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##LE_DEBAT_DU_SAMEDI-2022-02-12##
SPRINGFIELD — The clock is running on an April deadline to pass a $400 million bond bill that will put the state one step closer to millions in federal funding for a new Holyoke Soldiers’ Home.
The bill, H.64, is slated for debate Tuesday by the Joint Committee on State Administration and Regulatory Oversight, a vaguely named committee whose purview is wide and covers bonds and other financial legislation.
Gov. Charlie Baker has been pushing hard to woo members of the legislature to approve the bill.
“The current Holyoke Soldiers’ Home was constructed before modern design standards for medical facilities,” Baker’s filing bill reads, in part. “The Administration has taken immediate steps to address urgent capital and infection control needs, but we believe a major reconstruction of the campus is necessary for the health, safety, and comfort of future generations of veterans and staff.”
The April deadline comes ahead of another on Aug. 1, for the design phase of the project to be complete — a milestone that will make the project eligible for federal support. While Baker’s administration and advocates for the Holyoke Soldiers’ Home have been working at a feverish pace to get the project done, not all members of the Legislature are feeling the same urgency.
Also bearing down is a March 31 deadline for the Special Joint Oversight Committee on the Holyoke Soldiers’ Home to recommend reforms. The committee was born of the COVID-19 outbreak that claimed the lives of 76 veterans last spring, prompting public outrage and calls for reforms. Lawmakers have hosted six public hearings featuring families of veterans, staff, former administrators and state officials with oversight of the soldiers’ homes here and in Chelsea.
That deadline may be complicated by a shuffling of leadership, however. State Sen. Walter Timilty, a Milton Democrat and original co-chair of the committee, stepped down and was replaced by Sen. Michael Rush, a Suffolk and Norfolk county Democrat.
State Sen. John Velis speaks during a legislative hearing on the future of the Soldier’s Home in Holyoke, held at Holyoke Community College in October 2020. (Don Treeger / The Republican file)
State Sen. John Velis, a Democrat from Westfield, is the new chairman of the Joint Committee on Veterans and Federal Affairs, replacing Timilty in that post. Velis has been a member of the oversight committee and the most vocal member of the Legislature advocating for a new home.
“We are working tirelessly night and day to ensure that this bond bill is passed expeditiously. We can’t get to a point in our discourse where providing care with honor and dignity to our veterans becomes nothing but meaningless words,” Velis said, adding that he expects the oversight committee will host additional hearings despite the looming deadline.
A new facility with primarily private rooms and other enhancements has become the chief rallying cry of advocates for the Holyoke Soldiers’ Home. The bill must first clear the administration committee before moving on to the Joint Committee on Bonding, then the Committee on Ways and Means before going to the state’s full House and Senate.
While many legislators have gotten behind the project, not all are convinced the price tag is reasonable.
“Maybe there should be a look at what else really needs to be done, for a greater number of veterans across the state,” said state Sen. Marc Pacheco, a Taunton Democrat and co-chairman of the Administrative and Regulatory Oversight Committee. “I’m not saying don’t do Holyoke … not at all; that would be crazy. But whether or not they need $400 million of investment there is a legitimate question.”
Pacheco said that although he is skeptical, he looks forward to learning more about the needs in Holyoke through testimony from his colleagues and others.
Velis said he intends to go to the mat to push the bond bill through.
“The significance of this bill speaks for itself. All of the residents of Holyoke Soldiers’ Home — past, present and future — didn’t hesitate to to act when their national came calling. Now we must do the same for them,” he said.
State Sen. Marc Pacheco.Chris Lisinski/SHNS
Pacheco said while he is an advocate for veterans’ services, veterans in his district of southeastern Massachusetts and farther south to the Cape and Islands feel their own sense of neglect.
“I know the governor’s got a bill that’s just responding to Holyoke, but it’s not responding to the statewide need that has existed from quite some time,” Pacheco said.
