My name is Bonnie and I work with Best-mha-programs.com. I came across your blog and thought I’d direct your attention to our infographic, “Beyond 100: What We Can Learn from People Who Pass the Century Mark”. I think it’s something you and your community would enjoy reading or sharing. Here’s the link.

Let me know if there’s anything we can do for you. Hope you’ll keep up the great work and awesome content!

 

Thanks,
Bonnie Moore
 

ElderBranch issued a press release about palliative care at nursing homes.  Nursing homes largely do a poor job when it comes to palliative care today.  According to the Center to Advance Palliative Care, half of nursing home residents suffer from untreated pain. Comfort care and symptom management are lacking and hospice is under-utilized. With as many as 25% of people passing away in a nursing home setting, high quality support and care for the dying is critical in these environments.

Dr. Temkin-Greener, of the University of Rochester Medical Center, cites the lack of nursing home-specific palliative care practice guidelines, inadequate staff education and the failure to integrate palliative care practices into regular care as some of the key barriers to nursing homes offering high quality, comprehensive palliative care today.

ElderBranch is an online information portal that helps people find and evaluate long-term care providers. ElderBranch’s mission is to support users in making the best decision possible for themselves and their loved ones.

 

USA Today had an interesting article on health care spending since enactment of ObamaCare.  In the four years leading to expanded health insurance, the government has used authority in the Patient Protection and Affordable Care Act to try to reshape the economics of health care through regulation and financial incentives. That appears to be keeping a lid on medical costs.  One big change is the government’s revived push toward managed care. The government wants to pay a lump sum for a patient or diagnosis, demand higher standards and expect the medical provider to get the job done for that cost. Rather than cutting reimbursement rates, the government is raising the bar for what it expects for every dollar it spends.

 "Health care spending last year rose at one of the lowest rates in a half-century, partly the result of cost-saving measures put in place by the 2009 health care law, a USA TODAY analysis finds."  "Health care spending hit a record $2.67 trillion last year, but its share of the overall economy shrank, from 17.12% of gross domestic product in 2011 to 17.04%, … an analysis of Bureau of Economic Analysis data found."

"Cost-saving measures under the health care law appear to be helping keep medical prices flat, according to health care providers and analysts."   In 2012, the average price paid for medical care rose at about the same rate as other prices in the economy, an inflation rate of less than 2%.

Also keeping costs lower:

Government insurance. More people are getting health insurance from Medicare and Medicaid, which pay less to doctors and hospitals than private insurers. Medicaid, which pays the least, covers 56 million poor people, up 10 million from five years ago. It will add nearly 20 million enrollees next year.

Generic drugs. About four of five drugs used today are less expensive generic medicines. The nation’s top-selling drug, Lipitor, for high blood pressure, lost patent protection last year.

Competition. Health care exchanges, which start next year, may keep insurance prices down while limiting consumer choice. In early deals, hospitals and doctors are agreeing to lower rates than traditional private insurance in exchange for more volume.

Among the most visible successes are efforts to save money on the most expensive patients by permitting the use of a hospice rather than a hospital for end-of-life care and emphasizing home health care over nursing homes.

 

Fox News reported the charges against nurse Dale Kenyon for stealing pain medications from residents.  Investigators say Kenyon diverted pain medications intended for elderly dementia patients at the Mountain View Center nursing home where she worked.  Kenyon was arrested in January after administrators at the facility contacted the state Office of Professional Regulation to report the suspicion that Kenyon was stealing morphine checked out for patient use, according to court records.

Records for four patients at the facility showed that Kenyon had administered partial morphine doses to them on multiple occasions in December. In each entry, Kenyon administered 2 milligrams from a 10 milligram vial of morphine.  In accordance with the rules at the nursing home, she recorded that she “wasted” the remaining 8 milligrams of the drug — a process that requires another nurse to witness and sign off on the disposal of the excess morphine.   The alleged signatures were illegible and did not match anyone working at the time.

