Advocates for nursing home residents  applaud the Centers for Medicare & Medicaid Services’s .  Advocates for nursing home residents have been working for many years to eliminate all misuse of antipsychotic drugs for nursing home residents.  The Centers for Medicare & Medicaid Services’s new national initiative to address the drugging epidemic.

The Centers for Medicare & Medicaid Services’s  “National Initiative to Improve Behavioral Health & Reduce the Use of Antipsychotic Medications in Nursing Home Residents” will be announced via webcast on March 29, 2012 at 10:00 a.m. PST.  Janet Wells, (Director of Public Policy, The National Consumer Voice for Quality Long-Term Care)  thanked former Centers for Medicare & Medicaid Services Administrator Donald Berwick for his leadership in responding so forcefully to this national disgrace and for setting the wheels in motion to implement this long-overdue initiative.

CMS is developing a national action plan that includes raising public awareness of misuse of antipsychotic drugs, regulatory oversight, technical assistance, and research. The Initiative will be launched with a video streaming event at 1 p.m. EDT, March 29.
http://surveyortraining.cms.hhs.gov/pubs/VideoInformation.aspx?cid=1098 Several hundred thousand nursing home residents with Alzheimer’s Disease or other dementia are given one or more antipsychotic drugs. The HHS Office of Inspector General reported last year that the overwhelming majority of Medicare claims for antipsychotic drug were inappropriate.

In addition, hundreds of thousands of nursing home residents are inappropriately given antipsychotic drugs each day, despite the Food and Drug Administration’s ‘Black Box’ warnings that these drugs can kill  residents who have dementia. Too many nursing homes use antipsychotic drugs as a way to control residents when they don’t have enough well-trained staff who know their residents well and can give them the time and attention they need. The word needs to get out that chemical restraints are as dangerous for residents as physical restraints.

“Nursing home staff who take the time to understand what residents are communicating with their behavior can provide care to their residents without using chemical restraints,” said Claire Curry, Legal Director, Civil Advocacy Program, Legal Aid Justice Center, Charlottesville, Virginia. “We have seen good care like this in some facilities and know that all facilities can do the same.”

Federal law, to a large extent, already prohibits the drugging of residents,” said Toby S. Edelman, Senior Policy Attorney, Center for Medicare Advocacy, Washington, DC, ”but the law is often too timidly enforced. CMS needs to dramatically step up strong enforcement of the law to ensure that all residents get the care and services they need, accor. CMS needs to ensure that no resident receives antipsychotic drugs except in full compliance with the law.”

In August 2010, the California Advocates for Nursing Home Reform (CANHR) launched a campaign to end nursing home misuse of psychoactive drugs in response to the longstanding, widespread misuse of these drugs to chemically restrain residents. The campaign features a special website, educational presentations, consumer advice, administrative and legislative advocacy, stop-drugging blog and much more.  For more information about CANHR’s Campaign or the CMS initiative, please contact Michael Connors or Tony Chicotel,(415) 974-5171, or visit CANHR’s website www.canhr.org/stop-drugging.

This blog article is taken from CANHR’s 3.28.12 press release.

President’s budget proposal contains some significant Medicare changes. Below are some excerpts regarding these changes, including higher income-related premiums under Medicare Parts B and D, a new Part B premium surcharge for new beneficiaries who purchase first dollar coverage with a Medigap plan, a modified Part B deductible for new beneficiaries, and a home health care co-payment for new beneficiaries.

• Increase Income-Related Premiums Under Medicare Parts B and D (from from the budget for fiscal year 2013,  pages 34-35). Under Medicare Parts B and D, certain beneficiaries pay higher premiums as a result of their higher levels of income. Beginning in 2017, the Administration proposes to increase income-related premiums under Medicare Parts B and D by 15% and maintain the income thresholds associated with income-related premiums until 25% of beneficiaries under Parts B and D are subject to these premiums. This will help improve the financial stability of the Medicare program by reducing the Federal subsidy of Medicare costs for those beneficiaries who can most afford them. This proposal will save approximately $28 billion over 10 years.