Pacheco’s co-chairman, state Rep. Antonio F.D. Cabral, a Democrat from New Bedford, also appeared to be on the fence.
“Whenever you get 65 % on anything back from the federal government it’s a good investment,” Cabral said. “But I usually like to hear testimony before I make my position public. I’m not necessarily opposed to the concept and idea.”
The bond bill must pass before the U.S. Veterans’ Administration and other federal agencies will pledge the percentage of funding that is typical for capital projects for soldiers’ homes and other veterans’ facilities.
Since the bill will first debated by the House if it clears committee scrutiny, some representatives are looking ahead.
“I’m optimistic,” said state Rep. Pat Duffy, a Holyoke Democrat newly elected to the Legislature. “It does feel like everyone is pushing in the same direction.”
Duffy cited a last-minute pivot by the Baker administration to concede to Soldiers’ Home trustees and other advocates to increase the number of beds in their proposal.
“I’ll be listening closely to what the governor has to say” at Tuesday’s hearing, Duffy added. “And I certainly plan to testify myself.”
A spokeswoman for the Baker administration said the governor is committed to getting the bond bill passed on or before April 1, to meet the VA’s application deadline of April 15.
This would allow the Division of Capital Asset Management and Maintenance four months to complete the design development necessary to meet the Aug. 1 deadline, she said — a process that typically takes nine months.
Oğlum’un ilk bölümünde neler oldu?
“Bütün çocuklar masumdur…”
Bambaşka dünyalara sahip iki çocuğun hayatlarını anlatarak başlayan ilk bölüm izleyiciye birçok duyguyu bir arada yaşattı. İlyas ve Melike çifti, kızları Ceren ve 6 yaşındaki oğulları Kaan ile birlikte sakin ve sevgi dolu bir hayat sürmekteydi. Zeynep ve Tuğrul çifti ise oğulları Efe ile birlikte İlyas, Melike ve Kaan’ın aksine daha sevgisiz ve sorunları olan bir aileydi. Efe, ailesi ile iletişimi kopuk, babasından sevgi göremeyen, tek arkadaşı bilgisayar oyunları olan bir çocuktu. Sıradan bir iş gününde Melike, ilk maaşını alma heyecanıyla çarşıda mağazaları gezerken Kaan’ın okul çıkışına geç kaldı. Annesini okul bahçesinde bekleyen Kaan, bir kirpinin peşine takılarak okuldan uzaklaştı. Bu sırada okuldan kaçan Efe, Kaan’ın kirpiyi takip ederek ulaştığı parktaydı. Bir süre sonra Efe, Kaan’ın kaybolduğunu fark ederek ona yardım etmek istedi. Kaan ve Efe karakola doğru yola çıkarken bu sırada Melike ve İlyas, Kaan’ın okuldan çıktığını öğrenip telaşla oğlunu aramaya başladı. Yolda Kaan, Efe’nin kendisine verebileceği bir scooter’ı olduğunu öğrenince karakola gitmek yerine önce scooter’ı almak istedi. İki çocuk birlikte Efe’nin scooter’ını sakladığı ormandaki gizli yerine doğru yola çıkarken polis de her yerde Kaan’ı aramaya başladı. Bir süre sonra acı haber geldi, ormanlık alanda bir çocuk cesedi bulunduğu söylendi. Öldürülen çocuk Kaan’dı… İlyas ve Melike çifti bu olayla büyük bir yıkım yaşarken ailenin acısı ekran başındaki izleyicileri de derinden etkiledi. Polisler olayı araştırmaya başlayınca ormandaki eşyalardan ve parkı gören kamera kayıtlarından Efe’yi tespit etti. Komiser Sedat, Efe’nin okuluna giderek annesi Zeynep’e durumu açıklamaya çalıştı. Sedat ve Zeynep okulda Efe’yi ararken küçük çocuk bu sırada okuldan kaçarak olayı anlatmak için karakola gitti. Sedat, pedagog Demet ile Efe’yle konuşmaya çalışırken finalde küçük çocuk herkesi şoke eden bir itirafta bulundu ve Kaan’ı kendisinin öldürdüğünü söyledi. Demet’in, “Hikaye ne kadar sert olursa olsun, umut her zaman bir yolunu bulur.” sözlerinin dikkat çektiği son sahnede Efe’nin doğru söyleyip söylemediği büyük bir merak konusu oldu.
