Gv igh no116 apr15

in good GVhealthnews.com

April 2015 • Issue 116

One Year at the Helm As Michael McRae celebrates his first anniversary as president and CEO of St. Ann’s Community, he seems just a bit surprised at his good fortune.

See story inside

Lyme Disease

As temperature goes up, so does the risk of getting Lyme disease

How Medicare Covers In-Home Care

priceless

Rochester’s Healthcare Newspaper

Supplements Under Attack Major retailers, including Wegmans and Walmart, asked to halt sales of certain diet and herbal Page 7 supplements

Obamacare Excludes Pregnant Women Missing Enrollment ACA coverage gap leaves women two choices: 1) pay for insurance premiums or care out of pocket —to the tune of $10,000 to $20,000 or 2) skip prenatal care Page 16

Preventing Bad Dog Behavior

Demand for 3-D and 4-D ultrasound grows but local OB-GYN says better images don’t offer many prenatal advantages

Learn a few techniques to help train your dog

HEALTHY ROCHESTER Healthy workforce is a productive workforce: that’s the notion behind the increase in wellness programs sponsored by local companies Page 9

Meet Your Doctor

When my husband and I were first dating, he introduced me to a unique vegetable: fennel.

It was love at first bite!

Since then, I haven’t strayed. Find out why

Dr. David Baum, chief medical officer, says he and his team are working to turn Thompson Health into a regional, more complete hospital

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Page 8 April 2015 •

Red Wine One or two glass a day of wine.

Remember when researchers said this was a good thing? Well, a new study says it isn’t so Page 23

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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More Than 1 in 10 Use Daily Aspirin Wrongly For many users, the odds of heart attack, stroke are lower than the risk of serious bleeding, study says

M Flu Hospitalizations Soar Among Older Adults

T

his flu season has been particularly severe for older adults, with people in this age group experiencing the highest rate of hospitalizations in a decade, according to a new report from the Centers for Disease Control and Prevention.

Since October, the rate of flu hospitalizations among U.S. adults ages 65 and over has been 258 hospitalizations per 100,000 people, the report found.

Previously, the highest rate was during the 2012 to 2013 flu season, when there were 183 flu hospitalizations per 100,000 people ages 65 and older, the report said. Health officials started keeping track of flu hospitalizations in 2005.

For the U.S. population as a whole,

the flu hospitalization rate this season was about 52 hospitalizations per 100,000 people, which is higher than the rates for the past three flu seasons, the report said.

One reason the flu is more severe this year could be the types of flu strains that are circulating. The most common strain of flu this season is H3N2, and health officials know that in years when this flu strain predominates, there tend to be more hospitalizations and deaths.

A study published earlier this year also found that this year’s flu vaccine is not very effective at preventing the flu, likely because the strains in the vaccine are not a good match to the strains in circulation.

any Americans are likely using daily low-dose aspirin inappropriately in the hopes of preventing a first-time heart attack or stroke, a new study suggests.

Researchers found that of nearly 69,000 U.S. adults prescribed aspirin long-term, about 12 percent probably should not have been.

That’s because their odds of suffering a heart attack or stroke were not high enough to outweigh the risks of daily aspirin use, said Ravi Hira, the lead researcher on the study and a cardiologist at Baylor College of Medicine in Houston.

Experts have long known that for people who’ve already had a heart attack or stroke, a daily low-dose aspirin can cut the risk of suffering those conditions again.

Things get more complicated, though, when it comes to preventing a first-time heart attack or stroke — what doctors call “primary prevention.” In general, the benefits of aspirin therapy are smaller, and for many people may not justify the downsides.

“Aspirin is not a medication that comes without risks,” Hira said. He noted the drug can cause serious gastrointestinal bleeding or hemorrhagic stroke (bleeding in the brain).

Still, people sometimes dismiss

the bleeding risks, Hira said, partly because aspirin is so familiar and readily available.

The idea of protecting the heart by simply taking a pill might appeal to some people, he said. “It’s probably easier to take a pill than to change your lifestyle,” Hira pointed out.

But based on the new findings, many Americans may be making the wrong choice, Hira’s team reported online in the Journal of the American College of Cardiology.

The results are based on medical records for more than 68,800 patients at 119 cardiology practices across the United States. The group included people with high blood pressure who had not yet developed heart disease.

Overall, Hira’s team found, almost 12 percent of patients seemed to be prescribed aspirin unnecessarily — their risks of heart trouble or stroke were not high enough to justify the risks of longterm aspirin use.

And what is “high enough”? For this study, it was defined as having at least a 6 percent chance of suffering a heart attack or stroke over the next decade.

Hira’s team based that on recommendations from the American Heart Association and the U.S. Preventive Services Task Force.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Holistic Dentistry: “The Mouth-Body Connection” We provide dental care that supports optimum health for the whole body, while placing an emphasis on education and prevention. Our approach to biological/holistic dentistry includes: n Safe Mercury filling removal and Metal Free Restorations n Digital X-rays and Fluoride Alternatives n Collaborative Medical Treatment that includes the expertise of other health care professionals n Sedation Options for anxious or phobic dental patients n Customized Treatment Planning to each patient’s specific needs

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Local Teens Kick Butts Local youth’s goal: end tobacco use

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Cough. Sneeze. Laugh.

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We can help. As a woman, you’re not alone if you

experience some form of urinary incontinence or pelvic pain that interferes with daily activities.

We have physical therapists specially trained and certified to help women overcome the challenges of pelvic dysfunction through: n Regain control through education n Pain management modalities n Bladder retraining n Stretching and strengthening of pelvic floor muscles

To schedule an evaluation, speak to your physician about obtaining a referral for pelvic floor physical therapy.

For more information, visit ThompsonHealth.com/PelvicPT or call Thompson’s Rehabilitation Services at (585) 396-6050.

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ocal youth spoke out and stood up to the tobacco industry on March 18 in an effort to end tobacco use once and for all. Their efforts were part of national Kick Butts Day where they joined youth from around the country to share a unified voice about tobacco marketing and the community wide impact.

Organized by the Campaign for Tobacco Free Kids, Kick Butts Day engages youth in activities designed to increase awareness of the problem of tobacco use, encourage youth to reject the tobacco industry’s deceptive marketing tactics, and urge elected officials to take action to protect kids from tobacco.

The Tobacco Action Coalition of the Finger Lakes’ Reality Check program (TACFL), along with community partners, engages in activities to educate communities and elected officials about the toll of tobacco, especially on youth.

According to the 2014 Surgeon General’s report, if current smoking rates continue, 5.6 million Americans younger than 18 who are alive today are projected to die prematurely from smoking-related disease. In New York state, 108,500 high school students smoke cigarettes and each year more than 13,500 kids under the age of 18 become new daily smokers.

Repeated exposure to tobacco marketing at the point of sale (cash register/counter) influences a youth’s decision to try tobacco products.

Nicotine is highly addictive, especially on the developing adolescent brain, and what may begin as a curiosity can turn into a lifetime addiction.

“It’s interesting how nearly all youth in fifth and sixth grade that we talk to are adamant that they

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

Teens Encouraged to Join Campaign Against Tobacco Smoking The Tobacco Action Coalition of the Finger Lakes’ Reality Check program is now forming groups of teens in the region to help raise awareness of tobacco smoking risks. Youth between the ages of 13 and 18 interested in working to create change that will protect all youth, and generations to come are encouraged to contact Jessica Kenneda, Reality Check coordinator at 585-4841503.

For the Monroe County area, contact Smoking and Health Action Coalition of Monroe County’s Reality Check Coordinator Joseph Potter at 585-484-1504.

will not use tobacco, yet over time tobacco marketing, exposure to tobacco use in the home, and tobacco use and butt litter in public places begin to replace youth’s knowledge of the harm tobacco causes with a belief that maybe tobacco isn’t so bad,” said Penny Gugino, director at TACFL. Unfortunately, that is the turning point that the tobacco industry waits for, the end of a child making a healthy choice, and the beginning of a potential lifetime customer.

Submitted by The Tobacco Action Coalition of the Finger Lakes (TACFL) and the Smoking and Health Action Coalition of Monroe County (SHAC).

Cancer: U.S. Spends More, Saves Fewer Lives than Western Europe

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espite sharp increases in spending on cancer treatment, cancer mortality rates in the United States have decreased only modestly since 1970, Samir Soneji, PhD of Dartmouth’s Norris Cotton Cancer Center and The Dartmouth Institute for Health Policy & Clinical Practice has found.

Refuting previous studies, Soneji published his paper “New Analysis Reexamines the Value of Cancer Care in the United States Compared to Western Europe,” in the March issue of Health Affairs.

“Our results suggest that cancer care in the U.S. did not always avert deaths compared to Western Europe and, when it did avert deaths, it often did so at substantial cost,” explained Soneji.

“The greatest number of deaths averted occurred in cancers for which decreasing mortality rates were more likely to be the result of successful prevention and screening rather than advancements in treatment.”

U.S. cancer mortality rates decreased by 12 percent since 1970, compared to a 62 percent decrease

for heart disease. Such findings have raised questions about the additional value of U.S. cancer care derived from the additional spending, in comparison to the situation in other high-income countries.

This study compared U.S. and Western European spending between 1982 and 2010 for 12 of the most common cancers.

Compared to Western Europe, the U.S averted 67,000 breast cancer deaths, 265,000 colorectal cancer deaths, and 60,000 prostate cancer deaths between 1982 and 2010. The U.S. experienced 1,120,000 excess lung cancer deaths in this study period compared to Western Europe. The ratio of incremental cost to quality-adjusted-life-years saved equaled $402,000 for breast cancer, $110,000 for colorectal cancer, and $1,979,000 for prostate cancer. These amounts exceed most accepted thresholds for cost-effective medical care. The U.S. lost quality-adjusted-life-years despite additional spending for lung cancer where the cost was negative $19,000 per quality-adjusted-life-year saved.

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much heroin use,” Dunn said. “Once people are dependent on prescription drugs, it’s very rare for them to stop on their own with no treatment. If the drugs are suddenly less abusable, they will switch to something else that will alleviate withdrawal.”

The CDC’s National Center for Health Statistics reports that between 2000 and 2013, the age-adjusted rate for overdose deaths involving heroin nearly quadrupled, rising from 0.7 deaths per 100,000 Americans in 2000 to 2.7 deaths per 100,000 in 2013.

One of the most recent high-profile deaths was that of actor Philip Seymour Hoffman, who died in February 2014 from a heroin overdose at age 46.

Steve Pasierb, president and CEO of the Partnership for Drug-Free Kids, noted that Hoffman had been in recovery for a long time. “Then he went back to using, and ended up dying from respiratory failure. Heroin is a respiratory depressant, and it shut down his respiratory system,” Pasierb said.

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Heroin Overdose Deaths Quadrupled Since 2000 eroin overdose deaths have skyrocketed in recent years, quadrupling since 2000, U.S. health officials reported early March.

At the same time, poisoning deaths related to painkiller abuse have leveled off, even dropping slightly in recent years, according to the report from the U.S. Centers for Disease Control and Prevention.

Prescription drug addicts are turning to heroin due to successful efforts to curb narcotic painkiller abuse, said Kelly Dunn, an assistant professor in the behavioral pharmacology research unit at Johns Hopkins University School of Medicine.

It’s now harder to obtain prescription narcotics, thanks to improved tracking and regulation of the drugs, Dunn said. In addition, manufacturers have changed the formulation of painkillers like OxyContin to make them more difficult to abuse.

“Heroin’s cheaper and easily available, and we’re seeing increases in places that traditionally haven’t had

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Zoe Fackelman, PT, Ramona Stein, Au.D. Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

April 2015 •

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Do you live alone?

Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?

Living Alone: How to Survive and Thrive on Your Own Tuesday, April 14, 21 and 28 6:30 pm - 8:30 pm House Content B&B, Mendon, NY

In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. $145 fee includes manual, empowerment exercises and lots of helpful resources.

