Numerous media outlets have been reporting the nursing home industry’s attack on unpopular Republican Governor John Kasich.  The Columbus Dispatch reported that Kasich is cutting revenue for nursing homes in an effort to cut the state’s income tax in 2012.

Kasich accused the nursing home lobby of using political donations to win cash for votes and made a call to arms in the Senate to uphold $427 million in cuts to nursing homes that were approved as part of the budget.  Medicaid is the state and federally paid healthcare system that serves about 2.1 million poor, elderly and disabled Ohioans. About 50,000 people live in nursing homes under Medicaid while another 30,000 are receiving assistance at-home.

The Cleveland Plain Dealer reported the nursing home lobbyists responded with a 30-second television ad of an elderly woman in a bed and a picture of Kasich in the foreground. It ends with a condemnation of the "Kasich cuts," a hand pulling a plug out of the wall, a flat-line EKG and a message to call your state senator "before it’s too late."

The nursing homes said the proposed cuts will mean cuts to staff, as many as 7,000 jobs lost, and that will affect the quality of care offered to residents living at the facilities.   However, 15 percent of the nursing homes beds in Ohio are empty and facilities could consider consolidation to lower their overhead costs. Currently nursing homes spend about 60 percent of their budgets on administrative costs and the rest on the care of residents.

Kasich, citing 7-year-old statistics from a Kaiser Family Foundation analysis of spending on nursing-home care, said Ohio pays more per capita on nursing homes than all but five other states.  Citing numbers his staff has collected from the National Institute on Money in State Politics, Kasich said nursing homes and people affiliated with them have contributed $4.51 million to Ohio candidates and political-action committees since 2004. He said they donated $1.7 million to Ohio politicians and committees in 2010.

 "The amount of money we spend per capita (on nursing homes) is through the roof, and they have used their political influence to run public policy," Kasich said. "No group should use political influence to run public policy in the state of Ohio."

Bloomberg Business Week also had an article with additional information showing Medicaid money paying for six-figure salaries for Administrators in 200 Ohio nursing homes, and the industry is spending millions of Medicaid dollars to employ owners’ family members and to hire related side businesses. About 1,100 family members of owners are employed around the state, according to reports. Overall, nursing facilities reported spending $44.1 million on businesses in which owners have an interest.

Cathy Levine, executive director of the Universal Health Care Action Network of Ohio, an advocacy group, said nursing home expenses deserve review.

"We have terrifying unmet needs for basic human services like food and medical care that people are going without that need to be addressed through our government," she said. "So we need our lawmakers to scrutinize how every dollar is being spent on administration and overhead to make sure those resources are going to deliver care to the frail elderly and older adults."

 

 

Athens Banner Herald reported the arrests of CNAs at Winterville Retirement Center who assaulted and stole from residents, and the administrator embezzled an Alzheimer’s patient’s Social Security payments.  Three employees were arrested over the past two months.   Administrator Sherrye Dianne Huff apparently set the tone for an environment in which residents were punched and medication stolen. Huff is accused of stealing more than $4,000 from a 69-year-old Alzheimer’s patient.  Huff was booked into the Clarke County Jail on five felony charges – three counts of theft and two counts of exploiting an elderly or disabled person – and one count of misdemeanor theft. 

Cynthia Ann Barrow was the first employee arrested for punching an 82-year-old woman in the face because the resident had taken some butter from a food cart in the dining hall, according to police.  Barrow was charged with abuse of an elderly person.

The patient was treated at Athens Regional Medical Center for a "knot the size of an egg" on the back of her head where it struck the food cart and floor. She died a few weeks later, March 19, and the Georgia Bureau of Investigation is looking into whether the injury to her head contributed to her death.

Nine days after the resident died, another employee Shyniqua Anastacia Buckles stole more than 100 Xanax tablets that had been prescribed to the deceased resident.  Buckles was charged with fraudulently obtaining a controlled substance.

Assisted Living Concepts Inc. is the parent company that owns Winterville Retirement Center.

 

Nursing homes are requesting waivers or special exemptions from the new health care law which requires access to affordable coverage for all employees.  The nursing home industry has started a lobbying effort seeking some kind of exemption or special treatment.  Campaign contributions are flowing to politicians.

Most nursing homes and home care agencies do not provide health insurance to their workers, or they pay wages so low that employees cannot afford the coverage that is offered.  Among workers who provide hands-on care to nursing home residents, one in four has no health insurance. Among those who provide care to people living at home, one in three is uninsured.

