Area Agency on Aging: Advocates find issue with current waivers

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By Kay Kaylor

PREVIEW Columnist

I advocate for residents in skilled nursing and assisted living residences as the regional long-term care ombudsman. I also am trained as a Senior Medicare Patrol and State Health Insurance Assistance Program counselor, all as an employee of San Juan Basin Area Agency on Aging (SJBAAA). The many aging and care concerns will be addressed here.

Now that residents and staff of long-term care homes who choose to receive COVID-19 vaccinations have priority in the United States, advocates are asking for reinstatement and strengthening of rules that were waived in 2020 to the present. The devastating toll the pandemic has had on residents, elders and caregivers is well known, including ongoing depression and other mental and physical effects of isolation on health.

As the Center for Medicare Advocacy reports, the reduction in training requirements and waived competency evaluation for temporary nurse aides must be addressed, since the original law required that such aides work no more than four months. Some members of Congress also are asking for reinstatement of this and other laws enforced prior to the pandemic.

For example, advocates seek more protection for long-term care residents from antipsychotic medications, which often require a black box warning of their dangerous side effects for individuals living with dementia. A physician must prescribe these medications. However, evidence from national inspection surveys show that facilities tend to overuse these drugs to control behavior without enough attempts at noninvasive, person-centered methods, especially during the pandemic with its staffing issues. The requirement to try other methods to find the cause of harmful behavior and to calm a person, as well as to document it, is already in the Nursing Home Reform law and amendments. 

Advocates also ask for better data reporting on facility use of antipsychotics and more openness about facility ownership. They want to easily track the relationship between ownership and quality of care. Although a data resource exists, people who monitor resident rights state that its usability and access need to improve.

Deadline for changing Medicare Advantage March 31

As a reminder, if you already have a Medicare Advantage (MA) plan, your last opportunity to change it to another MA plan or to Original Medicare before October is March 31. This period, beginning Jan. 1, occurs every year. 

SJBAAA offers resources for people age 60 and older or on Medicare; see sjbaaa.org. For further information, please call 264-0501.