Going to a Nursing Home Following a Hospital Stay

Imagine this: You are admitted to a hospital for 5 or 6 days following a fall with broken bones. Upon discharge from the hospital, you are admitted to a nursing home or extended care facility until you are ready to care for yourself at home. The good news is that you healed completely and are able to care for yourself at home, again. The bad news: You receive a bill for more than $10,000 from the nursing home because the hospital changed your admission status and now claims that you were only "under observation". Because of that change of status, Medicare will not cover your nursing home bills unless you were classified as an inpatient and stayed at least three days. How could this happen? It already has, to more and more elderly patients on Medicare. According to the Center for Medicare Advocacy, they are hearing of many of these kinds of cases where patients who stayed several days in the hospital were re-classified as under observation, sometimes long after the hospital stay.

To make matters worse, there is a coverage gap for some patients who are not sick enough to become inpatients but not well enough to care for themselves at home.

What you can do:

1. If at all possible, contact your Medicare office before you are hospitalized. Get it on record that you are being admitted as an inpatient and will be staying several days.
2. If you know ahead of time that you may be sent to a nursing home following your hospital stay, contact the nursing home, as well, and get it clear with them as to what your hospital stay is about and how long you will probably be there.
3. Talk with your doctor about this issue and make sure he is on the same page with you. Let him know that you are taking a pro-active stance with your hospital visit and nursing home care.
4. When you are admitted to the hospital, let them know up front that you are aware of this practice of "re-classifying" patients from inpatients to observation. State clearly that you know you are being admitted as an inpatient with a several day stay and you will expect all of your qualifying Medicare costs to be covered under those guidelines.
5. If you have a family member or friend who is close to you, have them come with you through the Admissions process (to witness your statement about being an inpatient) and also to visit you while you are in the hospital. On the day you are to be moved to a nursing facility, you should have this person with you and you should ask, upon discharge, to see the classification of your inpatient stay, again. (There will be resistance to this, for obvious reasons, but you should insist before you are transferred). Don't sign any discharge papers from the hospital unless you read them carefully and make sure your status was not changed to "observation".
6. Write your congressman and voice your concern about the hospital's and Medicare's apparent collusion to deny their financial responsibilities to older patients. And you should know that this issue is NOT currently part of any health care reform discussions... but it should be.

It is difficult enough to have to go to the hospital for several days. (See my Med-Tips.com site for many more hospital tips). No one should have to worry that their rights under Medicare will be altered or denied because of this collusion between hospitals and Medicare.

Drinking and Driving Accidents Happen Daily: Protect Yourself

You might not be aware of how common drinking and driving accidents are or who is at risk. Drunk driving accidents are not limited to adults. In 2008 one out of every 7 drivers killed in a drunk driving accident was under the age of 21. This is below the legal drinking age.

Car accidents happen for all kinds of reasons, but when things like alcohol and texting are involved those are accidents that can easily be prevented by simply abstaining from the dangerous activity. But even if you know not to drink and drive you may do something unexpected after having a few drinks.

Driving after drinking is illegal and measured by the blood alcohol content of the driver. Unfortunately some people break the law and get behind the wheel.

The first rule is never to drink if you know you have to drive afterwards. These tips will help you stay in control of the situation and avoid making a bad choice:

• Drink only one alcoholic drink every hour. This gives your body enough time to metabolize the alcohol.


• Do not assume that because you only have beer you are good to drive, a drink is a drink and you should not drive after drinking.


• Take turns being the designated driver for the evening. Only do this with people you really trust. Or arrange to be picked up from a party by a sober friend or parent if you plan to drink.


• Keep the phone number of a taxi service in your wallet along with an emergency $20.


• Do not participate in drinking games. They encourage over-consumption and can easily get out of control.

Drinking and driving accidents do not just put the driver at risk. Passengers, pedestrians and other drivers on the road are all in danger when someone gets behind the wheel after drinking.

According to the Drunk Driving Prevention page of BloodAlcoholContent.Org, 20% of fatal accidents are caused because of drinking and driving.

Operating a vehicle while intoxicated can be a life altering decision. You could be charged with a DUI and have your license taken away or if you cause an accident that leaves someone injured or dead you may be facing some very serious criminal charges.

