• Medicare Services Diminished, Geriatric Care Management Services to the Rescue


    Last week we witnessed that last minute finagling of Congress and the Obama Administration to avoid the much-hyped “fiscal cliff”.

    What does this deal ultimately mean? Congress has simply rearranged our huge national debt, entitlements and taxes at the expense of Medicare benefits to seniors. Make no mistake: Across-the-board Medicare reimbursement reductions will hit physicians, hospitals and home health care agencies.

    Enter the Geriatric Care RN.

    Geriatric Care RN’s are be available to provide a number of services to ensure quality and continuity of care, including Extensive Registered Nurse Assessments, a therapeutic plan of care, safe and comprehensive discharge planning from hospitals, nursing homes, rehabilitation facilities, MD care, Home visits by MD’s, prescription facilitation, finding the least expensive pharmacy to refill your medications, arrange long distance transfer of clients accompanied by an RN.

    In general, Geriatric Care RN’s help local and long-distance families navigate the changes with the new healthcare system to protect and assist loved ones.

    We plan and provide the best individualized care and initial assessments to determine a plan of care and applicable services for seniors and all age groups that want to receive optimum healthcare with the very best outcomes.

  • Why Geriatric Care Management is Critical


    Dr. David B. Samadi, a regular contributor on medical issues on The Fox News Channel, recently appeared on the subject of overseeing the care of your relatives and why it needs to be current.

    His report included the need to have the nursing facility oversee nutrition, safety and fall precautions and abuse and neglect prevention. For this oversight to be truly effective one needs to employ a Geriatric Care Manager (GCM), a fairly new position.

    The GCM should be a Registered Nurse (RN) who is contracted by the family, attorney or Power of Attorney to evaluate and assess care, communicate with MDs, reconcile medications and treatments, and follow the client on a routine basis and report back to the families. The GCM should accompany the client to MD appointments and serve as a spokesperson for the family, communicate health issues and serve as an advocate on behalf of the client for appropriate and effective care.

    Often the client has memory issues or is simply unable to understand the medical terminology or ask the right questions, often during an NP or MD visit that lasts less than ten minutes. The GCM can get prescriptions filled and can set up a medication reminder box at home or in the facility where the client is staying.

    The GCM sends an assessment that includes problems the patient is experiencing, how the patient voices their problems, the RN assessment, and the recommended plan to improve the client’s care and to problem solve

    The family can respond to the need for further services, a will, advanced directives, estate attorney referrals, follow up appointments, special procedures, a referral to A Skilled Nursing Service and Private HHA for Activities for Daily Living (ADL) assistants. ADLs include incontinence care, feeding, dressing, ambulation, transferring and restroom use. They also include shopping for clothing, shoes and podiatry appointments (a podiatrist or pedicurist must have a license to trim toe nails or finger nails).

    For special procedures it is critical to hire and involve a GCM for any age group. The GCM can schedule the procedure, receive the MDs preparation orders for the patient, transport the patient to the hospital or outpatient center and stay with the client during the procedure and recovery. The GCM receives the MDs follow up orders for post procedural care, transport the patient back to their home or facility, obtain lab results and those of the procedure, assess the patient and assist in hiring one-on-one care for the client.

    As the healthcare system becomes more and more complicated, the GCM is increasingly becoming a critically important member of the healthcare team, An advocate such as a GCM is hired to navigate the system, including provisions of private insurance policies, Medicare, Medicaid, supplemental insurance coverage and long term care policies.

    Payment for a GCM is not reimbursed by insurance companies and is a private pay arrangement between the parties of the patient and GCM or legitimate GCM Company. The GCM company should have a corporate or LLC status, be bonded, insured, offer workman’s compensation insurance to its employees and to have sufficient additional liability insurance for the safe transportation of clients. The NAPGCM certification gives a seal of approval that the GCM company meets the standards of NAPGCM.

  • Zero Hour for Obamacare


    Today marks perhaps one of the most historic and important dates in the history of our government.

    The long-awaited Supreme Court case on the constitutionality of the insurance mandate contained within Obamacare – the one that forces every American citizen to purchase health insurance –has finally arrived.

    A well-known and publicized fact is that Obamacare, with all its whacky and unrealistic provisions, will now cost roughly $17 billion. As this number keeps rising, it may cost many times that number by the time it is fully implemented. From my perspective as a health care professional and small business entrepreneur, I have written extensively about the damage Obamacare is doing.

