Tag: Centre Crest

Saving Medicare billions: Trying too hard can get in the way

Ambulance parked in front of my bedroom window waiting to pick up a neighbor
Ambulance parked in front of my bedroom window waiting to pick up a neighbor

Today is Sunday, February 26, 2012.  I took the photograph above last week. My apartment is within an eight-story building housing 90 low-income elderly and disabled individuals, an ambulance parks outside my window at least once a week. Sometimes my neighbors and I return. Sometimes, not. The cost for Medicare, Medicaid, and other services to go on the gurney ride to the hospital and beyond is many times higher than the cost of preventing and treating.

The following article appeared in the October, 2011 issue of  HME News and it still reflects an ongoing concern. Following the article, I will provide a memorial note on one of the residents who did not return.

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The money saved as a consequence of concentrating on what is right will astonish the body politic

” I have saved up enough pills to kill myself,” a neighbor told me, “if I ever have to go to Centre Crest.”

I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor–the more affluent are on Social Security or Social Security Disability and Medicare.
At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante’s inscription over Hell: “Abandon hope, ye who enter here.”
Last year, Pennsylvania’s Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.
The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare‘s purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain’s adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.
“The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science,” by Columbia University’s Norman Doidge, M.D., points to the brain’s ability to recover from strokes and other disorders with rehabilitation and concern.
“Traditional rehabilitation,” Doidge writes, “typically ended after a few weeks when a patient stopped improving, or ‘plateaued.’ And doctors lost the motivation to continue.  But…these learning plateaus were temporary…Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined.”
The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare‘s frequent citations of the Congressional Budget Office‘s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out-of-state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.
Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.
“Individuals with disabilities remain one of our nation’s greatest untapped resources,” said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.
–Joel Solkoff is the author of “Learning to Live Again, My Triumph over Cancer” and is adjunct research assistant at Penn State’s Department of Architectural Engineering.
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Memorial Note: Tonight, November 14, 2011, Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assistive care facility in Bellefonte, PA, 11 miles from Addison Court.
Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year  He will be buried beside his wife in Harrisburg at a private funeral.
Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, “I have been studied enough.”
His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.

Rep. Glenn (GT) Thompson representing Penn State plus

Rep. Glenn Thompson discusses his nearly 30-year long career as a manager of rehabilitation therapists, as a rehabilitation therapist, and as a health worker, which included changing bed pans at Centre Crest, an assistive living facility near State College, PA.

You can listen to this interview below.

https://drive.google.com/file/d/0B6JAIMWh-_zIeFMyVUtXbjZWUkU/view?pref=2&pli=1

I interviewed the Congressman on February 6, 2010. Rep. Thompson called me at State College from Tuscon, AR where he was visiting his son who had been wounded during military service. He was unable to return to Washington, DC because the DC area which had received two feet of snow closing airports and requiring Congress to readjust its voting schedules.

At the time, I was a columnist for Voices of Central Pennsylvania, a publication that has been extremely kind to me. My monthly column, entitled From Where I Sit, ran for over a year and concentrated exclusively on disability-related issues. This voice interview, published on the web page of the publication, was an adjunct to the following March, 2010 printed column:

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Strangers, snow and rehabilitation

Thanks to a failure to act in January, the Obama administration has made a serious mistake in allowing competitive bidding for durable medical equipment such as oxygen canisters, wheelchairs, power chairs and other devices.
I believe that if President Obama had a Medicare adviser of stature to explain the
consequences, Obama would not have made this mistake that will continue to hurt people with disabilities—including me.

As a result of this competitive bidding process, T&B Medical and Dick’s Homecare—the only two companies providing power chairs, scooters and other equipment in State College—are in danger of losing to outside competitors, including competitors outside the state. What they are at greatest risk of losing are contracts to provide Medicare recipients such as myself with equipment and maintenance reimbursements.

Maintenance is the issue I worry about most. Some legislators have put together a plan, supported by a sizeable non-partisan group in the House, that would end the bidding process.

One of the authors of the legislation is Rep. Glenn (“GT”) Thompson, who represents Pennsylvania’s Fifth Congressional district, of which Centre County (his home) is one of 17 counties in a huge, 11,000 square mile district.

