The Caring Resource

Halloween At The Office!

Presidential Candidates view as it applies to healthcare/homecare:

Today we received this break down from home care industry expert, Stephen Tweed.  Thought I would share:

Let's take a quick look at the candidates, their position on healthcare, and how their approach to the presidency might affect your business, and your ability to care for patients. Then you can go to the polls and make the decision that is right for you.

Senator John McCain:

Supports home care as an alternative to institutional care
Believes in a free market approach to solving the health care problem
Proposes a move away from employer-sponsored health insurance
Proposes a $5,000 tax credit for families to purchase their own health insurance
Encourages incentives to use home health care as opposed to long term care in a facility
Acknowledges the massive costs of chronic disease on his web site
Calls for greater emphasis on preventive care
Calls for more use of health savings accounts
Supports association health plans and allowing purchases of health insurance across state lines
Advocates giving chronically-ill seniors and disabled persons cash to pay for their home care

Senator Barack Obama:

Believes in universal health care coverage like Federal government employees receive
Favors bigger government and higher taxes for the wealthy, including those home care business owners who make more than $250,000
Supports greater use of disease management for chronic illnesses
Favors mandating coverage only for children
Would offer employer reinsurance for catastrophic coverage
Would require employers that do not offer or contribute to employee health coverage to contribute a percentage of payroll to a fund for the national health insurance program
Endorsed the "Fostering Independence Through Technology Act" to establish demonstration projects supporting home health telemonitoring
Pledged to ensure that seniors have choices in their health care
Supports the expansion of government centered health programs
Favors more government regulation of many industries

Serena Brock

False Claims Act Education

Section 6023 of the Deficit Reduction Act (DRA) of 2005 requires providers receiving annual Medicaid payments of $5 million or more to educate employees, contractors, and agents about Federal and State fraud and false claims laws and the whistleblower protections available under those laws.

Beginning September 2007 and annually thereafter, DMA will notify providers that they received a minimum of five million dollars in Medicaid payments during the last federal fiscal year and that they must submit a Letter of Attestation to show that they are in compliance with the DRA. This minimum
amount may have been paid to one North Carolina Medicaid provider number or to multiple provider numbers associated with the same tax identification number. Each Medicaid provider who receives a notification must sign and submit the Letter of Attestation to EDS within 30 days of the date of notification.  Additional copies of the Letter of Attestation may be printed from this web page.  A separate Letter of Attestation must be submitted for each Medicaid provider number.

Compliance with Section 6023 of the DRA is a condition of receiving Medicaid payments. Medicaid payments will be denied for providers that do not submit a signed Letter of Attestation within 30 days of the date of notification. Denied claims may be resubmitted by the provider once Medicaid has received the Letter of Attestation. DMA will publish information on the status of receipt of providers' Letters of Attestation on this web page. For more information please visit the web page at:
http://www.ncdhhs.gov/dma/fca/falseclaimsact.html

Serena Brock

READ THAT LABEL

Advice on the Importance of Drug Compliance By: Eric Feil- Caring Today Magazine LLC

According to a new report, roughly 1.5 million Americans are injured every year by drug errors in hospitals, nursing homes and doctor’s offices—a number that does not include an estimate of mistakes patients themselves make! In hospitals alone, an average of one medication error per patient per day occurs.

Michael Cohen, president of the Institute for Safe Medication Practices and co-author of the study, offers patients and caregivers the following key recommendations:

Before leaving your doctor's office, know the name of each new prescription medication, how to take it, the side effects and potential adverse effects, and why it’s being taken.

Seek out doctors who prescribe by computer. Computers can alert doctors to the thousands of possible drug interaction concerns and also take into account a patient’s personal information (allergies, for example) to help screen out drugs and doses that might cause adverse effects.

Talk directly to your pharmacist before leaving the pharmacy with a new prescription. Obtain important information about the medication and, to avoid errors, make sure the information from the pharmacist matches what the doctor said.

Share important clinical information (allergies, chronic diseases, problems with liver or kidney, pregnancy status, whether you are breastfeeding, etc.) in confidence with your pharmacist. He or she can serve as an important double-check to make sure nothing is overlooked regarding you or your care recipient.

