Avoid

Telehealth Helps Patients Avoid Rehab in Nursing Homes


Telehealth policies have loosened since the pandemic began, helping feed the surge in at-home recoveries. Medicare has relaxed guidelines for the kinds of patients eligible for services that make rehab at home possible, and many insurance plans now cover those services.

“A lot of people don’t realize, when you check into a hospital, you really need to check out what the discharge plan will be,” says Elaine Ryan, vice president for state advocacy and strategy at AARP. “When you’re discharged, the question is: Can you receive in-home rehabilitation? And the answer is yes. You don’t have to go into those centers.”

Avoiding the nursing home

Nursing homes “were fighting a PR battle” even before the coronavirus swept the U.S. and sickened more than 238,000 residents, says Fred Bentley, managing director of Avalere Health. The pandemic has made that PR problem “way, way worse.”

“We are going to find patients who before COVID would have gone into a facility, no questions asked, and now they have options,” Bentley says.

That’s a problem for nursing homes, which for decades have depended on Medicare payments from short-term rehab patients. Many homes rely on Medicaid payments from long-term care residents but on Medicare reimbursements from short-term patients who’ve been discharged from the hospital after a fall, illness or elective procedure.

“Because Medicaid rates are quite low, [nursing homes] depend heavily on patients insured by Medicare, and Medicare pays for post-hospital care in nursing homes,” says the University of Pennsylvania’s Werner. Nursing homes averaged $544 per patient day in Medicare revenue from rehab patients last year, according to data from the National Investment Center for Seniors Housing & Care. That’s more than twice Medicaid’s rate of $216 per patient day from long-term care recipients.

But nursing homes’ Medicare revenue cratered when hospitals across the country

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‘Avoid picking inept contractors for lift maintenance’

THE lackadaisical attitude of the Joint Management Body (JMB) and Management Corporation (MC) of residential highrises in appointing incompetent contractors for elevator maintenance is seen as one of the reasons for the never-ending lift breakdowns.

Malaysian Elevators and Escalators Association (Malea) president Franky Ho Kai Satt said this happened because the building management wanted to save costs without thinking about the residents’ safety.

“The building management should have appointed only certified contractors listed by the Department of Occupational Safety and Health (DOSH).

“There are building owners that appoint incompetent elevator maintenance firms or unregistered contractors just to save costs and even some maintenance is done just to meet the minimum requirements,” he said.

He also said that the maintenance and inspection on the safety level of elevators should be done periodically according to standards set by the authorities without any compromise to ensure the mechanical level of all elevators is in perfect condition at all times.

Ho said residents’ reluctance pay the maintenance fee is also a factor that contributed to poor maintenance of lifts.

Since there is no fund, elevator maintenance could not be done, he added.

Malea, in collaboration with DOSH, also organises technical training related to elevator maintenance.

Meanwhile, DOSH director-general Omar Mat Piah said elevator owners must ensure that the machines were safe and could be used at any time in accordance with Section 17 (1) of the Occupational Safety and Health Act 1994.

Failing which, he said, it would expose elevator users to the risk of accidents.

“All elevator maintenance work must be carried out by a person who is qualified, trained and registered with DOSH.

“It has to be a competent person (OYK) from a competent firm (FYK),” he added.

Omar said a thorough inspection of the physical condition and safety level of an

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Mistakes to avoid when upgrading a kitchen: Don’t get sucked into tempting, one-function items

Your household may have grown during the coronavirus pandemic as adult children who lost their jobs returned home. At the same time, your wallet may have become thinner during the economic fallout caused by the global health crisis.

Combine those factors and it’s easy to see that a study by the National Kitchen & Bath Association (NKBA) found that people want to improve their kitchen, especially with germ-avoiding, touchless technology, while adhering to a tight budget.

An overwhelming 99% of manufacturing, construction, design and retail businesses surveyed by the trade association said more consumers are requesting assistance with small-scale, DIY kitchen projects.

To reduce the risk of getting Covid-19, the survey found people want contact-less products with automatic sensors and antimicrobial surfaces as well as outdoor kitchens, where they can safely entertain while social distancing.

