CMS Expands DMEPOS Competitive Bidding Program

After a successful first year, CMS has announced that it will expand its Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) competitive bidding program.

The next round will begin on July 1 and will expand the program from nine non-metropolitan areas to 91 areas, including Chicago, Los Angeles and New York City.

CMS noted that the program has resulted in savings for beneficiaries, taxpayers and the Medicare program. Under the terms of the program, fee schedules were replaced by prices determined through competitive bidding. 

Round two products include oxygen equipment, wheelchairs and walkers, CPAP devices and negative pressure wound therapy pumps, among other items. 

According to CMS, the bidding process has not resulted in any adverse clinical impacts on beneficiaries, although several groups have said it's caused service interruptions in facilities.

To learn more, click here.

South Korean Robot Sniffs Out Soiled Briefs, Deodorizes Air

How's this for innovation? South Korean researchers have developed a robot that deodorizes the air after it detects the scent of soiled briefs.

Known as KIRO-M5, the robot stands three feet tall and weighs 175 pounds. It can carry supplies, sterilize and deodorize the air and alert nursing staff when residents need their briefs changed. It also performs daily wake-up calls, informs residents when food is served, schedules their daily exercise and has an alarm function that is triggered in the event of an emergency.

KIRO-M5 wanders the halls and keeps a safe distance from residents and obstacles by utilizing bumper sensors, an obstacle-detecting laser and ultrasonic range finders. At night, its front-facing camera provides an extra set of eyes to nursing staff.

To learn more, click here.

Resolve to Move Forward in 2013

The end of January is typically when well-meaning New Year’s resolutions start to fall apart, but we know one resolution you’re keeping: making your facility an even better place for your residents to call home. To help you, we’ve created a list of five resolutions along with ways that ProMed can make them happen!

1. Ask your distributor partner about resources to help you save time and money.

Professional Medical’s exclusive online Role Management tool was designed to help both single homes and chains manage and control spending on multiple levels. Users can also access budget reports at the corporate, facility and department levels.

If you’re looking to identify the areas in which you have the greatest opportunities for trimming costs, ask your ProMed territory manager about our unique Per Patient Day (PPD) reports. This monthly analysis, broken down by resident day, provides you with baseline data to gauge savings potential.

2. Check out product innovations.

As technology advances, manufacturers have been able to introduce products designed to provide even better care for your residents and an improved user experience. A few examples:

• Poly exam gloves were recently introduced to the market. These gloves provide tactile sensitivity that is superior to vinyl and are easy to don, even with wet hands. Handling tapes and wound dressings is a breeze as well since adhesive materials don’t stick to the gloves.
• Dynamic Elite mattresses feature Visco Gel Technology (VGT) to provide optimized pressure redistribution, rapid heat dissipation and vast increases in breathability compared to standard foam.
• PolyMem wound care dressings can be used on all types of wounds as primary dressings, secondary dressings or both to support the entire healing process. The easy-to-use dressings cleanse, fill, absorb and moisten wounds.

3. Resolve to have a perfect survey.

If you haven’t seen the survey results that you want but aren’t sure how to take your preparation efforts to the next level, take a look at Compliance Solutions: For the Perfect Survey Every Day. Our exclusive online survey preparation tool puts a wealth of resources right at your fingertips. It’s ideal for preparing for both the QIS and traditional survey!

The Perfect Survey program pairs perfectly with Compliance Continuing Education, a collection of educational offerings that covers more than 20 wide-ranging categories. The courses are appropriate for the majority of your nursing staff, including nurses, CNAs and licensed nursing home administrators.

4. Implement an effective skin care program.

Protecting your residents’ delicate skin from breakdown can be a challenge. Professional Medical’s exclusive Embrace skin care products are formulated with best-in-class ingredients and are designed to work together as a system to cleanse, moisturize and protect.

