See You Next Year!

ProMed's offices will be closed on Thursday and Friday in observance of the New Year holiday. We wish you and yours a wonderful New Year and we look forward to continuing to grow together in health care in 2010!

Excellent End-of-the-Year News: Drugs Found to Slow MRSA's Resistance to Treatment

It used to be that Staphylococcus aureus could easily be treated with penicillin. Then it developed a resistance to that, and then to methicillin and other antibiotics. Eventually, it became the often-feared methicillin-resistant Staphylococcus aureus, or MRSA.

Recently, MRSA has been moving out of the hospital setting and into the community, raising new concerns about antibiotic resistance.

But there's good news: A new study conducted by pharmacy researchers at Oregon State University has identified two antibiotics that appear to be less likely to cause future antibiotic resistance: linezolid and moxifloxacin. On the flip side, doxycycline and clindamycin are likely to cause rapid development of resistance against community-associated MRSA.

Researchers were especially intrigued by the discovery that moxifloxacin might be effective against the new strain of community-associated MRSA. Moxifloxacin, and other antibiotics in its class, had not previously been thought of as an appropriate agent against MRSA because resistance to it often develops rapidly.

The researchers' analysis was published in the International Journal of Antimicrobial Agents.

An Early Christmas Gift for ProMed's Dave Welch

ProMed Territory Manager Dave Welch got the best Christmas gift anyone could ask for - a new granddaughter!

Alyvia Louise was born on December 19 and 3:54 a.m. She weighed in at 8 pounds, 3 ounces and was 21 inches in length. Her proud parents are Amanda and Ted.

Congratulations to Dave and his family on their precious new addition!

Happy Holidays from ProMed

From our team to yours - ProMed wishes you a safe and happy holiday!

New Fall Prevention Strategy is "Out of This World"

A new study at the National Space Biomedical Research Institute is suggesting that technology created to help astronauts might be helpful to seniors with balance issues.

The Adaptability Training System (ATS) was developed to help astronauts overcome the dizziness, disorientation, motion sickness and lack of a sense of direction they often feel while experiencing weightlessness. When they return to Earth, ATS can help them readjust to gravity.

During ATS use, a treadmill is mounted to a moveable platform and placed in front of a large projection screen. Images of streets, hallways and rooms are shown on the screen. As the person walks, the image moves along with the platform, simulating balance disturbances.

The people behind ATS say that it could have enormous benefits for seniors and other people with balance problems. Forty percent of nursing home admissions are due to injuries caused by falls, and falling is the leading cause of accidental death for people over 75.

Celebrity Recall Might Hold Key to Alzheimer's Risk

Do you remember who starred in True Grit? How about the names of the two men who dressed as women in Some Like It Hot? It turns out this knowledge might come in handy for more than trivia games. New research suggests that knowledge about celebrities might hold a clue in the early detection of Alzheimer's disease.

Researchers at the University of Montreal showed a group of 117 healthy seniors (aged 60 to 91) pictures of 30 celebrities and asked them to recall information about the celebrities, such as name, profession, nationality and biographical information. With the healthy seniors, researchers found that the ability to recall a subject's name decreased over time, but the ability to recall details about a celebrity is less affected.

The same researchers then performed a similar test on seniors who had mild cognitive impairment or the early stages of Alzheimer's disease. In this group, the seniors had an easier time recalling celebrities' names, but they were less able to recall details.

The researchers think that this type of semantic memory test might prove useful in assessing those at risk for dementia and Alzheimer's. Semantic memory is the information that we gather throughout our lives to help us remember and recognize other people.

Hospira Announces Urgent Device Recall

Hospira, Inc. has issued an Urgent Device Recall for certain IV gravity and pump administration sets with CAIR Roller Clamps. The company is voluntarily recalling specific lot numbers of the products, manufactured by Borla S.P.A. of Italy.

If you have purchased ProMed item number 001-11540-58, lot number 600-194W, IV Sets w/Y Injection Site Primary 80" Disp ST (48/cs), during the time period of the recall (since December of 2006), please do a facility-wide search for the product - check every storage room, med room, resident cabinet, etc.

If you locate this product in your facility, it needs to be returned to ProMed immediately. We appreciate your cooperation!

Still Looking for That Perfect Gift for Your Elderly Loved One? Try a Wii!

If you have a Wii on your "to-buy" list for the holidays, you might want to add another one - for your elderly loved ones.

While video game sales plummeted overall in 2009, sales are actually increasing in an unexpected demographic - senior citizens. According to an article posted on The Atlantic's Web site, Boomers who are edging into their golden years are far more likely than their predecessors to embrace video games.

The Wii has several features that make it a good fit for the older population. For starters, its games focus more on simple visuals than complex narratives, making it ideal for first-time gamers or those who are nostalgic for Atari, Sega or even arcade games.

Wii also has a surprising number of health benefits. The physical exertion it requires is fairly light, but still beneficial for anyone stuck in a sedentary lifestyle. Physical therapists have also been using "Wiihibilitation" to help motivate patients recovering from strokes, broken bones or other injuries that affect balance, coordination or circulation.

Facilities are also seeing the social benefits that the Wii can bring, according to an article in USA Today. Erickson Retirement Communities in Chicago has been organizing Wii bowling tournaments that have resulted in people who hardly knew each other cheering and hugging in the span of a few hours.

Seniors aren't the only group seeing unexpected benefits from the Wii. NPR's health blog noted that the popular gaming console is also being used to train students in CPR, help with physical therapy and even demonstrate virtual surgery.

