NURSING HOME, HOSPITAL INDUSTRIES

NURSING HOMES

Biden Administration Unveils New Nursing Home Rules

Long a contentious point, but highlighted by the disproportionate number of deaths among nursing home populations during COVID-19 pandemic, President Joe Biden emphasized the need for stricter mandatory threshold for staffing requirements of the nation's nursing homes during the 2022 State of the Union address. At that time, many advocacy groups and elder support groups have voiced support for Biden's focus on an issue that involves circa 15,000 facilities and about 1.2 million residents. 

On September 1, 2023, Biden administration unveiled its proposals that managed to anger both sides of the aisle. Under the rules that were published on the Federal Register on September 1, 2023, the minimum staffing threshold will be 3 hours per resident per day, including just over half-an-hour of the time coming from a registered nurse. Under the rules, there will be an RN 24/7 in the facility. Industry's main lobbying group American Health Care Association's president, Mark Parkinson, a former Democratic governor of Kansas, uttered that the rules were "unfounded, unfunded and unrealistic" and "we hope to convince administration" not to finalize them. 

Advocacy groups lambasted the proposals as the current average staffing level at the nursing homes is equivalent to 3.6 hours per resident per day, including over an half an hour coming from a RN. Biden's rulesets will mandate the current average thresholds without any improvement. Advocacy groups are pointing at a 2001 CMS-funded study that recommended 4.1 hours per resident per day, which, advocacy groups contended at that time, fell short of their expectation. Long Term Care Community Coalition leader Richard Mollot said that Biden's proposal will do a bare minimum ripple, not a significant reform that many advocacy groups have thought that it would herald in the most consequential piece of intervention step since the Nursing Home Reform Act of 1987. 

Texas Budget (Biennial 2012-13)

Texas House and Senate passed a $172.3 billion, two-year spending bluprint by 97-53 and 20-11 votes, respectively, on May 28, 2011, and sent it to Gov. Rick Perry for his signature. The budget cuts $20 billion from the present levels of spending.

As part of the budget, the school funding plan includes the most controversial elements as legislators proposed to cut $4 billion in school funding over the next two years. On the top of $2 billion per year, an additional $1.4 billion in grant money will also be chopped off. The proposed cut comes despite $830 million from the economic stimulus plan from the federal government. The compromise crafted between the House measure and Senate measure includes a statewide 3.3% cut for the first year and a statewide 5.6% cut for the second year for 1,030 ISDs of Texas. The second year cut would affect higher-spending, wealthier districts more than the midsize, rural districts. Under the current target revenue adjustment, districts such as Lubbock get less than the higher-spending, wealthier districts.

Although House approved the education measure on May 29 by 84-63 measure, Senator Wendy Davis, D-Ft Worth, put up with a spirited filibuster, jeopardizing the education measure at the Senate floor. Gov. Rick Perry on May 30, called a special session starting immediately as the education measure was stalled at the Senate.

Chrysler Paid Back $7.6 billion to Governments

Two years after lurking near bankruptcy and getting $10.5 billion bailout from US and Canadian governments, Chrysler on May 24, 2011 took a big leap towards fiscal health as it paid back $5.9 billion to the U.S. Treasuries and $1.7 billion to the governments of Canada and Ontario. This came on the top of the first quarterly net profit (this year's first quarter)in five years and CEO Sergio Marchionne's push to revamp the vehicle line to generate enthusiasm among consumers. Also, on May 24, Fiat infused an additional capital of $1.3 billion to raise its stake to 46%.

Barnes & Noble Received Acquisition Offer

Barnes & Noble, the iconic book retailer, on May 20 received an $1 billion offer from the Liberty Media conglomerate led by John Malone. Malone's offer specially hinges on the prowess of the chain's electronic book reader, NOOK. Liberty offered $17 a share in cash. Liberty runs three publicly traded companies: Liberty Interactive Inc., Liberty Starz Group and Liberty Capital Group. The iconic bookseller is a household name, brand created by a dedicated team of executives led by the founding Chairman Leonard Riggio.

