ProMed Holiday Closure Reminder

Professional Medical will be closed on Monday, December 31 and Tuesday, January 1 in celebration of the new year. 

If you have any questions or concerns, we invite you to contact our customer service team at (800) 648-5190.

We wish you and yours a safe and happy celebration and look forward to our continued partnership in 2013.

State Regulators Seek FDA Regulation of Compounding Pharmacies

State regulators are requesting that the FDA regulate compounding pharmacies in the wake of the recent fungal meningitis outbreak.

The regulators would like the FDA to establish federal definitions for both manufacturers and compounding pharmacies, with the most important task being defining the exceptions.

Traditionally, compounding pharmacies make custom medications for patients in response to a prescription. In the case of the meningitis outbreak, the New England Compounding Center produced large amounts of medication without individual prescriptions. So far, the outbreak has led to the deaths of 39 people. A total of 620 people have been affected.

To learn more, click here.

Santa Claus Goes Global

Sinterklaas

Here in the United States he's known as Santa Claus, but the jolly man in the red suit takes on many different names and roles around the world. 

The Netherlands: Known as Sinterklaas, the Dutch version of Santa reportedly lives in Spain during the off season. He takes a steamboat to Holland in mid-November and spends three weeks delivering presents to good children. Naughty children don't get gifts, though. Instead, according to legend, Sinterklaas kidnaps them and takes them back to Spain! 

Italy: Le Befana is a friendly holiday witch who delivers goodies to children on either Christmas or Epiphany (January 6). Unlike Santa, she prefers wine over milk and cookies and Italian parents often leave her a glass to enjoy during her stop. A Santa Claus figure, known as Babbo Natale, is also becoming more popular in Italy. 

Russia: Ded Moroz, or Grandfather Frost, looks a lot like the Santa we know in the U.S., but he also carries a magical staff and travels with his granddaughter Sengurochka, or Snow Girl. The pair plan New Year's Eve parties for Russian children and hand out gifts.

Mexico: While Santa Claus does travel to Mexico to hand out gifts, they're also distributed by El Nino Dio (Baby Jesus). Depending on the region, either Santa or El Nino Dios may bring the bulk of the gifts.

Sweden: Jultomten, Sweden's answer to Santa Claus, is actually a hybrid of Santa, Julbocken (a Swedish Christmas goat) and a garden gnome. Jultomten visits homes on Christmas Eve and asks "Are there any good children here?" before unloading gifts from his pack. 

Medicaid Underpayment to Grow to $7 Billion by End of 2012

A new report shows that Medicaid underpayments are expected to exceed $7 billion by the end of 2012, averaging out to a shortfall of $22.34 per resident day. In 2010, that figure was $18.54. The report was commissioned by the American Health Care Association (AHCA).

The following factors are likely to keep the situation from improving in the future:

• Dual-eligible integration, which will likely have implications for both Medicaid long-stay residents and Medicare-paid post-acute care average length of stay
• Reduced occupancy rates driven by government-encouraged expansion of home- and community-based services
• Managed care plans for Medicaid beneficiaries

To learn more, click here. 

Reminder: ProMed Holiday Closure Notice

Professional Medical will be closed on Monday, December 24 and Tuesday, December 25 in honor of Christmas. Orders that are placed by noon on Friday, December 21 will be delivered by Friday, December 28.

We invite you to call our customer service team at (800) 648-5190 with any questions or concerns.

We wish you and yours a safe and happy holiday!

Songs for Your Facility Christmas Celebration

The American Society of Composers, Authors and Publishers (ASCAP) named the following as the top 10 most-performed Christmas songs. You'll want to make sure they're on the soundtrack for your facility holiday party!

1. "The Christmas Song (Chestnuts Roasting On an Open Fire)"
2. "Have Yourself a Merry Little Christmas"
3. "Winter Wonderland"
4. "Santa Claus is Coming to Town"
5. "White Christmas"
6. "Let It Snow! Let It Snow! Let It Snow!"
7. "Jingle Bell Rock"
8. "Little Drummer Boy"
9. "Sleigh Ride"
10. "Rudolph the Red Nosed Reindeer"

To view the complete list, click here. 

Meet Cliff, the C. Diff Sniffing Dog

The British Medical Journal has reported that a beagle named Cliff was successfully trained to detect C. diff in stool samples in a lab environment.

Cliff was trained to either sit or lie down when he detected C. diff. He was tested on 100 C. diff positive and negative stool samples and was able to identify all the positive samples and 47 out of 50 negative samples. He was also taken to two Dutch teaching hospitals and taken through wards, where he identified 25 out of 30 cases of C. diff in patients and 265 out of 270 negative controls.

To learn more and see a video of Cliff working, click here.

Our Thoughts Are With Connecticut

Our hearts go out to all of those impacted by the devastating school shooting in Connecticut. We hope that the community is able to find strength in the worldwide support it is receiving and is, in time, able to heal.

With Deadline Approaching, Only 15 States Plan to Set Up Healthcare Exchanges

States have until tomorrow to notify the federal government of whether they plan to operate health insurance exchanges, a key provision of President Obama's healthcare reform law. So far, only 15 states are planning to do so, but that number is expected to rise to 18. This means that the government will be left to set up exchanges in at least 30 states.

The exchanges would allow individuals to purchase private coverage from online exchanges at federally subsidized rates. The administration in planning on beginning to enroll families via the exchanges beginning October 1, 2013. The insurance coverage would begin on January 1 of 2014.

According to the Congressional Budget Office, the administration estimates that approximately 26 million people will eventually purchase coverage through the exchanges.

To learn more, click here.

Navigating Sweets and Alcohol with Diabetes During the Holidays

The holidays are a great excuse for spending lots of time with friends and loved ones, but those visits often come with an abundance of sweets - and alcohol. This can spell trouble for people with Type 2 diabetes.

