Health and Disability

In 2012, 1 out of every 8 patients nationally suffered a potentially avoidable complication during a hospital stay, the government estimates. Even infections that are waning are not decreasing fast enough to meet targets set by federal health officials. Meanwhile, new strains of antibiotic-resistant bacteria are making infections much harder to cure.

Starting in October, a quarter of the nation's hospitals — those with the worst rates — will lose 1 percent of every Medicare payment for a year. In April, federal officials released a preliminary analysis of which hospitals would be assessed — they identified 761. 

Crystal Care, one of the largest home health care companies in Minnesota, was on the brink of collapse and had stopped paying its employees. Many had quit going to work, leaving their sick and bedridden patients at home for weeks with limited or no care. Even as state officials learned of the crisis, no one alerted Parson.

The slow demise of Crystal Care, which finally shut its doors in March, reflects the grave and widespread problems that shadow the home health care industry as it grows explosively in Minnesota and across the country.

The industry is also wracked by instability. Of the roughly 800 companies that employed personal care assistants in Minnesota in 2009, one-third have since closed their doors, according to a state database analyzed by the Star Tribune. State records also show that more than 100 home care companies have had more than $350,000 in unpaid-wages claims in the past five years.

Symptoms are interpreted differently depending on age. Hypoglycemia as dementia....

Most of the time, the older woman seemed sharp. But increasingly, she became confused and disoriented — a case of “intermittent dementia,” one doctor speculated. Further tests were ordered, and then another diagnosis emerged.

It wasn’t dementia at all. It was hypoglycemia, or low blood sugar. The woman had diabetes and was taking too much medication. Once the doses were lowered, her cognitive symptoms disappeared.

Dr. Kasia Lipska, an instructor at Yale School of Medicine, told me this story as she described hypoglycemia among older adults, a growing concern. Recently the Centers for Disease Control and Prevention reported that 29 million Americans have diabetes, up from 26 million in 2010.

Older adults with diabetes are more likely than younger people to have bouts of low blood sugar because of altered kidney function, other medical conditions, other medications that interact with their diabetes drugs and a reduced ability to sense the warning signs of hypoglycemia: shakiness, sweatiness, dizziness, weakness, a feeling of intense hunger and blurred vision, among others. When glucose circulating in the blood plummets precipitously, people can collapse, lose consciousness, become delirious and die.

The International Caregivers Association (ICA) has big plans to change the world of dementia care and we hope you'll join us. It is the ICA's goal:

1. to clearly communicate our mission of compassion, education, and advocacy;
2. to empower all stakeholders (care receivers and care providers);
3. to forever change the status quo in an effort to improve dementia care for the smallest of families to those in the largest of assisted living and long-term care facilities.

for many years, home health agencies and nursing homes who contract with Medicare routinely terminated Medicare coverage for a beneficiary who had stopped improving, even though nothing in the Medicare law required improvement as a condition for continued coverage.  In practice, both Medicare and the contract providers wrongfully applied an “improvement standard” to deny continued coverage to patients who had “failed to improve” or who had “plateaued”.  In short, once beneficiaries failed to show progress continued coverage was denied.  However, this misapplication of Medicare law was successfully challenged in a class-action lawsuit entitled Jimmo v. Sebelius, which was settled last year with nationwide impact. 

Under the settlement agreement, Medicare agreed to abandon its use of the so-called “improvement standard”.  It also agreed to revise its Medicare Benefit Policy Manual and to issue written instructions to its healthcare providers to make clear that continued  coverage of skilled nursing and therapy services does not turn on the presence of a beneficiary’s potential for improvement, but rather on whether he or she needs skilled care to “maintain” his or her current condition or to “slow further deterioration”.  Under the new policy, if your husband would be at risk for losing function or “backsliding”, then continued therapy ought to be provided and covered by Medicare.

Unfortunately, even though the Jimmo settlement is more than a year old,  we find that many healthcare providers are unaware of the end of the old “improvement standard”.  As a result, many seniors still experience premature Medicare coverage terminations because they are not improving.  This is especially problematic for person suffering with chronic conditions such as multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, ALS, heart disease and stroke.  The good news, however, is that advocacy on your part can play a big role in correcting premature coverage terminations.

If you receive a notice that Medicare coverage is about to terminate, consider an immediate appeal. 

For the study, occupational therapy and physical therapy students were taught the basic shiatsu techniques and in turn trained participants, who reported falling asleep faster - sometimes even while administering treatment - and slept longer after two weeks and eight weeks of treatment, compared with a baseline measurement.

Subsidized shoppers on HealthCare.gov are paying, on average, $82 monthly premiums for health plans, new data from the US Department of Health and Human Services shows.

Long-term care facilities are by far the most common settings for norovirus outbreaks, dwarfing the number of outbreaks in hospitals, according to government data released Tuesday.

But it's unclear whether the savings will be enough to help hospitals offset cuts from the Affordable Care Act.

Early evidence shows a dramatic drop in uncompensated care for hospitals in states that expanded Medicaid, according to a report released earlier this month by the Colorado Hospital Association. But it's unclear whether the savings will be enough to offset cuts from the Affordable Care Act (ACA).

The study, which provides the most comprehensive view yet of Medicaid expansion's impact on uncompensated care, analyzed data from 465 hospitals in 30 states in the first four months of Medicaid expansion. It found that unpaid care decreased by 30 percent in expansion states and remained essentially unchanged in non-expansion states. The report links an enrollment surge in expansion states to not only the reduction in uncompensated care but also the 25-percent decrease in people paying out of pocket.

Uncompensated care cost the country about $46 billion in 2012, according to the American Hospital Association. It's been increasing the past several decades and risen at an even faster rate the last ten years.

The device takes over the task of monitoring and regulating sugar levels in the blood. Every 5 minutes, a signal is sent wirelessly from a glucose monitor under the user's skin to an iPhone app, giving their blood-sugar status. The app calculates the amount of insulin or glucagon needed to balance blood sugar, sending a signal to pumps carried by the user to administer the required dose via a catheter. Before eating, people can input data about the type and size of their meal.

The artificial pancreas performed well in hospital-based clinical trials in 2010. But the important test is whether it works in a real-world environment. In the latest study, 20 adults wearing the device were put up in a hotel for five days but were otherwise free to do as they chose, including eat in restaurants and go to the gym. Thirty-two young people, aged 12 to 20, were also monitored for five days at a summer camp for kids with diabetes. For both groups, the results with the bionic pancreas were compared with five days of the participants using their usual method of controlling the disease – pricking their finger to monitor glucose levels and using an insulin pump, that requires them to manually calculate the dosage.