This Blog is created to stress the importance of Peace as an environmental directive. “I never give them hell. I just tell the truth and they think it’s hell.” – Harry Truman
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Nothing will ever change in Washington, DC, UNTIL the changes finally come. And the 'establishment' won't like it.
The other five CIA Directors dont' really matter, especially Goss and Hayden. They are all Republican appointees and who needs it anymore. The Cold War is over and I suppose they haven't gotten the word on that either.
After Deutch left the CIA, it was learned he had personal laptops marked as classified. He was never prosecuted for it.
...The discovery of classified information on Deutch's unclassified computer on December 17,1996 was immediately brought to the attention of senior Agency managers. In January 1997, the Office of Personnel Security (OPS), Special Investigations Branch (SIB), was asked to conduct a security investigation of this matter.1 A technical exploitation team, consisting of personnel expert in data recovery, retrieved the data from Deutch's unclassified magnetic media and computers. The results of the inquiry were presented to CIA senior management in the spring and summer of 1997....
Neocons aren't running the White House or Executive Branch anymore. Maybe 'the word' hasn't gotten out yet ! Who put them all up to it, Cheney? James Woolsey is a neocon and a advisor to the Libby Legal Defense Trust. You know the guy, Scooter Libby, the one that helped out a CIA agent in Valerie Plame. Yeah, that guy. Woolsey is an advisor to Scooters Defense Trust.
7 ex-CIA chiefs ask Obama to abort Holder's probe (click title to entry - thank you)
September 18, 2009
5:24 pm
Warning that the new Justice Dept. probe into past CIA activities will "create an atmosphere of continuous jeopardy," seven men who've run the intelligence agency under presidents of both parties over the past 35 years called today for President Obama to abort the investigation....
Nearly 45,000 annual deaths (click here) are associated with lack of health insurance, according to a new study published online today by the American Journal of Public Health. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002. The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993. “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health,” said lead author Andrew Wilper, M.D., who currently teaches at the University of Washington School of Medicine. “We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”...
One other thing I found fascinating. I received a new Lincoln penny the other day in some change from a purchase. I didn't know there was a new penny minted. It is really very nice. I love it. Love the artwork, too. I put it aside until I at least get another one.
Remember what Bush did when he got into office? With the currency. He wanted to melt down pennies and forget there was ever a denomination that small and he minted all these dollar bills with colors and gold leaf on them.
Pennies are important again. I like it. I like it a lot. It matches the color of the print I indicate are 'my words' to distinguish from newsprint. Yep. I have a small incomplete collection of 'Wheat Pennies.' Yep. Buffalo head nickels, too. I have nearly a complete set of them. Yep.
Honest Abe.
President Barak Obama is NOT a politician before he is this country's President. This speech took place in Texas where the Governor plays the electorate for fools in declaring he wants to secede from the nation.
This speech was in Texas where impoverishment of 'humanitarian values' is held near and dear to their hearts as a means to fight socialism.
Would Georgie Bush or Dickie Cheney ever take the chance of being booed at a rally of Democrats in Fint, Michigan? No. Their public appearances were insulated and orchestrated.
Hello? Our President is a real President. Hard to recognize I know since its been so long since we had one.
He went to Texas to initiate 'outreach.' He is a "Politician without Borders." I didn't see Governor 'what's his name,' oh, yeah, Perry there either.
Cost of health insurance rising faster than pay (click here) Associated Press 10:02 a.m. CDT, September 17, 2009 WASHINGTON - A national advocacy group says health insurance premiums rose five times faster than earnings in Illinois from 2000 to 2009. The report released Thursday says, on average, the annual insurance premium for a family paid by employers and workers rose from $7,220 to $13,397. That's an increase of nearly 86 percent. The workers' portion rose at an even steeper pace. Meanwhile, the median earnings of Illinois workers rose just 17 percent, from $26,806 to $31,414. The report comes from Families USA, a group working to expand health care coverage. The group based its findings on federal data. Congress is considering several bills that aim to restrain costs. But benefits consultants have said if any reform is passed this year, it won't have a major effect for a few years.
Let's do some reading. I think I left off with Page 600 or something close to that. It was the penalities to institutions that dragged their feet and broke the rules. That went on for awhile. Let's see.
Here is the paragraph that speaks to the closing of facilities:
Page 601, a word at the end of 14 to line 24:
...and some portion of such funds may be used to support activities that benefit residents, including assistance to support and protect residents of a facility that closes (voluntarily or involuntarily) or is decertified (including offsetting costs of relocating residents to home and community based settings or another facility), projects that support resident and family councils and other consumer involvement in assuring quality care in facilities,...
The Secretary intends to collect the money, too. They ain't messin' around. Well, they can't. People's quality of life and well being are on the line. You know?
Page 603, lines 15 through 25:
‘‘(IV) COLLECTION OF CIVIL MONEY PENALTIES.—In the case of a civil money penalty imposed under this clause, the Secretary— ‘‘(aa) subject to item (bb), shall, not later than 30 days after the date of imposition of the penalty, provide the opportunity for the facility to participate in an independent informal dispute resolution process...
Page 607, lines 6 through 14:
(1) IN GENERAL.—The Secretary, in consultation with the Inspector General of the Department of Health and Human Services, shall establish a pilot program (in this section referred to as the ‘‘pilot program’’) to develop, test, and implement use of an independent monitor to oversee interstate and large intrastate chains of skilled nursing facilities and nursing facilities.
This is an important provision and I am going to tell you a true story as to why this is important. It might not seem like a true story, but, it is. Has nothing to do with HIV/AIDS either.
There is a chain of nursing homes in this country that specializes in 'ventilator dependant' patients. Patients on vents are sometimes quadraplegics and need continuous monitoring. If a family is unable to care for them at home, the patients are placed in one of these nursing homes. The nursing home itself is very different than an ordinary facility. They have operating rooms where 'procedures' are performed and an emergency room that doesn't really accept patients for treatment, except for an occassion drunk that wanders in. The reason this chain has these 'extra' facilities is because it ranks them as an acute care facility and they are able to charge more for their services. They really are 'faux' hospitals, but, are sincerely 'dumping grounds' for nursing home patients no one else wants to accept.
There was a 19 year old man involved in a car accident where he was a passenger. He suffered a spinal cord injury that made him a quadreplegic.
Nice guy.
When he made it to the hospital emergency room, Level 1 Trauma Center, his cognition was intact. His cognition remained intact during his stay in the Intensive Care Units. He was stabilized. There came a time when there wasn't anything else the hospital could do for him and he needed to go home. His parents, people like you and me that would be grateful to have him alive, were unable to care for him. So, it was decided he would have to be placed in a nursing facility that would provide care to vent dependent patients.
