Four in 10 Americans are living paycheck to paycheck, study says

More than four in 10 Americans are living paycheck to paycheck and nearly one in 10 doesn’t earn enough to pay for essentials, according to a study released Tuesday.

The survey, conducted for the Allstate insurance company by FTI Consulting Inc., underscored the conflicted emotions and attitudes about personal finances among ordinary people.

It showed the challenges that people are facing in a soft economy and troubled labor market, but it also demonstrated that many people make unwise financial decisions even when they know better.

The survey found that 59% of Americans say they generally know how to handle money and make the right financial decisions. But 47% of respondents said they’re saving less money than they should be.

Underscoring the financial dichotomy in the U.S., half of the survey respondents described their financial situation as “excellent” or "good,” while half said it was “fair” or "poor.”

Though 41% live from one paycheck to the next, 8% can't even make it that far, saying they don't have enough to afford everyday essentials.

On the bright side, 82% of people think they’re financially better off than their friends and 52% say they’re better off than when they were growing up.

The survey of 1,000 Americans age 18 and older was conducted in mid-December. It has a margin of error of plus or minus 3.1% in 95 out of 100 cases.

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Grammys 2013: Fun., Mumford, Gotye lead a newer generation

Grammy Awards voters gave their top honor to British roots music band Mumford & Sons for their album "Babel" on Sunday at the 55th awards ceremony. Other top honors were distributed to a broad array of younger acts, including indie trio Fun., electronic pop artist Gotye, rapper-R&B singer Frank Ocean and rock group the Black Keys.

"We figured we weren't going to win because the Black Keys have been sweeping up all day — and deservedly so," Mumford & Sons front man Marcus Mumford said after he and his band members strode to the stage at Staples Center in Los Angeles to collect the award from last year's winner, R&B-soul singer Adele.

Pop culture historians may look back at 2013, however, as the year the Grammy Awards gave up its long fight against new forms of music dissemination, embracing songs and videos that consumers soaked up by way of YouTube and other Internet outlets as opposed to purchasing them.

PHOTOS: 2013 Grammy Award winners

"Somebody That I Used to Know," the wildly popular collaboration between Gotye and New Zealand pop singer Kimbra, took the top award presented for a single recording upon being named record of the year, which recognizes performance and record production.

"Somebody…" not only was one of the biggest-selling singles of 2012 but also has notched nearly 400 million views on YouTube, powerfully demonstrating the increasingly vital role of the "broadcast yourself" video Internet phenomenon. Different YouTube posts of Ocean's "Thinking About You" single have totaled nearly 60 million views.

New York indie rock trio Fun. was named best new artist, an acknowledgment of the good-time music the group brought to listeners and viewers last summer largely through its runaway hit single "We Are Young," which has racked up nearly 200 million YouTube views. It also was named song of the year, bringing awards for the group's songwriters, Jack Antonoff, Andrew Dost and Nate Ruess, and collaborator Jeff Bhasker.

GRAMMYS 2013: Full coverage | Pre-show winners | Winners | Ballot

"Everyone can see our faces, and we are not very young — we've been doing this for 12 years," Ruess said as they collected the award.

The song's title could also serve as a theme for the evening, which was dominated by other relatively young acts in the most prestigious Grammy categories.

Singer, rapper and songwriter Ocean emerged the victor in the one category that pitted him directly against real-life rival Chris Brown, as his critically acclaimed solo debut album, "Channel Orange," won the urban contemporary album award. A few minutes later Ocean got a second Grammy with Kanye West, Jay-Z and the Dream in the rap-sung collaboration category for their single "No Church in the Wild."

GRAMMYS 2013: Winners list | Best & Worst |  Red carpet | Timeline | Fashion | Highlights

Ocean's tuxedo covered all but his hands, but it appeared as he picked up the urban album award that his left arm remained in a wrist brace he'd exhibited Thursday at rehearsals for this year's broadcast, a remnant of his scuffle last month with Brown over a parking space at a recording studio. Los Angeles Police Department investigators said Ocean informed them that he would not press charges against Brown.