For more information, call (585) 624-7887 or email gvoelckers@rochester.rr.com Page 6

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April 10, 12 and 13

Medicine Buddha seminar slated for Rochester Brighton Pathways of Rochester is hosting Namgyal Monastery Institute of Buddhist Studies for a special event titled “Medicine Buddha Teaching & Empowerment.” Medicine Buddha is the Buddha of healing and happiness, according to a news release. “You will learn the causes of suffering and how to create long-lasting happiness,” reads the release. The seminar will take place April 10, 11, and 12 at Brighton Pathways, 3200 Brighton Henrietta Town Line Road in Rochester. Weekend seminar led by meditation master, scholar and teacher from His Holiness the Dalai Lama’s North American Seat, Geshe Tsering Choephel.

Advanced registration required. All three sessions discounted to $180. For more information, visit www.BrightonPathways.com, email info@brightonpathways.com or 585-317-7060.

April 14, 21, and 28

Workshop for women who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to find joy again and gain the know-how to forge a meaningful and enriching life on their own.

You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world.

The workshop takes place at House Content Bed & Breakfast in Mendon from 6:30 – 8:30 p.m. on three consecutive Tuesdays: April 14, 21, and 28. The workshop fee of $145 includes a Living Alone binder, empowerment exercises, and helpful resources you can trust. To learn more, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@ rochester.rr.com

April 14

Nurse to discuss fibromyalgia management Janet Pennella-Vaughan, a nurse practitioner for pain services and associate professor in the school of nursing at the University of Rochester, will be the guest speaker at the support group meeting organized by the Fibromyalgia Association of Rochester New York. The event will take place from 7 – 8:30 p.m. April 14 at Greece Town Hall Meeting Center, 1 Vince Tofany Blvd., Rochester. Pennella-Vaughan, who is also director of clinical operations with Anesthesia Research, provides pain management for patients and participates in clinical research in this field, assisting to

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

develop educational programs for both patients and health care providers.

For the past 10 years she has taught nursing, along with pain and palliative assessment and management strategies. During the event, she will discuss pain management and fibromyalgia.

It’s free and open to the public. For more information, visit www.farny. org or call 585-225-7515.

May 1

Flower show to take place at Legacy at Park Crescent The Legacy at Park Crescent will host its Third Annual Flower Show from 11 a.m. – 2 p.m. on Friday, May 1. The main focus, “Senior Gardening Made Easy” will show that older adults can still enjoy gardening without the demands of a large garden.

This event will feature local florists and garden shops who will be selling spring plants, bulbs, seeds and starter kits, vegetable plants and a variety of gardening products.

Light refreshments will be served.

Call Theresa at 585-865-0680 by April 29 for more information and registration. The Legacy at Park Crescent is located at 1000 Providence Circle in Greece.

May 2

Park Ridge Auxiliary holds annual fashion show

The Park Ridge Auxiliary will host its Sixth Annual Fashion Show to raise funds for Unity Health System.

The event will take place at 11 a.m., Saturday, May 2, at Rochester Airport Marriot, 1890 W. Ridge Road, Greece.

Fashions by Chico’s will be modeled by Park Ridge Auxiliary members.

Cost is $28 (pre-pay). Payment can be sent to Park Ridge Auxiliary, 1555 Long Pond Road, Rochester, NY 14626.

Registration by Friday, April 25. Contact Sharlene Penna at 585-861-8104 or email spenna415@gmail.com for registration or more information.

May 25

Clifton Springs: ‘Calling All Photographers’ Clifton Springs Hospital & Clinic Auxiliary, Ontario Pathways and Main Street Arts invite the community to participate in a local photography exhibit at Main Street Arts, Clifton Springs. Photos can be taken anywhere along the Ontario Pathways Trails and submitted digitally to Main Street Arts via their website, www.mainstreetartsgallery.com by May 25. Photos chosen will be displayed at the gallery and other locations throughout the area.

For more information, please call 315462-0120.

Supplements Under Attack State attorney general bans the sale of some diet and herbal supplements raising question about their effectiveness

By Deborah Jeanne Sergeant

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ew York Attorney General Eric Schneiderman has set his sights on diet and herbal supplements, forcing major retailers to stop selling certain formulas, claiming several do not contain the properties advertised on their labels.

In a recent issue of AARP The Magazine, physician Steven Nissen, chairman of the cardiology department at the Cleveland Clinic, stated, “Don’t take dietary supplements. There’s no way to know what’s in them and there’s little scientific evidence of any benefits.”

Nissen grudgingly acknowledged merit in taking vitamin D and calcium, but said that vitamin D supplementation is out of control. “Avoid vitamin E. Avoid coenzyme Q10. Avoid fish oil; just eat more fish,” he wrote in the AARP publication.

Considering these recent attacks on supplements, which are largely unregulated, how can one find products that offer benefits?

Physician Thomas Campbell of University of Rochester Primary Care, and instructor of clinical family medicine, authored “The Campbell Blend,” a book on nutritional blends (Rodale: 2015).

“When I think of supplements, I think of two categories: nutritional supplements and herbal supplements based on traditions around the world,” he said.

While he believes that certain

T

herbal products offer some benefits, particularly when offered by someone trained in Chinese or Ayurvedic medicine, he worries that over-thecounter herbals may affect people with food allergies. These preparations may contain wheat, for example, that could sicken someone with celiac disease.

“If you’re really interested in traditional Chinese medicine, go to a

Major Retailers Asked to Halt Sales of Certain Herbal Supplements

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ease and desist letters were sent in February to GNC, Target, Walgreens and Walmart, as most store brand supplements were found to contain contaminants not identified on ingredient labels. Just 21 percent of supplement tests identified DNA from plant species listed on labels Attorney General Eric T. Schneiderman Feb. 3 announced that his office sent letters to four major retailers, GNC, Target, Walmart, and Walgreens, for allegedly selling store brand herbal supplement products in New York that either could not be verified to contain the labeled substance, or which were found to contain ingredients not listed on the labels. The letters called for the retailers to immediately stop the sale of certain popular products, including echinacea, ginseng, St. John’s wort, and others. Attorney General Schneiderman requested the companies provide detailed information relating to the production, processing and testing of herbal supplements sold at their stores, as well as set forth a thorough explanation of quality control measures in place.

The letters come as DNA testing, performed as part of an ongoing investigation by the Attorney General’s

Fewer Americans Say Vaccines Are Crucial

office, allegedly shows that, overall, just 21 percent of the test results from store brand herbal supplements verified DNA from the plants listed on the products’ labels — with 79 percent coming up empty for DNA related to the labeled content or verifying contamination with other plant material.

The retailer with the poorest showing for DNA matching products listed on the label was Walmart. Only 4 percent of the Walmart products tested showed DNA from the plants listed on the products’ labels.

“This investigation makes one thing abundantly clear: the old adage ‘buyer beware’ may be especially true for consumers of herbal supplements,” said Attorney General Schneiderman. “The DNA test results seem to confirm long-standing questions about the herbal supplement industry.

Mislabeling, contamination, and false advertising are illegal. They also pose unacceptable risks to New York families — especially those with allergies to hidden ingredients. At the end of the day, American corporations must step up to the plate and ensure that their customers are getting what they pay for, especially when it involves promises of good health.”

traditional Chinese medical physician who’s trained,” Campbell said. “That doctor would give you the plants. I am not sure you can get that from a bottle.”

He doesn’t recommend general or multi-vitamins, not because of quality but “research shows they don’t have any good benefit for chronic disease.

Multi-vitamins aren’t beneficial. There are some vitamin supplements for some situations that are useful. In some cases calcium, B-vitamins, and vitamin D. But I don’t necessarily think everyone out there should be taking them.”

Cindy Bowen offered a different perspective. Bowen has studied nutrition since 1972. Owner and founder of Mother Earth Natural Foods in Geneva, Bowen has heard numerous attacks on supplements’ efficacy.

“In 36 years of Mother Earth’s history, we see supplements making a difference again and again for all ages in many diverse situations,” she said.

“It is true in the health supplement industry, that it is not FDA-regulated but that doesn’t mean that there are no standards.”

She said that the supplement industry self-regulates, which means that some companies abide by standards for quality, purity and truth in labeling.

“Hence you get the empty supplements very often found in the mass market or on the Internet,” Bowen said.

“The companies that we represent and sell do stand by these practices and have a history of making quality supplements of all kinds.”

Cindy Fiege, certified herbalist and owner of Harmony Health Store in Spencerport, agrees.

“I believe that supplementation is very important as our foods are depleted of vital nutrients that our bodies need to function,” she said.

She advises people looking for supplements to seek them through a health coach or other professional and “do your homework on the companies suggested. A lot of companies state on TV and in advertisements that they are the best, but can’t prove it.”

April 2015 •

he percentage of Americans who consider vaccines crucial for children has declined slightly in the past decade, according to a new survey.

This year, 54 percent of Americans said that it’s “extremely important” for parents to get their children vaccinated, down from 64 percent who said so in 2001,according to the survey from Gallup.

And 30 percent of Americans now say they’ve heard “a great deal” about the disadvantages of vaccines, compared to 15 percent who said that in 2001. But there was also an increase in the percentage who said they’ve heard a great deal about the advantages of vaccines, 49 percent in 2015 compared to 37 percent in 2001.

The percentage of Americans who say they consider vaccines to be worse than the diseases they prevent has not changed much in 14 years: 9 percent of Americans held this view in 2015, compared with 6 percent in 2001.

Still, most Americans (84

percent) now say that vaccines are either “extremely important” or “very important,” while the rest say vaccines are “somewhat important,” “not very important” or “not at all important.”

Only 6 percent of Americans say they think vaccines cause autism, while 41 percent say that vaccines do not cause autism, and 52 percent said they were unsure. The idea that vaccines cause autism first came about when a 1998 study claimed to have found a link between the condition and the measles, mumps and rubella (MMR) vaccine, but this study has been widely discredited, and multiple studies have refuted the findings.

The poll, which surveyed more than 1,000 U.S. adults ages 18 or older, was conducted between Feb. 28 and March 1, following news of a large outbreak of measles that started at Disneyland and has sickened more than 100 people. The rise in measles cases in the United States this year is mostly a result of people forgoing vaccinations, according to the Centers for Disease Control and Prevention.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Excellus embraces Choosing Wisely Initiative to partner with Consumer Reports on Choosing Wisely designed to reduce unnecessary care

E

xcellus BlueCross BlueShield announced it became one of just a few health plans across the country to partner with Consumer Reports on Choosing Wisely, a nationwide initiative to promote shared decision making between patients and doctors to improve the quality of care, and reduce unnecessary spending on services that have little or no proven benefit.

As a result of the partnership, Excellus BlueCross BlueShield will be better equipped to develop new approaches to care with area physicians, hospitals and health care facilities, and innovative wellness programs to the health plan’s members and employer group clients.

Choosing Wisely is a physician-led initiative developed by the American Board of Internal Medicine Foundation. Together, more than 60 medical societies have contributed more than 300 care recommendations that the Choosing Wisely initiative seeks to promote.

“Our analysis of regional health care data will guide us to the Choosing Wisely recommendations that we know will have an immediate and positive impact on the quality of care in upstate New York,” said physician Matthew Bartels, Excellus BlueCross BlueShield medical director for clinical quality.

According to Bartels, unnecessary care and waste have been well documented in the medical literature. A 2012 report from the Institute of Medicine calculated that about 30 percent of health spending was wasted on unnecessary services, excessive administrative costs, fraud and other problems. Moreover, inefficiencies cause needless suffering. By one estimate referenced by the IOM, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state.