About three days after his discharge, he was readmitted to the same exact Intensive Care Unit that sent him to the nursing facility. This time, however, he was without the cognition he left with. He had suffered an anoxic event. The event was so prolonged that he had a heart attack as well. There was significant damage to his body systems and he died approximately two weeks later in kidney failure as well as myocardial damage.
The nursing home facility had 'on staff' nurses certified in ACLS. As a matter of fact, all their nurses are certified in ACLS. One would think a person on a vent would be in the best of care in such a facility. However. That is not the case. The reason the nurses needed to be Certified in Advanced Cardiac Life Support is because there were frequent events where patients, including quads (sometimes in halo traction) unable to help themselves, would come off their vent. They would cough and sometimes plug their trachea tubes. They would have their vent tubing come off their trachea tubes. So, the anoxic events were an issue in this facility and the administrators had to come up with a way to 'MAKE THEM ALIVE' in case they died while 'on a ward' or in a 'multi-bed' room.
You see, vent alarms go off so frequently and there is less staff then necessary to maximize profits, that the nurses can't keep up with the care and if they simply run around putting out vent alarms they never get any of their medications passed or documentation done.
So, every once in awhile, when a patient is left on an alarm a little to long, they have to 'MAKE THEM ALIVE' even though they died. Hence, many patients with cognitive issues. But, they are cared for, right? I mean someone has to do it. And it is a good business for the economy as it employs folks and all that mess. There are very few visitors after a time.
So, this 'pilot' project is far, far overdue. Yep.
Page 208, lines 4 through 13:
(b) REQUIREMENTS.—The Secretary shall evaluate chains selected to participate in the pilot program based on criteria selected by the Secretary, including where evidence suggests that one or more facilities of the chain are experiencing serious safety and quality of care problems. Such criteria may include the evaluation of a chain that includes one or more facilities participating in the ‘‘Special Focus Facility’’ program (or a successor program) or one or more facilities with a record of repeated serious safety and quality of care deficiencies.
The House really has been working on this bill for some time now. I can tell.
Page 608, lines 14 through 17 and 23 through 25 and Page 609, lines 1 through 3:
(c) RESPONSIBILITIES OF THE INDEPENDENT MONITOR.—An independent monitor that enters into a contract with the Secretary to participate in the conduct of such program shall—... ...(2) undertake sustained oversight of the chain, whether publicly or privately held, to involve the owners of the chain and the principal business partners of such owners in facilitating compliance by facilities of the chain with State and Federal laws and regulations applicable to the facilities;
I guess they didn't want health care insurance reform, now did they?
Page 612, lines 14 through 23:
‘‘(7) NOTIFICATION OF FACILITY CLOSURE.— ‘‘(A) IN GENERAL.—Any individual who is the administrator of a skilled nursing facility must— ‘‘(i) submit to the Secretary, the State long-term care ombudsman, residents of the facility, and the legal representatives of such residents or other responsible parties, written notification of an impending closure—
Page 620, lines 1 through 13:
Subtitle C—Quality Measurements SEC. 1441. ESTABLISHMENT OF NATIONAL PRIORITIES FOR QUALITY IMPROVEMENT. Title XI of the Social Security Act, as amended by section 1401(a), is further amended by adding at the end the following new part: ‘‘PART E—QUALITY IMPROVEMENT ‘‘ESTABLISHMENT OF NATIONAL PRIORITIES FOR PERFORMANCE IMPROVEMENT ‘‘SEC. 1191. (a) ESTABLISHMENT OF NATIONAL PRIORITIES BY THE SECRETARY.—The Secretary shall establish and periodically update, not less frequently than triennially, national priorities for performance improvement.
I think it sounds like a good idea.
Page 620, lines 19 through 24 and Page 621, lines 1 through 15:
‘‘(c) CONSIDERATIONS IN SETTING NATIONAL PRIORITIES.—With respect to such priorities, the Secretary shall ensure that priority is given to areas in the delivery of health care services in the United States that— ‘‘(1) contribute to a large burden of disease, including those that address the health care provided to patients with prevalent, high-cost chronic diseases; ‘‘(2) have the greatest potential to decrease morbidity and mortality in this country, including those that are designed to eliminate harm to patients; ‘‘(3) have the greatest potential for improving the performance, affordability, and patient centeredness of health care, including those due to variations in care; ‘‘(4) address health disparities across groups and areas; and ‘‘(5) have the potential for rapid improvement due to existing evidence, standards of care or other reasons.
It looks self-explanatory. There isn't anything sinister about it.
Page 623, lines 23 through 25 and Page 624, lines 1 through 2 and Page 625, lines 1 through 3:
‘‘(c) DEVELOPMENT OF QUALITY MEASURES.— ‘‘(1) PATIENT-CENTERED AND POPULATION BASED MEASURES.—Quality measures developed under agreements under subsection (a) shall be designed— ‘‘(2) AVAILABILITY OF MEASURES.—The Secretary shall make quality measures developed under this section available to the public.
President Obama has promised transparency to his administration and there should not be censorship by the USA military. This isn't the Bush/Cheney years of paranoya anymore. The Associated Press had every right to publish what they felt was appropriate for the context of their news story.
We believe in democracy and have complained of lies in the media, it is hardly appropriate we propagate any lies or deceptions to the American people. Censorship is a form of deception. It is like putting blinders on the public. It is unethical. The American people have a right to know what their military is sacrificing.
I believe in the wars in Pakistan and Afghanistan. I hate the killing more than anyone. But, to allow international criminals access to two countries and one with nuclear potential is unrealistic. If soldiers are to be spared this fate, which they should be, that means there will be more civilian deaths due to more aggressive weapons. The entire war in Afghanistan doesn't make sense to me. Either there is a war to fight and we protect our military from harm or there isn't. This 'mess' of protecting civilians as if they are immune from the battlefield is hideous. If they choose up sides and decide it is more beneficial from a 'warlord' perspective to join the Taliban than they made their choice. The people of Afghanistan either move out of the way of 'shortening and capturing' the battlefield or they don't. But, that is just my opinion.
If the war in Afghanistan is proceeding so poorly, the military needs to weigh the stakes against the outcome. If the American people are going to be disgusted with the photos being published, there needs to be a strategy to success in Afghanistan that will deliver the same outcome.
I don't see a whole lot different between this photo and the flag drapped coffins coming into Dover. One leads to the other.