Barnes Foundation Presents $30K Donation to American Cancer Society

During ProMed's annual holiday party, held on December 18, the Barnes Foundation presented a check for $30,000 to the American Cancer Society. (The Barnes Foundation was established by ProMed's president, Terry Barnes.) The funds were raised during the first annual Barnes Foundation Walk for Life, which was held on October 4. The proceeds will benefit the ACS's Illinois Patient Navigation Services, which provides a full spectrum of hands-on cancer support to residents of Illinois. The donation will be matched in full by the Duchossois Family Foundation's Campaign of Hope.

Tips for Keeping the Holidays Jolly at Your Facility

'Tis the season for gifts and sweets and gathering together...but for many elderly Americans, the holidays can also bring depression and sadness. According to Mental Health America, the holidays can trigger self-evaluation, loneliness, reflection on past failures and anxiety about an uncertain future.

The American Geriatrics Society Foundation for Health in Aging recently shared "Tips for Beating the Holiday Blues." They recommend the following strategies for lightening the sadness and depression many older people feel during the holidays.

• Invite them to get-togethers (take into account their needs for transportation or special diets).
• Offer to help them with shopping and preparations for the holidays.
• Encourage them to talk about how they are feeling. Acknowledge the difficulty they might be having, including a sense of loss they might have if family or friends have died or moved away.
• Encourage them to talk to a healthcare provider. Many older people don't realize when they're depressed. Let them know that depression is a medical illness and nothing to be ashamed of.

The Mayo Clinic recommends being proactive in recognizing known triggers that can lead to stress and depression during the holiday season. If you see them, you might be able to defuse them before they worsen.
Common triggers include:

• Relationships: Facing the holidays alone can make people feel lonely and sad.
• Finances: The holidays can put a strain on your budget that can last for months.
• Physical demands: The events that pop up during the holiday season can leave people feeling wiped out. In addition, burning the wick at both ends can make people more susceptible to colds and other bugs.

What do you think? Do you have any additional strategies for helping residents enjoy the holiday season?

Is Cinnamon "Spicing Up" Glucose Regulation?

At a time of year when cinnamon is popping up in everything from coffee to candles, we thought we'd take a look at the current debate over whether the spice can regulate glucose levels for people with type 2 diabetes.

A 2003 study generated interest in the possibility that cinnamon could mimic insulin and be effective in the treatment of insulin resistance. The authors of the study found that people who consumed between one and six grams of cinnamon each day had a reduction in their serum glucose, trigylceride, LDL cholesterol and total cholesterol.

In 2004, another study found that the polyphenols in cinnamon bark mimic insulin and could potentially be used in some product form to reduce blood sugar levels. In 2007, researchers reviewed additional studies and reported that data from the studies suggested that cinnamon has a possible modest effect in lowering plasma glucose levels in patients with poorly controlled diabetes.

However, some members of the scientific community aren't quite ready to accept these findings. Maria Collazo-Clavell, a Mayo Clinic endocrinologist who addresses health issues on MayoClinic.com, cautions that most research suggests that cinnamon isn't an effective treatment for type 1 or type 2 diabetes. She urges diabetics to contact their doctors if they have questions or concerns about their diabetes treatment plans.

CMS Warns C. diff Can Stick Around for Six Months

C. difficile might be a tougher bug than we first gave it credit for.

CMS has just modified its infection control guidance regarding C. diff. They've upped the time that C. diff can survive in the environment (such as on or around toilet seats, bed rails and the floor) in its spore form from five to six months.

According to the revised guidance, “Rigorously cleaning the environment removes C. difficile spores, and can help prevent transmission of the organism. Cleaning equipment used for residents with C. difficile with a 1:10 dilution of sodium hypochlorite (nine parts water to one part bleach) will also reduce the spread of the organism. Once mixed, the solution is effective for 24 hours.”

To view the revised guidance in its entirety, click here.

Life Expectancies are Growing - and So are Medicare and Social Security Costs

Which would you like first - the good news or the bad news?

Okay, we'll start with the good news. A new study from the MacArthur Foundation reveals that by 2050, Americans may live 3.1-7.9 years longer than official government projections. For men, that means life expectancy would rise to 83.2-85.9 years, up from the current projection of 80.0-80.9 years. For women, the estimate of 89.2-93.3 years is up from 83.4-85.3 years.

Not only is this great for those of us who want to stick around as long as we can, it also means that American society can expect new and expanded markets in health care and leisure and an expanded work force.

By the middle of the next decade, researchers expect the United States to become an "aging society" in which people over the age of 60 outnumber people under the age of 15.

So what's the bad news, you ask? Well, as life expectancies go up, so do the costs for government programs that serve older citizens. The study's authors estimate that the cumulative outlays for Medicare and Social Security could rise by $3.2 to $8.3 trillion over current government projections by 2050.

Great News for a Monday Morning: Link Found Between Coffee and Prostate Cancer Prevention

Here's some news to savor as your sip your coffee this morning: Harvard researchers have found an intriguing link between coffee and the prevention of an aggressive type of prostate cancer.

The findings, which were presented at the Frontiers in Cancer Prevention Research Conference, revealed a strong inverse association between coffee consumption and the risk of lethal and advanced prostate cancers.

A press release on the study quoted Kathryn M. Wilson, Ph.D., a postdoctoral fellow at Harvard, as saying "Coffee has effects on insulin and glucose metabolism as well as sex hormone levels, all of which play a role in prostate cancer. It was plausible there may be an association between coffee and prostate cancer."

Interestingly, coffee's best-known ingredientt - caffeine - is not the key factor in this association. Researchers are unsure exactly which components are most important, as coffee contains many biologically active compounds, such as antioxidants and minerals.