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Nexstar Media Group has re-upped and expanded to a 28,766-square-foot lease at 2121 Wisconsin Avenue, a 110,960-square-foot office building in Washington, D.C.’s Glover Park neighborhood, with landlord, JBG SMITH.
The news media company currently occupies a portion of the third floor of the building. When its new space is ready next January, it will occupy the entire third floor and part of the first floor.
Additionally, CommuniKids, a language immersion preschool, has signed an 8,895-square-foot lease in the building and will open its doors next summer.
Cushman & Wakefield facilitated both leases on behalf of the landlord.
“For tenants, the much-higher-than-average ceiling heights allows for television studios to be created on-site,” Mark Wooters, a Cushman & Wakefield executive director, told Commercial Observer. “Additionally, the views of the Potomac River are surprising, as well as the access to nearby restaurants and residential, which make this building a particularly attractive location.”
The six-story building features a newly renovated lobby, fitness center and spa, courtyard and parking garage.
“The Glover Park market, despite the pandemic, remains strong with great tour activity and continued interest from tenants,” John Skolnik, a director at Cushman & Wakefield, told CO. “This is a premier area with great economic value, access to great amenities and easy commutes with close proximity to downtown, Northern Virginia and Bethesda. I anticipate we will see continued strong activity in this corridor over the coming months.”
CBRE’s Anthony Bolino and Jhon Pacheco represented Nexstar in its lease. Gordon Nielsen and Alexander Lofft of Summit Commercial Real Estate represented CommuniKids in its lease.
Keith Loria can be reached at [email protected].
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Perhaps most upsetting, she says, is the image from a video call of Joe, 68, sitting slumped over, his hospital-style gown falling off, leaving his torso bare. Seeing her husband in that state, “I wanted to cry,” says Kathy, 66, a retired police officer in Philadelphia.
The staffing level in the nursing home, Deer Meadows Rehabilitation Center, is “awful,” Kathy Pacheco says. The facility has a two-star, “below average” staffing rating from the Centers for Medicare and Medicaid Services, the federal agency that regulates nursing homes. When she recently raised questions about whether her husband is bathed twice a week as scheduled, she says, a staff member checked the records and couldn’t find any documentation of when he’d last had a shower. She noticed scabs on his back, she says, and later learned that he’d had scabies, an itchy skin condition caused by mites. And “he’s lost so much weight, we don’t know if he’s getting the food in his mouth,” she says. With pandemic visitation restrictions, her communication with her husband is often limited to a couple of 10-minute video calls per week, but “someone has to watch him” to make sure he eats, she says.
Deer Meadows executive Lisa Sofia said in a statement to MarketWatch that the facility can’t comment on any specific patient but “is dedicated to providing the best care for its residents and creating a safe environment. It does that by having trained and competent staff available to assist all residents.”
Despite receiving billions of dollars in federal aid during the COVID crisis, many nursing homes nationwide have done little to bolster the overstretched direct-care workforce that helps more than 1 million facility residents like Joe Pacheco bathe, dress and eat. Even as the nursing-home-resident population dwindled during the pandemic, staffing per resident has remained stagnant, studies show. The average nursing home’s daily direct-care staffing was about 3.6 hours per resident in the first quarter of this year, roughly the same as it was in the early days of the pandemic, according to the Long Term Care Community Coalition, a nonprofit advocacy group. The data indicate that many facility operators trimmed staff hours as patient numbers dropped, says Richard Mollot, the coalition’s executive director. Staffing cuts, he says, are “the sweet spot for the nursing-home industry to reduce costs and increase profits.”