Maintain an up-to-date list of all medications, nonprescription drugs, herbal remedies, vitamins, etc. It is critically important that caregivers have this information about their care recipients before treatment begins. Patients often overlook the importance of having this kind of list or do not consider certain items important enough to include.

Serena Brock

ALZHEIMER'S: CAREGIVING 101

By: Beth Polazzo-Caring Today Magazine LLC

Caring for a person with Alzheimer's disease (AD) at home is a difficult task and can become overwhelming as well as heartbreaking at times. Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.

When the patient is first diagnosed, they are often reluctant to admit even having the disease — it's easier to blame forgetfulness and other strange behaviors on aging, stress or anything else besides AD.  For the caregiver, the job goes from normal day-to-day living to watching and helping a loved one become someone they never married or even knew. One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating-basic activities of daily living-often become difficult to manage for both the person with AD and the caregiver.

 Dealing with the Diagnosis

According to the Alzheimer's Disease Education and Referral Center, finding out that a loved one has AD can be stressful, frightening, and overwhelming. As you begin to take stock of the situation, here are some tips that may help: 

Ask the doctor any questions you have and discuss what treatments might work best to alleviate symptoms or address behavior problems.

Contact organizations such as the Alzheimer's Association and the Alzheimer's Disease Education and Referral (ADEAR) Center for more information about the disease, treatment options, and caregiving resources. Find a support group where you can share your feelings and concerns.

Consider using adult day care or respite services to ease the day-to-day demands of caregiving.

Begin to plan for the future. This may include getting financial and legal documents in order, investigating long-term care options, and determining what services are covered by health insurance and Medicare.

You will find that as the disease progresses, you and your loved one must find new ways to do the things that you have long taken forgranted. Everything from communicating, bathing, dressing, eating, day-to-day activities and exercise become increasingly more difficult.  Some of the most stressful times for the caregiver arise when the patient has to surrender the car keys, experiences incontinence, has trouble sleeping (when you are ready to fall over in exhaustion), suffers from hallucinations or delusions, wanders away from home or, like a youngster, has no regard for home safety.

Although getting there might prove to be a monumental effort, it is important that the person with AD receive regular medical care since some symptoms or behaviors may be due to an illness that is not related to AD.

Not to be overlooked is your health and well-being. The mental, physical and emotional demands that you face on a daily basis are daunting. There is help available—and it comes in many different ways but you need to accept the fact that you are only one person and there are only 24-hours in a 7-day week. Just the pressure of knowing that "you can't get sick" can make you a nervous wreck. It is NOT a sign of weakness, incompetence or negligence to cry "uncle." In fact, it's normal to be overwhelmed.

What should you do for yourself?

When someone offers help, take it.

When you need a break, ask someone to step in.

Take time for you and your needs—go for a walk, go to a concert, play cards or just get a massage. The world will go on and nothing will happen if you plan a little bit ahead. Line up a few volunteer caregivers; you'll be surprised at how willing people really are to lend you a hand.

Think about adult day care offerings.

Consider community resources that can range from financial to emotional support.

Talk to a therapist—or a friend who makes you laugh.

If you aren't physically strong enough to lift your patient or even the groceries, try asking a neighbor or neighbor's son for help. And if it's really an emergency, the police or fire departments will be more than willing to literally lend a helping hand.

When you are feeling so frustrated that you want to scream, walk out the door and yell or pound your fist into something soft (walls are not soft!).

Don't ignore your physical ailments hoping that they'll go away. They won't. See a healthcare professional and stop diagnosing your aches and pains.

If you can afford it, pay for a professional caregiver. They are angels disguised as mere mortals.

When your patient seems to be close to death, call for hospice help. You have no idea how comforting it can be to put some of your concerns in their more-than-capable hands.

And don't forget about those "little" things, like eating and sleeping!

Serena Brock

Should You Get a Flu Shot? What You Need to Know

By Jeff Levine - October 10, 2008 - AARP Bulletin Today

Since the flu is nothing to sneeze at, experts are making their annual plea for people 50-plus and other at-risk groups to get their shots.

Public health officials say a new vaccine from five different manufacturers has been shipped to clinics and doctors’ offices around the country. There should be enough to go around. According to Julie Gerberding, M.D., director of the U.S. Centers for Disease Control and Prevention (CDC), between 143 million and 146 million doses are available, ruling out any shortage like the one that occurred in 2004, when the vaccine supply was cut in half.