    Jay Carney doesn't want to talk about Obamacare

    The facts and fears of Obamacare seem to have no end as more and more people – and Members of Congress – become more familiar with “what’s in the bill”. Successful efforts by Republicans in the House of Representatives to repeal Obamacare, spurred on by Rep. Michele Bachmann, were DOA in the Democrat-controlled Senate.

    Since then, Obamacare has continued to attract more commentary and analysis from concerned professionals in the medical community. Medicare-aged citizens, young people tuning into their future and the general public have become concerned that Obamacare was a dreadful mistake. Public opinion polls now show a majority of Americans support the repeal of Obamacare.

    An overriding fear of many is that this monster of a bill represents the single largest power grab in the history of the U.S. It has implications for nearly every area of our lives – taxation, real estate ownership, small business, privacy, and our own health and well-being. As Obamacare continues to reveal its true nature, outrage grows over how this bill was forced upon all of us without Members of Congress even taking the time to read it.

    Politically speaking, even though the Supreme Court is evaluating only one aspect of Obamacare – the individual mandate – it is clear that the implications of this decision will have a greater impact on how our government operates in the future. A 5-4 decision striking down the mandate will give a green light to the GOP to again move to repeal the whole law. A GOP victory in November giving them control of both the House and Senate will pave the way.

    The men and women who will decide our fate

    On the other hand, other SCOTUS scenarios are being tossed around town. One has SCOTUS affirming the constitutionality of Obamacare by a 7-2 margin with conservatives on the bench finding some way to join with the liberals. I don’t believe this will happen, but if it does, it will mark the end of constitutional government. We will no longer enjoy a free society, as the government will have free reign to mandate upon the citizenry anything they felt was best for us. This would be a political, social and economic nightmare.

    What if Obamacare is affirmed by the Supreme Court, but by a narrower 5-4 margin? It would still lead to a dangerous outcome for the future of our country as a free society, but would raise the stakes even further for November’s presidential election.

    As Obama gets his reelection campaign in gear, its clear Obamacare isn’t an issue he’s anxious to run on. White House spokesman Jay Carney has gotten rather adept at dancing around the issue when pressed by reporters. Obama may be unsuccessful in handling Obamacare during this election season no matter how it turns out. If Obamacare is struck down, he loses. If it is affirmed, America loses.

    “This is the most important election of our lifetime” is a cliché we hear ad nauseam every four years. But with Obamacare and the unprecedented powers it confers upon our government at hand, this cliché has unfortunately become a sobering reality.

  • Time to rally around Romney


    The race for the GOP nomination has been long, rocky, interesting and perhaps an exercise that will strengthen the campaign skills of former Massachusetts Governor Mitt Romney for the general election.

    But it clearly needs to end. The Gingrich and Santorum campaigns have now been reduced to juvenile games that only serve to weaken the GOP’s chances for victory in November. Both campaigns passed out Etch-a-Sketch toys at Romney’s event in Maryland – a desperate exercise in an attempt to revive their campaigns.

    Rep. Sean Duffy (WI), RNC Chairman Reince Priebus and Sen. Ron Johnson (WI)

    It won’t work. Santorum is now 300 delegates behind Romney, and Gingrich doesn’t stand a chance at the nomination. In his attempt to capitalize on Romney’s “Etch-a-Sketch moment”, Santorum went so far as to imply that Obama would be a better choice over Romney in November.

    It would be wise for both Gingrich and Santorum to realize their chances at the nomination have vanished and get behind Romney as former Florida Governor Jeb Bush and FreedomWorks’ Dick Armey have done. There’s too much at stake in this election – from the economy to repealing Obamacare – to let this campaign drag on and drag down the GOP in November.

    This week I attended an event for RNC Chairman Reince Priebus, who was celebrating his birthday. Priebus asked that I continue my fundraising efforts to unseat Obama as well as speaking out about how Obamacare is wrecking our once great health care system.

    Happy to oblige.

  • The Rounds: Obamacare back in the Spotlight


    As the GOP race for the nomination continues to slog along with no clear front-runner, people are now seriously looking at ways the decision might be rendered in Tampa. Conn Carroll of the Washington Examiner states that:

    Is it too late for a new candidate to enter the race for the Republican presidential nomination? Absolutely not. Is it probable? No. But it is much more likely than many Washington insiders let on.