The cost savings can come in the form of low wages and part-time positions for direct care workers. Nursing assistants in nursing homes earn a median $24,200 per year, 12% live in a household below the federal poverty line, and more than a third rely on public assistance, according to research and consulting group PHI.
“Locally, a lot of the factories are hiring with way higher wages,” says Jennifer Snow, a nursing assistant in Muskegon, Mich., who says she’s had to care for 35 residents on a single shift and often has to work 12 hours at a stretch. “I’ve definitely thought about quitting,” she says, “but I know it’s bad in every nursing home.”
That leaves nursing homes to face a virus resurgence with a burned-out and demoralized workforce, staff members, researchers and resident advocates say. In recent weeks, the rate of nursing-home-resident COVID cases hit its highest level since February, according to data from the Centers for Disease Control and Prevention, and the weekly number of resident COVID deaths is up more than 500% from late June. Several studies have concluded that facilities with higher nurse staffing levels are better able to contain the virus and generally have better resident outcomes.
Although understaffing in nursing homes long predates the pandemic, the long-term-care industry has recently used the staffing issue in a successful push for more government money and changes to the planned federal vaccine requirement for workers.
President Joe Biden’s August announcement that nursing homes must mandate staff vaccinations as a condition of participating in Medicare and Medicaid triggered industry objections that the move would cause nursing-home workers to decamp for other healthcare jobs. Last week, the administration expanded the requirement to all types of Medicare- and Medicaid-certified facilities and announced the release of another $25.5 billion in COVID relief for healthcare providers, including nursing homes.
To fix its staffing problems, the industry says it also needs more Medicaid funding and government support for tax credits for long-term-care workers, among other proposals. “We need state and federal policy makers to properly fund nursing homes, so they can become a more competitive employer,” Dr. David Gifford, chief medical officer for industry group American Health Care Association/National Center for Assisted Living, said in a statement to MarketWatch. Directing federal aid to staffing needs “has been a constant for providers during the pandemic,” he says, with many facilities hiring additional staff and offering bonus pay to caregivers.
Some researchers, meanwhile, say government funding of nursing homes needs more strings attached to ensure that facilities direct a substantial chunk of Medicare and Medicaid reimbursement toward staffing and other elements of direct patient care. Money that should be spent on patient care is often diverted into facility owners’ and investors’ pockets, researchers say, when facilities buy services from or pay rent to related parties. About 70% of U.S. nursing homes have for-profit ownership.
Congressional Democrats are pushing to address nursing-home staffing in their budget reconciliation package, including calling for a study of potential minimum staff-to-resident ratios. Such a study was done 20 years ago, establishing a recommended minimum of 4.1 hours of direct care staffing per resident day — a level most facilities still fail to meet. A minimum staffing threshold “should be implemented immediately,” says Toby Edelman, senior policy attorney at the nonprofit Center for Medicare Advocacy.
Even with the pandemic severely restricting nursing-home visitation, some facilities are putting undue burdens on residents’ loved ones to compensate for gaps in staffing, family members and watchdog groups say.
Marla Carter’s mother-in-law has lived in a Owensboro, Ky., nursing home since 2018. When the facility, now known as Chautauqua Health and Rehabilitation, changed hands earlier this year, Carter was asked to sign a new admissions agreement that contained some striking language, she says. The resident and “sponsor” — in this case, a family member — “agree to arrange for and provide supplemental private duty nursing to help reduce the risk of injury or to improve overall care if the Resident or Sponsor believes the Resident’s condition so requires,” the agreement said. Furthermore, the agreement said, the resident and sponsor agree to hold harmless the facility for any injury that “could have been avoided had supplemental private duty nursing been provided by the Resident or Sponsor.”
Under federal law, “the nursing facility has the legal obligation to provide all the care the resident needs,” says Eric Carlson, directing attorney at nonprofit legal advocacy organization Justice in Aging. “It’s improper for the facility to use an admissions agreement like this in an effort to get out from under the legal obligations” of the federal law, he says.