After initially denying that she took the drug, Kenyon allegedly admitted to forging the signatures and injecting the excess morphine into herself. Another registered nurse at Mountain View said he observed irregularities in Kenyon’s medication record-keeping in the past and had reported it to administrators. 

Ensuring proper use and disposal of powerful painkillers and narcotic drugs is a major consideration in every medical institution.

 

The Medicare drug benefit is provided by private insurance companies, competing with one another and operating under contracts with the federal government. Each insurer has one or more committees that decide which drugs will be covered. The decisions are supposed to be based on scientific evidence.

However, the NY Times reported that a new report by Daniel R. Levinson, the inspector general at the Department of Health and Human Services, which admitted that the federal Medicare agency had not clearly defined “conflict of interest” and did not enforce standards meant to prevent such conflicts from influencing drug coverage decisions by the panels, known as pharmacy and therapeutics committees.

“The Centers for Medicare and Medicaid Services does not monitor conflicts of interest on pharmacy and therapeutics committees,” Mr. Levinson said. In many cases, he said, the government cannot identify potential conflicts because committee membership lists are unusable — incomplete, inaccurate and full of discrepancies. The panels are appointed by insurers or pharmaceutical benefit managers hired by insurance companies.

 A separate study by university researchers found similar problems in many state Medicaid programs. The study, published this month in the journal JAMA Internal Medicine, described “inadequate management of conflicts of interest” among the panels that recommend drugs for coverage under Medicaid.

Since Medicare officials do not monitor conflicts of interest, Mr. Levinson said, they cannot be sure that prescription drug plans are complying with federal requirements that at least two committee members — one practicing physician and one pharmacist — be “independent and free of conflict.”

 

 

McKnight’s reported thatTennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary rehabilitation therapy.   A whistleblower said 10 Grace-operated skilled nursing facilities billed for unnecessary and unreasonable physical, occupational and speech therapy to meet the corporation’s reimbursement goals from 2007 to 2011.

The government proved that Grace’s billing was an example of “waste and abuse” driven by “financial considerations,” said U.S. Attorney for the Eastern District of Tennessee Bill Killian.  Grace will enter into a Corporate Integrity Agreement regarding its therapy services as part of the settlement. The former Grace employee received $405,000 under the settlement agreement.

 

The Post Star reported that investigators are probing the death of a 58-year-old Granville man at Indian River Rehabilitation and Nursing Center after he apparently lay dead in his bed for hours before being found.  John “Punk” Zellars suddenly died unexpectedly at the nursing home.  John Zellars’ death raises question about how closely the ailing patient was monitored overnight, officials said.  However, the facility did not call the Coroner about the suspicious death.

"But a source close to the investigation, speaking under the condition of anonymity because they weren’t cleared to discuss the probe, said Tuesday that Zellars’ body was in full rigor mortis when he was found dead the morning of Feb. 23 by facility staff. It typically takes between six and 12 hours for a body to reach full rigor mortis."

“I saw him Friday night and he was gone early Saturday morning,” Kevin Zellars said Wednesday. “He laid in bed for four hours and 45 minutes before the family was called.”

 

The Sacramento Bee reported the maximum fine of $100,000 against Lincoln Meadows for causing the death of a resident when the staff overmedicated him with a dangerous blood thinner. 
The partially paralyzed patient fell from his wheelchair on May 26, 2011, hitting his head and leaving him with a black eye and facial bruises.  He should have been immediately hospitalized after his fall.  The staff ignored his injuries and failed to properly assess.
At his daughter’s insistence, the man was hospitalized four days later and found to have a subdural hematoma, low blood pressure and multiple organ failure, and hospital admission records indicate his Coumadin levels were 18 times normal levels.  He died on June 4, 2011.
When the patient died, Herman said, the nursing home was owned by Horizon West Healthcare, which in 2010 was hit with $29.1 million in elder abuse damages in connection with the death of a patient at another of its facilities.

 

SCNow had another editorial article about the horrendous odors emitted from Lee County Landfill. 