• Introduce a Part B Premium Surcharge for New Beneficiaries That Purchase Near First-Dollar Medigap Coverage (from page 35). Medigap policies sold by private insurance companies provide beneficiaries additional support for covering healthcare costs by covering most or all of the cost sharing Medicare requires. This protection, however, gives individuals less incentive to consider the costs of health care services and thus raises Medicare costs and Part B premiums. Of particular concern are Medigap plans that cover substantially all Medicare copayments, including even the modest co-payments for routine care that most beneficiaries can afford to pay out of pocket. To encourage more efficient health care choices, the Administration proposes a Part B premium surcharge equivalent to about 15% of the average Medigap premium (or about 30% of the Part B premium) for new beneficiaries that purchase Medigap policies with particularly low cost-sharing requirements, starting in 2017. Current beneficiaries and near-retirees would not be subject to the surcharge. Other Medigap plans would be exempt from this requirement while still providing beneficiaries options for protection against high out-of-pocket costs. This proposal will save approximately $2.5 billion over 10 years.

• Modify Part B Deductible for New Beneficiaries. Beneficiaries who are enrolled in Medicare Part B are required to pay an annual deductible. This deductible helps to share responsibility for payment of Medicare services between Medicare and beneficiaries. To strengthen program financing and encourage beneficiaries to seek high-value health care services, the Administration proposes to apply a $25 increase in the Part B deductible in 2017, 2019, and 2021 for new beneficiaries. Current beneficiaries or near retirees would not be subject to the revised deductible. This proposal will save approximately $2 billion over 10 years.

• Encourages Beneficiaries to Seek High- Value Services (from page 112). The Budget includes structural changes that will help encourage Medicare beneficiaries to seek high-value health care services. To help improve the financial stability of the Medicare program, the Budget reduces the Federal subsidy of Medicare costs for those beneficiaries who can most afford them, and also introduces a modified Part B deductible for new beneficiaries beginning in 2017. To encourage appropriate use of home health services that are not preceded by inpatient care, new beneficiaries beginning in 2017 would be responsible for a modest co-payment for home health services in certain cases. Research indicates that beneficiaries with Medigap plans that provide first dollar or near-first dollar coverage have less incentive to consider the costs of health care services, thus raising Medicare costs and Part B premiums for all beneficiaries. The Budget applies a premium surcharge for new beneficiaries beginning in 2017 if they choose such Medigap coverage. In addition, it strengthens the Independent Payment Advisory Board to reduce long-term drivers of Medicare cost growth.

• Introduce Home Health Co-payments for New Beneficiaries. Medicare beneficiaries currently do not make co-payments for Medicare home health services. This proposal would create a home health co-payment of $100 per home health episode, applicable for episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay. This would apply to new beneficiaries beginning in 2017. This proposal is consistent with a MedPAC recommendation to establish a per episode co-payment. MedPAC noted that “beneficiaries without a prior hospitalization account for a rising share of episodes” and that “adding beneficiary cost sharing for home health care could be an additional mea­sure to encourage appropriate use of home health services.” This proposal will save approximately $350 million over 10 years.

The U.S. Departments of Education and Labor and the White House will host a Champions of Change event to highlight individuals, organizations, schools, or companies that are making a positive impact in STEM for people with disabilities in the areas of employment and education. Examples include hiring people with disabilities in STEM fields; making STEM materials accessible to people with disabilities; and advancing educational opportunities for people with disabilities in STEM. Deadline for nominations submissions is midnight on April 7, 2012.

The American College of Sports Medicine (ACSM) has just released new recommendations on the quantity and quality of exercise for adults, definitively answering the age-old question of how much exercise is actually enough. The position stand, titled “Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise,” reflects current scientific evidence on physical activity and includes recommendations on aerobic exercise, strength training and flexibility.

