Tips for Preventing Heat-Related Illnesses at Your Facility

With sweltering heat blanketing much of the country, now is a great time to take the following simple steps to get your facility summer-ready and help protect your residents from heat-related illnesses.

• Make sure that the temperature in your facility is safe and comfortable. 
• Keep residents indoors in the air conditioning during heat waves. 
• Close blinds or curtains to keep direct sunlight from entering rooms. 
• Turn off unneeded lights (they emit heat). 
• Use extra circulating fans to keep air moving within your facility. Avoid using fans directed at individuals when the ambient temperature exceeds 100 degrees Fahrenheit. 

Supreme Court Rules in Favor of "Obamacare"

This morning, the Supreme Court upheld the controversial Affordable Care Act, or "Obamacare." CNN is providing continually updated coverage of the decision. To read the latest, click here. 


Here's a brief overview of the key points in today's decision:

• The SCOTUS ruled 5-4 to uphold the individual mandate (Justices Roberts, Ginsburg, Sotomayor, Kagan and Breyer ruled in favor of upholding the law. Justices Kennedy, Alito, Thomas and Scalia were against it). Chief Justice Roberts was the swing vote.  
• They ruled that the requirement to have insurance is a tax, and therefore is constitutional (the requirement had previously been challenged under the Commerce Clause, which Chief Justice Roberts wrote in his opinion did not apply). According to Roberts’ majority opinion: “It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance. Such legislation is within Congress’ power to tax.”
• The federal government may not take Medicaid funds from the states that refuse to take part in the ACA. (This is a limited ruling – in its opinion, the SCOTUS offered the government a way to remedy this potential problem. Basically, they didn’t strike down the federal government’s right to force states to expand their share of Medicaid costs and administration, but they’re acknowledging that there’s going to be a fight.)
•   Perhaps the biggest take-away: The SCOTUS has affirmed that the President and Congress have power to regulate an important issue like health care.
•  Interestingly, the opinion notes that the SCOTUS “Does not express any opinion on the wisdom of the Affordable Care Act.”

The Straight Poop: Fecal Transplants Curing C. diff Infections?

Some doctors are introducing a rather unusual weapon into their arsenal of weapons for fighting stubborn, drug-resistant C. diff - feces.

Fecal bacteriotherapy - more popularly called "fecal transplants" - allow a donor's healthy fecal bacteria to help restore balance to the bowels of some infected with C. diff. During the procedure, stool from a healthy donor is emulsified, usually mixed with water or saline and then transferred via a nasal tube or enema to the gut of a seriously ill C. diff patient.

C. diff tends to develop when the typical gastrointestinal flora is disturbed, usually by overuse of certain antibiotics. C. diff rates in healthcare settings have skyrocketed recently, climbing more than 200 percent between 1996 and 2009 in people older than 65. Of those infected, between 20 and 50 percent will end up with hard-to-treat, recurrent infections.

To learn more about the procedure, click here. To learn more about how this procedure is being used in our own backyard, click here.

Hepatitis C Now Kills More Americans than HIV

According to the CDC, Hepatitis C has surpassed HIV as a killer of American adults. Hepatitis C, a liver infection caused by a virus of the same name, is typically spread through contact with contaminated blood. Frighteningly, about half of infected people do not know that they have the virus.¹

Roughly 50 percent of current cases of Hepatitis C are tied to injection drug use. Three percent of baby boomers, many of whom used drugs in their twenties and thirties before needle safety campaigns began to appear, are infected.¹


The good news is that Hepatitis C treatment has made great strides. Two new drugs have been licensed in the past year and approximately 70 percent of cases can be cured using an intense three-drug therapy that takes 24 weeks.² Success, however, depends on individuals being screened and treated in time. Since Hepatitis C doesn’t cause symptoms until serious damage has already been done, early screening is crucial. 

The CDC notes that when Hepatitis C is spread in healthcare settings, it is usually due to unsafe injection practices; reuse of needles, fingerstick devices and syringes and other lapses in infection control. To help prevent the transfer of Hepatitis C, as well as other bloodborne pathogens, the CDC recommends that healthcare workers adhere to standard precautions and fundamental infection control practices, including safe injection practices and the use of appropriate aseptic techniques.²

Reference
1 TIME. Q&A: What You Need to Know About Hepatitis C. Available at: http://healthland.time.com/2012/02/23/qa-what-you-need-to-know-about-hepatitis-c/. Accessed June 21, 2012.

2 Centers for Disease Control and Prevention. Health Care Settings and Viral Hepatitis. Available at: http://www.cdc.gov/hepatitis/Settings/HealthcareSettings.htm. Accessed June 21, 2012.

"Obamacare" Ruling Coming on Thursday

The Supreme Court didn't release a ruling on "Obamacare" today, which almost guarantees that the ruling will come down on Thursday, the Court's last day in session. There are three potential outcomes on the table:

1. The law is upheld in its entirety
2. The law is stuck down in its entirety
3. Something in between

At any rate, it's safe to say that the eyes of the nation are on the Supreme Court this week! 

