughter of a nursing home resident, who spoke about her experiences on “both sides” of the situation.

Whether you scrutnize or support nursing homes, the real question is, will any of this analysis create solutions?

AAHSA’s vision for long-term care is a “healthy, affordable and ethical” system of aging services. Today, those three criteria are far from reality. Few would argue that health care in general, and aging services in particular, reflects well-defined, healthy outcomes. Nor do I know any expert who says what we have today is affordable. Many countries spend far less and have better outcomes. Public outcries related to health care scandals have questioned health care’s ethical underpinnings. And now, Congress and the IRS have their sights focused on not-for-profit ethical behavior and accountability.

Recently, I met with a leading consumer advocate about the state of nursing home care in general and the future of aging services in particular. I asked her what AAHSA’s and the nonprofit role should be in getting beyond where we are today. She said she believes our responsibility is two-fold: continue to create a vision of what the continuum can be for older people in our society and create trust in our work. A provocative perspective succinctly stated.

I submit for your consideration that the vision so badly needed in our field and the trust so hard to earn begins and ends with ethics.

Oh, I’m sure most of us could say with confidence that we are corporately ethical. Our intentions have been noble and honorable for generations. But without a disciplined process of ethical reflection as organized as our processes for financial analysis, it is easy to drift ethically. Ethical lapses lead to crises of trust reflected in headlines that are etched in the public’s mind for decades.

What do ethical lapses look like and how do moral imperatives manifest themselves in difficult times? Let’s use a couple of human resources (HR) examples from real situations. I use human resources because AAHSA’s Ethics Commission, under the leadership of Audrey Weiner from the Jewish Home and Hospital Life Care System in New York, will soon publish a Quality First white paper entitled Our Moral Imperative: Creating an Ethical Workplace. It has guidelines for human resources ethics. It should become part of your corporate ethics tool kit and library, along with corporate compliance, codes of ethical conduct and social accountability material - examples of which AAHSA has available for our members.

In fact, AAHSA’s annual meeting in Orlando this fall is themed “Living Your Story” with daily themes of “A Life of Conscience,” “A Life of Community,” “A Life of Integrity” and “A Life of Legacy” - driven by the AAHSA Ethics Commission’s work.

Back to the human resources lapses and imperatives. Years ago, I visited a colleague’s facility to share solutions to common problems. My organization faced a much higher food service cost per meal than others I compared with. The colleague’s facility had a particularly low-cost program, with labor costs less than half of my facility’s costs. I asked the food service director his secret. He smiled and replied, “It’s simple. Our community has lots of immigrants who need work, so I don’t have to pay more than minimum and I don’t have to offer vacation and other benefits. And if they don’t like it, I can replace them immediately.” Stunning! I wonder: was that an HR policy sanctioned by the board? Did the board even know? Was this an ethical lapse under the board’s radar or corporate intent?

Contrast that with the ethical imperative loudly stated in the actions of Boston member Mary Immaculate Health Care, whose CEO is Barbara Grant. Mary Immaculate experienced a river flood that could have been an even worse disaster. Fire and rescue, local hospitals and nursing homes all responded nobly and quickly, resulting in no injury, no loss of life as the facility succumbed to the river. Perhaps most inspiring was the employee response. Employees on site stayed, others came in to help. All followed their residents to various facilities that took them in. Immediately post evacuation, with a now uncertain future for the facility, the board of Mary Immaculate reassured the staff that no employee would miss a paycheck! A moral imperative, from their perspective.

Our ethical imperative is the leadership dynamic of transformation needed in long-term care. Recently retired CEO Dick Lamden from Wexner Heritage Village in Ohio testified at a state legislative hearing in which conflict about a public policy objective was apparent. Dick’s recommendation to this committee contrasted significantly with the profit sector’s recommendation. After discussion, a prominent elected official stated that he trusted Dick’s recommendation because of Wexner’s history of quality and doing the right things for the right reasons. Unanimous approval.

The Kendal organization in Pennsylvania calls it “One Common Interest” on the cover of its 2006 annual report, which quotes John Woodman, who, in 1763, said:

“Here we face the prospect of one common interest from which our own is inseparable, that to turn all the treasures we possess into the channel of universal love becomes the business of our lives…”

Yes, we have an ethical imperative. It begins with corporate leadership, including the board. It should pervade all aspects of our work. It should encompass all groups of people with whom we have relationships. It is the key to transformational leadership to change a broken system of inadequate quality, despite the resources thrown at it and the competition for them. Ethical thinking is the foundation for change. And it needs to happen every day, in every community.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO

P.S. Be sure to watch for the September/October issue of AAHSA’s FutureAge magazine, where you’ll find articles that profile members who take ethics and quality to heart, examine the characteristics of a just society, look at what determines an ethical corporate culture and more.

The Good Lord didn’t make a more loyal AAHSA member or more credible elder advocate than Shirley Barnes from Minneapolis. On July 31, I asked all of you to flood your Congressman and Senators during their August recess at home about your concerns — even outrage — about freezes on Medicare cost–of–living increases, about the continuing problem with therapy caps, about user fees, about a broken Medicaid system, about inadequate housing funding, and the need for technology planning.