If you have been injured in an accident that was caused by another person drinking and driving then you can seek compensation from the driver and their insurance company. Driving drunk is negligent and puts lives in danger. Speaking to a car accident attorney will help you understand your rights and your options after being injured by a drunk driver.

Assisted Living Retirement Communities Can Be A Big Help To Seniors

When the years of a working life are over and it is time to retire, a lot of decisions must be made about what the best course of action is. For some seniors, the best thing is to move into the home of one of their children. For others, they need the amount of care that can only be found at a nursing home.

But for some people, the best place to spend their golden years is in one of the many assisted living retirement communities. These kinds of facilities offer a great balance between complete independence and skilled nursing care that is available in a nursing or rest home.

When a baby boomer moves to an assisted living facility, an initial assessment of medical and personal needs is completed and a care plan is created. This plan ensures that the care that is need by an individual is given at the right time, in the right place, by the right person, in the right way.

The folks who staff these facilities are top notch elder care professionals. They have had the best training available and are indeed specialists in providing care to elderly residents. It used to be that the only kind of facility available was a nursing home. And the horror stories you heard about those were frightening indeed.

Those were just stories, of course, but if you were involved in a situation where you were responsible for a senior and what they needed was a nursing home, the guilt you felt was almost overwhelming. That is one of the many reason why assisted living retirement communities were developed.

Many retired people do actually need some help in managing their medications, or with a bit of physical therapy or some other daily living activities, and it is in the assisted living facilities that they can get a program that is tailored to their particular needs. It is no longer, "one size fits all" kind of care, in a great assisted facility, the individual is paramount.

Even better, is the philosophy of the assisted living places, that there is no reason to give anyone care that they do not need. This was a problem in a nursing home, where everybody got total care even if they did not need it. And that kind of care more often than not created a set of people who wound up completely dependent on their caregivers. And that is never a good thing, if you don't need that kind of care.

Assisted living retirement communities are a great blend of enough individual help, without an overwhelming amount of assistance. They are a great middle ground for many people, and they might serve your needs perfectly.

Assisted Living Jobs and Your Career Search

Employers in the health care industry are constantly looking for qualified professionals to join forces with one of the most popular and growing fields today - healthcare. We see and use healthcare everyday of our lives in one area or another, but probably take a lot of it for granted. Those who choose to make healthcare a part of their lives by pursuing it as a career will find a world of opportunity at their feet. Whether you are interested in pursuing a nursing job, cardiology job, or working with the elderly in assisted living jobs, or prefer to take a seat in the administrative part of health care by having a business system job, you are sure to find a lot of opportunities and variety out there.

Healthcare is one of the only fields that is truly constant and will not go out of style. As we age and the population in general ages, there is going to be an increasing need for qualified and professional care on which our loved ones will need to rely. Assisted living jobs are one of most overlooked positions in the healthcare industry, but are very important and necessary. People working in assisted living positions have a variety of job opportunities that include working in nursing home facilities, hospice care or home health care. They assist the elderly or ill with daily functions and make it possible for these people to do and enjoy the activities that they can while receiving the proper medical care and attention that they need.

Cardiology jobs are also another area of the medical field that is constantly growing and expanding. You do not have to be a heart surgeon to be considered being a part of the cardiology field. There are many positions that work closely with the cardiologists, from working with the patients to assisting the physicians or reading and conducting the scans and exams that need to performed. There is a lot of growth potential within this field and it is always expanding.

If you prefer to stick with the business end of healthcare, there are plenty of job possibilities contained within the healthcare administrative staff and in business systems. This may involve being on the administrative staff or helping to develop new business systems and practices that are used by the hospital or other medical facilities. Whichever avenue you choose to pursue in healthcare, you are bound to find many great opportunities available.

Learn What Home Care and Health Care Providers Offer

Home care services range from highly skilled medical care, nursing and therapy to simple household task, such as activities of daily living (ADLs).

Arranging a program involves some searching and organizing and often requires you to use services from more than one source. To do this, you need to learn what services are offered by recommended agencies and individuals.

Particularly nursing and other medical services can be provided by home care or home health care agency. We will start by understanding what services this agencies provide.

MEDICAL SERVICES: agencies can provide a number of medical services, including skilled and basic nursing, rehabilitation therapies, and dietary services.

