BREAK IN TRANSCRIPT
SEN. GORDON H. SMITH (R-OR): Thank you, Mr. Chairman, I appreciate this important hearing and this continuing discussion we're having on nursing home quality. These discussions are necessary to ensure that those in need of long-term care get the quality care they deserve.
The issue of nursing home quality and safety is of particular interest to me and all members of this committee and I thank the panelists today for being here today.
I, like Senator Kohl, appreciate Senator Grassley. As a former chair of this committee and having served as both chairman and ranking member of the finance committee, the interest of our citizens in nursing homes has long been a priority for him.
We know that the need for long-term care is expected to grow significantly in the coming decades. Almost two-thirds of the people currently receiving long-term care are over age 65, and this number is expected to double by 2030.
We also know that the population over age 85 of that population, those are the ones most likely to need long-term services and supports, and this is expected to increase by more than 250 percent by the year 2040 from 4.3 million to 15.4 million.
Today, millions of Americans are receiving or are in need of long-term care services and support. They don't have to wait that long, it's already here. Surprisingly, more than 40 percent of persons receiving long-term care are between the ages of 18 and 64.
The past decade has revealed a shift in the provision of long- term care. A great example of this is in my home state of Oregon, where much of the care is provided in community settings and in recipient's home.
We've also seen that long-term care providers are offering services that put the patient at the center of care, encouraging inclusion of families in decision making and giving more choices in the location of the care, such as community-based and home care settings.
As I've said in this committee before, ensuring patient safety is a responsibility that rests with no one party or entity. It is shared by care providers, the federal and state governments, law enforcement agents, local agencies, and community advocates.
It is a responsibility that I and my colleagues take very seriously, and let's all work together more collaboratively in order to curb the incidence of elder abuse. We owe that to the millions of seniors who have placed their trust in our nation's long-term care system and to those who remain in their homes and in their communities.
The passage of the Elder Justice Act, this would be a wonderful and much needed step towards this goal. Apart from improving communication and cooperation of enforcement activities, there may have to be new, stronger policies in place to ensure that seniors receive the safest long-term care possible.
To that end, I've introduced the Long-Term Care Quality and Modernization Act with Senator Blanche Lincoln. This bill encourages a number of important improvements to nursing homes and the long-term care system that aims to enhance the quality and safety of care provided to our seniors.
I look forward to continuing to work with my -- the many advocates, industry representatives, and regulators here today to ultimately pass this important legislation. I'd like to applaud the work that Senator Kohl has done in this area as well, and especially in regard to helping nursing homes and other facilities better identify potential bad actors in the workforce and to ensure families are informed of facility quality.
It is essential that we find more effective ways to help poor performing facilities operate at a much higher level -- to help poor -- or to consider ways that they can be phased out of the system.
We cannot let the inappropriate actions of a few continue to destroy the trust our nation's seniors have placed in the long-term care system. I am confident this fine panel of experts will be able to provide a fresh light, some fresh insight on the work that is being done at the federal, state, and local levels to reduce elder abuse and provide the safest, highest quality care that is possible. Thank you.
BREAK IN TRANSCRIPT
SEN. SMITH: Mr. Chairman, thank you.
Kerry, thank you for being here.
MR. WEEMS: Good to see you, sir.
SEN. SMITH: I recognize that this is probably your last appearance for this committee for the balance of this year. And with the chairman's indulgence, I need to ask you to answer a couple of questions about two topics that we have had hearings on in this committee.
In no way to take away from the importance of the questions being asked for this topic, but they affect seniors and they affect people in nursing homes, and I need some answers from CMS that I fear are not -- I am not getting.
The first relates to the 1-800-MEDICARE call centers.
MR. WEEMS: Yes, sir.
SEN. SMITH: In anticipation of your appearance here today, I had my staff make 15 calls to these centers this past week. They asked very basic questions that should have a quality control so that there is very easy and accurate answers given. Like, what's the difference between Medicare Part D and Medicare Advantage. Pretty basic.
What are the enrollment periods for these plans? Pretty important.
Can a beneficiary switch plans after enrollment if they aren't satisfied with their plan? They were given false information repeatedly. Under what circumstances is the late enrollment penalty assessed? Again, very divergent kinds of answers.
I guess my point in raising this is I think you need some quality control at 1-800-MEDICARE. And I am hoping that you can tell me what you are going to do about it?
MR. WEEMS: Well, Senator, I certainly will look into it. Those are basic questions that --
SEN. SMITH: Ought to have really stupid answers.
MR. WEEMS: -- we audit answers, given we do have quality control processes in place. Obviously, if you and your staff are getting these kinds of answers, those aren't adequate. So, we'll need to make them so.
SEN. SMITH: Fifteen calls in the past week and the answers were all over the board and they were often inaccurate.
MR. WEEMS: Well, that is not acceptable, Senator.
SEN. SMITH: Secondly, another hearing we had was on the validity of genetic testing. Here is a Wall Street Journal article last week talking about genetic testing. Is there a heart attack in your future? Genetic tests promise to map your personal health risks. But some question usefulness. CMS has spent six years to underwrite guidelines for this.
They have just abandoned it. And this field is proliferating and its usefulness is clearly in question. I'd like to know what you will do in when CMS is apparently walking away from a felt need. I mean an obvious need, if the Wall Street Journal is questioning it, and other publications as well.
What CMS is going to do to re-pickup the ball and try to put forward some guidelines, so that the questions as to validity can be assured because a lot of seniors are getting this stuff, often scaring them to death, and often without any medical validity at all.
MR. WEEMS: Well, senator, first of all the -- this was brought to my attention just before this hearing, so I will respond in writing and with clarity as to what our plans are.
The FDA, of course, has responsibility for the initial approval of such tests, then CMS would work with them under the Clinical Laboratory Improvements Act. But exactly what actions we have taken in the past, and our current trajectory, I will provide to you in writing.
SEN. SMITH: Well, I appreciate it. It is a national issue. It is a legitimate concern of this committee. And I think many of the senators on this panel, and I don't think we are meeting our public responsibility if this field is growing.
Whether it is snake oil or not, it is attracting a lot of money. I am not saying it is, but I am saying it may be. And to make sure it isn't, there ought to be some federal standard that which -- that people can have confidence that is being met, so that people aren't just being scammed.
Thank you. Mr. Chairman.
BREAK IN TRANSCRIPT