Mature Arkansas JANUARY, 2013
"reJECTED" "reJECTED" ART: ART: Photos.com, Photos.com, ktsimage©; ktsimage©; Caduceus Caduceus Medical Medical Symbol: Symbol: Photos.com, Photos.com, james james steidl© steidl©
2 january, 2013 MATURE ARKANSAS
G UEST ED IT OR IAL
Medicare Rewards Better Care By Ron Pollack
hile politicians talk about how to reduce Medicare spending, the Affordable Care Act (healthcare reform law) is already reducing costs. One of the law’s big improvements is to encourage hospitals to do a better job of preventing avoidable readmissions. That’s when a patient has to go back into the hospital shortly after being discharged. Beginning October 2012, hospitals with high rates of readmission for three health conditions—heart failure, pneumonia, and heart attack—had their Medicare payment rates reduced. Over the next few years, more conditions will be added to the list. Why is this needed? Evidence shows that too many patients end up back in the hospital when they don’t get the right care while there or when being discharged. Most readmissions could be prevented with better care. For example, if no one tells a patient how to take her medications when she’s being discharged, she might have complications that put her back in the hospital. Until now, that hospital would have been paid when the patient was readmitted. That means a hospital that didn’t do a good job could easily get paid more than a hospital that kept its patients healthier. We want to reward hospitals for taking good care of their patients and changing the financial incentives will encourage hospitals to provide better care in the first place. For example, they can make sure patients (and their caregivers) know how to care for themselves when they leave the hospital and that their regular doctors know what tests were performed at the hospital and what medications were prescribed. Patients have a role to play, too. You and your caregivers need to ask important questions about your care plan and make sure you understand it. Here are several resources to help: • The Family Caregiver Alliance provides a guide for families and caregivers to use during hospital discharge planning. Visit www.caregiver.org under “Fact Sheets.” • Medicare has created a hospital discharge checklist, at www.medicare.gov/publications/pubs/pdf/11376.pdf • If you ever have concerns about the quality of your care, contact the Medicare Quality Improvement Organization (QIO). In Arkansas, the QIO is the Arkansas Foundation for Medical Care (AFMC), at 888-354-9100. Changing the way hospitals are paid is a smart first step to improve care for all of us. Mr. Pollack is executive director of Families USA.
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MATURE ARKANSAS welcomes letters or emails from readers on any subject of interest to older Arkansans. Letters to columnists are also welcome. Email your letters to annewasson@ arktimes.com and include “letter” on the subject line. GUEST EDITORIALS, on issues of interest to Arkansans over age 50, are encouraged. This is a forum for readers’ opinions and comment. Views expressed are not necessarily those of the Publisher. Contact the Editor at 501-375-2985 to discuss topics or send 300-500 word editorials to firstname.lastname@example.org All editorials are subject to editing and space limitations
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Mature Arkansas is published monthly by Arkansas Times Limited Partnership, 201 E. Markham St., P. O. Box 34010, Little Rock, Arkansas 72203, phone 501-375-2985. Reproduction or use, in whole or in part, of the contents without the written consent of the publisher is prohibited. Manuscripts and artwork will not be returned unless sufficient return postage and a self-addressed stamped envelope are included. The publisher assumes no responsibility for care or safe return of unsolicited materials. All letters will be treated as intended for publication and are subject to Mature Arkansas’ unrestricted right to edit or to comment editorially. All contents copyrighted 2012 Mature Arkansas. MATURE ARKANSAS
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Memories of Franke's Dear Editor,
hank you so much for your article on Franke’s Cafeterias (Dec. 2012). It brought back so many memories. My grandmother, Vivian Harding, started working at the original Franke’s as a counter girl for the bakery. She went on to manage the Town and Country Franke’s. Tuesdays were my grandmother’s day off. In the Arkansas August heat, she would drag me downtown to try on what seemed like hundreds of dresses for school. After finally deciding on a dozen or so dresses, she would take me to Franke’s for lunch. The rule was, I could get anything I wanted, as long as I ate everything on my plate. Naturally, as a child I wanted everything and would waddle back to her car feeling more than a little green. Back in the 1960s, Franke’s was the choice lunch spot for the politicians and movers and shakers of Little Rock. Granny told me stories of their personal lives, that the public never knew. She had great respect for most of them, but there were a few, that just rubbed her the wrong way. She would absolutely abhor when some of them would put on airs to her staff. And would let them know about it. Her staff loved her for this. They would always treat me like I was the Queen’s granddaughter. When my grandfather passed away, there must have been hundreds of current and former Franke’s employees who came to his funeral, offering hugs and kind words for my grandmother. At 65, she was forced into retirement and she was quite upset by this. She went to work full time for Aday’s Drug Store on 12th and Woodrow. Over
EDI TO RI A L
The Case FOR Medicaid
orally, ethically and legally, Arkansas owes its citizens. The state will default on this irrefutable social contract if the Arkansas General Assembly fails to expand Medicaid this session. It is the expansion of Medicaid, 100% of it paid for by the federal government, that will keep 15,000 Arkansans from losing services they literally need to stay alive. Their services are set to end July 1, because the state underestimated its Medicaid budget by $300 million. Some legislators say they will not support Medicaid expansion because the 100% federal funding will start to decline in three years and eventually drop to only 90% by 2020--still a huge financial boost to Arkansas’ economy. Some see it as a way to keep up the war against Obamacare, despite the program’s growing popularity. They view Medicaid expansion, required to make the Obamacare math work, as a way to diminish healthcare reform. It’s a cold, cruel game they play, using the lives of frail seniors as their pawns. Few want to see nursing home patients wheeled to the curb and abandoned. Most have no home to return to. Even if there is a home left, their health is so frail or their care so complex, that an equally frail spouse or overworked family member cannot provide care. Ironically, those legislators who reject the fed’s offer because of
the years, Stifft Station became gang ridden and they tried to rob her once. Two young men in bandanas stuck a pistol in her face and began beating her with it. She grabbed it and threatened to tell their mothers what they were doing. The next day, the two young men showed up with a bandana just for her, making her an honorary gang member. As far as I know, Vivian Harding (middle) worked Aday’s was never robbed again. at the original Franke’s Bakery as She worked there until the a counter girl; eventually being age of 90. When she was 90, promoted to manager at the Town they sold the store and finally and Country Franke’s Cafeteria. retired. Retirement was more than she could handle and she passed away at the age of 91. Whenever I get a chance, I stop by Franke’s just to bring back memories of a sometimes grouchy, but hard-working, loving, and funny woman who I was so lucky to call Granny. Oh, and the food’s still pretty good, too – but I have learned to pace myself. — Sandy K. Sarlo Little Rock
Expansion the vague chance that it might be reduced in the future, disproportionately represent the very people who would benefit most—the 250,000 working poor who would gain healthcare through Medicaid. Poor peoples’ healthcare won’t go away because their services disappear. They will end up in emergency rooms with their medical treatment logged onto the uncompensated-care side of hospital ledgers. More rural hospitals will close and urban ones struggle. They will flood into a higher level (and higher cost) of nursing home care. Some will survive for a while, homeless on our streets. Far too many will suffer and some will die…needlessly. Why would anyone reject the infusion of millions of dollars into the state’s economy for the foreseeable future? How can anyone, who purports to represent their fellow citizens in the legislature, deny the meager services Medicaid provides to “the greatest generation?” It is senseless; it is devoid of basic human kindness; it is purposefully cruel and unfeeling. Who are these people that would let the sword of Damocles hang over the frail lives of our most impaired citizens? Who will keep their blood from that sword? —Anne H. Wasson
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CA L EN DA R P IC KS
Fabulous Fun for the New Year
By A.H. Wasson
ART Jan.—Arkansas Arts Center exhibits, 9th & Commerce St., Little Rock; FREE, call 372-4000 or visit arkarts.com “Toys Designed by Artists,” an international juried exhibition, through Jan. 6 “Museum School Faculty Exhibition: Past and Present,” Jan. 11-Mar. 10 “55th Annual Delta Exhibition,” Jan. 18-Mar. 10 Now through Jan. 7—“And The Band Plays On,” and exhibit by Kevin Cole; Hearne Fine Art, 1001 Wright Ave., Suite C, Little Rock. Weekdays 10:00 AM-5:00 PM, Sat. 10:00 AM-6:00 PM. FREE. Call 372-6822. Also, Dec. 1-Jan. 7., “Highlights of 2012.”
