The number of infections that occur each year in the nation’s long term care facilities is estimated to be between 1.6 and 3.8 million resulting in 388,000 fatalities. These infections cost between $673 million and $2 billion every year.  A new study proves that the failure to change gloves is a significant factor in the spread of dangerous pathogens in nursing homes. The study from the University of Iowa College of Nursing was published in the September issue of the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

Incorrect glove usage by these healthcare professionals causes the spread of pathogens from patient to patient and in the environment. These pathogens then develop into healthcare-associated infections (HAIs).

Nursing home residents are vulnerable to infection. According to lead study author, Deborah Patterson Burdsall, PhD, RN-BC, CIC, using gloves are vital when it comes to preventing germs from spreading into infectious diseases. When the gloves have touched blood or body fluids, after completing a patient task, in between patients, and after the gloves touch a potentially contaminated surface are all points where gloves should be changed.

In the study, gloves were readily available in public areas, shower rooms, patient rooms, and patient bathrooms to the certified nursing assistants on duty. Although gloves were being worn for 80 percent of touchpoints, researchers noted that at 66 percent of glove change points, the certified nursing assistants continued using the gloves they already had on. They observed contaminated glove touch points more than 44 percent of the time. The study shows how much potential exists for cross contamination between patients and the healthcare environment, all from incorrect glove use.

Burdsall concludes that the study shows a definite need for the monitoring of glove use behavior the same way hand hygiene is tracked in healthcare facilities. To prevent the spread of infection, training programs must be developed to educate healthcare workers about the importance of proper glove use in patient care.

The Huffington Post reported on Republican Rep. Diane Black (R-Tenn.) who proposed that hospital emergency rooms should be able to turn patients away to help keep health care costs down.  Black is running for governor of Tennessee.

At issue is the Emergency Medical Treatment and Active Labor Act, which was signed into law by former President Ronald Reagan in 1986. It was a congressional response to stories of “patient dumping” ― hospitals would deny treatment to patients or send them elsewhere, usually because the individuals didn’t have insurance. Many of these patients were unemployed or were people of color.

Those transferred individuals were more likely to die, and the delayed care often jeopardized the patients’ health.

The law put a particular focus on pregnant women (hence “active labor” in the law’s name), to ensure that they would be able to deliver their babies and receive full care.

Changing the law, as Black advocates, would send America back to a time when hospitals can use their discretion to turn people away.

“We must treat everybody that walks in whether you’ve had a sore throat for a week, we must see them. And that crowds the emergency room. It drives the cost of emergencies up,” Black added on MSNBC.

CNBC reported that Trump’s new tax plan removes an important deduction for nursing home residents.  The Republican bill would repeal the medical expense deduction, which allows people who spend more than 10 percent of their income on out-of-pocket health costs to write them off.

The cost of living in a nursing home can easily run up to tens of thousands of dollars per year and wipe out the savings of elderly residents who are paying out of pocket. The deduction can be an important offset to taxes those Americans would owe on their retirement savings distributions.

“It tends to be mostly … older people who do not have long-term care insurance, and end up in a nursing home,” said Richard Kaplan, a professor who specializes in tax policy and elder law at the University of Illinois College of Law.  “For people who are receiving long-term care and are paying for it themselves, this is going to be a huge deal,” said Kaplan.

“This would be a joke if the consequences weren’t so serious,” said Brad Woodhouse, campaign director of health-care advocacy group Protect Our Care, in a statement. “Republican leaders are determined to raise health-care costs for middle-class families who need it most — in this case people with high medical costs or those paying for long-term care.”

 

Politico reported that Consumer Financial Protection Bureau Director Richard Cordray made a personal appeal to President Donald Trump to veto a congressional override of a landmark arbitration rule that allows consumers to bring class action suits against financial firms. The consumer bureau’s arbitration rule would allow consumers to fight disputes with their banks, credit unions and credit card companies in court. Many companies insert arbitration clauses into contracts with consumers requiring them to submit to arbitration instead.

In a letter to the president, Cordray said consumers should have the right to bring lawsuits just the way Trump had when he was in business.

“I think you really don’t like to see American families, including veterans and service members, get cheated out of their hard-earned money and be left helpless to fight back,” Cordray said.

“I know that some have made elaborate arguments to pretend like that is not what is happening, ” he wrote. “But you are a smart man, and I think we both know what is really happening here.”

The Senate last week overturned the arbitration rule after Vice President Mike Pence broke the tie.

The Des Moines Register had an article on the need for video surveillance of nursing home residents.  The article references the Des Moines Sunday Register investigation by Clark Kauffman that told the tragic story of Cheryll Scherf.   Her family installed a motion-activated camera in her room. This captured, among other incidents, staff repeatedly leaving Scherf in bed, naked from the waist down, with the door to the room left open. The video also showed she wasn’t given her prescription medication.