CNA, Nursing Aide Demand to Boom by 2025

A new report out of Georgetown University's Center on Education and Workforce found that the demand for CNAs and nursing aides is going to explode by 2025, growing faster than any other group of healthcare workers.

By 2025, 15 million Americans will need some form of long-term care, according to the report. The researchers suggest providing more educational opportunities and chances for advancement, along with giving the jobs more autonomy and flexibility, as ways to draw more people to these historically lower-paying jobs.

To learn more, click here.

Loud Traffic, Heart Attacks Linked

Want to pare down your heart attack risk? Move far, far away from loud traffic.

Researchers in Denmark have found that for every 10 decibels of added roadway traffic noise, the risk of a heart attack rises by 12 percent. Traffic noise during the night is especially dangerous because it disturbs sleep.

The researchers recommended sleeping in rooms with low exposure to traffic noise and insulating houses against noise.

To learn more, click here.

Lonely Seniors at Higher Risk of Decline, Death

Research from the National Institute on Aging shows that seniors who describe themselves as being lonely have a 59 percent greater risk of physical decline (defined as the inability to complete daily activities) and a 45 percent increased risk of death. 

The investigators found that loneliness was not necessarily tied to living alone. Of the 1,604 seniors who were surveyed, 43 percent said that they felt lonely, but only 18 percent lived alone. 

To learn more, click here. 

When Should Residents Be Weighed?

According to Tag F325, nursing home residents should be weighed on admission (or readmission) to establish a baseline weight, weekly for the first four weeks after admission and then at least monthly thereafter to identify and document any trends, such as insidious weight loss.¹

In order to obtain the most accurate readings, CMS recommends that staff use a consistent approach to weighing residents. This includes¹:

• Using an appropriately calibrated and functioning scale
• Weighing a resident at the same time each day (since weight can fluctuate throughout the day)
• Ensuring residents are wearing the same type/weight of clothing when weighed each day
•  Using the same scale for each weigh-in
• Making sure that residents are consistently either wearing or not wearing orthotics or prostheses when weighed

When weighing residents, keep in mind that fluctuations can be caused by factors such as current medical conditions, recent changes in dietary intake and edema.1

Reference

1 Centers for Medicare & Medicaid Services. State Operations Manual. Appendix PP – Guidance to Surveyors for Long Term Care Facilities (Rev. 70m 01-07-11). Available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf. Accessed June 19, 2012. 

No "Obamacare" Decision Yet; Expected Next Week

The U.S. Supreme Court justices released their latest set of decisions today - but a ruling on "Obamacare" wasn't among them.

With next Thursday, June 28, being the last day of the Supreme Court's current session, legal and political communities are expecting a ruling any day. It's anticipated that the justices will hand down additional decisions this Thursday as well as Monday and Thursday of next week.

Historically, the court has saved its most controversial and momentous rulings for the final day of the term. Many anticipate that "Obamacare" will follow that pattern.

Happy Father's Day!

Father's Day is this Sunday, June 17! How are you planning to celebrate in your facility?

Medicaid Fraud Detection Program Comes Up Short

According to a Government Accountability Office investigation, the federal program tasked with detecting Medicaid fraud costs more to operate than it has recovered in overpayments.

Since 2008, the Medicaid audit program has cost $102 million to operate and only identified $7.4 million million in overpayments. The report characterized close to two-thirds of the 1,550 audits of state records as "unproductive."

Click here to read the GAO report.

ProMed Independence Day Closure Notice

Professional Medical will be closed on Wednesday, July 4 in honor of Independence Day. All Wednesday deliveries will be made on Thursday, July 5. Customers who typically order on Wednesday for Thursday delivery will need to place their orders by noon on Monday, July 2.

If you have any questions or concerns, we invite you to contact our Customer Care team at 800.648.5190. 

More Healing, Less Pain: PolyMem®

When you choose PolyMem, you're picking a dressing that combines four key wound healing capabilities into one easy-to-use formulation. PolyMem wound dressings cleanse, fill, absorb and moisten wounds throughout the healing continuum. 

How does PolyMem...

• Cleanse? PolyMem contains a mild, non-toxic cleanser activated by moisture that is gradually released into the wound bed. These built-in cleansing abilities reduce the need to cleanse wounds during dressing changes, so caregivers can avoid disrupting the growth of healthy tissue as the wound heals.
• Fill? PolyMem gently expands to fill and conform to the wound.
• Absorb? PolyMem is able to absorb up to 10 times its weight in wound exudates. Depending on wound status, PolyMem allows up to seven days between dressing changes. This can lead to substantially lower labor and dressing costs.
• Moisten? PolyMem keeps the wound bed moist and contains glycerin to soothe traumatized tissue, reducing wound pain and providing comfort. The moisturizer also helps prevent dressing pads from adhering to the wound, so removal is painless.

PolyMem's family of dressings can be used on all wound types as primary dressings, secondary dressings or both to support the entire healing process. To learn more about PolyMem, visit our website.

Please Join Us in Supporting the Barnes Foundation

Professional Medical is proud to support the fundraising efforts of the Barnes Foundation, including their upcoming "Cocktails for a Cause" event on September 28. We hope you'll "like" the Barnes Foundation Facebook page to learn more about this exciting event as details become available! You can also learn more about the Barnes Foundation and purchase Cocktails for a Cause tickets by visiting the organization's website. 