•  Cleanse: Choose from no-rinse Embrace Moisturizing Cleanser & Skin Protectant with Breathable Barrier, Embrace Perineal Foam Cleanser or Embrace Sensitive Skin Caring Washcloths with Breathable Barrier. The washcloths can also be paired with our other cleansers.
•   Moisturize: Embrace Skin Repair Cream isn’t your typical lotion. It’s a whole-body moisturizer that nourishes and rejuvenates skin while forming an invisible protective layer with dimethicone.
•  Protect: Embrace Skin Protectant with Breathable Barrier features organic aloe vera, chamomile and dimethicone to moisturize, freshen and soothe delicate skin.

5. Beef up your infection control program.

It’s easier than ever to follow proper hand hygiene and infection control protocols. The Purell Sanitizing Station combines a touch-free dispenser with a sturdy, moveable stand that’s ideal for use in high-traffic locations. If you’re looking for a fast, effective way to clean the surfaces in your facility, check out our Super Sani-Cloth Germicidal Wipes. They offer a fast contact time and broad coverage of microorganisms.

To learn more about any of the products or programs mentioned in this article, give us a call at (800) 648-5190 or visit us online at www.promedsupply.com. 

Poll: Public Opposes Medicare Cuts

According to a new national poll, the majority of Americans are against cutting Medicare spending to reduce the national deficit. The poll was conducted by the Harvard School of Public Health, the Robert Wood Johnson Foundation and the Kaiser Family Foundation.

The poll found that:

• Two-thirds of respondents favor quick governmental action to reduce the deficit, but more than 70 percent felt this could be done without drastic Medicare cuts.
• 85 percent of respondents opposed across-the-board Medicare premium increases. 
• 85 percent of respondents said they would support legislation to push drug companies to lower the costs of medications for seniors, which would save the Medicare program money. 
• 60 percent of respondents felt the Medicare program is working well (80 percent of senior respondents felt this way). 
• Just over half of respondents opposed raising the Medicare eligibility age from 65 to 67. 
• Just over half of respondents felt that their states should expand Medicare under an optional provision of the Affordable Care Act. 

To learn more, click here. 

Vicious New Strain of Norovirus Taking Aim at LTC

The CDC has announced that a potentially dangerous new strain of norovirus is making its way into long-term care facilities across the country. The strain, known as Gll. 4 Sydney, was first identified in Australia last spring and has since spread around the globe. Gll. 4 Sydney accounted for the majority of norovirus outbreaks in the U.S. between September and December, 65 percent of which occurred in LTC facilities.

Gll. 4 noroviruses tend to cause more hospitalizations and deaths than other strains of the virus. Symptoms typically include diarrhea, vomiting, nausea and stomach cramping. Other less common symptoms are a low-grade fever, chills, headache, muscle aches and fatigue.

The CDC recommends taking the following steps to keep norovirus from spreading:

• Clean and disinfect. Use bleach-based cleaners to disinfect contaminated surfaces.
• Wash laundry thoroughly. Immediately remove clothing or linens that are contaminated with vomit or stool. Wear gloves while handling contaminated items and immediately wash your hands after handling them. The items should be washed with detergent at the maximum available cycle length and then machine dried. 
• Practice good hand hygiene. Wash your hands with soap and water, especially after using the bathroom or handling diapers and before eating or preparing food. If soap and water aren't available, use a hand sanitizer with an alcohol concentration of at least 60 percent.
• Be careful in the kitchen. Carefully wash all fruits and vegetables and cook shellfish thoroughly before eating them.
• Do not prepare food while infected. The CDC recommends that people with norovirus not prepare food for others while they have symptoms or for three days after they have recovered. 

To learn more, click here.

New Year, New Support Surfaces?

As you’re kicking off the new year by making updates around your facility, why not take the time to determine whether your residents are using the support surfaces that best fit their needs? According to CMS, “Appropriate support surfaces or devices should be chosen by matching a device’s potential therapeutic benefit with the resident’s specific situation; for example, multiple ulcers, limited turning surfaces, ability to maintain position.”¹

There are two types of mattresses: static pressure redistribution devices and dynamic pressure reduction surfaces.