It was the Black Keys' Dan Auerbach who quickly built up steam as the front-runner to dominate this year's awards, taking several statuettes barely an hour into the show, including producer of the year for himself and three with his group including rock performance, rock song and rock album for "El Camino."

The Black Keys homed in on the fundamentals of rock 'n' roll — big guitar riffs, lustful lyrics and a bevy of musical hooks on "El Camino," one of the best reviewed albums of the group's career.

FULL COVERAGE: Grammy Awards 2013

Auerbach picked up another award as producer of the blues album winner, Dr. John's "Locked Down."

Carrie Underwood grabbed the country solo performance Grammy for the title track from her album "Blown Away," which also won the country song award for writers Josh Kear and Chris Tompkins earlier during the pre-telecast ceremony at Nokia Theatre, across the street from Staples Center.

The Zac Brown Band added to its growing place as a new-generation country powerhouse with a win of the country album trophy for its "Uncaged," built on muscular Southern rock guitar riffs, elaborate multipart vocal harmonies and jam-band instrumental excursions.

Last year's big winner, Adele, collected the first statuette of the night for her single "Set Fire to the Rain" in the pop solo performance category.

The show got off to an eye-popping start with a Cirque du Soleil-inspired performance by Taylor Swift of her nominated single "We Are Never Ever Getting Back Together."

The preponderance of youthful acts not broadly known to mainstream TV audiences heightened the use of cross-generational pairings. Rising songwriter and singer Ed Sheeran shared the stage early with veteran Grammy darling Elton John, while Bruno Mars teamed with Sting and Rihanna in a Bob Marley tribute later in the show. Several members of Americana acts, including Alabama Shakes and Mumford & Sons, sang alongside veterans John, Mavis Staples and T Bone Burnett in a salute to drummer Levon Helm of the Band.

But it was the young guns to whom the evening — and perhaps the future — of the Grammy Awards belonged.

The Grammys are determined by about 13,000 voting members of the Recording Academy. The eligibility period for nominated recordings was Oct. 1, 2011, to Sept. 30, 2012. The show aired on CBS live except on the West Coast, which gets a tape delay.

randy.lewis@latimes.com

Twitter: @RandyLewis2

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Grammy audience down, still 2nd highest since 1993

NEW YORK (AP) — While the Grammy Awards couldn't come close to the freakishly high ratings generated in 2012 because of Whitney Houston's death and Adele's smashing success, this year's show had the second-largest audience for the program since 1993.

The Nielsen company said Monday that music's annual awards show was seen by 28.4 million people Sunday night on CBS.

The Grammys this year were packed with high-powered musical moments and, in its awards, celebrated the industry's diversity rather than overwhelmingly honoring one artist. It also had a few water-cooler moments: Which boyfriend was Taylor Swift specifically dissing in her latest performance of "We Are Never Ever Getting Back Together"? Was Chris Brown flaunting his revived relationship with Rihanna?

The music academy's decision to turn the televised Grammys into more of a showcase than an awards show appears to be bearing fruit, too. The show's audience was nearly 2 million higher than the 26.7 million who watched in 2011. From 2005 to 2009, the Grammy Awards audience fluctuated from 17 million to 20 million viewers.

Last year, 39.9 million people tuned in to see how the industry would react to Houston's death just before the awards and celebrate the coronation of its hottest star, Adele, who won six Grammys.

This year's show featured the musical return of Justin Timberlake, collaborations honoring Bob Marley and Levon Helm, and performances by the majority of stars up for major awards.

The Grammys far outpaced the Emmys, which had 13.3 million viewers last September for its more traditional awards show, and the Golden Globes, which had 19.7 million viewers in January. The upcoming Oscars usually get more than 30 million viewers.

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Chinese Year of the Snake may be bad for the stock market

The Chinese new year, the Year of the Snake, could leave the stock market snake-bitten.

Sunday ushered in the Chinese New Year but, investors may wish it hadn’t. The Year of the Snake is the only one of the 12 Chinese lunar calendar years in which the Standard & Poor’s 500 index has a losing record, according to researcher Capital IQ.