With Choosing Wisely, doctors are encouraged to initiate open and honest conversations about options for care, tests and procedures, so that the treatment ultimately chosen is evidence based, doesn’t duplicate other tests or procedures, is safe and is truly necessary. As the consumer communicator of the Choosing Wisely campaign, Consumer Reports publishes resources such as consumer-friendly magazine articles, brochures and web stories to help explain the Choosing Wisely recommendations put forth by the medical societies. More details about the campaign are available online at ConsumerHealthChoices.org.

Page 8

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Meet

Your Doctor

By Chris Motola

David E. Baum, M.D. Chief medical officer speaks on the efforts to turn Thompson Health into a regional, more complete hospital Q: Describe your role at F.F. Thompson Hospital.

A: It’s a very wide-ranging role, but the way I view it is as the chief safety and quality officer of the hospital. So my job is to make sure that care we provide here is top-notch. My mission when I was hired was to make us the outstanding regional medical center community in Western New York. We were doing very well when I started and now we’re moving toward another level of excellence. So that’s my mission and I’m very committed to it.

Q: In what ways do you feel you’ve succeeded so far?

A: I’m working with an excellent group of administrators who share this goal, and I also have an excellent medical staff. So we have efficient managers with vision who are able to execute it and a physician staff delivering a high-quality product, so that makes my job a lot easier. We also have the benefit of having a university affiliation, which helps our goal of going from a community hospital to more of a regional hospital. We’re going to need more critical care resources and having that tie-in gives us the resources to deliver more complicated care at Thompson.

Q: What are some of the key differences between a community and a regional hospital?

A: It’s really one of acuity of care, the level of complexity you’re able to deal with. So this goes toward Strong being a tertiary care center. They tend to see the most ill patients. When they embrace that role, they need hospitals to assist them with levels of care that might not able to be delivered at community hospitals but at what I consider more regional-level hospitals. So you have to have intensive care units, which we have here.

You have to have pulmonologists, dialysis capability. Those are the building blocks for dealing with the more complicated patients that we are now seeing at Thompson.

We’re able to capably deal with them here where, in the past, we would have to send them up to Strong. Now they need help offloading some patients to hospitals with the capability to treat them, and I think we’ve stepped up to the plate.

here. Time has gone by very quickly.

Frankly, I didn’t have much interest in doing the administrative aspect at first, but they saw someone with loyalty to the institution and the memory of where we’ve come from and where we need to go. So they offered me the position about eight months ago. So this job goes much more to the quality that the hospital delivers. It’s a big job.

Q: You also have a law degree.

A: Yes. That was many years ago when I was still young and single.

When I was in college, I had a combined major with biology and political science. It’s always been an interest. I did an internship down in Washington D.C. for Pat Moynihan. I loved it. I really wanted to concentrate my efforts on the legislative process, so I went to law school to make that happen.

Unfortunately, at the time when I graduated there were no openings I was interested in, so I never pursued the Washington angle. I’m still admitted to the bar in New York state and still do some consultations, particularly with the liability carriers.

Q: Do you find your law background helpful with your administrative duties?

A: It’s always of assistance. Even outside the law, it develops critical thinking skills I’ve always found beneficial. It tells you what the next question is that you need to answer to get to the root of the problem. That’s a lot of what we do here. Finding out why a process isn’t working as intended.

Having the mindset they teach you as a lawyer is extremely beneficial.

Q: What’s your own medical background?

A: I am an emergency physician and have been practicing since 1986. I came to Thompson in 1987. So that’s 28 years as an attending on the staff

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

Q: As a rural hospital under transition to a regional hospital, what are some of the challenges and opportunities of being in a lower population density region?

A: I think the major issue for any hospital is the uninsured, or Medicaid patients without primary care. As we go forward with the new accountable care organizations that grade you based on population health, we want people to be involved in the system.

The challenge is, one, get them into the system; and two, make sure we have enough primary care providers to keep people well. In order to be most cost-effective, we need to keep patients well and to manage chronic conditions.

The message is the same regardless of whether your population is rural or inner city, the new financial incentive will be to keep your population well and your outcomes strong. That’s not an easy task because when people are well, they don’t really think about their health. Even when they have chronic conditions, they may not being feeling symptoms on a daily basis.

Q: Doesn’t our insurance system encourage catastrophic medicine more than preventive care, though? Seeing a doctor when you don’t absolutely need to can be an expensive prospect for many patients.

A: People who are uninsured tend to delay care, there is no doubt about it. And a lot of insurance products out there have high copays or high deductibles. For the average family, that can be a lot of money. The flip side is that it also deters unnecessary care. So you have to find the balance between the two. But you don’t want people running to the emergency room to take care of things that could have been solved in an outpatient environment.

In order to make that happen, you have to have enough primary care providers, which can be a challenge in a rural area. Without increasing the supply of physicians, where do these people go?

Your ED will end up absorbing a lot of that. Ultimately, if we can’t produce enough primary care physicians, we’ll need to use physician assistants or nurse practitioners. In most cases that’s fine, but if you have a severe illness, you want to be seen by a physician.

Q: Given the systemic flaws you’re dealing with, to what degree can community education help?

A: That’s a major initiative here called the population health committee.

We’re reaching out to local institutions that are involved in health management to try to coordinate a message of good health and educate people on how to access the system. The system is pretty rigid in that it doesn’t expand quickly, so we can have increasing demand for a system that isn’t prepared for it. People tend to want immediate satisfaction for the health complaints, hence the growth of urgent care centers.

Lifelines Position: Chief medical officer and senior VP of medical service s at F.F. Thompson Hospital Hometown: Utica Education: Albany Medical College, University of Rochester Medical Center, Cornell Law School Affiliations: Thompson Hospital Organizations: Monroe County Medical Society, Medical Society of the State of New York Family: Three children Hobbies: Skiing, sailing, golf

More Companies Helping Employees Stay Fit Notion behind iniciatives: a healthy workforce is a productive workforce

By Ernst Lamothe Jr.

L

ynne Tran believes employees are every company’s greatest asset.

As the corporate communications official for The Cooper Companies, she has seen evidence of great changes in employees’ lives after the company implemented its wellness program in 2010. The company, which is located in Fairport, Henrietta and Scottsville, has a variety of initiatives that help people live their healthiest life.

“When you have healthy employees, you have people who are fully engaged and energized at home and at work. We are committed to continue to expand and enhance our programs,” said Tran.

The Optum Resource Center for Health & Well-being surveyed more than 500 human resource professionals from companies of all sizes across the U.S. More employers continue to show a strong commitment to employee health management programs, reporting a 21 percent increase spending on these initiatives. In addition, the use of incentives continued to grow, as did the average incentive dollar value per participant.

Employers report spending an average of $167 per participant per year on incentives, up from $154 a year ago.

Large employers spend $174.

As a global company, CooperVision — part of The Cooper Companies — recognizes the diversity and different cultures that exist throughout its different locations. At Coopervision, officials work with the culture of their employees. They understand what works for one group or site might not work for all. They go by the adage of keeping it simple. The company organizes step, stair climbing and weight

Coopervision employees have access to an exercise facility at work. loss competitions. They feel a mix of fun, support and occasionally prizes offers more participation and more positive vibes among the staff.

“The whole idea is making wellness personal,” added Tran. “We empower our employees to organize activities and programs that work for them and their site. Everybody views wellness differently and we encourage

our employees to define what wellness means to them.”

There are several examples in Rochester of companies thinking outside the box.

Allen-Bailey Tag & Label, 3177 Lehigh Street, Caledonia, created promotional and informational pieces representing the company’s healthy initiatives “Tag, You’re Fit” logo for

easy recognition, which also includes a monthly newsletter with healthy recipes, stretches and exercises. They also have a health and wellness committee with both office and plant workers, and meets twice a month to share ideas on how they can improve the health program. In order to increase employee participation, the committee represents their coworkers and reports outside opinions or suggestions. Officials used this information to offer a variety of seminars throughout the year to create a well-rounded approach to health, including mental health, stress management, skin cancer, bone density and healthy eating.

“Rochester Business Alliance encourages its members to embrace employee wellness programs. A healthy workforce is a productive workforce,” said Dan Smith, communication director at he organization.

“We are deeply involved in wellness initiatives across our region,” said Smith. “Our health care committee works on programs to reduce costs by making Rochester the healthiest community in America. We are also aligned with the Wegmans Eat Well Live Well challenge and partner with the Finger Lakes Health Systems Agency on the Community High Blood Pressure Collaboration.”

At Canandaigua National Bank, the goal of the health sense wellness program is to promote the health and wellness of employees through education and initiatives that encourage wellness habits. They have found success by getting senior leadership buy in with the message being that their bosses do care for their health.

“More companies are seeing good health as a connection to a higher quality of life for their employees,” said Philip L. Haberstro, executive director of the Wellness Institute of Greater Buffalo. “We used to ask people to identify the three most important things in your life. After we asked them, if good health wasn’t on that list, we would also say you won’t have the ability to achieve those three important goals without good health.”

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

April showers can bring more than May flowers

F

or me, the month of April is all about anticipation. I am eagerly awaiting the early arrival of crocus and daffodils. And I can’t wait for the butter-yellow forsythia to burst into color. The garlic in my vegetable garden is already poking through the frosty soil and I’m seeing other signs of spring all around me After this incredibly harsh winter, there’s nothing like the promise of a light at the end of the tunnel to help us endure this last rainy patch until the sunshine warms us on a more permanent basis.

As spring approaches, I can feel the anticipation in the air. I don’t know about you, but I’m looking forward to the change of season.

Anticipation is not the same as just waiting for something to happen. It’s not just letting time pass. I’ve discovered that intentional anticipation can be incredibly powerful and moving. It can spur us into action, awaken a longlost passion and inspire great “May flower” joy.

I’m a believer that anticipation itself can transform a possibility into a reality, and so I build it into my daily

routines. In doing so, I have made living alone more of an adventure than a carefully planned existence. I encourage you to join me and incorporate a little expectancy and suspense into your world.

Below are a few strategies that have worked for me. Perhaps they’ll work for you, too!

Fill your future with fun.

It could be concert tickets, a vacation, dinner with friends or a new class. I have tickets to see singer Michael Feinstein at the Rochester Philharmonic Orchestra in May. Whenever the doldrums set in, I put on his latest CD and imagine the good time I’m going to have with my sister Anne. She loves him, too!

I enjoy being uplifted by the anticipation of Michael’s performance and a fun night out with my best friend.

Plan ahead and look forward to holidays. Memorial Day is on the horizon.

Consider hosting a small get-together at your place. This “official start of summer” offers a great opportunity to bring people together for some good food and fun, in honor of veterans and soldiers both overseas and here at home.

Why not embrace the holiday, make plans, and look forward to sharing this national day of remembrance with friends and family?

Order something from a catalog or online store. I make good use of this simple strategy, perhaps more than I should (smile)! But, I like looking forward to a package waiting for me on my front porch.

I enjoy anticipating the arrival of a good book in the mail, or a new blouse, or home accessory. It makes coming home after a long day a little more fun and interesting.

Join Facebook, LinkedIn, or an online dating service. Make it possible for people to find you and for you to reach out

to others. You might be surprised by what you discover — a new friend, an old heart throb, a childhood buddy, or an unexpected opportunity to socialize.

Who knows what might arrive in your inbox?! The anticipation of a “hello” or “wink” can turn a dreary day into one filled with surprises.

Schedule a “day off” a ways off just for you. I do this throughout the year.

Monday is my preferred day off. I pick a Monday about four weeks out and look forward to filling it with activities I love.

I choose Mondays because when the weekend is over, it’s not over for me! My special day is still out there ahead of me, yet to be experienced and enjoyed.

Plant a seed for the future, literally. Just for the fun of it, I’ve purchased a container and “starter” seeds for kitchen herbs. It sits on the sunny ledge above my sink, and I just love tending it and waiting for the tiny tips to make their appearance. Consider growing a few plants from seed to harvest. It’s such a simple joy, and a reminder of the profound power of anticipating future positive events.

