We all know the tryptophan and Thanksgiving turkey connection, but overloading on turkey is not the only natural way to help promote sleep. Tryptophan is an amino acid that the body uses in the processes of making vitamin B3 and serotonin, a neurotransmitter that helps regulate sleep. It can’t be produced by our bodies, so we need to get it through our diet. From which foods, exactly? Turkey, of course, but also other meats, chocolate, bananas, mangoes, dairy products, eggs, chickpeas, peanuts, and a slew of other foods. Before you call the doctor and ask for an Ambien or Restoril for insomnia, consider adding these foods that promote natural sleeping to your diet. Natural sedatives offer a more restful sleep and don’t effect our circadian rhythm. (sleep/awake cycle) as sleeping pills. In addition to tryptophan, magnesium, calcium and Vitamin B help aid in production of turning serotonin into melatonin. Melatonin is a hormone found naturally in the body. As the sun sets, your body produces more melatonin and when you rise in the morning, melatonin levels taper off to allow you to wake up. Some people take melatonin to adjust the body’s internal clock. It is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes, and for helping blind people establish a day and night cycle.
Medicare Part D Plan Open Enrollment Every October 15 through December 7th Medicare Part D plans have Open Enrollment. The programs begin on January 1st. Medicare Part D is prescription drug coverage with a formulary of prescription drugs, managed by a plan sponsor. If a person participates in Medicare Part A or Part B, then the Part D enrollment is voluntary. If a person has Medicaid, then they must enroll in a Part D plan, or one will automatically be assigned. Medicaid coverage helps with costs of premiums, deductibles and co-pays. FLORIDA APPROVED PART D PLANS FOR 2020 SilverScript Choice Wellcare Classic Cigna Healthspring RX Secure (new for 2020) Clear Spring Health Value RX (new for 2020) Basic Plan for the Average Person Monthly premiums average $30.00 per month Annual deductible is $435.00 Co-pays for prescriptions up to 75% of the cost of drugs (depends on the drug) “Donut Hole” – is a gap in prescription coverage Coverage for drugs stops at $4,020 Beneficiary is responsible for 100% of drug costs from $4,020 until $6,350 out of pocket Once the annual cost of drugs reaches $6,350, Medicare Part D pays 95% of costs During Open Enrollment Oct – Dec Letters will be mailed to all “choosers” regarding their status The designated person that choose a plan any year since
All long term care facilities are required to have an effective immunization program that reflect current standards of practice. Receipt of vaccinations is essential to the health and well-being of long-term care residents. Influenza outbreaks place both the residents and staff at risk of infection. If your facility does have an outbreak, the CDC offers the following guidance. Flu Vaccines must be offered to patients October 1st through March 31st. Facilities are encouraged to promote 100% staff participation in flu shots to prevent outbreaks. Got to www.flu.gov for useful information and resources for your Influenza Vaccination Program. The following forms can be used for education, promotion and documentation of your facility’s Immunization Program. CLICK HERE for the CDC Long-Term Care Toolkit for valuable information. INFLUENZA VACCINE INFORMATION SHEET (English) INFLUENZA VACCINE INFORMATION SHEET (Spanish) POSTER/FLYER 65 YEARS+ (English) POSTER/FLYER 65 YEARS+ (Spanish) POSTER/FLYER HEALTHCARE WORKER (English) POSTER/FLYER HEALTHCARE WORKER (Spanish)
EFFECTIVE OCT. 1, 2018 Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Drug Regimen Review Quality Measure – At the Beginning of the Stay the following questions will be asked: Did a complete drug regimen review identify potentially clinically significant medication issues? Did the facility contact the physician or designee by midnight of the nest calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues? At the End of The stay the following question will be asked: Did the facility contract and complete the physician or designee prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the Admission? (This Quality Measure will affect the FY 2020 payment determination and subsequent years) Medication reconciliation is the formal process in which health care professionals partner with patients to ensure accurate and complete medication information transfer with the patient from one care level to another. Patients admitted to a hospital have a 50% chance that a medication error will occur. Many adverse drug events (ADE) occur as a result of poor communication between health care professionals and patients or caregivers when they are admitted to the hospital, change rooms within the hospital, are discharged to a skilled nursing facility and discharged home to the
On October 1, 2018, data will be collected to ensure that medication reconciliation is also completed at the time of admission. The new Quality Measure – Drug Regimen Review, will evaluate the percentage of resident stays in which drug regimen review was conducted at time of admission and if facility staff followed up with the physician before midnight the next calendar day. Facilities that are found non-compliant will have their Medicare Payment reduced 2%. Skilled nursing facilities are required to reconcile patient medications prior to discharge back to the community. F661 – Discharge Summary states “Facility staff must compare the medications listed in the discharge summary to medications the resident was taking while in the facility. Any discrepancies must be assessed and resolved, and resolution documented in discharge summary with rationale.” The Advancing Excellence “Medications at Transitions and Clinical Handoffs” (MATCH) toolkit incorporated experiences and lessons learned from staff of facilities that have implemented MATCH. The toolkit helps facilitate a review and improvement of current practices to strengthen the process and improve patient safety. The World Health Organization has developed a Standard Operating Protocol for Medication Reconciliation and assuring medication accuracy in transitions in care. To write your policy and start your program, click the link below:
Pneumococcal Disease According to F883, Immunizations for pneumococcal pneumonia the requirements have five aspects: The resident is provided education regarding the benefits and potential side effects of the vaccination The facility must offer each resident pneumococcal immunizations unless the immunization is medically contraindicated, ore the resident’s immunization status is current The resident, or resident’s legal representative, has the right to refuse the vaccinations Each eligible resident is administered the pneumococcal vaccine (unless refused or contraindicated or the resident has already been immunized) The facility must document that education was provided and that the resident either received the vaccine or, if not received, that the vaccine was refused or medically contraindicated or the resident had already been immunized Make sure your facility policy includes all five requirements and that the resident’s medical record documents patient education, offering the vaccine, administering the vaccine. Two pneumococcal vaccines are recommended for adults: PCV13, Prevnar13 and PPSV23, Pneumovax 23. One dose of PCV13 is recommended for adults 65 years and older who have not previously received PCV13. For patients who have not received any pneumococcal vaccine or with unknown vaccination history, give 1 dose of PCV13, and administer 1 dose of PPSV23 at least 1 year later. Once a dose of PPSV23 is given at age 65 or older, no additional doses of PPSV23 should be