The study found that men who drank the most coffee has a 60 percent lower risk of aggressive prostate cancer than men who did not drink any coffee at all.

It's Beginning to Look a Lot Like Christmas at ProMed

You can view even more pictures of our festive headquarters on our Facebook page!

Medicare to Cover HIV Screenings

On December 8, CMS announced that, effective immediately, it will begin covering HIV screenings for Medicare beneficiaries who are at an increased risk for the infection, including pregnant women and beneficiaries of any age who voluntarily request the screening. An estimated 19% of U.S. residents diagnosed with AIDS are age 50 or older.

Kathleen Sebelius, Secretary of the Department of Health and Human Services, was quoted as saying "Beginning with expanding coverage for HIV screening, we can now work proactively as a program to help keep Medicare beneficiaries healthy and take a more active role in evaluating the evidence for preventive services."

CMS has new flexibility in adding to Medicare's list of covered preventive services, thanks to the recently passed Medicare Improvements for Patients and Providers Act of 2008, or MIPPA. Before MIPPA, Medicare could only cover additional preventive screening tests when Congress authorized it to do so.

Of the more than one million people believed to have HIV, the CDC estimates that about one quarter do not realize they are infected. While there is currently no cure for HIV, screenings can help identify infected individuals so that they can begin receiving medical treatment that can help delay the onset the AIDS. Without treatment, AIDS usually develops within 8 to 10 years.

The final decision regarding HIV coverage can be found here.

Caring for an Elderly Loved One? You're Not Alone

"Caregiving in the U.S.," a new report from the AARP/National Alliance for Caregiving, reveals that nearly one-third of the population, or 65.7 million adults, provide some level of care.


About 70 percent of of those adults provide care to someone over the age of 50, usually a relative (86%) and often a parent (36%). The average caregiver spends about 20 hours a week providing care.

Additional findings:

• American caregivers are predominantly female (66%)
• The average caregiver is 48 years old
• One in seven caregivers provides care over and above traditional parenting to a child with special needs
• Caregiving lasts an average of 4.6 years

The top reasons cited for why people needed care included old age (12%), Alzheimer's disease (10%), mental/emotional illness (7%), cancer (7%), heart disease (5%) and stroke (5%).

The report also noted that both caregivers of adults and their care recipients are older than their counterparts were five years ago. For caregivers, the average age rose from 46 to 49. For those receiving care, the age shifted upward from 67 to 69.

To view the report, click here.

Nursing Homes Face $4.7 Billion Medicaid Shortfall in 2009

A new report is estimating that Medicaid will underpay nursing homes by $14.17 per patient day in 2009, for a total of $4.7 billion in unpaid Medicaid allowable costs. Researchers predict that this will only get worse in 2010 and 2011 due to unprecedented state budget deficits and the expiration of federal stimulus funds at the end of 2010.

The report also notes that states are continuing to redirect more of their long-term care budgets to non-institutional services, and that many states that use provider taxes to fund nursing home reimbursement chose to neither increase nursing home reimbursement nor lower provider tax rates.

To view the report in its entirety, click here.

Battling MRSA On a Cellular Level

A new study, highlighted in the journal Nature Chemical Biology and McKnight's Long-Term Care News, suggests that it might be possible to halt methicillin-resistant superbugs such as Staphylococcus aureus before they become harmful.

Researchers from the Jeff Brinker research group have discovered that the process of bacteria emitting toxins begins with a single cell that releases a peptide that "switches" bacteria from harmless to virulent. This is a stark contrast to current theory, which holds that staph infections develop when a large number of bacteria "signal" each other to start emitting toxins.

The researchers found that by introducing a lipoprotein, they were able to bind the peptide that triggers the switch from harmless to virulent to the cell, preventing bacteria from becoming harmful.

The researchers reason that this approach could make it easier to treat drug-resistant staph infections before they become life-threatening. It would also eliminate treating the infection with antibiotics, therefore preventing the good bacteria that live in the stomach and intestines from being affected.

CDC: Black Nursing Home Residents Need More Help with ADLs

A new data brief from the CDC titled "Racial Differences in Functioning Among Elderly Nursing Home Residents, 2004" reveals that black nursing home residents (who account for 11 percent of the 1.3 million nursing home residents aged 65 or older) typically have a lower functional status than residents of other races.

This determination was based on data gathered from the 2004 National Nursing Home Survey. The data showed that black residents:

• Are more likely to be totally dependent in both eating and toileting and as well as totally dependent in all five activities of daily living (bathing, dressing, eating, transferring and toileting)
• Are more likely to be incontinent of bowel, bladder or both
• Are less likely to have scheduled toileting plans when compared to bladder-incontinent residents of other races

In addition, the report notes that black nursing home residents are might be more likely to reside at facilities that have serious deficiencies, such as low staffing ratios and great financial vulnerability.

According to the report, these findings "identify important differences in the needs and care of black nursing home residents nationally."

Medical Alert Jewelry Gets a Makeover

Traditional but clunky medical alert jewelry is starting to give way to styles that are both information-loaded and stylish. According to McKnight's, USB jewelry has begun to enter the marketplace. These pieces contain a memory key that stores a resident's medical data, such as allergies, special needs or prescription information. In the event of an emergency, the information can easily be accessed on a computer.

The bracelet shown above is available from Amazon. Click here to learn more.

Inconsistencies Unearthed in Five-Star Quality Rating System

A Scripps Howard analysis of the CMS Nursing Home Compare system uncovered an uneven level of quality of the country, spotlighting just how complicated it can be to find a good nursing home.