HealthGrades recommends the following six strategies for keeping your blood sugar in check during the holidays:

1. Make sure to eat before drinking any alcohol. Try to choose complex carbs and proteins that will be digested and release sugar into your bloodstream slowly.
2. Check out everything on the snack table and then make a conscious decision about what you'll eat. 
3. Remember that if you eat dessert, you'll need to cut carbs from other places in your meal. 
4. Keep a nonalcoholic beverage on hand. 
5. Dilute your drinks for a lower alcohol content (for example, add club soda to wine). 
6. Check your blood sugar before going to bed to avoid nighttime low blood sugar.

To learn more, click here.

Kudos to Elmhurst Extended Care

Team ProMed congratulates Elmhurst Extended Care! The facility had a zero-deficiency survey that was completed on December 7.

VA Expands Benefits for Vets with Traumatic Brain Injuries

The Department of Veterans Affairs has announced that a number of conditions associated with traumatic brain injuries will be eligible for expanded benefits, including Parkinson's disease, unprovoked seizures, some dementias, depression and hormone deficiency diseases related to several glands. The new proposal could open the door for thousands of veterans to file treatment claims with the Veterans Benefits Administration.

There are some restrictions to the additional benefits. Veterans who suffer from Parkinson's, unprovoked seizures, dementias and hormone deficiency diseases will only qualify for additional benefits if their traumatic brain injuries are diagnosed as moderate or severe (only about one-fifth of the injuries are diagnosed at those levels). The proposal also puts time limits on claims related to dementia, hormone deficiency and depression.

To learn more, click here.

Surgeon Implants "Pacemaker" In Brain of Alzheimer's Patient

In a surgery that was the first of its kind in the U.S., a surgeon at Johns Hopkins implanted a pacemaker-like device in the brain of an Alzheimer's patient in the early stages of the disease.

The device, which has also been used in Parkinson's disease patients, is designed to help boost memory and reverse the mental deterioration of Alzheimer's patients. It provides deep brain stimulation and low-voltage electrical charges.

Approximately 40 Alzheimer's patients are expected to receive the device implant both at Johns Hopkins and other facilities across North America.

To learn more, click here.

Be On the Lookout for Abbott’s New Safety Screw Connector System

Abbott Nutrition has introduced a new Ready-to-Hang Safety Screw Connector System that was designed to help reduce the risk of potential misconnections. The Piercing Pin Set currently on Ready-to-Hang containers will be phased out. Abbott Ready-to-Hang containers will begin shipping with the new connector system in mid-December.

Abbott spike sets that are currently being shipped include a Transition Set adaptor that will work with both the old and new systems as the change is completed. To use the adaptor, simply unscrew the existing cap on the Ready-to-Hang bottle and replace it with the Transition Set.

To learn more about the new Ready-to-Hang Safety Screw Connector System, click here. Abbott has also created this video to help you understand and prepare for the modifications.

CDC: Flu Season Earliest In Nearly a Decade

According to the CDC, the flu season is already in full swing in some areas of the US. Tennessee, Mississippi, Alabama, Louisiana and Texas have already reported high levels of flu activity.

Typically, the flu season peaks after the holidays and sometimes as late as February or March. The CDC noted that this is the earliest regular flu season that the US has seen since the 2003-'04 season.

The earlier onset of the flu season might mean that a number of people haven't received their flu vaccines yet. The CDC recommends the flu vaccine for everyone six months and older.

To learn more, click here.

Congressman Wants Tougher Bed Rail Regulations

Representative Edward J. Markey (D-MA) is calling for increased government regulation on bed rails in the wake of a report that notes 550 people have died from bed rail entrapment since 1995. A quarter of those deaths occurred in a nursing home or assisted living facility.

Markey is asking the FDA, FTC and Consumer Product Safety Commission to create a national task force that will increase regulation of bed systems and bed rails.

To learn more, click here.

Nurse Practitioner Groups Merge, Seek More Active Role in Caregiving

The American Academy of Nurse Practitioners and the American College of Nurse Practitioners have announced that they will merge into one group, effective January 1, 2013, and will henceforth be known as the American Association of Nurse Practitioners.

The new group, which will have a membership of 40,000, hopes to become more involved in the formation of future caregiving models and expand the role of the nurse practitioner. However, the American Academy of Family Physicians has resisted the idea of allowing non-physicians to to take on more primary-care practices or certain other expanded roles, arguing that the training and education levels between the two groups are simply too different.

To learn more, click here.

Traditional Survey Changes Go Into Effect Tomorrow

As of December 1, a number of revisions to the traditional survey process will go into effect. The changes, which were first announced on September 27, include the following:

• Revisions to Appendix P of the State Operations Manual (including changes to MDS 3.0, new Quality Measures Reports and updates to CMS forms 672, 802, 802S and 802P)
•  Revisions to Chapter 9 of the State Operations Manual
• New Quality Measures Reports for use in the traditional survey process

Registered users of The Perfect Survey, ProMed’s exclusive online survey preparation tool, have access to all of the newly updated forms as well as additional information on the adjustments to the survey process. We will also address these changes during this month’s complimentary Perfect Survey webinar, which is scheduled for 11:30 a.m. on December 13. To learn more about The Perfect Survey and register for the webinar, click here.

To read the complete memo from CMS regarding the traditional survey changes, click here.  

ProMed and PolyMem Want to Give You a Free CEU Credit

ProMed and PolyMem have teamed up to offer nurses and wound care clinicians one free continuing education contact hour! The CEU is issued by the Wound Care Education Institute, an accredited continuing education provider.