There were many more issues with Vietnam. The Nixon administration invoked a draft of 19 year olds with a lottery and demonstrators were being killed on college campuses. The dynamics of opposition were different. Today, there were significant deaths for Italy and in that the Prime Minister Silvio Berlusconi called for the withdrawal of their forces. He is also involved in a tough election in Italy as well and it serves his purpose to ask for withdrawal even though it may not occur.
The war in Afghanistan has been allowed to deteriorate by the past administration and deteriorate it has. It is my opinion, it is by far the most dangerous place in the world today and if left to the devices of the Taliban any abandonment by all military forces will result in the return of power to them and a return to neglect of the world only to repeat what has occurred before.
Afghanistan is a disaster area. It is where the Taliban and international terrorists have taken haven from the attacks by The West to end their capacity to strive to destroy civilization as it exists in any country and not just the USA and Europe. As far as I am concerned, there was such gross neglect by the Bush/Cheney administration Afghanistan is a global emergency.
It is not another Vietnam that if left alone will heal its ills. Vietnam had no designs on killing innocent people in far away countries, nor achieving domination of global culture. Afghanistan is different. The consequences are higher.
The Geneva Conventions exist. Yes, they do. But, nowhere in those accords does it state civilized nations have to sacrifice their military or accept defeat for the sake of civilians in a country that has been allowed to become the enemy to the world. Charlie Wilson's War didn't fail because the USA did not send money for infrastructure improvements. Charlie's war was a defeat because he facilitated 'the base' of al Qaeda, while Russia signed onto the Geneva Convention of War. Why do I believe diplomacy with Russia to achieve the same outcomes while limiting the spread of international terrorists would have been a far better idea?
USA militaries are not supposed to have decade long wars and sustained body counts. It is supposed to end the dangers to the country and civilization and pay reparations afterward. If the war is wearing on American's patience AND their treasury that is all part of the battlefield picture. I suggest Secretary Gates, the Joint Chiefs and their generals start assessing the battlefield as it is, not as a politician would want it to be.
In this photo taken Friday, Aug. 14, 2009, Lance Cpl. Joshua Bernard is tended to by fellow U.S. Marines after being hit by a rocket propelled grenade during a firefight against the Taliban in the village of Dahaneh in the Helmand Province of Afghanistan. Bernard was transported by helicopter to Camp Leatherneck where he later died of his wounds. (AP Photo/Julie Jacobson)
...B’nai B’rith has some major concerns about the Senate Finance bill, which would still allow charging older people significantly more for coverage," says its release. "The bill also lacks a workable mechanism – such as a public option – that would force insurance companies to compete for our business, even in traditionally monopolistic markets like rural areas. The weakness of incentives for employers to have and maintain coverage for their workers is also an issue. And we are also concerned about the failure to include the CLASS ACT (from the Senate HELP bill), which would encourage long-term coverage in a revenue-neutral way....
...In one of the sharpest breaks yet with the policies of the Bush administration (click title to entry - thank you), Obama phoned the leaders of Poland and the Czech Republic last night to tell them that he had dropped plans to site missile interceptors and a radar station in their respective countries. Russia had furiously opposed the project, claiming it targeted Moscow's nuclear arsenal. Obama is to announce the reversal officially at a news conference today. This morning the Czech prime minister, Jan Fischer, revealed that Obama phoned him about it last night....
Let's get started. Russia played a huge role in defeating Hitler's Nazi War Machine. Russia took and held an entire border of Germany by themselves, they were the first to discover the 'Nazi Death Camps' and they were the first to retake Berlin.
On September 1, at the ceremony to mark the 70th anniversary of the Second World War in Poland, Russian Prime Minister Vladimir Putin and his Polish counterpart Donald Tusk exchanged barbs over the legacy of the war. But why has the controversy over historical memory erupted in recent years, and why can’t it be left to historians?...
Benedict XVI, 82, and his team will fly to Prague aboard a plane of the Italian Airlines. He will return to Rome by a Czech special plane. The Pope's team will also include a personal doctor, his assistant, two interpreters, an official photographer and three experts in liturgical ceremonies. On the other hand, Benedict XVI never takes a personal cook to his trips abroad as he is not on a special diet, a clerk, from the Vatican administration, told CTK. The Vatican also confirmed that Benedict XVI would spend two nights in the Czech Republic in the seat of the Vatican diplomatic mission in Prague, Federico Lombardi, spokesman for the Vatican state secretariat, told CTK. Two bulletproof "papa-mobiles" (cars specially adjusted for the Pope) were sent to the Czech Republic two weeks ahead of the visit. A Czech policeman is to drive them. Hundreds of Czech policemen will protect the Pope during his three-day visit to the Czech Republic on September 26-28. The security measures are to be as tight as during the April visit by U.S. President Barack Obama to Prague....
The Compromise Bill will be very interesting. The House and Senate needs to pass their final bills and move it to committee to finalize the Bill the President will sign. I congratulate the Democrats for fighting and continuing to fight an incredibly uphill battle for so very long. This is a wonderful legacy to the memory of Senator Kennedy as well.
...The House version of the health legislation (click title to entry - thank you) would require some employers to pay as much as 8% of payroll as a fine if they don’t offer coverage to workers. Under the Senate Finance measure, employers who decline to provide coverage would face a smaller penalty, and in narrower circumstances. The Senate Finance legislation — set to be unveiled on Wednesday — says employers with more than 50 full-time workers would pay a $400 fee for each employee if they don’t offer health insurance. The fee would be triggered if any employees apply for federal tax credits to buy coverage....
...When polled, "nearly three-quarters of physicians supported some form of a public option (click here), either alone or in combination with private insurance options," says Dr. Salomeh Keyhani. She and Dr. Alex Federman, both internists and researchers at Mount Sinai School of Medicine in New York, conducted a random survey, by mail and by phone, of 2,130 doctors. They surveyed them from June right up to early September....
The majority in TWO physician opinion polls shows a consistency in favor of the Bill for Reform that includes BOTH private and public options. We need to get this done, the nation is waiting for it. Enough already.
...Overall, a majority of physicians (62.9%) supported public and private options (click title to entry - thank you) (see Panel A of graph). Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option (see Table 1). Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001),>
The squeakiest wheel gets the most attention. That would be the case with Health Care Insurance Reform in the USA. In more and more polls across the country there is considerable consent for reform. The poll above is from The New England Journal of Medicine's current issue of September 10, 2009. The country is reconciled to have reform, it is simply the noisest and least informed that are opposed to it.