Some of the findings include:

• Institutions run by for-profit corporations (about two-thirds of all nursing facilities) generally receive lower scores than those run by nonprofits.
• Homes with more nursing staff per resident (typically nonprofits) generally fare better in ratings.
• Ratings are lowest in the Southern states and highest in Northeast states.
• Homes that have more than 100 beds tend to have lower ratings in all categories.
• A little more than 20 percent of nursing homes regularly receive the lowest ratings, while 12 to 13 percent have received the top rating.

The study also noted that while about 500,000 residents die each year in nursing homes, more than 2 million return home after a stay of less than three months.

These are just a few highlights of the study. To view it in its entirety, complete with recommendations on how to use the ratings most effectively, click here.

Tips for Safe Shoveling

Snow is in the forecast today here in New Lenox, Illinois, so we thought this was a perfect time to revisit safe shoveling tips (even though we hope we won't have to use them any time soon).

The AARP has assembled a list of pointers to help ensure that you'll be able to stand back and admire your work without huffing and puffing or nursing your strained back.

1. Make sure you have clearance from your doctor to be shoveling. People who smoke or have a history of heart trouble, pain, back problems or other ongoing health concerns need to be careful. Shoveling is more vigorous than you might think!
2. Warm up your back before you head outside.
3. Dress properly for the weather. Try layers that you can peel off when you start to work up a sweat.
4. Stay hydrated! Dehydration is just as big a problem during winter as it is during summer. Drink plenty of water.
5. Get a good shovel. It's tempting to get the biggest shovel out there because you think you'll get the area cleared faster, but you're more likely to hurt yourself. Get a smaller shovel that suits your size, and get one with a bend in it if possible. These are better for your lower back.
6. Pace yourself. Start out slow to avoid putting too much stress on your heart.
7. Use your legs rather than your back.
8. Push, don't lift, snow when possible to avoid straining or twisting your back.
9. Be on the lookout for ice that could cause you to fall. Black ice is especially dangerous!
10. Ask for help if you need it.
11. Listen to your body. If you feel any tightness in your chest, stop shoveling and call your doctor right away. If you're sore, take a hot shower, get a massage or take a pain reliever. If the pain persists, see your doctor.

A Few Extra Tips for Fighting H1N1 in LTC

By now, we all know the basics of H1N1 prevention. Here are a few additional tips geared specifically toward long-term care facilities.

1. Keep your building as clean as possible to help control the spread of the virus once it gets inside (at this point, it's practically inevitable that H1N1 will find its way in).
2. Observe people as they enter your facility to see if they exhibit signs of infection. If they do, politely ask them to leave until they recover.
3. Create a quarantine area to isolate residents with H1N1 from the healthier population.
4. Make sure you have a coordinated effort in place to keep surfaces clean. To clean surfaces, use antibacterial, alcohol-based sprays.
5. Don't forget the air! Use an industrial air purifier in areas where people congregate, such as dining rooms and social rooms.

If you start using best practices now, you'll be ready when H1N1 eventually creeps through the doors to your facility!

It's the Time of Year...To Take Grandpa to the ER?

Ah, the holidays. They're a time for gathering together, enjoying homemade goodies...and taking Grandpa to the ER?

Dr. Tamara Kuittinen, director of medical education in the Department of Emergency Medicine at Lenox Hill Hospital in New York, is reporting that, over the years, she and her colleagues have seen definite increases in the numbers of elderly patients seeking treatment at the emergency room during the holidays. They attribute this to two causes:

1. Relatives often don't stay up-to-date with their loved one's health throughout the year. When they get together for the holidays, they're shocked at their elderly family member's condition.


2. Children of aging parents aren't totally aware of how the normal aging process takes its toll.

In both of these situations, Kuittinen said, family members might become alarmed and rush their loved one to the hospital, sometimes needlessly.

Dr. Kuittinen and her colleagues recommend taking the following steps throughout the year to help relatives keep track of their loves ones' health:

• Maintain a database of up-to-date critical medical information about your loved ones.
• Make sure your loved one has easy access to emergency contact numbers.
• Discuss the possibility with your loved one of creating a living will or healthcare proxy.

The doctors also suggest contacting the loved one's physician for advice before taking them to the emergency room to avoid the risk of being exposed to infections or unnecessary tests.

OSHA: Yes, You Need Respirators

OSHA has issued a new compliance directive designed to minimize or eliminate high-risk exposures to H1N1. The directive very closely follows the CDC's guidance.

According to the directive's news release, "In response to complaints, OSHA inspectors will ensure that healthcare employees implement a hierarchy of controls, and encourage vaccination and other work practices recommended by the CDC."

The release continues, "Where respirators are required to be used, the OSHA Respiratory Protection standard must be followed, including worker training and fit testing."

OSHA is backing the CDC's recommendation that respiratory protection that is at least as protective as a fit-tested disposable N95 respirator be used by healthcare employees who are are in close contact (within six feet) of people who have suspected or confirmed H1N1.

If respirators are not commercially available in a given area, employers will be considered in compliance if they can demonstrate that a good faith effort has been made to acquire them. If inspectors determine that a facility has not technically violated an OSHA requirements, but could implement additional measures to better protect employees, they may provide a "hazard alert" letter that outlines suggested measures to further protect employees.

Need Another Reason to Treat Sleep Apnea? How about a Better Golf Score?

A new study, presented at the CHEST 2009 meeting in San Diego, has found that golfers with sleep apnea can shave strokes off their golf game as well as improve their overall health by treating the medical problem.