    Obamacare and its progenitor, Romneycare, continue to play a huge role in the race. Mitt Romney’s health reform law in Massachusetts remains a drag on his campaign. Dr. Milton R. Wolf, writing in The Washington Times, feels it’s time for Romney to stop defending it and issue a mea culpa:

    “Despite Mr. Romney’s current lead in the primaries, he just cannot seem to close the sale… If the former governor would like to reach out to the conservative Republican base, I suggest he start by finally acknowledging the obvious: Government has no business interposing itself between you and your doctor. He should begin his Romneycare mea culpa with these three words: I was wrong.”

    Speaking of Obamacare, Americans in increasing numbers simply don’t like it and more than 50% want it repealed. As the question of its constitutionality moves to the Supreme Court, the op-ed wars are heating up again.

    While President Obama’s director of the Office of Management and Budget, Jeffrey Zients, may have undercut the legal defense of Obamacare by stating that the fine for violating the insurance mandate would not be considered a “tax”, it was the fight over contraception coverage mandates that dominated the news.

    Obama’s decision to force the Catholic Church to provide contraception coverage, including the morning-after pill, sparked widespread outrage.

    From Charles Kadlec in Forbes:

    “Before our very eyes, President Obama is on the verge of establishing the principle that the right to religious freedom comes not from our Creator, but from those who rule us. A government endowed right granted to women now trumps our unalienable right to act in accordance with our religious beliefs and conscience. Not only does this overturn the First Amendment, it also tramples the nation’s founding principles as announced in the Declaration of Independence. Such an achievement would be the true audacity of power.”

    In The Wall Street Journal, Rivkin and Whelan state that:

    “In an effort to rally its base in the upcoming November election, the Obama administration seems more interested in punishing religiously based opposition to contraception and abortion than in marginally increasing access to contraception services. It is the combination of the political motive, together with the exclusion of so many employers from the mandate, that has profound constitutional implications. It transforms the mandate into a non-neutral and not generally applicable law that violates the First Amendment’s Free Exercise Clause.”

    Also in The Wall Street Journal is a nice snapshot of various left-wing defenses of Obama’s mandate on the Catholic Church and other religious entities.

    Charles Krauthammer, writing in The Washington Post, chides the GOP for not mounting a strong opposition to Obamacare beyond pledging to repeal it.

    “In 2010, when all this lay hazily in the future, the sheer arrogance of Obamacare energized a popular resistance powerful enough to deliver an electoral shellacking to Obama. Yet two years later, as the consequences of that overreach materialize before our eyes, the issue is fading. This constitutes a huge failing of the opposition party whose responsibility it is to make the opposition argument. Every presidential challenger says that he will repeal Obamacare on Day One. Well, yes. But is any of them making the case for why?”

  • The GOP Beat Goes On


    Rick Santorum’s recent sweep of Missouri, Minnesota and Colorado left many pundits scratching their heads. Once again, the polls and momentum were pointing to Romney after his wins in Florida and Nevada, and many were speculating that once again the path to the nomination was clear. With Santorum’s surprise surge, this sense of inevitability around Romney has been shattered while exposing the weaknesses many in the GOP base find with him. Santorum has even replaced Gingrich as the leading “non-Romney”.

    Santorum is riding a wave of momentum

    I have to yield to the “architect”, Karl Rove, who has, in my opinion, the best breakdown on the race so far. Rove believes that Gingrich and Paul will not drop out and will drag their baggage to the convention in Tampa. With some wind at his back, Santorum still has a huge hill to climb but is in the best position to mount a formidable challenge to Romney. Santorum is jumping ahead to Texas and will employ the same strategy that worked in Missouri, Colorado and Minnesota where he made 22 campaign stops. Compare this to the three stops Romney made.

    I believe that with Santorum getting an early start in Texas he will succeed in earning significant exposure towards winning the state’s rich delegate count. A lack of deep organization and funds compared to Romney’s war chest still represents Santorum’s major disadvantages. But Santorum is finding ways to succeed without.

    The GOP base and the public are still not sure about any GOP candidate. It’s still only February, and a brokered convention, the first in All in all, the public is not sure about any GOP candidate–and we are only in February. A brokered convention – something that hasn’t happened in modern times – remains unlikely but cannot be counted out.

    The sad reality now is that Obama has no one opposing him while he builds a monster organization. He has more than a billion dollars in his coffers and has a convention headquarters of more than 50,000 square feet. His campaign’s use of technology and social media will certainly eclipse their impressive efforts of 2008.

    While his poll numbers, the unemployment rate and the economy are still dismal, Obama overshadows them by thumbing his nose at Catholics over the abortion and contraception controversy. Obama is turning a deaf ear on his Democratic party, but his machine is getting in place while the GOP waffles. Don’t doubt for a second that Obama will resort to any tactics to be re-elected this year!