The free online course, which was originally presented at the Wild on Wounds 2011 Conference, is titled "Improved Wound Care Outcomes with Polymeric Membrane Dressings." Here is a course description: 

In this session, you will examine the unique actions of the Polymeric membrane dressings which help to reduce the spread of edema, inflammation and pain into surrounding undamaged tissues without interfering with the robust localized inflammatory response required for healing. The dressings help reduce both persistent and procedural wound pain, which improving wound healing. 

To register for the free course: 

• Go to www.polymem.com and click on "Improved Wound Care Outcomes with PolyMem Membranes Dressings CEU Webinar." 
• Complete the mini-registration form. 
• Once the form is completed, a coupon code will appear along with a link to the full registration page. Be sure to write down your coupon code!
• After you have registered, you can access the online course at any time. 
• Once you have completed the course, you will receive your Certificate of Ongoing Education via email. 

Seniors Are Sleeping Better Than Previously Thought

The common beliefs that seniors go to bed early and have a tough time sleeping through the night aren't true for most elderly people, according to a new study.  

Researchers at the University of Pittsburgh’s Sleep and Chronobiology Center (SCC) and University Center for Social and Urban Research (UCSUR) found that more than half of all retired people aged 65 and older reported sleeping at least 7.5 hours a night between the hours of 11 p.m. and 7:30 a.m.

 “Our findings suggest that in matters regarding sleep and sleepiness, as in many other aspects of life, most seniors today are doing better than is generally thought,” said Timothy Monk, Ph.D., D.Sc., the study’s lead author.

The researchers’ findings led them to believe that sleep issues in seniors depend more on the overall health of the individual rather than that person’s age. They also noted that daytime sleepiness is more likely to be related to medications, illnesses and poor nocturnal sleep, not necessarily age.

To learn more, click here. 

ProMed Holiday Closure Notice

Professional Medical will be closed on Monday, December 24 and Tuesday, December 25 in honor of Christmas. Orders that are placed by noon on Friday, December 21 will be delivered by Friday, December 28.

We will also be closed on Monday, December 31 and Tuesday, January 1 in honor of the new year. Orders placed by noon on Friday, December 28 will be delivered by Friday, January 4.

We invite you to call our customer service department at (800) 648-5190 with any questions.

We wish you and yours a safe and happy holiday season!

Generic Lipitor Recalled Over Glass Particles

Ranbaxy Pharmaceuticals Inc. has recalled more than 40 batches of its generic version of Lipitor after warning that the medication might contain small particles of glass.

The recall applies to to bottles of 10-, 20- and 40-milligram tablets of atorvastatin calcium, the generic version of Lipitor. According to a statement from Ranbaxy, "The recall is being conducted at the retail level for such select batches that may contain a foreign substance (small glass particles less than 1 mm in size). Ranbaxy is proactively recalling the drug product lots out of an abundance of caution, and in keeping the safety of our customers in mind."

To view a full list of the recalled lots, click here.

To learn more, click here.

ProMed Thanksgiving Closure Notice

Professional Medical will be closed this Thursday, November 22 and Friday, November 23 in honor of Thanksgiving. If you placed an order with us after noon on November 16, it will be delivered to your facility the week of November 26.

We invite you to call our Customer Care team at (800) 648-5190 with any questions or concerns. From our team to yours, have a safe and happy Thanksgiving! 

CMS Announces 2013 SNF Co-Insurance Amounts

On Friday, CMS released the 2013 co-insurance amounts for skilled nursing care services as well as the new inpatient hospital deductible amount.

For 2013: 

• The inpatient hospital deductible will be $1,184 (up $28 from 2012)
• The daily co-insurance amount will be $286 for days 61-90 of a benefit period
• For the twenty-first through hundredth days of extended care services in a SNF, the co-insurance amount will be $148 
• The standard monthly Part B premium rate for all enrollees will be $104.90 (up $5 from 2012)
• For all Part B beneficiaries, the Part B deductible will be $147 

To learn more, click here. 

Savor the Worldly Flavors of Thanksgiving

Since Thanksgiving was first celebrated in America in 1621, many other cultures have added their own flavorful spin to the celebration, making it into a veritable melting pot of delicious flavors. Here are just a few examples:

• Poland: In addition to turkey, many Polish American families serve kielbasa, meatballs in mushroom gravy, pierogi and other favorites.
• Hawaii: Thanksgiving turkey is frequently cooked in an imu, an in-ground oven, or marinated in the Chinese Char Siu style with red beans, honey and soy sauce.
• Africa: The turkey is typically heavily spiced and couscous might take the place of mashed potatoes. Collard greens with bacon is a popular side dish.
• China: Many Chinese families celebrate Thanksgiving by going out for dim sum and choose bao, soft dough-filled buns, over the traditional pumpkin pie. Roast duck is also a common dish on Chinese Thanksgiving tables.
• France: Roasted guinea hens are a nod to the traditional cuisine of rural France.
• Italy: The turkey stays front and center on many Italian tables, but it might be seasoned with a more traditional seasoning blend, such as juniper berries, rosemary and sage. Sausage stuffing is also popular.
• Mexico: On many tables, a suckling pig replaces the traditional turkey.

Why not ask your residents how their families put their own personal spin on Thanksgiving? You might come up with some great new dishes to try!

Alexian Village Achieves Perfect Survey

Team ProMed congratulates Alexian Village in Milwaukee on achieving their second consecutive perfect survey! We're proud to be your partner in health care.

Study: Diabetics Need to Be Tested Earlier for Hearing Impairment

A new study in the Journal of Clinical Endocrinology & Metabolism is recommending that people with diabetes be screened for hearing impairment at a younger age than non-diabetics. The authors note that an earlier diagnosis could lead to a lower incidence of dementia and depression.