Carter says she would move her mother-in-law to another facility rather than sign the agreement. The wording “seems to indicate that I can’t expect them to properly care for my mother-in-law,” she says. Although she checks in with her mother-in-law by phone and video, she says, “her mental capacity has changed so much during the pandemic, she wouldn’t be able to tell me if there was anything wrong.”
The facility’s new owner, according to Kentucky licensing records, is Owensboro KY Opco LLC, a company that state business filings show was set up earlier this year by Simcha Hyman, CEO of Englewood Cliffs, N.J.–based Portopiccolo Group. Portopiccolo has rapidly expanded its nursing-home portfolio during the pandemic and is a defendant in a class-action lawsuit filed in May in U.S. District Court for the Middle District of North Carolina, alleging “severe systematic understaffing” at a Portopiccolo-affiliated facility in the state.
“Our local care teams work extremely hard to provide residents with the highest-quality, individualized support — and love — they need,” a spokesperson for Portopiccolo’s ClearView Healthcare Management said. “We are proud of them and their work and any accusation otherwise is simply false.” Portopiccolo has asked the North Carolina court to dismiss the lawsuit, calling the understaffing claim “meritless.”
What was supposed to be a quick fix for nursing homes’ COVID-era staffing problems has dialed up risks for residents as well as pressure on the more experienced workers who remain on the job, staff members and watchdog groups say. At the start of the pandemic, federal regulators waived the 75-hour minimum training requirement that typically applies to nurse aides in nursing homes, and many states allowed workers who had completed an eight-hour online course to work as temporary nurse aides. Eighteen months later, many of these workers with minimal training remain in nursing homes.
One nursing assistant in northwestern Pennsylvania says she was so alarmed by some of her coworkers’ lack of training that she quit her nursing-home job earlier this year. Temporary nurse aides were left to look after whole halls full of residents by themselves, and residents were left in bed all day and not bathed on schedule, says the aide, who asked that her name not be published. “The ones suffering are the residents,” she says. “It’s just not fair.”
More professional development, combined with more reasonable workloads, would go a long way toward stabilizing a workforce of nursing assistants that has already shown extraordinary dedication to residents, says Lori Porter, CEO of the National Association of Health Care Assistants. “Some of them are living in their cars and haven’t missed a day of work,” she says, but “you can’t treat people like they don’t matter and expect them to have loyalty to you.”
While many facilities belonging to large corporate chains may be positioned to ride out staffing shortages with staffing-agency workers and other stopgaps, some independent and nonprofit facilities say they have no choice but to shut down units or close completely. Island Nursing Home and Care Center, a nonprofit facility in Deer Isle, Me., announced in late August that it would close this fall. “Facilities like ours can no longer find qualified staff,” the nursing home said in a Facebook post. “We have spent months exhausting every staffing resource at our disposal and beginning this fall, we will no longer be able to meet our minimum staffing requirements.” The facility, which didn’t respond to a request for comment, said in its announcement that it would spend the coming months finding appropriate placement for each resident.
At the Washington Veterans Home in Port Orchard, Wash., home to about 200 residents, there were recently about 40 vacant direct care positions, according to an Aug. 26 letter the facility sent to residents and families, and a summer COVID outbreak affected dozens of residents and staff members. As of early September, only 54% of staff were vaccinated.
Kris Boudreau, 48, a U.S. Navy veteran who has lived at the facility for several years, has multiple sclerosis and relies on the staff to help him get in and out of bed, transfer to his wheelchair and complete countless small tasks. But lately, he says, a decline in the facility’s staffing, combined with the virus outbreak, has made the challenges of his daily life even tougher. With just a handful of staff members to care for dozens of vets in his unit, “I’ve sat here for more than 20 minutes sometimes waiting for someone to put me on the toilet,” he says. His favorite outings — to Imagine Dragons or Lorde concerts, or just down the hill for wings and a beer — have been largely out of reach during the pandemic. More than 18 months into the crisis, he and the other veterans at the facility “shouldn’t be going through this,” Boudreau says. “It’s like prison.”
