News release from Tennessee Attorney General’s office:
MURFREESBORO, Tenn. — National Health Investors, Inc., (NYSE:NHI), National HealthCare Corporation (NYSE MKT: NHC, NHC.PRA), the court-appointed Receiver for two Tennessee nonprofits, SeniorTrust of Florida, Inc., (“SeniorTrust”) and ElderTrust of Florida, Inc., (“ElderTrust), and the Tennessee Attorney General announced today that they have agreed to resolve a long-standing dispute that has been the subject of litigation. The resolution of the litigation, together with the Receiver’s sale of 14 nursing homes and liquidation of the nonprofits’ assets, will ultimately result in approximately $40M for charitable purposes in Tennessee.
The Tennessee Attorney General had previously asked the Davidson County Chancery Court to place both of these nonprofits in receivership. The Receiver subsequently filed suit against National Health Investors, Inc. (“NHI”) and National HealthCare Corporation (“NHC”).
NHI helped to establish SeniorTrust and ElderTrust, two Tennessee 501(c)(3) nonprofit corporations, in 2000. Between 2001 and 2004, NHI sold a group of skilled nursing facilities in Missouri and Kansas to SeniorTrust and a group of skilled nursing facilities in Massachusetts and New Hampshire to ElderTrust. The Receiver’s primary dispute with NHI concerned the financial terms on which NHI had sold and financed the purchase of the facilities to the nonprofits.
In 2007, NHC acquired the lease of a long-term care facility in Chattanooga, Tennessee, known as Standifer Place from SeniorTrust. The Receiver’s primary dispute with NHC concerned the financial terms on which NHC acquired the lease.
The Receiver for SeniorTrust and ElderTrust claimed that the financial terms of the various transactions with NHI and NHC were unfair to the nonprofits, a claim NHI and NHC disputed.
Legislation to renew three special state “assessments,” all used to collect more money for health care facilities from the federal government and sometimes called taxes, are moving quickly through the committee system with very little discussion.
All are slated to expire on June 30 unless renewed. All involve facilities paying the “coverage assessment” with the resulting revenue then being used to trigger federal government payments of about $2 for every state dollar. Gov. Bill Haslam’s budget plan anticipates all of them being renewed.
The bill imposing a $2,225 levy on each bed in a nursing home (SB430) had been previously known as a “bed tax.” This year’s bill, sponsored by Republican Sen. Doug Overbey of Maryville, changes the terminology to “assessment.” It is otherwise unchanged from current law and is projected to bring in $235 million for TennCare payments to nursing homes.
The hospital assessment (SB441) imposes a 4.52 percent levy on net patient revenues of hospitals, producing $450 million in state revenue that brings in federal matching funds of about $843 million. It is the newest of the assessments, launched in 2010 at the urging of the Tennessee Hospital Association. U.S. Sen. Bob Corker has called it a “gimmick” and has filed legislation in Congress that would phase out such programs over a 10-year period.
The bill imposing a 5.5 percent levy on gross receipts of institutions serving the mentally disabled (HB157) brings in $11.4 million in state revenue, according to legislative staff, including $5.1 million paid by the Department of Intellectual and Developmental Disabilities.
The latter two bills got no discussion at all in winning voice vote approval of the House Health Subcommittee last week with Rep. Mike Harrison, R-Rogersville, as sponsor. The Senate Health Committee had only brief discussion on Overbey’s bills dealing with nursing homes and hospitals before they were unanimously approved.
The nursing home levy has, in the past, been renewed for longer periods. Asked why this year’s bill only gives a one-year extension, Overbey said the idea is to put all the levies on an annual renewal basis so they can be discussed regularly as developments unfold at the federal level on health care.
“I think if you took a poll (of legislators), most of us would like to take the hospital assessment fee and vote on it every 10 years,” quipped Sen. Lowe Finney, D-Jackson.
Several incumbent legislators — including Overbey — last year faced opponents who accused them of supporting a tax increase by voting for the assessment.
Tennessee collected a little more than $4 million in fines from nursing homes over the past three years, the sixth-highest total of any in the country, according to data collected by ProPublica,
From The Tennessean: The state imposed 86 fines, with the average fine being the second-highest in the nation. The fines, ranging from $2,015 to more than $525,000, were imposed on 42 of the more than 300 licensed nursing homes operating in Tennessee.
The largest single fine, $525,188, was imposed on Bristol Nursing home in Bristol. The second highest, $465,195, was imposed on Colonial Hills Nursing Center in Maryville, Tenn.
Data show that 40 nursing homes in the state were found to have serious deficiencies.
The ProPublica state-by-state list is HERE.
CHATTANOOGA, Tenn. (AP) — TennCare officials say it is getting more difficult for low-income seniors to qualify for nursing homes and other services.
Officials say under old rules, elderly people could qualify for up to $55,000 to pay for a nursing home, adult day care or assisted living if they weren’t able to groom themselves. Under rules that began on July 1, TennCare will take an overall assessment of a person’s need before that level of funding is allocated. Being able to groom oneself is just one measure that TennCare uses to assess a person’s ability to handle activities of daily life.
TennCare spokeswoman Kelly Gunderson said those who don’t qualify for the maximum assessment can still get up to $15,000 annually. She said those who think they need more can ask their health care coordinator for another assessment.
The change has led to concerns.