NURSING: With a physician overseeing the course of treatment, a home care agency can provide generic nurse practitioners, registered nurses, and licensed vocational. These highly skilled nurses plan and monitor health care, give injection and intravenous medication, and instruct you on self-administered medications, injections, and treatments. Aides, who work under the nurses' supervision, may monitor pulse, blood pressure, and temperature.

THERAPIES: Most agencies provide a physical therapist, respiratory therapist, speech therapist, or occupational therapist. These specialists give short-term assistance to people recovering from an illness or injury and ongoing therapy to those with permanent disabilities.

NUTRITION: Most agencies can arrange for someone to help plan a diet and show how to prepare foods that provide proper nutrition and meet special dietary needs. You may also be able to get help in shopping for and preparing meals of have prepared meal brought to your home.

MEDICAL AND SAFETY EQUIPMENT AND SUPPLIES: Agencies can provide medical equipment and supplies, such as hospital bed, wheelchair, walker, oxygen equipment and various home testing and monitoring equipment and supplies for incontinence and other conditions. You can buy or rent the equipment form the agency or from a medical equipment company with which the agency does business. Some home care agencies will also inspect your home for safety needs and arrange to install any necessary equipment, such as support railings, access ramps, of an emergency response system.

NONMEDICAL PERSONAL CARE: Most people who consider this option do not need skilled medical care as much as they need assistance with personal tasks that have become difficult because of frailty or other physical debility. This type of care is provided not by skilled medical personnel, but by Home Health aides. Aides are the people who spend the most time with the elder. Their tasks vary, depending on your needs, the rules of the agency and the willingness of the individual aide, but in general they include assistance with personal care, such as eating, dressing, and bathing, help with household chores, cooking, cleaning, shopping, and paying bills. For this kind of nonmedical assistance, home care is often better than residential care. Home care is provided one-on-one, whereas residential facilities have staff-to-resident ratios of one-to-ten or more. By choosing and monitoring a home care agency or individual home care providers, you may be better able to control the quality of care you receive. One of the great advantages of home care is that is permits an older person to maintain a feeling of independence and comfort in familiar surroundings. Also, you may be better able to control the care received and to avoid care that isn't necessary or desired. There could also be significant financial saving if the care you need is not too complicated. While residential care facilities average from $ 30,000 to $150,000 a year, this can average from 25% to 80% less, depending on what care is required. The things you provide yourself at home like food, drugs, and supplies, come without any nursing facility mark-up.

On the other hand, remaining at home also isolates some people from social activity and limits mental stimulation. Although friends and family often intend to provide lots of companionship, too many elders wind up spending their days in bed asleep or watching television. An organized elder residence on the other hand, offers both a community of people and a constant stream of activities.

RESPITE CARE: The primary responsibility for care and companionship often still rest with family members. Particularly if an elder requires extensive monitoring, it can become a substantial burden on family members to always stay around the house. Some agencies provide temporary respite care - a companion for the elder, whose presence allows a family member to leave the house and go to work, attend to other business, of simply have a break. Obviously, you can also make private arrangements for someone to fill this need.

Leaders We Can Fix This

Like every beginner, I have thought you could beat, pummel and thrash an idea into existence. Under such treatment, of course, any decent idea folds up its paws, turns on its back, fixes its eyes on eternity, and dies.

- Ray Bradbury

This is a key rule; create a contract with your subordinate that simply says: Your subordinates get the credit when things go well and you will take all the blame when things go wrong. The main reason subordinates will not take risks is that they are hung out to dry when things go wrong or someone else takes the credit when things go right.

To help your subordinates develop their leadership skills to the fullest potential you must delegate duties and assignments in greater degrees of complexity. Leaders are developed best through experiential projects or assignments rather than textbooks and manuals. As each new assignment is completed on time, but perhaps not perfectly, the level of difficulty must be increased. By adopting this tactic you are communicating the message clearly that your trainee is expected to perform at a high level of effectiveness and manage his or her time wisely. Your subordinate must take risks in order to satisfactorily meet your requirements.

The first step is to clearly outline what the assignment is and its corresponding time constraints, resources available, which by the way includes you, and what the expected outcome is to determine if the assignment is to be considered a success. Don't forget to allow time for questions. Provide a brief overview of why the assignment is important. Also include who, what and where the most likely areas of support and challenges will come from. Establish a schedule of meetings to monitor progress. These meetings should be brief, no longer than fifteen minutes. Now that you have set your subordinates up for success cut them loose and let them get to it.