The energy density of food and drink, portion size, and the number of meals and snacks per day have all been linked to increases in the average daily total energy intake of US adults over the past 30 years, but increases in the number of eating occasions and in portion size have accounted for most of this increase: energy density of food consumed may have actually slightly decreased.

In 2007, Stephen Luby (SPL), Head of the Program on Infectious Diseases and Vaccine Sciences at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) and colleagues studied hand washing behavior in 347 households from 50 villages across rural Bangladesh. Following the results of their study, they concluded that washing of hands with soap, or simply rinsing hands without soap prior to preparation of food can reduce the occurrence of diarrhea in children.

As major cardiac complications occur in a significant proportion of patients with community-acquired pneumonia-pneumonia contracted outside of health care settings-doctors should be more aware of this association to better inform, treat, and manage patients with this infection, especially as this form of pneumonia is the most frequent cause of infectious disease-related mortality in the US causing 60,000 deaths every year.

Cells that lack the protein HMGB1 have a different organization of genetic material than normal cells, which increases their sensitivity to genetic damage and changes the way that information contained within DNA is retrieved. These are the findings of a new study, published on 28 June in the online, open-access journal PLoS Biology.

The Care Quality Commission (CQC) has taken enforcement action against East Sussex Hospitals NHS Trust because it has failed to protect the safety and welfare of people who use its service. The enforcement action is in the form of a Warning Notice which requires the trust to make urgent improvement to patient care. In February this year CQC carried out a routine review of all five hospitals which make up the East Sussex Hospitals NHS Trust.

The government’s announcement of temporary measures for next year aimed at preserving financial support for medical students is a step in the right direction, but it must become a long term settlement, medical student leaders said today (Tuesday, 28th June 2011). David Willetts MP, the Minister for Universities and Science, confirmed in a statement to the House of Commons that the government intends to preserve the current arrangements for the NHS Bursary for the 2012 intake.

Medtronic, Inc. (NYSE: MDT) today announced the launch of Medtronic’s first mobile application for use with implantable cardiac devices. As health care shifts care delivery from outpatient to home, Medtronic is leading the implantable cardiac device industry by offering cutting-edge technology designed to give physicians greater flexibility in monitoring patient data. The CareLink™ Mobile Application allows clinicians to access cardiac device diagnostic and patient data directly from their mobile devices.

Patients treated with sunitinib and sorafenib responded to the flu vaccine, which suggests the agents do not damage the immune system as much as previously feared, according to a study in Clinical Cancer Research, a journal of the American Association for Cancer Research. Keith Flaherty, M.D., director of developmental therapeutics at the Massachusetts General Hospital and a senior editor of Clinical Cancer Research, said the findings have broad implications beyond questions of patient management.

The ultimate source of some cancers is embryonic cells. Research published in the June 24th Cell, a Cell Press publication, traces the precursor of deadly esophageal cancers to leftover embryonic cells found in all adults. Some people with gastric reflux disease have a greater risk of developing esophageal cancer.

EndoGastric Solutions (EGS), the leader in the emerging field of Natural Orifice Surgery (NOS), today announced that the first patient has been enrolled and treated in the RESPECT study (Randomized EsophyX vs. Sham/Placebo Controlled Trial). The RESPECT trial was designed by co-principle investigators Dr. John Hunter, Chairman of Surgery, Oregon Health & Science University, and Dr.

University of Rochester Medical Center researchers have pinpointed two genes that are amplified in the worst cases of esophageal cancer, providing data to support a new investigational treatment that targets those same genes. The study, led by Tony Godfrey, Ph.D., a research associate professor of Surgery at the James P.

Laparoscopic antireflux surgery or taking proton pump inhibitor esomeprazole for chronic GERD (chronic gastroesophageal reflux disease) were both found to result in similar rates of disease remission of five years, researchers from Nantes University, France, reported in JAMA (Journal of the American Medical Association).