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Nazareth, Pa., United States

Tuesday, November 17, 2009

Marcus: Pelosi Care To Make Nursing Home Access More Difficult

At last week's Northampton County Council meeting, Ron Angle suggested selling Gracedale, the county's nursing home. Suffering from declining numbers and escalating maintenance costs, it's become a financial nightmare. But for some reason, it remains very attractive to potential investors. Sale proceeds could be used as a stabilization fund against future tax increases. Yesterday, Human Services Director Ross Marcus made the case for saving what deceased Council member Wayne Grube liked to call the "crown jewel of Northampton County."

During a budget hearing, Marcus told Council he'd support a committee to study alternative uses of this property. He suggested "specialty units" might address specific needs presented by the closing of Allentown State Hospital. He agreed that the County may want to move some offices there, like the Department of Aging. He even suggested the possibility of relocating Nazareth's magistrate at a vacant and unused portion. But he warned against an outright sale. In one of those rare instances in which the stars are aligned and national and county politics intersect, Marcus' biggest concern is Pelosi care, recently passed by the House.

Believe it or not, this panacea may actually make it more difficult for seniors to get into nursing homes. According to an actuarial report prepared by the Centers for Medicare and Medicaid Services, noted by Marcus, nursing homes will be less likely to accept Medicare patients.

How's that for health care reform! Sometimes, irony has a way of being ... well ... ironic.

While the knuckleheads in Washington discuss how many angels can dance on the head of a pin, Marcus actually advocated for the needy. "We do have an obligation to care for the indigent."

Angle, noting the recent sale of Northumberland County's nursing home, asked "Are the indigent in Northumberland County going to be put out on the street?" Council member John Cusick noted that, in addition to Northumberland, four other counties (Luzerne, Lancaster, Dauphin and Lackawanna) have recently shed their nursing homes. "We need to sell." Council member Mike Dowd, presiding in place of an absent Ann McHale, noted we should consider our options. "To jump off and sell without knowing the implications is silly, but we need to know."

In yet another ironic twist, I need to know the absence of Council member Lamont McClure. Since he chairs the finance committee, you'd think he might want to drop in on a budget hearing, if only to say Hi.

15 comments:

Anonymous said...

Medicaid is the major funding source at Gracedale not Medicare. He should know the difference.

God help us, the blind leading the blind. Marcus has no real Human Serivce experience and he is talking about the future of the County Nursing Home.

These fools are dangerous. Now they are putting the well-being of the elderly and infirm in jepordy.

Sadly, Marcus will say whatever he thinks Council wants to hear. Hopefully this new "committee" will actually have some people who are not political hacks but people who actually understand Gracedale and have various knowledgable opinions.

I fear this is already a done deal. After a long and glorious history of being there for our Seniors, Northampton County is throwing in the towel and throwing out the old, sick and infirm to placate a political philosophy.

Cusick can kiss his dream of the County Executiveship goodbye.

Anonymous said...

Lay off Lamont. He's busy eyeing up Dally's seat. So O'Hare, shut up. We need to get rid of him.

Anonymous said...

Ron always has an angle. Money to be put into his pocket.

Anonymous said...

Anonymous 7:53, Amen, Angle will buy Gracedale with a cash deal and rent it back to the county, sharp, sharp, sharp at these deals.

Sandra Walters Weiss said...

Hey Anonymous, I beg to differ with you, Ross Marcus started out his career as the Executive Director of what was once the Easton Area Neighborhood Centers Inc. This Agency was responsible for many,many grassroots initiatives in the Lehigh Valley. He was one of my predecessors, and was responsible for getting the funding from Northampton County for all of the Homeless Assistance money and case management way back when.The Center was responsible for many,many individuals that fell through the cracks and through his and the lady that hired me efforts and support it was turned from what was once a small grassroots organization grew into a growing community based organization that was also the City of Easton's original CDBG funded agency, which through my efforts and the effort's of my site office manager ELSIE LUCIANO"Dutchtown Gallow's Hill" was THE safe haven for the many individual's who "ELSIE" another street savvy compassionate individual who could case manage like the pro she was, served.
It was Ross, Elsie, I and a group of folks that felt the very heartbeat of the street and worked tirelessly through all the political BS but alas dirty deeds done dirt cheap, happened and the Agency floundered. SO to say Mr. Marcus does not understand is like saying Mr.O'Hare is not controversial.Ross Marcus was responsible for a great deal of behind the scenes support as were too many individuals to note. I could go on an on Ad nauseum but no need. everyone knows the deal.

Bernie O'Hare said...

"Medicaid is the major funding source at Gracedale not Medicare. He should know the difference."

He does. As I understand it, many people will use their Medicare and private insurance for nursing homes. it is only when that runs out that people resrt to medicaid. What marcus is saying is that if Pelosi care becomes law, people usinmg medicare will have more difficulty entering a nursing home. It would not affect those using Medicaid.

Bernie O'Hare said...

"Ron always has an angle. Money to be put into his pocket." You'e on to his evil plan!

LVCI said...

Bernie, perhaps if many of these long term care patients can stay at home (as improved in the bill) there will be less required to use them. Also because of early FREE screening perhaps a lot more will be caught before things get so far out of hand someone has to be in one of these things in the 1st place.

I dispute that patients would lose out by cuts to these nursing care homes. I see nothing in your link that speaks of reduced funding to long term care facilities. Here's the only part I see Bernie that refers to "long term care" needs. Is there a particular page# or section in your provided link that specifically you base this on?