Starting in 2014, the law will require employers with 50 or more full-time employees to offer affordable coverage or risk paying a penalty. For a midsize nursing home, that penalty could easily exceed $200,000 a year. Nursing home executives are urging Republicans in Congress to spare them from the penalties.  One option would give nursing homes more time to comply with the requirement to offer coverage. Another proposal, according to a list of options prepared by lobbyists for the industry, would waive or reduce the penalties for nursing homes “placed in financial distress as a result of the new mandates and fines.” Alternatively, Congress could allow nursing homes to take tax deductions for the penalties, which under the 2010 law are nondeductible.

Charlene A. Harrington, a professor at the School of Nursing at the University of California, San Francisco, said it would be a mistake for Congress or the administration to relieve nursing homes of the obligation to provide coverage to employees.

“It’s scandalous to have nursing home employees taking care of people when they themselves lack coverage and go without care,” Ms. Harrington said. “If employees have health insurance, they are more likely to be treated for illnesses, less likely to pass on infections to nursing home residents and more likely to get early treatment for occupational injuries.”

Mark Parkinson, head of the American Health Care Association, the largest nursing home lobby and a group that threw its support behind the health law, said the employer mandate would be a challenge for some nursing homes. That raised eyebrows from opponents of the overhaul. Neil Trautwein, a vice president at the National Retail Federation, told CQ’s HealthBeat that the nursing homes’ request "reaches new heights of chutzpah." He said nursing homes should be given no special consideration that other employers don’t receive.

 

 

Connecticut’s The Day reported the guilty plea of Serena Sylvia for embezzling more than $53,000 while working as an accounts manager for the now defunct Haven Healthcare nursing homes.  She was only sentenced to 18 months in prison followed by two years of supervised release after pleading guilty to one count of health care fraud and one count of filing a false federal income tax return.

 

Sylvia was employed as a regional accounts receivable manager for Haven Health Care Management LLC, which ran several nursing homes in Connecticut.  Sylvia embezzled more than $53,000 from nursing home resident trust accounts between 2005 and 2008 and failed to pay taxes on the money she stole. She embezzled from residents of Haven nursing homes in Jewett City, Norwich, Waterford and West Haven.

 

U.S. Attorney David B. Fein encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at (203) 785-9270 or 1-800-HHS-TIPS.

 

 

Elisa Thomas from Mister Medicine blog sent us an article about the Top 25 Twitter Feeds for Finding Nursing Jobs.  Mister Medicine is dedicated to bringing the latest and greatest medical marvels and informational intricacies to the internet.  See article below. 

Although demands for qualified nurses can be on the rise, it can be difficult to be matched up to the right position. Location of employment, type of nurse, type of employer desired, and more can all have different nurses working different jobs. And a read of the latest classified section of your local paper doesn’t cut it anymore these days. With the internet having an answer for just about everything, those with a Twitter account have cause to exhale.

Far more than just listening to the latest celebrity rant, Twitter can be used for everything from breaking news to connecting with a new job contact. To help in a career search, we have gathered the below top 25 Twitter feeds for finding nurse jobs. Whether just looking to see what’s out there to finding specialty jobs in your area, there is something for just about everyone.

Top Twitter Feeds for Finding General Nursing
These groups and sites offer loads of nursing jobs and info.

Nursing Jobcast
Visit here for recent, up to date nursing job postings. Job alerts often come on an hourly basis.

Sharp Healthcare
This is the Twitter feed of an RN recruitment department based in San Diego. They have loads of tips for nurses, as well as a few jobs.

Get Nursing Jobs
This Twitter Feed delivers just what it promises. The title, link to the job, and short description are all given.

Nurse Jobs USA
Fresh nursing job listings in the USA are updated regularly as soon as jobs for nurses are posted on the main site. This often includes location, qualifications, and more.

Trustaff
This healthcare staffing firm specializes in placing nurses, pharmacists, doctors, and allied healthcare professionals in facilities nationwide. Visit for new job alerts, multiple openings, and even international opportunities.

Nurse Jobs Network
Retweets of nursing jobs from across the country are often shared here. The listings are available through NTN.

Nurse Careers
Find nurse registries and nursing jobs through this feed from Nurse Registry Info. Location, job, and a short description is shared.

Working Nurse
This nurse feed features job postings and articles to help your career. Links to items of interest are also shared.

Nursing Jobs
Stop here for the nursing job feed from Med Placer based in Nashville, Tennessee. They have many higher level positions, as well as the entry level.

Nurse Jobs Plus
LPNs, RNs, NPs, Nurse Managers, Directors of Nursing, CNAs, and more are all listed here. However, the feed isn’t updated as regularly as it should be.

Top Twitter Feeds for Finding Specific Nursing Jobs
These Twitter feeds have a specific area of nursing or location in mind.

