IHT Rendezvous: Environmental Warning Fatigue Sets in

Record levels of industrial smog? A dwindling number of fish in the world’s oceans? A 4° Celsius warming in global temperatures by the end of the century?

How about environmental warning fatigue?

Global concern for major environmental issues is at an all time low, according to the results of a global poll of more than 22,000 people in 22 countries, released earlier this week.

“Scientists report that evidence of environmental damage is stronger than ever — but our data shows that economic crisis and a lack of political leadership mean that the public are starting to tune out,” said Doug Miller, the chairman of GlobeScan, the company that carried out the study.

While respondents clearly still had grave environmental concerns, fewer people were “very concerned” about various environmental issues than at any point in the last 20 years. The sharpest decrease in global concern occurred over the last two years.

The issue of climate change, which 49 percent of respondents rated last year as “very serious” was the only exception to the general trend. Pollsters found that there was less concern between 1998 and 2003 than today.

Shortages of fresh water and water pollution were the highest global concern, with 58 percent of the respondents marking it as “very serious.”

Respondents were asked to rate seven different environmental issues – from climate change to loss of biodiversity – as being either a “very serious problem,” “somewhat serious problem,” “not very serious problem” or “not a serious problem at all.”

The latest numbers were gathered last summer in telephone and face-to-face interviews with participants in Australia, Brazil, Canada, China, France, Germany, India, Indonesia, Japan, Kenya, Malaysia, Mexico, Nigeria, Pakistan, Panama, Peru, Poland, South Korea, Spain, Turkey, the United Kingdom and the United States.

Join our sustainability conversation. Do you take the environmental issues more seriously now than in the past? Do you find yourself tuning out?

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Bonnie Franklin Played Struggling Everymom to Perfection, Says PEOPLE's Critic















03/02/2013 at 09:00 AM EST







Bonnie Franklin, Mackenzie Phillips and Valerie Bertinelli


CBS/Getty


When certain television stars pass away, they don't leave the stage – they leave your life. They played ordinary people so perfectly, you almost imagine that once their series concluded they went on living a plain existence parallel to yours as you worked, shopped, ate dinner, watched TV.

Actress Bonnie Franklin, who died of pancreatic cancer Friday at age 69, was for nine seasons America's most contemporary everymom on CBS's One Day at a Time (1975-1984). Franklin played Ann Romano, a divorced mother of two daughters (Valerie Bertinelli and Mackenzie Phillips) living in an apartment in Indianapolis.

Ann was cute but not pretty, youthful but not young, reasonable but not wise, optimistic but not deluded. You could have summed her up as pixieish, except she seemed too worn out to leap. Or maybe she'd need a minute to rev herself up.

Raising the girls and hoping for love, she seemed to understand that victories, as the title suggested, were achieved only incrementally.

There aren't many other sitcom performances that live on in the memory for such frank, simple concreteness. The show, for me, can be reduced almost entirely to close-ups of Franklin's watchful face, framed by her red page cut – and her expression is more anxious than amused.

Over the course of the show, there was plenty to be anxious about. One Day was developed by the legendary Norman Lear, who with All in the Family reformed the pastel-colored American sitcom into something not only set in a recognizably drab world but willing to grapple with hot-button topics like birth control and teen suicide. One Day dealt with both, and many more.

It's hard to be believe now, when TV sitcoms have become almost astonishingly inventive in constructing their comic situations, how essentially anguished such a show could be.

Which is why it's that face that I still see. That struggling but deserving woman, for whom everything is one day at a time.

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WHO: Slight cancer risk after Japan nuke accident


LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.


In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.


"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."


The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.


On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.


In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.


Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.


In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.


The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.


Wakeford said the increase may be so small it will probably not be observable.


For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."


David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.


Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.


Some experts said it was surprising that any increase in cancer was even predicted.


"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.


WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.


Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.


"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.


Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.


"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.


In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."


Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.


Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.


Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.


"I'm enraged," he said.


___


Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.