Influenza—the fancy word for the flu—is an infectious respiratory disease, caused by a virus, that can be really dangerous to at-risk groups, including the older people, infants and people with chronic diseases. Flu and bacterial pneumonia—a common complication of flu—each year send 200,000 people to hospitals in the United States and cause on average 36,000 deaths.

Immunizations usually help individuals avoid the flu, but public health officials are concerned that this season, people may be reluctant to be inoculated. That’s because last year’s circulating virus strains did not match up with the vaccine, so more people came down with the flu.

Vaccine formulations are determined each year by scientists who look at the dominant strains in the Southern Hemisphere. In February they recommend the three viruses that are most likely to strike the United States in the next flu season. Usually one or two strains are used from the previous year’s vaccine. But this year’s formulation is “unprecedented,” says Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), because the vaccine has been manufactured with three new strains.

In 16 of the last 19 years, the vaccine has been a good match with prevailing viruses, says Joe Bresee, M.D., head of the CDC’s flu prevention effort. Normally, a shot works for 70 to 90 percent of those immunized, he says, but last year only 44 percent were protected.

Betty, an 81-year-old Fairfax, Va., resident who doesn’t wish to be identified, was one person for whom last year’s vaccine failed. She got her regular flu shot in October 2007 and thought she was protected. A month later she became severely ill.

“One day out of the blue, I just got a real high temperature and almost blacked out and started sweating,” Betty says. She went to the emergency room, where she was diagnosed with the flu and spent four days in the isolation ward. Despite her experience, she says she’ll get another flu shot this fall.

Betty’s gerontologist, Joanne Crantz, M.D., was also disappointed with last year’s vaccine. “It’s always disconcerting when you give someone a shot that you think is going to be protective, and it’s not,” she says. She saw 20 cases of flu last year in patients, some of whom had been vaccinated.

The vaccine has come under scrutiny from other sources as well. In fact, some doctors don’t think it prevents disease in the older population. They point to a study published in the British medical journal the Lancet on Aug. 2, which found that the vaccine didn’t lower the risk of pneumonia. Researchers at the Group Health Center for Health Studies in Seattle found that older people who are the most likely to get a flu shot are generally healthy and the least likely to get pneumonia, while those too weak or frail to get to the doctor’s office for a vaccination are the most vulnerable. Factoring in the variations in health status, the vaccine appeared to make little difference in pneumonia risk. The findings were based on a review of thousands of medical charts of older members of a Seattle HMO.

Still, many health experts remained unconvinced. Crantz, despite her disappointment over the vaccine’s effectiveness last year, says she doesn’t agree with the study’s conclusions. “Some very hardy people get the flu,” she says. And even the study’s lead author, Michael L. Jackson, said in a press report that he “still wants my grandmother to keep getting the flu vaccine ... even if it might lower the risk of pneumonia and death only slightly.”

“People may question whether the vaccine is effective,” adds the CDC’s Bresee, “but they need to remember it’s still the best protection we have year in and year out.”

Walter Orenstein, M.D., the former head of the CDC’s national immunization effort, says flu “has emerged as a health security issue because of its huge medical and economic toll.” Despite this, he says, warnings about the flu are too often ignored.

A new CDC report shows that in 2006, 72 percent of those older than 65 were vaccinated, but only 42 percent of individuals ages 50 to 64 and 35 percent of 18- to 49-year-olds were immunized. Just 42 percent of health workers got the shots. And a new consumer survey commissioned by the National Foundation for Infectious Diseases (NFID) shows that four in 10 patients say they’ve never even talked with their doctors about being vaccinated.

What’s likely to get more people to roll up their sleeves is a longer-lasting vaccine that confers immunity from year to year. “I think that’s the ultimate endgame and endpoint, but we’re not there yet, obviously,” says Fauci. Currently, NIAID is spending about $94 million on developing vaccines for different types of flu, up from just $3.6 million in 2000, before the 9/11 attacks, the anthrax scare and worries about avian flu.

In the meantime, AARP board member Cora Christian, M.D., said at an NFID press briefing, “Get the flu shot—it’s a powerful preventive weapon.”