"The association of hearing impairment with diabetes is controversial, but it is believed that over time, high blood glucose levels can damage vessels in the stria vascularis and nerves, diminishing the ability to hear," said Chika Horikawa, the study's lead author.

To learn more, click here.

Happy World Diabetes Day!

Today, November 14, is World Diabetes Day! The World Diabetes Day campaign is led by The International Diabetes Foundation and its member associations.

Established in 1991, World Diabetes Day puts diabetes in the public spotlight and draws attention to issues that are important to the diabetes community. The theme of this year's World Diabetes Day is "Diabetes: Protect Our Future."

November 14 was selected as the annual date for World Diabetes Day because it is the birthday of Frederick Banting, who, along with Charles Best, is credited with the discovery of insulin.

To learn more, click here.

Total Hip Replacement Patients More Likely to Have Strokes Post-Surgery

A study out of the Netherlands has found that individuals who undergo total hip replacements are four times more likely to suffer a hemorrhagic stroke and five times more likely to suffer an ischemic stroke in the weeks following surgery.

The rates are highest in the two weeks following surgery and decline quickly thereafter, evening out after six to 12 weeks. The study's authors urge caregivers to conduct stroke risk assessments for total hip replacement patients during the first six to 12 weeks post-surgery.

The authors noted that further studies are needed to better understand the results.

To learn more, click here.

COPD Can Worsen During the Winter

As winter creeps in, people with chronic obstructive pulmonary disease, or COPD, are more likely to experience disease flare-ups involving increased coughing and other exacerbated symptoms. This is partially due to the respiratory viruses (such as colds and flu) that make the rounds when weather turns cold.

HealthGrades recommends taking the following steps to avoid wintertime flare-ups:

• Protect yourself from respiratory infections by staying away from sick people, practicing good hand hygiene and getting vaccinated against flu and pneumonia (check with your doctor before receiving the vaccines). 
• Shield yourself from the cold by checking the weather before going outdoors (keep a close eye on wind chill). If you can, stay inside when it gets very cold outside. If you must go out, wear a knit scarf or mask around your face and mouth as well as a hat, mittens and multiple layers of loose-fitting clothing topped with a weatherproof jacket. 
• Stay away from aggravating elements, including secondhand cigarette smoke, smoke from wood-burning stoves, chemical fumes and dust. It's also a good idea to have your furnace checked to make sure it isn't leaking irritating particles. 
• See your doctor regularly throughout the cold months and follow his or her suggestions on caring for yourself. 

To learn more, click here.

Private Nursing Home Rooms Now Average $90,520 a Year

According to a new report, the average annual charge for a private room at a nursing home has climbed to $90,520. This is a 3.7 percent increase over last year's figure.

Semi-private rooms rose 3.7 percent to $81,030 and assisted living residency was up 2.1 percent to $42,600.

Over the past five years, costs for a private room in a nursing home have gone up by an average of 4 percent annually. Semi-private room increases have averaged 3.8 percent a year and assisted living costs saw a 4.1 percent annual jump.

To learn more, click here.

Long Shifts Lead to Unhappy Patients, Nurse Dropouts

A new study has found that nurses who work long shifts (10 hours of more) are two and a half times more likely to leave the profession than nurses who work shorter shifts. These nurses are also more likely to have dissatisfied patients.

The study's authors suggested imposing restrictions on nurse shift length and voluntary overtime. They also recommended that nurse manager monitor which nurses are working second jobs.

To learn more, click here.

CMS Encourages Some MA Beneficiaries to Re-Evaluate Options

CMS has sent letters to beneficiaries of 26 poorly performing Medicare Advantage (MA) plans encouraging them to re-evaluate their options. This is a result of the agency's increased focus on quality ratings.

The letters, which were sent over the course of the past week, address the beneficiaries by name and alert them that their plans have been listed as "poor" or "below average" as a result of earning fewer than three stars under Medicare's five-star rating system for three years running.

Back in October, the agency forbade one of the low-performing MA plans from enrolling new members. Similar actions for other low-rated plans are expected.

To learn more, click here.

Happy Election Day!

Regardless of party affiliation, we've all been counting down to November 6. Chances are, your residents share your Election Day enthusiasm. Research has shown that there was a decline in voter turnout between 1960 and 1998 for every age group other than those over 65. In fact, seniors are 60 percent more likely to vote than young people and 10 percent more likely to vote than the national average.^1,2 

Once your residents have cast their votes, why not have an Election Day party at your facility?

Here are some ideas to get you started.  Place red, white and blue decorations in a common room (this is a great opportunity to get extra mileage out of your Fourth of July decorations). Many people enjoy watching the results come in, so make sure you have plenty of comfortable seating around the largest television in the facility. The results can take a while, so ensure you have healthy snacks and drinks on hand. Encourage the residents to discuss their favorite political memories. To get things going, ask them who won the presidential election the first time they voted. Create or download a list of candidates for your local election (these lists are typically available on your county's website) so that residents can keep track of the winners. However you choose to celebrate, keep the mood lighthearted – politics can spark a lot of heated discussions and the goal here is for everybody to have fun!  References 1 U.S. Department of State. The Senior Vote in the 2012 Election. Available at: http://fpc.state.gov/190787.htm. Accessed November 1, 2012.  2 America.gov. Senior Citizens Most Reliable Group of U.S. Voters. Available at: http://www.america.gov/st/usg-english/2008/September/200809171649211xeneerg0.88995.html. Accessed November 1, 2012.

