According to Think Progress, 95% of Americans will pay less for insurance in the coming years thanks to the popularly termed Obamacare plan. But depending on where you live affects how much you’ll be paying for insurance. Wyoming and Indiana will pay higher premiums than Florida and Texas, where those states refused to be a part of the plan. The medium plan cost for the nation is $328 a month. 6 million people will qualify for assistance in subsidies or reduced cost. Below is an infographic detailing projected premiums.

The USA Today has released a story in which eight separate individuals are accused of embezzling money from patients in nursing homes.  The idea behind a nursing home is that individuals who need daily living assistance are provided with care while still maintaining as much normality as possible, however in these cases the normality has been replaced with robbery.  Trust funds set up by the facility were drained to finance extravagant purchases by the employees. Patients in nursing homes typically set up a form of trust fund with the facility so that their finances are both protected and available to them during their residency.

According to USA Today, there have been 1500 recent cases involving the mishandling of these funds.  Numerous cases involved embezzling more than $100,000 and some even reached as high as $350,000 taken from patients.  While it may not be the fault of the entire nursing facility, it is hard to continue to feel cared for and safe in a place where such a violation occurs.

The methodology behind the scams is impressive and the scammers are careful. The victims are selectively chosen based usually on either the amount of close relatives the patient has or the patient’s state of mind. It is easier to explain an unusual charge when the patient’s denial of the charge can be discredited or, better yet, if no one is asking questions.  The charges were all well documented and receipts were saved, so to anyone other than the embezzler the books were legitimate and clean. The only way to discover the fraud is when each individual charge is investigated, like a $90 charge for designer jeans to the account of a man with no legs.

The reasons for the abuse of funds are many; however oversight is to blame according to a senior official with South Carolina’s Medical Fraud Control Unit. Ken Moore is referenced in the article as describing how usually the one responsible for managing the funds, such as an Office Manager or Financial Manager, is the one that is embezzling funds, and only a lack of checks and safeguards allows it to happen.  The lack of oversight is tragic and many cases could have been prevented had someone been checking the accounts thoroughly. The problem with this is that the responsibility of reporting the validity of the trust funds, as well as most nursing home accounts, has been left largely up to the nursing homes themselves.  While some may hire an external auditor, the majority of nursing homes are letting employees with training in health management perform a task that requires accounting or financial knowledge.  Without proper training it is difficult for anyone to catch the thieves, and the thieves rely on this to pull off simple tricks on large scale frauds.

The real tragedy is that nothing more is being done to attempt to protect the nursing home residents and establish more safeguards.  The lack of audits and control leave massive loopholes within the security of the funds and only when more care is taken with the accounts will they become safe.

U.S. News reminded us on this Thanksgiving of one of the great meal delivery programs in the country.  Mobile Meals is a program which delivers meals to those in need. US News reports that programs like Mobile Meals which deliver food to minimally dependent people could save states a bundle in the long run. It is also the right thing to do for the most vulnerable among us.

By increasing programs such as these by 1%, it could have a drastic impact on incoming nursing home residents. By increasing these delivery meals, it could mean a decrease in the number of people who have to go into nursing homes. This plan would be more viable for some states than for others, as Pennsylvania could save $5.7 million whereas Florida would have to pay $11.5 million. States need to determine if this would work for them, it shouldn’t be a plan implemented widely across the board, but should be worked out by each local community, said the investigators.

Happy Thanksgiving!

 

NPR reports that the Alzheimer’s Disease International released a study in September which projects that the number of people suffering from dementia will be tripled by 2050.  Although there is incredible research and progress being made to prevent or delay dementia especially in the stem cell area.

By 2050, the group predicts that by 2050, 227 million people will be affected by dementia.  Dementia is a factor which exacerbates other existing conditions affecting the elderly.  Dementia can also make long term care difficult.  ADI believes that the way to combat this growing trend is to make plans for better long term care.

According to the Journal of Patient Safety, between 210,000 and 440,000 people die from medical mistakes every year. NPR reports that the numbers of those dying from medical mistakes have been getting progressively worse, and may in fact be the third leading cause of death in America. While the initial projection of 98,000 in 1999, even medical professionals don’t know the exact number. Some tools have recently come onto the market to help prevent medical mistakes including the Global Trigger Tool which sorts through medical records for potential mistakes or preventable infections. The tool is what John T. James, the author of the article, used to calculate the 210,000 to 440,000 number.

Nicolas Charalambous was informed that his father, Bobby Charalambous, died from a fall.  He was later told that his father’s injuries were sustained in an altercation with another resident. Charalambous suffered brain injuries after the event at the Maison Herron and died in hospital 12 days later.  Charlambous had been transferred to the nursing home just two days before the incident.  The coroner’s office conducted an investigation into the man’s death following an incident at the Maison Herron. The findings showed that the death was the result of a homicide.

Montreal homicide detectives are now interviewing witnesses and possible suspects in connection with the death of 82-year-old Bobby Charalambous, whose death has been classified as a murder, following an incident which took place on December 16, 2012.  For more information see article here and here.

