Archive for 'Breaking News'

Bone Marrow Cells Help Fight Respiratory Viruses

Posted on 12. Jun, 2010 by .

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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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Red Flag Rule Sees Another Delay

Posted on 03. Jun, 2010 by .

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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 Federal Trade Commission has delayed enforcement of the rule requiring creditors, including most health care providers, to have an identity theft prevention program in place. The delay until Dec. 31 comes on the heels of a lawsuit by the American Medical Association and other physician trade groups arguing the FTC is incorrectly applying the law to physicians.

A History of Delays

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Spouses of People With Dementia Could Be at Higher Risk for the Condition

Posted on 13. May, 2010 by .

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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 six times more likely to develop dementia if their spouse has dementia – regardless of the effects of age, gender, and socioeconomic status. The study, which was published in the Journal of the American Geriatrics Society, found that the incidence of dementia was significantly associated with older age, and having a spouse with dementia.

Principal author of the study, Dr. Maria Norton of Utah State University, and colleagues gathered 1,221 married couples without dementia aged 65 years and older from Northern Utah (2,442 individuals), and studied them to monitor the onset of the condition in husbands, wives or both. Over the course of 12 years, 125 cases of dementia in the husband were diagnosed, 70 in the wife, and 30 where both spouses were diagnosed (60 individuals).

After adjusting for socioeconomic status — which is a significant predictor of many health-related outcomes including dementia — to control for shared environmental exposures that might influence risk for dementia for both spouses, the researchers found that participants with a spouse who developed dementia were at a six times increased risk of developing dementia.

Aside from socioeconomic status, Norton and colleagues also adjusted for gender, APOE genotype, and age-related factors. The results showed that the husbands were at higher risk (11.9) than the wives (3.7).

“Future studies are needed to determine how much of this association is due to caregiver stress compared to a shared environment,” said Norton in a press release by The American Geriatrics Society. “On the positive side, the majority of these individuals, with spouses who develop dementia, did not themselves develop dementia, therefore more research is needed to explore which factors distinguish those who are more vulnerable.”

Spouse caregivers of dementia patients are often put under intense stress and depression because of close emotional ties to their partner, fatigue, functional limitations, and their own medical condition. “The chronic and often severe stress associated with dementia care giving may exert substantial risk for the development of dementia in spouse caregivers,”  the authors write.

Resource: Read “12 Real-World Ideas for Improving Staff and Resident/Family Satisfaction,” in Long-Term Care Survey Alert, Vol. 11, No. 6, which you can access immediately in the Online Subscription System archives when you subscribe to the newsletter.

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Sleep Troubles Pester Shift Workers

Posted on 06. May, 2010 by .

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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 and Environmental Medicine (JOEM). It becomes most apparent in the early and middle years of working life.

However, young shift workers who have sleep troubles are more likely to quit their routine so the problem does not seem to get worse, Philip Tucker, Ph.D., of Swansea University, Swansea, Wales, UK, and colleagues noted.

The researchers studied a range of workers at different ages over time, looking into the relationship between shift work and sleep problems. “Former shift workers reported more sleep problems than both current shift workers and those who had never worked shifts,” reports JOEM. Shift workers specifically pointed to waking up too early as a hassle more than other types of sleep problems.

The effects on sleep may continue for a long time even after giving up shift work, but they are not permanent, concludes the study.

A problem: “Many people who work night shifts try to run errands, and take care of children during the hours that should be used to get an adequate amount of sleep,” the Washington University Sleep Medicine Center reports

This can help people feel more productive, but can result in sleep problems that “can become debilitating over time,” the Web site warns.

Proactive strategy: Nursing home managers can work with their night shift staff to assess whether sleep deprivation is taking a toll.

Resource: To help your staff stay on top of their game, read “Take This Balanced Approach to Maintaining Your Wellbeing,” in Long-Term Care Survey Alert, Vol. 12, No. 4, available online immediately when you subscribe.

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CMS Completes MDS 3.0 Train-the-Trainer Sessions, Shares Future Plans

Posted on 25. Apr, 2010 by .

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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 representatives, including state RAI coordinators. The agency has posted Q&As from those sessions on its Web site.

In April, CMS conducted intensive sessions for stakeholders, including industry association representatives and providers. The training was a “well-received success,” said CMS’ Mary Pratt in the April 22 SNF/LTC Open Door Forum. MDS nurse Nemcy Cavite Duran, CRNAC, who attended the April training, found the discussion to be “comprehensive” and the speakers “energetic.” She also found the training materials provided to be excellent.

Be on the lookout …

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Study: Baby Boomer Trends Portend Increased Demand for Long-Term Care

Posted on 22. Apr, 2010 by .

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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.

 A study performed by the RAND Corporation and the University of Michigan found that a significant number of 50- to 64-year-olds had more functional limitations than anticipated, according to a news release from RAND. The researchers came to that conclusion by analyzing data from the 1997-2007 National Health Interview Survey, which showed that more than 40 percent of the 18,000 from that age group reported having difficulties with a number of physical functions, including stooping, standing for two hours, climbing 10 steps without resting, and walking a quarter mile. 

The study also unveiled “a significant increase in the proportion of people who reported needing help with personal care activities of daily living such as getting in or out of bed or getting around inside their homes,” states the release.

“This is a disappointing trend with potentially far-reaching and long-term negative consequences,” said Richard Suzman, director of the Division of Behavioral and Social Research at the National Institute on Aging, which funded the study. “If people have such difficulties in middle age, how can we expect that this age group — today’s baby boomers — will be able to take care of itself with advancing age?” asked Suzman in the release.