Travel Max Nursing
Find direct placement and travel nursing jobs from across the United States with a visit here. New postings often involve travel registered nurses.

Onward Healthcare
They specialize in sharing travel nurse and physical therapy job information with interested candidates. Travel tips, how to get a job, and more are also shared.

Sarah, Nurses.co.uk
Visit here to get a listing of nursing jobs in the United Kingdom. Sarah also has other tidbits for nurses.

Nursing Jobs NY
Get real-time tweets and listings of available nursing jobs available throughout New York here. Many new entries are featured every hour.

Florida Nurse Jobs
The Sunshine State is the focus of this nursing job feed. New job listings can come several times an hour.

Nursing Jobs IL
Find nursing jobs in Illinois with this Twitter feed. Several entries a day and links to the full item are shared.

Texas Nurse Jobs
Use this Twitter feed to find jobs in nursing in the Lone Star State. The main site has more.

Health Job Australia
This Twitter feed is dedicated to helping those interested in medical jobs in the Land Down Under. Nurses and other healthcare professionals can find it of use.

Christian Nurse
Although there aren’t many job listings, there are items for those who want to integrate Christianity with their nursing practice. Articles of interest and links are often shared.

Other Top Twitter Feeds for Finding Nursing Jobs
These organizations have loads of tips for finding a job, being a nurse, and more.

McGraw-Hill Medical
Because the NCLEX is such an important part of finding a job, stop here. They have loads of sample questions and answers, as well as other tips.

Nursing in the News
Follow this user to get all the nursing news in one feed. Current sample stories include nursing home beds, nurse abuse, and nurse job satisfaction.

Nurse Hub
No matter whether you are a nurse practitioner or nursing student, use this feed to connect with others. The user often asks questions of her followers and posts the answers.

What Nurses Do
If you are looking for a nursing job, chances are you already know the answer. However, for items such as medical breakthroughs and controversial ideas, this feed is worth a follow.

American Journal of Nursing
This is one of the leading publications for nurses all over the country. Check out articles and other items of interest with a simple visit.

Nurse Educator
If education is part of your nursing job search, stop here. The publication provides practical and applied information on both the theories and practice of academic nursing education.

Although the above top 25 Twitter feeds for finding nursing jobs can bring every open position on the web to your Twitter page, they are not the only means you should use for finding a nursing job. If you know where you want to work, look up their website to see which positions they have open and check back regularly.

 

The Chicago Tribune reported the tragic death of Ramon Crisantos.  He was a 57-year-old nursing home resident who died after he fell while trying to climb down a rope of bed sheets.   Staff at the Woodbridge Nursing Pavilion found the makeshift rope hanging down the window around 5:16 a. It wasn’t clear why Crisantos was trying to sneak out of the facility. According to Woodbridge’s website, residents are allowed to leave the facility.

I hope there is an investigation.  Where was the supervision?  Did he show signs of dementia, wandering, suicide? 

 

 

Moultrie News published a letter from attorney A. Elliot Barrow about the misinformation and outright lies used to pass "tort reform" in South Carolina.  See article below.

Recently two of our state legislators published a public letter. Of interest was a lengthy discussion of so-called lawsuit abuse and how such alleged abuse injures existing businesses and prevents new businesses from coming to South Carolina.  Even more recently our Governor
has publicly stated that so-called tort reform, which is intended to limit the rights of wronged citizens to recover punitive damages, is high on her legislative agenda. She maintains that her
agenda is necessary to lure businesses to South Carolina.

Unfortunately, data do not support these fear mongering scare tactics employed by lobbyists who badger our elected officials into enacting legislation that hurts our citizens. Businesses from far and wide come to our state, and have been coming to our state for years; these companies aren’t masochistic, they don’t come here to face off against lawsuit abuse.

Lawsuit abuse is a complete fiction.  Let’s look the last twelve months for proof. 