The pandemic also made people aware of the need to prepare for an emergency and store provisions. Improved water and air filtration systems are also part of the plan to hunker down safely at home.

“We’re breathing this air all day now and we’re wondering, ‘What’s in it?’” says Barbara Miller, design director for the Neil Kelly design and remodeling company.

In any size home, people are placing even more value on storage space and pantries to keep surplus food and water. It’s not easy to add cabinets, let alone counters, a sink and electrical outlets, to what’s considered the busiest and most complex room in any house.

Experts are available to advise you at all levels. A design consultation is free at Home Depot, either in the store or virtually. If you haven’t thought about upgrading a kitchen in a while, this is an easy way to be introduced to new materials and approaches.

The National Kitchen & Bath Association maintains a directory of

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How to Avoid the 5 Worst Kitchen Design Mistakes

ALL-WHITE kitchens that look like operating theaters aren’t all that inspiring or even practical. But the overcooked alternatives—kitchens featuring grease-accumulating ceramic roosters or cabinetry festooned with grape-leaf swags—can seem depressingly cluttered. “It’s a place for creating meals, not Versailles,” said New York architect Kevin Lichten.

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Homeowners should view their kitchens first as machines for preparing food, he advised. “Then slowly add luxury to make it sensually appealing”—and ideally inject personality of the right kind. We asked design pros like Mr. Lichten to share their biggest kitchen-decorating pet peeves, from oversize islands to mixed-material counters, and to recommend chic, functional fixes.

HANG ‘EM HIGH In a kitchen in Oklahoma City, Okla., the upper cabinets continue to the ceiling, avoiding a common design error: a dust-collecting gap between the top of the millwork and the ceiling.



Photo:

David Tsay

Scattered Appliances

Countertop gear—coffee maker, toaster, blender, air fryer—might be essential to getting your three squares, conceded Los Angeles designer Amy Sklar, “but honestly, they don’t look so hot spread out over every usable surface.”

Instead Gather your gadget diaspora behind an accordion-doored “appliance garage” (think: a built-in bread box for your blender and such). This allows easy access to contraptions while hiding them. To ensure your juicer stays juiced, plan around an electrical outlet. Pullout drawers in lower cabinets, too, can be hidy-holes for lesser-used appliances.

Unintelligent Counters

Along with other dumb 1970s ideas like water beds, renounce tiled work surfaces. New York designer Alan Tanksley calls out their uneven surfaces and unsanitary grout lines. Even perfectly flat tiles installed tightly can pose a challenge, Mr. Tanksley noted. Any individual tile is more susceptible to chips and cracks than unified slabs of natural stone. That said,

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Officials urge patience, common sense to avoid unscrupulous contractors following Hurricane Sally

In the wake of Hurricane Sally, people are going to social media and asking what fair prices are for debris removal and rooftop fixes.

Some of the prices being cited on Facebook are alarming: $25,000 to $50,00 for tree removal.

It is a situation that Baldwin and Mobile County state and local officials want to stop before it gets worse. During a news conference Monday in Fairhope, officials urged residents to “be patient” and not rush into contracts in which they feel uncertain about or in which a contractor cannot provide adequate proofs of insurance and licensing.

“We are dealing with things we are not used to,” said Baldwin County District Attorney Robert Wilters who, himself, suffered flood damage to his house near Wolf Bay. “One thing we have to be patient with is cleanup and recovery. The scammers are coming in here and are looking for people who are desperate.”

State Rep. Matt Simpson, R-Daphne, was joined by a bipartisan group of lawmakers to push for increase penalties against contractors that bilk coastal homeowners during the cleanup. Simpson was the main sponsor of HB194, which was approved by a 97-2 vote in the Alabama House on March 5. The legislation, which increased penalties against homeowner fraud, never received a vote in the Alabama Senate because the session was abbreviated due to the coronavirus pandemic.

Under the proposal, which would establish the Alabama State of Emergency Consumer Protection Act, a felony offense would be assessed against people who commit aggravated home repair fraud against homeowners following an event that was declared a state of emergency by the governor. Currently, under Alabama state law, the first conviction for home repair fraud is a misdemeanor.

“What we need to do is make sure that law enforcement has the teeth and ability to

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