Health

Infection Lapses Rampant in Nursing Homes But Punishment Is Rare

Published

3 years ago

December 27, 2017

By Jordan Rau, Kaiser Health News

Basic steps to prevent infections — such as washing hands, isolating contagious patients and keeping ill nurses and aides from coming to work — are routinely ignored in the nation’s nursing homes, endangering residents and spreading hazardous germs.

A Kaiser Health News analysis of four years of federal inspection records shows 74 percent of nursing homes have been cited for lapses in infection control — more than for any other type of health violation. In California, health inspectors have cited all but 133 of the state’s 1,251 homes.

Although repeat citations are common, disciplinary action such as fines is rare: Nationwide, only one of 75 homes found deficient in those four years has received a high-level citation that can result in a financial penalty, the analysis found.

“The facilities are getting the message that they don’t have to do anything,” said Michael Connors of California Advocates for Nursing Home Reform, a nonprofit in San Francisco. “They’re giving them low-level warnings year after year after year and the facilities have learned to ignore them.”

Infections, many avoidable, cause a quarter of the medical injuries Medicare beneficiaries experience in nursing homes, according to a federal report. They are among the most frequent reasons resideents are sent back to the hospital. By one government estimate, health care-associated infections may result in as many as 380,000 deaths each year.

The spread of methicillin-resistant Staphylococcus aureus (MRSA) and other antibiotic-resistant germs has become a major public health issue. While Medicare has begun penalizing hospitals for high rates of certain infections, there has been no similar crackdown on nursing homes.

As average hospital stays have shortened from 7.3 days in 1980 to 4.5 days in 2012, patients who a generation ago would have fully recuperated in hospitals now frequently conclude their recoveries in nursing homes. Weaker and thus more susceptible to infections, some need ventilators to help them breathe and have surgical wounds that are still healing, two conditions in which infections are more likely.

“You’ve got this influx of vulnerable patients but the staffing models are still geared more to the traditional long-stay resident,” said Dr. Nimalie Stone, the CDC’s medical epidemiologist for long-term care. “The kind of care is so much more complicated that facilities need to consider higher staffing.”

The Centers for Medicare & Medicaid Services (CMS), which oversees inspections, has recognized that many nursing homes need to do more to combat contagious bugs. CMS last year required long-term care facilities to put in place better systems to prevent infections, detect outbreaks early on and limit unnecessary use of antibiotics through a stewardship program.

But the agency does not believe it has skimped on penalties. CMS said in a statement that most infection-control violations have not justified fines because they did not put residents in certain danger.

For instance, if an inspector observed a nurse not washing his or her hands while caring for a resident, the agency said that would warrant a lower-level citation “unless there was an actual negative resident outcome, or there was likelihood of a serious resident outcome.”

In November, CMS waived penalties for 18 months against facilities that violate the new stewardship rule. The industry had said nursing homes needed more time to prepare. (The moratorium does not affect California’s antibiotic stewardship requirement, which took effect last January.)

Holly Harmon, the senior director of clinical services at the American Health Care Association, a nursing home trade group, said the industry has made strides in combating infections through better training and encouragement for staff members to look for gaps in infection control and to speak up about them.

The percentage of nursing home residents with urinary tract infections — the only type of infection all nursing homes must report to Medicare — has dropped by more than half since 2011.

“Infection prevention control is a priority,” Harmon said. “The path really is focused on continuous improvement.”

Community

Fourteenth Street Market Gives Community Healthy Alternatives in Oakland

Published

3 days ago

May 6, 2021

Post Staff

Photo credit: Auintard Henderson

Owner Oscar Edwards stands in front of his “14 Street Market” located at 416 14^th St. in Oakland which opened on March 6. Edwards says he “. . . built his grocery store to give access to his community and provide healthy alternatives and still have things they know as well.” He adds that “Black press for him is the voice that helps to bring my ideas and expressions full circle to the people.”

“14 Street Market” is open 7 days a week, 10am – 8pm Monday through Saturday and 11am to 7pm on Sunday. It’s your neighbor market with groceries, snacks, drinks and more.

Follow them on IG: https://instagram.com/fourteenthstreetmarket

African American News & Issues

Blue Cross Blue Shield Association Announces National Health Equity Strategy to Confront the Nation’s Crisis in Racial Health Disparities Sets Goal to Reduce Racial Disparities in Maternal Health by 50% in Five Years

“Your health shouldn’t depend on the color of your skin or the neighborhood you live in,” said Kim Keck, president and CEO of BCBSA. “The crisis in racial disparities in our country’s health care is unconscionable and unacceptable. While BCBS companies have made great strides in addressing racial health disparities in our local communities, there is so much more to be done.”