Falls, CNA Staffing Levels Connected

New research has shown that the fall risk for newly admitted, short-stay nursing home residents is tied to CNA staffing levels.

The researchers analyzed MDS assessments for more than 230,000 such residents in 2006 and found that 21 percent of them experienced a fall within 30 days of being admitted. Facilities that had higher CNA-to-resident ratios had fewer falls.

The researchers theorize that new residents are more likely to fall partially because they are unfamiliar to staff who may not have conducted fall-risk assessments.

To learn more, click here.

Shingles Recurrence Low among Elderly, Regardless of Vaccination Status

Here's some good news for elderly adults who have been unfortunate enough to come down with shingles: a new study shows that it's unlikely they'll have a recurrence, regardless of whether or not they've been vaccinated. (Shingles, a painful, blistering skin rash, is caused by the same virus that causes chickenpox.)

Researchers at Kaiser Permanente found that the risk of recurring shingles is not as high as previous research indicated. The researchers analyzed health records of more than 6,000 people over the age of 60 who had shingles and then monitored them over a two-year follow-up period. At the end of the two years, the researchers had observed fewer than 30 recurrent cases, with very little difference in the rate of recurrence among vaccinated and unvaccinated seniors.

The CDC recommends that adults age 60 and older be vaccinated against shingles.

To learn more, click here.

CMS Creates Office of Information Products and Data Analysis (OIPDA)

CMS has announced the creation of the Office of Information Products and Data Analytics (OIPDA). This goal of this new entity is to maximize CMS data for both internal and external users.

According to CMS, OIPDA will ensure consistent implementation of policies related to data release and dissemination. The office will also update the suite of CMS data and information products and serve as the point of contact for external data requests.

Additionally, the office will ensure the privacy and security of personal health information while they simultaneously improve access to, and use of, CMS data and information resources.

To learn more, click here.

Keeping Dignity at the Forefront of Care

As you go through your routine each day, are you mindful of resident dignity? Tag F241 reminds us that "The facility must promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality."¹

Respecting residents' dignity can include actions as simple as helping them attend activities of their own choosing or making sure to label clothing on the inside rather than the outside. 

Here are some other examples cited in F241¹:

• Grooming residents according to their wishes (for example, clipping their nails, shaving or trimming their facial hair and shampooing and styling their hair)
• Encouraging residents to dress in their own clothes, appropriate to the time of day and according to their personal preferences (and assisting them as needed)
• Promoting independence and dignity in dining by doing the following:
• Limiting day-to-day use of plastic cutlery and paper or plastic dishes
• Using bibs (also known as clothing protectors) by resident request (otherwise, use napkins)
• Sitting with residents while helping them eat rather than standing over them
• Staff talking to residents, rather than each other, while helping residents eat
• Respecting residents' private space and property
• Speaking respectfully and addressing residents by the names of their choosing
• Refraining from posting signs in resident rooms that display confidential clinical or personal information (these signs may be posted in more private locations, such as inside a closet)
• Keeping residents sufficiently covered when they are taken to areas outside their rooms, such as the bathing area 
• Refraining from potentially demeaning practices, such as keeping urinary catheter bags uncovered, refusing to help with toileting during meal times and restricting residents from using common areas open to the public (unless they are on isolation precautions or are restricted according to care planned needs)

When in doubt, simply ask yourself: 
How would I want to be treated if I was the person receiving care? 


Reference
1 Centers for Medicare & Medicaid Services. State Operations Manual: Appendix PP – Guidance to Surveyors for Long Term
Care Facilities (Rev. 70, 01-07-11). Available at: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/
som107ap_pp_guidelines_ltcf.pdf. Accessed June 5, 2012. 

Medicare DME Competitive Bidding Program Under Fire

Investigators at the California Institute of Technology are warning that Medicare's competitive bidding program for durable medical equipment (DME) is intrinsically flawed and likely to fail.

Under the plan, skilled nursing facilities that need DME supplies can purchase them only from companies that submit the lowest bid to, and are approved by, CMS. The investigators are warning that this could force participants to submit low-ball bids, pushing prices down so low that the companies would have to cancel their offers.

If this were to take place, the researchers warn, the government could end up negotiating prices with individual companies, which negates the whole purpose of a competitive-bidding program.

To learn more, click here.

Affordable Care Act to Fund Aging and Disability Resource Centers

The Affordable Care Act, AKA "Obamacare," has designated $52 million to help keep seniors, disabled individuals and veterans in their homes rather than long-term care facilities.

The funds will be used to establish Aging and Disability Resource Centers (ARDCs), which are meant to be a "one-stop shop" for elderly and disabled people who would like to receive care in their homes and communities rather than enter a facility. The ARDCs will provide counseling services for those looking for access to services such as:

• Transportation to rehabilitation therapy
• Home health 
• Support with activities of daily living 

In addition, the Veterans Health Administration will contribute $27 million over three years to help disabled veterans in ARDC-funded states remain in their homes.

To learn more, click here.