__


Online:


WHO report: http://bit.ly/YDCXcb


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IHT Rendezvous: IHT Quick Read: March 1

NEWS As the sun set on Rome and on his turbulent eight-year papacy, Pope Benedict XVI, a shy theologian who never seemed entirely at home in the limelight, was whisked by helicopter into retirement on Thursday. Rachel Donadio reports from Vatican City.

As President Obama and congressional Democrats have tried to force U.S. House Speaker John Boehner back to the table for talks to head off the automatic budget cuts set to take effect on Friday, Mr. Boehner has instead dug in deeper, refusing to even discuss an increase in revenue and insisting in his typical colorful language that it was time for the Senate to produce a measure aimed at the cuts. Ashley Parker reports from Washington.

Local councils in rebel-held towns are trying to set up courts, police forces and social services, amounting to Syria’s first experiments in self-government after years under the Assads. David Kirkpatrick reports from Tilalyan, Syria.

In South Africa, where violent crime, vigilante attacks and police brutality are daily fare, a cellphone video of a man being dragged behind a police truck has incited outrage for its brazen and outsize cruelty. Lydia Polgreen reports from Johannesburg.

A U.S. soldier, Pfc. Bradley Manning, on Thursday confessed in open court to providing vast archives of military and diplomatic files to the antisecrecy group WikiLeaks, saying that he had released the information to help enlighten the public about “what happens and why it happens” and to “spark a debate about foreign policy.” Charlie Savage reports from Fort Meade, Maryland.

Jean-Claude Duvalier, the former dictator known as Baby Doc, walked into a muggy, packed Haitian courtroom on Thursday, sat down next to shocked victims and for the first time answered questions in a court of law about his brutal 15-year reign. Isabeau Doucet reports from Port-au-Prince, and Randal C. Archibold from Mexico City.

The European Union took a big step Thursday toward putting strict limits on the bonuses paid to bankers, hoping to discourage the risk-taking behavior that set off the financial crisis. But the proposal to cap bankers’ bonuses must still be approved by a majority of the E.U.’s members. James Kanter reports from Brussels and David Jolly from Paris.

FASHION Alexander Wang’s debut collection for Balenciaga was a promising start. Suzy Menkes reviews from Paris.

ARTS Historians will soon release a report on the Vienna Philharmonic’s links to Nazi activity in the 1930s and ’40s. James R. Oestreich reports.

SPORTS Somluck Kamsing became a muay Thai star 20 years ago. Now, at age 40, he’s back at his home ring and trying to bring artistry back to the sport. Joseph Hincks reports from Bangkok.

Under the owner Roman Abramovich, no manager of Chelsea can expect to last long, but Rafael Benítez took exception at being labeled “interim” from day one. Rob Hughes reports from London.

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Jennifer Lawrence Says She Sets Up Bradley Cooper









03/01/2013 at 09:45 AM EST



Clearly, the country has become enamored with this year's Best Actress winner, Jennifer Lawrence. And if Bradley Cooper wasn't charmed by her already, now he has plenty to love about her.

"I feel like all I've been doing lately is setting him up," Lawrence, 22, told MTV of her Silver Linings Playbook costar.

But interest in the actor (PEOPLE's Sexiest Man Alive in 2012) is so great that the actress has had to strategize.

"I was like, 'You know what? I'm going to save time, I'm going to get you a booklet of pictures of my friends and you just go through and pick them out,' " she joked. "Because this is getting exhausting for me."

Though he plays her love interest in their romantic comedy, the sparks between them are onscreen only.

Says Lawrence, "He's my brother."

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WHO: Slight cancer risk after Japan nuke accident


LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.


In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.


"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."


The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.


On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.


In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.


Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.


In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.


The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.


Wakeford said the increase may be so small it will probably not be observable.


For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."


David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.


Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.


Some experts said it was surprising that any increase in cancer was even predicted.


"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.


WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.


Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.


"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.


Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.


"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.


In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."


Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.


Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.


Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.


"I'm enraged," he said.


___


Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.