According to a new study published in the Science, our brains utilize sleep time to “remove waste products,” that build up while we’re awake. Researchers at the University of Rochester Medical Center studying the brains of mice found that a waste-draining process, called the “glymphatic system,” is ten times more active during sleep. The nocturnal cleaning system is crucial to our health, ridding our brains of toxins that can eventually lead to conditions like Alzheimer’s. “It’s almost like opening and closing a faucet—it’s that dramatic,” says Dr. Maiken Nedergaard, one of the leading scientists on the study.

"The conservation of sleep across all animal species suggests that sleep serves a vital function. We here report that sleep has a critical function in ensuring metabolic homeostasis. Using real-time assessments of tetramethylammonium diffusion and two-photon imaging in live mice, we show that natural sleep or anesthesia are associated with a 60% increase in the interstitial space, resulting in a striking increase in convective exchange of cerebrospinal fluid with interstitial fluid. In turn, convective fluxes of interstitial fluid increased the rate of β-amyloid clearance during sleep. Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system."

 

Reducing unwanted side effects and dangerous drug interactions?  There’s an app for that. A new study by researchers at the University of Pittsburgh School of Medicine polled nursing home doctors about how they used their smartphones in their practice.  Nearly half of them, more commonly the younger ones, say they use their smartphones to check drug information. Of those who are making use of the technology 75% are checking drug information more than three times a day.

Most report that this kind of information does in fact bring to light adverse drug reactions that they would not have caught using slower, outdated nursing home computer systems. Drug events are linked to 93,000 nursing home deaths a year, about half of which are thought to be preventable. Making prescriptions safer with smartphones might not be such a bad idea for the doctors who haven’t warmed up to the practice yet.  See artilce at Philly.com.
 

Hospital negligence is accountable for nearly 200,000 patient deaths per year, bringing medical errors to the top of the list as most lethal- but utilizing modern technology makes these deaths the most preventable.  EarlySense, an iPad sized device is the future of medicine, leaving little room for human error as the device continuously observes and records a patient’s vitals and movement, alerting nurses directly if there is a hazardous change in the patient’s condition.

EarlySense has brought to market an innovative technology designed to advance proactive patient care and enable clinicians to achieve better patient outcomes, by assisting in preventing adverse events from occurring. The company’s flagship product, the EarlySense System is a continuous, contact-free, patient monitoring solution that monitors and documents a patient’s vital signs and movement using a sensor that is placed underneath a bed mattress. There are no leads or cuffs to connect to the patient who ha complete freedom of movement and is not burdened by any cumbersome attachments. The system is designed to monitor non-ICU “lower risk” patients on medical surgical floors who are usually monitored by nursing staff approximately once every four hours.

See press release below.

Newton-Wellesley Hospital is the first hospital in the United States to implement continuous and contact-free monitoring on all general care beds. The decision to adopt EarlySense as the Standard of Care came after a successful clinical trial led by researchers from Harvard Medical School.

The implementation of the EarlySense System is part of Newton-Wellesley’s continued efforts to optimize patient care, and ensure quality, safety and efficiency for patients. The system offers advanced technology designed to identify early warning signs around patient safety and risk, and potentially adverse situations.

“The EarlySense System enhances the high quality of care we already provide at Newton-Wellesley Hospital by assisting clinical staff in detecting patient deterioration and the potential for an adverse event early on. By utilizing this technology, we feel we have added another layer of patient safety,” said Elaine Bridge, RN, MBA, DNP, Interim COO and Chief Nursing Officer, Newton-Wellesley Hospital.

Clinical studies have provided evidence that respiratory rate and heart rate are the two most important predictors for averting potential patient adverse events. By using a sensor placed under the mattress, the EarlySense system measures heart rate, respiration rate, and patient movement while in bed. The nursing team receives real time alerts on mobile devices and/or at the control center located in the nurse’s station if there are changes or findings that require attention. In addition, remote displays are frequently used for even more viewing options in all areas of a care environment.

David Bates, Director of the Center for Patient Safety Research and Practice one of the lead researchers in the trial, said, “The ability to find patients early in deterioration has enormous potential to improve patient safety. One of the reasons that EarlySense has been so successful is that not only are the sensors accurate, but they have developed approaches to sift through the alarms so that when one is delivered there is a high chance that there is an important clinical change, and the nurses have learned to take these alerts seriously.”

Tim O’Malley, President of EarlySense Inc. said, “We are very excited to see Newton-Wellesley Hospital leading the way by standardizing patient supervision and creating new patient safety standards for the community. The partnership between Newton-Wellesley Hospital and EarlySense is providing the nursing team with innovative solutions designed to enhance patient safety while being conducive to the general floor environment.”

“At Newton-Wellesley, we constantly strive for a culture of constant improvement, and this new technology helps us fuel that culture and provide even better care to our patients,” added Bridge.
About Newton-Wellesley Hospital

Newton-Wellesley Hospital provides a wide range of services, including medical, surgical, obstetrical, orthopaedic, neonatal, pediatric and psychiatric care. Newton-Wellesley has been serving its community for over a century. The medical staff of the Hospital includes nearly 1,000 physicians practicing a full range of specialties. NWH is a major teaching hospital for Tufts University School of Medicine and also has established post-graduate training programs for Harvard Medical School residents.

The system is currently installed at hospitals and rehabilitation centers in the USA and Europe. It is also commercially available in Canada. Early Sense INC is headquartered in Waltham, MA. For additional information please visit www.earlysense.com.
 

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