There are two things that happen when subordinates take risks; one is good and the other is not. However, both results have a tremendous impact on the willingness of your leader in-training to take future risks. The first is the assignment goes well, it is completed satisfactorily and on time. You must make a public acknowledgement of the accomplishment and make sure that he or she gets the credit for a successful outcome.

The second result is that the assignment does not go well or is completed after the deadline. There may be a number of valid reasons why the outcome was not what was required. Conduct an after action review to learn what when wrong and how this result can be prevented in the future. This process will contribute to the learning experience.

You must be the person to stop this practice. Simply approach your subordinate and say "We can fix this," then begin to assist your subordinate in taking the necessary steps to correct the assignment and give practical guidance to prevent a recurrence. If you follow this process faithfully your subordinates will continue to take on more challenging assignments and risks.

This practice demonstrates that you mean what you say, you are a person of character, you are making allowances for their professional development experience and you are not going to deliberately let them fail. The result of this process is that you will have an extremely loyal and competent staff whose performances will far exceed those of their contemporaries. Your reputation will spread throughout the organization as a leader's leader who trains the future leaders of the organization.

Remember when you adopt the practice of "We can fix this" you turn success into a given when your subordinates are assigned a task.

If you are experiencing fear about deciding to be a leader, laugh your fears away by following this simple plan.

Tennessee - Low Cost Yet Classy Lifestyle

Living in Tennessee presents a varied lifestyle for many. Residents enjoy an alternative lifestyle, community lifestyle, family lifestyle, opportunity lifestyle, parenting lifestyle; relationship lifestyle to teen's lifestyle. And the best part of living in the wonderful state of Tennessee is that you can choose your lifestyle in accordance with your taste and preference.

Here are important focal points about the classic lifestyle of the state:

1) An alternative lifestyle in Tennessee includes the Venus project that is meant to maintain the dynamic equilibrium in human beings. The lifestyles that are counted as the alternative lifestyle in Tennessee are categorized at omplace, science connection, green matters, angel coin, love and pride, urban outings, tipi tarot, Wendi and other websites.

For details on how to make the family lifestyle more lovable in the Tennessee, it's advisable to use lifestyle themed online resources such as family tree magazine, Venus project; we are family foundation, Alateen, American family safety, concerned united birth parents, centre for successful fathering, OneGreatFamily, sittercity and family on board.

2) The exotic region of Tennessee is famous for the variety of lifestyles that are found there such as the traditional and modern lifestyles. One can find any and every kind of happenings there; for example, the nightlife in Tennessee is categorized as the most chic and happening for party goers; pubs, bars and other places of adult entertainment abound.

3) Tennessee is among the best places available for retirees, as the cost of living is low here. Retired people can afford buy homes at reasonable rates.

4) Tennessee is also the perfect destination for those looking for a rural lifestyle. Residents can also get a taste of world class city life in major cities like Memphis and Knoxville.

5) Tennessee offers world class health services and affordable housing to residents. And one of the best parts of enjoying a Tennessee lifestyle is assisted living: a non- institutional setting promoting individual liberty and dignity for the residents and also encouraging community and family involvement.

6) Another popular benefit in the state is the low cost property that is available here in good numbers. Quality living at a reasonable cost means a sought after place among those looking for a reasonable yet quality lifestyle with the average expenditure on housing, transportation, food and groceries, health care, utilities, clothing and entertainment at about ten percent lower than the national average.

7) Another excellent aspect of living in Tennessee is that the residents are free from a state property tax burden. Their property taxes are usually determined and collected on the basis of the locality. Other beneficial features of living in Tennessee are its low sales tax of about six percents on food ingredients and zero tax on prescription drugs.

8) Tennessee is also famous for its cowboy lifestyle and western way of life. There are dude ranches and guest ranches spread all over Tennessee promoting cowboy lifestyle. You can still see cowboys in their cowboy boots with western gun holster, riding on their horse, herding the cattle and performing other tasks. You can also get a taste of this cowboy lifestyle by visiting these ranches as a tourist or working their as a help during your visit.

With so many tax benefits and low cost of living, Tennessee for sure offers an affordable yet classy lifestyle. Check it out for yourself!