__


Online:


WHO report: http://bit.ly/YDCXcb


Read More..

Wall Street slips on weak global data

PARIS, March 1 (Reuters) - Alex Ferguson's philosophy is behind the longevity of Manchester United's homegrown players, says Paris St Germain midfielder David Beckham. The former England captain and United player is still active at 37, having joined PSG on a five-month loan at the end of January. Former team mate Phil Neville, 36, plays at Everton and the 39-year-old Ryan Giggs, who started his youth career at Manchester City but ended it at United, is still at Old Trafford after signing his first professional contract there in 1990. ...
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IHT Rendezvous: Q and A: Keeping ‘A Chorus Line’ in Step

LONDON — For a musical that’s all about dancers, there’s not a huge amount of dancing in “A Chorus Line,” which opened last week at the London Palladium — the first West End revival of the musical since it opened here in 1976, a year after its smash-hit debut on Broadway.

But the most dance-intensive moments are fundamental to our very idea of “A Chorus Line”: the “Aaaah-5-6-7-8!” that unleashes the explosion of movement with which the musical opens, and the slow sideways-moving line of gold-clad top-hatted dancers with which it closes. In between those moments is the meat of the show; the passage from anonymity as the dancers begin the audition, to individuality as they tell their stories — and then back again, to an impersonal line of identically dressed, identically moving performers.

On opening night at the Palladium, the audience greeted those first moments with a roaring cheer, a salute to the love-story that “A Chorus Line” tells — not between its characters, but between them and showbiz. The choreography may look stylized, but it doesn’t really matter. Watching, we are both in 1975 (as the opening projection tells us) and in 2013; leotard and dance styles might have changed, but the desire to be on Broadway has not.

Michael Bennett, who conceived of the show, choreographed and directed it, died in 1987, and it is his co-choreographer, Bob Avian, who has been responsible for directing the major “Chorus Line” revivals since.

So how much does the dance (and the dancing) matter in “A Chorus Line”? Two days after the London opening — greeted by a positive storm of approval by the critics — Mr. Avian flew to Fort Lauderdale, Florida, for a well-earned rest after several months of putting the musical together in London. Speaking by telephone, he discussed the choreography, his approach to staging the work, and why “A Chorus Line” still speaks to a contemporary audience.

Q.

How did you and Michael Bennett approach the choreography? Is the opening number really the kind of routine you would have asked an audition group to do?

A.

Michael and I were a good team, because he was a jazz dancer, and my training was classical. Between us we came up with a lot of choreography that was more integrated. A lot of it was based on dance crazes of the time — disco, the toe-heel-heel, the body shifts that go along with that. We pulled on elements of popular dancing as we were doing it; we were children of our times, dance-wise. There’s actually not much contemporary dance in there; there is ballet, typical broadway and tap. The only jazz combos are in the opening sequence and the montage sections.

Q.

Did you initially think it would be more of a dance show?

A.

Well, it was a very slow process and I’m not sure we had an idea of how it would be. We had the original tapes of the stories from our dancers and once we decided to put those stories in the framework of an audition, we were able to construct the piece. But it took us a very long time. We did four workshops, which no one did in those days — we were the first ones ever to do it. The montage, which is 22 minutes, took us six weeks. You wouldn’t be able to do that today, it would be too expensive.

Q.

Is the routine we see at the beginning a realistic idea of what you might see at a Broadway audition today?

A.

A dance call is still pretty much the same. When we have an open call, you might get 700 people. We divide them into groups of 10 and make them all do double pirouettes — you can immediately see people’s training. We keep 2 or 3 people from each group, then we teach them the opening combination, a shortened version, then the full one, then the ballet combination. You get a feel for their jazz style, and the ballet combination is very revealing in terms of technique.

Q.

Are you strict about remaining faithful to the original choreography? Do you adapt to different dancers or, perhaps, a more contemporary style of dancing today?

A.

