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Lawmakers want more accountability from nursing homes, but will industry unite behind payment system?

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Lawmakers eye nursing home changes to increase accountability.

As the nursing home industry asks lawmakers for hundreds of millions in additional funds and seeks protections from COVID-19 related lawsuits, there is growing momentum the Capitol for greater scrutiny over how Florida’s nursing homes spend $4 billion annually.

The Republican-controlled Legislature is moving bills to require Florida nursing homes and their home offices to submit audited financial statements with the state.

But Sen. Audrey Gibson and Rep. Carlos Guillermo Smith want to go beyond increasing financial transparency at Florida’s 690 skilled nursing facilities. They have filed legislation (SB 1596 and HB 1237) that requires nursing homes to direct 75% of the Medicaid payments they receive to direct patient care.

The bills also place a cap on executive salaries. Nursing homes would not be able to use more than 15% of their total expenses funded through the Medicaid program on executive salaries and earnings.

“By doing this we will ensure … that those nursing homes are actually spending the $4 billion in taxpayer money that Floridians give them every year, they are spending it on actually caring for our seniors,” Smith said Thursday at a news conference. He and Gibson were joined by representatives of AARP Florida and United Healthcare Workers East 1199 SEIU, which published a case study of Consulate Health Care, A Crisis of Their Own Making.

Florida Health Care Association spokesperson Kristen Knapp said the comments amounted to “sound bites that sound great.” But she said the prospective payment system which the state adopted to use to set Medicaid rates takes quality of care into consideration. “If you are not making continuous quality improvements, your rates are reduced,” she told Florida Politics.

But Steve Bahmer, president and CEO of LeadingAge Florida, agrees with Gibson and Smith that there is no accountability in the rates. LeadingAge represents mission driven nursing facilities, continuing care retirement communities and assisted living facilities.

A medical loss ratio is one way to increase accountability, but it’s not the only way. Bahmer said the Legislature could also increase accountability by improving how the rates currently are formulated.

“Billions of taxpayer dollars are spent each year on Medicaid reimbursement for Florida nursing homes, and it’s reasonable to expect that those dollars result in the delivery of the highest-possible quality of care for Florida seniors,” Bahmer said in an email. “One of our primary concerns with the reimbursement system put into place in 2017 has been that it does not provide accountability for how Medicaid funds are spent.”

The remarks harken back to the 2017 Legislative Session and a bruising battle over the so-called prospective payment system (PPS).

Prior to adoption of the PPS system, the state used cost reports and rates were set retrospectively. But the FHCA pushed the Legislature to adopt a system where reimbursement rates are determined in advance of payment.

Lawmakers required that the change from a cost-based system to a PPS system had to be cost neutral.

“It shifted millions of dollars from high-cost and high-quality providers who invested more in patient care. And that shift occurred without any requirement that those new dollars providers received had to be spent on care,” Bahmer said. “Our argument at the time was, and remains to this day, that providers should be accountable for how Medicaid dollars are spent, and the system needs to be improved to ensure that accountability.”

The plan was adamantly opposed by LeadingAge Florida and was championed by the Florida Health Care Association. Consulate Health Care facilities benefitted from the switch in payment.

Meanwhile, the AARP and the SEIU also have come out in support of Gibson and Smith’s legislation.

AARP Florida Associate State Director for Advocacy Zayne Smith said transparency and accountability are key, and said the bills should have bipartisan support.

“It’s a win for the residents, it’s a win for the most vulnerable, the residents in Florida. It’s a win for the workforce and, frankly, it’s a win for the nursing homes to do the right thing and to place the emphasis on care, not profit.”


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300,000 Brits Have ‘Stealth’ Heart Condition That Could Kill Them ‘In 5 Years,’ Researchers Say

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 By Andrew White


 January 27, 2022 at 11:02am


Doctors are urgently warning people in the United Kingdom that 300,000 Brits are living with a “stealth” heart condition that could kill them within five years.

A report by The Sun warned that some 300,000 Brits in the United Kingdom are living with a “stealth” heart disease that could kill them in five years, according to researchers in the UK and Australia.

A third of the people with the mysterious heart disease are “likely to have no idea they are infected because they do not show clear symptoms.”

The disease, aortic valve stenosis (AS) is a heart condition that “often shows no symptoms until it’s already too late.”

From the report:

The condition is when the heart’s aortic valve narrows, reducing or blocking blood flow from the heart into the main artery to the body (aorta).

This can cause chest pain, dizziness, fatigue, or a rapid, fluttering heartbeat in the more severe and life-threatening cases.

Some people are more prone to getting it, including those of older age, with diabetes, high blood pressure, or heart conditions from birth.

Given the ageing of the UK population, it is thought that there may be a large pool of as yet undiagnosed people.

Does the COVID-19 vaccine adversely impact the heart?

Researchers in the UK and Australia set out to estimate how many people could be living with the condition now, and of those, how many are at risk of death.

According to the researchers, 1.5% of people over the age of 55 in the UK at any one time could have severe AS, equal to around 300,000 people.

