Happy Halloween from Team ProMed!

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

"Superbug" Storming into Chicago Hospitals

New research from Rush University and the Cook County Department of Public Health found that a superbug is roaming Chicago hospitals at a much higher rate than last year.

The bug in question is Klebsiella pneumoniae Carbapenemase, or KPC, an enzyme produced by common bacteria. The enzyme makes bacteria resistant to a class of antibiotics typically used as a last resort when other treatments fail.

Since last year, the number of Chicago hospitals and LTC facilities reporting KPC-producing bacteria has swelled from 26 to 37, an increase of 42 percent. The average number of patients with KPC at each of these facilities also grew from four to 10.

The study's presenters emphasized that it's important to try and get KPC under control as soon as possible so it doesn't become as rampant as MRSA.

KPC has been found to kill 40 percent of the people it infects. It is typically spread through contact with an infected person or on the unclean hands of healthcare workers. It doesn't typically sicken healthy people, instead favoring immunocompromised individuals, such as nursing home residents and hospital patients.

To learn more, click here.

Seniors Could Play Key Role in Next Week's Election

Recent news reports have noted that senior citizens, angered over healthcare Medicare cuts, will play a key role in next week's midterm elections.

Of course, the candidates who are running for office don't agree on what those Medicare slashes mean to seniors.  Republicans maintain that the government is trimming Medicare to the tune of $500 billion. Democrats have been defending the law, saying the it will save the government $533 billion during the first 10 years it's in effect. Frustration over this lack of clarity is driving many senior citizens to vote or even campaign for the party they support.

To learn more, click here.

Congratulations, Mike Kellenberger!

Team ProMed congratulates Mike Kellenberger on his recent nuptials! Mike and his bride, Michelle, tied the knot on Sunday, October 17.

CMS Seeks to Clarify Roles of Hospice, LTC Providers

CMS is seeking to revise the requirements that a facility would have to meet in order to participate as a skilled nursing facility in the Medicare program, or as a nursing facility in the Medicaid program. The goal of the proposed changes is to ensure that SNFs and NFs have a written agreement in place that would outline roles and responsibilities in the event that the facility chose to arrange for hospice care from a Medicare-certified hospice provider.

In the proposed rule, CMS stated that, "We believe there is a lack of clear direction regarding the responsibilities of providers in caring for LTC facility residents who receive hospice care from a Medicare certified hospice provider, which could result in duplicative or missing services."

To view the proposed rule, click here.

CDC: 1 in 3 US Adults Could Have Diabetes by 2050

A sobering new analysis from the CDC found that as many as one in three adults in the US could have diabetes by 2050 if current trends continue. By comparison, one in 10 US adults have diabetes now.

The rise is expected to be triggered by an aging population that is more likely to develop type 2 diabetes, increases in minority groups at a high risk for type 2 diabetes and people with diabetes living longer. It is estimated that the number of new diabetes cases each year will rise from 8 per 1,000 people in 2008 to 15 per 1,000 in 2050. Currently, about 24 million Americans have diabetes, and one quarter of them don't know that they have it.

Risk factors for developing type 2 diabetes include older age, obesity, family history, gestational diabetes and a sedentary lifestyle. Some races and ethnicities are also at a higher risk for developing the disease, including African Americans, Hispanics, American Indians/Alaska Natives and some Asian-Americans and Pacific Islanders.

Diabetes was the seventh leading cause of death in 2007. It's also the leading cause of blindness among adults under the age of 75, kidney failure and leg and foot amputations (not related to injury) among adults. On average, the medical expenses for people with diagnosed diabetes are twice that of non-diabetics.

To learn more, click here.

Congratulations to Kurt Gerling on His New Addition!

Team ProMed congratulates Territory Manager Kurt Gerling and his wife, Stephanie, on their new addition! Cole Haven Gerling was born on September 2. He weighed in at 8 lbs., 2 oz. and was 21 inches long. Congratulations to the beautiful family!

CPR: Ditch the "ABC"s and Catch a "CAB"

Chances are, when you learned CPR, you were taught your "ABCs" - airway, breathing, compressions. Now the American Heart Association wants you to catch a "CAB" - compressions, airway, breathing.

The steps are being reordered because taking time to open the victim's airway delays the start of chest compressions, which keep the blood circulating. Compressions act like an "artificial heart" to help keep the organ alive until help arrives. 

Under the new guidelines, CPR should consist of 30 chest compressions, then two breaths. Rescuers should push at least two inches deep on the chest of an adult and pump the chest at a rate of at least 100 compressions a minute. A good guide to this rate is to use the beat of the song "Stayin' Alive."

To learn more, click here.

CMS Planning Nov. 9 Conference Call to Discuss RUG-IV

If you still have questions about RUG-IV, CMS has answers. The agency has announced plans for a toll-free provider conference call that will take place from 2 - 3:30 p.m. (EDT) on November 9.