SEC. 1302. MEDICAL HOME PILOT PROGRAM.
the purpose of evaluating the feasibility and advisability of reimbursing qualified patient-centered medical homes for furnishing medical home services

SEC. 1312. INDEPENDENCE AT HOME DEMONSTRATION PROGRAM.
to test a payment incentive and service delivery model that utilizes physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improve health outcomes
---
What I do see are these positive things..

DIVISION B—MEDICARE AND MEDICAID IMPROVEMENTS
(Cost Savings)
Sec. 1114. Permitting physician assistants to order post-hospital extended care services and to provide for recognition of attending physician assistants as attending physicians to serve hospice patients.

(policing)
Sec. 1121. Resource-based feedback program for physicians in Medicare.
Direct meetings between contracted physicians... including any reasons for divergence from local or national averages.

(double billing)
Sec. 1122. Misvalued codes under the physician fee schedule.
... multiple codes that are frequently billed in conjunction with furnishing a single service; codes with low relative values, particularly those that are often billed multiple times for a single treatment

SEC. 1125. ADJUSTMENT TO MEDICARE PAYMENT LOCALITIES
(excessive fees)
The Secretary shall configure the physician fee schedule areas using the Metropolitan Statistical Areas.. not less than every 3 years the Secretary shall review and update the fee schedule areas

Sec. 1141A. Election to take ownership, or to decline ownership, of a certain item of complex durable medical equipment after the 13-month capped rental period ends.

LVCI said...

SEC. 1143. HOME INFUSION THERAPY REPORT TO CONGRESS.
shortened hospital and nursing home stays as a result of Medicare coverage of home infusion therapy.

Sec. 1145. Treatment of certain cancer hospitals.
(gouging/cost controls)
costs incurred by hospitals.. exceed those costs incurred by other hospitals furnishing services under this subsection,.. shall provide for an appropriate adjustment

Provisions Related to Medicare Parts A and B
(cheaper & preferable to remain in your home)
Sec. 1154. Payment adjustments for home health care.
Sec. 1155B. Permitting home health agencies to assign the most appropriate skilled service to make the initial assessment visit under a Medicare home health plan of care for rehabilitation cases.
Sec. 1158. Revision of medicare payment systems to address geographic inequities.
Sec. 1164. Extension of reasonable cost contracts.

Improvements to Medicare Part D
Sec. 1181. Elimination of coverage gap.
Sec. 1186. Negotiation of lower covered part D drug prices on behalf of Medicare beneficiaries.
Sec. 1188. Free generic fill.

MISC
Sec. 1232. Extended months of coverage of immunosuppressive drugs for kidney transplant patients and other renal dialysis provisions.

SEC. 1302. MEDICAL HOME PILOT PROGRAM.
the purpose of evaluating the feasibility and advisability of reimbursing qualified patient-centered medical homes for furnishing medical home services

SEC. 1305. COVERAGE AND WAIVER OF COST-SHARING FOR PREVENTIVE SERVICES.
SEC. 1306. WAIVER OF DEDUCTIBLE FOR COLORECTAL CANCER SCREENING TESTS REGARDLESS OF CODING, SUBSEQUENT DIAGNOSIS, OR ANCILLARY TISSUE REMOVAL.
SEC. 1309. EXTENSION OF PHYSICIAN FEE SCHEDULE MENTAL HEALTH ADD-ON.
SEC. 1310. EXPANDING ACCESS TO VACCINES.
SEC. 1311. EXPANSION OF MEDICARE-COVERED PREVENTIVE SERVICES AT FEDERALLY QUALIFIED HEALTH CENTERS.
SEC. 1312. INDEPENDENCE AT HOME DEMONSTRATION PROGRAM.
to test a payment incentive and service delivery model that utilizes physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improve health outcomes
SEC. 1313. RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS CERTIFIED PROVIDERS FOR PURPOSES OF MEDICARE DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES.
teaching individuals with diabetes to develop the necessary skills and knowledge to manage the individual’s diabetic condition

REFERENCE: H. R. 3962

Bernie O'Hare said...

LVCI, I will track Ross Marcus down and ask him to be more specific. I'm sure he will be.

Anonymous said...

Medicare has to go away for Obama/Pelosi/Reid public option to work. Everybody know it and Ds are trying to razzle-dazzle around it. Old folks aren't buying. It's the reason Ds had such a bad summer and continue to struggle with the legislation, despite overwhelming numbers that would otherwise enable its easy passage.

Anonymous said...

You are very good with the facts LVIC but facts don't matter when it involves the Stoffa Administration. Marcus had to really stretch to get in the shot at Healthcare reform. He should stick to his job.

By the way Ms. Weiss, given the scandals involving the Easton Area Neigborhood Center that is nothing to crow about. At its best it was a very low key operation, not exactly an MSW needed for that place.

Anonymous said...

I just read the article in the Express Times regarding Mr. Angle wanting to sell Gracedale, our family lost a brother recently, he was able to afford a nursing home but it took a great deal of searching to find one of the better ones, With brainstorming, I am quite sure that if there is open space available at Gracedale, it can be used in a cost saving duplicitous manner, Gosh Oh Gee Oh Golly, if not why doesn't Northampton County just sell its soul!

Anonymous said...

It is sad the County has reached this low point. Very sad. No leadership.

Anonymous said...

The Nursing Homre should not be sold. Tis is a sad chapter in County history.