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Kindred CNA With 25 Years of Service Shares Her Story

June 13, 2014

by Arianna Allen, Communications Intern

Josephine Holmes, CNA

Josephine Holmes, CNA

Josephine Holmes pushed Carol outside in her electric wheelchair so she could get some fresh air. Due to her medical condition, Carol was paralyzed. She could not speak, eat or breathe on her own. But Josephine Holmes loved her, and she took care of her nearly every day for 11 years.

Josephine is a Certified Nursing Assistant at Kindred Hospital Bay Area – Tampa in Tampa, Florida. Carol was one of her patients. As Josephine recalls the memory of Carol, her voice cracks.

“I became like her daughter,” Josephine said. “And before she passed away, her family called me at home because all she wanted to do was be with me. Carol’s family trusted me more than they trusted anyone.”

Carol was just one of the many Kindred patients that Josephine has impacted. Josephine has been a CNA with Kindred for 25 years. She is responsible for helping patients bathe, eat, walk, exercise and use the restroom. She also must take blood pressure, turn bedridden patients and give post-mortem care.

“I raised both of my kids being a CNA,” Josephine said. “Now, my son is an engineer and my daughter is a secretary at the hospital.”

Josephine’s colleague, Marisol Gonzalez, calls her a loyal asset to Kindred. And colleague Nancy Reyes agrees.

“Josephine was employee of the year two years ago, which was well deserved,” Nancy said. “She really cares about each one of her patients and takes an interest in their lives.”

While there can be no doubt Josephine has impacted the lives of many people, her patients have affected her own life as well.

“My patients taught me how to be a good mother,” she said. “They made me realize that I have to raise my children in a way that ensures they will always be there for me in case something happens.”

Every day, Josephine sits down and bonds with her patients. They tell stories. And Josephine says that oftentimes, patients just want someone to listen.

“Most of the time, nurses and doctors don’t have time to spend time with the patients,” she said. “I like to spend time with them and try to make them understand that they can get better if they just believe and have faith.”

For Josephine, the most challenging part of taking care of patients is losing them.

“When you take care of someone for so long and then he or she passes away, it’s hard to move on,” she said. “I talk to my patients for so long and I get to know them, but sometimes they can’t get better, and I lose them. When I lose a patient, I lose family.”

Though the job can be challenging, Josephine says that the idea of helping people and creating a difference makes everything worth it.

“I know that I make a difference because people come back and look for me when they get better,” she said. “That’s how you overcome the difficulties. My patients make me feel just as good as I make them feel.”

Josephine precepts and oversees all CNAs at Kindred Hospital Bay Area – Tampa. She says that she loves her job, but not everyone has what it takes to be a CNA.

“You have to have a caring heart,” she said. “You have to understand the patient and always put them first and then everything else will fall into place.”

Not everyone is capable of being a wonderful CNA, but Julie Feasel, Division Vice President, says that Josephine certainly makes being a CNA look effortless.

“Josephine could teach us all how to live the Kindred mission,” Julie said. “She represents and lives the vision of our organization. Though we have had her for 25 years, it isn’t enough. We need her for another 25 years!”

In celebrating National Nursing Assistants’ Week June 12-19, we would like to recognize and thank Josephine and all of our nursing assistants who are dedicated to hope, healing and recovery.

Men’s Health Matters…To Everyone

June 10, 2014

Men's HealthA car is a major investment and, for most of us, it’s something we take care of to make sure it stays in top condition and has a long life. Many men, however, don’t take that same approach with their own health – even if they’d never miss a regular oil change or vehicle tune-up.

During National Men’s Health Week, June 9-15, it’s a good time for men to take stock of their health and make a commitment to improving it.

According to the Centers for Disease Control and Prevention (CDC), the leading causes of death for men in the U.S. are heart disease and cancer. Even small steps toward a healthier lifestyle can help improve heart health and regular screenings can help detect cancer earlier.

Adopting healthier behaviors in general may be easier than you think. The Men’s Health Network provides a straightforward “Get It Checked” maintenance schedule for men that includes regular checkups and recommended screenings.

“Regular checkups and age-appropriate screenings CAN improve your health and reduce premature death and disability,” the guidelines say.

The CDC also offers some advice for Men’s Health Week that can help men “take daily steps to be healthier and stronger,” including:

  • Get a good night’s sleep.
  • Quit smoking – it’s never too late.)
  • Stay active.
  • Eat healthy
  • Get regular checkups.

Taking these daily steps can be a family affair – it’s no coincidence that Men’s Health Week ends on Father’s Day. As families celebrate this special day, dads should remember that their decisions about nutrition, exercise and regular checkups affect not only them but also their families and others who care about them. A healthier lifestyle for Dad benefits everyone and sets a good example for the whole family.