The ensemble stuff is set in stone, but with the solo work, we are very open. For Cassie’s dance, for instance, we try to pull on the strengths of the dancer performing the role. If she has a great extension, or very supple back, we make tons of adjustments along the way. In structure it’s still the same, because it’s about the music and the storytelling — it’s about narcissism, about the need to have her gifts recognized.

In the individual stuff, the staging of the songs, I make adjustments all the time. At the beginning of the rehearsal process, I just let them do the number and see what they will bring to it. In that way, I suppose it becomes more contemporary because they are performers of today.

Q.

Have the technical capacities of dancers changed since you first staged the musical in 1975?

A.

Undoubtedly. The quality of the dancing is much higher than it was when we made it. Also, then you still had a singing chorus, or a dancing chorus; it was hard to get people who could do everything really well, and now that is the norm.

It’s still hard to get a woman who can do Cassie’s big song-and-dance solo; we’ve had performers who are great dancers, but can’t really sing it. It’s a very difficult song and you need a lot of stamina. But every time I return to the show, the caliber is higher in general.

Q.

Is there a difference between the U.S. and the U.K in the quality of musical theater performers, given that there is more of a conventional theater tradition here?

A.

Not essentially. They were perhaps a little behind America in the past, but that’s mostly to do with the fact that we pull from a population that is so much bigger — it’s a numbers thing. But now they have the same all-around training, and they are fully the equals of U.S. performers. In fact, I think this London cast is the finest company we’ve had in 35 years. Every time I do “Chorus Line,” I think, not again! But this was all pleasure.

Q.

The audience was beyond rapturous at the performance I attended. Why do you think people identify so strongly with “A Chorus Line”?

A.

I think it speaks to everyone because it’s really about people on an assembly line. They are not stars, and they aren’t trying to be stars — they are trying to succeed in essentially a humble way. And the musical talks about things that weren’t discussed on Broadway before: homosexuality, plastic surgery, angry or troubled or loving relationships with parents. Even though much has changed socially since we made it, those issues don’t go away.

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Debbie Reynolds: Carrie Fisher Will Be 'Just Fine' After Hospitalization















02/28/2013 at 08:40 AM EST







Carrie Fisher (left) and Debbie Reynolds


Ethan Miller/Getty


Carrie Fisher was briefly hospitalized last week for her bipolar disorder after a bizarre performance aboard a cruise ship, but her mother Debbie Reynolds says she'll be fine.

"She's had manic depression bipolar since she was 13. It's an illness, and she's doing much better," Reynolds told PEOPLE exclusively Wednesday night. "I'm very proud of her, and she's doing exceptionally well. She'll be just fine, just great, and continue her writing as she always does."

Fisher, 56, who has spoken openly about her mental illness, performed on the Holland American cruise liner Eurodam in the Caribbean. The actress and author gave a rambling performance, leaving many in the audience wondering what was wrong.

"She clearly had trouble remembering things," says Chris Smith, a guest on the cruise. "She tried to tell some stories about her parents and Hollywood, but was having a hard time."

After a video of the performance went viral, her publicist released the following statement: "There was a medical incident related to Carrie Fisher's bipolar disorder. She went to the hospital briefly to adjust her medication and is feeling much better now."

Reynolds, 80, who spoke Wednesday to a sold-out audience attending the Rancho Mirage Lecture Series at Eisenhower Medical Center in Rancho Mirage, Calif., talked about the effects of mental illness.

"[It's] really dreadful, and you are so alone because you're criticized, and people think you're doing it on purpose, and that you're misbehaving or having a spell because you want attention," she says. "It's not true. It's extremely difficult for everyone to deal with."

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Medicare paid $5.1B for poor nursing home care


SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.


The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.


One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.


By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.


Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.


"These findings raise concerns about what Medicare is paying for," the report said.


Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.


In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.


In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.


The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.


That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.


Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.


In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.


"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."


CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.


Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.


"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.


Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.


"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."


Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.


Investigators found the homes didn't always do what was needed to ensure a smooth transition.


In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.


___


On the Web:


The OIG report: http://1.usa.gov/VaztQm


The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1


___


Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.


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