Incorporating Home Health Aides into the Care Team

The final report’s executive summary
A research brief outlining the study’s findings (pdf)
The implementation manual (pdf)

Home health agencies that want to improve staff retention and client outcomes will find some unexpected results and useful lessons in a report recently posted to the US HHS/ASPE Office of Disability, Aging and Long-Term Care Policy website.

Home Health Aide (HHA) Partnering Collaborative Evaluation: Final Report (pdf) assesses the impact of an effort to truly incorporate home health aides into care teams. The initiative was implemented in 2003 by the Visiting Nurse Service of New York (VNSNY) and several of its licensed agency partners.


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Hurricane Gustav: Nursing home evacuations run smoothly this time

In stark contrast to three years ago, when the elderly, and nursing home residents in particular, were especially hard hit by Hurricane Katrina, authorities were reporting smooth evacuation processes took thousands of elderly out of harm's way.

Officials reported three deaths related to "healthcare facility" evacuations but did not specify where they occurred. None of the three were believed to have perished due to rain, wind or other storm effects from Gustav.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Long-Term Care Providers Form Coalition for Capital Access

WASHINGTON, Sept. 3 -- Long-term care facilities from across the country are forming the Coalition for Senior Healthcare Reform, an organization that seeks to improve the quality of healthcare for seniors by ensuring access to capital for long-term care, assisted living and skilled nursing facilities.
Over 230 facilities in 21 states have joined the Coalition that seeks to improve existing facilities, replace outdated ones and build desperately-needed facilities for America's aging population primarily through the support and improvement of the Federal Housing Administration's Section 232 mortgage insurance program.
"Mortgage insurance through FHA doesn't just help individual homeowners, it's a major source of credit enhancement for long-term care facilities, too," said Coalition Chairman Ira Smedra, President of the Los Angeles-based ARBA Group. "The FHA Section 232 program allows facilities to renovate and refinance and is a vital tool for building new facilities to support the growing number of seniors who need care."


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Community Choice Act and the Presidential Nominees

 Members of the Atlantis Community CIL and Denver ADAPT met with the
Republican presumptive presidential candidate John McCain at a Town Hall Meeting today. Six members of ADAPT, including teenagers from the Summer Youth Program, sat in the front of the auditorium to listen to McCain's policies for his administration. When he took comments from the audience he handed the microphone
to Dawn Russell. She explained the legislation called the Community Choice Act and asked him why he was not signed on. Mr. McCain stated he would not support the legislation. He then offered several poor reasons for his decision and ended by saying we would have to let thevoters decide that one. Having recaptured the microphone, he did state he supported the ADA, but had no interest in hearing that the ADA was entirely different from the CCA.

CCA supports putting control in the hands of the individual instead of Government, it supports states' ability to use limited Medicaid funds for community services which people prefer and which are
more cost effective.

Presumptive Presidential Candidate Barak Obama has signed on as a co-sponsor to the bill already.

ADAPT's Statement on CCA:

For decades, people with disabilities, both old and young, have wanted alternatives to nursing homes and other institutions when they need long term services. Our long term care system has a heavy institutional bias

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Drinking More Water Given As Reason For Improved Health In Elderly Care Home Residents

Residents and staff at a care home for the elderly in Suffolk, UK are convinced that the improvements in residents' health is because they are now drinking more water after a "water club" was introduced last summer.

The residents at charity-run The Martins care home in Bury St Edmunds, Suffolk, were encouraged to increase their water intake when the water club was introduced by care home staff last summer. They were encouraged to drink between 8 and 10 glasses of water a day, they were each given a jug of water in their room and water coolers were installed throughout the home.

A year ago, 88-year-old resident Jean Lavender struggled to walk, but now she goes outside most days for a walk, and feels 20 years younger. She told BBC News that:

"I feel more alert - more cheerful too. I'm not a miserable person, but it's added a sort of zest."

The care home is also seeing fewer falls, significant improvements in health, fewer GP call-outs, reductions in the use of laxatives and urinary infections, less agitation among dementia residents, and residents reporting better quality of sleep.

Wendy Tomlinson, a former nurse who became manager of the home last year, suspected that the low intake of drinking water among the residents was not doing their health any good and with staff devised and introduced the water club. But even she was surprised at the difference it has made.


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

The STrains and Drains of Long Term Care

Published in June, 2008 by the Urban Institute, this report discusses the economic burden that Americans take on when they are no longer able to care for themselves as they age.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Lawmakers Discuss Delaying Medicare Durable Medical Equipment Bidding Program

Sens. Debbie Stabenow (D-Mich.) and George Voinovich (R-Ohio) on Friday circulated a letter in the Senate seeking support for legislation that would delay a competitive bidding program in Medicare for durable medical equipment, CongressDaily reports. The program is scheduled to begin on July 1 (Edney, CongressDaily, 6/9). CMS will select DME suppliers to participate in Medicare based on bids they submit. The 2003 Medicare law mandated the program as part of a larger effort to implement competitive bidding.

In 2008, the program will operate in 10 of the largest Metropolitan Statistical Areas and will apply to 10 of the top durable medical equipment, prosthetics, orthotics and supplies product categories. In 2009, the program will expand to an additional 70 MSAs and will continue to expand in future years. The program also will apply to additional product categories in future years. The program likely will result in an average 26% decrease in the prices of medical equipment in the 10 MSAs, according to CMS (Kaiser Daily Health Policy Report, 5/7).


Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Intestinal Superbug: A Serious Health Care Threat

In recent years, healthcare-associated infections—illnesses you acquire during a stay in a hospital or long-term care facility—have reached epidemic proportions. One of the most widespread and potentially serious of these illnesses is caused by the bacterium Clostridium difficile, often simply called C. diff, which is responsible for tens of thousands of cases of diarrhea and at least 5,000 deaths in the United States each year. And the problem is getting worse. According to a new study, the number of people hospitalized with this intestinal superbug has been growing by more than 10,000 cases a year.

Dr. L. Clifford McDonald, a CDC expert said, "The nature of this infection is changing; it's more severe."

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

House Committee Holds Hearing On Concerns About Nursing Home Ownership, Inspections

The House Energy and Commerce Oversight and Investigations Subcommittee on Thursday held a hearing to examine the effects that the "increasingly veiled nature" of nursing home ownership and problems with inspections have had on the quality of care for elderly and disabled residents, CQ HealthBeat reports (Reichard, CQ HealthBeat, 5/15). According to CongressDaily, more than 50% of nursing homes are part of chains, with many of those owned by private equity firms that establish "layered entities" to operate the facilities, "making it difficult" for CMS, states and consumers to determine their owners and operators (Cox, CongressDaily, 5/16).

At the hearing, Lewis Morris, chief counsel to the Inspector General for HHS, said that CMS operates a database called "Pecos" that includes some nursing home ownership information but added that the system does not address the issue adequately. The database includes ownership information on 70% of the nursing homes that participate in Medicare, according to acting CMS Administrator Kerry Weems. He said that CMS seeks to "populate Pecos 100%" and link ownership information to quality data on the Nursing Home Compare Web site but added that the agency must have "usable" ownership information (CQ HealthBeat, 5/15).

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/