May is national Arthritis Awareness Month. Flexcin International is conducting a survey.  Flexcin is a proud sponsor of the Arthritis Foundation,  Flexcin will reveal results of the survey for Arthritis Awareness Month in May.

The survey is open to anyone suffering from any form of arthritis, Osteoarthritis, Psoriatic arthritis, gout, joint pain, lupus or other joint-related pain, illness or disability. The purpose is to get a better picture of how aware other people are when any number of family members, friends or co-workers have arthritis or a joint pain-related disease. The twelve-question survey will help paint a picture between men and women coping with arthritis, and the level of support they receive on any given day.

With the survey we hope to accomplish a number of goals:

1) Learn more about how men and women differ in the type of arthritis and joint pain they suffer from.

2) Identify how much awareness and support arthritis sufferers currently receive from others around them.

3) Learn what things others can do to become more aware and be more supportive for arthritis sufferers.

Here is a link to the twelve-question survey. Flexcin will release results of the survey during the first week of May.


Levin & Associates reported the nursing home industry was profitable in 2010 as stock prices performed well, occupancy levels in seniors housing rose and Medicare reimbursement increased.  More money is flowing into nursing homes as demand for quality increased.

In 2010, the average price paid for skilled nursing facilities jumped to a new record of $62,500 per bed, besting the previous record set in 2007 by 13% and surging by more than 31% over the average price paid in 2009.

When looking at the industry over the past several years, there has always been a preponderance of sales of old, smaller, low occupancy, high Medicaid, low margin (and no margin) nursing facilities in secondary, rural or inner-city markets. "The prices of these were often between $15,000 and $25,000 per bed, and the likelihood of increasing the private pay, let alone Medicare, census was always quite small. In 2010, these sales didn’t disappear, but their volume declined, and the best bet is that buyers didn’t want to take the risk with low quality Medicaid mills (sorry) that they might have in the past, and lenders, or those that were still around, only wanted strong nursing facilities that could survive a 10% state Medicaid reimbursement cut."

The average operating margin of skilled nursing facilities sold increased, as did the average EBITDA per bed (also a new record) and the average occupancy level.

Maybe they can use all that money to increase staffing and training.

Approximately 1.5 million medical errors (out of a total 6.3 million measurable medical injuries) cost $19.5 billion from the American economy in 2008, representing an average total cost per error of $13,000, according to an objective analysis of insurance claims data completed by the consulting firm Milliman for the Society of Actuaries (SOA). "Of the $19.5 billion in total costs, approximately $17 billion was the result of providing inpatient, outpatient and prescription drug services to individuals who were affected by medical errors, said Jim Toole, FSA, CERA, MAAA and managing director of MBA Actuaries.

Medical errors caused more than 2,500 avoidable deaths and more than 10 million missed workdays. Five common medical errors accounted for 55 percent of total medical error costs in 2008:

Pressure ulcers, $3.86 billion ($10,288 total cost per error);
Postoperative infections, $3.66 billion ($14,548 per error);
Mechanical complications of devices, implants, or grafts, $1.13 billion ($18,771 per error);
Postlaminectomy syndrome, $1.12 billion ($9,863 per error)
Hemorrhages complicating a procedure, $960 million (12,272 per error).

I think that the number is much greater since this study was based on insurance data but it clearly shows how better care will save money in the long run.  Nursing homes should understand that if they spent a little more money on qualified, competent, and compassionate staff then these medical errors would be prevented.


Masters in HealthCare ran an article called 15 Disturbing Facts About the FDA.  Americans count on the U.S. Food and Drug Administration (FDA) to regulate food and pharmaceutical items so that only the safest, most effective products hit the market. That’s definitely not the case, as these disturbing facts show.

1.  They keep important drug information off the label: Two drug safety experts called out the FDA in the fall of 2009 for leaving off important drug information when listing ingredients on labels. Even doctors were left in the dark about certain drug information, and in the case of the osteoporosis drug, Zometa, a slightly higher dose could increase the risk of death in cancer patients.

2.  Their tomato mistake ruined the industry: During one of the many salmonella outbreaks in the last few years, the FDA pointed to tomatoes as being the carrying culprit. People all over the country stopped eating tomatoes, a major ingredient in all types of foods made at home and in restaurants. The slow-down of the industry was a huge hit to farmers, and Florida lost most of its harvest because of the FDA’s cautioning. Turns out tomatoes had nothing to do with the outbreak whatsoever.