Report from Board of Trustees on Social Security and Medicare

On May 13, 2011, the Board of Trustees issued the annual fiscal health report on two sacrosanct federal programs--Social Security and Medicare. According to this year's report, the surplus of the Social Security trust fund will disappear in 2036, a year earlier than predicted last year. Medicare Part A, or Medicare Hospital Insurance Fund, will run out of money by 2024, five years earlier than predicted last year. The report also suggests that retirees will get only 0.7% cost of living adjustment (COLA) to their social security paycheck next year after getting none for two years. The meager increase will be all but eaten away by higher Medicare Part B premium. The Board of Trustees also reported recommendations to fix the two mandatory programs and make them solvent for the next 75 years:

* Social Security: Raise the payroll tax by 2.15% or slash the benefit by 14%.

* Medicare: Raise the payroll tax by 1% or slash the benefit by 17%.

Nearly 55 million retirees, disabled people and children who had lost parents are recipients of social security benefit, while more than 46 million people are in Medicare roll.

Source: The Dallas Morning News

On June 1, 2013, the Board of Trustees issued its outlook for both Medicare and Social Security Trust Fund. Medicare Part A, or Medicare Hospital Insurance Fund, will run out of money by 2026. The standard Medicare Premium (Medicare Part B) for the next year (2014) will remain the same, $104.90 a month. Social Security Trust Fund will run out of money by 2033. The recipients of Medicare benefit will increase from the current level of 52 million to 73 million in 2025. At present, there are more than 57 million social security beneficiaries, and an average of 10,000 baby boomers become eligible each day.

 Last year (2012), the Board of Trustees estimated that the Medicare Hospital Insurance Fund would be exhausted in 2024, and Social Security Trust Fund would be exhausted by 2033.

Microsoft to Acquire Skype

On May 10, 2011, software giant Microsoft announced a $8.5 billion deal to acquire internet telephone company Skype SA from a group of sellers that include eBay Inc. and private equity firms Silver Lake and Andreessen Horowitz. The acquision marks the largest transaction in 36-year history of the software giant. Microsoft will use Skype's 170 million users to leverage its growth with its universal tools and applicatios such as XBOX game console, outlook e-mail program and Windows smartphones. However, 95% of the Skype customers use the service free of any charge, making it almost impossible for Skype to make money just by calling since it was founded in 2003 by the two entrepreneurs Niklas Zennstrom and Janus Friis.

On October 14, 2011, Microsoft closed the $8.5 billion deal.

Source: The Dallas Morning News

Southwest Acquires Airtran

On May 2, 2011, Southwest completed a landmark acquision of Airtran. Now, over the next several months, the Dallas-based carrier has to chalk out an aggressive integration process. The acquisition was announced on September 27, 2010. On February 29, 2012, the Federal Aviation Administration issued a single operating certificate, starting off a process of integrating the two airlines by converting the aircraft exteriors and combining other operational functions.

Partnership for Patients Program

The U.S. HHS on May 5 unveiled a $1 billion Partnership for Patients Program to cut down on medical errors and enhance patient care values. Through the program, $500 million will be disbursed by the HHS to test different models for improving patient care to reduce hospital-acquired conditions. The partnership will ask hospitals to focus on nine types of errors and complications, including adverse drug reactions, pressure ulcers, child-birth complications and surgical site infections. The other $500 million will be spent on grants to community-based organizations that come up with ways to keep patients compliant and healthy after they are discharged from the hospital. Locally Baylor University Medical Center will be at the forefront of this innovative initiative. If the pilot is successful, the initiative is estimated to save up to $35 billion a year, including $10 billion in Medicare.

Information Based on the May 31, 2011, Edition of The Dallas Morning News
The Partnership for Patients Program has set two important goals to achieve by the end of 2013:

(I) Aiming to keep hospital patients from getting sicker or injured and the reduction goal targeted is 40% (1.8 million fewer injuries and 60,000 lives saved)

(II) Striving toward reducing hospital re-admissions by 20% (1.6 million)