We asked you to flood your elected officials with appointments to meet with your boards, residents and staff about the effects of some of the Congressional actions or a predicted veto of the State Children’s Health Insurance Program (SCHIP) bill, which contains provisions for Medicare and nursing home payment. We also asked you to flood them with thanks for their interest and concern.

Typical of her leadership, Shirley Barnes contacted Congressman Keith Ellison (D–Minn.) even before we asked. The Congressman’s staff met with Shirley’s staff and residents at the Boulevard and sent a letter of thanks. He said,

“The feedback I received has given me a better perspective of how the legislative proposals in Congress affect Minnesotans. The residents of the Boulevard and their personal situations will remain with me as I cast my votes for health care and senior issues in the U.S. House of Representatives.”

Yes, we must change the perspectives of an elected official. And yes we must help them make it personal. If you watch much political discussion on television these days, you can see and hear how politicians can lose perspective on the personal problems families face every day.

Let the August flood continue. Make it personal about how Medicare and Medicaid freezes impact employees who may not get a raise and the quality of care that your residents and clients receive. Make it personal about how a veto of an SCHIP bill will jeopardize the health of your employees’ children. Tell them how user fees take away money from direct care services. Help them understand how badly seniors need affordable housing.

Shirley Barnes knew what to do. Don’t take no for an answer about a visit, a response to a letter or a petition from residents, families or employees. Don’t let them say no to a letter from your board.

Flood them with perspective and the reality about people and real situations. We have tools and contact to help you flood their offices with your perspective on the personal problems that your residents, clients and staff face. And let us know what you’re doing.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO

Contact Congress on SCHIP, appropriations and housing.

At the end of this week, Congress will recess for the month of August. They have left several issues unresolved that give us an extraordinary opportunity in housing, but that also pose grave risks for nursing homes and home health agencies. The legislators may be coming home for the month, but we cannot let them rest. We have to challenge them to do the right thing for the right reasons so that when September comes, legislation will be finalized to meet the housing and long-term care needs of this country’s elders. Otherwise, irresponsible measures may be locked into place that would do serious harm to your ability to continue providing the highest quality care and services.

Your advocacy will make the critical difference to our success on issues that matter to you, your staff, your organizations and, most importantly, those you serve. We must take every opportunity and use every means of communication to explain to your legislators how their decisions will affect their elderly constituents and the people who care for them.

That’s why I’m inviting you to join us in AAHSA’s “August Flood.” There are four ways you can help during this month:

1. Flood Your Legislators’ Offices in Washington With Calls and Letters.
Tomorrow, AAHSA will sponsor a “Capitol Hill Call-in Day” on behalf of H.R. 2930, Section 202 improvement legislation that we have finally gotten introduced. The bill streamlines financing for new projects and addresses several of the problems you have encountered in trying to preserve existing affordable housing for seniors. Call the U.S. Capitol Switchboard at (202) 224-3121 and ask to be connected to your House member’s office. Tell your legislators and their staff about how critical this measure is to the thousands of low-income seniors who cannot find affordable housing that meets their needs. Then, ask them to co-sponsor the bill so that it can move to the House floor.

Also this week, the House is voting on H.R. 3162, a bill that contains a Medicare payment freeze for long-term care providers in 2008. CMS estimated that your costs will increase by 3.3 percent for nursing homes and by 2.9 percent for home health agencies over the next year. Please contact your House members this week to urge that the payment freeze be removed from the bill. If this doesn’t happen (and we will let you know), please contact your House members and senators during the month of August to ask that the payment freeze be removed from the final version of the legislation.

2. Flood their District Offices With Appointments.
Don’t let your legislators forget who elects them. Set up a time to meet with him or her to put a name and face on the legislation they are considering. This includes the final version of the payment freeze legislation and S. 1710, a Senate spending bill that would continue the substantial user fee for regulatory agencies’ revisits to your facility. These fees would have to be paid regardless of whether the deficiencies are overturned on appeal. Urge your Senators to remove these provisions from the bill.

3. Flood AAHSA’s Contact Congress Web site.
Can’t make into the office? Our Contact Congress Web site lets you connect with members of Congress with the click of a mouse. Send a letter, find out more about the issues and learn how your legislators are voting on issues affecting your work.

4. Flood them With Thanks.
Your legislators are our allies in creating the right public policies for the right reasons. Don’t forget to thank them, and their staff, for their support and attention.

To make a difference, our flood needs leaders. Richard Schwalberg of Beachwood Ohio’s Menorah Park Center for the Aging is a flood leader. He realized the severe impact that dollar caps on Medicare therapy coverage would have on his residents and the hundreds of individuals his organization serves. That’s when he started the flood. He flooded Congressional committee members’ phone lines with calls about the issue. He flooded their schedules with meetings. He even helped more than 600 seniors flood their legislators’ offices with their therapy success stories. And it made a difference. In December, Congress extended the exceptions process for Medicare coverage for another year. How did Richard respond? With a flood of thank yous. He even gave Michelle Spence, a legislative assistant for Sen. John Ensign (R-Wyo.), an award for her hard work.

Richard would be the first to tell you that sometimes it takes a flood to get people’s attention. And for AAHSA’s members, that time is now.

Larry

William L. Minnix, Jr., D.Min.
AAHSA President and CEO