ProMed Labor Day Closure Reminder

Reminder: ProMed will be closed on Monday, September 2 in honor of Labor Day. If you typically order on Monday for Tuesday delivery, please place your order by tomorrow, Friday, August 30. If you have any questions, please contact our Customer Care team at (800) 648-5190.

Researchers Testing Robots Designed to Help with Falls

Every few months, it seems that a new caregiving robot pops up. The newest one, being tested in Europe, is designed to help residents who have fallen and send an alert when there is unusual behavior, such as a resident attempting to leave a facility in the middle of the night..

The researchers behind the robots hope that they can eventually be used as 24-hour surveillance throughout long-term care facilities. They would work alongside their human counterparts.

The robots are described as looking like human-sized chess pawns and have blinking, illuminated "eyes."

To learn more, click here.

Let's Work Together to Design Better Care

When you’re ready to make a change at your facility, turn to the experts. Professional Medical has partnered with Basic American to offer a complimentary interior design program to enhance resident comfort and wellness. We want to help you create a warm, home-like environment that your residents and their families will enjoy.

As soon as you start thinking about updating your facility, give us a call. The Basic American design team and ProMed will be with you every step of the way, from planning to design and implementation. You’re also welcome to join us on a visit to Basic American’s 11,000 square foot showroom in Atlanta to meet with their team and gain inspiration for your own facility.

Through this partnership, not only will you avoid having to pay an interior designer's hourly charges, you'll also be partnering with a team of professionals who are in tune with the specific challenges of designing for long-term care. Our team is detail-oriented and aware of the codes and regulations that need to be taken into account when designing a space that is both attractive and functional.

We provide the following services, all at no charge:

• Space planning
•  Schematic design
• Design development
•  Furniture selection
• Color and materials selection
• Custom furniture and millwork design
• Artwork selection
• Graphics and signage
• Accessories and lighting specifications
• Installation administration
• In-house purchasing

Whether you're looking to spruce up or completely overhaul resident rooms, dining areas, activity spaces, common areas or office settings, experienced interior designers are ready to help you create the perfect look for your facility.

To learn more, contact your ProMed territory manager or call our Customer Care team at (800) 648-5190.    

ProMed Labor Day Closure Reminder

Reminder: ProMed will be closed on Monday, September 2 in honor of Labor Day. If you typically order on Monday for Tuesday delivery, please place your order by Friday, August 30. If you have any questions, please contact our Customer Care team at (800) 648-5190.

CMS Sprinkler Requirement Now In Effect

CMS's automatic sprinkler requirement for nursing homes is now in effect. As of August 13, all nursing homes must be fully sprinklered in order to participate in Medicare or Medicaid.

The sprinkler requirement was first announced in 2008. Facilities were given a five-year window to become compliant.

CMS notes that it does not have authority to allow extensions for this deadline. While the agency issued a proposed rule on February 7 that would grant a limited extension of the due date for some facilities, that rule has not been finalized.

To learn more, click here.

Advancing Excellence Campaign Announces Nine New Goals

The Advancing Excellence Campaign has announced nine new quality goals and toolkits.

The nine new goals are:

• Process Goals: 
• Improving staff stability
• Increasing use of consistent assignment
• Increasing person-centered care planning and decision making
• Safely reducing hospitalizations
• Clinical goals
• Using medications appropriately
• Increasing resident mobility
• Preventing and managing infections safely 
• Reducing the prevalence of pressure ulcers
• Decreasing symptoms of pain 

The goals will be featured in a free webinar on September 10. To register for the webinar, click here. 

The Campaign's goal is to engage and challenge nursing homes to provide valuable data as well as make quality improvements. More than 60 percent of nursing homes have joined the Campaign and are committed to working on at least one process and one clinical goal. 

To learn more, click here. 

Seniors with Existing Disabilities Less Likely to Recover From Falls

Researchers at Yale have found that seniors who sustain a hip fracture or other serious fall are injury are significantly  more likely to recover if they did not have other serious disabilities before the fall.

The researchers studied 100 seniors who had fallen within the past year. They found that those with no preexisting disabilities had a 45 percent probability of a rapid recovery and a 38 percent probability of a gradual recovery. On the other hand, those with existing progressive disabilities had a 70 percent chance of not recovering and those with existing severe disabilities had a 100 chance of not recovering.

The 13 activities used to classify disability level were bathing, dressing, walking inside the house, transferring from a chair, shopping, housework, meal preparation, taking medications, managing finances, mobility, climbing a flight of stairs, lifting or carrying 10 pounds and driving. In order to be classified as having a severe disability, seniors had to be impaired for at least 10 of the 13 activities.

To learn more, click here.