  • Where Have All of the Doctors Gone?


    Now well into 2012, we are starting to see the vast changes in Medicare takingshape and it’s not pretty.  Expect the doctor shortage crisis that’s been picking up steam in America to come to a boil in a couple of years.

    Beginning in 2013, doctors and hospitals treating individual patients will be held accountable for “rehospitalizations” within 30 days and face penalties if they have high 30-day readmission rates. The reason behind this move is that readmissions are costly to Medicare and the public. Watch for even more doctors and health care facilities to turn away older patients out of fear their readmission rates will spike.

    Beginning this year, Medicare reimbursement rates will be cut yet again, further slashing into the income MDs make along with the incentive to take on older patients. Couple that with rising liability insurance premiums, office space rental fees and salaries for qualified office personnel. Note too that Medicare does not cover for state of the art medical equipment. Private insurance reimbursements aren’t enough to bridge the gab while more and moreof our population is aging.

    The Great MD Squeeze is fully underway.

    Read more

  • Newt is Running out of Steam


    The flavor of the day (month?) continues in the GOP race for the nomination.

    One thing’s for sure: No one can say that this race is dull. Former Speaker Newt Gingrich was obviously resurrected because of his sharp-tongued response to CNN’s John King in the South Carolina debate, which played a significant factor in his big victory in the state. This caused a near panic in the Romney camp and Republicans across the country.

    The battle between Mitt and Newt has thrown conventional theories and pundit models out the window. The polls are erratic because the voters are erratic as they move from one candidate to another with unusual frequency. They do not know whom they can trust and have emerged as a flighty and unpredictable group.

    By all measures of political scrutiny and facts Romney should win in Florida. He has the campaign organization. He has the money advantage. He has the advantage of thousands of mail-in ballots already cast.

    However, even though Romney is gaining back some ground in the polls today and had a strong performance against Gingrich in last night’s debate, this race has proved anything can happen. The Florida primary is a week away, and a week is an eternity in this erratic political game.

    I predicted a Romney victory in South Carolina and was way off. But I sense that Newt’s second resurgence is running out of steam.

  • Cliffhanger in South Carolina


    Newt Gingrich once again finds himself in the right place at the right time — this time in South Carolina. Mitt Romney has struggled with questions over his taxes and offshore bank accounts while losing bragging rights over winning Iowa. Rick Perry threw in the towel, along with his support for Gingrich. And polls now show the primary in South Carolina tomorrow — the first in the South — is a toss-up.

    Marianne Gingrich delivers a January surprise for Newt

    Newt’s newfound momentum doesn’t change the fact that it’s just a matter of time before he will self destruct — and it may already be underway. Yesterday’s string of events, including the bombshell interview with Newt’s ex-wife, haven’t been factored into the polls and we will unlikely know how they’ll affect the results prior to tomorrow evening.

    Good timing for Marianne Gingrich, but unfortunate timing for Newt. After all, this is the South Carolina primary tomorrow, and its heavily evangelical and social conservative constituencies may sour on the former Speaker after digesting Marianne’s charges just as they began turning to him. Is this still someone they can get behind?

    Newt has moved into a slight lead over Romney in the polls, but not significant enough to assure a win. I predict that Romney will eek out victory in South Carolina. As far as Newt goes, he does not deserve to win a single primary.

  • American Doctors in Crisis, Many Going Broke


    I have written often about crisis doctors are facing with the challenges government policies are presenting for them.

    Now CNN Money has a new article out about how doctors across America are going broke, and we need look no further than Obamacare and the related changes in Medicare to know why.

    The article quotes Dr. William Pentz, a cardiologist in Philadelphia:

    …recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue.

    These cuts have destabilized private cardiology practices,” he said. “A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well.

    This crisis isn’t limited to cardiologists. We know that many doctors have quit seeing Medicare patients entirely, and more are sure to follow. Many health facilities, including hospitals and hospices will fail. Further Medicare cuts will total $575 billion over the next decade and 7.5 million people will lose their Medicare Advantage plans and be forced into paying higher premiums for fewer benefits.

    America’s once superb healthcare system is crumbling before our eyes. Reversing this trend must begin with a change in leadership at the top in 2012 and the repeal of Obamacare. President Obama and his allies in socializing our healthcare system cannot be allowed to continue pushing forward. We’re seeing the results of their handiwork already.

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