I agree with 'torture', sorry if it offends bourgoise sensibilities.
wcm>
> Elderly poor are tortured to death in US nursing homes, concludes a
> Clinton Administration report, released after... eight !!! years of
> study, right before the Democratic Party Convention.       Hard not to
> be cynical about this fluff piece to highlight a new Clintonite health
> offensive against the Republicans.
>
> TORTURE........ isn't that too severe a word to used here?      Not if
> you  consider not giving the elderly food and water, and not turning the
> immobile on a regular basis,  to be a very real torture..       This is
> TORTURE, and I'm sorry if it is impolite to say so.        Want to lie
> in those beds?        Want to not be suctioned as you choke constantly
> in your own phlegm?
>
> I first became exposed to the US torture of the elderly when I was hired
> as an.. Ass Wiper Line Worker.. in a Seattle nursing home in the Central
> District.     They issued the too few of us roller skates and rags, and
> pointed down the hall, and said....start cleaning.... and I did.    It
> was a most aerobic exercise (and anaerobic, too).
>
> This was factory medicine at its most basic.      And things have gotten
> a lot worse due to the pathetic pretense of Clinton's health care
> proposals.
>
> This report is a sham and fraud.    As were the earlier 'reform'
> efforts.    It is simple enough to announce that the United States
> government is going to make sure that bed sores are eliminated, and that
> all nursing home residents will get adequate food and water.        And
> to just do it.
>
> Instead Clinton/ Gore prefer to do this big joke, of doing battle with
> the evil Republicans, that just won't allow reforms to be implemented.
> All that is needed is to pay for enough CNAs to get the job done.
> And make sure that the nursing home administrators don't pilfer the
> money away.       The Clinton government has been as unwillful as the
> Republicans.     And only the most gullible can think otherwise.
>
> Yes, there is torture in the United States of America.
> ...................................Tony Abdo
> _______________________________
> July 22, 2000
> U.S. Recommending Strict New Rules at Nursing Homes
> By ROBERT PEAR
>
>
> WASHINGTON, July 22 -- Federal health officials have concluded that most
> nursing homes are understaffed to the point that patients may be
> endangered. For the first time, the government is recommending strict
> new rules that would require thousands of the homes to hire more nurses
> and health aides.
>
> In a report to Congress based on eight years of exhaustive research, the
> Clinton administration says that understaffing has contributed to an
> increase in the incidence of severe bedsores, malnutrition and abnormal
> weight loss among nursing home residents. Many of the patients end up
> hospitalized for life-threatening infections, dehydration, congestive
> heart failure and other problems that could probably have been prevented
> if the homes had more employees, the report says.
>
> Nursing homes with a low ratio of employees to patients are
> "significantly more likely to have quality-of-care problems," the study
> says, and "substantial increases" in staff may be required to ensure
> that homes do not endanger the safety or health of patients. The
> 200,000-word report is to be sent to Congress this month.
>
> It recommends new federal standards to guarantee, for example, that
> patients receive an average of two hours of care each day from nurse's
> aides. It says that 54 percent of nursing homes fall below this
> "proposed minimum standard."
> The quality of care depends not only on the number of nurse's aides, the
> lowest-skilled workers, who help feed and bathe patients, but also on
> the number of registered nurses and licensed practical nurses, who
> supervise the aides, the study says.
>
> Accordingly, the report says that nursing homes should have enough
> registered nurses to provide at least 12 minutes a day of care to each
> resident, on the average. But, it says, 31 percent of nursing homes do
> not meet that standard.
> The government emphasized that the proposed levels of staff were not the
> optimal levels, but the minimum needed to prevent patients from being
> exposed to "a substantially increased risk" of poor-quality care.
>
> The report, from the Department of Health and Human Services, was
> required by a 1990 law and was originally supposed to be completed by
> Jan. 1, 1992. But health officials experienced many delays, and the
> scope of the project grew as they conducted more research and analyzed
> huge amounts of data from nursing homes around the country.
>
> Federal researchers said they found that staffing levels were much
> higher at nonprofit nursing homes than at for-profit homes. Large
> nursing home chains that had financial trouble in the last two years,
> including chains that filed for protection under the bankruptcy law,
> have cut staff to control costs, the report said.
>
> The cuts come when nursing home residents are typically sicker than in
> the past, with more serious disabilities.
> Hospitals have reduced the length of stays, releasing patients "quicker
> and sicker." Many people with less severe conditions, who might have
> gone to nursing homes 15 years ago, now receive care in their own homes
> from visiting nurses and aides.
>
> Nursing homes said it was unrealistic for the government to specify
> minimum levels of staff when it was providing what they called
> inadequate payments under Medicaid and Medicare, the programs for
> low-income people and those who are elderly or disabled.