...On health care reform Rasmussen reveals that a majority of people (51%) (click here) actually support reform as opposed to a minority (46%) that oppose. While Rasmussen still has a "large intensity gap" between the number strongly supporting reform and strongly opposing reform a ABC/Washington Post poll finds that gap closing. The Rasmussen numbers are nearly a new high for support and is tremendous jump from the lows of August when (53%) actually opposed reform...
I left off the review on Page 151, that is more than half way through the proposed legislation.
Page 151, lines 6 through 15 addresses the 'need to know' by the USA government of the nature of facilities that provide Long Term Care. This provision sets up the ability for the GAO (Government Accounting Office) to do so:
(c) GAO STUDY ON NURSING FACILITY UNDER CAPITALIZATION.—
(1) IN GENERAL.—The Comptroller General of the United States shall conduct a study that examines the following:
(A) The extent to which corporations that own or operate large numbers of nursing facilities, taking into account ownership type (including private equity and control interests), are undercapitalizing such facilities.
This is a transparency measure so the people of the USA are aware of the structure of their health care system. One cannot sufficiently administer correct policy to reduce costs while still maintaining high quality health care without this information. There isn't anything sinister about it. The tone of the legislature is to empower facilities that provide care to do it well and efficiently.
There are people that need us to pass these bills and provide quality care to them, it's time to get this done and stop procrastinating.
Following these surveys by the GAO, the Comptroller will have 18 months to prepare a report to Congress.
The Bill goes on with its usual definitions, the particulars on the website that will carry information to the health care community as well as the public.
Page 555, lines 20 through 25 state there is going to be important information (of which this is a sample) on the website for consumers to consider when chosing a Long Term Care facility:
‘‘(vi) Summary information on the number, type, severity, and outcome of substantiated complaints. ‘‘(vii) The number of adjudicated instances of criminal violations by employees of a a nursing facility—
The States will be contributing information to the website as well. The surveys will be required to be updated every six months. That means every SNF (Skilled Nursing Facility / Long Term Care Facility) will be required to not only report their facts with the initial survey, but, every six months to maintain and improve on quality of care. There will be no 'flash in the pan' in improvement of care of people just to look good on a survey only to return to bad habits and poorer conditions.
Page 560, lines 20 through 25 and Page 561, lines 1 through 6 states:
‘‘(i) Staffing data for each facility (including resident census data and data on the hours of care provided per resident per day) based on data submitted under subsection (b)(8)(C)(ii), including information on staffing turnover and tenure, in a format that is clearly understandable to consumers of long-term care services and allows such consumers to compare differences in staffing between facilities and State and national averages for the facilties. Such format shall include—
The Bill seeks to be helpful to consumers while empowering them with Federal laws that will require good quality care PERFORMANCE.
Page 568, lines 7 through 18 is to be sure there are provisions that allow the States and Federal government to communicate and develop together web-based information to close the 'gap' to consumers for well informed decisions:
(1) GUIDANCE.—The Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) shall provide guidance to States on how States can establish electronic links to Form 2567 State inspection reports (or a successor form), complaint investigation reports, and a facility’s plan of correction or other response to such Form 2567 State inspection reports (or a successor form) on the Internet website of the State that provides information on skilled nursing facilities and nursing facilities and the Secretary shall, if possible, include such information on Nursing Home Compare.
There is provisions for protections for Whistle Blowers. too.
Page 575, lines 1 through 11:
‘‘(C) WHISTLEBLOWER PROTECTION.— ‘‘(i) PROHIBITION AGAINST RETALIATION.—No person who works at a skilled nursing facility may be penalized, discriminated, or retaliated against with respect to any aspect of employment, including discharge, promotion, compensation, terms, conditions, or privileges of employment, or have a contract for services terminated, because the person (or anyone acting at the person’s request) complained,
The provision is a lot longer than those 11 lines.
Within the reporting the facilities have to perform is the status of the 'staff' of the facility. That status is to be derived from recorded payroll data. The 'measure' of stating the reporting is to be from payroll data is to insure accuracy in reporting. It demands accuracy so a 'source' of auditing can be conducted to be sure the 'patient : professional staff ratio' is best for the residents of that facility. In other words the Bill states clearly where reporting information on exact type of staff is coming from to insure there cannot be any misunderstanding or misreporting. That is the only reason any mention is made of 'payroll data.' It isn't about monitoring what people are paid, so much as whom is getting paid in relation to the capacity they serve the residents.
Page 588, lines 14 through 25 and Page 589, lines 1 through 4 addresses monetary penalites any non-compliance with the law will be rendered. The Bill delineates that there will be penalities and not a suspension of payment of Medicare or Medicaid benefits so there is no undo outcomes to residents depending on the facility. I am sure of the facility is a chronic offender, the facility will face possible sanctions on accepting patients for care with potential of closing their doors. The line has to be drawn somewhere otherwise the Bill becomes meaningless.
SEC. 1421. CIVIL MONEY PENALTIES. (a) SKILLED NURSING FACILITIES.— (1) IN GENERAL.—Section 1819(h)(2)(B)(ii) of the Social Security Act (42 U.S.C. 1395i– 3(h)(2)(B)(ii)) is amended to read as follows: ‘‘(ii) AUTHORITY WITH RESPECT TO CIVIL MONEY PENALTIES.—
‘‘(I) AMOUNT.—The Secretary may impose a civil money penalty in the applicable per instance or per day amount (as defined in subclause (II) and (III)) for each day or instance, respectively, of noncompliance (as determined appropriate by the Secretary).
This provision of hte bill is quite extensive and spells out all the particulars of the penalities, how the monies will be collected, the participation of the States and so on and so forth. The provision goes past page 606 and it is here I will end for now. I'll return to it later.
Write your legislators and ask to have this Bill moved forward. Thank you.
I'll let you in on my busy schedule lately. My oldest son is getting married on October 3rd and we are holding a Bridal Shower for he and his bride on Sunday. Needless to say it has been a busy and joyful time.
I have some short errands to run and I will return tonight to do some reading of the Current House Health Insurance Reform Bill.
I do want to express sympathy for the loss of Yale Student Annie Le. It is more than sad. According to her roommate, Annie was the kindest person she had ever come to know. The murder has shaken a Yale Campus whom now believe more than ever, a murderer walks among them.
It was a gruesome reality. She was working hard in her lab one minute and killed the next. The building where she was found is one of the most secure buildings on campus with 700 cameras in and around the building. The one place there were no cameras was the basement where her body was found. The murderer knew that building from every angle. We look forward to the good work of the police.