Simple, Affordable Linen Solutions at Your Fingertips

Our newly launched Textile and Linen Solutions catalog connects you with everything you need to create a welcoming, homelike environment at your facility. In the catalog’s pages, you’ll find:

• Reusable and disposable pillows with non-woven or vinyl bodies
• Premium, standard and knitted sheets
• Bath blankets to keep residents warm and protect modesty
• Woven and ribbed blankets and spreads in a spectrum of colors
• Quilted spreads in both solid colors and stylish prints
• Premium and standard white terry in multiple weights
• Colored terry for color-coding by use, department or resident
• Generously cut clothing protectors in terrycloth and flannel
• Reusable underpads in a variety of absorbencies
•  Related items such as mattresses, laundry carts and hampers

Every item in the catalog was specially selected to help you meet your goal of delivering great care while remaining budget-conscious. We welcome your feedback on any items you’d like to see added to the product lineup. You can share your thoughts on our Facebook page.

Click here to view and download the catalog. To learn more about any of the featured products, contact your territory manager, give us a call at 800.648.5190 or visit us online at promedsupply.com. 

Buy Five Foam Mattresses, Get One Free!

For a limited time, when you buy five or more foam mattresses of any size of any combination, you'll receive one for free! Simply enter the code FOAMB5G1 when you check out online or mention it to our Customer Care team if you place your order over the phone. To view our complete selection of eligible products, click here. 

Do You Know the Six Types of Urinary Incontinence?

Urinary incontinence is an involuntary loss or leakage of urine. The type of incontinence a resident is experiencing can greatly impact the way that your facility addresses it. Keep in mind that a resident might suffer from several different types of incontinence at the same time.

There are six types of urinary incontinence: 

Functional incontinence is a loss of urine that occurs in residents who cannot remain continent because of external factors, such as the inability to get to the toilet in time. These residents have sufficiently intact urinary tract function.

Mixed incontinence is a combination of stress incontinence and urge incontinence.

Overflow incontinence occurs when the bladder has reached its maximum capacity and becomes distended. This type of incontinence is associated with the leakage of small amounts of urine.

Stress incontinence causes small amounts of urine leakage when intra-abdominal pressure on the bladder is increased (such as with sneezing, coughing, lifting, standing from a sitting position, climbing stairs, etc.). Stress incontinence is associated with malfunction of the urethral sphincter.

Transient incontinence refers to temporary episodes of incontinence that are reversible once the cause is identified and treated.

Urge incontinence, also referred to as overactive bladder, is caused by excessive contraction of the detrusor muscle in the bladder, which results in the strong urge to urinate even when the bladder is not full.

Researchers Identify Criteria for Identifying Seniors at Risk of Delirium

Scientists at the University of California-San Francisco have identified a new delirium detection tool that could help identify at-risk seniors as well as reduce hospital-to-nursing home transfers.

The tool uses the following four criteria for identifying at-risk seniors:

• Age 80 or older
• Inability to spell the word "world" backward 
• Confusion about where they are
• Suffering from moderate to severe illness

According to the researchers, 19 percent of the studied seniors who met three of four of the criteria became delirious, compared to 4 percent of patients with none. Delirious individuals are more likely to go straight from a hospital to a nursing home. 

The researchers note that if doctors are able to determine which patients are at risk of delirium, they can take steps to keep those people mentally sharp. 

To learn more, click here. 

AHCA: Keep QIOs State-Based

The AHCA is urging CMS to keep using state-based quality improvement organizations, or CIOs, for Medicare oversight. They are joined in their support by nearly 50 medical societies.

The groups oppose the potential replacement of state-level QIOs with regional ones and argue that doing so would damage the relationships that SNFs have built with their QIOs over the past decade. They also argue that it would be difficult to form relationships with an organization several states away.

To learn more, click here.

Picking the Perfect Wheelchair Cushion

Gone are the days of a “one-size-fits-all” mentality when it comes to wheelchair cushions. Today, there’s a cushion to meet every need.

Whatever the fabrication, the four primary goals of wheelchair cushions are to improve comfort, aid posture, absorb shock and reduce pressure on tissues.¹ Ideally, wheelchair cushions should be purchased at the same time as wheelchairs because the two components work together as a system. When this isn’t done, less-than-ideal performance can occur.

When selecting a wheelchair cushion, keep the following factors in mind to help you evaluate a cushion’s clinical appropriateness¹:

•  Distribution of stresses on soft tissues
• How much stability the cushion provides
• Whether the cushion allows moisture to accumulate
•  Heat accumulation and loss
• The cushion and cover’s frictional properties
• Durability and need for maintenance
• Flammability

Each type of wheelchair cushion has its own strengths. We’ve created the following chart to help you select the best cushion for each of your residents.²

Type	Strengths
Foam	Inexpensive       Lightweight    Multiple densities            Even support
Gel	Excellent pressure redistribution            Very comfortable
Gel/foam hybrid	Combines benefits of foam and gel cushions
Air flotation (inflated cells)	Lightweight            Even pressure redistribution            Will not bottom out if inflated properly            Can be modified to relieve pressure sores            Can be inflated to resident’s specific needs            Waterproof

The following specialty cushions can also help meet individual resident needs:

• Lap positioners provide upper torso support and can help assist with upper-body alignment. They also serve as a gentle reminder to residents to stay seated.
• Abductor (pommel) cushions hold the legs slightly apart to help keep a resident’s hips and knees properly aligned and reduce forward sliding. They can also be used to help prevent hip dislocation following surgery.
•  Wedge cushions offer improve posture and slide control.  