3.  Budget cuts might be coming: Earlier this year, Congress looked ready to cut funding to the FDA as with many other government agencies. The FDA is worried about handling the fallout from Japanese radiation, however, possibly swaying President Obama to override the cuts and in fact give more money to the FDA for 2012.

4.  The FDA approved canola oil: There’s a bit of debate among health experts and natural foodies about the safety of canola oil, which is no longer extracted from the somewhat toxic plant, rapeseed. Mayo Clinic blogger Katherine Zeratsky, R.D., L.D., points out that "canola oil is generally recognized as safe by the Food and Drug Administration," which isn’t a very strong stance one way or the other, and it has actually been banned in Europe.

5.  They failed to comment on a test subject’s suicide: A 19-year-old college student who was working as a test subject for the FDA as it researched a new antidepressant hanged herself in the lab of an Indianapolis-area drug company. Because the drug manufacturer hadn’t publicized any negative side effects about their product, the FDA was expected to share its findings and continue with research to attempt to find a reason for the suicide. They didn’t. Instead, the FDA said that if they released information about how the suicide and drug’s side effects were related, they would be releasing trade secrets, possibly compromising the drug company’s recipe and overall business.

6.  The FDA tends to "sit on" questionable data: In a 2009 New York Times article, it was revealed that the FDA has a nasty habit — it "often sits on data that raise questions about a drug’s safety or therapeutic value." In other words, FDA agents keep quiet when they learn about adverse side effects, including shocking symptoms like increased heart attack risks in one painkiller and an increase in children’s suicidal thoughts and behaviors in antidepressants. Their obsession with keeping trade secrets safe inspired a call for more transparency in the process of drug approval.

7.  They were partly behind the Vioxx deaths: Along with drug company Merck, the FDA was blamed for promoting and refusing to recall the drug Vioxx, which "caused an untold number of fatalities among the American population," according to Apparently, the FDA was pressed to run additional clinical trials after Vioxx caused heart attacks, but the FDA approved the drug anyway, without extra research or recalls.

8.  Just because a drug is approved, doesn’t mean the FDA believes it works well: The main rule of thumb for drug approval is that if its benefits outweigh its side effects, it gets the go-ahead to hit the market. But while many Americans think that FDA-approved medicine means the drug is high quality, it may not be.

9.  FDA leaders have chosen to side with drug companies, and ignore science: Two years ago, a group of FDA scientists wrote a letter to President Obama asking for wholesale change of the organization, as they believed leaders were corrupt and consistently ignoring their research, and instead choosing to promote drug companies. At first, some believed the letter was a fake, but when it was validated, a closer look of the letter revealed that the scientists also accused the FDA of actually breaking their own laws, "altering scientific findings," removing Black Box warnings, made false statements in FDA documents, and the approval of a mammogram device after FDA experts voted unanimously against it.

10.  They re-approved a drug that killed 80,000 people: Many health and patient advocates felt that the diabetes drug Avandia should be taken off the market after it was suspected of killing around 80,000 people, but after a special meeting was called, the FDA disagreed. Although the FDA proved through a vote that they believed the drug was dangerous, they decided stronger warning labels would be a sufficient solution.

11.  Most Americans don’t approve of the FDA’s alleged neutrality: Four out of five Americans believe that the FDA is too heavily influenced by drug companies, and 96% of Americans want the government to put warning labels on drugs with known safety concerns.

12.  It’s all relative: In a report by, the FDA’s twisted logic for drug approval was unwound. Their decisions are based on relative comparisons — not on drug safety but on drug deadliness. If a drug is no more deadly than any other comparable drug on the market, it can be approved.

13.  Stock scandal: A FDA chemist was charged with insider trading, stockpiling — along with his son — $3.6 million. He used inside information about drug approvals to make calculated trades.

14.  "Extraordinarily complex" data is an excuse for making the wrong decisions: When called out on the Avandia scandal, FDA officers blamed the drug company Glaxo for throwing "extraordinarily complex" data at them, apparently thinking that was a valid excuse for making a bad decision endangering tens of thousands of lives.

15.  They were reluctant to pursue criminal prosecutions: Last spring, the FDA began stepping up its criminal prosecutions of offending drug and food company executives after it was pressured by Congress to do so. Critics of the FDA had noticed that the agency was being too lax with its investigations and had "fallen short" in terms of developing performance standards in its criminal unit.

California’s Ventura County Star had an article about the epidemic of chemical restraints in nursing homes.  The article states that nearly 25 percent of the residents in California’s nursing homes are placed on antipsychotic drugs, often used as sort of a chemical leash to control behavior.  Often the drugs are given in nursing homes or other facilities for dementia without the informed consent of residents or surrogates and are used as a restraint rather than to treat psychiatric conditions.  The drugs can double the risk of death for seniors with dementia and cause side effects ranging from stroke to delirium.