As for the causes of the functional decline …

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HHS Office of Inspector General Investigating Alleged Rehab RUG Upcoding by National SNF Provider

Posted on 08. Apr, 2010 by .

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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 in point, North American Health Care (NAHC) may have gone overboard by putting about 64 percent of its patients in the highest rehab RUG category, according to a Washington Post analysis.

A union, which was involved in a dispute with NAHC, uncovered the billing pattern, turning over its findings to Rep. Peter Stark, who got the HHS Office of Inspector General on the case, reports the Post.

John L. Sorensen, NAHC’s president and chief executive, justified the provider’s actions, pointing out that the residents who receive the highest level of rehab are recovering from major surgeries and thus require specialized care.

“But NAHC’s residents were no sicker or in greater need of therapy than other nursing home residents, the union’s analysis of medical records says,” the Post reports. (While the Post says it independently confirmed the RUG pattern identified by the union, the Post didn’t have access to the NAHC medical records and couldn’t confirm the union’s claim about the residents’ acuity levels.)

The Post reports that Sorenson said the company is cooperating with the OIG investigation. “They have not told me about any upcoding or wrongdoing at all,” the article quotes Sorenson as saying. “We have honest and forthright business practices in place. . . . We don’t have any need or reason to be doing any kind of upcoding. That would be completely wrong.”

According to NAHC’s Web site, as of April 2010, 21 of NACH client facilities had a 5-star rating, which is the top score in Medicare’s online Five-Star rating program which aims to help consumers to make informed decisions about selecting a nursing home. The Five-Star rating is based on a facility’s survey results, performance on MDS-driven quality measures, and staffing levels. “In all, 94 percent of all NAHC client facilities have either a 4 or 5-star rating,” the company reports (see the company press release) .

RUG-IV to Change This Utilization Pattern (more…)

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RUG-IV Hits a Bump in Rollout

Posted on 26. Mar, 2010 by .

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A one-year legislated RUG-IV delay includes a troublesome twist.

It’s final, for now anyway: The healthcare reform bill rolls back the RUG-IV classification system debut until Oct. 1, 2011, which means RUG-III will remain in place until then. The measure doesn’t, however, affect MDS 3.0 implementation, which is still a go for Oct. 1, 2010.

If you’re wondering how that’s going to work out for SNFs, you’re not alone. And it gets even trickier: The legislation implements two key RUG-IV payment features this Oct. 1: a limitation on concurrent rehab therapy and elimination of the hospital lookback period.

In other words, “we’d have the worst part of RUG-IV without any of the benefits,” says Peter Arbuthnot, a regulatory analyst for a long-term care software developer.

“The delay and changes to the RUG-III system provide a lot of challenges,” says American Health Care Association spokeswoman Susan Feeney, “which is why we want RUG-IV and MDS 3.0 to be implemented at the same time.”

Congressional leaders had hoped to repeal the RUG-IV delay as part of the reconciliation process, Feeney tells InHealthcare. However, “strict procedural rules for reconciliation didn’t allow them to do so.”

The American Association of Homes & Services for the Aging is telling its member facilities to continue to assume that RUG-IV will be fully implemented as planned on Oct. 1, advises Barbara Manard, PhD, VP for long-term care health strategies for the organization. “Efforts are underway to devise an appropriate solution and return to the full implementation as originally planned for October 1, 2010,” Manard said in an e-mailed statement.

Arbuthnot notes that “it’s not 100 percent [certain] that trade groups are going to be able to stop” the legislated RUG-IV delay. But he thinks the odds are stacked in favor of that happening. “I don’t see how anyone who thought about this measure logically could think it should remain.”

Improve Medicare billing at your SNF with these field-tested techniques.

© MDS Alert.


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What Are the Top Challenges for Those Working in Nursing Homes?

Posted on 07. Feb, 2010 by .

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It’s not salaries or job security, according to a recent AANAC survey.

If you view survey readiness and follow-up issues after state surveys as really challenging — you’ve got company.

That concern ranked among the top three challenges cited by American Association of Nurse Assessment Coordinators’ members who responded to a recent AANAC survey. The other challenges were as follows:

Training and continuing education for staff to keep up with regulatory and industry changes; and

The burnout and stress of everyday work. “Close to 60 percent of respondents report working overtime on a regular basis and 40 percent report being pulled from their regular duties,” according to a press release. As for key elements of how respondents felt about their job, the survey found that:

75% were satisfied or very satisfied with their compensation … (more…)

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Couldn’t Make It To Chicago? An AAHSA Report from Karen Lusky

Posted on 15. Nov, 2009 by .

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From HAL, the robot helper, to raucous rock-and-roll to RAC readiness: AAHSA Convention & Expo a Big Hit

With reported attendance topping the 6,000 mark, the American Association of Homes & Services for the Aging’s annual meeting and expo in Chicago covered topics ranging from using a wellness approach to dementia to the practical realities of ramping up for the growing government crackdown on compliance.

A popular session on Recovery Audit Contractors (RACs) addressed how SNFs can prepare for RACs without reinventing the wheel. Co-presenter Terri Cunliffe, VP of health and wellness for a national non-profit chain, talked about how her organization has partnered clinical and third-party billing — a team approach that allows the SNF communities to more quickly fix shortfalls in clinical documentation or a problem on the clinical side. “Really, billing comes out of clinical … ,” Cunliffe pointed out.

In an interactive session on quality improvement, one nursing facility clinician shared how staff finally overcame a family member’s fear of doing away with her resident’s lap-buddy restraint. Another presenter talked about the surprising root cause of a cognitively impaired resident’s frequent falls. (For details, see MDS Alert, Vol. 7, No. 13). Next, AAHSA meets The Jetsons … (more…)

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