In the study, participants who received nasal positive airway pressure (NPAP) lowered their golf handicap by as much as three strokes. The study's authors note that sleep apnea can cause sleepiness, fatigue and cognitive impairment, all of which can affect a golfer's game.

To truly be effective, NPAP needs to be used regularly. Studies have reported that men comply with treatment only about 40 percent of the time. However, the current study's authors reported a compliance rate above 90 percent, something they attribute largely to the participants' desire to improve their golfing. This apparently outweighs discomfort, inconvenience, cost, noise and embarrassment, all of which are commonly cited reasons for noncompliance.

Congratulations to Team Mather!

Congratulations to Team Mather, who were crowned the victors at this year's AAHSA Chef Challenge!

The contest featured chefs from Aramark, Morrison, Mather and Sodexo and took place over the course of three days. Each day, contestants had an hour to create a three-course meal using a secret ingredient.

The Mather Pavilion is located in Evanston, Illinois, a suburb of Chicago.

Let's Stomp Out Smoking!

Good luck to those taking part in the Great American Smokeout today! Stay strong!

FDA Zeroes in on Fraudulent H1N1 Products

The FDA is warning that consumers shouldn't always believe what they read online - especially when it comes to H1N1 products. So far, the agency has been alerted to 143 products that fraudulently claim to diagnose, prevent or cure H1N1.

Consumers can click here to view a list of products that "are or were illegally marketing unapproved, uncleared or unauthorized products in relation to the 2009 H1N1 Flu Virus."

The products listed on the site aren't necessarily ones that the FDA hasn't approved - they're just not approved for uses related to H1N1.

Today is World COPD Day!

Today is the eighth annual World COPD Day! The goal of the day is to spread awareness about COPD and and improve COPD care througout the world. To learn more, click here.

FDA: Be Vigilant with Negative Pressure Wound Therapy

The FDA has issued a public health notification about the potential complications, especially bleeding and infection, associated with negative pressure wound therapy. According to the notification, the FDA has received reports of six deaths and 77 injuries associated with NPWT.

Rather than steer healthcare practitioners away from NPWT, however, the FDA is advising that they remain vigilant about following manufacturers' instructions and carefully select the patients who receive treatment. Caregivers should also be prepared to immediately address any complications that might arise from NPWT.

While NPWT is commonly used to manage wounds, burns, ulcers, flaps and grafts, there are a number of situations in which it should not be used. Those include:

• Necrotic tissue with eschar present
• Untreated osteomyelitis
• Non-enteric and unexplored fistulas
• Malignancy in the wound
• Exposed vasculature
• Exposed nerves
• Exposed anastomotic site
• Exposed organs

If you suspect that a reportable adverse event related to an NPWT system has occurred, the FDA urges you to follow the reporting procedure established by your facility.

To view the notification in its entirety, click here.

What Do You Think of the New Breast Cancer Screening Recommendations?

The U.S. Preventive Services Task Force has turned conventional wisdom about breast cancer screening on its ear with its new recommendations.

The recommendations include:

• Recommending against routine mammograms for women between 40 and 49 years old (This is a "C" recommendation, which has this definition: "The USPSTF recommends against routinely providing the service. There may be considerations that support providing the service in an individual patient. There is at least moderate certainty that the net benefit is small.")
• Mammograms every two years for women between 50 and 74 years old (This is a "B" recommendation: "The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.")
• Recommending against clinicians teaching patients to perform breast self-exams. (This is a "D" recommendation: "The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."

The task force also notes that current evidence is insufficient in order to assess the additional benefits and harms of performing mammograms on women 75 years or older, clinical breast examination beyond screening mammography in women 40 years and older and digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.

The task force also notes that "the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms."

This is a big change from current recommendations. What do you think? Will these recommendations help or harm the quality of care that patients receive? Or will the difference be negligible? We'd love for you to weigh in!

Wound Care Clinics in SNFs? Not a Bad Idea, Experts Say.

Many skilled nursing facilities already offer rehabilitation services - so is it crazy to think that freestanding wound-care clinics are far behind? Not really, according to an article in McKnight's Long-Term Care News.

Some experts believe that SNFs are in a great position to establish themselves as wound care specialists "based on the volume of cases, experience in detecting nuances of pressure ulcers and success rates in healing advanced wounds," according to the article.

The article encourages any SNF thinking about creating a commercial wound care segment to think about what really constitutes a quality program: "clinical expertise, full complement of products, innovative treatment options, high-caliber staff training methods and consistently excellent outcomes."

According to the article, other things that SNFs should examine when they consider creating a wound care clinic include:

• Is the clinical team able to handle additional patients?
• Does the facility have the right skilled staff? Experts recommend having a physician team that includes a surgeon, podiatrist and dermatologist.
• Are you using wound care products that maximize value without sacrificing clinical efficacy? Some products might cost more, but if they deliver results in five days rather than 10, they create savings in staff time.
• Do you have protocols in place to measure the results of your facility's wound care? If so, you can use these results to connect with key referral sources in hospitals and the physician community.

To view the article in its entirety, click here.

ProMed's Cookie Monsters

ProMed held a cookie competition today! We had 15 awesome entries, but in the end one cookie garnered the most votes and was declared the winner. And which cookie was that, you ask? Well, you're just going to have to wait for the debut issue of Embrace. We'll be publishing the winning cookie recipe and a short bio of the chef!

AHCA: Treat Chronic Pain as a Public Health Crisis

The AHCA is supporting a new report that calls on government agencies, the medical community and Congress to treat chronic pain as a public health crisis.

