Got Staffing Shortages? Eliminate These 3 Management Mistakes
Posted on 12. Jun, 2010 by Editor in Staff Management.
Find out how one nursing home manager changed his style and found everything fall into place.
Does your nursing facility or rehab facility have any of these surefire strategies for causing staff to head to happier work grounds? If so, follow these tips for turning things around.
1. A finger wagging atmosphere. Consultant Barbara Frank recently heard an administrator share how he used to use a “shake the finger” approach but now “checks in with people” rather than checking up on them. By being supportive instead of punitive, he found that staff morale and performance picked up immensely. “And he said he enjoys his job a lot more,” says Frank in Warren, R.I.
Ultimate goal: Create a “we’re in this together for the residents” culture. Frank saw this concept in action when visiting two nursing homes within ashort distance of each other that were owned by the same company. The facilities had comparable resources. But one facility smelled bad and had signs posted everywhere with various dates on them “scolding people for not clocking in and out when they went outside for a smoke,” Frank reports.
By contrast, when walking into the second facility, you “heard residents laughing and conversation between staff and residents. The clinical outcomes were good. Managers were out on the floor helping with meal trays. The difference wasn’t in the staff — it was in the management. And it showed up in the care outcomes.”
The Bottom Line …
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Physical Rehab and Exercise Offers More Than Meets the Eye
Posted on 12. Jun, 2010 by Editor in Clinical Notes.
Not all patients do their homework, but now you can give them more reasons to stick to an exercise program.
Here’s some news that may be music to the ears of people with hearing problems or worried about developing them.
The American Journal of Audiology published research earlier this year reporting that cardiovascular health positively impacts hearing over time, according to a press release from the American Speech-Language Hearing Association.
And the benefits were particularly notable among older adults. Many people naturally lose some hearing acuity as they grow older, but aging is only one of many factors that contribute to the decline, researchers pointed out.
The study reports evidence that cardiovascular fitness has a protective role in hearing loss prevention, the release reported. Other health and fitness determinants, body composition, blood pressure, and blood lipids displayed no significant relation to hearing sensitivity, whereas muscle strength was inversely related, researchers noted.
Why It Works …
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Bone Marrow Cells Help Fight Respiratory Viruses
Posted on 12. Jun, 2010 by Editor in Breaking News.
Virus-resistant leukocytes migrate to the lungs and protect it.
People with influenza, Sendai virus, or even HIV could turn to their bone marrows for temporary treatment. Research by Mount Sinai School of Medicine suggests that bone marrow cells play a critical role in fighting respiratory viruses.
When an individual gets respiratory tract infection, cells produced by the bone marrow are instructed by proteins to migrate to the lungs to help fight infection, according to a report by the Mount Sinai Medical Center.
“Very limited research has been done to evaluate bone marrow’s response to a virus infection. Our study is the first to determine the pivotal role bone marrow cells play in fighting a respiratory infection. This discovery has broad-reaching implications in boosting protection against viruses,” said lead scientist Carolina Lopez, PhD, Assistant Professor of Microbiology at Mount Sinai School of Medicine, in a statement.
Mounting the Immune Response
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Patients lose understanding of certain tastes and food combinations.
Ever cared for long-term care patients with dementia who develop abnormal food preferences and a taste for eccentric food combinations? That behavior is most likely due to their loss of meaning for flavors, according to a study.
Dr. Katherine Piwnica-Worms from Washington University in St Louis, Mo., together with Dr. Jason Warren and colleagues from University College London, tested how four patients with dementia processed flavor information. They used jelly beans to stimulate the understanding of different flavors. They then compared those patients’ performance to the abilities of six healthy subjects — of the same age and cultural background — to process the same types of flavors.
Research Findings Explained
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CMS to Conduct Additional MDS 3.0 Training in August
Posted on 06. Jun, 2010 by Editor in MDS Minute.
The August training will include MDS 3.0 updates.
Folks who didn’t get to go to CMS’ April MDS 3.0 training in Baltimore will have another shot at receiving in person training before the new instrument debuts on Oct. 1.
People should…
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FDA: Proton Pump Inhibitors Could Increase Fracture Risk
Posted on 04. Jun, 2010 by Editor in Clinical Notes.
PPIs linked to wrist, hip, spine fractures.
Putting residents on proton pump inhibitors long-term or at high doses may be fraught with fracture risk.
Recently, the Food and Drug Administration (FDA) has ordered a revision to the prescription and over-the-counter…
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The initiative is expected to end confusion and misdiagnosis.
Experts have agreed on three uniform definitions of malnutrition that will help scientists, health care professionals, and clinicians deal with its treatment better.
Members of the European Society for Clinical Nutrition…
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You now have until the new year to get your identity theft plan in order.
