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News Roundup: June 10, 2013

New program provides home health care training

Published by Las Vegas Review-Journal
June 5, 2013

Home health care is one of the fastest growing businesses throughout the country, especially in Nevada. And at the College of Southern Nevada, Dan Gouker is overseeing a program that is answering the need to provide staffing for this growing profession .

The program is titled Home Care Aide Training. Gouker, executive director for the Division of Workforce, Economic Development and Apprenticeship Studies at CSN, said the course is designed to prepare students to work as home care aides and to assist elderly and disabled adults with daily living activities.

“The program is brand new,” he said. “We started with just two students in January, and this semester we have 11 students. It’s an intensive five-week program with students in class Monday through Thursday from 9 a.m. to 3:30 p.m. That equals out to 120 hours of classroom lectures and lab time.”

Developed by the U.S. Department of Labor and with federal dollars, the CSN program graduates students with a National Career Readiness Certificate and National Home Care Credentials.

Steve Gleicher, owner and operations director for Right at Home, has already hired one of the first two graduates.

“When the program got under way, I reviewed the syllabus, met the first two students and spoke with several of the professors,” Gleicher said. “The growth prospect for health care aides is huge and the task before us is getting trained, qualified and responsible people to work in this industry. The CSN program is positioning itself to provide these individuals and grow with us.”

Right at Home is licensed by Nevada and provides personal care services to seniors in their homes. Those services might include bathing, light housekeeping, dressing, toileting, errands, meal preparation and companionship.

“Our goal is to keep people in their homes for as long as possible,” Gleicher said. “There is a large retirement community in Nevada, and it continues to grow.”

At CSN, Melissa Schroeder is student adviser for the Home Care Training program. She said classroom emphasis is placed on communication skills and understanding individual client needs.

“We stress a number of topics,” she said, “including patient rights, understanding the effects of aging, common disease processes, caregiver etiquette and infection control procedures. Our students graduate with a good knowledge of body systems and body mechanics.

“One of the biggest components is nutrition as it relates to diseases such as kidney and heart. They also learn to cook and prepare meals for patients with different needs such as gluten allergies. We’re able to do this because we have a complete lab kitchen.”

But it’s more than just making breakfast or lunch. Students learn how to physically transfer patients from beds to wheelchairs and vice versa. They are taught companionship, client safety and the person’s legal rights within Nevada.

“After graduating,” Schroeder said, “each student receives a certificate of completion to approach a home health care company and say, ‘Here are my credentials.’

“During the final week of class, students take a national credential assessment test and if they pass, they become nationally certified as a caregiver. This certification is transferable to other states and it’s what employers want to see. It’s a big thing.”

It is a big thing, and it’s what Gleicher wants to see.

“Graduates come to us with home care training skills and that’s very important, but it can’t replicate real-life situations,” he said. “As a person gets older and his or her energy declines, they tend to stop taking care of themselves and their home. What they need is for someone to come in and shop for food, make a meal or two, do laundry and clean up the house a bit.

“The second issue, and I consider this one to be epidemic, is dementia or early stages of Alzheimer’s. A family member may be taking care of mom or dad or an aunt or uncle, but occasionally need a break. That’s where we come in to enable that family caregiver to spend some time away from home because mom or dad can’t be left alone.”

According to Schroeder, all students submit to a background check to investigate for misdemeanors or felonies and a prescreening for drugs before being admitted to classes at the CSN Sahara West Center.

For many, the student is already an adult with several skills, but is interested in obtaining another parallel skill that provides an opportunity to grow in a new profession.

New Efforts Deliver Results as Medicare Readmission Rate Declines

Published by Senior Housing News
Jason Oliva
June 3, 2013

Hospital readmission rates for Medicare beneficiaries fell more in 2012 than in the five preceding years combined, according to a report from the Centers for Medicare & Medicaid Services (CMS).

During calendar year 2012, the national 30-day hospital readmission rate averaged 18.4%, down from an average 19% between 2007 and 2011.

Hospitals participating in certain initiatives geared toward avoiding readmissions saw their average rates decline lower than those of non-participating hospitals, notes the results published in the online academic journal Medicare & Medicaid Research Review.

Over the years, CMS has undertaken several initiatives to curb readmissions among the Medicare fee-for-service population. These have included reporting hospital readmission rates through programs such as Hospital Compare and Partnership for Patients, as well as changing payment policies and various shared savings initiatives.

As a result, many hospitals and other organizations have employed strategies to reduce readmissions, such as enhanced patient education, more post-discharge follow-up care and increased coordination with outpatient providers.

Although claims data has not yet been filed for 2012, preliminary data included in the report indicates that hospital readmission rates among Medicare fee-for-service beneficiaries were significantly lower that year compared to previous years.

Since the report analyzes the trends in readmission rates and does not address the factors that may have played a role in the observed change, the reasons behind the reduction for 2012 are not yet clear, writes the study’s authors.

One possible explanation the analysis suggests is that payment reforms and other initiatives are starting to have a measurable impact on provider behavior, and thus, are resulting in improved care.

Another possible explanation is that rates have declined as a result of more beneficiaries receiving post-discharge care through emergency departments, observational stays or other non-inpatient settings.

Hospital readmission rates heading in the right direction

Published by Fierce Healthcare
Alicia Caramenico
May 31, 2013

A new analysis from the Centers for Medicare & Medicaid Services shows progress on reducing hospital readmission rates, AHA News Now reported.

CMS found all-cause, 30-day readmissions for Medicare patients dropped to 18.4 percent in 2012 from 19 percent during the previous five years. That means hospitals saw about 70,000 fewer readmissions during last year, according to the analysis.

The number index admissions and readmissions have been on a slow decent since 2007, with per-beneficiary index admissions and readmissions down 10 percent to 14 percent in 2012 than in 2007. Readmissions falling slightly faster than corresponding index admissions partly explains the lower readmission rate, according to the analysis.

CMS did not adjust the data for age or health status and included potentially planned or unavailable readmissions.

Moreover, the analysis didn't explore what caused the drop in hospital readmission rates, but suggested payment reforms and efforts to prevent avoidable readmissions may be affecting rates in a measurable way. CMS also noted a flood of new, younger Medicare beneficiaries is not responsible for the reduction.

"[T]he reasons behind the reduction, as well as the implications for clinicians and policy makers, are not yet clear and merit further monitoring and analysis," the analysis states.

The new analysis builds on a March testimony from Jonathan Blum, director of the Center for Medicare and CMS acting deputy director, that credited payment and delivery reforms for the falling readmission rates, FierceHealthcare previously reported.

Blum noted the threat of reduced Medicare reimbursements for hospitals with high rates of readmissions under the Affordable Care Act already has produced results, given the rate of 30-day readmissions dropped to 17.8 percent in the fourth quarter of 2012.