The report recommends that federal, state and local agencies adopt a fairer regulatory approach toward controlled prescription drugs. States are being tasked with striking a balance between reducing drug abuse and addressing unrelieved pain.

According to the report, many states still have laws with outdated requirements that reflect "poor medical practice."

We Had a Great Time Meeting You at AAHSA!

Team ProMed thanks all of you who stopped by our booth at AAHSA! We had a wonderful time and the convention, and the highlight was meeting and talking to so many of you. We also wanted to share a few of the pictures we took. As you can see, Captain Compliance was a popular attraction at the show!

Can Statins Help Prevent Flu Death?

This might be the one time that having high cholesterol works to your favor.

An Oregon Public Health Division study of 2,800 patients during the 2007-'08 flu season found that people who were taking statins to manage cholesterol were twice as likely to survive the flu than those who weren't taking the drugs.

The reason? A lot of damage caused by the flu comes from inflammation, a condition that statins have long been known to reduce.

The report went so far as to suggest that statins might be a good treatment for influenza, and one that could be less expensive than treatments like Tamiflu.

The study was presented at the 2009 annual meeting of the Infectious Diseases Society of America. The meeting was held October 29-November 1 in Philadelphia.

Study: Lifestyle Changes Can Reduce Dementia Risk

A new study is casting doubt on the theory that there's little people can do to halt the development of Alzheimer's disease if they're genetically predisposed to it.

Researchers found that while 60% of an individual's risk of developing Alzheimer's is genetic, the rest of the risk might be due to changeable lifestyle factors. Specifically, high blood pressure, clogged arteries and pro-inflammatory cytokines were cited as potentially contributing to Alzheimer's development.

As one of the researchers put it, "It is important to realize that early interventions could prevent late-onset Alzheimer's disease."

The study was published in the November 2009 issue of Archives of General Psychiatry.

Come Visit Us at AAHSA!

We loved seeing current customers and meeting new people on Day 1 of AAHSA! Stop by the ProMed booth (#2666) and find out what we're all about!

Time is Ticking for Illinois Admininstrator License Renewal and CEUs

Illinois nursing home administrators who haven't already renewed their licenses might need to hurry up. The two-year renewals, issued through the Illinois Department of Financial and Professional Regulation, are due November 30.

Administrators renewing their licenses are required by law to obtain 36 CEUs between December 1, 2007 and November 30, 2009. Administrators who obtained their first administrator's license after December 1, 2007 will be allowed to renew their licenses without the CEUs, but they will have to get the CEUs for future renewals.

Information on how to renew a license can be found here. Licenses can be renewed online using a Visa, Mastercard or Discover card.

Aggressive Osteoporosis Prevention Plans Could Drop Hip Fracture Rate by 25%

A study at Kaiser Permanente found that more active disease management could potentially cut the rate of hip fractures in the U.S. by at least 25%. The study, published in the Journal of Bone and Joint Surgery, found that the key to this prevention is orthopaedic surgeons taking a more active role in osteopororis disease management.

The current rate of treatment after a fragility fracture is only 20%. Comparatively, treatment at Kaiser Permanente in Southern California is now 68%. Kaiser Permanente's Healthy Bones Program identifies at-risk patients using Kaiser Permanente HealthConnect, the world's largest civil electronic health record database. A multidisciplinary team, including orthopedic surgeons and providers from endocrinology, family practice, internal medicine, rheumatology, gynecology, physical therapy, disease/care management, radiology and nursing education ensures that at-risk patients get the bone density screenings and medications they need.

“The most important thing an orthopedic surgeon should know about osteoporosis/fracture prevention is that we can take action that helps to prevent hip and other fragility fractures,” said Dr. Richard Dell, the study's lead author. “Simple steps like suggesting calcium and vitamin D for all your patients and bone mineral density testing in patients at higher risk for osteoporosis should be considered part of your daily practice.”

Help Noah Have a Special Last Christmas

We're touched by Noah Biorkman's story. This five-year-old has terminal cancer and isn't expected to survive through the holidays. His family is trying to gather as many Christmas cards as possible for him to help make his last Christmas special. Can you send a card and bring a smile to his face? Cards can be sent to:

Noah Biorkman

c/o 99.5 WYCD

2201 Woodward Heights Blvd.

Ferndale, MI 48220-1511

(photo: wycd.com)

Unused Medicines: To Flush or Not To Flush?

The FDA recently launched a new Web page designed to let consumers know which unused medicines are safe to toss out with the trash and which need to go down the sink or toilet.

According to the site, almost all medicines can be safely thrown out with household trash after they are mixed with something unpalatable (i.e., kitty litter or used coffee grounds) and sealed in a container such as a plastic bag. However, there are some medicines that are especially harmful or even fatal in a single dose if they are taken by someone other than the person for whom the medicine was prescribed. These medicines should be flushed down the toilet or rinsed down the sink to eliminate the possibility that they could be swallowed by a child, pet or other household member.

You can also contact your local government to find out if your community has a drug take-back program and which drugs are accepted.

Click here for a list of drugs that the FDA recommends flushing. You can also visit Drugs @ FDA for specific drug labeling product information. Click here for Drugs @ FDA.

New MRSA Strain Is Deadlier, More Focused on Elderly

Researchers at Henry Ford Hospital have found that a particular strain of MRSA is five time more lethal than other strains - and it seems to be targeting older patients.
The strain is also more resistant to vancomycin, the potent drug used to treat MRSA.

The average age of patients with the strain, known as USA600, is 64. The average age of patients with other MRSA strains is 52. According to the study, USA600 has unique characteristics that could possibly be linked to the high mortality rate. The study found that 50 percent of patients who were infected with the strain died within 30 days, compared to 11 percent of patients with other strains of MRSA.