I anticipate good things ahead for all of you who adopt some of these strategies. And I invite you to share your experience with me. email me at the address below and I’ll look forward to hearing from you!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585-6247887 or email: gvoelckers@rochester.rr.com.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

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Preventing Bad Dog Behavior

By Deborah Jeanne Sergeant

B

ad dog behavior like chewing furniture or jumping frustrates many owners. But it doesn’t have to. You can teach old dogs new behavior and prevent pups from picking up bad habits.

The latter is immeasurably easier.

Amy Ricotta, canine behavior counselor and practice manage at Coldwater Animal Hospital in Rochester, offers new puppy orientation classes.

“I used to do strictly behavior problems, but I realized that most of these problems wouldn’t have become issues if we started early with new dog or puppy orientation,” she said.

Her program involves teaching owners how to interact with their dog to teach positive behavior, not inappropriate behavior. For examRicotta ple, a puppy jumping up to greet its owner is cute. After the dog grows to 75 pounds, the animal can knock adults to the ground with the same behavior.

The dog doesn’t realize why it’s now wrong to jump.

Many owners unwittingly teach bad behavior by offering positive reinforcement, such as petting and giving attention to a jumping puppy. Instead, Ricotta tells owners to teach their puppies to sit and stay. Only when the dog

remains calm can it receive attention.

Tricia Kennedy, dog trainer at Boom Town Canine Campus in Farmington, uses clicker training to signal that the dog needs to sit instead of jump.

“You know when your dog is about to jump,” Kennedy said. “They hunker down first. Just ask them for a sit instead. Then immediately reinforce them with a little food, the strongest reinforcement, or petting if there’s no food available.”

Instead of enduring incessant barking, you can train your dog to remain quieter. Kennedy said that boredom, watching other animals outside or hearing sounds of the neighborhood cause many dogs to bark. Crate training can solve many of these problems, as it offers a cozy “den” where the dog is off-duty.

“Just as when you crawl into bed, it stimulates rest for you,” Kennedy said.

“Going in the crate prevents problems because they’re not at the window barking at the UPS man, mailman, and squirrels in the yard. One of the biggest mistakes with young dogs is too much freedom. Structure teaches them how to behave well.”

Regular feeding times and exercise periods helps dogs understand what happens next and relieve anxiety.

Exercise also helps dogs burn energy positively.

“If you could only imagine the amount of energy the average dog has,” Kennedy said. “It’s a lot.”

Dogs tossed in the backyard often lie around because they have nothing to do. Or, they expend their energy by destroying the fence, digging holes or barking for hours.

Rachel Leavy, Canine Good Citizen instructor and owner of Miss Rachel’s School for Dogs in Rochester, advises clients to walk their dogs before work, during their lunch break (or hire a dog walker) and after work.

“If they are getting walked and trained, they’ll be more relaxed in the house,” Leavy said.

Inside dogs may be distracted from outside sounds if you leave a radio on all day.

Leaving chew toys “gives them a project” as Leavy put it.

“Many toys dispense treats.”

Scatter three or four toys around the house. Hollow, rubbery Kong toys may be filled with peanut butter and Leavy kibble. Freeze the toy in advance for a greater challenge. Rotate toys with different types to avoid boredom.

Scolding the dog after it chews up a sofa may seem like the right follow-through, but Kennedy said that reaction gives the dog what he wants: attention. Even negative attention is

attention.

“They need to learn calm, quite behavior gives them what they want,” she said. “So if you have a dog quietly playing with toys and you ignore it, and then you pay attention when it’s barking or chewing up furniture, they learn those inappropriate behaviors get them what they want.”

Leaving random objects lying around invites bored dogs to destroy them, so look for items on his level that he might want to chew, and then put them away.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

SmartBites

By Anne Palumbo

The skinny on healthy eating

Why Fennel Deserves a Fan Base

W

hen my husband and I were first dating, he introduced me to a unique vegetable: fennel.

It was love at first bite!

Since then, I haven’t strayed.

I’m sweet on the taste (slightly licorice), I dig the texture (super crunchy), I’m crazy about the calorie count (only 30 per cup) and I’m smitten with its nutritious spunk.

While pale green fennel may never achieve the superfood status of some of its more brightly colored comrades, it can certainly march down the “goodfor-you” aisle with its feathery fronds held high.

Similar to other plant-based foods, fennel is packed with antioxidants — those magical molecules that can help prevent a host of maladies, from heart disease to arthritis. In animal studies, one of fennel’s antioxidants in particular, anethole, repeatedly reduced inflammation and helped prevent the occurrence of certain cancers. Go, fennel!

Fennel deserves a shout-out for its bounty of vitamin C. In addition to its antioxidant benefits, vitamin C, which is needed to build collagen, is super good for your skin. A study published in the American Journal of Clinical

calories per cup, as mentioned above, deserves a standing ovation.

Helpful tips: Choose whitish to pale green bulbs that are firm and solid, minus any splitting, bruising or spotting. Fresh fennel has a fragrant aroma, smelling slightly of licorice. Although fennel can be stored in the fridge for up to four days, it’s best to consume as soon as possible. The longer it languishes, the less flavorful it will be.

Fennel Salad Nutrition, in fact, found that higher vitamin C intakes were associated with skin that had fewer wrinkles and aged better.

This bulb-shaped vegetable also boasts a decent amount of fiber — both soluble and insoluble.

Insoluble fiber promotes regularity, while soluble fiber helps us stay healthy by ferrying artery-clogging cholesterol out.

In addition to its fiber, fennel rocks with two nutrients that also promote heart health: folate (a B vitamin) and potassium. Folate helps to derail vessel-damaging homocysteine; and potassium can lower your risk of high blood pressure.

Lastly, this aromatic vegetable warrants a round of applause for having no cholesterol, next to no fat, little sodium and a smidge of protein. The 30

with Celery and Toasted Pine Nuts

Adapted from Bon Appetit Serves 4-6

¼ cup pine nuts or chopped wal-

nuts 2 large fennel bulbs, thinly sliced 4 celery stalks, thinly sliced 1 red pepper, thinly sliced ½ cup fresh flat-leaf parsley leaves, lightly chopped 1 to 2 teaspoons fresh lemon zest 3 tablespoons fresh lemon juice 2 to 3 tablespoons olive oil Kosher salt, coarse black pepper (to taste) ¼ cup shredded Parmesan cheese

Preheat oven to 350°. Toast nuts on a rimmed baking sheet, tossing occasionally, until golden brown, 6 to 8

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

minutes; let cool.

Toss fennel, celery, red pepper, parsley, and toasted nuts with lemon juice, zest, and oil in a large bowl; season with salt and pepper. Serve salad, topped with Parmesan.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes.

She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Praise for CEO’s First Year Michael McRae celebrating first anniversary as head of St. Ann’s Community

By Mike Costanza

A

s Michael McRae celebrates his first anniversary as president and CEO of St. Ann’s Community, he seems just a bit surprised at his good fortune.

“I have the opportunity to work for an organization that is a true community asset,” he says. “We are caring for the most important people on earth.”

McRae has gained praise for his dedication to St. Ann’s, knowledge of health care and style of leadership since he joined the well-known organization.

McRae joined St. Ann’s Community as senior vice president and administrator in 2010 after more than 20 years in health care, predominantly with organizations that care for seniors. He still remembers how he felt on April 7, 2014, when he took the CEO’s chair for the first time.

“I would say that I’m incredibly humbled,” he says. “My mother was a nurse, I have three sisters who were nurses, my father was in health care management, so it was in the blood to sit there and understand the responsibility that I had.”

While being CEO of St. Ann’s could be challenging at any time, McRae took his position at a time when health care in general is in the midst of vast changes.

“We are going through an unprecedented time, at least in my 28-year history of being in health care…of change for the delivery of health care for all levels, let alone for seniors in our community,” McRae explains.

Those changes have come in many forms.

In recent years, private insurers and the state and federal governments have pressured hospitals to reduce their readmission rates — the rates at which former inpatients return to their wards within 30 days of discharge.

Surgical complications, lack of patient education regarding subsequent treatment, ineffective monitoring of patients’ conditions and other factors can all increase readmission rates, and the cost of medical care. The pressure has increased under the Affordable Care Act, also known as Obamacare.

“What the government has realized is we spend so much of our health care dollar on people that…receive treatment, leave, and within 30 days,

St. Ann’s Community at a Glance Founded in 1873, St. Ann’s Community provides a continuum of services for seniors and the disabled at facilities around the Rochester area, including day programs, rehabilitation services, independent and assisted living facilities and hospice care. St. Ann’s Home, the nonprofit’s centerpiece, is a 388-bed skilled nursing facility that sits opposite Rochester General Hospital. Altogether, the organization employs about 1,240 people.

bounce back into the hospital,” McRae explains.

St. Ann’s, as an institution that provides residential and outpatient care for patients who have been discharged from local hospitals, has also come under pressure to reduce readmissions. At the same time, the institution has had to adapt to health care’s changing financial conditions. Government payments for the care of seniors have not kept pace with the rising cost of that care.

Medicaid reimbursements, for example, have consistently lagged behind expenses.

“For every dollar it costs us to care for a recipient of Medicaid, we get reimbursed 73 cents,” McRae points out. “When you have a significant portion of your population that their payment source is Medicaid…it creates a significant challenge.”

St. Ann’s has sought to address both issues by a variety of means. To begin with, the institution has sought to carefully train its staff members to care for their charges as effectively as possible.

“One of the things that any health care provider needs to be able to do today is to make sure that you have Bringewatt the highest skill set…in health care workers,” McRae explains. “[I] wanted to make sure, especially in my first year, that we were doing everything we can to position St. Ann’s to continue to meet the demands from the seniors, and what they want.”

St. Ann’s has also sought to keep costs under control, or reduce them.

“We approach our expenses as if they were our own personal expenses, and try to be as judicious as we can with them,” McRae asserts.

To that end, the institution is establishing a new cost accounting system.

“This cost accounting system will allow us to track costs by diagnosis, by day, by floor, by room number,” McRae explains. “It will really allow us…to look for opportunities where we can reign in costs, when appropriate.”

Though the new system will not be up and running before this fall, some

and all of our locations,” Bringewatt says. “They all got to meet him and hear what his vision of St. Ann’s was.”

McRae’s easy way with people has also made itself felt among those who sit on the board of St. Ann’s.

“I like the way he engages the board,” explains Mark Cronin, who is also COO of Accountable Health Partners. “He calls you and invites you to breakfast or lunch every now and then, or calls you for advice.”

Such skills have also helped St. Ann’s interface with other elements of the local health care community.

Jane Shukitis, president and CEO of Visiting Nurse Service of Rochester and Monroe County, Inc, (VNS) has come to know McRae as a member of her organization’s board of directors, and through the Leo Center for Caring, a 10-bed hospice that VNS and St. Ann’s operate jointly.

“He’s been a very proactive, real smart, real community-connected, very much a relational guy,” Shukitis says. “He has, I think, done a wonderful job positioning St. Ann’s for the future.” of St. Ann’s other efforts to respond to the pressures under which it finds itself have borne fruit. Effective training, for example, has helped the institution maintain or improve its level of care.

“We have, over the last few years, elevated our team’s clinical capabilities, allowing for the safe and comprehensive care of our seniors within their home here at St. Ann’s,” McRae says.

“We currently have a 30-day readmission rate back to the hospital that is about half that of the national average.”

Those who work with McRae have lauded the knowledge, skill and personal attributes he has brought to St. Ann’s. Board of directors chairwoman Maggie Bringewatt Cronin says his years with the institution helped him ascend easily to the CEO’s office.

“He knew the organization in and out, environment and staff, so I think he was able to pretty much…hit the ground running,” she explains.

At the same time, McRae has also demonstrated the personal skills needed to guide the institution, especially the willingness and ability to reach out to St. Ann’s employees.