The facility is actively recruiting and using staffing agencies to fill in gaps, says Heidi Audette, a spokesperson for the Washington State Department of Veterans Affairs. “We always attempt to answer call lights as quickly as possible,” she says, “but, if staff are caring for other residents, it can cause a delay in responding.”
Back in Philadelphia, Kathy and Joe Pacheco will mark their 50th wedding anniversary this weekend. But Kathy is worried that COVID restrictions could prevent her from celebrating the milestone in person with her husband. “This is not what we planned on,” she says of Joe’s life in the nursing home. “He always told me we were going to dance on that day.”
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CATS will make you LAUGH YOUR HEAD OFF – Funny CAT compilation
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あんさんぶるスターズ！！ Music MV、『2wink』の『Swee2wink Love Letter』です！
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『Swee2wink Love Letter』
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作曲/編曲: kz（livetune）
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Alemán
G-500
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Letra:
Ah, la-la (La-la)
La-la-la (La-la-la, la-la-la), ja
La-la (La-la)
Ey
Apenas me levanto y sé que ya me están mirando (Ey)
Estoy seguro no es por el flow que estoy derramando
Se espantan porque no saben lo qué está pasando (¿Qué?)
¿Es lo que sea que este moreno acaso está ganando?
Mundo lleno de serpientes, mucho veneno
Pero bueno, ya es inmune este moreno (Ah)
Callejero (Yeah) y traigo lo cuelgaеro
Voy pa’ dondequiera y tengo lo quе quiero
A huevo que sí puedo, no hace falta que sea güero
Me la pela, soy rapero, pinche clasista y culero
Miro claro en su mirada cuando sienten el temor
Cuando miran en mi frente el nopal y el sudor
Cosas que nunca han sentido por tener todo a favor
Y aún así son mierda, esa gente es la peor
Hacen meno’ a los demás, se creen ser superior
Ocupan bola de vergazos pa’ tener mi posición
Y más vale que vayas quitando esa cara de asco
Que ahí les va la verga, mejor usen casco
Desean verme fracasar, pero no los complazco
Ya les llegó el Huracán, les cayó el chubasco
Putos (Putos, putos)
Esta bola de vergas no saben de respeto, homs
Ahora sí pa’ que se caguen, y el prejuicio se traguen
Les paso por encima arriba en la G Wagon
Ahora sí pa’ que se caguen, y el prejuicio se traguen
Les paso por encima arriba en la G Wagon
Cuando mejor es mi racha y me encuentro en trance
Estos pendejos me bloquean, no quieren que avance
Pero no vo’ a pedirles chance, vo’ a romper el alambre
Vo’ a cambiar tu sonrisa por una boca con sangre
Yo voy a progresar, puto, tengo mucha hambre
Ya me compré el penthouse, van y chingan a su madre (Jajajaja)
Mira nomás qué cura agarro
No pueden solos los culones, mandan a sus guarros
A sus putas, a sus bitches, a sus marionetas
Ahora sí pa’ que se caguen, y el prejuicio se traguen
Les paso por encima arriba en la G Wagon (Ah)
Ahora sí pa’ que se caguen (Ah), y el prejuicio se traguen
Les paso por encima arriba en la G Wagon (Ah, ah, ah)
Ahora sí pa’ que se caguen (Oh), y el prejuicio se traguen
Les paso por encima arriba en la G Wagon (Yeh, yeh, yeh, yeh)
Ahora sí pa’ que se caguen (Ah), y el prejuicio se traguen (Ah)
Les paso por encima arriba en la G Wagon (Ah)
Yah-yah, yah-yah, yah, ah
Haciéndolo fino, ah
Homegrown Entertainment ©
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