>
> In addition, nursing home executives said it was hard to attract and
> retain good workers in a booming economy, when the unemployment rate is
> at a 30-year low and other industries offer less demanding,
> better-paying jobs. Nurse's aides provide more than 70 percent of the
> hours of care given to nursing home residents.
>
> The American Health Care Association, a trade group for the industry,
> said it could not support "minimum staffing ratios" unless the
> government agreed to help pay the additional cost, which could total
> several billion dollars a year.
>
> A report finds a dangerous shortage of nurses and aides.
>
> About 1.6 million people receive care in 17,000 nursing homes
> nationwide. Ninety-five percent of the homes participate in Medicaid or
> Medicare and are therefore subject to federal standards. But, the report
> says, the federal law and regulations are "too vague" to guarantee an
> adequate number of employees.
>
> The law, adopted in 1987, says that nursing homes must have enough staff
> to provide services enabling each patient to achieve "the highest
> practicable physical, mental and psychosocial well-being." Neither the
> law nor the rules indicate the minimum or appropriate numbers of
> employees.
>
> Congress could amend the law or health officials could revise the rules
> to set tougher, more explicit standards.
> Nursing homes, like hospitals and other health care providers, are
> lobbying Congress to restore money cut from Medicare in 1997. Senator
> Charles E. Grassley, the Iowa Republican who is chairman of the Special
> Committee on Aging, said he would consider earmarking some of the money
> to ensure that nursing homes hire additional workers.
>
> "More than half of the nation's nursing homes don't meet a minimum
> benchmark for staffing," Mr. Grassley said. "That means residents don't
> get fed enough. They don't get turned to prevent bedsores. They end up
> in the hospital much more often than they should."
>
> The report found that nursing homes with low staffing levels tended to
> have large numbers of residents with nutrition problems. Many frail
> elderly patients need help with meals but do not receive it, and their
> health declines as a result, the study said.
>
> When employees are in short supply, they often prod patients to eat
> faster, forcing "huge spoonfuls of food into their mouths," so the
> patients cough and choke, the report says.
>
> Statistics compiled by the government show that 47 percent of nursing
> home residents need some assistance in eating, and 21 percent are
> totally dependent on assistance.
>
> To prevent severe bedsores, also known
> as pressure ulcers, patients must be turned or moved every two hours,
> the report said, but this is unlikely to occur in homes with low numbers
> of nurse's aides. The sores can be painful, become infected and damage
> underlying muscle and bone.
> The General Accounting Office, an investigative arm of Congress, said
> last year that more than one-fourth of nursing homes had deficiencies
> that "caused actual harm to residents or placed them at risk of death or
> serious injury."
>
> Charlene A. Harrington, a professor at the School of Nursing of the
> University of California in San Francisco, said, "Medicare payments are
> calculated on the assumption that nursing homes will have certain levels
> of staff, but the government does not require homes to have the amount
> of staff they are paid for."
> The report said the staff-to-patient ratio was lower in the United
> States than in other countries like Britain, Sweden and Spain.
>
> Nursing homes in Delaware, Maine, Alaska and Hawaii consistently have
> high ratios of employees to patients, the report said. Staffing levels
> are low in Oklahoma, Kansas and Iowa. New York, New Jersey and
> Connecticut fall in between.
>
> Medicaid pays for the care of 68 percent of nursing home residents. A
> 1980 law required that such payments be "reasonable and adequate" to
> cover the costs of "efficiently and economically operated facilities."
> Many nursing homes invoked that law to get higher reimbursements. But in
> 1997, Congress repealed the law, at the behest of states, which share
> Medicaid costs with the federal government.
>
> The report said that repeal of the law had put downward pressure on
> nursing home payment rates in some states like Oregon.
> Several nursing home chains have filed for bankruptcy protection in the
> last two years. They include Sun Healthcare, Vencor, Integrated Health
> Services and Mariner Post-Acute Network.
>
> Charles Leonard, a spokesman for Sun, said, "There has been a reduction
> in therapy provided to patients in our nursing homes, and we've had a
> significant reduction in therapy staff, because of Medicare policies
> that sharply reduced the amount of therapy for which the government will
> pay."
>
> In 1999, the Clinton administration gave inspectors new guidance on how
> to determine if a home had sufficient nursing staff to meet the
> residents' needs. But even with this guidance, the report said, there is
> "no evidence" that inspectors can actually determine whether homes
> comply with the general federal requirement to have sufficient staff.
>
> Inspectors are supposed to make unannounced visits to each nursing home
> at least once a year to assess compliance with federal standards. But,
> the report said, patients "report a fear of retaliation from staff or
> other residents" if they express concern about the staff, and employees
> "have also voiced the fear of losing their jobs if they discuss staffing
> issues with the survey team."
>