“One of the most important things that he did once he became president, was to reach to all the staff and meet with all of the staff on all of the shifts

April 2015 •

Future of St. Ann’s

As part of preparing St. Ann’s for the future, McRae began guiding the revision of its strategic plan—its blueprint for the coming years—soon after taking office.

“You could imagine someone wanting the seat to be warmer for a little longer before deciding to take that one on, but Mike really saw, ‘I need to do this,’” Cronin asserts.

While others might find such challenges daunting, McRae seems to relish them.

“We are doing some great things, and here is an opportunity to keep going,” he says.

When not at the office, McRae, who hails from the Buffalo area, has enjoyed getting to know his new home. The Webster resident, who is married and has two daughters, regularly samples the wares at new Shukitis restaurants with his wife, and attends local shows.

“We’re really getting immersed in the community,” he says.

Every month, he turns the key on the 1978 Pontiac Firebird Trans Am 400 in his garage to keep its mammoth 6.6-liter engine in trim.

“It’s looking forward to drier roads,” he says.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Women’s issues Demand for 3-D and 4-D ultrasound grows But local OB-GYN says better images don’t offer much prenatal advantages

OB-GYN Loralei Thornburg

By Deborah Jeanne Sergeant

A

fter the positive pregnancy test, the most exciting milestone of pregnancy is viewing the growing baby via prenatal imagery.

Compared with 2-D ultrasound’s fuzzy-looking sonograms, 3-D sonograms are a photograph of babies before birth, and 4-D sonograms offer video footage of babies moving.

While it’s exciting for parents to get to know their new little one, 3-D and 4-D imagery typically aren’t used medically.

“In reality, 3-D imagery doesn’t add that much to prenatal diagnosis,” said OB-GYN Loralei Thornburg with University of Rochester Medical Center. “There have big improvements, but the 2-D imagery has improved markedly as well and that’s where the majority of improvements have come from.”

2-D imagery offers a look inside the baby, such as organs and bones, but 3-D and 4-D imagery looks at the surface.

“If you look at me and the outside looks totally normal, that doesn’t tell anything about if the inside is normal,” Thornburg said. “We can see finer detail with the 2-D ultrasound. You can see differences between structures inside than we used to.”

Doctors order 2-D ultrasound because it helps them know how the baby develops structurally.

“If there’s major structure missing or they’re not put together correctly, that can give us a clue as to how they’ll function after birth,” Thornburg said.

In some cases, providers can offer medication or surgery that can help improve the baby’s outcome.

Or, at least families know what to expect for the rest of the pregnancy and after the baby’s birth.

3-D ultrasound can help providers identify issues such as a cleft lip or cleft palate, missing or short fingers or toes or other problems that require detail.

“We have a lot of people request 3-D to see if the baby’s OK, but that’s just one of the tools we use to see what’s going on,” Thornburg said.

“2-D gives us a better idea of what is going inside the baby.”

But parents’ desire to see what their baby looks like has made 3-D imagery very popular. Some OB-GYNs purchase the equipment to make their practices more attractive to clients, even though the imagery really isn’t necessary for diagnosing most fetal problems.

The demand for 3-D and 4-D ultrasound has grown so much that

some facilities such as Baby Moments in Webster provide non-medical ultrasound for parents who want a glimpse of their baby.

While getting a “sneak peek” into baby’s development can delight parents, Darcy Dreyer, associate director of program services for March of Dimes’ Central New York, Genesee Valley/ Finger Lakes and Western New York Divisions, cautions parents about 3D and 4-D imagery taken at non-medical facilities.

“Sometimes there are false-negative or false-positives, which can be

emotionally and financially taxing,” Dreyer said.

View non-medical ultrasound as a pre-birth portrait, but not as medical information. Rely only on medical imagery read by OB-GYNs for diagnosing prenatal problems.

“If you confirm the absence or presence of a problem, it helps families prepare,” Dreyer said. “It’s a resource and parents need to make the best decision with the information given to them based on their family health history and resources.”

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Infant, Early Childhood, K-12 School and Sign Language Learning Programs Call: 585-544-1240 u Visit: www.RSDeaf.org u E-mail: info@RSDeaf.org Page 14

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Meet Your Provider Contemporary Dentistry

Dentists Arlene Messer and Anna Belous see patients at their office in Rochester.

Dentist Arlene Messer discusses how holistic dentists are changing minds about modern dentistry “Change is the law of life and those who look only to the past or present are certain to miss the future.”—John F. Kennedy Q. What is a holistic dentist and how are you different from a regular dentist?

A. Holistic or biological dentists practice dental care with a view to how oral health affects or is affected by your body’s general health. We take into consideration mind, body, nutrition and lifestyle. It is a different way of thinking.

Our recommendations are targeted to address our patients specific needs. We also strongly believe that each patient is a part of their own healing process, so there is a strong emphasis on educating you to understand why we recommend a certain treatment, and giving you strategies for prevention. You’ll notice that a holistic dentist spends more time with you, asks more questions, and may even inquire about things that seem unrelated to your teeth, such as stress levels, sleep, habits, and diet. We may also have you work with complimentary providers such as integrative physicians, chiropractors, nutritionists, acupuncturists, and meditation centers. We are mercury free, use biocompatible materials, and have very specific protocols for the removal and disposal of hazardous mercury fillings.

Q. What do you offer?

A. For fearful patients, we offer private rooms, television or music with headphones, blankets, a menu of sedation forms to fit their needs.

We also offer: • Saliva testing and cavity risk assessment for tooth decay to customize treatment plans • Fluoride alternative products • Referral to integrative physicians and practitioners, if you have complex healthcare needs • Dental materials testing if you suspect an allergy • Metal free restorations, dentures and implants • Limited field digital CT scans to detect cavitations that are undetectable in traditional dental X-rays and which aid in implant planning • Screening for TMJ disorders and migraines, sleep disorders, and oral cancer Q. How should I look for a holistic dentist?

“Holistic” has become a catchphrase in health and dental circles, so as a patient you should use caution and ask questions when you see the phrase “holistic dentist.” Make sure that the office does more than just “take out mercury fillings.”

Your risk factor for dental decay should be

determined at your first visit and targeted therapies suggested. Preventive strategies should be reviewed with you. Try the International Academy of Oral Medicine and Toxicology (IAOMT) or Holistic Dental Association for members in your area.

The key to receiving the best dental care is to communicate and build a relationship with the right holistic dental team. Hygienists, assistants, and doctor will all become a part of your healing process.

Think of your mouth as being one part of the greater health in your whole body and you will be on the right path to wellness!

Dr. Arlene Messer is an accredited member of the IAOMT, Fellow at Las Vegas For Advanced Dental Studies, board member of the Rochester Integrative Health Committee and member of Holistic Dental Association.

Along with Dr. Anna Belous, she operates Contemporary Dentistry in Brighton.

Contemporary Dentistry • 2052 Clinton Avenue South • Rochester NY 14618 • 585-244-3337 • dentistrywithaheart.com

What if you could choose?

5 Days or 45 Days move in

without settling When you’re looking for senior housing, it’s rare to find everything you want in one place. Episcopal SeniorLife Communities offers something for everyone. With six campuses across Monroe County and a variety of housing options, ESLC is a good place to begin — and end — your search.

We welcome your calls to 585.546.8400 or Info@EpiscopalSeniorLife.org.

EpiscopalSeniorLife.org

hoacny.com

Pinehurst - located in Honeoye Falls and recently affiliated with Episcopal SeniorLife Communities - now offering Spring Move-In Specials!

April 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Women’s Obamacare Excludes Pregnant Women Missing Enrollment ACA coverage gap leaves women two choices: 1) pay for insurance premiums or care out of pocket (to the tune of $10,000 to $20,000) or 2) skip prenatal care

By Deborah Jeanne Sergeant

U

ninsured women who missed the three-month open enrollment period have few options for pregnancy medical expenses.

Though the Affordable Care Act, commonly known as Obamacare, doesn’t classify pregnancy as a pre-existing condition for women when they sign up, health benefits won’t kick in for women until after delivery if they sign up outside of the open enrollment period.

This ACA coverage gap leaves women two choices: 1) pay for insurance premiums or care out of pocket (to the tune of $10,000 to $20,000) or 2) skip prenatal care. The March of Dimes states that 50 percent of pregnancies are unplanned. Of course, some pregnant women caught in the ACA coverage gap may qualify for Medicaid.

But many of those making too much money may still find paying for their pregnancy expenses daunting.

Consider a family of three in which one parent stays home with the child and the breadwinner earns an income greater than $39,779. If the wife be-

comes pregnant, they won’t qualify for Medicaid, yet could find purchasing their own insurance out-of-pocket devastating to their budget. Excellus BlueCross BlueShield’s individual plans all cover prenatal care and delivery and start at $317.63. This entry-level plan includes a $3,000 deductible that must be met out-of-pocket before the plan covers prenatal care and most other services.

For the baby’s delivery, this plan requires 50 percent co-insurance, which for many deliveries is sizeable. Paying $5,858.67 ($650 a month, between out-of-pocket deductible expenses and premiums) is outside of many families’ reach. Plus, the family must pay the 50 percent co-pay for delivery.

Some advocacy groups such as Young Invincibles (www.younginvincibles.org) want a special enrollment period for women caught in the ACA coverage gap by classifying pregnancy as a qualifying life event (QLE).

Approved QLEs permit people to sign up outside of a standard enrollment period.

Medical professionals agree that prenatal care promotes healthy pregnancies.

OB-GYN Loralei Thornburg, with University of Rochester Medical Center, wants women to plan pregnancies, including obtaining coverage and seeing their physicians ahead of conception to prepare.

“Not having care during pregnancy and not having the appropriate check-ups to check issues and take care of them is more costly down the road,” Thornburg said. “A safe delivery is more cost-effective in the long run.”

One of the objectives of March of Dimes is to remove barriers to receiving prenatal care because it’s so important.

Darcy Dreyer, associate director of program services for March of Dimes Central New York, Genesee Valley, Finger Lakes & Western Divisions, listed barriers such as finances, inadequate system capacity, long waits to get appointments and personal factors.

“The ACA gap would certainly affect [some women’s] ability to get

care,” Dreyer said.

March of Dimes advises mothers who cannot afford medical care and don’t qualify for Medicaid to seek clinics that offer sliding fees or to see what services community clinics can provide.

In the meantime, basic questions (Is coffee OK? Should I skip alcohol?) may be answered on pregnancy websites.

Dreyer said that www.Marchofdimes. org, babycenter.com, and kellymom. com offer accurate information.

“Look for sites that are evidence-based,” she added.

In general, avoid sites selling things.

“Pregnancy information changes all the time, so if you have a prenatal provider, take the questions to your provider,” Dreyer said.

Women’s and Men’s Health Physical Therapy. What Is It?

By Zoe Fackelman, PT

G

ender specific problems require gender specific qualifications for the quickest and most satisfying outcomes. It is important for you to see a physical therapist that is focused on getting you feeling better than you expected in the shortest amount of time.

High deductible insurance plans and high co-pays restrict many community members from receiving the frequency and duration of treatment needed to get rid of pain or limitations related to work, sports, recreational and activities of daily living. As a result it is important to be sure you are receiving care from the most conveniently located, qualified physical therapist.

Since women’s and men’s health or female and male pelvic health physical therapy is the term used to describe gender specific health problems, it is important to ask if the physical therapist is uniquely and specifically

qualified and trained to treat the condition you are seeking help to resolve.

Some physical therapists only treat women; others treat both men and women. Some only treat specific conditions.

It is always most helpful to receive treatment from a hands on manual therapy physical therapist with strong orthopedic and, in some cases, sports injury experience.

Compliance to attendance in physical therapy and to your home self- care program is the key to successful outcomes. You want to be sure you are receiving care from a physical therapist who takes the time to explain your condition and why you are being asked to do specific things at home to resolve the problem.

