Mad Dog Donald Trump Has A New Target-- Vulnerable Seniors In Long Term Care Facilities

What's more exciting, watching the new season of Game of Thrones or the new season of the Señor Trumpanzee Presidency? Remember, though, while we're being distracted by the outrageous antics of America's first-ever kakistocracy, they're working behind the scenes to chip away at everything that makes America great... little by little, relentlessly. Their latest victims: residents of nursing homes. No, really... that's who the Regime is going after now (No, not MS-13, seniors in nursing homes.) The audio above ran on NPR's Morning Edition yesterday.

What Trump wants to do-- well it's what the Chamber of Commerce wants to do but Team Trump is doing the dirty work for them-- is take away the right of abuse and negligence victims' right to sue nursing homes by forcing them to agree to arbitration rather than jury trials. 17 state attorney generals--led by Brain Frosh (D-MD) and Xavier Becerra (D-CA)-- and 31 senators-- led by Ron Wyden (D-OR) and Al Franken (D-MN)-- and the AARP are trying to stop Trump but he now seems to have gotten it in his mind that targeting nursing home patients is something he needs to stand firm on.

Long before he was a congressman, Alan Grayson wrote his masters thesis at Harvard on gerontology and then founded and ran the non-profit Alliance for Aging Research, after serving as a law clerk for both Ruth Bader Ginsburg and Antonin Scalia! Elder-care has always been one of the portfolios of issues that has driven his political career. He helped write the Medicare-For-All legislation and worked to try to persuade the leaders of both parties to include the care of teeth, eyes and ears in Medicare. When that eventually happens-- and it will-- we'll have Grayson to thank. There is no political leader who gets more incensed over elder-abuse than Grayson, so I went right to him when I saw what Trump is trying to do with these new rules. "It’s just typical of the kind of regulatory 'initiatives' that you see whenever the GOP has power," he told me this morning. "They pay lobbyists billions of dollars a year to generate this kind of malicious garbage, and press the buttons to have it proposed in the Federal Register, 'dropped' as a bill in Congress, inserted into the 'legislative history' of an appropriations bill, etc. In this case, it’s particularly malicious though, because Trump will never find himself in any 'long-term care facility,' unless it’s a federal prison."

Robert Pear covered the ugly news for the NY Times last week, as the Regime brings "its campaign to relax federal regulations to the delicate business of care for older Americans."

The push would undo a rule issued by the Obama administration that would have prevented nursing homes from requiring that consumers agree to resolve any disputes through arbitration rather than litigation. Nursing homes routinely require consumers to sign an arbitration agreement as a condition of admission to the home.

The proposed rule brings together a broader private-sector effort to slip binding-arbitration clauses into the fine print of consumer contracts with the Trump administration’s expansive efforts to roll back regulations and reduce the costs to businesses.

But both matters are particularly sensitive when it comes to older Americans, especially those in nursing homes where such arbitration agreements have already blocked legal recourse, even in egregious cases. About half of nursing home residents have Alzheimer’s disease or other dementia, according to the National Center for Health Statistics, and consumer advocates say harried family members could easily miss the arbitration clauses as they move a loved one into a home offering care.

“Individuals are very vulnerable when they sign contracts to enter a nursing home,” said Kimberly A. Valentine, a lawyer in Orange County, Calif., who has represented scores of nursing home residents. “In many cases, they are transferred from a hospital, and they are in a nursing home bed for several days before the contracts are even signed. The arbitration agreement may be just one page in a voluminous contract of 30 to 40 pages. Most of the people who come to me have no idea they’ve even signed an arbitration agreement.”

The Obama administration tried to ban such agreements, saying it was “almost impossible for residents or their decision-makers to give fully informed and voluntary consent to arbitration before a dispute has arisen.” Poor or negligent care at some nursing homes has persisted, even after the facilities have attracted regulatory scrutiny.

But the Trump administration says the ban on arbitration agreements imposes “unnecessary or excessive costs on providers” of nursing home care. It noted that President Trump, in an executive order, had directed agencies to roll back rules and reduce “regulatory costs.” The Centers for Medicare and Medicaid Services cited that guidance from the White House in issuing the new proposal.

“Upon reconsideration,” the Trump administration said of the proposed nursing home rule, “we believe that arbitration agreements are, in fact, advantageous to both providers and beneficiaries because they allow for the expeditious resolution of claims without the costs and expense of litigation.” The money that nursing homes spend on lawsuits could be better used caring for patients, it said.

Nursing homes generally welcomed the proposal, but other reaction has been overwhelmingly negative.

...Nursing home inspectors have documented many cases in which patients were injured as a result of infected bedsores, medication errors, malnutrition, dehydration or sexual assault.

The ban on arbitration agreements was issued by the Obama administration in September 2016. Nursing homes challenged it in court, and Judge Michael P. Mills of the Federal District Court in Oxford, Miss., blocked enforcement, pending a trial on the merits of the case.

But, Judge Mills said, “the practice of executing arbitration contracts during the nursing home admissions process raises valid concerns, on a public policy level, since many residents and their relatives are ‘at wit’s end’ and prepared to sign anything to gain admission.”