ProMed stocks a complete collection of wheelchair cushions and positioners. To learn more, give us a call at 800.648.5190.

References

1 Ferguson-Pell M. Seat Cushion Selection. JRRD Clinical Supplement No. 2: Choosing a Wheelchair System. Available at: http://www.rehab.research.va.gov/mono/wheelchair/ferguson-pell.pdf. Accessed August 7, 2013.

2 Karp G. Choosing a Wheelchair: A Guide for Optimal Independence. O’Reilly Media; 1998. 

Ancient Remains Show Early Evidence of Caregiving

We all know what is credited as the world's oldest profession, but it appears that caregiving isn't too far behind.

Archaeologists have discovered the remains of the world's first known disabled, elderly human. They estimate that the man lived in what is now Spain more than 500,000 years ago and received support from his group.

His remains, dubbed "Elvis," shown clear signs of aging and impairment. His spine is deformed in a way that would have caused him a lot of pain and forced him to stoop over. He likely would not have been able to hunt or carry heavy loads, which means that he would have depended upon the help of others.

Because he lived to a ripe old age, the archaeologists believe that his remains provide some of the world's first evidence of compassion and cooperation among early humans.

To learn more, click here.

Survey: Residents Happy, But Food and Activities Still Lacking

A new study found that while nursing homes with more staff and fewer deficiencies tend to have happier residents, they're still coming up short when it comes to food and activities. The results of the study were based on three years' worth of satisfaction surveys in Massachusetts.

The researchers also found that non-profit and government-owned facilities tended to score better than their for-profit counterparts.

The researchers hope that their findings will help CMS decide whether to make consumer surveys a part of national nursing homes' report cards.

To learn more, click here.

Labor Day Closure Notice

Professional Medical will be closed on Monday, September 2 in honor of Labor Day. All Monday deliveries will be made on Tuesday, September 3.

Customers who typically order on Monday for Tuesday delivery will need to place their orders by Friday, August 30.

Please contact our Customer Care department at 800.648.5190 if you have any questions or concerns.

Thank you!

When Should Residents Be Weighed?

According to Tag F325 of CMS’s State Operations Manual, long-term care facilities must ensure that residents maintain “acceptable parameters of nutritional status, such as body weight and protein levels, unless the resident’s clinical condition demonstrates that this is not possible.”¹ Is your facility following the recommended weight monitoring guidelines?

According to CMS, 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 after that to identify and document any trends, such as insidious weight loss. Weighing is also recommended if the resident has a significant change in condition, if their food intake has declined for more than a week or if there is other evidence of a change in nutritional status. Weight monitoring is not necessary for terminally ill individuals receiving only comfort care.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 (such as a wheelchair scale or bed scale)
• Consistently weighing a resident at the same time since weight can fluctuate throughout the day
• Ensuring residents are wearing the same type/weight of clothing for each weigh-in
• 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

ProMed offers a complete line of scales, including wheelchair scales, chair scales, bariatric scales and physician’s beam scales. Your ProMed territory manager is ready to help you find the scales that best fit your facility’s needs. To connect with us, give us a call at 800.648.5190 or visit us online at promedsupply.com

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 July 31, 2013.  

In Wake of Cyclosporiasis Outbreak, Brush Up on Food Handling Skills

The recent cyclosporiasis outbreak, which has now been found in 16 states, serves as a reminder of how important it is to practice safe food handling procedures. The CDC recommends washing hands, utensils and surfaces with hot, soapy water before and after handling food. Additionally, produce should be washed thoroughly before it is eaten - even if it is advertised as being pre-washed.

To learn more about the cyclosporiasis outbreak, click here.

New House Bill Seeks to Improve Surveys, Surveyor Training

A new House bill is aiming to change the results of a U.S. Government Accountability Office report in which 46 percent of surveyors and 36 percent of directors reported feeling that there were weaknesses in the traditional survey methodology.

The bill seeks to improve the nursing home survey process, increase whistleblower protections for surveyors and create a CMS advisory committee that would include SNF administrators, DONs and other stakeholders.

The bill also proposes making surveyors' tests more rigorous and comprehensive and would crack down on employees or others who attempt to influence surveyors by subjecting those people to fines up to $10,000.00.

To learn more, click here.