This will be the fourth call that CMS has hosted to provide details on the signifcant changes happening with RUG-IV. After the formal presentation, callers will have a chance to ask CMS subject matter experts questions.

The RUG-IV SNF PPS case mix system was put into place on an interim basis effective October 1.

To learn more and register for the call, click here. Registration closes on November 8, or when all available spots have been filled.

CMS Snafu Means MDS 3.0 Validation Reports Will Be Reprocessed

A glitch in the new MDS 3.0 system means that CMS will have to reprocess validation reports from more than 100,000 nursing home records. The problem has been traced to an error in lines of code in the MDS program. That incorrect code caused validation reports to contain incorrect RUG groups.

The MDS system has been down since last weekend while CMS works to correct the error. The agency hopes to have it fixed by the end of this week.

The good news is that problem hasn't affected payment because providers haven't been billed for October yet.

To learn more, click here.

Pharmacist Group: Drug Take-Back Law Unclear

Last week, President Obama signed the Secure and Responsible Drug Disposal Act of 2010 into law - but one pharmacist group is saying the new law raises more questions than it provides answers.

The law permits community-based drug take-back programs and law enforcement officials to accept unused controlled prescription medications from long-term care facilities for safe disposal, thereby reducing the risk of the drugs being abused or misused.

However, the American Society of Consultant Pharmacists (ASCP) has criticized the law, saying that it could actually lead to more uncertainty for those in LTC. The law allows the attorney general to establish guidelines for long-term care facilities disposing of medications, but it doesn't require that the attorney general make the guidelines. According to the ASCP, this leaves facilities and pharmacies without clear instructions on how to dispose of drugs.

To learn more, click here.

Keep Walking to Stave Off Dementia

Want to cut your dementia risk? Then lace up your walking shoes! According to a new study out of the University of Pittsburgh, walking at least six miles a week helps to protect brain size and, in turn, preserve memory.

Our brains begin to shrink in late adulthood, which can cause trouble with memory. Walking has been found to increase the volume of the brain's gray matter, which is associated with fewer memory problems.

During the study, 299 dementia-free participants recorded the number of blocks they walked in a week. People who walked at least 72 blocks a week - or roughly six miles - were found to have more gray matter nine years later than people who didn't walk as much. The participants who walked the most during the study cut their risk of memory problems in half. However, walking more than six miles didn't appear to increase gray matter volume any further.

The study was published in the October 13 online version of the journal Neurology and was supported by the National Institute on Aging. To learn more, click here.

Senator Blasts Sebelius, Berwick

In an October 6 letter, Senator Chuck Grassley (R-Iowa) took CMS Administrator Don Berwick and HHS Secretary Kathleen Sebelius to task for "inadequate management and oversight of contractors by the Centers for Medicare and Medicaid Services (CMS)." He goes on to express his concern over his perception that CMS "does not seem to examine its contractors' roles in enabling taxpayer dollars to be misused or wasted and to hold contractors accountable if they fail to carry out their responsibilities as expected."

Grassley cites a report from the Office of the Inspector General (OIG), Analysis of Errors  Identified in the Fiscal Year 2009 Comprehensive Error Rate Testing Program, in his letter. According to the report, a total of $4,720,432 was spent on improper payments during FY 2009. The majority of those payments (40%) were made to inpatient hospitals. Skilled nursing facilities received 6% of the improper payments, for a total of $260,381.

Grassley also expressed concern over what he perceives as an apparent lack of accountability by Medicare contractors known as Quality Improvement Organizations (QIOs). He is challenging HHS and CMS to address his concerns and allegations in a response by October 20.

To view Grassley's letter, click here.

EPA Bites Back at Bed Bugs

The Environmental Protection Agency is biting back at nuisance bed bugs by providing consumers with a Bed Bug Search Tool on their website. Consumers can use the tool to search for an EPA-approved bed bug product by the product name, manufacturer, EPA registration number, where they plan to use the pesticide or pesticide type.

The site also addresses why some treatments might not work, such as failure to use them correctly or inadequately preparing an area before using a treatment.

To visit the EPA's main informational page on bed bugs, click here.

CMS Experiencing MDS 3.0 Processing Problems

According to multiple industry sources, CMS has temporarily suspended processing MDS 3.0 files because of a "glitch" in the RUG DLL. In the meantime, submission files are still being accepted and timestamped to ensure that nursing homes get credit for timeliness.

The agency is hoping to start processing files again on Monday morning, and they're downplaying the magnitude of the glitch. The system that processes files can handle about 20,000 files per hour and currently there are less than 2,000 files in the queue.

We'll keep you posted as we learn more!

CDC: Healthcare Workers Play Key Role in Flu Prevention

The CDC is reminding healthcare workers that they play a special role in fighting the flu. The agency is recommending that all physicians, nurses, other workers in hospital and outpatient-care settings and emergency-response workers receive the flu vaccine. By doing so, they're not only protecting their health, but the health of their families and residents/patients as well. Additionally, high vaccination rates among healthcare workers have been tied to improved resident/patient outcomes, reduced absenteeism and lower flu rates among staff.

Healthcare workers should also encourage vulnerable residents and patients to consider getting flu shots to protect themselves.

To learn more, click here.

Congratulations, Patty Adams!

Team ProMed congratulates Patty Adams on being named the October 2010 Employee Spotlight Award winner! Patty is a CPC Data/Pricing Analyst and has been with ProMed six years this month.

“Patty’s dedication and loyalty over the years have proven to be an asset to ProMed. She is very detailed and conscious about her job performance, which makes her valuable in the tasks she performs in the Special Sales Department,” said Jodi Dzak, Director of Special Sales/Customer and Vendor Contracts and Patty’s manager. “She is ready and willing to move on to the next level in her position and I look forward to helping her grow. “

Added Jodi, “Patty is a very friendly and outgoing person who enjoys time with her family. Her family values extend here to her ProMed family and she is liked by many of her coworkers.”

When we asked Patty what makes ProMed a great place to work, she responded “the interaction with my coworkers. We have a lot of great people working here and I enjoy their humor and good-natured teasing, which helps us all get through the day even though we're busy.”

As the Employee Spotlight Award winner, Patty will be able to proudly display the Torch of Excellence trophy at her desk for the month of October. She was also given a $100 cash award.

IOM: Give Nurses a Larger Role in Healthcare Reform

A new report from the Institute of Medicine calls for nurses to be given a larger, more fundamental role in the transformation of the US healthcare system.

Titled The Future of Nursing: Leading Change, Advancing Health, the report calls for the removal of barriers currently preventing nurses from being able to respond quickly and effectively to changing healthcare settings. In turn, this will allow nurses to play a vital role in meeting the objectives of the 2010 Affordable Care Act, more widely known as the healthcare reform law.

The report contains four key messages:

• Nurses should be practice to the full extent of their education and training.
• Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
• Nurses should be full partners, with physicians and other healthcare professionals, in redesigning health care in the United States.
• Effective workforce planning and policy making require better data collection and information infrastructure.

The report notes that other groups should also play a role in helping to revamp the current healthcare system, including government, businesses, healthcare organizations, professional associations and the insurance industry.

To learn more, click here.

Happy National Gerontological Nurses Week!

October 1-8 is National Geronological Nurses Week! Team ProMed wishes to extend our appreciation to the gerontological nurses across the nation for all they do to care for America's elders.

National Gerontological Nurses Week is sponsored by the National Gerontological Nursing Association. To learn more, click here.

CMS Updates SOM Appendix PP

On September 24, CMS announced that Appendix PP of the State Operations Manual has been updated to reflect MDS 3.0, which took effect on October 1. The revised appendix was released on October 1 as an agency transmittal.

Changes to the appendix include:

• Removal of references to MDS 2.0
• Replacing Resident Assessment Protocols (RAPs) terminology with Care Area Assessment (CAA) terminology

Additionally, CMS forms 672, 802 and 805 have been updated.

Hello, MDS 3.0!

MDS 3.0 - touted as the largest operational change in nursing homes since the dawn of the prospective payment system - goes into effect today!

Revamping the MDS meant that nursing homes have had to update their computer hardware and software, change policies and train employees on what to expect.

Among the biggest changes from MDS 2.0 to 3.0 are:

• The introduction of the resident interview
• Changes to Medicare Part A therapy's payment system
• Resident Assesment Protcols (RAPs) are replaced by Care Area Assessments (CAAs)

To learn more, click here.

Happy National Physical Therapy Month!

October is National Physical Therapy Month! This year, the American Physical Therapy Association (APTA) is focusing its efforts on educating people of all ages on the importance of physical activity in preventing and combating obesity and its consequences.

When working with obese children and adults, physical therapists work to promote movement, reduce pain when it is present, maintain or restore function and prevent disability. They also incorporate behavior modification into weight loss programs, such as identifying causes of unhealthy behaviors and recognizing any barriers to forming healthy habits.

During National Physical Month, the APTA will also strive to educate the public on how physical therapists can help ease complications associated with type 2 diabetes. For example, they can perform tests to check foot sensation, help decrease cramping pain during walking, evaluate and care for skin ulcers and slow-to-heal sores and improve walking ability with orthotics and special shoes. They can also provide diabetics with an individualized program to help reduce the need for medications, lower the risk of heart disease and stroke and manage glucose levels.

To learn more about National Physical Therapy Month, click here.