Serenity Adult Day Care Center owner DeNessa Cartwright told the Chattanooga Times Free Press (http://bit.ly/Oj5nnV) that $15,000 might not be enough for the level of care some seniors require.
“A person can be lacking in only one ADL, but that one ADL could be so major that you still have many needs and need maximum funding,” said Cartwright.
Gunderson said changing the rules will save the agency $47 million a year and it will be able to redistribute money to serve more people.
“This is a critical next step in helping the state continue to expand access to home-based care, delay and/or prevent the need for nursing facility placement, when appropriate, and rebalance the state’s long-term care system for the elderly and adults with physical disabilities,” Gunderson said.
But Tennessee Justice Center Executive Director Gordon Bonnyman said he is concerned the state will be unable to provide needed services.
“It just defies common sense that you’re going to actually be able to maintain everybody, meet those needs and yet take $47 million out of the budget once used to pay for those services,” Bonnyman said
NASHVILLE, Tenn. (AP) — A federal delay may cause rate cuts for TennCare providers in areas including nursing homes, home health providers, transportation services, dentistry and labs and X-rays.
The state’s expanded Medicaid program announced Friday that it no longer anticipates receiving the federal money in time to stop the rate cuts from growing from 4.25 percent to 8.5 percent in January.
Lawmakers last session approved a TennCare budget contingent on receiving an estimated $82 million from the federal government to make up for billing mistakes for people eligible for disability benefits from the Social Security Administration.
The U.S. Department of Health and Human Services now expects it will require federal legislation to resolve the money owed to the states.
Gov. Bill Haslam said three weeks ago the state may face deep cuts in federal funding, with services for the poor and disabled disproportionately affected.
TennCare would possibly cut up to $2.2 billion. The program serves 1.2 million people.
See also The Tennessean, which focuses on nursing home cuts. An excerpt: Staffing is the only place nursing homes can cut back, said Jesse Samples, executive director of the Tennessee Health Care Association. Labor accounts for 70 percent of costs, he said, while the other 30 percent are for fixed costs.
“You’re looking at personnel,” Samples said. “It’s not like the facilities are going to be taking care of the same number of patients with less staff. What they are going to have is less patients to go along with that less staff. What will happen will be an access problem.”
An explanatory note to media from TennCare officials is below.
First Lady of Tennessee Crissy Haslam came “home” Monday to belatedly celebrate Knoxville’s 220th birthday and to praise Knox County’s historic house museums, reports the News Sentinel. Haslam spoke at a luncheon fundraiser held by the Historic Homes of Knoxville. About 160 people attended the event that grossed some $7,100 for HHK.
The group is a partnership of six Knox County historic homes open to the public. Those homes are Blount Mansion, Crescent Bend House & Gardens, Ramsey House, James White’s Fort, Mabry-Hazen House and the Marble Springs State Historic Site.
The structures range from those built in the late 18th century to those built in the 19th century. Knoxville marks its founding on Oct. 3, 1791. That’s when James White sold one-half acre lots to establish the town.
Haslam moved into the Tennessee governor’s mansion in Nashville from Knoxville when her husband, former Knoxville Mayor Bill Haslam, was elected governor. That residence, built in 1929 as a private home and acquired by the state later, was renovated during the administration of Haslam’s predecessor, Phil Bredesen.
Crissy Haslam is heading an effort to restore the property’s gardens and landscaping using private funds.
Even as a large segment of the population moves into its later years of life and might require nursing home care, Tennessee is moving toward lighter regulation of nursing homes, fewer state investigations and laws that make it more difficult to bring potentially costly lawsuits against operators, according to The Tennessean. Many nursing homes in Tennessee also now require patients or their families to sign agreements waiving their rights to a trial before admission.
A measure passed earlier this year by the legislature places strict new limits on the rights of nursing home patients and their families to sue nursing homes for poor care. That law, which caps the amount a jury can award, goes into effect this week.
This comes just a couple of years after the legislature in 2009 vastly reduced oversight of the 325 nursing homes in the state by eliminating regulations mandating that nursing home operators file detailed reports on adverse events affecting patients. Also eliminated were requirements that the state investigate those incidents. Officials said the change was needed so they could spend their time investigating more serious complaints.
Tennessee has not fared well compared with other states in some key quality measures of nursing homes. And federal officials have said the state has failed in its regulation of such homes. A report issued this year by the U.S. Government Accountability Office gave the state Health Department failing scores for its performance in investigating serious complaints against nursing homes. It said there was a backlog of cases that had gone uninvestigated, and it cited a staff shortage as a factor.
…Data compiled by the federal Centers for Medicare & Medicaid Services show Tennessee ranks fourth out of 50 from the bottom in the number of hours per patient per day provided by certified nurse assistants. It ranks seventh from the bottom in registered nurse hours per patient per day, according to the CMS data.
The latest data show Tennessee nursing homes provide an average of 0.62 hours of registered nursing care per patient per day. Assistant Health Commissioner Christy Allen said that was comparable to other states in the region. Neighboring Kentucky provides 0.8 hours, while Florida provides 0.64. The states that provide the most hours are generally lower-population states: Hawaii nursing homes average 1.36 hours, Delaware provides 1.22 hours and Alaska 1.86 hours.
According to state health officials, current law and regulations require licensed nursing personnel to provide only 0.4 hours of direct care per patient each day.