"By 2010 we had an epidemic," according to Sylvia Taylor Stein in a symposium attended by a packed house of nursing home leaders, assisted-living administrators, elder abuse lawyers and state licensing agencies.  Some at the conference linked the use of antipsychotics to staff shortages that make it impossible for employees to properly care for patients, state cuts in mental health programs that have brought more patients with psychiatric problems to long-term care facilities and doctors who have a drug-first mentality when it comes to long-term care residents.

Medicare statistics from the second quarter of last year showed 24.2 percent of the residents in the state’s nursing homes were on antipsychotics. Medicare statistics from 2009 showed the use of the medication fluctuated greatly at different Ventura County nursing homes — from a low of 7 percent of the patients on the drugs seven days over one week to a high of about 30.6 percent.

Lawyers involved in elder abuse cases said over-reliance on the drugs is common. Laws are in place to protect patients, including a prohibition on using medication for the purpose of discipline or convenience. But enforcement is weak and the drugs are routinely prescribed without obtaining informed consent.

Advocates cited the drastic decline in the use of physical restraints in nursing homes over the past two decades, suggesting a similar drive is needed for antipsychotics.

Another article from Medpage Today points out that psychotropic drugs are given to up to 2/3 of dementia patients in nursing homes. Treatment with conventional antipsychotics increased the relative risk of death by 47% and femur fractures by 61%. Benzodiazepines were associated with a 54% increased risk of heart failure, while antidepressant users had 20%-30% increased risk of death and femur fracture.


Twenty years ago, The National Consumer Voice for Quality Long-Term Care released a compendium of research that proved the axiom "an ounce of prevention is worth a pound of cure." The High Cost of Poor Care-The Cost Effectiveness of Good Care Practices (1991) showed how good nursing practices and routine assistance with activities of daily living could prevent billions of dollars in medical expenditures.


This week the Consumer Voice publishes a new version of that report, The High Cost of Poor Care: The Financial Case for Prevention in American Nursing Homes. The new report summarizes studies showing the extraordinary cost of treating preventable medical problems in persons over 65-$19 billion for falls; $11 billion to treat pressure sores; and $5 billion in hospital charges for dehydration. It also reports research on the cost-effectiveness of preventive measures. Nursing home residents account for only part of the costs cited above, but rates of avoidable medical conditions and hospitalization are particularly high among the nursing home population. One study quoted in the report concluded 20 to 30 percent of nursing home falls are preventable and that the best fall prevention method is exercise. This is "a relatively simple intervention," says The High Cost of Poor Care, "with the potential to dramatically lower costs."


The Christian Post had a great article by Ken Connor that I wanted to share on this Easter Sunday. 

“Our society must make it right and possible for old people not to fear the young or be deserted by them, for the test of a civilization is the way that it cares for its helpless members.” Pearl S. Buck, My Several Worlds.

In an economy that is increasingly calibrated for a two-person income, millions of parents across the country rely on some form of professional child care in order to meet the demands of their busy lives. Choosing the right childcare has become one of the primary challenges new parents face when Mom decides to re-enter the workforce. Parents want the best for their children. They want them to be cared for by high-caliber, qualified individuals that they can trust completely.

As might be expected, then, the childcare industry is heavily-regulated. After all, children need to be protected from those who might exploit or abuse them. While the licensing requirements vary from state-to-state, most include some form of professional training or certification for select employees, and virtually all mandate across-the-board criminal background checks. Few parents would have it any other way! Children are weak, vulnerable, and helpless. Better to eliminate potential problems by denying or restricting those with a criminal history the option of employment in a childcare setting.

Sadly, however, the same pains are not taken to protect a class of individuals that is just as weak, vulnerable, and helpless as children. According to a recent report issued by the Department of Health and Human Services, more than 90% of nursing homes employ at least one ex-convict. The very same people who go out of their way to ensure that their children are safe and protected while at daycare may have a grandparent in a nursing home who is suffering at the hands of poorly qualified, sometimes criminally-abusive staff members.

Why is this happening? Why would those in the business of caring for America’s elderly turn a blind eye to such behavior? As with so many other instances of reprehensible human conduct, the culprit lurking behind the curtain is Greed. Because the largest expense of a nursing home’s budget is “labor,” corporate executives at these companies have learned that one surefire way to increase the profitability of their homes is to reduce costs by cutting back on staff and hiring individuals who are willing to accept lower wages. The end result? Profits up! Patient welfare down, forgotten, ignored, and suffering.