Mankiewicz Coatings, a German industrial firm, just cut the ribbon on a $2 million relocation to the Charleston area; Michelin just broke ground on a $200 million expansion of an existing facility in Lexington that will add at least 270 jobs; SPAWAR recently broke ground on a $9.5 million tech lab in the Charleston area; Verizon is in the process of adding 500 jobs to its call center in Elgin; an
auto transmission plant which will employ at least 900 people recently broke ground in Laurens County; a South Carolina company recently joined hands with another group to purchase 7390 acres near the coast for development; an out of state company recently opened a grain handling
operation at the Wando terminal; an out of state solar company is planning to invest more than $300 million in a midlands manufacturing plant that will hire 1000 people over the next
few years; a Chinese candy maker is building a $6 million factory in Sumter which will employ at least 120; a New Orleans based defense contractor and information tech company is planning to open a facility in North Charleston, a $2 million investment that will generate at least 100 jobs;
a North Carolina company plans to open a sock packaging facility in North Charleston which will employ over 20 workers; a Washington based distribution company recently purchased a 351,000 square foot industrial building on Clements Ferry Road and will employ 30-50 people; Amazon
is opening a distribution center in Lexington County which will bring at least 1000 jobs to the area; Bosch plans to invest $125 million in its equipment and will add an additional 300 employees over the next few years; a North Charleston chemical business is expanding its business, investing $2 million, and will add additional jobs; a new $50 million wood waste burning plant which will produce biomass fuel is slated for construction in Dorchester County and will
bring at least 20 new jobs; AFLAC is building its insurance business in the Columbia area, investing $100 million and adding at least 100 local jobs; a California plastics firm is investing $2
million in the upstate, adding at least 39 new jobs to its production facility; a Korean company has indicated it will spend $21 million to begin assembling electric cars in the upstate, bringing at
least 400 new jobs; a major player in trucking along the south Atlantic has opened a Mount Pleasant office, adding 50 trucks, bringing new ancillary businesses with it; and the list goes
on and on and on.

Even conservative Senator Jim DeMint told Fortune magazine that “South Carolina is one of the best places in the world to do business, and that’s why so many international companies are moving jobs into our state.”

Lawsuit abuse? Total baloney. A need to limit damages for wronged citizens? More baloney.

So, politicians, if you’re going to pass laws that limit the rights of our citizens, that make it difficult if not impossible to get justice, at least tell the truth about why you’re doing so.

Don’t fabricate fictions. Don’t falsely claim lawsuit abuse. Don’t blame trial lawyers and create a false dichotomy of “business v. lawyers.”  Don’t make it sound as if legal fees defending cases are paid by businesses themselves; everybody knows the truth, the legal fees are paid by the insurance companies, the financial giants that hire lobbyists by the thousands to pressure elected officials into enacting laws that benefit them and injure our citizens.

Just tell the truth. Is that too much to ask?

A. Elliott Barrow, Jr.

I saw a recent press release for a new study by researchers at the University of South Carolina School of Public HealthSouth Carolina.  With 1.5 million residents in nursing homes, the implementation of a medication management system could potentially save the healthcare system billions of dollars per year by avoiding unnecessary nursing home admissions.  The study was published in The American Journal of Geriatric Pharmacotherapy .  The use of the Medicine-On-Time medication delivery technology reduced the likelihood of nursing home admission by 66 percent.  Medicine-On-Time’s medication management system helps ensure that medications are taken properly through the use of patient-specific customized packaging.

The study was commissioned by South Carolina Medicaid and funded by the Centers for Medicare and Medicaid (CMS). The study examined the causes of nursing home admissions among a population of more than 1,000 seniors and 15 community pharmacies that serve them.

Nonadherance to medication therapies is estimated to cost approximately $300 billion, according to a study published by Med Care in 2004.

About Medicine-On-Time (http://medicine-on-time.com)

Medicine-On-Time provides simple and convenient medication delivery systems that make it easy for pharmacists, caregivers and healthcare professionals to administer and track medication. Medicine-On-Time’s mission is to improve patient quality of life by providing a common-sense solution to the problem of medication management; to simplify the administration of pharmaceutical care for caregivers and healthcare professionals; to reduce the rate of prescription errors that can potentially cause major health complications while costing the national healthcare system hundreds of billions of dollars annually. Medicine-On-Time is in use by independent pharmacies across the United States, serving approximately 125,000 patients per year.

 

Internal Medicine News had an article on new research presented at the American Society on Aging.  Although safety and patients’ rights are not mutually exclusive, sometimes balancing residents’ autonomy related to sex, smoking, and behavioral medications with safety poses challenges for nursing homes according to recent studies.

Dr. Melissa L. Martin, medical director of Margaret Tietz Nursing Home and is in the department of medicine at Cornell University, and two colleagues researched nursing home residents’  decisions on smoking, swallowing treatments, sexuality, and antipsychotic drugs at the annual conference of the American Society on Aging. 

Smoking

Between 2% and 10% of nursing home residents smoke, Dr. Martin said. She pointed out that, besides its familiar health implications, smoking can accelerate residents’ cognitive decline and risk fires and personal burns.  One way to evaluate a nursing home resident’s ability to smoke safely is to test whether the person can extinguish a cigarette or hot ashes. Both the capacity to recognize the danger and the physical ability to respond are necessary.