Since 1900, the benchmark index is down an average of 2.9% in the Year of the Snake, according to Capital IQ. It has risen in only three of the nine snake years since 1900, marking the worst performance of the any of the named lunar years.

Investors will miss the just-departed Year of the Dragon, which has a 10.4% average historical return, according to Capital IQ.

The best showing has come during the Year of the Pig. The S&P is up an average of 12.8% in those years and has risen during 78% of them.

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Ambitious makeover planned for old housing project

Denise Penegar puts a little extra effort into the teenage girls, the ones who've dropped out of high school to care for their firstborns.

Don't be afraid, the outreach worker tells them. Come down to the housing project's community center, get your GED and some job skills. Change your life.

"I was one of those girls," said Penegar, now 51 and still living in Jordan Downs, the Watts housing project where she was born.

Sometimes, she imagines how different her life might have been if someone had knocked on her door when she was 17, caring for her first baby. What would it have meant just to have "someone who is here who can help pick me up"?

Penegar is on the front lines of a bold social experiment underway at Jordan Downs, a project notorious to outsiders for its poverty, blight and violence but seen by many longtime residents, for all its problems, as a close-knit community worth preserving.

In the last year, the Housing Authority of the City of Los Angeles has begun an effort to transform Jordan that could cost more than $600 million. The plan is to turn the complex of 700 aging units into a mixed-income community of up to 1,400 apartments and condominiums, with shops and restaurants and fancy touches such as native plant gardens. The city hopes to draw in hundreds of more-affluent residents willing to pay market rate to live side by side with the city's poorest.

Spurred by changes in federal funding and policy, such "mixed use" developments have sprung up in place of infamous housing projects all over the country. But experts say Jordan is taking an approach that has not been tried on this scale.

Typically, public housing residents are moved out ahead of the bulldozers, scattered to search for new shelter. In Los Angeles, the housing authority has promised that any of the 2,300 Jordan residents "in good standing" can stay in their old units until the day they move into new ones. The project is to be built in phases, beginning with units on 21 acres of adjacent land purchased by the authority in 2008 for $31 million.

To ease the transition, the city has dispatched "community coaches" like Penegar, along with teachers, social workers, therapists — even police officers whose charge is not to make arrests but to coach youth football and triathlon teams.

In essence, officials intend to raze the buildings, not the community — and radically change its character.

It will be an enormous challenge, with success likely to be measured in tiny increments.

Only 47% of adults at Jordan reported any wages to the housing authority last year. As in many urban projects, poverty and social ills have multiplied through the generations, leaving some residents unfamiliar with opportunities and expectations beyond the neighborhood. Some rarely leave the area.

Before inviting in new neighbors with expectations of safety and comfort, the housing authority has begun flooding Jordan Downs with social services. Many of the programs are focused on women, because more than 60% of Jordan Downs' tenants live in households headed by single mothers. But men are targeted too — for job training and lessons in parenting, for instance.

By December, 10 months into the effort, more than 450 families had been surveyed by intake workers and 280 signed up for intensive services.

"Most people would say it's ambitious, but I think it's essential," said Kathryn Icenhower, executive director of Shields for Families, the South Los Angeles nonprofit that is running many of the new programs under a more than $1-million annual contract with the housing authority.

It is unknown, however, how effective the social services will be, how easy it will be to draw in wealthier residents and how many millions of dollars the federal government — a major source of funding — will provide.

Already, the housing authority has picked a development team — the for-profit Michaels Organization and the nonprofit Bridge Housing, both with respectable track records in other cities. But with financing still uncertain, it is unclear exactly how many units will be built or how much various occupants would pay.

Ultimately, a working family could pay hundreds of dollars more in rent than unemployed tenants next door for a nearly identical unit. Officials say they do not expect Watts to draw the same kind of high-income residents as the former Cabrini Green project in Chicago, which sat on prime real estate near downtown. But Jordan is in a convenient location, near the intersection of the 105 and 110 Freeways; and in a high-rent city like Los Angeles, even the steepest rates at Jordan are likely to seem a bargain.

