Showing posts with label nursing homes. Show all posts
Showing posts with label nursing homes. Show all posts

Sunday, 12 June 2016

Princess Health and Health ranking of Kentucky seniors moves up, but they are still last in health outcomes, says America's Health Rankings. Princessiccia

By Melissa Patrick and Al Cross
Kentucky Health News

Kentucky moved up three spots, from 48th to 45th, in the fourth annual Senior America's Health Rankings Report. But the state ranked last in health outcomes and 44th in determiners of those outcomes, so it remains one of the least healthy places in the nation for seniors to live.


Among negative measures, Kentucky seniors ranked first in preventable hospitalizations, second in tooth extractions and premature death; and third in physical inactivity and hospital re-admissions within 30 days of discharge.

Among positive measures, the state also ranked poorly: for example, 46th in the percentage (34%) of seniors who reported that their health status was good or excellent and 48th in the percentage (56.9%) who reported having no disability.

The state's best ranking was No. 3 in influenza vaccinations, reflecting an increase to 70 percent from 62 percent of seniors vaccinated in the past two years. It was No. 8 in the percentage of seniors with arthritis who self-report arthritis or joint pain does not limit their usual activities. It tied for 10th in the percentage of seniors with a "creditable prescription-drug plan" and was 17th in the percentage of senior who reported having a mammogram or a colonoscopy or similar screening.

Kentucky ranked low in volunteer activity by seniors (45th) and nursing home quality (43rd) but has fewer people in nursing homes who perhaps shouldn't be there. Only 7 percent of its nursing-home residents, the No. 7 ranking, were considered "low care" and thus candidates for living in less restrictive environments. However, it was 46th in the number of personal-care and home-health aides per 1,000 adults aged 75 or older.

The state tied for 44th in the percentage (32.1) of seniors who reported falling in the previous 12 months. It was 44th in the percentage (42.8) of seniors who were enrolled in hospice during the last six months of life after being diagnosed with a condition that carried high probability of death.

It was also 44th in a related measure, the percentage (16.6) of seniors who spent seven or more days in an intensive- or critical-care unit during their last six months. Generally, use of an ICU correlates with the number of ICU beds, which "could indicate a supply-induced remand," the report says. "Overusing the critical care system often goes against the wishes of dying patients and is costly. Research indicates many patients receive care they would not choose in their final days."

The rankings are based on 35 measures of health, as well as supplemental measures such as education and mental health. Combined, they paint a picture of how individual behavior, our communities and their environments, health policy and access to care influence health.

One area that Kentucky consistently ranks low in is government support for seniors in poverty. It was 45th again this year, spending $382 per senior when federal, state and local funds were all counted. Massachusetts, which ranked first in overall senior health this year, spends $4,053 per senior in this category, more than any other state but Alaska, which has many rural elderly. The national average, which has been declining, is $811.

Kentucky leads the nation in smoking, so it's no surprise that its seniors also rank in the bottom five states for this negative category (47th). Kentucky seniors' smoking rate is 12.4 percent; the national average is 8.8 percent. Both have declined about 40 percent in the last 15 years.

Smoking is the leading cause of preventable death in the United States," says the report. "Cessation, even in older smokers, can have profound benefits on current health status as well as improve long-term outcomes."

Kentucky was fifth from the bottom in dental visits by seniors, but the good news is that the share of seniors having such visits rose to 57 percent from 53 percent last year.

"Poor oral health is associated with such chronic diseases as diabetes and cardiovascular disease, and can have a large impact on quality of life resulting in pain and affecting the ability to chew or speak," says the report.

Kentucky improved its senior obesity ranking, another negative measurement, to 24th from 41st. About two out of every seven Kentucky seniors are obese, or 27.5 percent, the same as the national average. Last year the rate was 29.6 percent.

"Obese seniors experience more hospitalizations, emergency department visits, and use of outpatient health services than non-obese seniors, leading to higher health care costs," says the report. "Physical activity, healthy diet, supportive communities and social networks, and an environment that encourages exercise all play a role in reducing obesity in older adults."

The report says that between 1999 and 2014, Kentucky's middle-aged population (50-64) saw a 34 percent increase in in obesity and a 68 percent increase in diabetes. These findings were similar across the nation.

The report says Kentucky's senior population is expected to increase 44 percent by 2030. "Over the next 15 years, the health of this population will be challenged by large numbers of new people becoming seniors and the additional health challenges, such as diabetes, that this groups brings with them," it says."These higher rates of diabetes and obesity are expected to put significant strains on the Medicare program and the overall health-care system."

The report, sponsored by the United Health Foundation, is a call to action for states, offering specific benchmarks that can be changed to improve health.