Who should get immunized?

• People age 50 and older
• Nursing home residents
• Health care workers
• People with chronic diseases that weaken their immune systems
• People who are in contact with those at high risk for flu
• Children and teens, from six months to 18 years old
• Pregnant women

Types of vaccines

• Traditional flu shot consisting of a “killed” virus for healthy people older than six months
• Nose spray consisting of a weakened live virus for healthy people ages 2 to 49 years (but not pregnant women)
• A one-time vaccination against bacterial pneumonia, a common complication of flu, for those 65 and older and nursing home residents

Clinics and Costs

• Flu shots generally cost between $15 and $30, but check hospitals, senior centers, pharmacies and public clinics in your community for free or low-cost shots.
• Some polling places are offering flu shots on Election Day through the Vote and Vax program.

• Medicare pays for the total cost of flu and pneumonia vaccinations, and so do many private health plans.

Helpful Websites:

• AARP offers tips on protecting yourself from the flu.
• The Centers for Disease Control and Prevention offers information on everything from prevention to flu symptoms to treatment.
• The American Lung Association provides information on pneumonia associated with the flu and a site to help you find a flu clinic in your area.
• Medicare’s site focuses on flu and people 65-plus.

 

Medicaid Spending Will Join Medicare in Out Running the Economy in Years Ahead

Long-term care for low-income senior citizens will help drive cost to $4.9 trillion in 10 years.

Oct. 19, 2008 - Under current law, spending on Medicaid is expected to substantially outpace the rate of growth in the U.S. economy over the next decade, according to a new annual report released Friday by the Centers for Medicare & Medicaid Services (CMS). This is the first time the government has spotlighted Medicaid spending as it does annually with Medicare and Social Security all three critical programs to millions of senior citizens. For a copy of the full CMS report, please email serena@avenuehomecare.com or visit the CMS website.

Serena Brock

Medicare Critical to Long-Term Care for Senior Citizens

Elderly Americans most frequently turn to Medicaid for long-term care, as the cost of nursing homes and other intensive care quickly diminishes the financial resources of many families.

Among the different types of health care services, Medicaid plays the largest role in the funding of long-term care. According to the 2006 National Health Expenditure data, Medicaid is estimated to have paid for 34 percent of all home health care and 43 percent of all nursing home care in
the U.S.

Medicaid has a major responsibility for providing long-term care because the program covers some aged and many disabled persons, who tend to be the most frequent and most costly users of it, and because private health insurance and Medicare often furnish only limited coverage for such care, particularly for nursing homes.

Many people who pay for nursing home care privately become impoverished because nursing home care is very expensive; as a result, these people eventually become eligible for Medicaid.

Medicaid spent $99.9 billion on long-term care and $66.6 billion on managed care and other premiums in FY 2007.

During FY 2000 through FY 2005, Medicaid growth was faster than in the previous 6 years, with spending increasing an average of 8.9 percent per year over the 6-year period.

Several trends contributed to this acceleration. First, Medicaid enrollment increased at an average rate of 6.4 percent per year between FY 2000 and FY 2005. It grew fastest between FY 2000 and FY 2002, coinciding with the 2001economic recession, and reached a peak of 9.3 percent in FY 2002.

While blind or disabled enrollees and aged enrollees are the smallest enrollment groups in Medicaid, they are projected to account for the majority of spending. As indicated in the table below, for FY 2007, estimated benefit spending was $126.7 billion for blind or disabled enrollees and $70.9 billion for aged enrollees.

Combined, spending on these two groups constituted 67 percent of Medicaid expenditures (excluding DSH, territory expenditures, and adjustments which cannot be allocated by eligibility group). Medicaid spending on non-disabled children was about 19 percent of total Medicaid benefit expenditures, and spending on non-disabled and non-aged adults was about 13 percent.

Serena Brock

As Seen in Simply The Best Magazine

Thank You To Our Road Warriors!

A recent study conducted by the National Association for Home Care and Hospice shows that nurses, therapists, home care aides, and others who serve elderly and disabled patients in their own homes drive nearly 5 billion miles each year. Caring for nearly 12 million patients annually with 428 million visits, the dedicated providers of home care and hospice services are health care's version of "road warriors."

Serena Brock