Be back shortly. Staying connected to the Reform and Recovery of my country is important to me. I also want to stay up to date on Afghanistan, Iraq and the Middle East in general. I believe Secretary Clinton has been addressing the issue of Iran's nuclear program. I want to look for any news about the IAEA, too.
Police find 'person of interest' in Yale slaying (click here) By RAY HENRY AND SUSAN HAIGH ASSOCIATED PRESS WRITERS NEW HAVEN, Conn. - Police investigating the slaying of a Yale graduate student zeroed in on a "person of interest" Tuesday after keeping tabs on an ever-tightening circle of people connected to the medical lab where her body was found stuffed behind a wall. Authorities on the case have been tight-lipped almost since the minute 24-year-old Annie Le was reported missing Sept. 8, just a few days before her wedding day. Police say they have ruled out her fiancee, a Columbia University graduate student, but they have provided little additional information - other than to deny reports that a suspect was in custody. On Tuesday, investigators descended in large numbers on the home of a Yale animal research technician who lives in an apartment in Middletown, about 20 miles from the New Haven campus. Le worked for a Yale laboratory that conducted experiments on mice, and investigators found her body stuffed in the basement wall of a facility that housed research animals. It was unclear whether the technician was the "person of interest," and whether police were giving the same attention to any others who had access to the lab where Le worked. Detectives have questioned more than 150 people, many of them believed to be connected to the busy medical research building where Le was a rising star....
...When Clinton left office in 2000, the Census counted almost 31.6 million Americans living in poverty. When Bush left office in 2008, the number of poor Americans had jumped to 39.8 million (the largest number in absolute terms since 1960.) Under Bush, the number of people in poverty increased by over 8.2 million, or 26.1 per cent. Over two-thirds of that increase occurred before the economic collapse of 2008....
On every major measurement (click title to entry - thank you), the Census Bureau report shows that the country lost ground during Bush's two terms. While Bush was in office, the median household income declined, poverty increased, childhood poverty increased even more, and the number of Americans without health insurance spiked. By contrast, the country's condition improved on each of those measures during Bill Clinton's two terms, often substantially.
Date of chart : 12/31/05 11:57 AM
When George Walker Bush FIRST came into office, he wasted no time in seeking a 'melt down' of the economic infrastructure he and Henry Paulson would harvest just before the second term of Bush was completely. How did he accomplish such a task? By proposing OPPORTUNITY for people unable to sustain it !
George Walker Bush 'legislated' the economic collapse and paid for its deployment out of the coffers of the USA Treasury. All of it was done in the name of Compassionate Conservatism, in the 'flag waving' initiative to 'spread the American Dream' among the impoverished. The global economic collapse cost the American Tax Payer $1.7 billion to get it started in 2000.
Housing: Help low-income purchasers, and housing developers Bush’s main proposals on housing: Creation of an “American Dream Downpayment Fund” to allow low-income families to use HUD rental vouchers to make a down payment on a home. Bush says this could help as many as 650,000 families become homeowners. A tax break aimed at real estate investors that would provide them with tax credits of up to 50% of costs, totaling $1.7 billion over five years. This tax credit would provide incentives for private investors to redevelop single-family housing or build new homes for low- and moderate-income Americans. Bush said he expects this plan would build or rehabilitate 100,000 homes in five years. Individual development accounts giving tax credits and other financial incentives for low-income families to save money for a home purchase, for education costs, or to start a business. Source: Washington Post, p. G5 Oct 28, 2000
Recession's toll: more Americans in poverty, without health insurance (click here) By Mike Swift and Steve Johnson Mercury News Posted: 09/10/2009 07:57:44 AM PDT Surveying the pain of the first full year of the recession, a new U.S. Census Bureau report shows that household income has dropped, millions more are in poverty — and for the eighth year in a row, fewer Americans are covered by private health insurance. Given the rising job losses in 2009 that could very well continue into 2010, more people could lose private health insurance and fall below the poverty line, continuing the grim trend, economists and analysts said Thursday....
Nelson said Powell had been working with firewood with a helper who briefly stepped away. Powell was discovered a short time later on the ground. Powell was said to have had a previous heart attack, but that it was some time ago in the early or mid-1990s. Sad news: Jody Powell (click title to entry - thank you)
I had intended to finish up a big "how to think about the Chinese tire tariff" item, when instead I heard the news that Jody Powell had died. This is sad in its own right, and when coupled with the death last year of Hamilton Jordan is unexpectedly poignant. Jimmy Carter, who will soon turn 85, is in the position every parent dreads, that of outliving the children.
Powell and Jordan were of course only virtual children to Carter, slightly older than his real offspring and having a work-centered relationship with him. But they'd driven with him across Georgia in the early days and to fund raisers and stump speeches when he was starting his improbable run for the presidency. In the public imagination they survive as the jaunty young characters -- "jaunty" to their friends, "cocky" to their detractors -- they were when Carter took office, as captured in the classic Rolling Stone cover published 32 years ago....
..."At issue," House Majority Leader Steny Hoyer said earlier, "is whether we are able to proceed with a degree of civility and decorum that our rules and our democracy contemplate and require." Wilson, speaking after Democrat Hoyer, refused to back down. "I think it is clear to the American people that there are far more important issues facing this nation than what we're addressing right now." He said Obama had "graciously accepted my apology and the issue is over."...
There is much more 'at issue' than civility in Congress. This measure comes at a time in the USA when decorum within any political spectrum is being assaulted with escalating tones of anger. I believe this measure was more than appropriate.
I'll be back to resume the 'reasonable' approach of actually reading legislation and looking at the facts as they actually exist.
Oh.
My the way.
Did everyone notice the sale of Opel?
I want to thank all those that believe agreements between 'peoples of countries' and 'companies in need' that work together to save economies and improve opportunities for workers is important. I thank you from the bottom of my heart. It is about time, citizens and businesses truly appreciate the dynamics of the decisions and promises they make to each other.
EU won't block Opel deal: Magna's Wolf (click title to article - thank you) “The whole idea is based on economics, and I cannot imagine that someone has something against economics,” co-CEO Siegfried Wolf says
The co-chief executive of Magna International Inc. (MG.A-T47.00-0.23-0.49%) said Tuesday that he doesn't believe the European Union will block his company's acquisition of a majority stake in Opel. “The whole idea is based on economics, and I cannot imagine that someone has something against economics,” Siegfried Wolf said at the 2009 Frankfurt Auto Show where Opel debuted a new version of its Astra, its mainstay in European markets. Mr. Wolf's comments came as a German government official met with representatives of six other European countries that host Opel factories to discuss sharing the burden of the €4.5-billion ($6.55-billion U.S.) in state guarantees needed to launch the new Opel....