I asked Tina Kreisher, Thompson’s press secretary, for a 20-minute exclusive telephone interview because I thought we could cover the details on Thompson’s health care background so readers can see the link between what our congressman knows and the unsolved problems he is equipped to solve.
Thompson and I spoke by telephone for over an hour on Tuesday, Feb. 9 at 6 p.m. I did not realize the degree of detail we would get involved in, especially since Thompson is himself the father of a disabled Iraqi war veteran. Thompson does not make a practice of talking in public about 22-year-old Logan, who was wounded when shrapnel and explosives caught him by surprise.

Thompson called me from Tucson, Ariz. where he was attending Logan’s graduation from Army intelligence training, an experience that filled him with the special gratitude we in the disability community feel when someone we love makes progress toward independence. The two feet of snow in Washington had left him stranded in Tucson and he observed, “There are worse places to be stranded.”

Thompson’s advancement in health care followed two tracks. Academically, he received a bachelor’ degree from Penn State in Therapeutic Rehabilitation, a master’s degree from Temple for Health Science Recreation and a certification from M a r y w o o d University in Nursing Home Administration.
M e a n w h i l e , Th o m p s o n ’s career involved working in central Pennsylvania as a residential services aid, a recreation therapist and a rehabilitation services manager at Susquehanna Health Services in Williamsport.

Thompson was at one time an orderly at Centre Crest Nursing Home, and for three years cleaned out bed pans, changed patients out of soiled clothes and changed bedding. He worked with his wife Penny, who did similar work as a nursing assistant. At the same time, Thompson’s mother was a patient at Centre Crest’s Alzheimer’s facility.

Glenn Thompson [everyone calls him (“GT”)] developed a reputation for good work and excellent managerial abilities, including people skills. When GT visited State College on Labor Day weekend, his charm was evident. He talked about health care in the social hall and bingo parlor (across the hallway from where I am keyboarding this column) of Addison Court, which is an apartment house for senior citizens and those with disabilities. The Congressman arrived for the 8 a.m event just as the Webster’s coffee and goodies arrived. (It helps turnout for these events when food is present and Elaine Madder-Wilgus has been most obliging in providing the coffee Thompson was so grateful to drink.) The 10 additional members of the audience were mostly men and women in their 70s, 80s and 90s.

GT charmed everybody—83-year-old Lilian Hutchison, put her hand on my shoulder and said, “I like that fellow” and Lilian is very influential at Addison Court. Win Lilian Hutchison and you have won votes at Addison Court. Lilian is a registered Republican who voted for Obama.

In my interview with Thompson, I asked about each portion of his 31-year career, which ended when he was supervising 25 rehabilitation specialists and coming up
with strategies for improving ongoing rehabilitation.

For me, sitting in a power chair right now, Thompson is the guy to know. I am at a point where I can now go back to rehabilitation to Dr. Colin McCaul, a brilliant rehabilitation physician at Healthcare South, because I recently passed a cardiac stress test. Since I cannot walk, cannot stand without holding on to something and can dislocate my shoulder if I throw my right arm straight in the air, I need a specialist to adapt special exercising tools so I can get the cardiovascular exercise I need. In my considerable experience with physical rehabilitation in three states, the people who do the hands-on work, the people who touch my body to show me how to do special exercises, when touching is appropriate (a pat on the back is always useful)—these people are uniformly kind and helpful.

I am impressed by the kind of work Glenn Thompson did and taught other rehabilitation specialists how to do. Based on his experience, his testimonials, his conversation and his education, I feel sufficiently trusting to put my exercise program in his hands if he has time.

Obama, the president I helped elect, is doing some truly bad things to Medicare that will have severely negative effects on the disabled. They have potentially disastrous effects on me. I use my power chair frequently; I require battery replacements every six months. What if the competitive bidding process the Obama administration is implementing results in requiring me to get batteries from an out-of-area supplier and I have to wait too long?