Celebrate National Men’s Health Week and make a commitment to better health today.

Healthcare Headlines Week of June 2, 2014

June 6, 2014

Healthcare_Headlines_6.2.14EU Funds Program to Protect Elderly from Choking

The European Union is funding a consortium to use 3-D technology to make pureed food look more appetizing, in an effort to protect the elderly in nursing homes from choking hazards. Read the story

Cynical People More Likely to Develop Dementia

According to a new study, cynical people are more likely to develop dementia and die sooner than less cynical counterparts. Read the story

Affordable Care Act Appears to be Behind More Revenue for Local Hospital

Despite critical comment about the Affordable Care Act’s effect on one local hospital in Kentucky, data seem to indicate that the hospital has experienced a big boost in revenue since the law’s implementation. Read the story

Personalized Medicine Leads to Drugs Aimed at Smaller Patient Populations

For scientific and economic reasons, the pharmaceutical industry appears to be moving away from one-size-fits-all drugs and toward the approval of drugs from which a small patient population might benefit. Read the story

It’s a new world. We’re segmenting what we thought of as large diseases into smaller populations of patients that are defined by genetic distinctions. . . . The goal is to match the right therapy to the right patient, and to do it with minimal collateral damage. — Wendy Selig, president of the Melanoma Research Alliance, the largest private funder of research on the disease, which this year is expected to kill nearly 10,000 Americans.

Specialty Drug Pricing Causing War Between Pharmaceutical Companies and Insurers

The rising cost of specialty drugs — such as one that is used to treat Hepatitis C — is causing a standoff between insurance companies, which say that the drugs are raising healthcare costs and threatening the whole system — and pharmaceutical companies, which say the high cost is necessary to cover research and development. Read the story

Ventas Makes Two Acquisitions

Real estate investment trust Ventas will aquire American Realty Capital Healthcare Trust as well as — in a separate deal — 26 senior living communities in Canada. Read the story

Advisors Urge Value Over Volume

In a report to President Obama, the President’s Council of Advisors on Science and Technology (PCAST) recommended quickly moving to payment models that stress quality of care over fee-for-service transactions. Read the story

How Old is Too Old for a Colon Cancer Screening?

Some new studies suggest that people may benefit from colon cancer screening at age 75 and beyond, particularly those who have never been screened. Read the story

ICD-10 Test Goes Well

ICD-10 test week went well, with no issues identified with claims processing. ICD-10 implementation is expected in October of 2015. Read the story

Reimbursement for End-of-Life Care at Issue

The American Medical Association is expected to provide data to the Centers for Medicare & Medicaid Services regarding resources needed for end-of-life medical consultations, information that will be used to set reimbursement rates. Read the story


Opinions expressed in any of the included stories or their publications do not necessarily reflect the opinions of Kindred Healthcare and this blog post is a compilation of news stories from other sources that have appeared during the past week.



Have Fun in the Sun (But Be Safe!)

June 3, 2014

Taking advantage of the longer days and warmer temperatures of summer and having fun in the sun is great, but staying safe is important, too. Whether you’re planning a picnic at your local park or a vacation at the beach, take steps to protect yourself and your loved ones from the dangers of too much sun.

Ultraviolet rays can damage your skin in less than 15 minutes of exposure. That’s why it’s important to be aware of the risks of skin cancer and take precautions.

UV rays can damage our bodies all year round, but preventive steps should be taken especially in the summer when the risks are highest. During Sun Safety Week, take a few minutes to find out what the risks are and how you can have fun outdoors while limiting the risks of skin cancer.

Skin cancer rates rising

Unlike many other types of cancer, the rates for skin cancer are rising. The Centers for Disease Control and Prevention reports that, “Skin cancer is the most common cancer in the United States. Most cases of melanoma, the deadliest kind of skin cancer, are caused by exposure to ultraviolet (UV) light.” UV rays damage and age skin cells.

This not only means being careful when you head outdoors, but also avoiding the tanning bed, which poses significant skin cancer risks as well.

Sun damage is a risk for all ages

elderly sun safetyThe elderly are at a high risk for sun damage since their skin can often be thin, sensitive and more prone to sun burn. Their skin is as sensitive as that of a newborn baby. A high SPF is ideal even on days when prolonged or direct sun exposure isn’t expected. The sun may also be a factor in macular degeneration and other vision problems leading to vision loss for seniors. Other factors such as medications, illness and family history can increase the risk of sun damage.

What you can do

The CDC provides the following tips for skin cancer prevention:

  • Stay in the shade, especially during midday hours (11 a.m. – 4 p.m.).
  • Wear clothing that covers your arms and legs.
  • Wear a hat with a wide brim.
  • Wear sunglasses that block both UVA and UVB rays.
  • Use sunscreen with SPF 15 or higher and both UVA and UVB protection – don’t forget to reapply.
  • Avoid indoor tanning.
  • Assist young and elderly loved ones with the tips above.