Undoubtedly, most Americans with family members in nursing homes have no idea that this is happening, and truly believe that their loved ones are being treated well. They have no idea that behind the reassuring advertisements and sophisticated marketing are profit-driven enterprises who often care more about the bottom line than they do about the welfare of seniors. They are unaware that these business often take advantage of programs like the Work Opportunity Tax Credit, which incentivizes the hiring of certain “target groups,” including convicted felons. By hiring hard to employ ex-cons, nursing home operators get a “two-fer”: tax credits that improve the bottom line, and lower paid employees (which produces the same result).

One possible reason for such widespread ignorance is that, quite simply, there is very little media coverage of elder abuse (the New York Times being a notable exception). Aside from the occasional headline-grabbing report like the one recently issued, the subject is largely ignored. Perhaps that’s because much of it goes on behind the closed doors of nursing homes. Perhaps it’s because our culture is obsessed with youth and no one wants to contemplate getting old. Or perhaps it’s because we simply devalue the elderly―after all, many of them have substantially degraded mental and physical abilities.

It’s not difficult to feel concern for the welfare of our children. They represent the next generation, and are full of potential for the future, and we’ll stop at nothing to ensure that these children and grandchildren are protected and provided for. Meanwhile, America’s Greatest Generation has been largely forgotten, and is often being left unwittingly in the hands of predators who abuse or exploit them.

If compassion for the plight of our elderly loved ones is not enough to spur us to action, then perhaps the thought of our own elder-years might prompt a call for change. It’s high time that the American people wake up to the implications of what it means to become a mass geriatric society, which is where what we are rapidly becoming. Individuals need to prepare now for the years when they will live in decline. Families must prepare to assume a greater role in caring for their aging loved ones, and our churches must acknowledge that the elderly are part of the “least among us” and reach out to lend a helping hand. On the legal side of the equation, government needs to begin protecting our elderly citizens by instituting the same safeguards afforded to children and ensuring that predatory nursing homes are not selling out the care of the elderly to the lowest bidder.

We can, and must, do better.


Ken Connor is the Chairman of the Center for a Just Society in Washington, DC, the former President of the Family Research Council, and a nationally recognized trial lawyer.

The National Consumer Voice for Quality Long-Term Care (formerly NCCNHR), announced the launch of its new guide Piecing Together Quality Long-Term Care: A Consumer’s Guide to Choices and Advocacy, which is intended to educate people with disabilities and older adults about their options for long-term services and supports and empower them to be self-advocates for quality long-term care. The guide also provides information and resources to assist people currently living in nursing homes to move back into the community.

The Consumer Voice has developed a website ( for the guide, which features Piecing Together Quality Long-Term Care in different formats, including an HTML version, a PDF version and audio portions of the guide. The website also includes three state-specific guides funded by the Consumer Voice and written by citizen advocacy groups in Kansas, North Carolina and Virginia. These state guides are designed to assist older adults and persons with disabilities in making informed decisions when choosing long-term care services. A hardcopy of the 80-page, professional bound guide is available for $20 and can be purchased online.

 "While older adults and individuals with disabilities may have different needs, they all deserve a choice of quality long-term care services," said Consumer Voice Executive Director Sarah F. Wells. "Many consumers face the daunting and overwhelming task of trying to navigate a long-term care system that is fragmented and complicated. This project aims to build a bridge between the aging and the disability communities and create a strong, unified long-term care consumer voice.

 "We are launching the guide at this time because the Affordable Care Act is increasing opportunities for the elderly and persons with disabilities to receive care in their own homes."

 The publication of this new resource coincides with the one-year anniversary of the signing of the ACA, which created some of the most significant improvements and changes in long-term care in a generation. Through the ACA, consumers will see increased transparency of nursing home operations and quality; improved safety for people receiving care in long-term care facilities and their homes; strengthening of agencies that investigate neglect and abuse of the elderly, including the long-term care ombudsman program, state survey agencies and Adult Protective Services; and new programs that provide incentives to states to provide more Medicaid home and community-based services.