Despite the onslaught of social services and some palpable changes — including a 53% plunge in the violent crime rate at Jordan last year — financial risks abound.

Later this spring, the authority plans to put in an application for $30 million from the federal government's Choice Neighborhoods Program as seed money. Without it, the project could be delayed.

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All eyes on Frank Ocean as Grammy Awards approach

LOS ANGELES (AP) — Everybody's thinkin' about Frank Ocean.

Ocean is a cause celebre and the man with the momentum as Sunday's Grammy Awards approach. One of six top nominees with six nominations apiece, the 25-year-old R&B singer turned cultural talking point will have the music world's attention.

It remains to be seen if it will be the "Thinkin Bout You" singer's night, but there's no question he's dominated the discussion so far. Already a budding star with a gift for building buzz as well as crafting songs, Ocean was swept up by something more profound when he told fans his first love was a man last fall as he prepared to release his major-label debut, "channel ORANGE."

It was a bold move and one that could have submarined his career before it really even got started. Instead, everyone from Beyonce to the often-homophobic R&B and rap communities showed public support. It was a remarkable moment.

"It speaks to the advancements of our culture," renowned producer Rick Rubin said. "It feels like the culture's moving forward and he's a representative of the new acceptance in the world for different ideas, which just broadens (our experience), makes the world a better place."

A recent altercation in a parking lot with Chris Brown only focused more attention on Ocean. Ocean says Brown was the aggressor; both are competing against each other in one of the Grammy categories.

Ocean is up for the major awards best new artist, album of the year and record of the year when the show airs live on CBS at 8 p.m. EST from the Staples Center, sharing top-nominee billing with fun., Dan Auerbach of The Black Keys, Mumford & Sons, Jay-Z and Kanye West.

Don't hand Ocean those trophies just yet, though. R&B and hip-hop performers (Ocean is part of the Odd Future collective) have had a spotty history at the Grammys recently when it comes to major awards.

Only one R&B act has won album of the year this century, and it's hard to even call him just an R&B act given his legend, artistic scope and material: Ray Charles for his "Genius & Friends," an all-star collaboration that was honored posthumously.

Also limiting Ocean's chances for a clean sweep are his fellow top nominees. Most are riding waves of their own.

Fun. became just the second act to sweep nominations in all four major categories with a debut album, equaling Christopher Cross' 1981 feat. Like Cross' "Sailing," the New York-based pop-rock band has ridden along on the crest of an inescapable song: "We Are Young," featuring Janelle Monae.

Cross won five Grammys, sweeping the major awards. Fun. likely will have a much harder time piling up that number of victories because of the buzz surrounding the group's competitors. It's not just Ocean who has people talking.

London-based folk-rockers Mumford & Sons had one of the top-selling albums of the year with "Babel" and already has a history with The Recording Academy's thousands of voters, having been nominated for major awards the year prior. Also, The Black Keys have a winning track record at the Grammys.

And don't count out West and Jay-Z, who were shut out of the major categories but remain very much in voters' minds.

Jack White's "Blunderbuss" competes with fun.'s "Some Nights," Ocean's "channel ORANGE," Mumford's "Babel" and The Keys' "El Camino" for the night's top award, album of the year.

Gotye's "Somebody That I Used To Know," featuring Kimbra, Taylor Swift's "We Are Never Ever Getting Back Together" and Kelly Clarkson's "Stronger (What Doesn't Kill You)" join the fun., Ocean and Black Keys entries in record of the year.

Fun. and Clarkson also are nominated for song of the year along with Ed Sheeran's "The A Team," Carly Rae Jepsen's "Call Me Maybe" and Miguel's "Adorn."

And rounding out the major categories, fun., Ocean, Alabama Shakes, Hunter Hayes and The Lumineers are up for best new artist.

Those major nominees figure prominently on the 3 1/2-hour telecast, broadcast live on CBS at 8 p.m. EST.

Swift will kick things off with a show-opening performance. Fun. and Ocean will take the stage. Others scheduled to perform include Justin Timberlake, Carrie Underwood, Clarkson, White and Juanes.

