Category: Regulation

Lessons Learned During the Pandemic Can Help Improve Care in Nursing Homes

Mary Pat Campbell

Link: https://oig.hhs.gov/documents/evaluation/9808/OEI-02-20-00492.pdf

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OIG recommends that the Centers for Medicare & Medicaid Services (CMS):

1. Implement and expand upon its policies and programs to strengthen the nursing home workforce.

2. Reassess nurse aide training and certification requirements.

3. Update the nursing home requirements for infection control to incorporate lessons learned from the pandemic.

4. Provide effective guidance and assistance to nursing homes on how to comply with updated infection control requirements.

5. Facilitate sharing of strategies and information to help nursing homes overcome challenges and improve care.

CMS did not explicitly state its concurrence or nonconcurrence for the five recommendations.

Author: Christi A. Grimm

Publication Date: February 2024

Publication Site: Office of the Inspector General, HHS

Staffing shortages, poor infection control plague nursing homes

Mary Pat Campbell

Link: https://www.upi.com/Health_News/2024/03/01/nursing-home-staffing-shortage/8751709302182/

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Although the pandemic has ended, staffing shortages and employee burnout still plague U.S. nursing homes, a new government report finds.

But the problems didn’t end there: The report, issued Thursday by the Inspector General’s Office at the U.S. Department of Health and Human Services, showed that infection-control procedures were still sorely lacking at many facilities.

Not only that, COVID-19 booster vaccination rates remain far lower than they should be, with only 38% of residents and 15% of staff up-to-date on their shots, according to a recent KFF report.

Author(s): Robin Foster

Publication Date: 1 Mae 2024

Publication Site: UPI

Bizarre Valedictory Interview by CalSTRS Investment Chief, Chris Ailman, Asks Private Equity to Be Nice and Share with Workers

Mary Pat Campbell

Link: https://www.nakedcapitalism.com/2024/02/bizarre-valedictory-interview-by-calstrs-investment-chief-chris-ailman-asks-private-equity-to-be-nice-and-share-with-workers.html

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The Financial Times made its interview with departing CalSTRS’ Chief Investment Officer Chris Ailman its lead story yesterday: Private equity should share more wealth with workers, says US pension giant. The Financial Times was too polite to say so, but Ailman could lay claim to being the best large public pension fund chief investment officer. CalSTRS, which manages the pensions of California teachers, is in the same general size league as its Sacramento sister CalPERS, and regularly outperforms CalPERS by a meaningful margin.

….

It’s hard to know where to begin with this. Limited partners like CalSTRS, who are, in Wall Street parlance, the money, have not even been able to get basic disclosures from the general partners like how much in total the private equity firms hoover out in fees and expenses, despite many years of pleading. Mind you, it’s a requirement for a fiduciary to evaluate the costs and risks of any investment, yet these investors have accepted this abuse.

Limited partners don’t get P&Ls of portfolio companies. They don’t get independent valuations even though that is considered to be essential for every other type of investment. So it’s ludicrous to think that general partners will share money with one of the very weakest parties in the picture, mere workers, when they won’t give information to the limited partners.

Someone new to this topic might wonder why limited partners don’t say “no”. The reason is they perceive private equity to be necessary for them to earn enough to reduce their level of underfunding, which in the public pension fund world is typically pretty bad. To make up for the shortfalls, pension funds like CalPERS and CalSTRS have also been increasing the amount they charge to cities, counties, and other local government entities. These pension costs are taking up larger and larger proportions of these budgets, creating concern and anger.

Author(s): Yves Smith

Publication Date: 16 Feb 2024

Publication Site: naked capitalism

Fixing Medicare Starts With Cracking Down On A Multibillion-Dollar Catheter Scam

Mary Pat Campbell

Link: https://thefederalist.com/2024/02/20/fixing-medicare-starts-with-cracking-down-on-a-multibillion-dollar-catheter-scam/?utm_source=feedly&utm_medium=rss&utm_campaign=fixing-medicare-starts-with-cracking-down-on-a-multibillion-dollar-catheter-scam

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The New York Times reported recently about a sharp spike in Medicare spending on catheters, amid numerous signs that scammers have targeted that benefit to bilk the government out of taxpayer funds. With Medicare rapidly approaching insolvency, the problem is twofold: Criminals still consider the program such an easy source of cash — because the feds do such a poor job at finding and catching the crooks. 

Times reporters interviewed several seniors explaining how they had been billed for catheters they never received and do not need or use. It also noted that the number of Medicare beneficiary accounts billed for catheters rose roughly nine-fold last year, from 50,000 to 450,000. 

The pattern of Medicare spending on catheters echoes the increase in beneficiaries billed. Based on this graph from the Times story, it doesn’t take a doctorate in economics to realize that something fishy has happened regarding payments for catheters — and that, assuming most or all of the increase is due to fraud, Medicare has already given the scammers billions of dollars.

Over and above whether and when the feds can catch the scammers, the real question is: How did this happen? Or, given the federal government’s history of permitting fraud in federal health care programs, how does this keep happening?

Author(s): Christopher Jacobs

Publication Date: 16 Feb 2024

Publication Site: The Federalist