Louisiana again ranked last for overall senior health, followed by Oklahoma. Kentucky, West Virginia, Arkansas and Mississippi had similar scores. The top six states for overall senior health are Massachusetts, Vermont, New Hampshire, Minnesota, Hawaii and Utah. Click here for the full report. (Click on chart for another version that may be clearer)

Saturday, 19 March 2016

Princess Health and  Bill for review of medical lawsuits dies from special elections. Princessiccia

Princess Health and Bill for review of medical lawsuits dies from special elections. Princessiccia

A bill that would create panels of experts to review lawsuits against health-care providers is going nowhere, again.

State Senate President Robert Stivers said Friday that he and other leaders of the Senate's Republican majority sent Senate Bill 6 back to committee because last week's special elections continued Democratic control of the House. They did likewise with a bill for a "right to work" law that would ban union membership or fees as a condition of employment.

�The reality is the House does not see as the majority party in this Senate does, that right-to-work would even be another tool that could increase and expand on job recruitment and retention,� Stivers said. �The other thing is we�ve had Senate Bill 6 sitting on the board for quite some time. But, because of the elections two weeks ago, the consequences are, they would pass this chamber but die in the House.�

Thursday, 25 June 2015

Princess Health and The Homeplace at Midway opens, with cottages for nursing, assisted living, memory care; first 'Green House' facility in Ky..Princessiccia

By Kacie Kelly and Al Cross
University of Kentucky School of Journalism and Telecommunications

The Homeplace at Midway was formally opened Thursday, June 25, bringing to fruition a 16-year campaign for a nursing home in the Woodford County town of 1,700. For photos from its June 28 open house, click here.

Construction this spring (Christian Care Communities photo)
The Homeplace, which has four residential buildings that look like single-family homes, is more than a nursing home. Two of the buildings are for skilled nursing, but one is for assisted living and the other is for "memory care" or personal care of patients with dementia and other cognitive impairments.

�The Homeplace at Midway represents a new beginning for older adults in Kentucky and for communities across the commonwealth to embrace them as living treasures, not a burden or a challenge,� Dr. Keith Knapp, president and chief executive officer of Christian Care Communities, which built the Homeplace and will operate it, said at the ribbon-cutting ceremony.

Assisted living cottage (Photo by Kacie Kelly)
�We are extremely grateful to the City of Midway, the Midway Nursing Home Task Force, Midway College, state and local government agencies, our capital campaign�s Leadership Council and all our friends and supporters who championed this new direction and envisioned with us a new day when older adults would receive the highest quality care and support, without feeling their lives are being disrupted or overtaken,� Knapp said. �We trust that it will inspire other senior living providers to move in a similar direction.�

The Homeplace is the first facility in Kentucky built with The Green House model, which includes home-like environments and strong relationships with caregivers, with the goal of meaningful lives for residents. Dr. William Thomas, creator of the model, told the crowd at the event, �The Homeplace, with its emphasis on home, shows how care can be made more loving, community centered and effective.�

One of the two skilled-care cottages (Photo by Kacie Kelly)
Patients have been moving in all month. The staff at The Homeplace is trained to use the �best friend approach,� Laurie Dorough, the facility's community-relations manager, said in an interview. Staff and volunteers are to treat residents as they would treat a best friend.

Knapp said at the ribbon-cutting, �Each resident will have a private bedroom and bath and share, just as people do in any home, the kitchen, living room, den and porch areas. It�s all designed to give residents the freedom to set their own daily routines and to live life to its fullest, while receiving the individual care they need � within each cottage.

The assisted-living cottage is larger than the others, to provide room for more activities and �the potential for spouses to live there,� said Laurie Dorough. �It�s kind of the first step out of independent living,� she said. The cottage has an open kitchen where residents can get involved with meal preparation or �come out and see what�s cooking.�

Skilled-care cottage bathroom lift system (Photo by Kacie Kelly)
The skilled-nursing cottages have bedrooms with medicine cupboards rather than medical carts, and a bathroom lift system (photo at right) that takes the resident straight to their own bathroom. The bedrooms are relatively small, an incentive for residents to spend more time in the communal living space.

The Homeplace campus, across Weisenberger Mill Road from Midway College, also includes an administrative cottage and the Lucy Simms Lloyd Gathering House for special gatherings, worship services and activities.

Between the cottages is the courtyard, with lighted walking paths from building to building, a gazebo, and space for outdoor activities. �Our hope is to maybe start a community garden,� said Dorough.

The long campaign for a nursing home, led by the Midway Nursing Home Task Force, began to see success in 2010 when Louisville-based Christian Care agreed to be the developer. Christian Care has facilities in 11 Kentucky cities, and a church-outreach program with more than 230 churches as partners.

The Homeplace will have a partnership with Midway College, which becomes Midway University July 1. �We are excited to work with Midway College to not only provide learning opportunities for students but also for the residents of The Homeplace,� said Tonya Cox, the facility's executive director.