Superstorm Sandy Leaves Health Risks Behind

If you or a loved one live in an area affected by Superstorm Sandy, there are a number of health risks to keep in mind in the aftermath of the storm:

1. Reduce your risk of carbon monoxide exposure by avoiding using appliances such as generators or stoves indoors to heat your home. 
2. Keep in mind that floodwater may contain bacteria that can cause gastrointestinal diseases. Be sure to throw out any food that was touched by floodwater or sewage. You should also toss any food or drinks that were not properly refrigerated. 
3. Stay away from downed power lines and assume that all power lines are live. 
4. Wear gloves and protective glasses during cleanup to protect yourself from hand and eye injuries. 
5. Avoid letting mold develop by getting water-damaged items dried and removed. 
6. Check with your local department of health before drinking tap water to ensure that you are not under a boil order. (Most of the tap water across the New York area is safe to drink, but some areas, such as Long Beach City in Nassau County, are having problems.)
7. Chronic health conditions, such as diabetes and high blood pressure, might be exacerbated in the wake of Superstorm Sandy. Don't skip taking your medications. 

To learn more, click here. 

Red Cross Seeking Help in Wake of Hurricane Sandy

The Red Cross is mobilizing to help the victims of Hurricane Sandy and there are a number of ways that you can help aid in their efforts. 

To donate:

• Visit www.redcross.org
• Call 1-800-RED-CROSS 
• Text the word REDCROSS to 90999 to make a $10 donation

You can also mail donations to your local Red Cross chapter or to the American Red Cross at P.O. Box 37243, Washington, DC 20013. 

The Red Cross is also urging people to donate blood and platelets. The storm has caused the cancellation of a number of blood drives in the region and blood products are greatly needed. To schedule a blood donation, visit redcrossblood.org or call 1-800-RED-CROSS. 

ProMed Thanksgiving Closure Notice

Professional Medical will be closed on Thursday, November 22 and Friday, November 23, 2012 in honor of Thanksgiving.

Orders that are placed by noon on Friday, November 16 will be delivered by Wednesday, November 21. Orders placed after noon on November 16 will be delivered the week of November 26.

We invite you to call our Customer Care team at (800) 648-5190 with any questions or concerns.

From our team to yours, have a safe and happy Thanksgiving!

Scare Up Some Halloween Fun at Your Facility

Has Halloween crept up on you? Don't be spooked! We have lots of ideas to help you create a memorable celebration at your facility.

Have a pumpkin decorating contest
Talk to local farmers in your area to see if they would be willing to donate small pumpkins for a pumpkin decorating contest. Gather interested participants and provide them with an array of non-toxic paints, markers and other decorative elements (while some residents might still possess the dexterity needed to carve a pumpkin with a knife, paints and markers are a safer choice). Have residents vote for their favorite pumpkin and award a prize to the winner. 

Show a scary movie
Your residents might enjoy watching spooky movies that were popular when they were younger. Many of these movies are available on DVD at your local library. Alfred Hitchcock films, such as Psycho, The Birds and Rear Window, are sure to be crowd pleasers. For additional ideas, click here to view the American Film Institute's "100 Years…100 Thrills" list.

Celebrate with healthy treats
Traditional Halloween goodies are packed with sugar, making them a bad choice for your diabetic residents. The American Diabetes Association suggests swapping out candy for beloved fall flavors, such as low-sugar apple and pumpkin goodies, broth-based soups and vegetarian chili.

How are you celebrating Halloween at your facility? Head over to our Facebook page and tell us!

How Hurricane Sandy Affected East Coast LTC Facilities

The American Health Care Association has been in contact with LTC facilities on the East Coast that were affected by Hurricane Sandy and has these preliminary findings to report:

• About 900 residents were evacuated from facilities in New Jersey 
• 180 nursing home residents were moved from a facility in Long Island to one in Nassau County that was unaffected by the storm 
• Nursing homes in Westerly, Rhode Island and Waterbury, Connecticut also chose to evacuate their residents

To learn more, click here. 

NY DOH Issues Guidance To LTC Facilities On Preparing for Hurricane Sandy

With Hurricane Sandy barreling toward the East Coast, the New York Department of Health (DOH) has issued storm guidelines for healthcare facilities in the state.

The agency emphasizes that facilities should focus on making plans for residents who are dependent upon electrical equipment, including ventilators, dialysis units and oxygen concentrators.

They also recommend the following:

• Check that generators are functioning properly 
• Ensure that your facility has adequate fuel
• Make sure that you have adequate food and water supplies 

To learn more, click here. 

Aspirin May Extend Survival for Colon Cancer Patients

Aspirin's benefits have long been touted, and now it appears that we can add another one to the list. A new study in the New England Journal of Medicine reports that aspirin can help prolong the lives of colon cancer patients - specifically, patients whose tumors had a mutated form of the PIK3CA gene.

Of the patients with the mutated gene who took aspirin, 97 percent were alive five years after receiving their colon cancer diagnosis. Only 76 percent of those with the mutation who didn't take aspirin were alive.

Colon cancer is the third leading cause of cancer-related deaths in the United States when men and women are considered separately. When they are grouped together, it is the second leading cause of cancer deaths.

To learn more, click here.

Green Tea Tied to Reduced Digestive System Cancers in Older Women

A study of more than 69,000 Chinese women found that older women who regularly drink green tea might have slightly lower risks of developing digestive system cancers.

The women, who drank green tea at least three times a week, were 14 percent less likely to develop colon, stomach or throat cancer.

The researchers also refer to "strong evidence" from other animal and human studies that seemed to point to green tea having the potential to fight cancer.

Green tea is considered safe in moderate amounts, but the tea and its extracts do contain caffeine, which some people need to avoid. Green tea also contains small amounts of Vitamin K, which can interfere with warfarin and other drugs that prevent blood clots. Older people are encouraged to talk to their doctors before using green tea as a health tonic.

To learn more, click here.