While listening to 'Talk Radio' yesterday I marked an event. It occured at 3:26 PM on September 9, 2009. It occured while listening a Murdock production. It occured while listening to Shea Hannity. Mr. Hannity stated, "Later in the program I will show you how there is domination by a Conservative, White nation in the USA." When is this going to stop? When is this 'reference' to skin color going to stop. Mr. Hannity stated it very quickly and for the most part would have gone unnoticed, but, it alarmed me and I looked at the clock to make the occassion.
There is a profound problem within the Republican Party in the USA. They are too rigid in the views and their party platform is highly bigoted. It discriminates against theGLBT community (click here), it discriminates against any other 'religion and/or belief' system other than Conservative Christian.
Hate crimes plague Hispanic community (click here) Hispanic Heritage Month is an opportune time to rethink racism
Derrick Skaug The Daily Evergreen
...In this country of tolerance, Jose Osvaldo Sucuzhañay walked the streets of Brooklyn on Dec. 7, 2008, never expecting his life was about to end. Sucuzhañay, a 31 year-old Ecuadorian and father of two, was walking home from a church party arm in arm with his brother, according to The New York Times.
Two men drove up to the brothers yelling anti-gay and anti-Hispanic slurs. Sucuzhañay was struck down to the ground after a beer bottle was smashed against his head. Another attacker proceeded to bash his head in with an aluminum baseball bat. The attackers kicked and punched him as he lay motionless on the ground. Suffering severe head fractures and extensive brain damage, he died two days later....
They are chronically complaining, ALWAYS angry, they propagate hate and breed killed such as Timothy McVeigh, Eric Rudolph and James von Brunn just to new a very, very few.
Freedom is speech is limited. It begins with yelling "Fire" in a crowded theater when there is no such fire. It causes reaction. The Talk Radio ignites hatred and propagates intolerance. When are we going to put an end to the exploitation of supposed 'political opposition' that does nothing but increase the intolerance of decency and spreads lies, hate and anger. When it this going to stop?
The intolerance of the GOP on so many social issues reflects 'poor' choices in options for government focus. They attack nearly half the population of the USA on social issues for the sake of being elected, when they should be addressing their own issues, such as how do they allow their party to conduct poor oversight of economic structures that allow the implosion of an entire global framework?
How doee that happen? By mistake? "On a drunk." Or is there something profoundly "W"rong with 'platform' of the Republican Party. The answer to that question is that there is something PROFOUNDLY "W"rong with the Republican Party and their ? Political Platforms ?.
Correct me if I am wrong, but, the economic collapse occurred while the Republicans had exploited the powers of the USA Legislature since 1998 and continually deregulated the Finance Industry to the point where government oversight meant absolutely NOTHING. The implosion of the fiscal infrastructure of the entire global market place plummeted out of greed and corruption and I dare anyone to state otherwise.
The Republican Party 'hides' their incompetency by screaming about social issues and their 'corruption' of the youth of the country as if it were the truth. They interlace their political priorities with that of ???????? religious bias ???????? as if they were on the Panel of Cardinals to the Pope.
This is a political movement? No. It is a dead edifice of a 'movement' of continual corruption.
Not in any of their political venues is there open-mindedness. There is no movement of acceptance of difference. There is only anger and hate and more it everytime their 'wallets' feel a little pinch of taxation.
That isn't a political party. That is a manipulative movement built on indulge of cronies by their elected authority. It has to stop.
Being 'out of order' during a speech by The President in a joint session of Congress is only a futher demonstration of the continued "Anarch Advocacy" of these people. They aren't political anything. They are hate mongerers. They can't deny it. They hate and free any PEOPLE that are Gay. They hate and fear all those that aren't marching to The Pro Life Movement and they hate and fear anyone with ideas that a meltiing planet should have priority in the future of our children, HENCE, therefore an economic issue that should actually cause them more taxes. The hate and fear any form of government control that actually brings more opportunity to people through health, wellness and a change in direction of our economy.
There is more than little 'validation' of the positions of the Republican Party and their punits in the year 2009, so much as continued DOGMA of the same old rhetoric of anger and hate. They don't have solutions to modern problems, they have only the emotional tirade of people UNWILLING to participate in government in a manner that promotes acceptance of differences, brings people together to open a new understanding of common values and move the country forward on venues of economic growth and opportunity, including the opportunity to have a safe and sane health care insurance system.
Heckling a President of this country in an accepted place of civility was the last straw. It is over for the GOP and their extremist base !
Talk Radio, the liar's forum. I am surprised Joe Wilson wasn't sponsoring the rally.
These are the same people that caused all the fiscal trouble President Obama inherited. Now they are 'attempting' to appear as the 'aggreived' in order to influence voters that are easily 'swayed' by fear. The Independants. The ones with 'real backbone.'
These are the folks that whine and cry because they were unfairly caught up in a fiscal circumstance(s) created by government, therefore, it is up to government to bail them out. I heard it over and over and over again, about when will the government 'do something' to give them relief from exploitation of the market place they knew full well they were 'gambling with.'
These are the folks that wave the Red, White and Blue when they should be waving a flag covered in "Gold Leaf." They are the ones that 'practice' fiscal brinkmanship all the time. They 'count' on the government to act in their favor when the 'number of troubled citizens' are too large to ignore. Their numbers alone constitute the 'collective' equivalent of "The Too Big to Fail Category." Their 'habits' chronically set the economy of the USA 'at risk' and it is them that the Legislature and Executive Branch need to treat as dangerous as any 'Mega Bank.'
No wonder they carry guns.
I only have one thing to say.
"They need jobs !"
...Against a backdrop of tens of thousands of Americans marching on Washington to oppose health care reform, the White House dismissed the president's critics, reinforced his message while offering few specifics, and continued to back away from insistence on the public option....
The Motto for the Day is "I voted for President Bush the First and I voted for President Bush the Second !"
Rob Miller for South Carolina House. Let's face it, South Carolina needs someone that cares about the people. They have a Governor that was legislated into receiving Stimulus dollars and now this humiliation. How much can the people of South Carolina stand? Act Blue (click here)
Meet Rob Miller (click here) - One of Rob's Campaign focus is to stop outsourcing jobs.