There will be no shortage of mashups the Grammys have become famous for, either. Elton John, Mavis Staples, Mumford, Brittany Howard, T Bone Burnett and Zac Brown are saluting the late Levon Helm, who won the Americana Grammy last year a few months before his death. The Keys will join Dr. John and the Preservation Hall Jazz Band on stage. Sting, Rihanna and Bruno Mars will perform together. Other team-ups include Miranda Lambert and Dierks Bentley, and Alicia Keys and Maroon 5.

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Online:

http://grammy.com

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Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.

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For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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Fee increases are making FHA mortgages more expensive

WASHINGTON — If you want to buy a house with minimal cash by using an FHA-insured mortgage, here's some sobering news: Because of an ongoing series of fee increases and underwriting tweaks, those mortgages are getting steadily more expensive and may not work for you.

The Federal Housing Administration is the largest source of low-down-payment mortgage money in the country. Its minimum down is just 3.5%, compared with 5% to 20% or more from conventional, non-government sources. For decades, FHA financing has made homeownership possible for first-time buyers with modest incomes and credit history blemishes.

But in the wake of losses tied to bad loans insured during the housing bust years, the FHA has been raising its loan insurance fees and backing more loans to applicants with higher credit scores. With the latest increases, things have gotten to the point where some lenders wonder whether the agency is trying to move away from its traditional customers.

Dennis C. Smith, broker and co-owner of Stratis Financial Corp. in Huntington Beach, is blunt: "I think FHA is putting itself out of business with the moves they've made in the past couple of years."

Although they wouldn't agree with that assessment, the FHA's top officials readily admit that their priority is not increasing market share but protecting the agency's multibillion-dollar insurance fund reserves and cutting losses.

Starting April 1, the FHA's annual mortgage insurance premiums for most new loans will jump one-tenth of a percentage point (10 basis points in lending parlance). This is on top of two previous increases since 2011.

Other changes that won't take effect until June 3 include mandatory manual underwriting of applications by borrowers whose total household debt-to-income ratios exceed 43% and who have credit scores below 620, and mandatory 5% minimum down payments on FHA loans above $625,500 in high-cost areas such as California, metropolitan Washington, D.C., and others.

The FHA also announced that as of June 3 it is rescinding its popular policy of canceling mortgage insurance premium charges for borrowers whose loan balances decline to 78% of the original amount. This will require FHA customers to pay premiums for as long as they keep their loans, and is in stark contrast to the private mortgage insurance market, in which homeowners can request cancellation of premium payments once their loans hit the 78% mark.

"That stinks," said Steve Stamets, a mortgage officer with Apex Home Loans in Rockville, Md. "It's just a money grab" that will cause creditworthy borrowers to avoid FHA loans and seek out low-down-payment alternatives through Fannie Mae and Freddie Mac, using private mortgage insurance.

Already, Stamets said, FHA is the more expensive option for many borrowers who have good credit but don't want to make hefty down payments.

He estimates that with the FHA's new fees, an applicant with a 720 FICO score making a 3.5% down payment on a $250,000, fixed-rate, 30-year FHA mortgage will pay $144.66 more a month than a borrower with the same credit score on a conventional loan of the same amount with a 5% down payment and private mortgage insurance.

Even with a 680 credit score, the conventional loan is cheaper by $85 a month based on the FHA's new fee levels, Stamets said. And those monthly premium payments can be canceled at the 78% loan-to-value level, whereas the FHA will keep charging them for the life of the mortgage.

Steven R. Maizes, managing director of mortgage banking for Mortgage Capital Partners Inc. in Los Angeles, says the FHA's new fees and policies are likely to cost the agency valuable low-risk business on refinancings. Maizes recently ran a spreadsheet analysis for a client with a $460,000 FHA loan at 5%. Even with a 1.5-point rate reduction, the added fees caused the monthly payment to decrease just $97.11.

"If you couple that [small saving] with the fact that the mortgage insurance payment can never go away," he said, refinancing an existing FHA loan for a creditworthy borrower into a new FHA loan will be tough to justify.