Just under 200,000 of them were symptomatic, indicating that they had a severe case of the disease and were eligible for surgery.

The remaining 90,000 had a “silent” case and will “probably not be diagnosed” unless they are screened for other issues.

Without timely treatment, researchers say, an estimated 172,859 people will die over the next five years heading into 2024, meaning 35,000 people every year, with 10,000 of those deaths being among 55-64 year olds.

Studies have shown that people with a severe case of AS who do not get treated with surgery have a 25% chance of dying within the first year after symptoms begin, with the risk increasing to 50% in the second year.

The researchers, led by Geoffrey Strange, a cardiologist at the Royal Prince Alfred Hospital, Sydney, said: “In conclusion, this study suggests that severe [aortic stenosis] is a common condition affecting many individuals within the UK population aged 55 [and older].

“Without appropriate detection and intervention, their survival prospects are likely to be poor.”

The researchers are concerned the NHS will not be able to cope with the wave of older people with aortic disease over the next few years.

The research comes as some remain concerned that myocarditis and other heart conditions known to be side effects of the controversial COVID-19 vaccines are not being taken seriously.

Some suggested the new warning regarding AS and the COVID-19 vaccines could be linked, though National File was not able to find evidence confirming this.

It’s the jabs!! Don’t flannel the truth! This stealth heart disease bollocks is just the cover up to justify the coming deaths!!!https://t.co/EPtx83GdMV

— Truthseeker1984 (@Truthseeker1985) January 27, 2022

hey vaxxers.

they’re already setting up the excuse when you mindless sheep start dying.

300,000 Brits living with stealth disease that could kill within 5 years pic.twitter.com/K0RsnoXfjL

— Talking Surface Monkey (@blackbarthnews) January 27, 2022

Cover stories already circulating to cover long term vax injuries in the next 5 years???? https://t.co/9Q2zSJS2A0

— Marmite 🌸🌸🌸 (@marmite2021) January 27, 2022

About the Author:


Andrew White is a Northern Virginia native. His work here at National File has been previously featured on Alex Jones’ Infowars and Revolver News. White is a constitutionalist Patriot, who focuses on social issues, election integrity, globalism, US politics, as well as general corporate and government corruption.

National File is committed to ensuring your voice can and will be heard. To keep your speech free, we are switching our commenting platform to Insticator. Don’t worry! All you have to do is create a commenting account with Insticator. We will be transferring previous comments to our new site, and then you will be able to link your past comments to your new Insticator account. If you have any feedback or questions about your Insticator commenting account, please email them at: [email protected]

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HERE IT IS: Supreme Court Justice Stephen Breyer Publishes Letter Announcing His Retirement

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Justice Breyer on Thursday officially announced his retirement from the Supreme Court after 27 years on the bench.

Joe Biden and Stephen Breyer will be speaking at 12:30 on Thursday where the president will announce his new SCOTUS nominee to replace Breyer.

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Stephen Breyer, a Bill Clinton appointee, released a letter about his retirement.

Justice Breyer said he plans to retire at the end of the current SCOTUS term (June/July).

TRENDING: Fauci Proposes Three Shot Series for Babies 6-Months-Old Up to Children 4-Years-Old (Video)

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Judge Forces Trump Attorney to Turn Over 1,500 Pages a Day for Liz Cheney’s Amusement

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A California judge is forcing Trump Attorney John Eastman to review and turn over at least 1,500 documents a day in the Democrat Party’s continued harassment and abuse of the opposition party.

Eastman, a staunch Trump supporter, is a major target of the communist left in their ongoing attempt to crush their opponents and send a message to the people of America. NO dissent will be allowed.

Liz Cheney and her committee members must be very pleased.

Eastman was outspoken in his belief that the 2020 election was stolen from the most popular president in American history. Trump recorded more votes by a sitting President in a national election. A majority of Americans to this day believe the election was decided by fraudulent means.

TRENDING: Fauci Proposes Three Shot Series for Babies 6-Months-Old Up to Children 4-Years-Old (Video)

Via Newsmax:

A federal judge Wednesday night ruled that former President Donald Trump’s lawyer must review at least 1,500 pages of records per business day and immediately transfer any unprivileged documents to the House Jan. 6 committee.

Judge David Carter, of the U.S. District Court for the Central District of California, ordered attorney John Eastman to begin producing pages to congressional investigators beginning Friday, Politico reported.

Any documents Eastman deems privileged must be given to Carter. If the committee challenges the lawyer’s claim, the judge will review the records to determine whether the assertion was valid before holding a hearing to adjudicate the privilege disputes.

Carter earlier rejected Eastman’s attempt to block the committee’s subpoena for 19,000 pages of emails held by his former employer, Chapman University. Eastman has claimed that many of the emails relate to his legal clients and therefore be subject to potential attorney-client privilege.

The Wednesday night ruling showed that Carter is taking a more hands-on approach than any federal judge so far to assist the Jan. 6 select committee’s effort to access specific documents from a reluctant witness.

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