Long-term care ombudsmen, who receive federal funds to serve as advocates for nursing home residents in each state, are skeptical of the new initiative. “The proposed rule would undermine the rights of people living in nursing homes-- rights established in a 1987 law,” said Patty Ducayet, the Texas ombudswoman, who is a state employee.

The Trump administration has also proposed several requirements to protect nursing home residents who agree to binding arbitration. For example, arbitration agreements would have to be written in “plain language” and be explained to the consumer “in a form and manner that he or she understands.”

The innocuously-named American Health Care Association represents nursing homes in Washington and bribes members of both parties. The top recipient of their "contributions" last cycle was Todd Young, then a House Republican, now a Senate Republican. They always give more to Republicans but they also write checks for the most corrupt of the conservative Democrats from the Republican wings the Democratic Party. Among their biggest investments last cycle were corrupt scumbags on the blue side of the aisle:

• Joe Crowley (D-NY)
• Steny Hoyer (D-MD)
• Ben Ray Lujan (D-NM)
• Patrick Murphy (D-FL)

Each got the same $10,000 PAC check that was given to:

• Paul Ryan (R-WI)
• Rob Portman (R-OH)
• Greg Walden (R-OR)
• Cathy McMorris Rodgers (R-WA)

Two years early their biggest investments went to sleaze bags Cory Booker (D-NY- $15,000) and Fred Upton (R-MI- $15,000). they give especially large sums to Blue Dogs and New Dems and anyone else who has the reputation for selling their votes for a few thousand dollars... in a bipartisan way, of course. On Monday the National Law Review noted that "The current administration has set its sights on another federal rule, seeking to eliminate the ban on pre-dispute arbitration agreements for nursing home residents. Pre-dispute arbitration agreements require elderly adults and individuals with disabilities, as well as their families, to waive their right to file a lawsuit in the courts – before admission to a nursing home. As a condition to entering the nursing home, the prospective resident and his or her representative would be required to submit any dispute, including claims of egregious abuse or neglect, to mandatory arbitration proceedings."

Nursing home admission is a stressful and emotional time for the prospective resident and his or her family. Requiring a waiver of rights as a condition of admission, as occurs with pre-admission arbitration agreements, puts the person and his or her family in a time-sensitive quandary, literally at the nursing home door. Under the new amendments, if they refuse to sign away their right to go to court, they can be denied admission to the facility.

Imagine after months of discussions, the decision is finally reached to admit an elderly or disabled individual to a nursing home. This decision often involves the heartache of giving up one’s home and freedom, many possessions, and even treasured pets. The decision is often motivated by a desire to keep the individual safe and ensure that he or she receives required medical care.

But, are nursing home residents safe when they are required to sign away any right to legal accountability for mistreatment or harm in the facility?

Arbitrations take place in private meetings and are confidential. Because arbitrations are not public proceedings like lawsuits and trials, nursing homes have little to fear in terms of lost business or reputation, even if the arbitrator rules against them. To make matters worse, usually the pre-admission arbitration agreements give all the decision-making about the process to the nursing home, including selecting the arbitrator, location, and rules that will govern the proceedings. That removes other safeguards provided by the original rule such as choosing a neutral arbitrator.

The Journal points out that what Trump is doing is "to strip nursing home residents of that right [a jury trial] by removing the provisions prohibiting binding pre-dispute arbitration in long term care facilities," claiming the Obama rule would "likely impose unnecessary or excessive costs on providers."

We reached out to Dr. David Gill, the progressive candidate for Illinois' 13th congressional district. He told us that "As an emergency department physician, I frequently work with social services personnel to facilitate transfer of patients from the emergency department to nursing homes, in situations in which patients can no longer care for themselves at home but are not so acutely ill as to require inpatient care in the hospital. This is an extremely stressful time in the lives of patients and their family members, and it amazes me that our government would seek to take away the rights of these patients and families at such a pivotal moment in their lives. Given the frequent difficulty in obtaining a nursing home bed in these situations, it is extremely unlikely that a family would refuse to sign the waiver being proposed by the Trump administration. To take advantage of individuals in such dire circumstances is shameful, to say the least. I am running against a representative who stands firmly with the president on virtually all matters, and I look forward to replacing him in January of 2019, and bringing compassion and my knowledge gained through 30 years in the healthcare profession with me to Congress."

James Thompson is running for the KS-04 congressional seat, but he's better known as one of Kansas' top civil rights attorneys. This is right in his wheelhouse. He told us that "Arbitrators can play an important role in ending litigation when both sides possess equal bargaining power and agree to arbitration. However, these efforts to deny the right to a jury trial and force arbitration are nothing more than big corporations operating from dominant positions in the business relationship and attempting to deny individual working class Americans a means of redress when nursing homes choose profits over people. Arbitrators are paid on a regular basis by big corporations who have numerous disputes, which provides a financial incentive to rule in favor of big corporate interests. Big corporations weed out arbitrators that rule against them by refusing to use them, while often going back to favorable arbitrators. We need to fight laws that take power from working Americans to give that power to corporate interests."