The following is a list of conditions, signs or symptoms a women’s and men’s health physical therapy specialist may treat: • Urinary and bowel urgency, frequency and leakage (incontinence)

• Urinary and bowel symptoms after prostate removal or surgery for organ prolapse or hernia • Constipation • Anal fissures and hemorrhoids • Pelvic floor and lower abdominal /groin pain, tension myalgia, trigger points • Painful sex • Scar tissue, adhesions, swelling after surgery, radiation, C- section, labor and delivery • Prenatal Prevention of incontinence and hernia • Pain during and after pregnancy • Diastasis recti treatment and prevention and treatment after repair • Limitations in function and fatigue related to menopause • Osteoporosis / osteopenia • Female athlete • Orthopedics – joint, muscle, tendon, cartilage, ligament, fascia causing pain and limitation Many conditions listed require treatment to the pelvic floor, a group of

In Vitro Births Continue to Rise

M

ore babies in the United States are being conceived by in vitro fertilization, a new report

shows.

Nearly 2,000 more infants were born with the help of this assisted reproductive technology in 2013, compared with 2012, the researchers reported.

Almost 175,000 in vitro fertilization Page 16

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(IVF) cycles led to the birth of slightly more than 63,000 babies, compared with just over 165,000 IVF cycles that led to the birth of slightly fewer than 62,000 babies in 2012.

Babies conceived through fertility treatments account for more than 1.5 percent of children born in the United States, according to the report from the Society for Assisted Reproductive

Technology.

The society also said more women, regardless of age, chose to have a single embryo transferred. The rise in the number of women making this choice was greatest among women under 35.

In that age group, 22.5 percent decided to have a single embryo transferred, compared with almost 15 percent in 2012.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

muscles spanning the space between the pubic bone and the tailbone. Specific care and instruction to accomplish spinal symmetry, core strength and postural correction is a key component in most treatment plans. Every treatment plan is individualized and based on your medical history and goals.

To find a physical therapist visit www.womenshealthapta.org.

Zoe Fackelman, physical therapist, specializes in the treatment of female and male pelvic health at Lake Country Physical Therapy and Sportscare, PC.

“We are extremely encouraged to see the number of embryos transferred per cycle continue to go down and that more and more patients are choosing single embryo transfer,” said Dr. James Toner, president of the Society for Assisted Reproductive Technology.

“The goal of reducing the incidence of multiple pregnancies is extremely important, and patients can see from the data that fewer embryos transferred do not mean a lower chance of pregnancy,” he said in a news release from the group.

Spring into Action!

Sign up today for the Roc City Wellness Weight Management Program.

By Jim Miller

How Medicare Covers In-Home Care Dear Savvy Senior, How does Medicare cover home health care?

Because of my illness, my doctor suggested I get home health care, but I want to find out how it’s covered before I proceed.

Need Some Help Dear Need, Medicare covers a wide variety of intermittent inhome health care services (usually up to 28 hours per week) to beneficiaries, if you meet their specific requirements. Here’s how it works.

In order for you to secure coverage for home health care, Medicare first requires that you be homebound.

This means that it must be extremely difficult for you to leave your home, and you need help from a device (like a wheelchair or walker) or a person in doing so.

You will then need your doctor to approve a “plan of care” confirming that you need skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis. Your doctor can also request the services of an occupational therapist and a home health aide to assist with activities of daily living such as bathing, dressing and using the bathroom.

Your doctor must renew the “plan of care” once every 60 days.

You will also need to use a home health agency that is certified by Medicare.

If you meet all of the requirements, Medicare should pay for your in-home care.

But be aware that Medicare will not pay for home health aide services (such as bathing, dressing or using the bathroom) alone, if you do not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either.

You also need to know that Medicare has recently changed their home health care policy regarding degenerative diseases. They will now pay for in-home physical therapy, nursing care and other services to beneficiaries with chronic conditions like multiple sclerosis, Parkinson’s or Alzheimer’s

disease in order to maintain their condition and prevent deterioration. In the past, Medicare would only cover home health services if the patient were expected to make a full recovery.

If you have original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting medicare.gov/homehealthcompare. If you have a Medicare Advantage plan, you should contact your plan directly and ask which home health agencies work with the plan and are within the plan’s network of providers.

For more detailed information on how Medicare covers in-home health, see the “Medicare and Home Health Care” online booklet at medicare.gov/ pubs/pdf/10969.pdf.

Other Options

If you don’t qualify for Medicare coverage, there are other coverage options depending on your situation, including: Insurance: If you happen to have long-term care insurance, check to see if it covers in-home care. Or if you have a life insurance policy, see if it can be utilized to pay for care.

Medicaid: If your income is low enough, all states offer Medicaid programs that will pay for some forms of in-home care. To investigate this, contact your local Medicaid office.

Veterans Assistance: If you’re a veteran, some communities have a veteran-directed home and community based service program, which give veterans a flexible budget to pay for in-home care.

Also available to wartime veterans and their spouses is a benefit called “aid and attendance” that helps pay for in-home care, as well as assisted living and nursing home care.

To be eligible, you must need assistance with daily living activities like bathing, dressing or going to the bathroom. And, your annual income must be under $21,466 – minus medical and long-term care expenses. If you’re a surviving spouse of a veteran, your income must be below $13,794 to be eligible. Your assets must also be less than $80,000 excluding your home and car.

Learn the safe and effective powerful tool of selfhypnosis and resolve to improve your well-being.

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your emergency is our emergency.

The experienced emergency department staff at Clifton Springs Hospital focuses on compassion and optimal care.

We are proud to offer excellent customer service and minimal wait times.

To learn more, see va.gov/geriatrics or call 800-827-1000.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

April 2015 •

In an emergency, call 9-1-1.

Request Clifton Springs Hospital as your destination.

2 Coulter Road, Clifton Springs, NY 14432 CliftonSpringsHospital.org | 315.462.1991 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

One in 3 Americans Lives an Hour or More From a Stroke Center

The Social Ask Security Office

Least access found in southeastern U.S., researchers say

O

ne-third of Americans can’t be transported by ambulance to a stroke center within one hour, a new study reports.

Even under the best conditions, a large number of Americans would not be able to arrive at a stroke center within an hour because they live too far away, according to the study.

“Research has shown that specialized stroke care has the potential to reduce death and disability,” wrote study author, physician Michael Mullen, from the University of Pennsylvania.

“Stroke is a time-critical disease.

Each second after a stroke begins, brain cells die, so it is critically important that specialized stroke care be rapidly accessible to the population,” he explained.

Results of the study were published online March 4 in the journal Neurology.

Mullen and his colleagues examined data from 2010, when there were 811 primary stroke centers in the United States. Certification of comprehensive stroke centers — a higher level

of classification — did not begin until 2012.

The researchers modeled what might happen if 20 ideally located primary stroke centers in each state were transformed into comprehensive stroke centers.

This change would mean that 63 percent of Americans would live within a one-hour drive, and another 23 percent would be within a one-hour flight of a center.

However, they also found significant regional variations, with access to a stroke center lowest in the southeastern United States, an area often referred to as the stroke belt because of the high rate of stroke incidence there.

“There are geographic differences in stroke incidence, especially in rural areas and in the stroke belt,” Mullen said in a journal news release. “Reduced access to specialized stroke care in these areas has the potential to worsen these disparities. This emphasizes the need for oversight of developing systems of care.”

Why should you consider a hearing aid?

By Ramona Stein, Au.D.

H

earing aids can turn your life around. They can make communication with family, friends and acquaintances easy and natural again. Isn’t that what it’s all about? We all need the joy of connecting with our fellow human beings!

Think about how lonely life becomes when you are unable to share your thoughts, ideas and dreams with those closest to you. The voice of a spouse, grandchild or lifelong friend is precious and irreplaceable. The sounds of nature or the music and voices of the holidays are all so vital to a happy and fulfilled life.

A restaurant, a concert or any large gathering of people can become a very stressful event for anyone suffering with hearing challenges.

Many new hearing aid wearers report their ability to hear regular, everyday conversations as well as the soft speech of a child’s voice or the gentle sound of rain on the roof or leaves blowing across a yard is much improved.

Hearing aids can be fine-tuned to suit your needs and lifestyle. They can amplify the voices of people in settings such as restaurants where background noise can make communication almost impossible. Thus, you’ll find crowded settings such as parties and gatherings much more enjoyable to attend.

Modern hearing aids are very small, highly sophisticated computers that can be customized to a person’s particular needs. When you meet Page 18

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with a qualified audiologist you will discuss lifestyle as well as any and all situations where you have difficulty hearing. The audiologist will then work with you to modify and adjust your aids to address any particular needs you have. For example, a business executive may need to hear more clearly in large meetings or during presentations whereas a grandparent may need help with the gentle voices of grandchildren.

Hearing aids are not perfect and cannot restore hearing that is lost due to long-term damage from loud noise.

However, they can offer great help in improving and maximizing the existing hearing capability and are of great help in restoring quality of life.

Your audiologist will discuss care and maintenance of your new hearing aids and will make adjustments that will best address your particular hearing challenges.

Audiologist Ramona Stein is the founder and owner of Sounds for Life, located at 135 Sully’s Trail, Suite 10, in Pittsford.

Her resume includes 14 years as director of audiology at one of the area’s largest organizations. He has taught at the college level, including graduate programs, and has experience with diagnostic evaluations, hearing aid fitting and adjustments, cochlear implants for adults and children, intraoperative monitoring and balance testing. She can be reached at 585-248-5212 or info@SFLHearing.com.

By Deborah Banikowski

A

Taxes, Ex-Spouse Benefits — and You

pril 14 is both Ex-Spouse Day and the eve of tax day. These two observances are doubly important if you are an ex-spouse, because Social Security pays benefits to eligible former spouses, and you may need to claim this income on your tax forms.

If you are age 62, unmarried, and divorced from someone entitled to Social Security retirement or disability benefits, you may be eligible to receive benefits based on his or her record. To be eligible, you must have been married to your ex-spouse for 10 years or more.

If you have since remarried, you can’t collect benefits on your former spouse’s record unless your later marriage ended by annulment, divorce or death. Also, if you’re entitled to benefits on your own record, your benefit amount must be less than you would receive based on your ex-spouse’s work. In other words, we’ll pay the higher of the two benefits for which you’re eligible, but not both.

You can apply for benefits on your former spouse’s record even if he or she hasn’t retired, as long as you divorced at least two years before applying.

You can also elect to receive only the

Q&A

Q: My father receives Supplemental Security Income. He recently moved, but he hasn’t reported his new address to Social Security yet. What’s the easiest way to do that?

A: You can check your address online by using your personal my Social Security account at www.socialsecurity. gov/myaccount. It is very important that Social Security has your father’s most up-to-date information, including any change in income, resources, or living arrangements. This will guarantee that he is getting the benefit amount to which he is entitled. You can learn more about the rights and responsibilities of Supplemental Security Income recipients at www.socialsecurity.gov/ ssi.

Q: Someone stole my Social Security number, and it’s being used repeatedly. Does Social Security issue new Social Security numbers to victims of repeated identity theft?

A: Identity theft is one of the fastest growing crimes in America, so you aren’t alone. If you’ve done all you can to identify and fix the problem, including contacting the Federal Trade Commission, but someone is still using your number, Social Security may assign you a new number. If you decide to apply for a new number, you’ll need to prove your identity, age, and U.S. citizenship or immigration status. You’ll also need to provide evidence you’re having on-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

divorced spouse benefits and delay benefits on your own record until your full retirement age, which may translate to a higher monthly amount for you. If, however, you decide to wait until full retirement age to apply as a divorced spouse, your benefit will be equal to half of your ex-spouse’s full retirement amount or disability benefit.

The same rules apply for a deceased former spouse.

The amount of benefits you get has no effect on the benefits of your exspouse’s and his or her current spouse.