Fight Infections with Hand Hygiene

Infections are a major problem in long-term care facilities, with an estimated 1.6 to 3.8 infections per resident occurring annually. These infections account for up to half of all nursing home resident transfers to hospitals.¹

Infectious organisms can be transmitted either through direct contact (e.g., skin to skin) or indirect contact (for example, through air, water or inanimate objects).¹ One of the easiest and most effective ways to halt infections is through proper hand hygiene. 

Depending on the situation, hand hygiene can include either washing the hands with soap and water or using an alcohol-based hand sanitizer. According to the CDC, alcohol-based hand sanitizers are appropriate for use when hands are not visibly soiled and before having direct contact with residents.² 

In addition to establishing hand hygiene policies and procedures for your employees, you might also want to consider placing hand sanitizer in high-traffic areas of your facility, where interaction among staff, residents, family members and guests can increase the likelihood of germ transmission. Hand sanitizers are also now available in convenient touch-free dispensers, which can be mounted on stands and placed throughout the building. Touch-free dispensers have been shown to increase hand hygiene compliance by 20.8 percent.³ 

Your ProMed territory manager is ready to talk to you about creating a comprehensive hand hygiene program! Give us a call at (800) 648-5190 or visit us online at www.promedsupply.com.

References
1 Centers for Medicare and Medicaid Services. State Operations Manual. Appendix PP – Guidance to Surveyors for Long Term Facilities (Rev. 70, 01-07-11). Available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf. Accessed August 16, 2012. 

2 Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR.2002;51(RR-16). 

3 Larson EL, Albrecht S, O'Keefe M. Hand hygiene behavior in a pediatric emergency department and a pediatric intensive care unit: comparison of use of 2 dispenser systems. Am J Crit Care. 2005 Jul;14:304-11; quiz 312. 

Falls: Which Residents Are At Risk?

Falls can happen in a split second. While they can’t always be prevented, it’s important to know which of your residents are at an increased fall risk.

According to the CDC, residents are more likely to fall if they have the following traits^1:

•   Have muscle weakness and walking or gait problems (these residents account for almost a quarter of all falls in nursing homes)
• Take medications, including sedatives and anti-anxiety drugs
• Have difficulty moving from one place to another
• Have poor foot care or poorly fitting shoes
• Use walking aids improperly or incorrectly

Environmental risks, including wet floors, poor lighting, incorrect bed heights and improperly fitted or maintained wheelchairs, can also contribute to falls.

The CDC recommends implementing a fall prevention strategy that includes a combination of medical treatment, rehabilitation and environmental interventions that should be undertaken at the organizational, staff and resident levels. To learn more, click here.

Reference

1 Centers for Disease Control and Prevention. Falls in Nursing Homes. Available at: http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html. Accessed October 8, 2012. 

Study: Residents Successfully Taking Risperdal Should Stay On It

Despite a recent push by regulators and LTC groups to reduce the use of antipsychotics in nursing homes, researchers are cautioning that taking residents off Risperdal might actually do more harm than good.

The study, published in the New England Journal of Medicine, noted that when dementia care residents were switched from taking Risperdal to taking a placebo, they were twice as likely to relapse compared to residents who remained on the medication. Additionally, the researchers found that the rates of side effects or death were not any higher in those who continued taking Risperdal.

To learn more, click here.

Get to Know Your Support Surfaces

		Support Surface	Type of Support*	Description
		Solid foam	Static	Porous polymer material that conforms according to applied weight
		Gel-infused foam	Static	Provides the support and conformity of foam with the addition of gel that allows for rapid heat dissipation and better breathability
		Convoluted foam (i.e., channel-cut or "egg crate" foam)	Static	Cuts in the supportive foam create a pressure-reducing, anti-shear surface
		Gel	Static	Semisolid (can range from soft to hard) with elastic, pressure-redistributing properties
		Alternating pressure mattresses and overlays	Dynamic	Provides pressure redistribution by cycling through loading and unloading via inflation and deflation
		Low air loss	Dynamic	Provides a flow of air to assist in managing the skin’s heat and moisture

Gel and foam and air, oh my! There are a lot of support surfaces on the market and it can be tricky to match your residents with the product that best fits their needs. We created the chart above to help you weigh your options.¹ Keep in mind that these components can bused alone or in combination. 

* Static pressure redistribution devices are non-powered devices that may be indicated when a resident is at risk for pressure ulcer development or delayed healing. Dynamic pressure reduction surfaces are powered devices that are indicated if a resident can't move into a variety of positions without placing weight on a pressure ulcer, if their weight completely compresses a static device that otherwise maintains its original integrity or if they have a pressure ulcer that is not healing as expected and it is determined that the pressure could be contributing to the delay.


Reference
1 National Pressure Ulcer Advisory Panel. Terms and Definitions Related to Support Surfaces. Available at: http://www.npuap.org/wp-content/uploads/2012/03/NPUAP_S3I_TD.pdf. Accessed October 3, 2012.

Norovirus Mortality, Hospitalizations Linked to Low Staffing Levels

A new report has linked low staffing levels and negative outcomes related to norovirus outbreaks in long-term care facilities.

Researchers at the University of Chicago studied 308 nursing homes that reported a total of 407 norovirus outbreaks to the National Outbreak Reporting System (NORS) between January of 2009 and December of 2010. They found that facilities with lower nurse-hour-to-bed ratios were most at risk for increased mortality and hospitalizations during norovirus outbreaks. An increase in mortality during outbreak periods was limited to homes with less than 0.75 daily registered nurse (RN) hours per bed.

Residents older than 90 experienced the greatest increase in hospitalization and mortality during the norovirus outbreaks.

to learn more, click here.

FDA Encourages Healthcare Providers to Contact Patients Who Received Injectables from NECC in Wake of Fungal Meningitis Outbreak

The FDA is recommending that medical professionals reach out to any patient who was administered an injectable product distributed by the New England Compound Center (NECC). This comes on the heels of a fungal meningitis outbreak being tied to steroids distributed by the NECC.