Right now, Travis would be right over with the batteries. With competitive bidding, I have to depend on some anonymous supplier. During that wait, if my batteries won’t take a charge and I soil my bed repeatedly, I might have to move to CentreCrest, which would severely limit my opportunities.

The failure of the Obama administration to reach across the aisle, as it promised to do, is shocking when Glenn Thompson’s special knowledge is going to waste. At the time of my interview with Rep. Thompson on Feb. 6, the President had yet to announce an Administrator for Medicare and Medicaid. Medicare is the largest health insurance company in the United States. Medicare needs an administrator who can be confirmed by the Senate. Thompson would be confirmed by the Senate.

Or, President Obama, please find him a better job. Or wake up the Republican House Leadership and have him put on the Ways and Means Committee where he will have oversight over Medicare. Given the overwhelming Republican composition of the Fifth Congressional District, Thompson will eventually gain the seniority he needs.

I don’t want to wait. I want Thompson‘s special skills available to me now because I believe he can assure me a more secure future.

—Joel Solkoff

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Saving Medicare billions: Trying too hard can get in the way

Memorial Note: November 13, 2011, Jack Seidner aged 93, my neighbor and friend at Addison Court, State College. PA, died while talking to his son who had called from Israel. He died at Centre Crest, an assistive care facility in Bellefonte, PA, 11 miles from Addison Court.
Jack was a veteran of World War II and was a monthly calendar boy on the Jewish War Veterans calendar last year  He will be buried beside his wife in Harrisburg at a private funeral.

 

Jack was a wonderful man. He was basically an intellectual although he hid it as much as possible. When I wrote a story about home medical oxygen, oxygen which he received to stay alive, he refused to be photographed saying, “I have been studied enough.”
His sense of humor was ever-present, sometimes to the point of reciting bawdy limericks to the residents of Addison Court. I will miss him. He died at Centre Crest. The article below, originally published in HME News on September 27, 2011, is dedicated to his memory. In these days of turmoil at Penn State University, the need to care for the real needs of this community should be apparent.+++
Saving Medicare billions: 
Trying too hard can get in the way 
The money saved as a consequence of concentrating on what is right will astonish the body politic
“I have saved up enough pills to kill myself,” a neighbor told me, “if I ever have to go to Centre Crest.”

I live in an independent housing apartment building in downtown State College, Pa. The nearly 100 residents of Addison Court are disabled or elderly. Most of us are poor–the more affluent are on Social Security or Social Security Disability and Medicare.

At least once a week, the ambulance stops by my window and a resident goes off to the hospital. The lucky return. The not-so-lucky move on to Centre Crest, the default public nursing home about 11 miles away, where assisted living means expensive round-the-clock care, diaper changes, attachment to machines that keep the biological aspects of life going, medical personnel who make sure medications are taken correctly, and a world view that echoes Dante’s inscription over Hell: “Abandon hope, ye who enter here.”

Last year, Pennsylvania’s Department of Aging estimated it costs Medicare $40,000 extra each year for a resident to move from an independent living to an assistive living facility. The loss of dignity to the individual is incalculable.

The French philosopher Jean Paul Sartre observed that when one tries especially hard to listen, often the trying gets in the way of hearing. Medicare is trying too hard to do the wrong thing. Medicare‘s purpose is not to save money, but to provide health care in a way that concentrates on improving the quality of life. Recent evidence on the brain’s adaptive capacity provides hope that not only can individuals resume physical capacity from the devastation of a variety of afflictions that affect us at Addison Court, but also we can regain our talents to improve this society, not simply take from it.

“The Brain that Changes Itself, Stories of Personal Triumph from the Frontiers of Brain Science,” by Columbia University’s Norman Doidge, M.D., points to the brain’s ability to recover from strokes and other disorders with rehabilitation and concern.

“Traditional rehabilitation,” Doidge writes, “typically ended after a few weeks when a patient stopped improving, or ‘plateaued.’ And doctors lost the motivation to continue.  But…these learning plateaus were temporary…Though there was no apparent progress in the consolidation stage, biological changes were happening internally, as new skills became more automatic and refined.”