Visit “Retirement Planner: If You Are Divorced” at www.socialsecurity.gov/ retire2/divspouse.htm to find all the eligibility requirements you must meet to apply as a divorced spouse. Our benefits planner gives you an idea of your monthly benefit amount. If your ex-spouse died after you divorced, you can still quality for widow’s benefits.

You’ll find information about that in a note at the bottom of the website.

Visit www.socialsecurity.gov/ retire2/divspouse.htm today to learn if you’re eligible for benefits on your ex-spouse’s record. What you learn may bring a smile to your face … even on tax day!

going problems because of the misuse of your current Social Security number.

You can read more about identity theft at www.socialsecurity.gov/pubs.

Q: My father collects disability benefits, but he is interested in trying working again. Is there a program that helps disabled people find work while they’re collecting Social Security disability benefits?

A: Social Security’s Ticket to Work program can help beneficiaries go to work, get a good job that may lead to a career, save more money, and become financially independent. This program doesn’t affect your disability benefits — you can keep collecting your benefits while participating. Ticket to Work is a free and voluntary program that gives beneficiaries real choices to help them create and lead better lives.

You can learn more about our Ticket to Work program at www.socialsecurity. gov/work or www.socialsecurity.gov/ work/home.html.

Q: I served in the military, and I’ll receive a military pension when I retire. Will that affect my Social Security benefits?

A: You can get both Social Security retirement benefits and military retirement at the same time. Generally, we don’t reduce your Social Security benefits because of your military benefits.

When you’re ready to apply for Social Security retirement benefits, go to www.socialsecurity.gov/applyonline.

H ealth News Episcopal SeniorLife acquires Pinehurst facilty Episcopal SeniorLife Communities (ESLC) recently announced it has acquired Pinehurst Senior Living from The Conifer Group. The transition process is currently underway and ESLC will assume formal operations upon closing.

Pinehurst is a 68-unit independent living facility in Honeoye Falls that was developed and opened by The Conifer Group in 1991.

The addition of Pinehurst is consistent with ESLC’s plan to expand into new neighborhoods and reach seniors as they age in their place of choice. ESLC will look to add neighborhood outreach services and build a larger referral network to strengthen the supportive housing program that currently exists.

This is the fourth new senior community for ESLC in two years.

“Pinehurst holds a unique niche in the rural community of Honeoye Falls and is an area where we are eager to grow,” said Loren Ranaletta, president/CEO of Episcopal SeniorLife Communities. “It fits nicely with our vision of supporting and growing housing and community-based services for seniors.”

ESLC offers a full continuum of care, specializing in senior housing and neighborhood programs, currently operating five campuses, eight communities, and five neighborhood programs in the Rochester area. Services include skilled nursing, transitional and rehabilitation care, assisted living, memory care, hospice, independent living, affordable housing, patio homes, and an adult day program.

Physicians organization achieves high score

The Greater Rochester Independent Practice Association (GRIPA), a physician organization that partners with Rochester Regional Health System, announced that it has achieved the highest overall level of health care quality from Excellus BlueCross BlueShield’s Accountable Cost and Quality Arrangement (ACQA).

The ACQA is designed to achieve enhanced care coordination, improve patient satisfaction and outcomes and reduce health care costs. The ACQA assesses quality performance by using national quality measures, which include performance thresholds for diabetes, blood pressure and coronary artery disease, amongst others. Physicians must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe and timely.

Participation in an Excellus BlueCross BlueShield ACQA is voluntary. This is the second year in a row GRIPA has earned this distinction.

GRIPA team members have worked diligently with patients to improve physician-patient engagement and outcomes through such efforts as improving access to primary care

medical services (to manage chronic illnesses such as diabetes and reduce the need for emergency room visits), improving medication adherence rates, and limiting duplication of services.

“The Excellus BlueCross BlueShield ACQA has recognized GRIPA’s focus on improvement initiatives important to the care and outcomes of our patients,” said physician Joseph Vasile, president and CEO of GRIPA. “We appreciate the Excellus incentive program’s support of our quality goals and the recognition of the creative and hard work of our team that positively impacts the people in our community who come to us for care.”

Glenmere at Cloverwood hires sales coordinator Robin C. Levitt has joined Glenmere at Cloverwood as its sales coordinator. In this role, Levitt is responsible for assisting and advising prospective residents and families throughout the decision-making and move-in process. Glenmere offers assisted living, enhanced assisted living, and memory care programs.

Most recently, Levitt was the marketing director at The Summit at Brighton, an affiliate of Jewish Senior Levitt Life, for 10 years.

Prior to that, she worked as a retirement counselor at St. Ann’s Community at Chapel Oaks and Cherry Ridge.

“We are very pleased to welcome Robin to Glenmere. Her background, knowledge and experience in every area of senior living are valuable assets to our organization and to individuals who are interested in pursuing life at Glenmere,” says Daniel Goldstein, Cloverwood’s executive director.

Levitt has an associate’s degree from Monroe Community College, studied communications at the University of Colorado, and holds a certificate in gerontology from Lifespan/St. John Fisher College. She resides in West Brighton.

in Phoenix, Ariz.

She first joined M.M. Ewing in 2010 as a nursing supervisor, and from 2011 through late 2014 served as nurse manager of a 42-bed long-term care unit in the skilled-nursing facility.

“Jennifer has nearly a decade of experience in nurse management, both in the long-term care setting and the post-acute care setting. With a strong focus on process improvement as well as a commitment to the customer, she will ensure exceptional care for the residents of M.M. Ewing as well as the participants at The Brighter Day,” said Thompson Health Senior Vice President of Senior Living Services Dona Rickard.

M.M. Ewing, located adjacent to Thompson Hospital at 350 Parrish St. in Canandaigua, has a total of 188 beds and offers long-term care, dementia care and post-hospital care. Located at 30 Fort Hill Ave. in Canandaigua, The Brighter Day provides personal care, social opportunities and meals to individuals who live alone or with caregivers but need medical supervision during the day.

Koczent gets top healthcare management credential Geneva resident Kurt Koczent, executive vice president of UR Medicine’s Thompson Health and chief operating officer of its F.F. Thompson Hospital, recently became a fellow of the American College of Healthcare Executives (ACHE), the nation’s leading profes-

Hunnicutt named director of nursing facilities Jennifer Hunnicutt of Bloomfield was recently named director of nursing for the M.M. Ewing Continuing Care Center at UR Medicine’s Thompson Health and the center’s medical adult day program, The Brighter Day. Hunnicutt holds bachelor’s and master’s degrees in nursing, both from Grand Hunnicutt Canyon University April 2015 •

sional society for healthcare leaders.

To obtain fellow status, candidates must fulfill multiple requirements, including passing a comprehensive examination, meeting academic and experiential criteria, earning continuing education credits Kocent and demonstrating professional/community involvement. Fellows commit to ongoing professional development and undergo recertification every three years.

“The healthcare management field plays a vital role in providing high-quality care to the people in our communities, which makes having a standard of excellence promoted by a professional organization critically important,” says Deborah Bowen, president and CEO of ACHE. “By becoming an ACHE Fellow and earning the distinction of board certification from ACHE, healthcare leaders demonstrate a commitment to excellence in serving their patients and the community.”

Koczent is a registered nurse who served 10 years with the U.S. Army Reserve and was honorably discharged at the rank of captain. He holds a Bachelor of Science in nursing from Roberts Wesleyan College, a Master’s of Science in health administration from Roberts Wesleyan and a position of adjunct professor in the nursing program

Excellus Awards Hospitals $26 Million for Quality Improvements Forty-five Upstate New York hospitals and health centers — including eight in the Finger Lakes region — last year earned $26 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer’s hospital performance incentive program (HPIP).

In the past 10 years quality performance incentives from Excellus BCBS have exceeded $197 million.

“We applaud our hospital partners’ not only for their willingness to collaborate with our health plan on methods and measurements to improved health outcomes and patient safety, but also for tying those outcomes to a financial incentive to drive focus in mutually agreed upon quality goals,” said Carrie Whitcher, vice president clinical quality at Excellus BlueCross BlueShield.

Eight hospitals in the Finger Lakes Region participated in this program in 2014 including Clifton Springs Hospital, F.F. Thompson Hospital, Highland Hospital, Newark-Wayne Community Hospital, Nicholas H. Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital and Unity Hospital.

“The Excellus hospital performance incentive program over the years has recognized Rochester General, Unity and Newark-Wayne Community Hospitals’ focus on improvement initiatives important to the care and outcomes of our patients,” said Cindy Bileschi, senior director clinical regulatory compliance, Rochester Regional Health System. “We appreciate the Excellus incentive program’s support of our strategic quality goals and the recognition of the creative and hard work of our clinicians that positively impacts the people in our community who come to us for care.”

Launched in 2004, the HPIP program evaluates participating hospitals on over 247 performance measures. In 2014, hospitals achieved 88 percent of all target quality levels. In addition to required clinical and patient safety measures, other nationally-endorsed measures and target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement and others.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

H ealth News at Keuka College.

He has been in his current position at Thompson since 2012.

Firm offers new boardroom amplification system Pittsford-based Sounds For Life, a holistic hearing healthcare practice, will offer a revolutionary new amplification system called Dynamic SoundField

that offers greatly enhanced speaker communication for a variety of listening environments, including board and committee meetings, training seminars, sales meetings, as well as educational/ classroom settings.

According to Sounds for Life, this new and highly portable technology enhances listening, learning and group communications. It provides for an enhanced listener experience, while reducing speaker repetition and vocal strain.

The system is light and portable, easy to install, and eliminates the feedback and echo often present with traditional public address systems. Dynamic SoundField provides advanced digital sound quality and eliminates any potential interference caused by a building’s existing WiFi or Bluetooth networks.

According to Souns for Life, the system is simply the state-of-the-art technology that improves presentations and meetings by allowing the audience to hear and clearly understand the speaker’s voice.

A limited number of units are available for temporary installation to demonstrate this system’s capabilities.

Demonstrations may be arranged by calling Sounds For Life at 585-248-5212.

Dr. Cohen receives award from pediatrician group

The duet, above, massage room is a luxurious couples retreat.

The quiet room, left, is a calming, tranquil escape for Woodhouse guests before and after experiencing the results-oriented treatments.

The Woodhouse Day Spa Opens in Victor — First New York Location The Woodhouse Day Spa, the ultimate full-service luxury day spa founded in 2001 in Texas, is continuing its expansion by opening its first New York location in Victor.

The spa will offer invigorating, rejuvenating and results-oriented spa services to provide the utmost relaxation to its guests.

It currently has over 40 locations in 13 states, with plans to open 320 locations in the coming years.

The new location — 235 High Street Extension — opened in midMarch in the historic High Point III. The distinctive blue building has attracted continued attention for the historic design, and is located behind The North Face and Alex & Ani. The Woodhouse Day Spa, known for its dedication to wellness and stress relief, will offer guests a chance to relax and renew themselves in its elegant facilities in their “own backyard.” The use of innovative products combined with a serene spa environment and handcrafted spa treatments have made The Woodhouse Day Spa a popular place for a luxurious getaway where guests can enrich the mind and delight the senses. With a firm belief in the link between health, well-being and beauty, The Woodhouse Day Spa offers over 70 stress-relieving, soothing services, including The Woodhouse Signature Minkyti Facial, The Woodhouse Four-Handed Page 20

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Massage, in addition to sleep treatments, body treatments, manicures and pedicures.

“Since our establishment in 2001, The Woodhouse Day Spa continues to provide a peaceful and relaxing environment for the body, mind and spirit,” said Jeni Garret, founder of The Woodhouse Day Spa. “We want our guests to receive the care they need for their overall well-being, and we are thrilled to bring exactly that to our guests in our newest location in Rochester.”