Bottom line for you: Make sure your loan officer runs the numbers comparing FHA loans with privately insured conventional alternatives. You may not want to be saddled indefinitely with higher payments — and no right to cancel.

kenharney@earthlink.net

Distributed by Washington Post Writers Group

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A delicate new balancing act in senior healthcare

When Claire Gordon arrived at Cedars-Sinai Medical Center, nurses knew she needed extra attention.

She was 96, had heart disease and a history of falls. Now she had pneumonia and the flu. A team of Cedars specialists converged on her case to ensure that a bad situation did not turn worse and that she didn't end up with a lengthy, costly hospital stay.

Frail seniors like Gordon account for a disproportionate share of healthcare expenditures because they are frequently hospitalized and often land in intensive care units or are readmitted soon after being released. Now the federal health reform law is driving sweeping changes in how hospitals treat a rapidly growing number of elderly patients.

The U.S. population is aging quickly: People older than 65 are expected to make up nearly 20% of it by 2030. Linda P. Fried, dean of the Columbia University Mailman School of Public Health, said now is the time to train professionals and test efforts to improve care and lower healthcare costs for elderly patients.

"It's incredibly important that we prepare for being in a society where there are a lot of older people," she said. "We have to do this type of experiment right now."

At Cedars-Sinai, where more than half the patients in the medical and surgical wards are 65 or older, one such effort is dubbed the "frailty project." Within 24 hours, nurses assess elderly patients for their risk of complications such as falls, bed sores and delirium. Then a nurse, social worker, pharmacist and physician assess the most vulnerable patients and make an action plan to help them.

The Cedars project stands out nationally because medical professionals are working together to identify high-risk patients at the front end of their hospitalizations to prevent problems at the back end, said Herb Schultz, regional director of the U.S. Department of Health and Human Services.

"For seniors, it is better care, it is high-quality care and it is peace of mind," he said.

The effort and others like it also have the potential to reduce healthcare costs by cutting preventable medical errors and readmissions, Schultz said. The federal law penalizes hospitals for both.

Gordon, an articulate woman with brightly painted fingernails and a sense of humor, arrived at Cedars-Sinai by ambulance on a Monday.

Soon, nurse Jacquelyn Maxton was at her bedside asking a series of questions to check for problems with sleep, diet and confusion. The answers led to Gordon's designation as a frail patient. The next day, the project team huddled down the hall and addressed her risks one by one. Medical staff would treat the flu and pneumonia while at the same time addressing underlying health issues that could extend Gordon's stay and slow her recovery, both in the hospital and after going home.

To reduce the chance of falls, nurses placed a yellow band on her wrist that read "fall risk" and ensured that she didn't get up on her own. To prevent bed sores, they got her up and moving as often as possible. To cut down on confusion, they reminded Gordon frequently where she was and made sure she got uninterrupted sleep. Medical staff also stopped a few unnecessary medications that Gordon had been prescribed before her admission, including a heavy narcotic and a sleeping pill.

"It is really a holistic approach to the patient, not just to the disease that they are in here for," said Glenn D. Braunstein, the hospital's vice president for clinical innovation.

Previously, nurse Ivy Dimalanta said, she and her colleagues provided similar care but on a much more random basis. Under the project, the care has become standardized.

The healthcare system has not been well designed to address the needs of seniors who may have had a lifetime of health problems, said Mary Naylor, gerontology professor at the University of Pennsylvania School of Nursing. As a result, patients sometimes fall through the cracks and return to hospitals again and again.

"That is not good for them and that is not good for society to be using resources in that way," Naylor said.

Using data from related projects, Cedars began a pilot program in 2011 and expanded it last summer. The research is continuing but early results suggest that the interventions are leading to fewer seniors being admitted to the intensive care unit and to shorter hospital stays, said Jeff Borenstein, researcher and lead clinician on the frailty project. "It definitely seems to be going in the right direction," he said.

The hospital is now working with Naylor and the University of Pennsylvania to design a program to help the patients once they go home.

"People who are frail are very vulnerable when they leave the hospital," said Harriet Udin Aronow, a researcher at Cedars. "We want to promote them being safe at home and continuing to recover."

