Leader

Collapse

Announcement

Collapse
No announcement yet.

Nursing Homes & Sprinklers

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • #46
    Randsc: What we have is most of agreeing that the faciites should sprinklered, and I doubt many of us are saying that reimbursement rates shouldn't change. But since you seem to be up on the topic, is there a current difference in reimburment rates? Why should the rates change so that sprinklers can be affordable to small homes when most larger homes already provide the safety measures?

    While you may think I'm being naive to say cost should not be the deciding factor, I ask you: Who pays when the Fed's mandate vehicle safety measures? The end users. And that is part of doing business in our country. It comes down to the great divide- liberal vs. conservative, democrat vs. republican, user's pay vs. we all share the costs. I'll pay for elderly housing when I or my family needs it, and I'll pay more than those who need it now are paying now.

    But having fire service members who will make the opposing arguement certainly won't help raise the safety measures in these target occupancies.

    As for naivity, you don't beleive unfunded mandates will continue to be a daily occurence in this country, and many at a lesser benefit?

    Comment


    • #47
      Again, the Missouri fire was NOT in a nursing home

      Originally posted by btrotta
      Anyone who doesn't think that nursing home sprinklers should be mandatory should talk to some of the guys in Hartford, CT who had the misfortune of responding to a nursing home fire about 3 years ago. There were 16 patient deaths in that fire and only luck, and a quick, massive response by fire and EMS prevented many more.

      The State of Connecticut responded quickly to the problem and mandated sprinklers in all nursing homes. To date, none of the nursing homes in the state have gone out of business because of the mandate, though many have changed hands several times since then.

      At $3-$5 a square foot, retrofitting a building with sprinklers isn't an outrageously expensive proposition for a facility -- certainly not in comparison to the lives lost, or the cost of the lawsuits that follow a fire in such a facility.
      It continues to amaze me that people in a profession that gets all prickly if some poor civilian calls a fire engine a "truck" could fall to understand the importance of being precise about language.

      In any case, here is the Connecticut law, which applies ONLY to nursing homes, and not to residential care homes:

      Public Act No. 187 An Act Concerning Fire Sprinklers in Nursing Homes


      SUMMARY: The act extends the deadline for nursing homes to install automatic fire extinguishing systems, expands the scope of reporting requirements, and adds employee fire training requirements. Under prior law, each nursing home had to have an automatic fire extinguishing system approved by the state fire marshal on each floor by July 1, 2005. This act extends the deadline to July 1, 2006, specifies that the system should be complete, and requires it to be installed throughout the nursing home instead of on each floor. It requires the Connecticut Health and Educational Facilities Authority (CHEFA) to create and administer a loan program to help pay for the cost of installation.


      Please note that last line, which is exactly the sort of thing I have been talking about.

      Comment


      • #48
        You fundamentally mistate the nature of residential care

        Originally posted by Dave1983
        Right, I was talking about NOW. BTW, every existing home I have been in has been retrofitted (and I have been in many). Maybe its a local thing.


        Back to the orignal question. IMHO, all homes, be it full nursing, ACLF, ALF, group home or whatever you want to call it needs sprinklers. And that includes retrofitting existing homes. I dont give a rats *** how much it costs, and NO, the goverment shouldnt pay a dime. You want to open a business, you meet the requirements. Period. Why should I as a tax payer support a private, for profit business?
        at least in most of the country. Residential care in most places is almost entirely funded by medicare. Providers are government contractors. They cannot do what truely private business owners do when faced with a mandate, which is raise prices. The rates are set by law.

        I have news for you; you as a taxpayer are already paying. And you as a taxpayer will also end up picking up the bill if the residents of these homes end up with nowhere to go but private apartments with weekly trips to the the ER.

        Also, as I would think should be clear, the providers HAVE met the requirements.

        Comment


        • #49
          Let's go through this one step at a time

          Why should the rates change so that sprinklers can be affordable to small homes when most larger homes already provide the safety measures?
          The answer has to do with the nature of the business. Large homes, companies like Courville in the Northeast, or MHA or Alliance in other parts of the country, do not accept medicare/medicaid patients. They really are just "Old Folks Homes" though in order to operate they need to be licensed for res care.

          The same is true of some (a very small number) of smaller homes. However, the vast majority of smaller homes are essentially government contractors. They take the people the larger places won't, and have no control over their own revenue. They are not "businesses" in the sense of the word that most people use. They have various forms of incorporation, many are 501(c)(3) non-profits, many are religious-based not-for profits, some are, largely for purposes of available of financing, technically for-profit. In any case, no body is getting rich running them.

          While you may think I'm being naive to say cost should not be the deciding factor, I ask you: Who pays when the Fed's mandate vehicle safety measures? The end users.
          This is exactly right. And the end user in the case is the resident, not the provider. In homes that do not accept government-paid residents, the rate will simply be raised. What we are talking about here, however, is a situation where the cost for the end-user (the resident) is borne by the government.