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. 

Examples:

• Solid foam
•  Gel-infused foam
•  Convoluted foam (i.e., channel-cut or “egg crate” foam)
• Gel

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.

Examples:

• Alternating pressure mattresses and overlays
• Low air loss devices

Professional Medical offers a complete line of support surfaces to meet your residents' needs. To learn more, contact your ProMed territory manager, visit us online at www.promedsupply.com or give us a call at (800) 648-5190.

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 January 9, 2013. 

FDA Okays Botox as Treatment for Overactive Bladder

The FDA has approved Botox as an effective treatment for overactive bladder after two clinical trials involving more than 1,100 patients.

During the studies, participants whose bladder muscles were injected with Botox experienced between 1.6 and 1.9 times fewer daily episodes of incontinence compared to those who received the placebo injection. Those who received the Botox injections also had less frequent urges to urinate and produced more urine than the placebo group.

The Botox injections relax the bladder muscle, increasing the bladder's storage capacity.

To learn more, click here.

Flu Hospitalizations In Elderly Up, Immunization in LTC Workers Low

Only about half of long-term care workers have received the flu vaccine, according to new information from the CDC. This is especially worrisome considering that the flu has hit the elderly hard this year.

Hospitalizations related to laboratory-confirmed flu cases among those 65 and older have reached a rate of 82 per 100,000 people. By comparison, the rate for all age groups is 19 per 100,000 people. The CDC notes that these figures are undoubtedly low because influenza-rated hospitalizations can be missed because of lack of testing or because cases may be attributed to other illnesses.

The CDC's vaccination data notes that only about 50 percent of long-term care workers have received the flu vaccine, compared to 85 percent of pharmacists, doctors and nurses. They point out that vaccination routinely reaches 90 percent or higher at facilities that provide the flu vaccine during work hours.

To learn more, click here.

Tips for Safe Snow Shoveling

Our headquarters here in New Lenox, Illinois, got its first real dusting of snow this winter season. We're not seeing a lot of the fluffy white stuff this year, so many of us are out of practice at shoveling. If you need to head outside to clear your driveway or sidewalk, keep the following pointers in mind - especially if you're elderly. 

1. If you have a chronic health condition, ask your doctor if you should be shoveling. People who smoke or have a history of heart trouble, pain, back problems or other ongoing health concerns need to be careful. 
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. 
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.

Got Flu? Get Resources from Flu.gov

The Department of Health & Human Services has plenty of tools to help you handle a flu outbreak in your facility. In fact, they've created a website for just that purpose - Flu.gov.

On the site, you'll find information on symptoms, prevention and vaccination, at-risk groups (including seniors), up-to-date information on the current flu season, and planning and preparation (including this information specifically for healthcare professionals). 

You'll also find a newsroom, videos and other resources. It's a one-stop shop for battling the flu - check it out! 

Renting vs. Owning Equipment: Are You Paying Too Much?

When was the last time your facility evaluated how much money you’re spending on rentals versus the relatively low cost of purchasing equipment? At what point does the money you’re spending for the convenience of rentals become large enough to cause you to consider purchasing instead?

Professional Medical has developed a step-by-step process to help your facility identify whether purchasing makes more financial sense than renting.

1.  Begin by identifying all of the rental equipment that you have in your building (concentrators, beds, specialty mattresses, etc.).
2. Determine the length of use of each piece based on resident status. Multiply the monthly rental cost by the estimated length of the resident’s stay and then subtract the cost of purchasing the equipment from this number. This will help you determine whether it makes sense to purchase the equipment.
3. Determine whether equipment can be purchased out of your current budget or whether a payment plan is necessary.

 Once you’ve decided that purchasing is a good fit for your facility, ProMed will be happy to work with your facility to get you the equipment you need in a manner that works with your budget. We’ll also arrange for your staff to be in-serviced on the new equipment! 