At this point, the fungal meningitis has been traced to injections of  methylprednisolone acetate as well as triamcinolone acetonide. NECC has issued a recall of all of its products (to view the list of affected products, click here).

Since the outbreak began, the FDA has has been conducting an ongoing investigation into contamination at  NECC, which is located in Framingham, Massachusetts. As a result of this investigation, they have recommended that healthcare professionals retain NECC products, secure them and withhold them from use. They are also advising them to follow up with any patient who received an injectable drug from NECC and asking them to be on the lookout for symptoms of possible infection, including fever, swelling, increasing pain, redness, warmth at the injection site, chest pain, drainage from the surgical site, visual changes and redness or discharge from the eyes. If patients notice any of these symptoms, they should contact a healthcare provider immediately.

At this time, the FDA is not urging patient follow-up for those who received non-injected NECC drugs, such as lotions, creams, suppositories and eye drops not used in conjunction with surgery.

To learn more and stay up to date on any new developments, click here.

Breast Cancer Myths Debunked

In honor of October being National Breast Cancer Month, we're taking a look at some breast cancer myths that were debunked in an article on Health.com.  Some of them might surprise you!

Myth: Family history is the biggest risk factor for breast cancer.
Fact: The vast majority of women who have breast cancer have no family history.

Myth: Most breast lumps are cancerous.
Fact: About 80% of lumps found in breasts are benign.

Myth: All women have a one-in-eight chance of getting breast cancer.
Fact: Risk of developing breast cancer actually rises as we age. A woman who is in her 30s has about a one-in-233 chance. This rises to one-in-eight by the time she reaches 85.

Myth: Small-breasted women have a lower risk of breast cancer.
Fact: There's no connection between breast size and developing breast cancer.

Myth: Breast cancer presents in the form of a lump.
Fact: You should be alert for other signs of breast cancer, including swelling, skin irritation or dimpling, breast or nipple pain, nipples turning inward, discharge and redness, scaliness or thickening of the nipple or breast skin.

The article addresses 25 common myths and we've only addressed a few of them. Click here to read the article in its entirety.

Generic Version of Wellbutrin Pulled Off the Market

The FDA has asked Teva Pharmaceuticals to pull its generic version of the popular antidepressant Wellbutrin  XL 300 mg off the market after discovering that the generic version releases its key ingredient faster than the original drug.

The generic version, Budeprion XL 300 mg, was pulled after hundreds of reports that the drug did not work or caused side effects including headaches, anxiety and insomnia.

There are four other generic versions of Wellbutrin XL 300 mg that have been approved by the FDA.

To learn more, click here.

FDA Approves Actemera for Earlier Stages of RA

The FDA has widened the approved use of rheumatoid arthritis drug Actemera to include patients who are in earlier stages of treatment for the disease. Previously, Actemera was approved for patients who were not helped by use of TNF inhibitors (such as Humira and Embrel).

To learn more, click here.

Healthcare Sector Adds 43.5K Jobs in September

According to new data from the Bureau of Labor Statistics (BLS), the healthcare sector added 43,500 jobs in September 2012. Of those jobs, 5,700 were at skilled nursing facilities.

In the past year (ending in September 2012), healthcare has added a total of 294,000 jobs, up 2.1 percent over the previous year.

To view the full report from the BLS, click here.

CDC Launches Online Healthcare-Acquired Infection Tracking Tool

The CDC's National Healthcare Safety Network (NHSN) has launched a new online tracking tool designed to help nursing homes monitor healthcare-acquired infections, or HAIs. HAIs are a serious problem in the long-term care setting with staggering statistics¹:

• 1 to 3 million serious infections occur every year in long-term care
• As many as 380,000 residents die every year from the HAIs they contract
• Infections are one of the most common reasons that residents are admitted to hospitals 

By using the tracking tool, the CDC expects that nursing homes will be better able to identify problems, implement preventive measures and monitor their progress in halting infections. Right now, the tracking tool is available to record data on C. difficile, MRSA and other drug-resistant infections as well as urinary tract infections. In addition to capturing data, the online tool also offers access to forms, protocols, training information and additional resources for preventing HAIs. Facilities can begin using the program by enrolling here. 

The NHSN's website notes that submitted data will be used to help gauge progress toward meeting national HAI reduction goals. To learn more, click here.

Professional Medical offers a complete line of infection prevention products, including the new CaviWipes1^™, which are effective in killing 99.9% of bacteria, viruses and fungi in one minute. To learn more, contact your ProMed territory manager, visit us at online at www.promedsupply.com or give us a call at (800) 648-5190.
Reference
1 Centers for Disease Control and Prevention National Healthcare Safety Network. Tracking Infections in Long-term Care Facilities. Available at: http://www.cdc.gov/nhsn/LTC/index.html. Accessed September 26, 2012.

Study: Tomatoes May Lower Stroke Risk

According a new study published in the journal Neurology, eating tomatoes can help reduce your risk of a stroke. Why? They contain a powerful antioxidant, lycopene, that promotes brain health.

According to Jouni Karppi, the study's author, "A diet containing tomatoes...a few times a week would be good for our health. However, daily intake of tomatoes may give better protection." The study noted that cooked tomatoes seem to offer better protection than raw.

To learn more, click here.

Botox, Oral Drugs Both Effective in Treating Incontinence in Women

Researchers at Loyola University in Chicago have found that both Botox injections and oral drugs known as anticholinergics are effective in reducing urinary incontinence in women.

Women in the study were divided into two groups. One group received Botox injections in their bladders as well as a placebo pill. The other group received a daily oral anticholinergic. On average, the women who were treated with Botox reduced the daily frequency of their incontinence episodes by 3.3 For the anticholinergic group, this figure was 3.4. Overall, 27 percent of women who received the Botox treatment and 13 percent of the women taking the anticholinergics saw their symptoms resolve completely.