The Homeplace will be offering internships and other learning opportunities for students. This partnership will also benefit residents, Cox said: �Our residents will also have the opportunity to attend events and classes to foster their lifelong learning.�

Cox said The Homeplace aims to provide �unique long-term care in a way that honors their preferences and desires to be home.� More information is on the facility's website. It will host an open house from 1 to 3 p.m. Sunday, June 28.

Sunday, 24 May 2015

Princess Health and Louisville's PharMerica is still a defendant in federal cases in which big drug makers have paid billions in fines.Princessiccia

Abbott Laboratories has paid billions, and Amgen Inc. has paid millions, in fines for offering "rebates" or "kickbacks" to get pharmacy companies to increase their prescriptions of drugs in nursing homes, and PharMerica Corp. of Louisville is the remaining defendant in both civil cases, according to a detailed report by James McNair at the Kentucky Center for Investigative Reporting.

PharMerica manages drug benefits for nursing homes, hospitals and assisted living facilities. McNair paints a dismal picture of nursing homes and says they are ripe for this type of abuse, writing that they house "people with age-weakened bodies, multiple ailments and, often, severe mental impairment. Many are over-medicated. Many have no visitors. A third of them will die within a year of admission." (Click on chart for larger version)


McNair notes that a whistleblower lawsuit first called attention to Abbott Labs, which pled guilty in 2012 to a criminal charge, settled civil kickback and fraud claims, and paid $1.5 billion in fines for its role in paying millions of dollars in "rebates" to get pharmacy companies to increase prescriptions for an anti-seizure drug, Depakote, for uses beyond its Food and Drug Administration approval. Medicaid payments for this drug "went on to top $7 billion," McNair reports.

Amgen also enlisted these same pharmacy companies to promote its anemia drug, Aranesp, for uses beyond its FDA approval, and after pleading guilty settled civil kickback and fraud charges and paid a total of $762 million in fines.

These two cases brought more government attention to such schemes, which are "standard practice in the pharmaceutical industry," and also on the pharmacy companies that are on the receiving end of the payoffs, McNair writes.

McNair describes PharMerica as the "second-biggest operator of nursing home pharmacies in the country" and writes that it had " $1.9 billion in revenue last year," making it the "10th-biggest publicly traded company in Kentucky, according to rankings by The Lane Report." Since 2007, the chief executive has been Gregory Weishar (pronounced WISH-er) .

Companies like PharMerica, and its larger competitor Cincinnati-based Omnicare Inc., act on behalf of the nursing homes, buying drugs from the pharmaceutical companies in bulk and then dispensing them under the supervision of "consultant pharmacisits," McNair reports.

The Abbott Labs and Amgen lawsuits assert that PharMerica gave "certain drugs to nursing home patients in return for drug company kickbacks, not because they were the "right medication."" McNair reports that the suits were filed by drug company insiders who have knowledge of these payoffs disguised as "rebates" or "discounts."

"PharMerica denies the claims," writes McNair. But the company has been in this type of case many times since 2005, McNair reports: It has agreed to pay $40 million in fines to settle federal complaints, five additional closed cases connected to this company.

McNair also reports that just last week, the Justice Department said PharMerica will pay $31.5 million for dispensing addictive painkillers to nursing home patients without prescriptions, then falsely billing Medicare. As part of this settlement, PharMerica also agreed to a five year "corporate integrity agreement," which McNair notes later in the article are rarely enforced.

McNair goes on to list the details of several other cases PharMerica has been involved in, one of them "deemed so flagrant that the inspector general sought to ban PharMerica from federal health-care programs for 10 years."

PharMerica declined to make its executives available for an interview with the Kentucky Center for Investigative Reporting but said in a statement: �PharMerica is committed to outstanding compliance and the highest standards of ethical conduct, and we are diligent in ensuring that we comply with all applicable law and regulation,�

Jan Scherrer, vice president of Kentuckians for Nursing Home Reform, a non-profit advocacy group based in Lexington, told McNair that the CEOs of companies involved in kickback schemes should be held personally accountable, "These are not victimless crimes," he said.

�It�s the same players -- PharMerica and Omnicare,� Scherrer continued. �They keep doing this over and over and over, and all they get is a fine. And for them that fine is nothing more than the cost of doing business.� (Read more of this detailed report by clicking here.)

Monday, 19 May 2014

Princess Health and Princess Health andForum hears ideas for improving long-term care in Kentucky.Princessiccia

Princess Health and Princess Health andForum hears ideas for improving long-term care in Kentucky.Princessiccia

People gathered at the Lexington Senior Citizens Center May 16 to discuss problems with long-term care and potential ways to improve it, at an event organized by the Nursing Home Ombudsman Agency of the Bluegrass. Gov. Steve Beshear requested that such forums occur across Kentucky.