Get more information

Find out more about the risks of indoor tanning on the CDC’s Burning Truth site. The Burning Truth initiative encourages you to keep your skin healthy and beautiful by protecting yourself from too much exposure to UV rays from the sun and tanning beds.

The UV index can help you stay informed. It provides a forecast of the expected risk of overexposure to UV radiation from the sun. The National Weather Service calculates the UV Index forecast for most ZIP codes across the U.S., and the Environmental Protection Agency publishes this information. The index is accompanied by recommendations for sun protection and is a useful tool for planning sun-safe outdoor activities.

The American Cancer Society also offers information and tips on staying protected from the harmful effects of the sun, not only during the summer, but all year round.

Healthcare Headlines Week of May 26, 2014

May 30, 2014

Healthcare_Headlines_5.26.14Blog Implores Readers to Treat Vets Better

In a blog post, McKnight’s Editorial Director John O’Connor muses on his observation that vets are treated well in theory — given recognition at sporting events for example — but incidents such as the recently reported delays in treatment and preventable deaths at the Veterans Affairs hospitals in Arizona remind us that more must be done. Read the story

ACA May do Away With Wild Rate Hikes

Competition and greater scrutiny, both fostered by the implementation of the Affordable Care Act, may lead to less drastic insurance rate hikes, according to nonpartisan industry watchers. Read the story

Hospitals Cut Assistance for the Poor

Hoping to steer the poor and uninsured toward coverage under the Affordable Care Act, some hospital systems across the country have begun scaling back on assistance programs which formerly helped that demographic. Read the story

Driving the new policies is the cost of charity care, which is partly covered by government but remains a burden for many hospitals. The new law also reduces federal aid to hospitals that treat large numbers of poor and uninsured people, creating an additional pressure on some to restrict charity care.

Primary Care Docs Not Seeing Explosion of Newly Insured Patients

New data show that new visits to primary care physicians have actually dropped since this time last year, and the reasons are unclear. Read the story

“Safety Net” Hospitals Seeing More Paying Patients

So-called “safety net hospitals,” which treat a disproportionate share of poor and uninsured people and therefore face billions of dollars in unpaid bills, are already seeing a big boost in paying patients and the revenue they bring as a result of the Affordable Care Act. Read the story

Worries, Conflicts and Demands Increase Mortality Risk

A new study has shown that worries, conflicts and demands — especially conflicts — can contribute to an earlier death, particularly among men and those without jobs. Read the story

Medicare Claims Review Process Could be More Robust

A report from government officials finds that a more uniform and unified post-payment review system could improve Medicare oversight significantly. Read the story

Could Moderate Exercise Preserve Independence?

A new study has found that for people in declining physical condition, a moderate exercise program worked to keep them on their feet longer than those who did not partake. Read the story

Losing mobility is so disruptive. People who cannot walk a quarter of a mile cannot walk around their neighborhoods to socialize; they can’t go out and run their own errands.  — Lead author Marco Pahor, a geriatrics researcher at the University of Florida, Gainesville.

McConnell Says Kentucky’s Insurance Exchange Could Survive if ACA Repealed

Senate Minority Leader Mitch McConnell has said that Kentucky’s health insurance marketplace, which includes Kynect, would stand a chance of surviving even if the Affordable Care Act were repealed, noting that Kentuckians would have the chance to decide to keep it or implement something else. Read the story

Could Greater Awareness of End-of-Life Dreams and Visions Lead to More Peaceful Deaths?

End-of-life caregivers who dismiss end-of-life dreams and visions, or ELDVs, as delirium may be doing a disservice to dying patients, who often take great comfort in these experiences. Read the story

Proposed Legislation Would Give All Vets Access to Hospice

A new bill, proposed by Rep. Bill Collins of New York, would give all veterans access to hospice care through the Department of Veterans Affairs. Read the story

Opinions expressed in any of the included stories or their publications do not necessarily reflect the opinions of Kindred Healthcare and this blog post is a compilation of news stories from other sources that have appeared during the past week.

What Is Bundling and What Does It Mean for Patient Care?

May 29, 2014

It is widely recognized by policymakers and payers that our nation’s healthcare system is fragmented, creating gaps in care for patients. Researchers believe that part of this fragmentation is a result of the separate payments furnished by Medicare for each provider type that a patient may encounter during a single care episode.

This assertion led to the Bundled Payment for Care Improvement (BPCI) initiative, which was established under the Affordable Care Act.

What Is the Bundled Payments for Care Improvement Initiative?