White House Ponders Lowering Provider Tax Threshold

The White House's 2013 budget proposes lowering the Medicaid provider tax threshold to 3.5% in an effort to lower the national deficit. It estimates that this would save $21.8 billion on federal Medicaid payments between 2015 and 2022.

The provider tax, also known as a "bed tax," uses provider tax revenue to help finance Medicaid, which in turn pays for a bulk of nursing home care. Forty-three states currently have a provider tax.

Greg Crist, spokesman for the American Health Care Association, criticized the plan. "What's missing in these reports is the human element - the complete picture of who provider assessments directly benefit and how their lives are changed for the better because of the care they receive in our centers. This is a significant source of income for providers who already face a significant shortfall in Medicaid reimbursement. If those assessments are scaled back, there's real concern those less fortunate patients and residents won't be able to have their care paid for by Medicaid."

To learn more, click here.

Protect Your Facility from the Flu

The flu season, which typically peaks in January or February, is off to an early, vicious start. The CDC is reporting that flu activity is continuing to increase across the U.S. and that most of the country is now experiencing high levels of influenza-like illness.¹ The situation has gotten so severe in some areas that hospitals have been forced to go on bypass status, rerouting non-critical patients to other hospitals because their emergency rooms are at capacity with patients complaining of flu-like symptoms.

Seniors are more susceptible to flu due to their weakened immune systems. Ninety percent of flu-related deaths and more than half of flu-related hospitalizations are in people age 65 years and older.²

The CDC recommends taking the following steps to help prevent flu and other respiratory infections from spreading throughout your facility³:

1. Post signs around the facility that instruct residents and visitors to alert staff members if they have any symptoms of a respiratory infection.
2. Ensure that hand hygiene and other necessary items are within easy reach.
• Place alcohol-based hand-rub dispensers in convenient locations throughout your building.
• Provide tissues and no-touch receptacles for disposing of used tissues.
• Make sure that supplies for handwashing (i.e., soap and disposable towels) are readily available at all sinks.
3. Encourage residents, staff and visitors to perform proper respiratory hygiene and cough etiquette, including:
• Covering the mouth and nose with a tissue when coughing or sneezing (to download a handy "Cover Your Cough" poster from the CDC, click here).
• Placing used tissues in the closest waste receptacle after use.
• Performing hand hygiene (with alcohol-based hand rub, antiseptic handwash or non-antimicrobial soap and water) after having contact with respiratory secretions or contaminated objects or surfaces.
4. Offer masks to residents who are coughing to contain respiratory secretions. 
5. Advise your staff to observe Droplet Precautions (i.e., wearing a mask during close contact) in addition to Standard Precautions when they are with residents who have symptoms of a respiratory infection, particularly if a fever is present.

The CDC also recommends the flu vaccine as the best defense against the seasonal flu. The vaccine is approved for everyone six months of age and older. 

References

1 Centers for Disease Control and Prevention. Situation Update: Summary of Weekly FluView. Available at: http://www.cdc.gov/flu/weekly/summary.htm. Accessed January 9, 2013.

2 Flu.gov. Seniors. Available at: http://www.flu.gov/at-risk/seniors/index.html. Accessed January 9, 2013.


3 Centers for Disease Control and Prevention. Respiratory Hygiene/Cough Etiquette in Healthcare Settings. Available at: http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm. Accessed January 9, 2013. 

What to Do - and What Not to Do - When You Have the Flu

There are plenty of old wives' tales on how to ease flu symptoms. Which of them can actually help, and which aren't worth wasting your time?

Five things worth trying

1. Antivirals. Tamiflu and Relenza have been shown to cut a day or two off the time you spend suffering from the flu. 
2. Analgesics. Ibuprofen and acetaminophen can reduce fever and help ease muscle aches, but patients who have asthma, high blood pressure or other chronic conditions should check with a doctor to ensure it's safe to take them. 
3. Fluids. Clear liquids such as water, broth and sports drinks can help prevent dehydration. 
4. OTC remedies. Decongestants and antihistamines can help ease runny noses, congestion and coughing. 
5. Rest. The best thing to do for yourself and others if you have the flu or a bad cold is to stay home and rest. That way, you won't spread germs - and admit it, you probably wouldn't be that effective at work feeling the way that you do. 