The majority of MRSA infections occur in hospitals and other healthcare settings, but a growing number are being acquired by otherwise healthy people outside of those settings.

NAWC Launches Redesigned, Reinvigorated Web Site

The National Alliance of Wound Care has launched its redesigned Web site, and it's packed to the gills with timely, valuable info for wound care certified (WCC) nurses.

One of the site's hottest additions is its Job Resource Center, which allows users to post their CVs anonymously for employers who are looking to hire WCCs. It also offers a glimpse at open positions.

Other site features include:
- A new look and user-friendly design
- Instant WCC certification verifications
- A networking search that connects WCCs
- Answers to FAQs
- Links to wound care resources
- Downloadable handbooks for certification and recertification candidates

America's Best Nursing Homes Named

U.S. News & World Report has released its annual ranking of America's Best Nursing Homes. How does your facility measure up?

Residents Have Achy Knees? Try Tai Chi!

A recent study conducted at Tufts revealed that tai chi can reduce pain and improve physical function, self-efficacy, depression and health-related quality of life for seniors with knee osteoarthritis.

The study examined 40 patients with a mean age of 65, all of whom had knee osteoarthritis. The subjects who were randomly assigned to 60 minutes of tai chi twice weekly for 12 weeks reported a significantly greater reduction in pain than those assigned to the control group.

Congrats to Gary Hill, a Team ProMed First-Time Grandfather!

Team ProMed would like to congratulate Gary Hill, Senior Key Accounts Manager, on becoming a first-time grandfather! His grandson, Landyn, was born on October 30 and weighed in at 8 pounds, 7 ounces. His proud parents are Meghan and Brent Miller.

Congratulations to Gary and Landyn's entire family!

Happy Halloween from ProMed!

A Few Simple Tips to Keep Halloween from Playing Tricks on Your Health

Taking a few simple precautions on Halloween can help prevent your evening of treats from playing tricks on your health.

Face paint is the perfect accessory for lots of costumes, but could it be hazardous to your health? The Campaign for Safe Cosmetics recently released a report titled Pretty Scary: Could Halloween Face Paint Cause Lifelong Health Problems? The report detailed researchers' scary findings from testing 10 different face paint products that are widely available via the Internet or in craft or Halloween stores. All 10 face paints contained low levels of lead, and six out of 10 contained the potent allergens nickel, chromium and/or cobalt. The Campaign for Safe Cosmetics is recommending that face paints be avoided until safety standards are put into place.

Trick-or-treating can also be "tricky" for kids with food allergies. Food manufacturers are required to disclose, in plain English, the top eight food allergens (milk, egg, wheat, peanut, tree nut, soy, fish and shellfish) as the source of ingredients in their products, but there are no regulations regarding advisory labeling (such as "May Contain").

Studies have shown that consumers with food allergies are increasingly ignoring advisory labels or misunderstand the risks associated with terms such as "shared equipment," "shared facility" or "may contain."

The Food Allergy & Anaphylaxis Network offers a safe trick-or-treating alternative for children with food allergies. Their Trick-or-Treat for Food Allergy encourages children to obtain special bags to use while trick-or-treating for coins instead of candy. The funds that are raised are put toward FAAN's food allergy education and and research programs.

From all of us here at ProMed, have a safe and fun Halloween!

MDS 3.0 Is Still On Track!

It's been a few years in the making and it'll be another year before it's completely rolled out - but MDS 3.0 is right on track. At the AANAC Fall Education Forum, held in Baltimore on October 22 and 23, Mary Pratt, MSN, RN, Peggy Williams, SW, MS and Sheila Lambowitz, MBA led a session titled "CMS Updates." They told attendees that MDS 3.0 continues to meet its benchmark dates and that that CMS expect to release an updated RAI manual by October 31, 2009.

To view CMS's MDS 3.0 implementation timeline, click here.

New AMA Site Makes Sense of Coughs and Sniffles

The American Medical Association (AMA) has created AMAfluhelp.org to help the sniffling and coughing public quickly figure out if their symptoms are serious and suggest the best course of action.

Users are invited to create a free account and are then able to subscribe to personalized, interactive Health Session Programs. Program topics include:

• Child Assessment: H1N1 flu and children under 18
• Am I high risk for H1N1 and need the vaccine>
• Adult Self Assessment: Do you have the H1N1 flu?
• H1N1 Post Vaccine Monitoring
• Pregnancy: Do you need the H1N1 flu vaccine?
• H1N1 Flu: Can I return to school or work?

The site also allows users to create their own "Health Team" by inviting their family and caregivers to keep tabs on the user's health. Once team members accept this invitation, they can use the Health Team Message Center to receive reports and notifications on the user's health. The team members can also post messages and recommendations.

Another feature on the site is the Personal Health Record, which is compatible with Microsoft's HealthVault. This feature allows users to connect to their pharmacies and get a direct deposit of their latest medication list, receive lab results and immunization records electronically and store X-rays and EKGs. Users can also upload, store and graph measurements from home blood pressure monitors, glucose meters and other devices.

Check out the site and all of its features here.

Abbott Nutrition Opens New R&D Center at U of I Research Park

Abbott Nutrition - a ProMed strategic partner - will soon open a new facility at Research Park on the University of Illinois campus. They plan to use the facility to research and develop nutritional products for infants through adults.

In the beginning, the company will be collaborating with students and faculty from the College of Agriculture, Consumer and Environmental Sciences (ACES) at U of I. They plan on starting with 11 student interns as well as full-time management.