Published

1 week ago

April 29, 2021

Post Staff

CHICAGO, IL (April 20, 2021) – Today, as part of its ongoing mission to improve the health of America, the Blue Cross Blue Shield Association (BCBSA) announced its National Health Equity Strategy to confront the nation’s crisis in racial health disparities. This strategy intends to change the trajectory of heath disparities and re-imagine a more equitable healthcare system. BCBSA has convened a national advisory panel of doctors, public health experts and community leaders to provide guidance.
“Your health shouldn’t depend on the color of your skin or the neighborhood you live in,” said Kim Keck, president and CEO of BCBSA. “The crisis in racial disparities in our country’s health care is unconscionable and unacceptable. While BCBS companies have made great strides in addressing racial health disparities in our local communities, there is so much more to be done.”
“Starting here and starting now, we can begin to put an end to the racial disparities in health care,” continued Keck. “Our deep roots in the local communities we serve, combined with the scale and scope of our national reach, enable all of us at Blue Cross Blue Shield companies to drive this new strategy and bring real change. But we cannot do it alone. It is a moment in time when we as a nation must come together to build a new model of equitable health care.”

BCBSA’s National Health Equity Strategy is comprehensive and relies on close collaboration with providers and local community organizations. This collaboration was essential in recent months as BCBS companies worked with local leaders to support vulnerable communities with COVID-19 vaccine access. The strategy includes collecting data to measure disparities, scaling effective programs, working with providers to improve outcomes and address unconscious bias, leaning into partnerships at the community level, and influencing policy decisions at the state and federal levels. The multi-year strategy will focus on four conditions that disproportionately affect communities of color: maternal health, behavioral health, diabetes and cardiovascular conditions. BCBSA will first focus on maternal health, then behavioral health in 2021.
Setting a Goal to Address Racial Disparities in Maternal Health BCBSA has set a public goal to reduce racial disparities in maternal health by 50% in five years.
“BCBS companies are fully committed to reach this goal,” said Keck. “We will continue to collaborate with our local partners and providers to continually improve our programs and build momentum, and we will seek out new ideas and proven initiatives that accelerate health equity reform.”
Metrics will include the Centers for Disease Control and Prevention (CDC) Severe Maternal Morbidity measures. BCBSA will report results annually. Use of nationally consistent measures will evolve over time based on research, industry development, and in-market learnings.
BCBS companies currently have a range of maternal health programs supporting women of color during their pregnancies. Each program is tailored to the needs of the communities they serve. These BCBS companies’ maternal health programs support both BCBS members and non-members of their partner organizations.

Commenting on the breadth of the BCBS companies’ maternal health programs, Dr. Rachel Hardeman, Founding Director, Center for Antiracism Research for Health Equity and Assistant Professor, Division of Health Policy & Management, University of Minnesota School of Public Health, and member of the newly formed advisory panel, said: “Who better to address racial disparities in maternal health than Blue Cross Blue Shield? BCBS companies serve every ZIP code across the U.S., and they have the scale and resources needed to ensure women of color get equitable maternal health care.”
A Panel of Experts Focused on Closing America’s Gap in Health Equity “The more people we bring to the table, the more we can create lasting change,” said Keck about the nine handpicked members of the BCBSA National Advisory Panel on Health Equity. “I’m excited we have brought together such experienced, highly regarded leaders in health equity and the community, and I look forward to their guidance as we move forward.”
Members include: Tracey D. Brown, CEO of the American Diabetes Association®; Marshall Chin, MD, MPH, Richard Parrillo Family Professor of Healthcare Ethics at the University of Chicago; Gilbert Darrington, CEO of Health Services, Incorporated; Adaeze Enekwechi, PhD, MPP, Research Associate Professor at the Milken Institute School of Public Health at George Washington University; Maria S. Gomez, RN, MPH, President and CEO of Mary’s Center; Rachel R. Hardeman, PhD, MPH, Tenured Associate Professor in the Division of Health Policy & Management at the University of Minnesota; Stacey D. Stewart, President and CEO of March of Dimes; Richard Taylor, CEO of ImbuTec; and Kevin Washington, President and CEO of YMCA of the USA. The National Health Equity Strategy is part of the Blue Cross Blue Shield Pledge to Make Meaningful Change. The Pledge speaks to BCBS companies’ broad commitment to addressing racial disparity in health and all its forms.

ABOUT BLUE CROSS BLUE SHIELD ASSOCIATION
The Blue Cross Blue Shield Association is a national federation of 35 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for one in three Americans. BCBSA provides healthcare insights through The Health of America Report series and the national BCBS Health IndexSM. For more information on BCBSA and its member companies, please visit BCBS.com. We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter and Instagram. You can read our Pledge to Make Meaningful Change here. To learn more about our National Health Equity Strategy and our Maternal Health Program, visit BlueHealthEquity.com.