Five things to forget 

1. Herbal supplements. There's very little evidence that any of them work and it's hard to get concrete evidence because they come in different formulations, sometimes even from different types of plants. 
2. Zinc: Again, the different formulations of zinc make it difficult to definitely say whether it boosts the immune system, as claimed. The FDA recommends against using it in the nasal gel form because it can lead to a permanent loss of smell. 
3. Cough syrup: The American Lung Association cautions that there is no evidence that guaifenesin, an expectorant, can help ease a cough. The American College of Chest Physicians recommends against using any cough syrup. 
4. Cold remedies for kids: The FDA says OTC cold, flu and cough remedies shouldn't be given to children under 2 and the Infectious Diseases Society of America says not to give them to kids under 4. 
5. Vitamins: Ultra-high doses of Vitamin C, the supposed cure-all, can lead to diarrhea. There are no major studies that prove Vitamin C can shorten the duration of a cold. Ditto for Vitamin E. 

To learn more, click here.

Flu Now Widespread in 47 States

According to the CDC, the flu is now widespread in 47 states, up from 41 last week. Twenty-four states and New York City are reporting high levels of flu-like illness, which is actually a decrease from 29 states and NYC last week.

The CDC cautions that people shouldn't be too optimistic about the decline in high levels of flu as the illness is unpredictable and could easily rebound or worsen.

Since October, 3,700 people have been hospitalized for the flu, most of which were people older than 65

To learn more, click here.

FDA Requires Lower Doses of Sleep Meds to Avoid Morning Drowsiness Injuries

The FDA is requiring makers of sleeping pills, such as Ambien, to lower the dosage of their drugs after finding that patients who take them face an increased risk of injury due to morning drowsiness.

According to the studies, the drugs can stay in the bloodstream long enough to interfere with morning driving and increasing the risk of car accidents. The FDA is ordering that the dose be cut in half for women, who process the drug more slowly. This would lower the dosage from 10 milligrams to 5 milligrams (or from 12.5 milligrams to 6.25 milligrams for extended-release formulas). This adjustment is also a recommendation, but not a requirement, for the dosage taken by men.

The new regulation applies to all sleep medications containing zolpidem, which is sold under the brand names Ambien, Edluar and Zolpimist.

The FDA said that doctors should aim to prescribe the lowest possible dose of the drug that will successfully treat insomnia.

Current patients should continue taking their prescribed dose until they can talk to their doctors about the best way to proceed.

To learn more, click here.

Study: Beta Blockers Could Lower Risk of Alzheimer's

A study of 774 elderly Japanese-American men found that those who took beta blockers for high blood pressure were also receiving an additional benefit: a reduced chance of brain changes linked to Alzheimer's disease.

The men whose hypertension was treated with beta blockers showed fewer brain lesions associated with Alzheimer's disease than the men who had not been treated at all for their high blood pressure.

Men who took other blood pressure medication in addition to beta blockers also showed fewer brain abnormalities than the men whose hypertension was untreated, but more than the men whose hypertension was treated with beta blockers alone.

To learn more, click here.

Overwhelmed By Flu Bug, Chicago ERs Reroute Non-Critical Patients

According to the Chicago Tribune, seven Chicago-area hospitals are so overwhelmed by an influx of patients with flu-like symptoms that they had to re-route non-critical patients to other hospitals this morning.

Doctors at the hospitals are reminding citizens that the flu in and of itself is not a reason to visit the emergency room. Typically, emergency attention is not necessary unless the flu is accompanied by a shortness of breath or the patient has another serious illness, such as heart disease. Instead, flu sufferers should first contact their healthcare provider or local health department.