The Obama administration’s penny-wise-and-pound-foolish cutbacks on availability to durable medical equipment, rehabilitation services, and home health care are forcing residents of independent living facilities into the Centre Crests of this country. For example, the narrow focus is apparent in Medicare‘s frequent citations of the Congressional Budget Office’s competitive bidding estimates of relatively insignificant savings for Medicare Part B ignoring the astronomical costs that will result to Part A when disabled individuals like me can no longer pick up the phone and call my local medical equipment provider. Instead, I must wait for a competitive bidding winner (several have unsavory reputations and some are based out-of-state) to provide a battery. Delays could easily force me into Centre Crest as a result of falls, problems getting to the bathroom, etc. Delays would rob me of the ability to work as an adviser on virtual reality models for construction of future aging in place housing–construction which will result in significant Medicare savings.

Medicare is discouraging the necessary alliance between rehabilitation therapists and medical suppliers. This alliance will help restore the ability of my fellow residents to function and contribute to society.

“Individuals with disabilities remain one of our nation’s greatest untapped resources,” said Rep Jim Langevin, D-R.I., the only quadriplegic in Congress. To release the untapped resources of the elderly and disabled, Medicare must stop thinking about saving money and start thinking about improving health. The money saved as a consequence of concentrating on what is right will astonish the body politic. Providers of durable medical equipment require the support of consumers like me. Providers and rehabilitation therapists have been slow to recognize that in unity there is strength. Together they must spread the word that when an individual becomes old or disabled, science is rapidly increasing the ability to regain talent and good health.
Joel Solkoff is the author of “Learning to Live Again, My Triumph over Cancer” and is adjunct research assistant at Penn State’s Department of Architectural Engineering.

http://www.hmenews.com/?p=article&id=hm201109OayJh3 

MY CHOICE TO HEAD MEDICARE a.k.a. Administrator for the Centers for Medicare and Medicaid Services

[The following is my March, 2010 column for Voices of Central Pennsylvania see http://voicesweb.org/archive/10mar/10mar-community-lifestyles.pdf (end of pdf.) or visit a newstand in Centre County.]

Strangers, snow and rehabilitation

From where I sit

Thanks to a failure to act in January, the Obama administration has made a serious
mistake in allowing competitive bidding for durable medical equipment such as oxygen
canisters, wheelchairs, power chairs and other devices.


I believe that if President Obama had a Medicare adviser of stature to explain the
consequences, Obama would not have made this mistake that will continue to hurt
people with disabilities—including me.


As a result of this competitive bidding process, T&B Medical and Dick’s Homecare—the only two companies providing power chairs, scooters and other equipment in State College—are in danger of losing to outside competitors, including
competitors outside the state. What they are at greatest risk of losing are contracts to provide Medicare recipients such as myself with equipment and maintenance reimbursements.


Maintenance is the issue I worry about most. Some legislators have put together a plan, supported by a sizeable non-partisan group in the House, that would end the bidding process.

One of the authors of the legislation is Rep. Glenn (“GT”) Thompson, who represents Pennsylvania’s Fifth Congressional district, of which Centre County (his home)
is one of 18 counties in a huge, 11,000 square mile district.


I asked Tina Kreisher, Thompson’s press secretary, for a 20-minute exclusive telephone interview because I thought we could cover the details on Thompson’s health care background so readers can see the link between what our congressman knows and
the unsolved problems he is equipped to solve.


Thompson and I spoke by telephone for over an hour on Tuesday, Feb. 9 at 6 p.m. I did not realize the degree of detail we would get involved in, especially since Thompson is himself the father of a disabled Iraqi war veteran. Thompson does not make a practice of talking in public about 22-year-old Logan, who was wounded when shrapnel and explosives caught him by surprise.


Thompson called me from Tucson, Ariz. where he was attending Logan’s graduation from Army intelligence training, an experience that filled him with the special gratitude we in the disability community feel when someone we love makes progress toward
independence. The two feet of snow in Washington had left him stranded in Tucson and he observed, “There are worse places to be stranded.”