 This guide was funded by the Milbank Foundation for Rehabilitation. For more information on this project and on health care reform, visit

The National Consumer Voice for Quality Long-Term Care is a 501(c)(3) nonprofit organization founded as the National Citizens’ Coalition for Nursing Home Reform (NCCNHR) in 1975 by Elma Holder. The organization represents the consumer voice at the national level for quality long-term care, services and supports by advocating for public policies that support quality care and quality of life responsive to consumers’ needs in all long-term-care settings; empowering and educating consumers and families with the knowledge and tools they need to advocate for themselves; training and supporting individuals and groups that empower and advocate for consumers of long-term care; and promoting the critical role of direct-care workers and best practices in quality-care delivery.

Athens Banner-Herald had an article about Georgia’s attempts to prevent infections in nursing homes.  Most infections are preventable with proper infection control procedures including washing hands, changing bandages, and maintaining proper hydration and nutrition. Georgia has launched an initiative to help reduce preventable infections in nursing homes.

A division of the Department of Community Health is implementing a long-term care infection prevention and control training program to educate nursing home personnel about ways to prevent health care-associated infections in their facilities.  Health officials at the national and state levels have identified the reduction of such infections as a priority.

The new initiative in Georgia includes a two-day curriculum of instructor-led, interactive sessions. In addition to receiving training in infection prevention and control, attendees also learn to develop strategies to implement and maintain an infection prevention program at their facilities.


 Below is a Press Release from DRI-The Voice of the Defense Bar. 

DRI-The Voice of the Defense Bar released a report confirming that large scale contributions to judicial campaigns have reached unprecedented levels in the aftermath of the Supreme Court’s decision in Citizens United v. Federal Elections Commission, posing critical threats to the notion of judicial independence and the integrity of the American civil justice system.

The report, Without Fear or Favor in 2011, examines a vast array of issues affecting judicial independence and accountability, explaining how judicial campaign contributions and attack ads are polarizing the judiciary and compromising the appearance of fairness in our court systems.

The report – with “A New Decade of Challenges” as its underlying theme – proposes a number of solutions. DRI recommends the automatic disqualification of judges who accept campaign contributions above a specific threshold, the establishment of procedures for handling disqualification motions by a judge different than the one who is subject of the recusal motion and expanding the use of non-partisan judicial performance evaluations to help educate voters and promote a less politicized electoral process. DRI also recommends increased diversity in the judicial ranks to better ensure that decisions are perceived to be fair.

Not just concerned with the appearance of fairness of the judicial process, the DRI report also shows with unlimited campaign contributions to judges running for election or retention, how the conduct of judicial elections has significantly degraded. “With increased special interest funding, attack ads have become common, altering both the substance and tone of judicial elections,” said Matt Cairns, president of DRI. “As demonstrated by what occurred in the 2010 Iowa Supreme Court retention election, special interest groups want to treat judicial decisions like they treat the decisions of other branches of government. And, they want treat judicial elections like they are just another partisan political election. However, judicial decision making and judicial elections are different. Our courts act as a check on the excesses of the other branches of government. Judges are supposed to be neutral and fairly evaluate cases based on their interpretation of the facts and the law. Judges shouldn’t be worried about the latest opinion poll on a hot button issue” added Cairns.


DRI’s report also chronicles the ongoing impact of the recession on the judiciary. It notes that states have resorted to periodically closing their courts, eliminating programs, imposing unpaid furloughs, reducing court hours and staffs – dubbing these collective cutbacks an improper “rationing of justice.” “Our courts have to be open to all in our society to use to resolve their disputes” added Steve Puiszis, editor of Without Fear or Favor, and chair of DRI’s Judicial Task Force. In some parts of the country, counties do not have sufficient funds to hold jury trials in civil cases. “State courts have been hit especially hard by legislators looking to slash budgets. Systems are stagnating, and public awareness of the problem is unfortunately very low,” said Puiszis.

Finally, DRI’s Without Fear or Favor looks at the overall tone of public discourse surrounding judicial decisions, citing the Internet as a venue increasingly hostile to judges and the judicial system. Indeed, the net effect is to significantly increase the need for tighter courthouse security. “The time to act is now,” Puiszis said. “DRI invites other organizations and concerned observers to join us in a shared effort to defend and preserve our besieged court system.”

DRI created the Judicial Task Force in 2005 to address problems threatening the viability of the American judicial system. DRI’s first Without Fear or Favor report was published in 2007. To read the report, go to

About DRI – The Voice of the Defense Bar

DRI – The Voice of the Defense Bar is an international organization of defense attorneys and corporate counsel that is recognized as a thought-leader and an advocate for the defense bar at the national and state level as well as in Europe. With more than 22,000 members, DRI provides members and their clients with access to world-class education, legal resources and numerous marketing and networking opportunities that facilitate career and law firm growth. For more information log on to


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