The Centers for Medicare and Medicaid Services says in its regulations that residents may not smoke in their bedrooms unless supervised by staff, and nursing homes must restrict nursing home smoking in compliance with the National Fire Protection Association’s Life Safety Code . However, most nursing homes prohibit smokers since the CMS’s rules allow nursing homes to refuse to admit new residents who smoke.

Dysphagia

Dysphagia is a common swallowing problem with many elderly residents.  In a nationwide survey of nursing directors of skilled nursing facilities through the National Association Directors of Nursing Administration/Long-Term Care, most survey responders thought they had both a right and a responsibility to restrict residents’ access to over-the-counter medications, cigarettes, and alcoholic beverages (J. Am. Med. Dir. Assoc. 2009;10[6]:419-22). But only 17% thought that facilities had a responsibility to restrict access to food, and 24% thought they had a right to do so.  In fact, while only 10% of residents smoke, 97% of nursing homes have smoking policies. By contrast, 40%-60% of residents in nursing homes have dysphagia, but only 37% of facilities have policies on food brought in by visitors.

Antipsychotics

In 1986, a study indicated that nursing homes used sedatives and physical restraints on up to 85% of residents, leading to the passage of OBRA 1987.  Now research indicates that the prevalence of antipsychotic use in nursing homes declined after that event and now is 15%-27% (J. Am. Med. Dir. Assoc. 2010 Sept. 30.  However, researchers have reported increasing use of antipsychotics since 1999 because of the advent of new medicines with reduced side effects. The Food and Drug Administration reacted against this trend in 2005 with a "black box" warning that elderly patients with dementia are at increased risk of death when they are prescribed antipsychotics.

Citing the NADONA/LTC study, 64% of nursing homes give antipsychotics only when family members sign consent forms. The study found that 65% of the facilities were using lower doses of antipsychotics since the FDA warning, but only 39% reported a reduced use of antipsychotics overall. Just over half had increased their use of nonpharmacologic interventions, and a similar proportion was using other types of medications, such as anticonvulsants and benzodiazepines.

Other researchers have found that facilities with higher staff-to-resident ratios use less antipsychotic medication, and the same is true of those that educate staff about these issues.

Sexuality

The sexuality of nursing home residents presents a different set of challenges especially if mental competence is unknown.  Can residents have sex with each other?  Visitors?  Do they have the right to masturbate?  Should the family be notified? 

It is there home.

 

Caring for an Aging America Act Critical to Address Workforce Shortage to Care for Older Adults

The Eldercare Workforce Alliance praises Sens. Boxer (D-CA), Collins (R-ME) and Kohl (D-WI), and Sanders (I-VT) for introducing the Caring for an Aging America Act. If enacted, the bill, which is endorsed by the Alliance, recognizes the importance of ensuring that the healthcare workforce is prepared to meet the needs of the nation’s growing population of older adults.

This year the first baby boomers turned 65 years old and by 2029 this group will total an estimated 70 million people, far outpacing our current health care system’s capacity to care for them. The Caring for an Aging America Act is will attract health professionals to the field of geriatrics and gerontology by providing them with loan repayment opportunities in exchange for agreeing to
work in underserved areas.

"This bill codifies loan forgiveness for health professionals who pursue geriatrics and gerontology training into law. This is critical to recruiting the next generation of health professionals with specialized training in care of older adults. It will help us to ensure that America’s frailest elders
receive high quality, well-coordinated, interdisciplinary team care," said Nancy Lundebjerg, C.O.O. of the American Geriatrics Society and co-convener of the Alliance. “We commend Senators Boxer, Collins, and Kohl for their leadership on this bill and foresight to invest in a well-trained health care workforce with the skills to care for older adults.”

This bipartisan bill expands the Health Resources and Services Administration’s National Health Service Corps Program to include primary health care professionals with training in geriatrics and gerontology.

"Supporting health professionals who go into geriatrics and gerontology is also supporting family caregivers, who increasingly rely upon the specialized expertise and training of these eldercare professionals," Kathy Kelly, Executive Director of the Family Caregiver Alliance, headquartered in San Francisco.

“By introducing this bill, Sen. Boxer, Kohl, Sanders, and Collins are alerting their fellow members of Congress that there is a critical need to address the elder care workforce shortage by emphasizing the importance of having training in geriatrics and gerontology. I am hopeful that this bill will lead to future congressional action and creation of additional incentives to encourage people to enter into the geriatrics field in order to improve older adults’ access to trained providers," said geriatrician Dr. Jabbar Fazeli from Falmouth, Maine.

The Eldercare Workforce Alliance is comprised of 28 national organizations united in their commitment to address the eldercare workforce shortage in order to ensure that our grandparents and parents receive quality care in the settings of their choice.