Under the authority established within the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) created the “Innovation Center” with the responsibility of supporting and testing innovative payment and delivery care service models. The goal of the efforts is to deliver higher quality, more coordinated care at a lower cost.

Because evidence-based research has shown that a bundled payment for care provided across settings may align incentives across provider type and encourage them to work collaboratively, bundled payments are among the models being tested within the Innovation Center.

What Implications Will Bundled Payments Have on Patient Care?

Within a healthcare system that is seeking to recognize and reward value over volume – patients are the clear winners within the equation. Bundled payments, as well as other health reforms such as Accountable Care Organizations and patient-centered Medical Homes, build in financial incentives that encourage enhanced care management and closer alignment among clinicians and providers. This collaboration will contribute to fewer gaps in the delivery of medical care.

How Are Bundles Performing?

A 2013 report released by Booz & Company included the results of an online survey of more than 400 physicians and 150 hospital executives which found interesting differences between those participating in bundles and those that were not. Sixty-four percent of the survey respondents that are already involved in a bundle reported cost savings.

The input from providers highlighted the fact that larger provider organizations represent the majority of bundle participants. In fact:

  • 53% of hospitals with greater than $1 billion in patient revenues reported that they have already taken action in a bundle.
  • Whereas only 24% of hospitals that have less than $1 billion in revenues have participated in a bundle.

Smaller providers agree on the potential benefits, but are more cautious because of the uncertainty and complexity in participating in a bundle.

Initial results for those providers participating in bundles are positive, but the survey also revealed several significant challenges for providers.

  • According to survey respondents, the greatest challenge to hospitals in the design component was establishing the risk and gain sharing arrangements.
  • In regard to implementation, two components ranked highest: persuading physicians to deliver against bundles and integrating clinical and administrative data.

The Future of Bundled Payments

While the precise future of bundled payments is unclear, early evidence of improved outcomes and savings to the Medicare program indicate that these arrangements will remain a viable option for providers seeking to provide better coordinated care. Additionally, consumers support the concept of care bundles – with an earlier Booz & Company survey indicating that more than three-fourths of the consumers surveyed are ready for bundles.

However, much is still unknown as to the success of the different types of bundles within the CMS pilot program. The BPCI initiative is still in its initial 3-year window, therefore a full analysis of the performance of the participating providers is unavailable. But published reports have indicated the gain-sharing incentives have had a positive impact in the relationship and communication between bundle participants.

Additionally, the lessons learned from providers participating in the pilot program will be invaluable for the next generation of bundles.

ACOs: Past, Present and Future

May 27, 2014

What is an Accountable Care Organization (ACO)?

The Centers for Medicare and Medicaid Services (CMS) broadly defines ACOs as “groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.” The ultimate goal of this care coordination is to streamline services and ensure that patients get the right care at the right time with better clinical outcomes. A secondary goal is to create savings to the Medicare program by eliminating duplicate services, medical errors and preventable rehospitalizations.

ACO Performance to Date

The first year featured 23 Pioneer ACOs and 114 Shared Savings ACOs. In late 2013, the Centers for Medicare and Medicaid Services (CMS) released data detailing the first year of performance for all ACOs. Overall data indicates that the ACO model saved the Medicare program $380 million in the first year. However, the data released by CMS does not identify which ACOs were able to produce savings and which ones were not able to reduce costs for patient care.

Cost Savings Slim, But Quality Indicators Are High

While the savings sound significant, analysts were quick to point out that this translates to an average savings of only $80 per each of the 1.6 million beneficiaries covered by these ACOs, or a little less than 1 percent of spending. CMS was quick to point out that,

“On 15 out of 15 quality measures, [the ACOs] did better than national benchmarks, as well as on four out of four patient satisfaction benchmarks.”

Additionally, some analysts further defended the program by pointing out that the savings are a good start and the program is relatively new.

To date, the program has steadily grown by about 100 ACOs each year, with a total of 360 ACOs participating today covering the lives of 5.3 million Medicare beneficiaries.

The Future of ACOs

The initial data just released by CMS represents less than half of current ACOs, so the future of ACO performance, popularity, and the formation of new ACOs will likely rely on consistent positive results. With the first year of data showing a “good start,” experts believe that some groups still considering whether to form an ACO may wait for another full year of data before forming and establishing value-based contracts.

While this may mean that the pace of the formation of new ACOs may be a little slower in 2014, this should not be misinterpreted as a failure of the program.

It is evident that there is much more data that needs to be tracked, over a prolonged period, to truly understand the impact that ACOs are having in terms of quality, value and cost savings. CMS remains confident that ACOs and the partnerships between multiple care providers will improve the patient experience, and ultimately save critical funds for the Medicare program. Therefore, it can be concluded that CMS will continue to encourage participation, provide support for and grow the ACO program.

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