“A reasonable person would feel degraded, embarrassed and ashamed” by this treatment, according to the Iowa Department of Inspections and Appeals.  The family could not have proven neglect without the video.  The neglect was covered up with false documentation and tampering with patient records, according to criminal charges filed against the caregivers.

The story of this Iowa woman underscores the need to ensure all residents in long-term care facilities are guaranteed the explicit right to possess and use cameras in their rooms.

The Centers for Medicare and Medicaid should implement a rule specifically guaranteeing residents can use cameras for their own protection as long as the privacy of other residents is respected. The agency administers Medicaid, the federal health insurance program that pays the bills for more than 60 percent of the 1.4 million people in this country’s nursing homes.

Nursing homes should welcome such personal use of cameras anyway. Families bear the cost. Workers who know they’re being watched may be motivated to follow guidelines and provide good care. That helps protect nursing homes from allegations of mistreatment and vulnerable patients from abuse.

KBTX reported that Health Services Management Inc. (HSM) has paid the United States $5 million to resolve claims that the company billed the Medicare and Medicaid programs for worthless services and for services that were never provided.  HSM is based in Murfreesboro, Tennessee, and owns and operates nursing homes throughout the United States.

The whistleblower worked at Huntsville Health Care Center, a 92-bed nursing home and rehabilitation facility that HSM owned and operated.  She claimed that during her employment, she witnessed patient abuse and neglect, inadequate care, physical and verbal abuse and denial of basic services, such as providing patients with food and water.

The investigation concluded that from Jan. 1, 2013, through Dec. 31, 2015, Huntsville Health Care Center billed for services that were not provided or which were so substandard and deficient that they were considered worthless and potentially harmful to specific Huntsville patients.

“We take seriously the care of our most vulnerable citizens, the elderly and infirm,” said Martinez. “When providers accept federal funds for reimbursement, they have a duty and responsibility to provide the best care possible to the patient, especially when those patients are elderly and at times incapacitated. The United States Attorney’s Office (USAO) for the Southern District of Texas will aggressively hold those accountable who fail to provide the care that is expected when the failure to do so results in harm to the patients and the treasury.”

“It’s disturbing when a nursing home company accepts Medicare and Medicaid money to care for vulnerable nursing home residents and in return provides substandard care, as alleged in this case,” said Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services – Office of Inspector General (DHHS-OIG). “We will continue to hold nursing homes accountable to give residents the quality health services, and living conditions, taxpayers pay them to provide.”

New York Magazine had an article explaining how Trump continue to sabotage ObamaCare which will cause increased premiums with less access to health care.  Not a good deal.

“The president’s suspension of Cost Saving Reduction reimbursements for insurers is one example. The administration’s sabotage of the Obamacare enrollment effort (so important in attracting as broad a risk pool as possible) is another.

But now the administration’s Center for Medicare and Medicaid Services (CMS) has issued a new proposed rule that seeks to indirectly accomplish what nearly all the Obamacare repeal-and-replace bills addressed directly: the weakening of Obamacare’s “essential health benefits” requirements for insurance plans in the individual and small-group marketplaces.”

The ACA defined ten “essential health benefits” all health plans it covered must supply including a “benchmark plan” from the employer-supplied insurance market to serve as a model. Trump proposes to let states do is patch together a model from different plans from anywhere in the country that have at least 5,000 enrollees.  The rule would allow insurers to shift benefits across the 10 categories — not just within them.  In doing so, insurers could potentially make plans less appealing to someone they don’t want to cover — like someone with pre-existing conditions like diabetes or arthritis.

A separate part of the proposed rule would let states waive what is known as the Medical-Loss Ratio limitation imposed by Obamacare: the requirement that 80 percent of premiums be spent on actual medical care rather than, say, advertising. It’s hard to see how that will operate to help consumers rather than insurers.

McKnight’s reported that a pharmacist involved in a scheme to repackage drugs that went unused by area nursing homes was sentenced to probation and community service.  Correna Pfeiffer, manager for Aliquippa Med-Fast Institutional Pharmacy, was part of an investigation into Med-Fast’s repackaging practices that concluded with a $2.7 million settlement and charges against an executive.

Pfeiffer, the first employee named in the case, pleaded guilty to charges that she helped facilitate a scheme in which the pharmacy would pick up unused drugs from nursing homes and bring them back. Pharmacy employees would then remove the medications from their original packages and restock them for use in future prescriptions, the Pittsburgh Post-Gazette reported.

As a result, medications with different makers and expiration dates were mixed in with other stock. Employees would use fake labels on the repackaged drugs.