Your Red Flags Rule plan may be good for your patients, but it probably won’t help your regulatory status for a while yet.
That’s because the…
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Peek, You Pay: Case Provides Impetus for Shoring Up HIPAA Compliance
Posted on 28. May, 2010 by Editor in Regulatory Trends.
HIPAA violation lands an employee federal prison time.
When training staff about the dangers of accessing people’s medical records without a legit reason, you might cite a recent case as a cautionary tale.
A hospital researcher recently received a four-month…
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CMS to pay RUG-IV rates for the MDS 3.0 with retroactive payment adjustments.
CMS recently provided a heads up on its plans for managing the legislated RUG-IV delay. In a May 24 update for SNF providers, the Centers for Medicare…
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HHS Office of Inspector General Investigating Alleged Rehab RUG Upcoding by National SNF Provider
Posted on 08. Apr, 2010 by Editor in Breaking News.
Lesson learned: Be prepared to support outlier utilization.
Compliance experts often advise SNFs to keep an eye on their RUG patterns to see if anything jumps out at them as a red flag for potential inappropriate utilization.
As a case…
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CLASS Act Aims to Defray LTC Costs for People With Functional Limitations
Posted on 14. Apr, 2010 by Editor in Reimbursement.
Find out what the CLASS Act provides and a potential Achilles’ heel.
How many times have you admitted residents who were counting on Medicare to pay for their long-term care needs way beyond a 100-day SNF stay? In reality, of…
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Sleep Apnea Identified As a Stroke Risk Factor
Posted on 15. Apr, 2010 by Editor in Clinical Notes.
Study shows that men are at higher risk than women.
People who habitually snore and breathe abnormally through the night — especially middle-aged and older men— are more in danger of suffering from a stroke, according to a
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Be Prepared to Do Discharge MDS Assessments When the MDS 3.0 Goes Live
Posted on 16. Apr, 2010 by Editor in MDS Minute.
Find out what CMS may be able to tell based on this assessment.
Unless CMS makes a change before the MDS 3.0 rolls out on Oct. 1, your team will be doing MDS discharge assessments that make the current discharge…
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New Research Boosts Hope on the Breast Cancer Front
Posted on 21. Apr, 2010 by Editor in Clinical Notes.
If your post-acute patients with breast cancer ask you for the latest Rx news, here it is.
Researchers have found that two types of commonly used medications — beta blockers and aspirin — appear to have a positive impact on breast…
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Study: Baby Boomer Trends Portend Increased Demand for Long-Term Care
Posted on 22. Apr, 2010 by Editor in Breaking News.
Study finds pre-Medicare age group shows surprising rate of functional limitations.
A new study appears to call into question the image of a future where the majority of Baby Boomers manage to sidestep disability and the need for ongoing long-term care….
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Integrate Liberal Doses of Nonpharmacological Remedies in Your Pain Managment Toolkit
Posted on 22. Apr, 2010 by Editor in Clinical Notes.
Think inside the box for making the most of what you have to combat pain.
If notions of non-medication pain management bring to mind aromatherapy, biofeedback, and acupressure — those modalities are definitely on the list. But a pain management care plan…
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CMS Completes MDS 3.0 Train-the-Trainer Sessions, Shares Future Plans
Posted on 25. Apr, 2010 by Editor in Breaking News.
Tap these MDS 3.0 Q&As and other training materials.
The Centers for Medicare & Medicaid Services has achieved a major MDS 3.0 milestone. The agency has completed its MDS 3.0 train-the-trainer sessions.
In March, the agency conducted training for state…
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Tap the MDS 3.0’s Heightened Risk Prediction Powers
Posted on 30. Apr, 2010 by Editor in MDS Minute.
Coding for falls and behaviors can give you an edge in heading off problems.
The MDS 3.0 allows you to distill a more accurate resident risk profile to head off problems from admission on. Check out these five key assessment…
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FDA Approves Prostate Cancer Vaccine to Treat Metastatic Disease
Posted on 30. Apr, 2010 by Editor in Clinical Notes.
Add this novel option to the prostate cancer Rx list.
When patients with hormonally-resistant metastatic prostate cancer or their families ask you about their next treatment step, be prepared to let them know about a new vaccine.
What it is: The Food…
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Does Staying on Top of DAB and ALJ Rulings Pay Off as a Survey Management Strategy?
Posted on 01. May, 2010 by Editor in Surveys & Compliance.
Doing this instead may provide a bigger bang for your effort.
Questions: How advantageous is it for nursing facilities to review ALJ or DAB rulings in terms of applicability to their own situations? Can you sometimes identify trends by staying…
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Federal Probe Targets Nursing Home Operator for Potential Illegal Referrals to Psych Facility
Posted on 01. May, 2010 by Editor in Surveys & Compliance, Uncategorized.
Convicted physician points incriminating finger at nursing home operator.
The net is widening in a case where a Chicago internal medicine physician was convicted last year for providing kickbacks to other doctors to refer Medicare patients to a private psychiatric facility…
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Talking to your night shift folks may unveil whether sleep deprivation is taking a toll.
People in their 30s and 40s who work night shifts have trouble sleeping, according to a report in the April Journal of Occupational…
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Got EMRs? Brush Up on Privacy Basics Before Your Next Survey
Posted on 06. May, 2010 by Editor in Surveys & Compliance.
2 common privacy missteps will translate into F tags.
HIPAA compliance is hot these days. And the best w
ay to stay out of survey hot water for privacy breaches involving electronic health records is to know what surveyors will…
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GAO to CMS: Get Tougher on Special Focus Facilities
Posted on 07. May, 2010 by Editor in Surveys & Compliance.
CMS gets poor marks from GAO on enforcement of SFFs.
The Centers for Medicare & Medicaid Services (CMS) should exert more efforts to improve poorly performing nursing homes, as some states have not adhered to the requirements of CMS’s Special Focus…
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Ramp Up for the MDS 3.0 Interviews Now — Here’s How
Posted on 08. May, 2010 by Editor in MDS Minute.
Tips help residents participate more fully.
The MDS 3.0 resident inter
views will play a pivotal assessment role once the instrument goes live on Oct. 1. And now’s the time for your team to get a solid grip on the…
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LTC Planning Starts With Knowing the Bottom Line, Options
Posted on 14. May, 2010 by Editor in MDS Minute.
Preparing for future long-term care is a conversation everyone should have.
Thinking through long-term care costs and coverage should be part and parcel of all retirement planning. In fact, one financial counselor notes that you either talk long term care…
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Spouses of People With Dementia Could Be at Higher Risk for the Condition
Posted on 13. May, 2010 by Editor in Breaking News.
Spousal caregiver burden may include a heightened risk for developing dementia.
Previous studies have linked spousal caregiver stress to an increased incidence of depression and physical ailments. But a new study has come up with a disturbing finding: People are…
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Tune Up Patients’ Stooping, Crouching, Kneeling Abilities
Posted on 15. May, 2010 by Editor in Clinical Notes.
Get the inside scoop on how rehab therapists can help older adults with these functional limitations.
Documenting strength measurements may be especially important when working with elderly rehab patients. Recent research published in Physical Therapy suggests that decreased muscle strength is…
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RUG-IV May Require Revamping Case Management Strategies
Posted on 16. May, 2010 by Editor in Surveys & Compliance.
Home therapy visits could help achieve targeted outcomes under RUG-IV.
RUG-IV will only allocate half of a resident’s concurrent therapy minutes toward placement in a rehab RUG category. And the industry will take some time to figure out if having…
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Study suggests abnormal sleep predicts worsening quality of life.
Older people living in Assisted Living Facilities (ALFs) suffer from sleeping problems, a study published in the Journal of the American Geriatrics Society claimed. Poor sleep is…
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Study Connects Elderly People’s Falls with Blood Pressure and Flow
Posted on 21. May, 2010 by Editor in MDS Minute.
Seniors with blocked arteries fall an average of 1.5 times a year.
There could be a significant link between high blood pressure, slow blood flow in the brain, and incidence of falls in elderly people, according to a study published…
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Keep Your Eye Out for This IJ Citation Waiting to Happen
Posted on 22. May, 2010 by Editor in Surveys & Compliance.
Just because a nursing home resident doesn’t have an identified risk doesn’t mean you can’t get penalized for it.
How’s this for a survey management twist? Facilities can get hit with F tags for identifying a risk that doesn’t really…
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Create Crystal Clear Phone and Preauthorized Orders With These Tips
Posted on 23. May, 2010 by Editor in LTC Trends.
A standing physician’s order can help or hurt depending on whether you have these controls in place.
You can manage many conditions in the nursing home with telephone and standing orders. But your facility should take steps to ensure that…
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Poll Finds Californians Fear Long-Term Care Costs
Posted on 26. May, 2010 by Editor in LTC Trends.
Californians may not be the only ones with long-term care on their minds.
With the passing of the new health care law comes a new study that says two-thirds of registered California voters are anxious about the costs of long…
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Heading Off Delirium Could Prevent Permanent Cognitive Loss
Posted on 26. May, 2010 by Editor in Clinical Notes.
The MDS 3.0 Confusion Assessment Method could be a tool to help prevent dementia.
Clinicians often spell out the ways to tell dementia from delirium. But are the two actually linked so that preventing delirium could help protect a person’s…
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