Born and raised in South Carolina as the youngest son of a Navy Veteran, Rob learned the importance of hard work from a very early age. Facing staggering medical bills after his father passed away, 14-year old Rob went to work washing dishes to help support his family. Through hard work and lots of support from family and the community around them, Rob’s family weathered the financial storm....
12:42 September 11th, 2009
No lie! Poll shows Joe Wilson trailing in reelection bid (click here) Posted by: Thomas Ferraro Congressman Joe Wilson might be tempted to yell “You lie!” again – this time at a poll that shows the presidential heckler trailing in his reelection bid.
The survey by Public Policy Polling found Democratic challenger Rob Miller leading the five-term Republican lawmaker by 44 percent to 43 percent. The numbers had Democrats cheering, and at least one pollster offering a new view of the contest in the heavily Republican South Carolina district....
Evidently, the Obama Presidency is making history at every turn.
...Campaigns have always played fast and loose with the facts. (click title to entry - thank you) But as the partisan divide in Washington has grown, the rules have changed
“Now we’re in an era of the permanent campaign, and the line between campaigning and governing is virtually gone,” said Gary Jacobson, a political science teacher at the University of California-San Diego.
Enter Wilson. After his shout on Wednesday night heard ’round the political world, his Democratic challenger raised $400,000 by Thursday evening.
Proof enough for Kim Alfano Doyle, a Republican campaign strategist for two decades, who said that Wilson’s move was crass and that the take-no-prisoners approach is a mistake.
“It just looks ugly, it looks petty, it looks like no one’s getting anything done,” she said. “When you’re up there having a slap fight, you’re not taking it seriously. Everything’s a campaign, and that’s a shame.”
The Washington Post contributed to this report. To reach David Goldstein, call 202-383-6105 or send e-mail to dgoldstein@mcclatchydc.com.
Wilson took caffeine pills in 2007 (click here) By Jordan Fabian - 09/10/09 06:21 PM ET
Rep. Joe Wilson (R-S.C.), who shouted "you lie!" at President Obama during his Wednesday night address to Congress, admitted to regularly consuming caffeine pills in 2007.
It is unclear if Wilson still takes NoDoz, a brand of pill that contains 200 milligrams of caffeine a pop. By comparison, a seven ounce cup of drip coffee contains 115 to 175 milligrams of caffeine.
A source told The Hill in 2007 that the congressman ingested the tablets “like candy," but Wilson insisted he was not addicted despite the fact that he had been taking them since high school.
"I love coffee, but I don’t have time to drink it and I don’t have access to it," Wilson said at the time.
The fifth-term Republican said he shared his NoDoz use with his doctor, who Wilson said assured him that the over-the-counter pills are not dangerous unless you get addicted.
Wilson interrupted the president yesterday night after he said that his health reform plan will not insure illegal immigrants. He quickly apologized for his outburst last night but maintained that Obama was lying in a radio interview today.
Page 151, lines 6 through 22:
(c) GAO STUDY ON NURSING FACILITY UNDER CAPITALIZATION.—
(1) IN GENERAL.—The Comptroller General of the United States shall conduct a study that examines the following:
(A) The extent to which corporations that own or operate large numbers of nursing facilities, taking into account ownership type (including private equity and control interests), are undercapitalizing such facilities.
(B) The effects of such undercapitalization on quality of care, including staffing and food costs, at such facilities. (C) Options to address such undercapitalization, such as requirements relating to surety bonds, liability insurance, or minimum capitalization.
Nursing Homes are a huge issue. It requires attention and it requires attention now. There are many reasons to 'get this right.' The next generation of elderly will be numerous and some will require Long Term Care. The Baby Boomers come from a generation that would rather 'opt' for longevity with activity and purpose, however, there will be the exceptions.
By every definition of 'Sandwich Generation' I should be one of those taking care of elderly parents while paying for a child's wedding. But. I am not. Why? Because my parents are in excellant health for their age and they live in their own home able to take care of themselves. That, by the way, is true for most of my extended family. Irish Americans. Evidently, we are a sturdy bunch.
I say this with anticipation of seeking the same autonomy for myself, until my death. And. I expect the same 'ideals' hold true for my generation. I believe that is an important 'directive' for any Health Care Insurance Reform. Why? Because if The Baby Boomers are able to care for themselves all their lives, the SNF (Skilled Nursing Facilities) just might be a thing of the past. And, that is another thing. Why aren't their 'earning' opportunities for Seniors that live in Nursing Homes, should they have the ability. Imagine a 'Mom and Pop Country Store' in every SNF that residents and visitors can frequent for the latest in DVDs, Music Downloads or Gourmet Frozen Dinners.
It will be vital for the next generation of 'elders' to remain active, in good health and quite possibly able to produce an income that will continue to contribute to the country's tax base. BUT. In realizing there is a chance that will be part of the American Landscape, please let it be in balance with 'respect for The Golden Years' and some entitlement of Seniors for 'down time' and relaxation as they seek to send it.
There is also this 'hazard' accompanying longevity. It is the 'longevity of job occupation.' And by occupation, I don't mean 'profession.' By occupation I mean staying in a position too long. While some of the most qualified employees a company has is their 'experienced' and older workers and executives, there is a moral issue with 'job protection' in the face of a younger generation 'stuck in the rut' of No-Advancement and no advancement opportunity. It is a concern for many reasons.
As Americans live longer, they will work longer. Even in retirement, the opportunities to earn and fight 'built in' inflation of retirement income, will be met with job seekers. There is a problem with that as it 'oppresses' younger workers and potential executives. There needs to be a 'longevity' component to those jobs frequently sought for their higher income or prestige or responsibility. There comes a time when 'the younger generations' need a chance at their goals. Now, this is somewhat of Age Discrimination, but, it doesn't have to be. If an individual comes into a managerial position with a healthy income in their forties, there needs to be some expectation on 'changing' such employment within twenty years of achieving it.
Why?
Not because the older worker can't do the work, they can probably accomplish it handily. But. There are several reasons that will enhance 'the futrue' of any enterprise, including, local economies.
An enterprise that has longevity has the right to remain vital. It is good for the economy. Often younger workers will become diminished in abilities if they are 'stuck' in lower paying and lower expectation employ. In that, there is a hazard. It is a dynamic that needs to be addressed from the standpoint of what is good for any company to remain viable and what enhances 'vitality' in the American economy. Why discourage younger workers from achieving if they feel their best years will be stalemated in lower or middle management or jobs of lower esteem than they hoped for when graduating from classes, be it High School or the University.