Thompson’s advancement in health care followed two tracks. Academically, he received a bachelor’ degree from Penn State in Therapeutic Rehabilitation, a master’s degree from Temple for Health Science Recreation and a certification from M a r y w o o d
University in Nursing Home Administration.


M e a n w h i l e , Th o m p s o n ’s career involved working in central Pennsylvania a a residential services aid, a recreation therapist and a rehabilitation services manger at Susquehanna Halth Services in Williamsport.


Thompson was at one time an orderly at Centre Crest Nursing Home, and for three years cleaned out bed pans, changed patients out of soiled clothes and changed bedding. He worked with his wife Penny, who did similar work as a nursing assistant.
At the same time, Thompson’s mother was a patient at Centre Crest’s Alzheimer’s facility.


Glenn Thompson [everyone calls him (“GT“)] developed a reputation for good work and excellent managerial abilities, including people skills. When GT visited State
College on Labor Day weekend, his charm was evident. He talked about health care in the social hall and bingo parlor (across the hallway from where I am keyboarding this
column) of Addison Court, which is an apartment house for senior citizens and those with disabilities. The Congressman arrived for the 8 a.m event just as the Webster’s coffee and goodies arrived. (It helps turnout for these events when food is present and Elaine Madder-Wilgus has been most obliging in providing the coffee
Thompson was so grateful to drink.) The 10 additional members of the audience were mostly men and women in their 70s, 80s and 90s.


GT charmed everybody—83-year-old Lilian Huffman, put her hand on my shoulder and said, “I like that fellow” and Lilian is very influential at Addison Court. Win Lilian Huffman and you have won votes at Addison Court. Lilian is a registered
Republican who voted for Obama.


In my interview with Thompson, I asked about each portion of his 31-year career, which ended when he was supervising 25 rehabilitation specialists and coming up
with strategies for improving ongoing rehabilitation.


For me, sitting in a power chair right now, Thompson is the guy to know. I am at a point where I can now go back to rehabilitation to Dr. Colin McCaul, a brilliant rehabilitation physician at Healthcare South, because I recently passed a cardiac stress test. Since I cannot walk, cannot stand without holding on to something and can dislocate my shoulder if I throw my right arm straight in the air, I need a specialist to adapt special exercising tools so I can get the cardiovascular exercise I need. In my considerable experience with physical rehabilitation in three states, the people who do
the hands-on work, the people who touch my body to show me how to do special exercises, when touching is appropriate (a pat on the back is always useful)—these people are uniformly kind and helpful.


I am impressed by the kind of work Glenn Thompson did and taught other rehabilitationspecialists how to do. Based on his experience, his testimonials, his conversation and his education, I feel sufficiently trusting to put my exercise program in his hands if he has time.


Obama, the president I helped elect, is doing some truly bad things to Medicare that will have severely negative effects on the disabled. They have potentially disastrous affects on me. I use my power chair frequently; I require battery replacements every six months. What if the competitive bidding process the Obama administration
is implementing results in requiring me to get batteries from an out-of-area supplier and I have to wait too long?


Right now, Travis would be right over with the batteries. With competitive bidding, I have to depend on some anonymous supplier. During that wait, if my batteries won’t take a charge and I soil my bed repeatedly, I might have to move to Centre Crest, which would severely limit my opportunities.


The failure of the Obama administration to reach across the aisle, as it promised to do, is shocking when Glenn Thompson’s special knowledge is going to waste. At the time of my interview with Rep. Thompson on Feb. 6, the President had yet to announce
an Administrator for Medicare and Medicaid. Medicare is the largest health insurance company in the United States. Medicare needs an administrator who can be confirmed by the Senate. Thompson would be confirmed by the Senate.

Or, President Obama, please find him a better job. Or wake up the Republican House Leadership and have him put on the Ways and Means Committee where he will have oversight over Medicare. Given the overwhelming Republican composition of the Fifth Congressional District, Thompson will eventually gain the seniority he needs.

I don’t want to wait. I want Thompson‘s special skills available to me now because I believe he can assure me a more secure future.


—Joel Solkoff, author of The Politics of Food ,can be reached at his Voices of Central Pennsylvania blog http://voicesweb.org/blog/1242