“Bringing The Woodhouse Day Spa to Rochester allows us to provide the community with an exceptional spa-going experience,” said Abby Weaver, director of operations, The Woodhouse Day Spa Rochester. “The Woodhouse Day Spa offers the best environment, guest services and treatments. We are happy to provide Rochester with the chance to get away and indulge in rest and relaxation, just minutes from home. We are thrilled to be part of the community and support local organizations, while offering employment opportunities to over 20 staff members including massage therapists, estheticians, nail technicians, and spa concierge staff.”

For more information about Woodhouse Day Spa, including events and scheduling a visit, please visit www.rochester.woodhousespas.com .

Mark Cohen, board-certified pediatrician and internist with Lifetime Health Medical Group, is the recipient of the 2014 American Academy of Pediatrics CME/CPD Award.

The award is given to acknowledge pediatricians who make the commitment to remain current with pediatric care information and treatment

guidelines through continuing medical education. He has received this recognition numerous times, and therefore has also received the American Medical Association’s Physician’s Recognition Award. This award recognizes physicians (in any area of practice) knowledgeable on Cohen the most up-to-date teachings on practice and care treatment guidelines in medicine.

In addition to his duties as a primary care physician, Cohen is also associate medical director of Lifetime Health. He led the team responsible for all of Lifetime’s practices achieving recognition from the National Committee for Quality Assurance as Level 3 Patient-Centered Medical Homes, the national agency’s highest designation.

Additionally, Cohen has lent his time and input to a number of committees to help create patient-centered policies and quality initiatives within the group. He continues to provide clinical leadership for Lifetime’s Patient Centered Medical Home certification and peer review program.

Group for those experiencing loss being formed

A

creative transitions group is now forming in Brighton for adults seeking healing from traumatic loss or losses, including loss of loved ones, health, identity and employment, among others. Group members are encouraged to share their stories in a safe, confidential space facilitated by Lee Ann McAvoy, a licensed mental health counselor, EMDR practitioner and certified mind/body therapist.

“Traumatic loss keeps one frozen in time, often unable to move forward in ways essential to forming healthy relationships and leading a fulfilling

life. With diligent self-care and support from others, we can access the inner wisdom needed to live with greater peace and deeper compassion,” says McAvoy, who has more than 20 years of experience working with traumatic loss.

Optional writing exercises will be assigned and participants encouraged to share their own creative abilities and solutions.

For more information, call 585-3016196, email lmcavoy@rochester.rr.com or visit LeeMcAvoyLMHC.com.

Jewelry Donations Needed

C

lifton Springs Hospital & Clinic Auxiliary is seeking donations of previously loved jewelry, both vintage and costume, for its Baubles & Bubbles jewelry event. Jewelry can be dropped off at the Clifton Springs

Hospital main lobby information desk or operator; tax deductible receipts will be available. For more information, please call 315-462-0120. Clifton Springs Hospital is located at 2 Coulter Road, Clifton Springs.

gvhealthnews.com

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

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s snow banks stubbornly cling to the landscape, it may seem much too early to think about Lyme disease, which is largely spread by ticks.

But Joe Koval, owner of Mosquito Squad of Rochester, warned that ticks that find a host remain active even during cold months. Once temperatures reach the 40s and 50s in May, ticks become active and breed.

Koval said that about one-fifth of his calls for insect control involve tick prevention.

“It’s become a really serious problem,” Koval said.

First identified in Lyme, Conn., Lyme disease can cause serious and Beer long-lasting health problems. Initial symptoms include a bull’s-eye rash (which may feel warm to the touch), possibly accompanied by joint pain, chills, fever and fatigue.

Later symptoms that manifest a few days to a week after the bite can include severe fatigue, stiff neck, tingling or numbness in the extremities or facial paralysis. Weeks after the bite, the patient can experience headaches, arthritis, swelling and heart and central nervous system issues.

In Monroe County, 61 cases were reported in 2014. Ontario County saw 18 cases the same year.

“Two to three cases per year is average,” said Health Department Director Mary L. Beer, a registered nurse.

The black-legged tick, which can carry Lyme disease, waits on a strand of grass, ready to grab hold of anything that brushes by.

“My counterparts in nearby counties saw the same jump. There’s no explanation as to why it happens, like the weather or anything.”

Removing a tick can be challenging. Using a pointed tweezer, grasp the tick as near to its mouth as possible and lift straight up without twisting.

Beer advises people to watch a video on YouTube or leave it in the hands of the pros to avoid breaking off the tick and leaving part of its head or mouth embedded in the skin. Prompt treatment with antibiotics can help reduce lasting effects of Lyme disease if an infected tick bites you.

A canine vaccine for Lyme disease can help your dog; however, no human formulation exists.

Preventing bites involves keeping ticks away from your property and off your clothing. Nymph ticks feed on small hosts such as field mice, which are close to the ground. Adult ticks wait on tall grass to attach themselves to a larger host, such as a deer, dog or human.

Because ticks breed in decomposing leaves, woodpiles and tall grass, it’s important to keep your property clear.

Mow your lawn to between three and four inches tall.

Heed trail signs warning of ticks. Spray your clothing with an insect repellent containing DEET per package directions. Change clothing and shower when you come inside.

“If you’re in tall grass or in the woods, wear light-colored long pants and tuck them in your socks,” Beer said. “Ticks can jump on you. Check anything exposed and check pets, even if you use flea and tick drops.”

Ticks will feel like a scab under your pet’s fur. Flea and tick collars can help, but dogs may act as a taxi to carry ticks inside.

For property owners, Koval offers an organic or chemical-based tick spray which he typically applies in spring and fall to keep ticks away.

It’s also important to eliminate mouse and nuisance deer problems, since these animals transport ticks.

After a day or two after embedding in the skin, this engorged tick has nearly finished its blood meal.

April 2015 •

They rehabilitated my heart.

And my feeling that this world is full of

good people.

Choosing where you go for transitional care is one of the most important decisions you can ever make.

And you can’t choose any better than St. Ann’s Community.

St. Ann’s provides complete rehabilitation services for people recovering from heart surgery, stroke, joint replacement surgery and other hospitalizations. 98% of our patients say they would choose St. Ann’s again.

And remember: you can plan ahead for your rehab. Just call St. Ann’s at 585-697-6311 for your free Transitional Care Planning Kit. Where you go for your rehabilitation is completely up to you. So why let someone else make that decision for you?

Because a great transitional care experience does more than make you feel healthy again. It makes you feel good about the world again.

www.StAnnsCommunity.com

Caring for the most important people on earth.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

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Raise Legal Smoking Age to 21, U.S. Expert Panel Says Such a move would save thousands of lives, lower number of smokers, Institute of Medicine finds

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More and more people on Medicaid who might otherwise be in a nursing home won’t have to because of HomeFirst.

HomeFirst is one of the oldest managed long-term care (MLTC) plans in the state. Our Personal Care Workers provide assistance with bathing, dressing and meals. You can keep your own doctor, and we provide transportation to medical appointments. There is no cost to participate.

HomeFirst is an affiliate of MJHS, which was founded on the core values of compassion, dignity and respect for every culture. Those core values date back to 1907, when MJHS began a tradition of caring every minute, every day.

Call 1-866-384-3509 or visit homefirst.org

Services covered by HomeFirst are paid for by New York State Medicaid. The services not part of HomeFirst benefits continue to be covered by Medicaid and/or Medicare benefits. All services are coordinated, even those not included in the MLTCP benefit package. EPHF13197 12062013

aising the legal age to buy tobacco products from 18 to 21 would save hundreds of thousands of lives and substantially reduce the number of smokers in the United States, a new report finds.

Such a change would result in 249,000 fewer premature deaths among people born between 2000 and 2019, and 12 percent fewer smokers by 2100, according to the report released in March by the Institute of Medicine (IOM).

“The public health benefits of raising the age to 21 are substantially greater than raising it to 19,” said Richard Bonnie, chairman of the IOM committee that wrote the report, and a professor of medicine and law at the University of Virginia.

The IOM is an independent panel of experts that advises the federal government on public health issues.

According to the report, increasing the minimum age to 21 would prevent or delay 15- to 17-year-olds from taking up the smoking habit. The report specifically looked at the benefits of raising the age to 19, 21 and 25, Bonnie said.

Bonnie explained that younger teens often get older teens to buy cigarettes for them — and they may know a lot of friends who are 18 and 19.

However, they are unlikely to have as many 21-year-old friends. That’s why raising the age to 21 seems to have the most public health benefit, he said.

Raising the age to 25 has some additional value, but a smaller one because there is already a lot of social overlap among 21-year-olds and 25-year-olds, Bonnie said.

The committee found that there would be about 3 percent fewer smokers by 2100 if the age were raised to 19, and 16 percent fewer smokers if the age were increased to 25.

If someone is not using tobacco by age 26, it is highly unlikely they ever will, the panel added.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015

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ll that talk of red wine and other alcoholic beverages being good for your health if consumed in moderation is just plain wrong, a new analysis contends.

A review of nearly 53,000 British people found little to no health benefit linked to alcohol consumption, once the results were adjusted for a range of personal, social, economic and lifestyle factors, the researchers reported.

“Based on the findings from this study, alcohol consumption appears to confer little to no protection against mortality [death] in most age-sex groups,” said study author Craig Knott, a research associate in the department of epidemiology and public health at University College London.

Previous research has shown that light alcohol consumption may confer some degree of protection against early death and illness, with people who have fewer than two drinks per day living longer than both those who drink more and those who don’t drink at all, the researchers said.

But these earlier studies were flawed because researchers lumped former drinkers in with people who’ve never touched a drop, calling all of them non-drinkers and then comparing them to people who imbibe lightly, Knott said.

“Importantly, former drinkers appear to be less healthy and at greater risk of mortality than never drinkers,” he said. “With existing research having largely grouped former and

never drinkers together, there was the possibility that protective effects seen among lighter drinkers may be less a consequence of a real biological relationship and more a statistical artifact arising from their comparison against people who are simply less healthy.”

In this study, published Feb. 10 in the BMJ, researchers compared interview data from the annual Health Survey for England with national death records, analyzing the drinking habits and health of almost 53,000 people aged 50 and older.

Compared with people who never drank, any protective benefits from alcohol were largely limited to men aged 50 to 64 who reported having an average 15 to 20 drinks a week, and women 65 and older who had an average 10 drinks or less per week, the investigators found.

And even for these groups, the benefits are so minimal that they might be explained by so-called “selection bias” -- “including but not limited to the possibility that individuals participating in a study are healthier than those who do not,” Knott said.

Most of alcohol’s benefits evaporated after factoring in various definitions of occasional drinking, as well as a range of other personal and social influences, the study authors said.

“On this basis, it seems sensible for current drinkers to consider moderating the amount of alcohol they consume, and for non-drinkers to remain abstinent,” Knott said.

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© 2015 HearUSA, All Rights Reserved.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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150401 HearUSA Ultra Ad_In Good Health Magazine_5.25x14_to run 4-1_02.indd 1

3/4/15 5:13 PM

Page 23

FACT: Smoke-free housing policies can improve your business’ health.

Everyone knows the personal health benefits of going smoke-free.

But did you know that it can also improve your business’ health?

Many New York landlords have already gone smoke-free in order to: • Lower maintenance costs and improve value retention • Make units easier to rent or sell • Reduce fire risk and insurance premiums • Set policy that is legal and nondiscriminatory • Significantly lessen tenant conflicts due to secondhand smoke • Follow HUD guidelines and help earn LEED certification • Reduce potential legal liability from secondhand smoke

It’s easier than you think.

Download a free Landlord Toolkit at SmokeFreeHousingNY.org or call for a free copy.

We can also provide policy support and free signage to landlords in Ontario, Seneca, Wayne and Yates Counties interested in going smoke-free.

Contact the Tobacco Action Coalition of the Finger Lakes at (585) 666-1401.

A grant funded program to help NY landlords.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2015