Now through Jan. 12—Southern Abstraction, a group exhibition at Greg Thompson Fine Art; 429 Main St., North Little Rock; 10:00 AM-5:00 PM, Sat. 10:00 AM-2:00 PM; FREE. Call 664-2787. Jan. 18—Argenta ArtWalk, every third Friday, features galleries’ open house; 300-700 blocks of Main St., North Little Rock; 5:00-8:00 PM; FREE, call 993-1234.
CLASSES & LECTURES Jan. 11—iPadWorkshop; UAMS campus, Little Rock; 2:00-3:30 PM; sponsored by SeniorNet, you’ll learn Wi-Fi with 3G, data plans, how to download books, how to print and popular Apps; $15; call 603-1262 to register. Jan. 15—“Fit 2 Live,” learn about topics to keep you healthy and happy; Laman Library Main Branch, 2801 Orange St., North Little Rock; 6:30 PM; FREE; call 758-1720. Jan. 15—“The New South Wing of AR. Children’s Hospital,” an Architecture and Design Network lecture by Architect Kent Taylor and David Berry with ACH; Clinton School of Public Service, Little Rock; 6:00 PM; FREE; call 683-5239. Jan.—FREE Fitness Classes, open to the
6 january, 2013 MATURE ARKANSAS
Jan. 11—Second Friday Art Night, open house at downtown Little Rock art galleries and museums includes art and entertainment from 5:00-8:00 PM; FREE.
Jan.—Little Rock Zoo, Jonesboro Dr., War Memorial Park, Little Rock; 9:00 AM-5:00 PM; $10; 60+ and children under 12, $8; Call 666-2406. Photo by Brian Chilson.
public, in North Little Rock at Community Center, 2700 Willow St. (791-8541); Sherman Park Rec. Center, 624 Beech St. (340-5373); Glenview Rec. Center, 4800 E. 19th St. (945-2921) and North Heights Rec. Center, 4801 Allen St. (791-8576). Call for class schedules; NO registration or center membership required. Jan.—Yoga classes; Quapaw Community Center, 500 Quapaw Ave., Hot Springs; 5:30-6:30 PM on Wed. & 10:00-11:30 AM on Sat. Call 501-6239922. FREE for members; $5 non-members. Jan.—Conversational Spanish lessons; Oley Rooker Library, 11 Otter Creek Ct., Little Rock; meets every Mon. 6:00-7:00 PM. For beginners; lots of review. FREE. Call 907-5991. Jan.—Zumba Gold classes modify for active older people the regular Zumba moves and pacing. Call each location for class schedule. Sponsored by CareLink.
In Little Rock: • UAMS Institute on Aging Ottenheimer Fitness Center, call 526-5779. • Bess Chisum Stephens Community Center, call 664-4268. • Pulaski Heights United Methodist Church, call 664-3600. • LifeQuest of Arkansas, 2nd Presbyterian Church, call 225-6073. In North Little Rock: • Indian Hills Church, call 835-2838. • Lakewood United Methodist Church, call 753-6186. • Tai Chi class; Quapaw Quarter United Methodist Church, Tues/Thurs @ 4:30; call 529-2140. Jan.—SeniorNet Classes in Little Rock: Fundamentals for Beginners, Intro. to Computers, File Management, Excel. 4-week classes, Reynolds Institute on Aging, UAMS campus, Little Rock. $45
LIMITED TIME ONLY per class ($75 for couples), manuals are $15. Call 603-1262. Jan.—SeniorNet Classes in Hot Springs: Basics, Level 1& 2; Word; Print Artist; and The Internet/Windows Live Mail. Meets weekly for 1.5 hrs. for 8 wks.; 210 Woodbine, Hot Springs. $20 per class ($30 couples), plus an initial membership fee of $40 ($60 couples). Call 501-624-5415.
COMEDY & GAMES Now through Jan. 12—Fri. & Sat. nights—“A Fertle Holiday,” family-friendly, original live comedy at The Joint; 301 Main St., North Little Rock; 8:00 PM; $20, reservations at 372-0205. Beverages, snacks at your table during the show. Starting Jan. 25 through April, “The Last Night at Orabella’s” family-friendly comedy about the most popular honky tonk in Dumpster, AR is closing down…
Nathan Sawaya and Dean West
December 12, 2012 – February 1, 2013
Jan. 15 through Feb. 9—“I Ought To Be In Pictures” (PG), a Neil Simon favorite; Murray’s Dinner Playhouse, 6323 Col. Glenn Rd,. Little Rock. Dinner 6:00 PM; curtain 7:45 on Tues.-Sat.; Sun. matinees. Call 562-3131 for reservations. Jan.—Looney Bin Comedy Club, 10301 Rodney Parham Rd.; 7:30 PM, Wed.-Sat $7; FREE for ladies on Thursdays; 10:00 PM Fri. & Sat., $10; call 228-5555. Jan. 10 or Jan. 24—play Dominoes or Poker, all skill levels welcome; Ester Nixon Library, 703 W. Main St., Jacksonville; 6:00 PM; Dominoes meets 2nd Thurs; Poker on 4th Thurs. FREE. Call 457-5038. Jan.—Bingo at the Quapaw Community Center, 500 Quapaw Ave., Hot Springs; Tues. & Thurs. 12:30-3:30 PM. Call 501-623-9922.
CRAFTING Mon.—Knitting Circle; Roosevelt Thompson Library, 38 Rahling Circle, Little Rock; 1:00 PM. FREE. All ages, all skill levels welcome. Call 821-3060.
Back by popular demand!
Artist Nathan Sawaya, the Picasso of LEGO® bricks, returns to the Clinton Center with a new show. “In Pieces” partners seven large-scale, highly stylized photographic images with uniquely constructed threedimensional LEGO® brick sculptures.
Mon.—Knits & Purls; Adolphine Terry Library, 2015 Napa Valley Dr., Little Rock, 5:00 PM; FREE, refreshments provided. Call 228-0129. Third Tues.—Sit & Stitch; Main Library, 5th Floor, 100 S. Rock St., Little Rock; Noon-1:00 PM; all skill levels of knitting, croquet, embroidery; FREE. 918-3000. Thurs.—Stitch Night; enjoy knitting, crocheting, cross-stitch; all are welcome Argenta Branch Library, 506 Main St., North Little Rock; 6:00 PM; call 687-1061. Thurs.—Fiddlesticks Knitting Group; Amy Sanders Library, 31 Shelby Dr., Sherwood; 1:00-3:00 PM; all skill levels. FREE. Call 835-7756 Fri.—Pinnacle Piecemakers Quilting Circle; Roosevelt Thompson Library, 38 Rahling Circle, Little Rock; all skill levels; 10:00 AM. FREE. Call 821-3060.
DANCES Every Sat. in Jan.—Fraternal Order of Eagles Dance with Warren Crow & The Classics; 6200 Aerie St., Little Rock; 7:00-11:00 PM (line dancing at 6:00); FOE members $5; guests $6. Smoke-free ballroom. Jan. 13, DJ Alex Ward will play danceable rock and roll, 3:00-7:00 PM; $5; call 562-0876 or 837-6766. Jan. 3—The Arts in Motion: Tango Holiday Twist; Arkansas Arts Center (AAC), 9th & Commerce St., Little Rock; 7:00-10:30 PM; FREE for AAC members, $10 non-members. For dance experts and people with no dance
1200 President Clinton Avenue • Little Rock, Arkansas 72201 501-374-4242 • clintonpresidentialcenter.org
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CA LEN DA R PI CKS experience; no partner required. Starts with Tango lessons; general dance at 8:00 PM. Call 372-4000. Jan. 4, 18 & 25—Country Dance Society dances will include a contra dance on Jan. 4 & 18; English Country Dance on 25th; Park Hill Presbyterian, 3520 JFK Blvd., North Little Rock, 7:30-9:30 PM. No experience needed, all ages welcome. $4 for society members, $5 nonmembers. Call Carolyn at 252-0094 or visit arkansascountrydance.org Mondays—Scottish Country Dance Society, Park Hill Presbyterian Church, 3520 JFK Blvd., North Little Rock. Beginner’s class 7:00-8:00 PM; Intermediate class 8:00-9:00 PM; no experience or partner required; $5. Call 821-4746. Wednesdays—Village A-Team Square Dancers, Coronado Community Center, Hot Springs Village, 7:30 PM; $5 for guests. Fridays--Spa City Bop and Swing Dance Club, VFW, 2231 E. Grand Ave., Hot Springs, 7:00 PM, 2nd, 4th 5th Fridays, $2. Free lessons with $20 membership at 7:00 PM Thurs. Call 501-760-7375. Saturdays—Merry Mixers Dance Club; Coronado Center, Hot Springs Village; 1st Sat. 7:00-10:00 PM; $10; 3rd Sat., 7:30-10:30 PM, $10. Call 501-922-2997. Third Sat.—Burns Park Dancing; Burns Park Hospitality House, North Little Rock; polka, waltz and potluck supper; 7:00-10:00 PM; $10. Call 680-2994; $10. First & third Fri.—Quapaw Community Center dancing includes ballroom lessons, Thurs. 7:00-8:00 PM; Clogging, Tues & Thurs, 8:30-11:00 AM; Line Dancing, Tues.& Thurs. 11:00 AM-noon; and Dance Party, 8:00-10:00 PM Thurs.; 500 Quapaw Ave., Hot Springs. Call 501-623-9922.
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Jan.—Dances and dance lessons at Bess Stephens Community Center, 12th & Cleveland Streets, Little Rock:
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North Little Rock • • Little Rock Hot Springs • Pine Bluff
With the opening of our new offices in Pine Bluff and Conway, Snell Prosthetic & Orthotic Laboratory now has • El Dorado eleven locations across the state to more conveniently serve our patients. So regardless of which office you decide to visit, our professional staff will be waiting to provide the best in care and the latest in technology.
Statewide Toll-Free: 1-800-342-5541 625 North University Avenue • Little Rock, AR www.snellpando.com
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NOW OPEN IN PINE BLUFF AND CONWAY! Providing the Latest in Technology & the Best in Care for More Than a Century PROSTHETICS / ORTHOTICS / PEDORTHICS / POST-MASTECTOMY
8 january, 2013 MATURE ARKANSAS
Little Rock Country Dancers; 6:00-9:00 PM, 1st, 2nd, 3rd Sundays (821-9353); $5; Ballroom, Latin and Swing Social Dance Assoc.; 7:00-11:00 PM; 1st, 2nd, 4th Fridays; (664-4268); $10; Little Rock Bop Club; 7:00-10:00 PM, every Wed. (350-4712); $4. Square Dance; 2:00-4:00 PM, every Thurs. (490-1197); $3.
MUSEUMS Now through Feb. 1—“Battle Colors of Arkansas,” Old State House Museum, 300 W. Markham; several permanent collections also on exhibit; 9:00 AM-5:00 PM Mon.-Sat. &1:00-5:00 PM Sun.; FREE; call 324-9685. Now through Jan. 26—Ark. League of Artists juried competition exhibit; Butler Center Galleries, 401 Pres. Clinton Ave., Little Rock. Also, works from the CALS Permanent Collection on exhibit through March. 9:00 AM-6:00 PM, Mon.-Sat. FREE, call 320-5700.
MUSIC First Thurs. of each month—Bluegrass Jam; Garland Co. Library, 1427 Malvern Ave., Hot Springs; 5:30-7:30 PM; all acoustic, all ages; FREE. Call 501-623-4161. Second Thurs. of each month—Ark. Accordion Association; Community Room, Whole Foods Market, I-430 & Rodney Parham Rd., Little Rock; warm-up starts at 6:30 PM. FREE, call 228-7166.
New Year, New Reads “Read in” the New Year with the library’s (CALS) adult winter reading program; from Jan. 7 to Mar. 2, patrons may read or listen to any book and submit reviews one of three ways: in writing at any branch library; via email to NewYearNewReads@cals.org; on Twitter at #NewYearNewReads. Door prizes for the best reviews at most branches; a Kindle Fire awarded to most creative review. Reading suggestion bookmarks and review cards at any branch library. FREE and open to public. Photos.com, Thinkstock Images©
Mature Arkansas_Layout 1 12/17/12 3:41 PM Page 1
Now through Jan.—Historic Arkansas Museum includes exhibits ranging from Bowie Knives to Indians in Arkansas to puppet theatre; 200 E. Third St., Little Rock. Hourly tours 10:00 AM-4:00 PM Mon.-Sat. & 1:00-4:00 PM Sun.; $2.50; 65+ $1.50; 17 and younger $1. Call 324-9351.
Third Fri.—Ark. River Blues Society; Cornerstone Pub & Grill, 314 Main St., North Little Rock; 8:00 PM; $3 members, $5 non-members. Call 374-1782. Saturdays, “Pickin’ Porch;” Faulkner County Library, 1900 Tyler St., Conway, Sat. 9:30 AM, FREE. Call 501-327-7482. Second Sat.—Ark. Dulcimer Society; Pulaski Heights Baptist Church, 2200 Kavanaugh Blvd., Little Rock; hammered and mountain dulcimers welcome; 2:00-4:00 PM; FREE. Call 661-1129. First and third Sun.—Traditional Irish music; Hibernia Irish Tavern, 9700 Rodney Parham Rd., Little Rock; 2:30- 5:00 PM; FREE. Call 246-4340. Also on second and fourth Mondays at 7:00-9:00 PM. First & Third Wed.—Ark. Celtic Music Society session; Something Brewing, 1156 Front St., Conway; 7:00-9:00 PM; FREE. Call 501-602-5508. Everyone welcome to sit in and jam.
TAKE THE GRANDKIDS Now through Jan. 6—River Market on Ice (ice-skating), 400 Pres. Clinton Ave., Little Rock; $9 for everyone over age 5, free for under age 4, skate rental included; group discounts available. Weekdays 4:00-9:00 PM; Sat. 10:00 AM-10:00 PM; Sun. noon-8:00 PM. Call 375-2552. Jan.—Mid-America Science Museum, 500 Mid-America Blvd., Hot Springs; features over 100 hands-on exhibits; Tues.-Sat. 10:00 AM-5:00 PM, Sun. 11:00 AM-5:00 PM; $9; $7 for 65+ and ages 3-12; Call 501-767-3461. Now through May—“The Science of the Human Body,” Museum of Discovery; 500 Pres. Clinton Ave., Little Rock. Also, “GPS Adventures” through April 1. 9:00 AM-5:00 PM Tues.-Sat. &1:00-5:00 PM Sun.; $10 adults & $8 children 1-12. Call 396-7050.
Feb. 22-24, 2013 Statehouse Convention Center Little Rock, Arkansas • Hear nationally known horticulture experts P. Allen Smith and Chris Olsen. • Shop at more than 90 vendors. • Take in gardening tips & trends. • Tour inspiring display gardens.
Gold sponsors Clark Trim & Henrik Thostrup Dr. Steve & Merilyn Tilley Media Sponsors
Carol & Allan Mendel
501-821-4000 • www.argardenshow.org Proceeds fund scholarships. MATURE ARKANSAS
The Face of
Allean Jones qualified for Medicaid services only after she had spent all but $2,000 in retirement savings. She worked 52 years to save so she could live independently. 10 january, 2013 MATURE ARKANSAS
W h at we lo s e w i t h o u t e x pa n s i o n n B y C a l Wasson
“I’d crawl around and do the best I could,”
responds Allean Jones, 89,
of Little Rock when asked what she would do if her services stopped because of state Medicaid cuts. Jones uses a wheelchair and may have to crawl, literally, to survive. The Medicaid home
care services that keep her off the floor have been put in serious financial jeopardy.
The demagogues who see her as a welfare loafer, and the accountants who see her as just a number, don’t understand her situation. She was a small business owner/operator for 42 years. She had a decent nest egg saved for her retirement but outlived it. When she started making retirement plans in about 1950 the average life span for women was 52. It’s now 77 years. She only qualified financially for Medicaid late last year. Jones clearly sees her option. “I would be in a nursing home without this program.” But for her that is not an option. She’s been there twice for short rehab stays. She has spent all of her resources just to stay out of a nursing home. Now she defiantly says, “I am not going back there.” Like most of her peers, she wants to stay at home as long as possible. Spending her savings on personal care so she wouldn’t have to go to a nursing home
was alright with Jones. It was the “spendingdown” of her resources that made her eligible for Medicaid and the array of services that help her live independently. Individuals must qualify for Medicaid, both in terms of their medical/physical condition and their financial resources. Medical evaluators determined Jones could not perform the basic activities of daily living (cooking, eating, bathing, dressing, etc.) without assistance. That determination qualified her medically. Financial eligibility means an individual’s resources cannot exceed $2,000 (not counting a home and one vehicle) and a very low income.
Social contract broken By accepting Medicaid services, Jones agreed that her remaining assets, or the part of it that would cover the costs Medicaid spent maintaining her, would go to the state on her
death--called Medicaid estate recovery. Jones made this major commitment as her part of the “social contract” with the state. Now Arkansas has put its part of the commitment into question by saying Jones, and about 15,000 other clients, may lose services, beginning with state fiscal year 2014 that begins July 2013. If the state’s commitment ends, so will the hot noon meal Jones gets on weekdays from the home-delivered meals (HDM) program operated by CareLink, a non-profit agency that receives both federal and state funds to provide services for older people in central Arkansans. The home health aide services that keep Jones’ apartment clean, food cooked, shopping done, medications checked and her personal functions attended to will also end. Researchers at Brown University say HDM are the top single factor in keeping people out of nursing homes. If they’re right, ending these meals will lead to an onslaught of malnourished, sick, high-dollar, emergency room or nursing facility patients. Jones is tough and independent but her knees are too weak to stand. Her mobility is limited to a wheelchair and she can rarely use a walker. If her support system goes, crawling will be her only way to a drink of water, a bite MATURE ARKANSAS
of food or the bathroom. The state of Arkansas may force her to crawl. “The magnitude of the proposed cuts is overwhelming,” CareLink President and CEO Elaine Eubank told Mature Arkansas. “Thousands of older people would lose services.” She says her agency now struggles to keep up with the ever growing elderly population and doesn’t have the resources to replace the services. All of the state’s Area Agencies on Aging are facing (in addition to proposed Medicaid cuts) an additional 8% cutback in federal grants under the so called fiscal-cliff negotiations. For CareLink this means about a $275,000 a year loss with most of that coming from client service.
Why the cuts? The cuts and freezes are necessary because the state missed the Medicaid budget by $298neikirk million. Toadmake for the shortfall, the10:52 Department carelink zumba mature up arkansas.pdf 1 11/28/12 AM
Call CareLink at 501-372-5300 or 800-482-6359 Joan takes Zumba Gold classes provided by CareLink at the Bess Chisum Community Center and at UAMS two to three days a week. She feels better, has more energy and weighs ten pounds less than she did when she started.
“I love it. You don’t even realize that you are exercising with Zumba Gold. Some music routines are easier than others. They involve side steps, bends and squats that get us moving,” said Joan. “I think the classes help me stay more alert and more interested in what is happening around me.” Make a call to CareLink at 501-372-5300 or 800-482-6359 or visit carelink.org to find out more about programs for active older people.
of Human Services (DHS) has proposed cutting back services by $138 million. Additionally, Governor Beebe proposes a budget increase of $160 million. The programs that keep Jones off the floor cost a whopping $4 million a year, less than 3% of the total cutbacks. According to DHS Director of Communications Amy Webb, most of the proposed cuts that DHS announced to legislators in November will come from rate freezes, eliminating “optional” Medicaid services (such as home care and Level III nursing home care), and new efficiencies. Governor Beebe says saving Level III services is a top priority. It should be. Almost half of the state’s nursing facility residents are at Level III, the lowest level of care. About 75% of home care recipients have the same level of impairments as Level III residents. If the cuts are implemented, Level III nursing home residents will have to find a place to live and try to cobble together similar services. For home care clients, the services that keep them in their home, rather than in a nursing home, will end. Some may be able to develop support networks that will keep them at home for a while. But caregiving is relentless and often physically difficult. Unpaid, non-family caregivers cannot maintain the same services that Medicaid provides. Others will live short and terrible lives. They will deteriorate quickly and likely end up in emergency rooms, if not morgues. Either option will be a much bigger cost to the state’s Medicaid budget. Just listening to Catherine Perito, 72, of Hot Springs, you’d think she is living a great life. Alert, extroverted, attentive and with a quick wit and wry sense of humor, all seems well. But this buoyant spirit is bound by medical devices and legs that barely work. She’s a virtual captive in
“The magnitude of the propo Thousands of older peopl
Catherine Perito, former business owner and teacher, has no options if Medicaid services are cut.
dance your cares away
12 january, 2013 MATURE ARKANSAS
the few hundred square feet of her Hot Springs home that she can use. Perito receives a few hours a day of home care/personal care from the Area Agency on Aging of West Central Arkansas (AAA). Her home care is funded by a Medicaid waiver program called ElderChoices. It permits individuals who qualify medically for nursing home care to instead receive care at home. As is common in home care, Perito has become close to her personal care aide, her most consistent companion. For the gregarious Perito, human contact is a source of life. Perito also receives a noon meal from the HDM program at Mercy Hospital Hot Springs. While she has no family that can help, her bright nature attracts a few friends. They would likely help some but it’s hard to see her surviving on her own. The state has already made the determination that she cannot live alone without some help and that, plus having low income and few resources, is why she qualifies for Medicaid services. She might survive awhile but it would be a brutal existence, far more brutal than the former teacher and small business owner should have to face.
traditionally have some of the strongest and best-financed lobbyists. The nursing facility trade group, the Arkansas Health Care Association, did not respond to our repeated phone calls and email requests for comment. Jonas Schaffer is a third generation owner/administrator of Greenhurst Nursing Home in Charleston, considered one of the state’s best facilities. He worries what will happen to the patients, “Some of them will end up homeless and some will try to get along at home. Many of them have Alzheimer’s disease and cannot live alone,” he told Mature Arkansas. Schaffer also questions whether the cuts and freezes would actually save money. “These cuts look good on paper but end up costing the state more money. If they have to go back home they may get hurt, or get sick, or get lost, and have to go back to the hospital. Then they’ll have to go to a rehab facility or maybe back into a nursing home to recuperate,” Schaffer says.
osed cuts is overwhelming. le would lose services.”
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Who loses? Webb estimates the Level III nursing facility and home care cutbacks proposed by DHS would affect about 15,000 people. She says about half now live in nursing facilities and the rest receive home care. The numbers are vague at the moment as agencies are switching funds in attempts to mitigate another looming mandatory federal cutback. The Arkansas Democrat Gazette reported the state’s action could close as many as 90 nursing homes across the state, most in rural areas and small towns. It’s hard to imagine this happening as nursing homes
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A simple solution The cost-cutting proposal that would devastate Medicaid Level III nursing facility care and home care comes with a solution. Raise Medicaid eligibility to 138% of the federal poverty level, the benchmark included in the Affordable Care Act. This Medicaid expansion would provide enough federal financial incentives—about $160 million by 2015—to cover most of the shortfall and allow the state to avoid these cuts. This is Gov. Beebe’s preference. He supports the full expansion of Medicaid because he says it will make our citizens healthier in the long run, and will help the state’s economy as well. It would provide health insurance for about 250,000 mostly low-paid workers. Approving it would make Arkansas a rare “red state” that accepts expansion. Ultimately, it will be the Arkansas General Assembly that decides if these 250,000 Arkansas citizens get health insurance. At press time, a simple majority to pass enabling legislation seems obtainable. But approving the appropriation bill would require a super-majority vote (75%) in the Republican-controlled House and Senate. Arkansas has one of the stingiest Medicaid programs in the country, it stands to propor-
Louis Webber says he doesn’t know what would become of him if he loses Medicaid services.
tionately reap some of the largest benefits by implementing Medicaid expansion. The costbenefit ratio of Medicaid expansion in Arkansas may well be the best in the nation. The federal government will pay 100% of the expansion for the first three years. Thereafter, the amount decreases slightly until, in 2020 the feds will pay 90%. Implementation would solve, or at least postpone, several knotty problems. Politically the GOP majorities are thin and the bill that creates expansion will have great leadership. At this point intentions to negotiate seem sincere.
ered meals each week and warms them up in a microwave sitting on the lowered cabinet in his small and neatly kept apartment. He also receives, through CareLink’s ElderChoices program, homemaker and case management. His personal care aide cleans, does laundry, cooks and helps him dress, bathe and use the toilet. Webber has one niece, 73, who is his only visitor, besides his personal care aide. His niece does his shopping and other chores and drives him to medical appointments. Like many of his peers, Webber knows about the potential to cut his services and it worries him. “It’s on my mind and bothers me all the time.” When asked what alternatives he has if his services end, he says, “I don’t know what I’d do. No telling what would happen to me.” With a pause and a sigh he expresses everyone’s hope, “I just wish they would settle it.” The American social contract means we have legal, ethical and moral obligations to each other. Yet, that this has become an issue at all, that thousands of sick older people are now trembling over their very existence; that our most vulnerable have become abstract budget numbers, means the strength of those obligations has wavered.
“I don’t know what I’d do. No telling what would happen to me. I just wish they would settle it.”
14 january, 2013 MATURE ARKANSAS
Short of Medicaid expansion it’s hard to imagine the legislature not coming up with funding to stop the cuts and freezes. The impact would be cruel and lethal and the savings would soon be offset by increased Medicaid costs in other areas. These are speculations about life and death to Louis Webber, 84, of Little Rock. Retired from the City of Little Rock, Webber now spends his day in a wheelchair, occasionally going outside in the electric wheelchair he calls “the Cadillac.” Webber receives seven frozen home-deliv-
A WARD WIN NER S
Dougherty Wins Tops AARP Award
Billie Jean Dougherty accepts the Andrus Award from Harroll Backus (left), an AARP vice-president and Jim Clemmons (right), an AARP volunteer director, during a volunteer appreciation gala at Crystal Bridges Museum in Bentonville last month.
illie Jean Dougherty of Ward is the 2012 recipient of the Andrus State Award for Community Service, AARP’s most prestigious volunteer award. Maria Reynolds-Diaz, state director of AARP Arkansas, calls Dougherty one of the longest-serving and most active volunteer leaders. “Well-versed on the issues and an excellent spokesperson, Billie is a constant presence at the state Capitol in Little Rock during legislative sessions,” Diaz says. Dougherty coordinated volunteer advocates for many years via the Capitol City Task Force. Under her leadership, Arkansas became the first state to implement “Do Not Call” legislation, nursing home tort legislation was stopped, and she was a leader in a coalition that helped rid Arkansas of abusive payday lending. Dougherty received AARP Arkansas’ Distinguished Service Award in 2011. She was a 2011inductee to the Senior Arkansans Hall of Fame and has been a longtime, elected member of the Silver Haired Legislative Session. Others recognized for their volunteer ser vice include Leroy Williams of Helena-West Helena, Charles Abanathy of Paragould, Lee Campbell of Horseshoe Bend, Loretta Echols of Jonesboro, Al Janssen of Little Rock, Bill Keller of Bella Vista, Ron Newport of Jacksonville, and Mary Purselley of Harrison.
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A WOULD-B E G OU R MET n By bob wood
Steak, fries and spaghetti at Venesian Inn in Tontitown.
I Miss the Beehive Hairdos L
ines outside the door at 5:00 PM. Half-inch thick steaks. A squat, cinder-block building on the side of Highway 412. Big, puffy dinner rolls and spaghetti. Could this be any place other than The Venesian Inn? Of course not. For those of us who went to school in Fayetteville in the 1960s and 1970s, The Venesian Inn was a reliable place to go for an inexpensive steak and some spaghetti. In 1970, you could get the #9 medium sirloin (16 oz.) steak with a salad, fries, and big, puffy dinner rolls for less than $6. And, you could substitute a half-order of spaghetti for the French fries for a little extra. It was a filling, quasi-extravagant meal for a college student like me. Part of the charm of the place has always been its distinct lack of it. The Venesian Inn is about as unprepossessing a place as you can find. But it was never about looks. When a friend and I went to Bentonville
recently, we swung by the Venetian Inn for dinner. Naturally, I met someone I hadn’t seen in years leaving the place. He had been going to the Venesian Inn since his college days in the 60s. It gets in your blood, I guess, like cholesterol. We split a #9 and I got a full order of spaghetti to go with it. They serve beer in attractive aluminum cans, and have wine listed on the menu. The days of sub-$6 steaks are long gone, and the #9 today is $19.65. As always though, it is about a half-inch thick but spacious and lops over the sides of your plate. The “Italian salad” hasn’t changed: shredded iceberg lettuce soaked in oil, vinegar and enough garlic powder to stucco a building. Yes, the Venesian Inn insists on using nothing but the absolute cheapest ingredients possible. But, somehow it all tastes so good.
They’ve always made their own pasta noodles and big, fluffy dinner rolls. Their spaghetti sauce is amazingly good. Total for our meal, a couple of beers and one glass of wine and tip was $42.28. Very pleasant. If you find yourself hungry and driving west on Highway 412, give it a try. And, don’t worry about being under-dressed.
Yes, the Venesian Inn insists on using nothing but the absolute cheapest ingredients possible. But,
somehow it all tastes so good.
The Venesian Inn 582 W. Henri De Tonti Blvd., aka Hwy. 412 Tontitown 479-361-2562.
Rockettes Perform for Fun T he Little Rock Rockettes, a dance troupe comprised of ladies over 60, includesTherese Axenfield, Winness Bell-Cowden, Ann Crow, Beverly Culwell, Linda Edmonson, Nancy Elliott, Helga Halloran, Carolyn Henry, Ethel Lawrence, Thea Smeets, Margaret Tate-Lee and Susan Wood. Organized two years ago, founder and coordinator Carolyn Henry of Little Rock says the group’s purpose is “to provide entertainment, portray a positive image of older women,
16 january, 2013 MATURE ARKANSAS
increase self-confidence, but mostly to have fun.”Their 45-minute show includes a variety of dance styles, including tap, jazz, Middle Eastern and clogging. They perform free at area nursing homes and assisted living facilities at least once a month. Their next performance will be Jan. 22 at Pulaski Heights United Methodist Church’s gym on Woodlawn in Little Rock at 1:30 PM. Visit littlerockrockettes.com for their complete 2013 performance schedule.
New Lease on Life : N utrition
Nutrition: One Answer to a Healthy Future By Jeanne Wei, MD, PhD
e are always looking for answers about improving the aging process. Part of the answer to living better and aging well is right in front of us, on our dinner plates. Increasingly, we know that diet and nutrition significantly affect the body’s functions. Start 2013 by paying more attention to what you eat and drink. Here’s why:
activity is at the base of the pyramid. Daily water intake is immediately above the base. Above these two levels are the nutrient-dense foods such as fruits, vegetables, whole grains, olive oil, low-fat dairy, fish and poultry. Decreased intake of red meat and sweets is encouraged.
Affects in the gut An interesting study in Ireland showed that the type of food we eat can influence the type of micro-organisms that live in our gut, called gut microbiota. The composition of the gut organisms correlated with health in elderly people. These intestinal changes were associated with chronic conditions including obesity and inflammatory diseases. The changes correlate with nutritional status and certain illnesses. Eating certain foods also correlates with the presence of certain species of microbiota.
Helps the heart and memory Research on the outcomes of medical nutritional therapy is relatively scarce. The restrictive diets (low salt, low sugar, reduced cholesterol) seem to be less effective in improving the quality of life, or increasing lifespan in the elderly. Future research should focus more on palatable diets that are rich in macro-and micro-nutrients. Micronutrients definitely have a role in keeping our hearts healthy. It was recently
Calories and muscle decline Research has improved our understanding of how age-associated changes also change our nutritional needs. Generally, at around age 50, energy or calorie needs progressively decline at the rate of about 8% per decade. Lean skeletal muscle on our limbs is gradually lost at about 1% per year after age 30. The skeletal muscle fibers tend to gradually decrease in size and number. Sarcopenia, or the disproportionate and degenerative loss of skeletal muscle, can occur in Foods such as salmon and spinach are rich in nutrients up to half of those over 80. The result is weakness, fatigue and significantly increased reported from the Framingham Heart Study, healthcare costs. It can even exist in those who that individuals living in the community (mean are overweight or obese. age 75 years) with a low vitamin B-12 level in the blood, combined with either a high folate Protein and exercise level or use of supplemental folate (vitamin Age may be associated with reduced appetite B9), was associated with a more rapid loss of and low calorie intake, often resulting in weight memory and cognitive decline over the ensuing loss. An increase in protein (lean meat and fish, eight years. beans, low-fat dairy and cheese) and regular Reversible heart failure has been described exercise are two of the best ways to maintain as a consequence of severe deficiencies of your physical independence. Good nutrition certain micronutrients (thiamine, selenium, can promote well-being, maintain muscle mass taurine, etc.). Vitamins A, C, D, E, thiamine, and prevent disability caused by frailty, falls, other B vitamins (including riboflavin and pyrifractures and general weakness. doxine), selenium, zinc, magnesium, copper, In the revised Food Pyramid for Older Adults arginine, etc., all have been reported to have created at Tufts University (nutrition.tufts.edu/ significant effects on the treatment of heart research/myplate-older-adults), daily physical failure.
Malnutrition common In addressing the nutritional needs of overweight or obese seniors, the approach is not so clear. Both malnutrition and sarcopenia are common in obese seniors. Malnutrition is present in 15-50% of older adults. Symptoms may include weight loss, confusion, lightheadedness, lethargy and poor appetite. Approximately 30% of seniors may skip more than one meal a day; 16% of older Americans consume less than 1,000 calories a day. Weight loss In seniors who present with the “dwindles,” weight loss is a symptom which can have many causes. Weight loss can be caused by declines in taste and smell, decreased saliva flow and reduced ability to chew. In addition to memory loss and/or depression, there may be other chronic medical conditions and side effects of medications that cause weight loss. Psychological, social and environmental factors can also have a profound impact on food intake, as can financial burdens, which a common problem in seniors on fixed incomes. To enhance appetite, one needs to be creative and use aromas, flavors and textures and provide a variety of foods. Encouraging several minimeals with nutrition-dense foods throughout the day is also beneficial. Providing help with grocery shopping and reminders to eat are also important. Keeping non-perishable foods in storage for emergency use is also helpful. Photos.com, Kenny Haner ©
EDITOR’S NOTE: This month we kick off a new year-long series, “New Lease on Life,” to help you make 2013 your healthiest year. Our experts will examine 12 key topics, all of them essential to good mental and physical health. This month we start with nutrition tips from the esteemed Director of the Reynolds Institute on Aging and Chair of the UAMS Dept. of Geriatrics Dr. Jeanne Wei.
Dr. Wei is the executive director, Reynolds Institute on Aging and chair, Department of Geriatrics at the University of Arkansas for Medical Sciences in Little Rock. MATURE ARKANSAS january, 2013 17
A D VOCAC Y
Nursing Homes in Yoyo Compliance Violations rarely punished, often repeated By Jack Whitsett
EDITOR’S NOTE: Last month, our series on Arkansas nursing homes examined the inspection process, and how owners can avoid accountability by separate licensure arrangements. This month, we explain why the laws designed to protect residents too often fail to protect them in deficient facilities. Next month, the series continues with a look at nursing facility staffing issues.
er head was down, her chin resting on her chest. She appeared to be asleep. Though the resident was sitting in a wheelchair at the nurses’ station, no one had noticed her choking on a sandwich she wasn’t supposed to be eating. When several horrified nurses realized the patient wasn’t breathing, nothing went right as they tried to resuscitate her. The April 16, 2012 incident resulted in the
resident’s death; a complaint to the U.S. Centers for Medicare and Medicaid Services (CMS); and a severe deficiency report for Searcy Healthcare Center. The CMS report, dated April 27, noted numerous violations of federal law that occurred before and during the failed attempt to save the resident. “Based on record review and interview, the facility failed to ensure a patient airway was established prior to or during cardiopulmonary resuscitation (CPR) for … (Resident #3), who had a documented swallowing problem,” the report read. “The facility failed to ensure that an established emergency crash cart available for CPR was maintained in such a manner as to have adequate supplies for the initiation of CPR. “Additionally, the facility failed to ensure
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Yoyo compliance Several CMS inspections in the two years prior to the April 27 report noted violations at the Searcy Healthcare Center in the same categories, a situation known as “yoyo compliance.” “That is typical for many facilities in the state,” according to Martha Deaver, president
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professional nursing staff was familiar with policies and procedures for CPR, an emergency crash cart supplies check list and assignment of responsibility for crash cart inventory on a daily basis. “This failed practice had the potential to affect 75 residents who had full code status, as documented on a Physician Orders List.” The resident, who had been assigned a “puree” diet on physician’s orders dated April 13, had been eating a peanut butter and jelly sandwich.
Where to Get Help â€˘ Ark. Advocates for Nursing Home Residents of Arkansas Advocates for Nursing is a non-profit advocacy group. For questions or to report Home Residents (AANHR), a nonsuspected abuse or neglect, contact President Martha profit, residentsâ€™ advocacy group. Deaver at 501-450-9619; or email MarthaDeaver@aanhr. â€œYoyo compliance happens when org Visit their website aanhr.org another complaint is called in,â€? â€˘ Ark. Office of Long Term Care (OLTC), Dept. of Deaver said, â€œor when the same Human Services, is the state government entity that violation is found on a subsequent inspects nursing homes, assisted living facilities, adult day survey.â€? cares, and residential care facilities; call 501-682-8430; toll The facility works until it is free for complaints: 800-582-4887. judged to have fixed the particular â€˘ Ark. Division of Aging and Adult Services, deficiency. Dept. of Human Services, can provide free, unbiased â€œ T h e [ s t a t e g ove r n m e n t ] information and counseling about care options. Call their surveyors recommend remedies â€Śto Choices in Living toll free at 866-801-3435; or visit choicesinCMS,â€? Deaver said. â€œThe CMS writes living.ar.gov/ Also available: information and assistance, them a letter back saying â€˜we agree.â€™ benefits counseling and access to publicly funded programs The nursing home will very quickly such as ElderChoices, Alternatives (to institutionalization), come back into compliance.â€? Deaver Independent Choices, and Living Choices. says the matter is then closed. Often, though, Deaver says the same violation is found again on the next inspection survey and the process there are very few nursing homes that donâ€™t starts over. â€œI have seen the exact same plan have a deplorable record of yoyo compliance.â€? of correction submitted in response to different inspections,â€? she said. â€œThey are allowed to Some improve, some don't continue until their next survey or until a The Arkansas Office of Long Term Care complaint survey. In the central Arkansas area (OLTC), the state government entity respon-
sible for regulating nursing home care, readily acknowledges the existence and difficulty of the yoyo compliance problem. â€œItâ€™s an issue that greater minds than ours havenâ€™t been able to solve,â€? said OLTC Director Carol Shockley. â€œThere are hundreds and hundreds of deficiencies and many of them are related in type. For a facility to be out of compliance is not unusual at all.â€? â€œSome facilities get a handle on it, others have a problem,â€? she said. â€œThereâ€™s not a solution that seems to stick.â€? â€œIf they repeat deficiencies there is an enforcement process and the enforcement keeps growing. It can lead to a loss of funding or the ability to admit Medicare residents,â€? Shockley said. â€œOnce a facility is out of compliance theyâ€™re put on an enforcement track,â€? she said, adding that the home has six months to come into compliance or the enforcement agreement is terminated. â€œAny time during that six-month track that
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H I K I N G WITH L EE HIL L ER
“The problem is greed. You can still make money on Photos.com, Andrew Gentry ©
a bad nursing home. The bad homes are designed and operated to meet the minimum standards, while making the most money.
That’s not the way to serve our nation’s elderly.”
we recognize compliance, then that track is closed,” Shockley said. Critics charge that the system therefore allows facilities to come into compliance, close the investigation, and then repeat the deficiency numerous times without penalty, as long as compliance is achieved each time a deficiency is noted. Jonas Schaffer, administrator of Greenhurst Nursing Center in Charleston, said, “The problem is greed. You can still make money on a bad nursing home. The bad homes are designed and operated to meet the minimum standards, while making the most money. That’s not the way to serve our nation’s elderly,” Schaffer said. The state’s nursing homes are represented by the Arkansas Health Care Association (AHCA), a trade group and political action committee. AHCA spent more money on political advocacy than any other trade group in Arkansas during the just completed 2012
20 january, 2013 MATURE ARKANSAS
election cycle. Though the trade association frequently speaks on behalf of the industry, AHCA ignored multiple requests for comment on this article.
Why not decertify? Deaver proposes a direct solution. “They need to be decertified. That’s it in a nutshell,” she said. “Nursing home owners should become unable to be certified when they show a repeat history of deficiencies.” CMS categorizes deficiencies from A through L, in ascending order of severity. Those coded G and higher have the potential to cause actual harm to a resident. Last year, Arkansas nursing homes tallied over 2,800 of these “actual harm” violations, according to a report from the state’s Office of Long Term Care. The report was released in response to a request under the state’s Freedom of Information Act made by Deaver. “The violations were cited for harm or the potential for death to the nursing home residents,” Deaver said. “This is an average of
seven incidents per day in 2011.” For the year ending Dec. 31, 2010, the most recent year for which complete statistics were available, Arkansas ranked among the top 10 states with deficient facilities in the categories of accidents and quality of care, according to statistics compiled by the University of California at San Francisco. In the accident category, the state’s facilities ranked second among states with 72% ranked deficient. In the quality of care category, Arkansas ranked eighth with 54% of facilities considered deficient. In addition, 52% of homes in the state were graded deficient in infection control, compared to a national average of 43%. Food sanitation was also a problem, with 46% of Arkansas facilities in violation, compared to a national average of 39%. Conversely, the state compiled better records than average in the categories of comprehensive care plans and clinical records. Only 16% of the state’s facilities were judged to have administered unnecessary drugs, compared to a national average of 23%.
MEDICAR E MAT T E RS n B y Sally J ohnson
End of the “Improvement Standard” A
recent court settlement may make it easier for people with chronic conditions and disabilities to have Medicare pay for home healthcare, nursing home stays and outpatient therapy. In what is commonly called the“Jimmo”case, several organizations sued the federal government over the “improvement standard.” For decades, some contractors who handled Medicare claims would not approve payment for skilled nursing or therapy services unless the beneficiary could show that services were likely to improve his or her health or ability to function.That meant some patients with chronic conditions like Parkinson’s disease, stroke, spinal cord injuries, Alzheimer’s disease and multiple sclerosis could not get Medicare to pay for care they needed to stay at their current level of health and functioning. Medicare law and regulations never officially excluded that kind of care. But some provisions in the Medicare manual and guidelines, used by Medicare claim handlers, suggest that coverage should be denied or stopped if a patient is not improving or is stable. In most cases, the contractors’ decisions denying coverage were final. Under the new court settlement, Medicare makes it clear that it will pay for services to “maintain the patient’s current condition or prevent or
slow further deterioration,”even if the patient is not expected to get better. The Jimmo settlement also affects claims that were denied in the past. If you or a loved one were denied Medicare coverage for skilled nursing facility care, home healthcare, or outpatient therapy services because of the Improvement Standard—and that denial became final and nonappealable after Jan. 18, 2011—you can ask to have the claim reviewed again. The lead plaintiff in the lawsuit is Glenda R. Jimmo, a 76-year-old woman from Vermont. Jimmo is blind and uses a wheelchair because one leg was amputated below the knee due to diabetes complications. Nurses and home health aides had been visiting her to take care of wound treatment and other health issues. Medicare denied coverage for those services because Jimmo’s condition was not likely to improve. Several national advocacy organizations joined the lawsuit, including the National Multiple Sclerosis Society, the Parkinson’s Action Network, Paralyzed Veterans of America and the National Committee to Preserve Social Security and Medicare.
Medicare will pay for services...
even if the patient is not expected to get better.
Mrs. Johnson is beneficiary relations director with the Arkansas Foundation for Medical Care. For answers about Medicare, call her toll-free 888-354-9100.
money n By S cott Mc Elmurry
Re-Entering the Housing Market B
aby boomers have long believed that home home and buying another one, here are some ownership is the “American dream.” Most– things you need to think about: 92%--of homebuyers 65+ are repeat buyers, according to a recent National Association of When to sell Realtors’ report. Another study by Fallon Research You may hear we’re currently in a buyer’s and Communications, Inc. reports 86% of those market. You might think twice about selling 60+ believe home ownership is a good investyour home. Selling your house is a decision that ment; compared to 69% of those 18-29. should depend more on your needs and lifestyle While the dream is to own a home, the home than current market trends. You may not get the you’re currently in may not be the dream you price you might have gotten at the height of the had when it was originally purchased. Lives housing boom, but you’re still likely to make a change, houses can feel too large, loved ones profit. Because most people buy less house the move away, or you simply want a change of second or third time around, you might not need scenery in your retirement years. Those are as much to buy your retirement home. The may New be York Times Syndication Sales Corporation some of the main reasons you ready 620 Eighth Avenue, New York, N.Y. 10018 to re-enter the housing market. Save your cash For Information Call: 1-800-972-3550 If you are thinking of selling yourFor current Since retirement Friday, December 07, 2012 homes are often smaller and
Edited by Will Shortz ACROSS 1 & 10 “Down, boy!”
41 Like many batters 42 Neighbor of Lat.
15 Something that’s 43 Place to get hardly fitting? clean 16 High-culture 44 ___ legs work 45 Western 17 Crush, say phenomena 18 Drive home 47 Barrio kinsman 19 Grp. organizing booster shots
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6 Capital along Interstate 15
Age in place According to AARP, most people want to remain in their homes as they age. This might require some remodeling of your new home if it hasn’t already been upgraded. You may need to change the flooring, widen door frames to accommodate a wheelchair, add grab bars in the bathrooms, or install better lighting. Having extra money from the sale of your old home makes these 1102 projects more affordable.
less expensive, odds are you could pay for your new home with the equity from your old home. Extra cash could come in handy during retirement or use it for safe investments. Rather than putting all of the money into buying a new home, consider a small mortgage. This would free up some of your money to remodel the new home to fit your retirement needs. Mortgage interest rates are at all-time lows.
39 40 7 It forms a strong 38 52 1990s girl group bond 41 42 43 member with a 8 Topic de Freud 22 Very insignificant tongue piercing 44 45 46 47 9 Hungarian 24 Have legs 56 ___ dixit city that has 25 Leather variety 48 49 50 51 hosted two 60 Voiced 28 Piranhas World Puzzle admiration 52 53 54 55 56 57 58 59 Championships 31 No-goodnik 61 They’re 61 62 10 “This Boy’s Life” 60 measured in 34 Model quality author Wolff 55-Downs 63 64 36 “Paint the Sky 63 Astrologer Dixon 11 “Not for me” With Stars” 65 66 12 Not make a singer 64 Be extremely mistake on conspicuous 37 “Written in the something Puzzle by Derek Bowman Stars” musical 65 & 66 Like water 13 Land o’ blarney 33 Once-faddish 46 What’s used for 54 Nudge 38 Battle of good that’s behind aerobics site-seeing? 14 Was like a bell alternative versus evil, e.g. you? regimen 49 The “you” in the 55 See 61-Across 21 Like a bell 35 Apt to artifice lyric “I’ll see you ANSWER TO PREVIOUS PUZZLE 23 Drink brand with in my dreams” 57 Lumber 37 It’s always a polar bear B L A C K S O X S C A N D A L increasing 51 Heat source? 58 Hard punch mascot E A R E A S E L R E U S E 39 Turns sharply 52 Korean liquor E L E C T R O N I C G A M E S 25 Equipment for 59 Toward the similar to sake 40 Constellation pentathletes P L A T O L A D D E R Atlantic, in animal 53 Either director S Y R I N G E I N S I T U 26 Eraser head? Mexico 45 Tom of of 2010’s “True D E M F O N T D E S 27 1962 film “Tomorrow” 62 A ways away Grit” T H E I C E M A N C O M E T H starring Elvis For answers, call 1-900-285-5656, $1.49 a minute; or, with a credit R E N E N A V E L A A R E Presley as a card, 1-800-814-5554. E X T R A C U R R I C U L A R boxer Annual subscriptions are available for the best of Sunday V E E M A L E A S P 29 R&D locales: crosswords from the last 50 years: 1-888-7-ACROSS. I S R A E L A R T I S A N AT&T users: Text NYTX to 386 to download puzzles, or visit Abbr. nytimes.com/mobilexword for more information. R R A T E D A N O D E 30 In droves Online subscriptions: Today’s puzzle and more than 2,000 past J E S S I C A F L E T C H E R puzzles, nytimes.com/crosswords ($39.95 a year). 32 Estes was his A A R O N P O I S E I E D Share tips: nytimes.com/wordplay. 1956 running B L I N D C A R B O N C O P Y Crosswords for young solvers: nytimes.com/learning/xwords. mate
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Seek advice It may have been decades since you last dealt with buying or selling a home. Tax issues, mortgage rates and the market itself have changed dramatically. Seeking help will ensure your home-buying process goes smoothly. Scott McElmurry is president of Bank of Little Rock Mortgage.
Why Move? H
omeowners over 55 say these reasons motivate them to sell their home, in order of importance: n Want to move closer to family and friends (increasingly important with age) n Relocate due to retirement n Home is too large, too much to take care of n Neighborhood becoming less desirable (less important with age) n Change in family situation--death, divorce, remarriage n Home upkeep too difficult due to health or financial limitations. Source: National Association of Realtors, 2010 report
How To Get Rid Of Knee Pain Once And For All... Without Drugs, Shots, or Surgery Do You Have Any Of The Following Knee Conditions: Pain, Arthritis, Cartilage Damage, Bone-On-Bone, Bursitis, Popping/Crunching Sounds? Hot Springs, AR‐ Living with knee pain can feel like a crippling experience.
penetrates the surface of the skin with no heating effect or damage.
Let's face it, your knees aren't as young as they used to be, and playing with the kids or grandkids isn't any easier either. Maybe your knee pain keeps you from walking short distances or playing golf like you used to.
Cold laser therapy has been tested for 40 years, had over 2000 papers published on it, and been shown to aid in damaged tissue regeneration, decrease inflammation, relieve pain and boost the immune system. This means that there is a good chance cold laser therapy could be your knee pain solution, allowing you to live a more active lifestyle.
Nothing's worse than feeling great mentally, but physically feeling held back from life because your knee hurts and the pain just won’t go away! My name is Dr. Randall Roth, owner of the Arkansas Spine And Joint Pain Clinic. After we started treating knee pain with a breakthrough technology, I’ve seen hundreds of people with knee problems leave the office pain free. If you're suffering from these conditions, a new breakthrough in medical technology may completely eliminate your pain and help restore normal function to your knees. Finally, You Have An Option Other Than Drugs or Surgery New research in a treatment called low level laser therapy, or cold laser, is having a profound effect on patients suffering with knee pain. Unlike the cutting type of laser seen in movies and used in medical procedures, the cold laser
Professional athletes rely upon cold laser therapy to treat their sports‐related injuries. These guys use the cold laser for one reason only… It Promotes Rapid Healing Of The Injured Tissues. Before the FDA would clear the cold laser for human use, they wanted to see proof that it worked. This led to two landmark studies. The first study showed that patients who had cold laser therapy had 53% better improvement than those who had a placebo. The second study showed patients who used the laser therapy had less pain and more range of motion days after treatment. If the cold laser can help these patients, it can help you too. Could This Non‐Invasive, Natural Treatment Be The Answer To Your Knee Pain? advertisement
Through February 1, 2013, I’m running a very special offer where you can find out if you are a candidate for cold laser therapy. What does this offer include? Everything I normally do in my “Knee Pain Evaluation”. Just call before February 1, 2013 and here’s what you’ll get… An in‐depth consultation about your problem where I will listen…really listen…to the details of your case. A complete neuromuscular examination. A full set of specialized x‐rays to determine if arthritis is contributing to your pain. A thorough analysis of your exam and x‐ ray findings so we can start mapping out your plan to being pain free. You’ll see everything first hand and find out if this amazing treatment will be your pain solution, like it has been for so many other patients. Until February 1, 2013 you can get everything I’ve listed here for only $47*. The normal price for this type of evaluation including x‐rays is $149, so you’re saving a considerable amount by taking me up on this offer. Remember what it was like before you had knee problems. When you were pain free and could enjoy everything life had to offer. It can be that way again. Don’t neglect your problem any longer – don’t wait until it’s too late.
Here’s what to do now: Due to the expected demand for this special offer, I urge you to call our office at once. The phone number is 501‐881‐4407. Call today and we can get started with your consultation, exam and x‐rays as soon as there’s an opening in the schedule. Our office is called Arkansas Spine And Joint Pain Clinic and you can find us at 804 Higdon Ferry Rd. in Hot Springs. Tell the receptionist you’d like to come in for the Knee Evaluation before February 1, 2013. Dr. Randall Roth, D.C.
804 Higdon Ferry Rd. Hot Springs, AR 71913 501‐881‐4407 P.S. Now you might be wondering…“Is this safe? Are there any side effects or dangers to this?” The FDA cleared the first cold laser in 2002. This was after their study found 76% improvement in patients with carpal tunnel syndrome. Their only warning – don’t shine it in your eyes. Of course at our office, the laser is never anywhere near your eyes and we’ll give you a comfortable pair of goggles for safety. Don’t wait and let your knee problems get worse, disabling you for life. Take me up on my offer and call today 501‐ 881‐4407. (*$47 per region) Copyright © 2012 RMG
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