Attendees split into groups to discuss various topics regarding care of the aging in Kentucky. DG Gridley, founder of Grace Place, said that when she gets older, she would like to continue living in her own house but go to a facility during the day. Grace Place, staffed by medical professionals, is a health club for seniors. Several attendees said care in a nursing home should be based the preferences of each resident. For example, if the requirements were that each resident get a bath twice per week, and one resident wants a bath every day, he or she should be able to do that.

Some attendees encouraged others to speak up when they think elders are not being properly cared for. If something seems out of line, investigate, but people should also share positive stories, they said. Discussing such topics will help get people involved in such issues, some said.

Do you have complaints or comments about long-term care in Kentucky? Do you have suggestions to improve care for the aging population? Send your comments to nhoa@ombuddy.org. Comments will be sent to Beshear. All submissions must be sent by Aug. 31.

Forum attendees addressed these questions:

1. What does quality care mean to you? What does quality care look like, feel like? What are the key components to quality care? Who is responsible for good quality care in each of the settings?

2. If you have used a facility (assisted living, personal care, adult day and nursing homes) what did you like the most? The least? If you could make one improvement in a facility placement, what would it be?

3. What are the qualifications of a good caregiver regardless of the setting? How does staff impact care? Is staff education and training important? What topics/techniques should staff learn to address or demonstrate proficiently?

4. In a facility, is the number of staff persons on duty important, or is the quality of the staff more important? Why do you feel that way?

5. Where do you believe abuse and neglect are most prevalent? Knowing the definitions of abuse, neglect and exploitation which do you think is the biggest threat to the elderly and why? What might reduce these threats and help the elderly live safer higher quality lives?

6. Community involvement aids facilities, caregivers and providers in ensuring quality care and quality living for Kentucky's vulnerable citizens. How can members of our community be more involved in ensuring quality living and quality care for the elderly and individuals with disabilities?

Thursday, 15 May 2014

Princess Health and Princess Health andPublic forum on nursing homes set Friday at 2 in Lexington.Princessiccia

Princess Health and Princess Health andPublic forum on nursing homes set Friday at 2 in Lexington.Princessiccia

A public forum on nursing-home care will be held Friday at 2 p.m. at the Lexington Senior Citizens Center on Nicholasville Road next to the University of Kentucky campus.

The forum "may reveal what, if anything, is being done in Kentucky to improve care in nursing homes," Kentuckians for Nursing Home Reform says in a news release. It says the event "is a result of direction from Gov. Steve Beshear that public forums be held across the state to give citizens a chance to present not only their complaints about long-term care, but suggest possible improvements. Tomorrow�s forum is the only reaction so far to the governor�s request."

The forum is organized by the Nursing Home Ombudsman Agency of the Bluegrass.

Sunday, 16 March 2014

Princess Health and Princess Health andActivist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill.Princessiccia

"Health-care industry witnesses appeared to have presented incorrect information" to the House Health and Welfare Committee in speaking March 6 against House Bill 460, which would require all health-care facilities to report infections associated with their treatment, Dr. Kevin Kavanagh of Somerset writes in an op-ed piece in the Lexington Herald-Leader. The bill remains in committee, but its goal could be accomplished by regulation.

Dr. Kevin Kavanagh
Kavanagh is chairman of Health Watch USA, a group that tries to focus attention on the problem of health-care associated infections, also called hospital-acquired infections. He said the industry witnesses "were asked if any of the various types of facilities in Kentucky were exempt from reporting. The answer was no, that all facilities had to report through the Centers for Disease Control's national reporting system. However, critical-access hospitals and ambulatory-surgery centers are not required to report infection to the CDC. Nursing homes also do not have to report through the CDC's system."

Kavanagh writes that nursing homes report urinary-tract infections to the federal Centers for Medicare and Medicaid Services, but "there is no data on the deadly staph infection, MRSA," or a deadly gastrointestinal infection caused by the bacteria C. Difficile, "which can run rampant in some nursing homes."

Kavanagh said the industry witnesses also misled the committee when asked "asked if a patient who was going to have hip surgery could find information on infection rates on Hospital Compare," a Medicare website. He writes, "The answers appeared to indicate that such information was available," but is "woefully inadequate" because the state doesn't have an adequate reporting system.

"For acute-care hospitals, only, bloodstream MRSA infections (a relatively rare event), colon surgeries, abdominal hysterectomies, urinary tract infections and central-line infection data can be found. Little use for patients needing hip surgery. In the past, CMS has posted on the Hospital Compare website information regarding hospital-acquired conditions, and was slated in the future to have information on neck and spine surgery. However, this information is now gone from Hospital Compare. I can only assume it, too, has fallen to the legions of health-industry lobbyists." (Read more)

For Kavanagh's March 6 testimony to the committee, click here. For his March 13 rebuttal to industry witnesses, go here.
Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy