Doctors’ Choice of Words Critical to End-of-Life Decisions
The way doctors present end-of-life decisions, such as do-not-resusitate (DNR) orders, heavily influences the decisions of patients’ families in how they handle these difficult choices, according to a new study published in the journal Critical Care Medicine. Read the story
“Simple changes of words and perceptions about social norms resulted in large differences in CPR choices,” said study author Dr. Amber Barnato, an associate professor of clinical and translational science at the University of Pittsburgh School of Medicine in a statement. “This study suggests that the change isn’t just window dressing — it makes a real difference in the choices that people make. We expect that it also may reduce feelings of guilt for choosing against CPR by making family members feel like they are doing something positive to honor their loved one’s wishes at the end of life, rather than taking something away from them.”
Exercise May Improve Fibromyalgia Pain
Medicare Cuts May Be Affecting Cancer Care
Eight Northern California Hospitals Experience Readmissions Penalties
Eight hospitals in Northern California, many of which serve low-income patients, have been hit with penalties from Medicare for higher-than-expected readmissions rates. Their experiences detail the complexities surrounding the readmissions penalties and how they are calculated. Read the story
Opting for a Non-smoking Hotel Room May Not Protect Against Tobacco Exposure
A new study, published in the journal Tobacco Control, found that guests in hotels with partial smoking bans (some designated non-smoking rooms) were still exposed to harmful thirdhand smoke at levels that can affect health. Read the story
Blog Helps De-Mystify Medicare as Part of a 16-week Retirement Planning Tool
For those approaching their 65th birthdays, understanding Medicare benefits is key to implementing a successful retirement plan. Part 13 of this 16-week planning resource is devoted to explaining Medicare and its relationship to other insurance plans seniors might have. Read the story
Finding affordable medical insurance is a critical part of your retirement planning. Once you’re eligible for Medicare at age 65, insurance becomes more affordable, and you can’t be denied coverage for pre-existing conditions. Despite these benefits, managing your insurance can still be complicated, and you’ll need to plan carefully to make every dollar count. — CBS Moneywatch
Some Doctors Using Innovative Ways to Practice Medicine in Changing Healthcare Environment
In response to a changing healthcare landscape, where less-but-better care is seen as the goal, some doctors have changed their practices in hopes of keeping up. Integrated care plans and wellness programs are just two examples. Read the story
Definition of Stroke Altered
The American Heart Association/American Stroke Association (AHA/ASA) will now define stroke as tissue damage shown by neuro-imaging, whether or not symptoms exist. The new definition was revealed this week in a consensus document put forth by the organization. Read the story
Are House Calls a Needed Component of Healthcare Reform?
Retired physician Michael Fleming makes the case that healthcare at home, which played an important role in his 29-year career as a doctor in Louisiana, can play a critical role in reducing costs and providing better care to patients. Read the story
Innovative Proposals for Post-acute Projects Solicited
The Centers for Medicare and Medicaid Services (CMS) issued a call for proposals for programs that can help reduce healthcare spending in outpatient and post-acute settings. The application period for the $1 billion innovation initiative runs from June 14 through August 15, 2013. Read the story
Each May, we recognize Better Hearing and Speech Month to honor and thank the speech language pathologists who work for us and celebrate their accomplishments. SLPs take the lead in caring for language, speaking and hearing disorders that often afflict our patients. Our SLPs most frequently treat patients with dysphagia, a disorder that affects the physical and/or sensory aspects of swallowing, and aphasia, a language disorder resulting from brain damage. SLPs are uniquely trained to assess the problems affecting communication and swallowing, design a rehabilitation program and motivate the patient through rehabilitation. An SLP can teach compensatory strategies in areas where communication or swallowing function may not be regained.
Given their wide range of skills, SLPs are an integral part of the therapy mix for patients facing recovery from different ailments or disabilities. Speech language pathology is a common part of recovery for stroke victims, whose language and speech may be impaired following an episode. Cancer patients who have undergone neck radiation, which alters taste and saliva flow, also may receive speech language pathology services. In addition to seeing adults, SLPs are trained to help children with developmental disabilities ranging from pronunciation and stuttering to dyslexia and literacy.
Kindred extends our gratitude to our SLPs for their dedication to restoring all of these critical functions to our patients each year. To learn more about the role of the speech language pathologist, the conditions they treat and the methods they use, visit RehabCare Advantage, the blog for Kindred Healthcare’s rehabilitation division. Have a great month, SLPs!
Join us as we recognize Kindred Hospitals – transitional care and inpatient rehabilitation – during National Hospital Week, May 12-18. This is an excellent opportunity to acknowledge the innovations, technologies and staff dedicated to quality patient care.
This year’s theme, “A Guiding Light for Changing Times,” echoes the changes happening nationwide in healthcare however, Kindred’s goal of making recovery and rehabilitation possible for patients today and in the future remains the same. Kindred Transitional Care Hospitals play a vital role in the recovery process for the sickest and most medically complex patients who require acute care and rehabilitation over an extended recovery period. Kindred Inpatient Rehabilitation Hospitals and hospital-based Acute Rehabilitation Units – all certified as Inpatient Rehabilitation Facilities (IRFs) by the Centers for Medicare and Medicaid Services (CMS) – provide rapid recovery and improved function for patients who can tolerate at least three hours of rehabilitative care per day. Additionally, these settings provide physician-supervised care, use an interdisciplinary approach and certify for each patient a clinical need for therapy in at least two disciplines.
As a result of Kindred’s Hospital Division leadership and dedicated hospital staff, the transitional care hospitals outperform national quality benchmarks in key clinical areas, discharge patients home or to a lower setting of care after an average length of stay of 27.3 days, and play a critical role in reducing costly rehospitalizations. In addition, Kindred’s freestanding inpatient rehabilitation facilities (IRFs) delivered 4% greater functional improvement to patients than the national average in 2012. For more information about Kindred Hospitals and their performance outcomes, read the 2012 Quality and Social Responsibility Report.
Watch the videos below to learn what makes Kindred’s Transitional Care and Inpatient Rehabilitation Hospitals unique.
Genes for Longevity May Protect Against Early Dementia
A study published in the journal JAMA Neurology found that people with long-living blood relatives are significantly less likely to develop dementia until they themselves are in their nineties. The subjects in the study were compared to their spouses, who did not have long-living relatives. Read the story
Observation Care for Seniors Targeted by New Medicare Proposal
Medicare has proposed limiting the number of days patients can be under “observation care” in the hospital, during which they are not admitted but are viewed as outpatients. The controversial proposed changes would require physicians to admit patients who they expect will be in the hospital longer than two days. Read the story
Study Examines Three Proposed Changes to Cut Medicare Costs
The RAND Corporation has conducted a study comparing three ways to cut Medicare spending, from requiring wealthier seniors to pay more for Part A, to providing seniors with a sum of money to purchase insurance plans, to raising the Medicare eligibility age. Read the story
Data Show that Hospitals Charge Medicare Different Sums for the Same Procedures
The amounts that hospitals are charging Medicare, often for the same procedures, can vary incredibly, according to new data released this week from the Centers for Medicare and Medicaid Services. This information is leaving many people scratching their heads about how hospitals determine what to charge, why the discrepancies are often so big between institutions, how this affects patients and what may need to be done about it. Read the story
Study Shows Sun’s Benefits May Outweigh Risks
According to a Scottish study, exposure to the sun may protect against heart attack and stroke, which may outweigh or at least offset the risk the of skin cancer. The results of the study were presented this week at the annual International Investigative Dermatology conference. Read the story
Benefits of Electronic Health Record Go Far Beyond the Incentives for One Rural NP
Nurse practitioner Carol Taylor, who practices in rural New Mexico, implemented an electronic health record and was pleasantly surprised with the results of her efforts, seeing significant improvement in patient outcomes. Read the story
Since implementing the EHR system…I can see that the benefits extend far beyond the incentives. In my practice, the EHR has improved patient outcomes due to integrated standards in the system.
- Simple clinical guidelines pop up when entering the diagnosis “diabetes.” These prompts facilitate the care of diabetic patients with current evidence-based techniques. This is just one example of the better patient care enabled by committed providers who use EHRs.
- When e-prescribing, the system prompts us with safety alerts such as drug-allergy interactions and drug-to-drug interactions. The process just simplifies prescribing and renewals. – Read the blog
Bundled Payments May Curtail Spending on Post-Acute Care
Post-acute Medicare spending per patient has seen a staggering increase over the past 15 years, according to a Harvard study that examined spending related to three conditions: congestive heart failure, hip fracture and heart attacks. The researchers speculate that bundled payments may help to address this issue. Read the story
Pilot Program Aims to Get Seniors Online
Isolation is an “unrecognized crisis among seniors,” said Tom Kamber, executive director at Older Adults Technology Services, which developed the program and is training its volunteer instructors. “A lot of older people feel, in the digital age, that they are not relevant or included.”
Medicare Hospice Expansion Project Has Not Taken Off
A 2010 Congressional order for a project to expand the provision of hospice services to Medicare patients who wish to continue potentially curative treatments has remained largely un-implemented, possibly costing Medicare more and denying helpful therapy to patients who need it. Read the story
Can Eating Peppers Protect Against Parkinson’s?
A new study suggests that eating peppers and other foods that naturally contain nicotine may offer protection against Parkinson’s, an incurable neurological disease that causes dizziness, tremors and stiffness of the face and limbs. According to the Parkinson’s Disease Foundation, nearly one million Americans have Parkinson’s. Read the story
“When you are comfortable with the person you are seeing long-term, they become your family,” she said.
When she graduated from nursing school nearly four years ago, Marvalyn, 28, took a job with Kindred Hospital Cleveland, and has never looked back. She was recently promoted to nurse supervisor.
“Because our patients are here long-term, I really get to know them, and I love that part of my job,” she said. “When something is wrong, I know it, because I know them so well.”
There are challenges as well, but addressing them and rising to them can have its own rewards, Marvalyn said.
“One of the hardest things is explaining to some of the family members that things might not be going the way they expected,” she said. “Sometimes they will have unrealistic expectations for their loved one’s full recovery and bringing them to reality is sometimes hard. It’s usually that they don’t understand, and helping them understand what is going on is really important.”
A positive mindset is key, she said.
“Hopefully the next step is rehab and then coming back home,” she said. “I tell them to keep that mind.”
But seeing patients progress is often the greatest reward of all.
“It feels excellent,” Marvalyn said. “ I am seeing patients come in sick, sometimes frustrated and angry, and go to alert and oriented, to leaving, and even to coming back and saying, ‘hey I’m doing fine.’”
Marvalyn also serves as a mentor to those she supervises.
“Seeing my employees have a good day, and being there for them when they need me, whenever they need me, is rewarding as well,” she said.
For those considering a career in nursing, Marvalyn cautions students to go in with eyes wide open.
“It’s not easy, make sure you understand every aspect of nursing,” she said. “And make sure you understand everything along the way, because if you don’t, you may never catch up.”
Every day, and especially this National Nurses Week, Kindred Healthcare celebrates and takes pride in our outstanding nurses, like Marvalyn, who embody the idea of hope, healing and recovery.
Representing the commitment to pursuing improved quality and the innovations that enable better patient care in our nation’s skilled nursing facilities, the Alliance for Quality Nursing Home Care (the Alliance) published its 2013 Quality Report on Skilled Nursing Facility Care. The stated goal of which “is to provide an objective national overview of Skilled Nursing Facility (SNF) patient care quality, pertinent quality trends, specific improvements, and areas of care requiring continued attention.” The report relies on publicly reported data as well as expert third-party experts to provide an effective assessment.
The release of the report is timely as legislators in Washington, DC, prepare to consider Medicare payment reforms for post-acute care – especially in light of the wide recognition that nursing facilities are a cost-effective and important element in the care continuum.
Some of the top line findings of this report include:
- Quality Measures (QMs) – as tracked by the Centers for Medicare and Medicaid Services (CMS) – for short-stay patients, including pain and pressure ulcers, are steadily improving (trending improvement since 2003);
- A majority of CMS QMs for long-stay residents are improving;
- Staffing levels as measured by hours per patient day for both licensed nurses (RNs, LPNs, etc) and certified nurse aides (CNAs) have steadily increased since 2005, and the percent of reliance on contract staff has been significantly reduced over the same period;
- Nearly nine out of 10 residents and their families – a full 88 percent – have high overall satisfaction levels and would recommend to others the facility in which they or their loved one resides;
- Standardized patient assessment and quality measurement across post-acute settings are necessary to improving patient-centered coordinated care and overall quality of care in our nation’s healthcare delivery system.
The Alliance Quality Report also features three “Spotlights on Success” that detail programs and innovations being pursued by nursing center companies – including Kindred – to improve patient outcomes. The purpose of the spotlights is to provide objective evidence of the industry’s commitment to providing the highest possible quality of care and quality of life to patients by shortening lengths of stay, discharging more patients home, reducing rehospitalizations, and creating better outcomes through rehabilitative therapies.
This report underscores the industry’s commitment to pursuing quality, and ties in to the performance outcomes Kindred published earlier this year through its 2012 Quality and Social Responsibility Report, which included quality improvement in its Nursing and Rehabilitation Centers and Transitional Care Centers. The report highlighted that:
- In 2012, Kindred’s Nursing and Rehabilitation Centers discharged 53% of patients home – after an average stay of 31 days;
- From 2008 to 2012, these centers reduced rehospitalizations by 11.7%
- From 2008 to 2012, the total length of stay in Kindred Nursing and Rehabilitation Centers were reduced by 27%.
Medicare Readmissions Rules Questioned as Hospitals Face Penalties
As hospitals face penalties for higher-than-expected readmissions rates and new programs are implemented to keep patients from returning, some people are questioning if certain hospitals, such as those that treat the sickest patients and those that serve lower-income populations, are at an unfair disadvantage. Read the story
Ethics of High-Priced Cancer Drugs Questioned
A recently-published research paper takes the pharmaceutical industry to task for allegedly charging exorbitant prices for some drugs that cancer patients cannot live without. Read the story
Hospitals May Get a Raise from CMS
A Centers for Medicare and Medicaid Services (CMS) proposal provides a 0.8 percent pay raise for acute care hospitals and a 1.1 percent increase for long-term acute care facilities that would take effect in October. Read the story
What Skills Will Tomorrow’s Doctors Need?
According to internal medicine physician and geriatrician Leslie Kernisan, the physician of the future will need to be: willing to use new technology; collaborative (with patients and families); open to continuous review of current practice, and comfortable with patients who are actively engaged in their own conditions and treatments. Read the story
It’s not that prevention isn’t important, or that we couldn’t face a radically different healthcare landscape in 20 years.
Rather, it’s that it slightly kills me that so much of this creativity and intelligence and innovation keeps leapfrogging over the very important — and very interesting — problems facing healthcare’s power users, and these are problems that we need to solve by tomorrow. Or the day after. Or maybe the year after, but really, if they don’t get meaningfully addressed within the next several years, we are going to have even worse problems than we have now. — Leslie Kernisan, MD, MPH
New Health Insurance Form Shortened
A form from the Department of Health and Human Services, aimed at single adults looking for help paying for insurance, has been shortened from 21 pages to three and will give Americans an easier way to apply for health insurance by fall. Read the story
Gene Therapy Tested in Heart Failure Patients
Researchers in the UK are infusing sick hearts with a “heart-healing virus,” genetically modified to produce a type of protein that is deficient in heart failure patients, hoping to strengthen the heart muscle and improve quality of life. Read the story
Can a Mediterranean Diet Help Preserve Memory?
A study has found that a Mediterranean diet, rich in omega-3 fatty acids and low in saturated fats, may help sustain memory and shield against cognitive impairment. Read the story
Benefit of Surgery for Non-Melanoma Skin Cancer in Elderly Patients Questioned
Poor wound healing and other surgery-related complications, yes. But an increased life expectancy as a result of surgical intervention? Maybe not. A new study questions whether the risks of surgery for non-melanoma skin cancers outweigh the benefits for some elderly patients. Read the story
Healthcare Providers May Be Misunderstanding HIPAA
Misunderstanding or “over-interpretation” of provisions of the Health Insurance Portability and Accountability Act may be putting patients – and the public – at risk, according to some members of Congress. Read the story