Activism

MAYOR LONDON BREED NOMINATES CITY ATTORNEY DENNIS HERRERA TO LEAD THE SAN FRANCISCO PUBLIC UTILITIES COMMISSION

As the new General Manager of the SFPUC, Herrera would bring decades of experience serving San Francisco residents and advancing the fight for significant environmental policies.

Published

1 week ago

April 29, 2021

Staff Post

San Francisco, CA — Today Mayor London N. Breed nominated City Attorney Dennis Herrera to serve as the next General Manager of the San Francisco Public Utilities Commission (SFPUC). Herrera was elected as City Attorney of San Francisco in 2001, and will bring decades of experience serving City residents and advancing environmental policies through his nationally-recognized office.

The SFPUC provides retail drinking water and wastewater services to the City of San Francisco, wholesale water to three Bay Area counties, green hydroelectric and solar power to Hetch Hetchy electricity customers, and power to the residents and businesses of San Francisco through the CleanPowerSF program.

“I am proud to nominate Dennis Herrera to serve as General Manager of the San Francisco Public Utilities Commission,” said Mayor Breed. “Dennis has been a great champion in San Francisco across a wide range of issues from civil rights to protecting our environment, and most importantly he has been someone who always puts the people of this City first. By bringing his experience in office and his commitment to public service to this new position, I am confident the SFPUC will be able to deliver the high-quality services our residents deserve while continuing to advance nationally-recognized programs like CleanPowerSF and pursue ambitious efforts like public power. Dennis is the right leader for the hard-working employees of the SFPUC and this City.”

“I will always cherish the groundbreaking work we have done in the City Attorney’s Office over these nearly 20 years,” Herrera said. “We advanced equality for all, pushed affordable housing at every turn, gave our children better opportunities to grow and thrive, and took innovative steps to protect the environment. We never shied from the hard fights. Above all, our approach to government has had an unwavering focus on equity, ethics and integrity.”

“It is that focus that drives me to this new challenge,” Herrera said. “Public service is an honor. When you see a need, you step up to serve. The test of our age is how we respond to climate change. San Francisco’s public utility needs clean, innovative and decisive leadership to meet that challenge. I am ready to take the lead in ensuring that all San Franciscans have sustainable and affordable public power, clean and reliable water, and, overall, a public utility that once again makes them proud. I want to thank Mayor Breed for this unique opportunity to stand up for ratepayers and usher in a new era of clean leadership at the top of the San Francisco Public Utilities Commission.”

The next step for the nomination is for the five-member commission that oversees the SFPUC to interview City Attorney Herrera and forward him as a formal recommendation to the Mayor. After this, and once a contract is finalized, City Attorney Herrera would be officially appointed by the Mayor and confirmed by the Commission. This process will take a number of weeks.

For nearly two decades, Herrera has been at the forefront of pivotal water, power and sewer issues. He worked to save state ratepayers $1 billion during PG&E’s first bankruptcy in the early 2000s and has been a leading advocate for San Francisco to adopt full public power for years. In 2009, he reached a key legal agreement with Mirant to permanently close the Potrero Power Plant, San Francisco’s last fossil fuel power plant. The deal also included Mirant paying $1 million to help address pediatric asthma in nearby communities. In 2017, Herrera sued the top five investor-owned fossil fuel companies in the world, including ExxonMobil and Royal Dutch Shell, seeking billions of dollars for infrastructure to protect San Francisco against sea-level rise caused by their products, including large portions of the SFPUC’s combined sewer and stormwater system.

In 2018, Herrera defeated an attempt to drain Hetch Hetchy Reservoir, the crown jewel of the SFPUC system, which provides emissions-free hydroelectric power and clean drinking water to 2.7 million Bay Area residents. He is also leading efforts before the Federal Energy Regulatory Commission and the courts to fight PG&E’s predatory tactics to grow its corporate monopoly by illegally overcharging public projects like schools, homeless shelters and affordable housing to connect to the energy grid.

Herrera was first elected City Attorney in December 2001, and went on to build what The American Lawyer magazine hailed as “one of the most aggressive and talented city law departments in the nation.”

Herrera’s office was involved in every phase of the legal war to achieve marriage equality, from early 2004 to the U.S. Supreme Court’s landmark rulings in June 2013. Herrera was also the first to challenge former President Trump’s attempts to deny federal funding to sanctuary cities. He repeatedly defeated the Trump administration in different cases as it sought to punish sanctuary cities, deny basic benefits like food stamps to legal immigrants, and discriminate in health care against women, the LGBTQ community and other vulnerable groups. He brought groundbreaking consumer protection cases against payday lenders, credit card arbitrators and others. He also brought pioneering legal cases to protect youth, including blocking an attempt to strip City College of San Francisco of its accreditation and getting e-cigarettes off San Francisco store shelves until they received required FDA approval.