          I'll pay for elderly housing when I or my family needs it, and I'll pay more than those who need it now are paying now.
          No, actually, you almost certainly will not. You may well be able to pay for res-care, or "elderly housing", but if your mom needs a nursing home, how long will you or she be able to pay $400 a day? Almost everyone who ends up in an acute-care nursing home is on government assistance within a year. In res-care, it can be as long as three years. The fact (and it is a fact) that the vast majority of nursing home residents end up being paid for by the state is the reason that a private comapny can not simply choose to open a nursing home if they feel like it. They need to obtain something called a "certificate of need" which is essentially the government's acknowledgement that more nursing home beds are needed in the state, and that government will end up paying for most of the people in those beds.

          But having fire service members who will make the opposing arguement certainly won't help raise the safety measures in these target occupancies.
          Having fire service members make dogmatic statements from a position of profound ignorance only causes us to be held in contempt by those who do know what they are talking about. Sorry to be so blunt, but there it is. If people roll their eyes when we join the conversation, that is not a good thing. We need to be, and be seen as, clear-headed and realistic, while still primarily motivated by public safety.


          As for naivity, you don't beleive unfunded mandates will continue to be a daily occurence in this country, and many at a lesser benefit?
          In my state, unfunded mandates are expressly forbidden by the state constitution. I prefer to think of my belief that governments should follow their constitutions as "optomistic".

          Comment


          • #50
            Originally posted by randsc
            No, actually, you almost certainly will not. Almost everyone who ends up in an acute-care nursing home is on government assistance within a year.
            Maybe I should have said we will pay, as in case you've forgotten we are the government, we pay for these things. The government gets its money from us and maybe a slight bit of overborrowing. And if the governement is the end user/payer in these home, then wouldn't making sprinklers mandatory now in effect make them/us pay for it?
            Originally posted by randsc
            Having fire service members make dogmatic statements from a position of profound ignorance only causes us to be held in contempt by those who do know what they are talking about. Sorry to be so blunt, but there it is. If people roll their eyes when we join the conversation, that is not a good thing. We need to be, and be seen as, clear-headed and realistic, while still primarily motivated by public safety.
            Ah yes, the name calling begins. Luckily bother, if you are actually a firefighter, I don't care what you think and as a firefighter I've certainly been called worse by better men (and women). I don't agree with stalling for dollars, so I must be profoundly ignorant. I have not disputed your facts, I merely do not agree that the mandate shouldn't be pushed through now, reagrdless of funding. At some point we should take our fire problem seriously. As the largest industrialized nation in the world we should not have a fire death rate that rivals third world countries. Also, I have never said that better funding shouldn't be done to offest costs, but I don't think that should be the stalling point on this issue. I see people rolling their eyes at how easily "we" can be knocked off our convictions. "OK yep, we asked, they said no, I guess its time to go back to the firehouse and think up another hairbrained idea to protect them from themselves."
            Originally posted by randsc
            In my state, unfunded mandates are expressly forbidden by the state constitution. I prefer to think of my belief that governments should follow their constitutions as "optomistic".
            Mine too. Still happens every day! Most codes change every few years yet we don't subsidize corrections for compliance. Unfunded mandate. Laws that cost people money are passed every day, yet still no funding or reimbursement. So every change in your state is funded? By who? You? Taxpayers? Yeah, lets make everything required be paid for by the masses.

            You know I'd like a new SUV, maybe the government should pay for all that safety crap and emissions BS and stuff, I just want a plain jane Hummer without all that other garbage. With the feds share I'll bet I can just about swing it!

            Comment


            • #51
              Still no optional solutions?

              So as I asked earlier, what is the answer?

              If sprinklers cost too much and will cause facilities to close and put people out into the streets, what's the solution? How about a few ideas? What do we do? Nothing? Screw it, we can't afford to keep the elderly safe from fire, is this what is comes to?

              A few of you are ready to shoot down any mandatory requirements for sprinklers in existing facilities, so what's your idea to improve fire safety for these people?

              Comment


              • #52
                If the cost of a sprinkler system will put the place out of business...what will the cost of an uncontrolled fire do to that same place of business?
                "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

                Comment


                • #53
                  Originally posted by Bones42
                  If the cost of a sprinkler system will put the place out of business...what will the cost of an uncontrolled fire do to that same place of business?

                  Bing-fracking-o!!!
                  Last edited by CaptainGonzo; 11-30-2006, 07:43 PM.
                  ‎"The education of a firefighter and the continued education of a firefighter is what makes "real" firefighters. Continuous skill development is the core of progressive firefighting. We learn by doing and doing it again and again, both on the training ground and the fireground."
                  Lt. Ray McCormack, FDNY

                  Comment


                  • #54
                    In my state, unfunded mandates are expressly forbidden by the state constitution.
                    randsc, either you are deliberately misrepresenting the NH constitution or you are not familiar with it. The NH constitution prohibits unfunded mandates from the state to POLITICAL SUBDIVISIONS (i.e. local government). What relevance does that have to the discussion regarding funding of sprinklers in nursing homes, assisted living, etc.?