"Consequently, it’s easy to see the point of the plaintiffs in the Lee County Landfill lawsuit, which returned to court this week for a few necessary clarifications, prior to an appeal. The plaintiffs in question, three couples, purchased lands and built homes long before the giant dump off Interstate 20 began accepting waste in 1994. Time passed and a huge pile of trash – some locals refer to the man-made feature as “Mt. Lee” – arose from the plain outside of Bishopville. Then it got hot and the trash, as trash is wont to do, began to emit a powerful odor. Motorists who regularly ply the I-20 stretch between Florence and Columbia can commiserate. It’s more common than not to catch a whiff of freshly minted landfill fumes when passing by the Highway 15-501 exit."

"Part of the issue in Lee County is that the landfill far exceeds the needs of tiny Lee. Most of the trash that goes into the Lee County landfill is from outside the county, much of it from outside the state. Some of it is from far outside the state – New York City. There’s something that’s just a little galling about those Yankees using a part of our state as a trash can."

The State newspaper also had an article which reported the following:

"Six neighbors of the Lee County landfill won a stunning $2.3 million court verdict last year, when a federal jury agreed that powerful odors from the dump had escaped the site and affected nearby residents."

"The case is considered unusual because odor lawsuits don’t typically go to trial for a verdict, but instead are settled, attorneys said."

 "But Gary Poliakoff, an attorney for the landfill’s neighbors, called those arguments “ludicrous,’’ saying the 2012 court decision is a strong lesson to industries to control odors that might affect nearby residents.  During last year’s trial in U.S. District Court in Columbia, landfill neighbors said the smells were so strong and nauseating that they sometimes could not have outdoor cookouts or garden in their yards. In one instance, neighbors who went outside to view a colorful rainbow fled back into the house because of the landfill’s stench, according to testimony. One resident likened the landfill to a “monster’’ that haunted the neighborhood."

"Poliakoff said if the $2.3 million court award is overturned, people would not be able to collect more than token damages from industries, no matter how strong the odors are.“The U.S. Chamber always wants to express concern when it thinks some huge corporation is going to be hurt,’’ Poliakoff said Monday. “But the effect of these landfills, especially the one in Lee County, is they kill local business. They kill property values for people who live around them. They create economic dead zones.’’

"Republic Services, one of the nation’s largest garbage corporations, is the parent company of a local firm that owns the Lee County landfill. The mega dump, along Interstate 20 near Bishopville east of Columbia, is permitted to take more waste than any other dump in the state, much of it from other states. It is a destination for trash from states as far away as New Jersey and New York, which ship rail cars of rotting garbage to the 140-foot tall disposal site."

"Poliakoff and other critics of the Lee County landfill say it is symbolic of South Carolina’s long legacy of catering to the waste industry. As nuclear and radioactive dumps have scaled back operations, the household garbage industry still is keenly interested in expanding in South Carolina, he said. At the same time, officials in New Jersey have expressed interest in shipping lightly radioactive soil to the Lee County landfill for disposal."

 

The Hartford Courant reported that another choking death of a nursing home resident. One of the most unnecessary and preventable dangers in nursing homes are food related injuries and deaths as a result of neglect.  Patients who are cognitively impaired and require special diets have become victims of neglect. These patients, in their impaired state, are given food they cannot consume.

An incident at Paradigm Health Care Center in Norwalk, represents at least the fifth choking related death in Connecticut nursing homes in the past ten months.  Researching developmentally disabled deaths in group homes and nursing homes, The Courant, a Hartford newspaper, found 76 cases of deaths from 2004-2010.  In all of these cases, abuse, neglect, or healthcare error was a contributing factor.  Of these deaths, 14 were on special diets and choked to death after eating food they should never have ingested. 

Incidents like these, where patients die as a result of choking from food they should never have eaten are too common within nursing homes. Upon further investigation, there were a number of instances of improper food consumption within Paradigm. The facility was fined just over $1000 and had to submit a plan of correction to the Connecticut Department of Public Health.

How much do you believe a life is worth? Because the Connecticut Department of Public Health has consistently said that a life is only worth a thousand dollars.

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