Companies who set up shop at Research Park are attracted to the opportunity to team up with faculty and students year-round to supplement their R&D operations. To learn more about the new Abbott Nutrition Research Park location, click here.

Blair Expands Chenille Product Recall

Blair LLC, in conjunction with the Consumer Product Safety Commission, has issued an expanded recall of its chenille products after reports of the items catching fire. The company first issued a recall of 162,000 chenille robes in April of 2009 amid reports of the robes catching on fire while being worn, including several incidents that resulted in death. After this initial recall, the company learned of four additional deaths allegedly linked to the robes catching fire while being worn by elderly women in their 70s and 80s. So far, a total of nine deaths have been reported to Blair, all of which occurred before the product recall in April.

Blair has expanded the recall to include all chenille products from A-One Textile & Towel of Pakistan. This includes the following products:

• Full Length Women’s Chenille Robes
• Women’s Chenille Jacket
• Women’s Chenille Lounge Jacket
• Women’s Chenille Top

Blair has since severed ties to A-One. To learn more about the recall, including specific product item numbers, click here.

CMS Issues a Heads-Up on DMEPOS; ProMed is Prepared

CMS is currently sending notification letters to beneficiaries who might need to change suppliers in order for Medicare to continue paying for their equipment and supplies. Certain durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) dealers were required to meet Medicare's quality standards and become accredited by October 1 and obtain a surety bond by October 2, 2009. According to CMS, the new supplier requirements "will help to ensure that people with Medicare get high-quality medical items and services from qualified suppliers while helping to prevent fraud in the Medicare program."

Beneficiaries are urged to contact their suppliers to find out if they have been approved by Medicare. If a beneficiary's supplier has not been approved, that person will need to shop around for a Medicare-approved supplier in order for their equipment and supplies to be covered.

ProMed is a Medicare-approved supplier. Our customers will not encounter any interruption in services.

FDA: Power Cords Linked to Sparking, Charring and Fires

On October 19, The FDA announced that they are investigating defective medical device power cords. So far, the FDA has received 122 reports of defective power cords from Hospira, Inc. and Abbott Nutrition. These two companies have reported sparking, charring and fires from the cords in question. The root of the problem appears to be the power cord's prongs cracking or failing at/or inside the plug (see the FDA-released image above). The risks associated with power cord failure include electrical shock, delay in setup and therapy, interruption of therapy, device failure and fires. The FDA also notes that, depending on the device and therapy, these failures might lead to serious health consequences, including death.

All 122 of the reports from Hospira and Abbott involved AC power cords manufactured by the Electri-cord Manufacturing Company. The FDA knows Electri-cord has supplied cords to other medical device manufacturers and the agency is currently trying to determine which additional devices are equipped with these cords. While the FDA's investigation continues, the agency is recommending that all users of medical devices closely monitor the wear and tear on these devices' power cords. It's especially important to pay close attention to to any devices used in oxygen-rich settings in which sparking and arcing could trigger a fire.

To view the cord in question and learn more about actions that should be taken in the event of cord failure, click here. The FDA will continue to provide updated information as soon as it is available.

We're All "Pumped Up" to Meet with Medela

ProMed's Sales Education and Training (SET) team is being in-serviced and trained on application and use for Medela's negative pressure wound therapy products today! We're looking forward to discussing how these products can benefit residents who have wounds with high exudate.

CDC: Start Antiviral Treatment ASAP for Hospitalized Patients with Suspected Flu

The CDC's message is clear: time is of the essence. They're recommending that any patient hospitalized with suspected flu begin receiving antiviral medication immediately. According to the CDC, "Treatment should not wait for laboratory confirmation of influenza because laboratory testing can delay treatment and because a negative rapid test for influenza does not rule out influenza." Antiviral medications can reduce the severity and duration of influenza as well as influenza-related complications, including severe illness and death.

Do You REALLY Need N95 Respirators? YES!

The CDC wants healthcare providers to know that not just any mask is going to do if you find yourself face-to-face with H1N1. In fact, they recommend that "all healthcare personnel who enter the rooms of residents in isolation with confirmed, suspected or probable novel H1N1 influenza should wear a fit-tested disposable N95 respirator or better." In addition, Flu.gov, which is maintained by the Department of Health & Human Services, is advising personnel that N95 respirators should be removed and appropriately discarded once they've been worn in the presence of a resident with pandemic flu.

Why We Support Repealing Competitive Bidding

On October 13, Representative Kendrick Meek (D-FL) introduced House Resolution (H.R.) 3790, which aims to repeal competitive bidding for durable medical equipment and prosthetics, orthotics and supplies (DMEPOS) in a budget-neutral manner.

We support the bill because we believe that the current competitive bidding program is broken. If it is allowed to continue on, we have no doubt that it will drive reputable suppliers out of business and all but eliminate market-based competition. What’s even scarier is that this could limit product choice and access for Medicare’s frailest and sickest patients.

The current competitive bidding program is awarding business to an overwhelming number of out-of-area companies, inexperienced businesses and illegitimate bidders. While a re-bid is scheduled to begin this month, Medicare hasn’t made sufficient changes to fix the program’s problems.

H.R. 3790 is budget-neutral , and Representative Meek has outlined a strategy for delivering the same cost savings as the competitive bidding program without limiting access to care.

If you’d like to learn more about H.R. 3790, please click here.

Welcome!

Welcome to Growing Together in Health Care, Professional Medical's official blog. Since 1968, ProMed has been a dedicated supplier to the long-term care industry. On this blog, we'll be keeping tabs on current issues in health care and helping you find ways to improve care, save time and reduce costs.