Fifteen hundred pages of rules governing the Medicare Prescription Drug program have now been published in final form. Are you feeling a little overwhelmed at this point?The Washington Post published a piece on this describing the changes made to the rules as proposed last summer:The agency also outlined several changes made in the regulations since a preliminary version was announced in July. They now assure that beneficiaries have access to convenient pharmacies, and charity payments have been … [Read more...] about Medicare Prescription Drug Rules Now Issued
Do Your Residents Use Plavix?
The New York Times published a piece about a study raising questions about its safety:Patients taking Plavix, a popular and expensive antistroke drug, experience more than 12 times as many ulcers as patients who take aspirin plus a heartburn pill, a study to be published today in The New England Journal of Medicine found.Up to half of those now taking Plavix do so because their doctors assume that Plavix is safer on the stomach than aspirin, said Dr. Francis K. L. Chan, the study's lead author. … [Read more...] about Do Your Residents Use Plavix?
What About Tort Reform?
Dr. Charles alerts us to an archived editorial on tort reform published in the New York Times. Common Good excerpts the article here. The title of the article is It's Time to Try Special Health Courts. Here's the excerpt:We hold no brief for the current medical liability system, which does a poor job of compensating most victims of medical malpractice. An authoritative study of thousands of patients in New York State found that the vast majority who were harmed by medical errors or negligence … [Read more...] about What About Tort Reform?
Ms. Manners For Surveyors
Representative Deshotel has filed a bill which mandates that surveyors treat nursing facility staff with courtesy during inspections. It reads specifically:Sec. 242.0447. DUTIES OF REPRESENTATIVES. The department shall adopt written policies requiring representatives of the department to treat the residents of an institution and the institution's staff with courtesy, consideration, and respect during an inspection, survey, or investigation conducted under Section 242.043 or 242.044 or in … [Read more...] about Ms. Manners For Surveyors
Resident Choice of Pharmacy vs. Facility Choice of Medication Distribution System
Do you use a pharmacy that has adopted the Opus system or a similar system? Have you specified that any pharmacy who does business with your facility must use the Opus system including the part where the pharmacist generates the MARS and physician order forms and provides other services?If so, you may run afoul of DADS. Recently, a facility was cited for having such requirements on the basis that this is a violation of resident rights. As you know Rule 19.1502, Choice of Pharmacy states: A … [Read more...] about Resident Choice of Pharmacy vs. Facility Choice of Medication Distribution System
They’re After Aleve Now
Doubtless, you've all heard the news about Vioxx and Celebrex and the allegation that those drugs increase the risk of heart attack or stroke. Now an Alzheimer's Prevention Study is being halted because Aleve, one of the medications they are using in the study, contains naproxen, the same ingredient contained in Celebrex. The subjects of the study were being administered Aleve, Celebrex or a placebo. I cringe to imagine of the activity going on in offices of plaintiff's personal injury lawyers … [Read more...] about They’re After Aleve Now
Double Penalties
If you have a pending nursing home Civil Penalty case based on a survey that predates September 1, 2003 and you have already paid a Federal Civil Monetary penalty, the Fort Worth Court of Appeals has rendered a favorable decision. The case is The State of Texas v. Haltom Medical Investors, L.L.C. d/b/a Haltom Convalescent Center.The facts of the case involve a survey done in July, 2002 which resulted in a recommendation of Federal Civil Money Penalties and a referral to the Texas Attorney … [Read more...] about Double Penalties
Adjusting To The Medicare Drug Prescription Plan
The Robert Pear from the New York Times has published a piece opining that confusion will be caused by the fact that the Medicare Drug Prescription Plan may cause confusion for nursing home residents as a result of the fact that residents will be allowed to choose between two or more government subsidized plans. The article states:The premise of the law is that Medicare beneficiaries will carefully compare these plans and enroll in the ones that best meet their needs.But more than one-third of … [Read more...] about Adjusting To The Medicare Drug Prescription Plan
Pitfalls of Pain Management
You all know that Pain Management is a quality of care concern for DADS. Facilities have been cited for failing to adequately and systemically deal with pain being suffered by residents.Nursing facilities must, of course, obtain physician's orders for pain medication and increasing dosages and types of medications. Today, there was a column in the New York Times by Sally Satel regarding the criminal liability risks assumed by physicians who are managing pain with narcotics.(You may need to … [Read more...] about Pitfalls of Pain Management
Written Statements for Incident Reports
Lately, several people have asked me about the advisability of having employees write statements to accompany reports of incidents sent to DADS. It is my position that having your employees write such statements is neither advisable or required.Thus, the next question is--how do you conduct your investigation if you don't have your employees write statements? My answer is that your investigator actually investigates. That means interrogating employees who are witnesses to an incident or who may … [Read more...] about Written Statements for Incident Reports