                    And further, even if the state funded sprinklers in these facilities, who do you think pays? the taxpayers. Bottom line is the gov't at any level doesn't pay for anything. What we are talking about here are complex social/political issues such as wealth re-distribution which in effect is the source of revenue for anything that someone benefits from that they don't foot the entire bill for.

                    Comment


                    • #55
                      And with regard to the original discussion. Should be re-distribute wealth to pay for sprinklers in these facilities. My personal opinion is yes. In a country as wealthy in the U.S. and that has the wealth to fund pork barrel earmarks, we should protect our older citizens who have very limited or no ability to self-rescue.
                      Pork-barrel spending was $50 some billion dollars in recent years, that would pay for a lot of sprinklers. To bad the "compassionate conservatives" that have run up pork barrel spending to record levels don't have a little compassion for our older folks in these types of facilities.

                      Comment


                      • #56
                        Originally posted by RFDACM02

                        A few of you are ready to shoot down any mandatory requirements for sprinklers in existing facilities, so what's your idea to improve fire safety for these people?
                        Who, exactly? I have read back through the threads, and I have not found one post that says sprinklers can't be made madatory. The question is whether the cost should be borne by the provider, in return for no increase in revenue.

                        Several proposed solutions have been offered, including increasing the state medicaid/medicare reimbursments, providing tax credits, and low interest loan and grant programs.

                        Comment


                        • #57
                          Who's stalling?

                          Originally posted by RFDACM02
                          Maybe I should have said we will pay, as in case you've forgotten we are the government, we pay for these things. The government gets its money from us and maybe a slight bit of overborrowing. And if the governement is the end user/payer in these home, then wouldn't making sprinklers mandatory now in effect make them/us pay for it?

                          Ah yes, the name calling begins. Luckily bother, if you are actually a firefighter, I don't care what you think and as a firefighter I've certainly been called worse by better men (and women). I don't agree with stalling for dollars, so I must be profoundly ignorant. I have not disputed your facts, I merely do not agree that the mandate shouldn't be pushed through now, reagrdless of funding. At some point we should take our fire problem seriously. As the largest industrialized nation in the world we should not have a fire death rate that rivals third world countries. Also, I have never said that better funding shouldn't be done to offest costs, but I don't think that should be the stalling point on this issue. I see people rolling their eyes at how easily "we" can be knocked off our convictions. "OK yep, we asked, they said no, I guess its time to go back to the firehouse and think up another hairbrained idea to protect them from themselves."

                          Mine too. Still happens every day! Most codes change every few years yet we don't subsidize corrections for compliance. Unfunded mandate. Laws that cost people money are passed every day, yet still no funding or reimbursement. So every change in your state is funded? By who? You? Taxpayers? Yeah, lets make everything required be paid for by the masses.

                          You know I'd like a new SUV, maybe the government should pay for all that safety crap and emissions BS and stuff, I just want a plain jane Hummer without all that other garbage. With the feds share I'll bet I can just about swing it!

                          Pass a spinkler mandate tomorrow. Pass the funding mechanism as part of the same legislation. Like the connecticut law cited above. Pretty simple, really.

                          Comment


                          • #58
                            Well

                            Originally posted by CaptainGonzo

                            Bing-fracking-o!!!
                            According to you, the cost hardly matters, right? Since the providers are bring in tens of millions a year, according to your math?

                            Comment


                            • #59
                              So for all of you who believe...

                              ...that an immediate mandate with no regard to funding is called for, how about addressing my original analogy?

                              [QUOTE]My analogy would be this. A municipality contracts with a fire district for a particular level of protection, for example, that a firehouse will be staffed with an engine company and a truck company, and in exchange the municipality will kick in a million dollars to the fire district budget. (am quite common arrangement in the States) There is then a bad fire, and the municipality decides it would feel more comfortable with TWO engine companies and a truck company. Should the municipalty be able to mandate that staffing level without adjusting its payment to the fire district?{/QUOTE]

                              Comment


                              • #60
                                Originally posted by randsc
                                According to you, the cost hardly matters, right? Since the providers are bring in tens of millions a year, according to your math?

                                You haven't answered Bones' question...

                                Originally Posted by Bones42
                                If the cost of a sprinkler system will put the place out of business...what will the cost of an uncontrolled fire do to that same place of business?
                                ‎"The education of a firefighter and the continued education of a firefighter is what makes "real" firefighters. Continuous skill development is the core of progressive firefighting. We learn by doing and doing it again and again, both on the training ground and the fireground."
                                Lt. Ray McCormack, FDNY

                                Comment

                                300x600 Ad Unit (In-View)

                                Collapse

                                Upper 300x250

                                Collapse

                                Taboola

                                Collapse

                                Leader

                                Collapse
                                Working...
                                X