In Gordon's case, she lives alone with the help of her children and a caregiver. The hospital didn't want her experiencing complications that would lengthen the stay, but they also didn't want to discharge her before she was ready. Under the health reform law, hospitals face penalties if patients come back too soon after being released.

Patients and their families often are unaware of the additional attention. Sitting in a chair in front of a vase of pink flowers, Gordon said she knew she would have to do her part to get out of the hospital quickly. "You have to move," she said. "I know you get bed sores if you stay in bed."

Gordon said she was comfortable at the hospital but she wanted to go back to her house as quickly as she could. "There's no place like home," she said.

Two days later, that's where she was.

anna.gorman@latimes.com

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Stars salute MusiCares honoree Bruce Springsteen

LOS ANGELES (AP) — Be it concert or charity auction, Bruce Springsteen can bring any event to a crescendo.

Springsteen briefly took over auctioneering duties before being honored as MusiCares person of the year Friday night, exhorting the crowd to bid on a signed Fender electric guitar by amping up the deal. The 63-year-old rock 'n' roll star moved the bid north from $60,000 by offering a series of sweeteners.

"That's right, a one-hour guitar lesson with me," Springsteen shouted. "And a ride in my Harley Davidson sidecar. So dig in, one-percenters."

That moved the needle past $150,000. He added eight concert tickets and backstage passes with a bonus tour conducted by Springsteen himself. That pushed it to $200,000, but he wasn't done.

"And a lasagna made by my mother!" he shouted as an in-house camera at the Los Angeles Convention Center cut to his 87-year-old mother Adele Ann Springsteen.

And with an extra $250,000 in the musicians charity's coffers, Springsteen sat down and spent most of the evening in the unusual role of spectator as a string of stars that included Elton John, Neil Young, Sting, Kenny Chesney, John Legend, Faith Hill and Tim McGraw, Patti Smith, Jackson Browne took the stage two nights before the Grammy Awards.

"Here's a little secret about Bruce Springsteen: He loves this," host Jon Stewart joked. "There's nothing he'd rather do than come to Los Angeles, put on a suit ... and then have people talking about him like he's dead."

Alabama Shakes kicked things off with "Adam Raised A Cain" and over the course of the evening there were several interesting takes on Springsteen's voluminous 40-year catalog of hits. Natalie Manes, Ben Harper and Charlie Musselwhite played a stripped down "Atlantic City." Mavis Staples and Zac Brown put a gospel spin on "My City of Ruins." John added a funky backbeat to "Streets of Philadelphia." Kenny Chesney offered an acoustic version of "One Step Up."

Jim James and Tom Morello burned through a scorching version of "The Ghost of Tom Joad" that brought the crowd out of their seats as Morello finished the song with a fiery guitar solo. And Mumford & Sons took it the opposite way, playing a quiet, acoustic version of "I'm On Fire" in the round that had the crowd leaning in.

Legend offered a somber piano version of "Dancing in the Dark" and Young shut down the pre-Springsteen portion of the evening with a "Born in the USA" that included two sign-language interpreters dressed as cheerleaders signing along to the lyrics.

"John Legend made me sound like Gershwin," Springsteen said. "I love that. Neil Young made me sound like the Sex Pistols. I love that. What an evening."

Springsteen spoke of the "miracle of music," the importance of musicians in human culture and making sure everyone is cared for. And he joked that he somehow ended up being honored by MusiCares, a charity that offers financial assistance to musicians in need run by The Recording Academy, after his manager called up Grammys producer Ken Ehrlich to seek a performance slot on the show in a "mercenary publicity move."

In the end, though, he was moved by the evening.

"It's kind of a freaky experience, the whole thing," Springsteen said. "This is the huge Italian wedding Patti (Scialfa) and I never had. It's a huge Bar Mitzvah. I owe each and every one of you. You made me feel like the person of the year. Now give me that damn guitar."

He asked the several thousand attendees to move toward the stage — "Come on, it's only rock 'n' roll" — and kicked off his five-song set with his Grammy nominated song "We Take Care Of Our Own." At the end of the night he brought everyone on stage for "Glory Days."

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Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott.

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