WHEN YOUR LOVED ONE IS ABUSED IN A NURSING HOME: A PERSONAL STORY

My sister opened the door of our mother’s nursing home room one afternoon just in time to see the nursing assistant hit her. It was a real haymaker that snapped Mother’s head back.

“Why did you hit my mother?” my sister asked.

“I asked her to sit up and she didn’t,” the young woman replied. Our mother was....

….FULL ARTICLE

MARRIED COUPLE MEDICAID ASSET PRESERVATION USING RESOURCE ASSESSMENTS

Medicaid Resource Assessment are an important tool to understand and utilize when one spouse is in need of long term care. A portion of the Medicaid rules is designed to protect the community spouse (spouse at home) from impoverishment and unnecessary dissipation of family assets. Only the institutionalized spouse (spouse in a facility) is required to have assets of $2,000 or less and a pre-paid funeral.

….FULL ARTICLE

CAREGIVER SUPPORT GROUPS: IS THERE ONE THAT’S RIGHT FOR YOU?

If you’re a caregiver, you may have already read articles about the importance of preventing burnout. Usually these articles include a suggestion to join a support group. Perhaps you’re reluctant to do so because you wonder what caregiver groups are all about and whether joining one would really help you.  The overall goal of caregiver support groups is to enhance participants’ coping skills through mutual support and information sharing. Objectives may include:.....

….FULL ARTICLE

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Although most infusion drugs are covered under Medicare Part D, the Centers for Medicare and Medicaid Services has decided it does not have the authority to cover these infusion-related services, equipment and supplies costs under Part D. This leads to many Medicare beneficiaries being denied access to home infusion therapy. They then must receive treatment in hospitals at a significantly higher costs to Medicare. There is some coverage under Medicare Part B for certain therapies administered using durable medical equipment, such as a mechanical or electronic external infusion pump.

Infusion therapy involves administering medications intravenously by needle or catheter rather than orally. It is used when a patient’s condition is so severe that oral medications are not effective. Injections can also be delivered into muscles or epidural routes – the membranes surrounding the spinal cord. The medications can be antibiotics, antifungals, antivirals, chemotherapy, hydration, pain management and parenteral nutrition. Additionally, blood factors, corticosteroids, inotropic heart medications, growth hormones, immunoglobulin and other types of biologics can be given through infusion therapy.


Infusion therapy is often used for infections that are unresponsive to oral antibiotics, as well as for cancer and cancer-related pain. Patients with chronic pain, gastrointestinal diseases, congestive heart failure, Crohn’s disease, hemophilia, immune deficiencies, multiple sclerosis, rheumatoid arthritis and other ailments also benefit from infusion therapy. The most common type of infusion therapy is IV antibiotics for cellulitis, sepsis, osteomyelitis, urinary tract infections, pneumonia and sinusitis.


Infusion therapy is generally done in the patient’s own home, reducing healthcare costs. This also allows for minimal disruption of the patient’s day-to-day life. Infusion therapy can also be delivered at outpatient infusion sites. Both at-home and outpatient infusion sites are

INFUSION THERAPY ADMINISTERED WHEN ORAL MEDS ARE INEFFECTIVE

called alternate-site infusion therapy because they are alternatives to an inpatient hospital delivery setting. Currently, alternate-site infusion therapy is estimated to cost about $9 billion to $11 billion a year in U.S. health care expenditures. More than 1,500 infusion pharmacy locations offer infusion therapy, according to the National Home Infusion Association (www.nhia.org).


Nearly all commercial health plans consider home infusion therapy to be a medical service reimbursable under the insurance policy’s medical benefit, as opposed to a prescription drug benefit that is paid for using a per diem for clinical services, supplies and equipment with separate payments for the drugs and their delivery. Government health plans such as Medicaid, TRICARE and the Federal Employees Health Benefits Program also reimburse for home infusion therapy; however, in a few states, Medicaid has some gaps in the extent of coverage. Medicare’s fee-for-service program – Parts A, B and D – is the only major health plan in the country that has not recognized home infusion therapy has a benefit. Therefore, most Medicare beneficiaries enrolled in the fee-for-service program cannot afford to receive infusion therapy at home because of the professional services, specialized equipment and supplies that are required for home infusion therapy.

ANGELA S. HOOVER

Angela S. Hoover is a Staff Writer for Living Well 60+ Magazine

more articles by Angela S. Hoover