With anticipated increased longevity. Longevity with purpose and income. There needs to be an understanding to the extent longevity will play in any economic dynamics. That is not Age Discrimination, unless, it is viewed as being OPPRESSIVE against young workers. And by young, it includes those in their fourth and fifth and sixth decade of life that has yet 'the chance' to reach for the Gold Ring.
It may be that this unique dynamic might be exclusive to the Baby Boomers and Generation X will find a more 'traditional' meaning to retirement. But, to anticipate such an issue is to address it. That was off the path of reading the House Bill as it stood before Summer Recess.
There are problems with 'chain store' SNFs. Corporate structure removes 'compassion' from SNF. There are also opportunities for fiscal exploitation of the USA Treasury and SSI, especially considering there might be increased demand for such services. So, to understand the SNF and its fiscal 'habits' is more than prudent for any National Health Care Insurnace Reform Bill.
Page 551, lines 23 and 24 and Page 552, lines 1 and 2:
(2) REPORT.—Not later than 18 months after the date of the enactment of this Act, the Comptroller General shall submit to Congress a report on the study conducted under paragraph (1).
It sound not only correct to proceed, but, neglectful if we don't.
The bill goes on to list definitions, the website which sounds like a central clearinghouse for information and certifications. There is recommendations for 'staffing improvements' or at least 'consumer awareness' of what staffing should be available. Usually that type of information will bring about change for the better with consumer advocacy.
Page 555, lines 1 through 3:
‘‘(IV) an explanation that appropriate staffing levels vary based on patient case mix.
That is more than interesting. In today's SNF, staffing it arbitrary based on parameters set up by the Director/Vice President of Nursing. They are viewed as 'standards' by the profession, but, there is little to no application of 'staffing for acuity.' There is no reason why a SNF should not be viewed as a 'fluid' environment for changes in 'residents' acuity. There is also no reason why that dynamic should be 'ignored' as a part of any management practice within any facility. It may mean that two more Nursing Assistants are needed on The Alzheimer Unit as some of the residents are changing their wellness status, while The Rest Home Unit is enjoying many agile residents needing far less assistance.
Most hospital units today use some type of acuity scale to staff probably. There is no reason why that dynamic cannot be applied to SNFs as a way of maintaining clearer understandings of their 'client population' and their ever changing needs.
But, this is more or less about 'empowering' the consumer seeking a SNF, as a method to compliance of 'quality of care.' The new website, of which has a name, ‘Nursing Home Compare,’ will provide a place to download forms when a complaint needs to be filed.
Page 555, lines 13 through 19:
‘‘(v) The standardized complaint form developed under subsection (f)(8), including explanatory material on what complaint forms are, how they are used, and how to file a complaint with the State survey and certification program and the State long-term care ombudsman program.
The legislation goes on to define staff that acts in a criminal manner, enforcement, deadlines for provisions in the bill to be incompliance, there is stated the 'agencies' the Secretary will consult with, Page 557, line 21 and 25, Page 558, lines 1 through 5:
‘‘(B) CONSULTATION.—In conducting the review under subparagraph (A)(i), the Secretary shall consult with— ‘‘(i) State long-term care ombudsman programs; ‘‘(ii) consumer advocacy groups; ‘‘(iii) provider stakeholder groups; and ‘‘(iv) any other representatives of programs or groups the Secretary determines appropriate.’’.
Young adults a key to health care reform (click title to entry - thank you) Many are uninsured, with mixed opinions on need for change By Childs Walker, Stephanie Desmon and Paul West Baltimore Sun reporters September 11, 2009 ...In the debate over health care reform, Stokes and his peers are known as "invincibles," strong and healthy young adults who have no experience with wallet-crippling illness and feel they have no need for coverage....
Yet, young males are at risk for serious diseases such as Testicular Cancer. Young women have incidence of Breast Cancer. We aren't speaking to our young people the way they need us to speak to them.
This table is on Page 46 of article (click here). It was the only 'study' on the internet that was handy. Unfortunately, it only addresses White Males, but, I think the 'idea' of misinformed youth is validated.
TABLE 1. Age-specific and age-adjusted incidence rates of testicuiar cancer (per 100,000) for US White males from 1973 to 1995: Surveillance, Epidemiology and End Results Program In 1995 - ages 15 thru 19 there were 3.9 cases per 100,000 Caucasian men.
In 1995 - ages 20 to 24 there were 7.9 cases per 100,000 Caucasian men.
In 1995 - ages 25 to 29 there were 15.9 cases per 100,000 Caucasian men.
To return to the legislation, Page 559, lines 11 through 17:
‘‘(8) SPECIAL FOCUS FACILITY PROGRAM.— ‘‘(A) IN GENERAL.—The Secretary shall conduct a special focus facility program for enforcement of requirements for skilled nursing facilities that the Secretary has identified as having substantially failed to meet applicable requirement of this Act.
This entire provision sets up Consumer Education and Advocacy as well as sets expectations for SNFs. The title of this initiative is "Special Focus Facility Program." It's a good title. Leaves open the inclusion of 'miscellaneous' facilities including Rehab facilities like the one that welcomes and specializes in returning, disabled veterans.
Proper staffing will ultimately be an initiative with this Secretary of Health and Human Services.
Page 560, lines 20 through 25 and Page 561, lines 1 through 6.
‘‘(i) Staffing data for each facility (including resident census data and data on the hours of care provided per resident per day) based on data submitted under subsection (b)(8)(C)(ii), including information on staffing turnover and tenure, in a format that is clearly understandable to con2 sumers of long-term care services and allows such consumers to compare differences in staffing between facilities and State and national averages for the facilities. Such format shall include—
Properly staffed and well run SNFs looks to be a priority of the Secretary.
Page 566, lines 7 though 10:
‘‘(B) PERIODIC SURVEYS.—Under such program the Secretary shall conduct surveys of each facility in the program not less often than once every 6 months.’’.
The provision provides for transparency in that the reports and surveys will be available at the website to the public and professionals. The States are going to have a role in quality assurance as well.
Page 568, lines 7 through 18:
(1) GUIDANCE.—The Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) shall provide guidance to States on how States can establish electronic links to Form 2567 State inspection reports (or a successor form), complaint investigation reports, and a facility’s plan of correction or other response to such Form 2567 State inspection reports (or a successor form) on the Internet website of the State that provides information on skilled nursing facilities and nursing facilities and the Secretary shall, if possible, include such information on Nursing Home Compare.
And I have to apologize here. I usually cover at least 50 pages per day, but, I have some personal business that is pressing and I won't be able to complete this review until Monday afternoon or evening.