Both groups also reported quality of life improvements.

To learn more, click here.

90% of Seniors Happy with Medicare Part D

According to a new survey, about 90 percent of seniors are happy with Medicare's prescription drug program. This includes seniors who have dual eligibility for both Medicare and Medicaid. Seniors with dual eligibility typically have multiple chronic illnesses and make up a large percentage of nursing home residents.

The 90 percent satisfaction rate has risen 12 percentage points over Medicare Part D's seven-year life.

Medicare Recipients Choose Nursing Homes Over Hospices for End-of-Life Care

According to a new study, nearly one-third of Medicare beneficiaries choose to stay in nursing homes over hospices for end-of-life care because Medicare doesn't cover room and board at hospices.

The study's authors believe that Medicare's nursing home benefits should cover palliative and hospice care: "Perhaps having Medicare pay concurrently for post-acute SNF care and hospice services for the same condition could allow earlier incorporation of palliative care for these medically complex patients."

To learn more, click here.

CDC: Cancer Patients, Survivors Need the Flu Vaccine

October is National Breast Cancer Awareness Month - and it's also the beginning of fall, when flu starts to crop up.

While cancer patients and survivor are not more likely to get the flu, they are at an increased risk of complications if they do, including pneumonia, hospitalization and even death. The CDC recommends that cancer patients and survivors get the flu vaccine (they should receive the shot, not the nasal spray).

Cancer patients and survivors are also advised to contact their healthcare providers immediately if they experience flu-like symptoms.

To learn more, click here.

Medicare Hospital Readmission Fines Begin Today

Beginning today, Medicare will start to fine nearly two-thirds of hospitals that have high numbers of patients readmitted within 30 days for heart attacks, heart failure and pneumonia. On average, the penalties will costs hospitals about $125,000 a year.

The fines are currently capped at 1 percent of a hospital's Medicare payments for the first year, but they will eventually rise to 3 percent under the Affordable Care Act.

To learn more, click here.

FDA Launches BeSafeRx to Raise Awareness of Unsafe Internet Pharmacies

The FDA has launched BeSafeRx: Know Your Online Pharmacy, a national campaign aimed at raising awareness of Internet pharmacies and their potential risks to consumer health.

According to the FDA, some Internet pharmacies may sell fake, expired, contaminated, non-FDA-approved or otherwise unsafe products.

According to BeSafeRx, the following should raise red flags about online pharmacies:

• Allow you to buy drugs without a prescription from your doctor
• Offer deep discounts or cheap prices that seem too good to be true
• Send spam or unsolicited email offering cheap drugs
• Are located outside the United States 
• Are not licensed in the United States 

The BeSafeRx site also contains a state-by-state directory of safe online pharmacies. 

To learn more about BeSafeRx, click here. 

Knee Replacement Surgery Rate Soars

The number of first-time knee replacement surgeries among Medicare recipients has jumped 162 percent in the past 20 years, according to a new study out of the University of Iowa. The surge in surgeries has cost Medicare roughly $9 billion annually.

The researchers also found increases in the number of hospital readmissions and infection rates, which they attributed to shorter hospital stays after surgery.

The jump in knee replacement surgeries was attributed to an increase in obesity rates and a rapidly aging baby boomer population.

To learn more, click here.

AHRQ Develops Pilot Program to Allow Patients, Families to Report Medical Mistakes

The Agency for Healthcare Research and Quality (AHRQ) has developed a pilot program that would allow patients and their families to report medical mistakes directly to the federal government. The agency is hoping to gain approval for the project from the Obama administration.

The AHRQ hopes that issues such as medication errors, uncommunicative doctors and nurses, poor collaboration between providers, infections, failure of clinicians to disclose a mistake and unsanitary conditions would be reported. The claims would then be researched by the RAND Corporation and ECRI Institute.

The concerns could be reported through online or phone questionnaires.

To learn more, click here.

COPD Linked to Low Blood Oxygen Levels, Poor Sleep

Researchers have found that people with chronic obstructive pulmonary disease, or COPD, are more likely to have low arterial blood oxygen levels as well as fatigue, sleepiness and an impaired quality of life.

The research team also found that individuals with COPD have a more difficult time getting to sleep and have more interrupted sleep. These sleeping troubles are likely tied to the low arterial blood oxygen levels (also known as daytime hypoxemia).

To learn more, click here.

High Normal Blood-Sugar Levels Can Lead to Brain Shrinkage

A new study has found that blood-sugar levels that are at the upper end of the normal range can still be detrimental to the brain.

Being on the high end of the normal range - in other words, not high enough to be classified as diabetes or prediabetes - can make somebody more likely to have brain shrinkage in certain areas than people with lower blood-sugar levels. Previous studies had linked Type 2 diabetes to brain shrinkage.

The researchers noted that their findings could lead to the reevaluation of normal blood-sugar levels and the definition of diabetes.

The study involved 249 people, aged 60 to 64, whose blood-sugar levels were in the normal range as defined by the World Health Organization (WHO).

To learn more, click here.

Scientists Link Second-Hand Smoke to Memory Problems

The results of a small study have linked exposure to second-hand smoke to memory problems. This could lead to embarrassment as well as more serious complications, such as forgetting to take medication. 

The researchers added that while the study doesn't prove that smoke damages memory, it is nonetheless cause for concern. 

According to Tom Heffernan, the study's lead author, "This research extends what is already known about the effects of smoking and second-hand smoke, suggesting there is not only health effects from it, but cognitive consequences too." He added that the researchers are looking to confirm their findings using other methods as well. 

To learn more, click here.