Illinois is among the 29 states that the CDC listed as experiencing "high" flu activity as of last Friday.

To learn more, click here.

Keep Your Resolution to Quit Smoking in 2013

If your New Year's resolution was to quit smoking, the U.S. Department of Health & Human Services (HHS) has resources to help you out. Head over to BeTobaccoFree.gov  for information on how smoking affects your health and steps to take on the day you decide to quit.

If you're still looking for motivation to quit, consider the following. If you quit smoking right now:

• Within 20 minutes, your heart rate and blood pressure drop.
• Within 12 hours, the carbon monoxide level in your blood drops to normal. 
• Within three months, your circulation and lung function improve. 
• Within nine months, you will cough less and breathe easier. 
• After one year, your risk of coronary heart disease is cut in half. 
• After five years, your risk of developing cancer of the mouth, throat, esophagus and bladder is cut in half. 
• After 10 years, you are half as likely to die from lung cancer. Your risk of developing larynx or pancreatic cancer also decreases.
• After 15 years, your risk of coronary heart disease is the same as a non-smoker's. 

To learn more, click here. 

Illinois Ranks Third in CMS Suspended Payments

According to data gathered by the independent investigative group ProPublica, Illinois ranks third among states (behind just Texas and Michigan) in the number of times federal officials have suspended payments to a nursing home over serious deficiencies. This measure is taken when deficiencies at a facility are so serious that regulators push for immediate improvements.

Over the past three years, CMS has suspended payments 91 times to 78 Illinois long-term care facilities.

Illinois also ranked third in the number of total serious deficiencies and fourth in the number of total deficiencies, but was in the middle of the pack for both amount of average fine and number of serious deficiencies per home.

To learn more, click here.

Flu Season Off To an Early Start

The CDC has reported that flu season is off to an early start in the U.S. Typically, flu season peaks around January or February, but the agency began to see significant increases in flu activity beginning in late November. 

According to the CDC's most recent FluView influenza surveillance report, dated December 22, 31 states have reported widespread flu activity. There was also an increase in outpatient visits for influenza-like illness (ILI). 

The CDC recommends that anyone six months or older get the flu vaccine to lessen their chances of contracting the illness. The agency also recommends taking the following steps to help prevent flu and other respiratory infections from spreading throughout your facility: 

1. Post signs around the facility to instruct residents and visitors to alert staff members if they have any symptoms of a respiratory infection.
2. Ensure that hand hygiene and other necessary items are within easy reach.
   • Place alcohol-based hand-rub dispensers in convenient locations throughout your building.
   • Provide tissues and no-touch receptacles for disposing of used tissues.
   • Make sure that supplies for handwashing (i.e., soap and disposable towels) are readily available at all sinks.
3. Encourage residents, staff and visitors to perform proper respiratory hygiene and cough etiquette. This entails:
   • Covering your mouth and nose with a tissue when coughing or sneezing (to download a handy "Cover Your Cough" poster from the CDC, click here).
   • Placing used tissues in the closest waste receptacle after use.
   • Performing hand hygiene (with alcohol-based hand rub, antiseptic handwash or non-antimicrobial soap and water) after having contact with respiratory secretions or contaminated objects or surfaces.
4. Offer masks to residents who are coughing to contain respiratory secretions.
5. Advise your staff to observe Droplet Precautions (i.e., wearing a mask during close contact) in addition to Standard Precautions when they are with residents who have symptoms of a respiratory infection, particularly if a fever is present.

Depressed Elderly Men More Likely to Have Emergency Hospital Admissions

A study published in the Canadian Medical Association Journal concluded that elderly men who are depressed are twice as likely to have an emergency hospital admission than their non-depressed peers.

The study's authors suggested that depressed patients might not carefully follow treatment plans. They also noted that depression could inhibit communication with patients who are suffering from acute or chronic illnesses.

The study also indicated that depression was a strong independent risk factor for longer hospital stays and worse hospital outcomes.

To learn more, click here.