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Safely Reopening Nursing Homes: Quick Summary of New CMS Guidance

Blog by:  Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, Director of Regulatory Services, Proactive Medical Review

As part of President Trump’s Guidelines for Opening Up America Again, the Centers for Medicare and Medicaid Services (CMS) announced new nursing home reopening recommendations for state and local officials. These recommendations detail criteria for relaxing certain restrictions and mitigating the risk of resurgence, visitation and service considerations, and restoration of survey activities.

The guidance encourages state leaders to collaborate with the state survey agency and state and local health departments to decide how these criteria or actions should be implemented in their state and provides examples of how a State may choose to implement the recommendations, which includes options of states to require that all facilities go through each phase at the same time, allowing facilities in a certain region within the state to enter each phase at the same time, or permitting individual facilities to move through each phase based on their status for meeting the criteria for each phase.

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About Proactive Medical Review
HTS partners with Proactive Medical Review, a third party company who specializes in ensuring compliance with regulatory standards and promoting measurable care excellence. The team includes SNF experienced nurse, MDS, Health Facility Administrator, therapist and reimbursement specialists with experience serving in multi-site contract therapy operations, as corporate directors of quality, clinical program specialists, and Compliance Officers. Proactive is uniquely positioned to assist in managing the many changes and challenges facing providers partnered with HTS. Learn more about our commitment to compliance here.

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Therapy Provider Partners with Brewery to Provide Hand Sanitizer for Indiana Skilled Nursing Communities

HTS Partners with the Hoosier Brewing Company

Healthcare Therapy Services, Inc. (HTS) has partnered with the Hoosier Brewing Company, a Greenwood, Indiana based craft beer producer and distributor to provide much needed hand sanitizer to skilled nursing facilities statewide. “As the economy is reopening, we have to remain diligent in our efforts to continue to protect our residents and teams. Since hand sanitizer still remains in short supply for some buildings, we wanted to do our part to support our partners across Indiana.” Steve Chatham, HTS President.

Late-March, Hoosier Brewing Company switched their production from brewing craft beer to mix ethanol, glycerol and hydrogen peroxide into 80% alcohol hand sanitizer. They manufactured the sanitizer based on the TTB, the governing agency over the distillery and from guidelines from FDA and World Health Organization (WHO).

Healthcare Therapy Services, Inc. purchased the hand sanitizer and received additional donated gallons from the Hoosier Brewing Company. “They have been a great partner. Hoosier Brewing Company has already donated hundreds of gallons to first responders and senior living communities. It just made sense for us to work together to continue this effort since we serve so many homes throughout the state.” Amanda Green, HTS Executive Director of Strategic Development.

HTS has delivered so far, over 90 gallons of hand sanitizer from both Hoosier Brewing Company and Jim Beam to skilled nursing communities throughout Indiana.

If you need hand sanitizer or want information on requests for donating to your community, contact Hoosier Brewing Company at info@servehoosiers.com or call Dylan Shaffer, Customer Service Manager at 317-215-4753.

To find out more information about HTS, contact Amanda Green at amanda@htstherapy.com | 317-523-7358

 

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Chair Exercises to Get Fit While You Sit

Did you know that you can still get a workout while sitting down? Exercise helps keep our bodies healthy and strong. Try incorporating these exercises into your daily routine to stay active and in shape at home.

 

Ankle Circles

Sit in a chair with feet flat on the floor. Extend your right knee and move your foot in a circle 20 times. Then move in the other direction 20 times. Repeat with the other ankle.

 

Seated March

Sit in a chair with feet flat on the floor. Lift up your right knee as high as comfortable. Lower your leg. Alternate lifting your knees for a total of 10 lifts each leg.

 

Arm Circles

Stand or seat and raise your arms to shoulder height. Begin arm circles in 360 degree circles to the rear and back to your beginning position. Repeat 10 times, go in opposite direction

 

Shoulder Rolls

Stand or sit with or without weights in hands and arms at side. Feet are shoulder width apart. Raise shoulders upward toward ears, backward and down. Return to the starting position and repeat 20 times.

 

Tips for your workout:

  • Wear comfortable clothing that will allow you to freely move your arms and legs.
  • Choose a sturdy chair that doesn’t slide or roll.
  • Don’t overdo it, take your time and allow yourself several breaks.
  • Gently stretch before and after your workout.

 

Therapy Can Help Aging Adults Stay Active & Independent

Exercise is extremely important in managing many common symptoms of aging. Physical therapists evaluate your needs and teach you how to exercise appropriately for joint mobility, muscle strength and fitness. Occupational therapists help older adults to safely do the things they want to do, stay active and live well despite limitations. Therapy can help with pain associated with sitting too much, address postural issues, and create strategies to get you moving more and sitting less.

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Properly Using Personal Protective Equipment

Blog by the Centers for Disease Control and Prevention

SEQUENCE FOR PUTTING ON PERSONAL PROTECTIVE EQUIPMENT (PPE)

The type of PPE used will vary based on the level of precautions required, such as standard and contact, droplet or airborne infection isolation precautions. The procedure for putting on and removing PPE should be tailored to the specific type of PPE.

  1. GOWN

    • Fully cover torso from neck to knees, arms to end of wrists, and wrap around the back Fasten in back of neck and waist

  2. MASK OR RESPIRATOR

    • Secure ties or elastic bands at middle of head and neck Fit flexible band to nose bridge Fit snug to face and below chin Fit-check respirator

  3. GOGGLES OR FACE SHIELD

    • Place over face and eyes and adjust to fit

  4. GLOVES

    • Extend to cover wrist of isolation gown

USE SAFE WORK PRACTICES TO PROTECT YOURSELF AND LIMIT THE SPREAD OF CONTAMINATION

  • Keep hands away from face
  • Limit surfaces touched
  • Change gloves when torn or heavily contaminated
  • Perform hand hygiene

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 1

There are a variety of ways to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Here is one example. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GLOVES

    • Outside of gloves are contaminated!
    • If your hands get contaminated during glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Using a gloved hand, grasp the palm area of the other gloved hand and peel off first glove
    • Hold removed glove in gloved hand
    • Slide fingers of ungloved hand under remaining glove at wrist and peel off second glove over first glove
    • Discard gloves in a waste container

  2. GOGGLES OR FACE SHIELD

    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band or ear pieces
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container

  3. GOWN

    • Gown front and sleeves are contaminated!
    • If your hands get contaminated during gown removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Unfasten gown ties, taking care that sleeves don’t contact your body when reaching for ties
    • Pull gown away from neck and shoulders, touching inside of gown only
    • Turn gown inside out
    • Fold or roll into a bundle and discard in a waste container

  4. MASK OR RESPIRATOR

    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container

  5. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

HOW TO SAFELY REMOVE PERSONAL PROTECTIVE EQUIPMENT (PPE) EXAMPLE 2

Here is another way to safely remove PPE without contaminating your clothing, skin, or mucous membranes with potentially infectious materials. Remove all PPE before exiting the patient room except a respirator, if worn. Remove the respirator after leaving the patient room and closing the door. Remove PPE in the following sequence:

  1. GOWN AND GLOVES
    • Gown front and sleeves and the outside of gloves are contaminated!
    • If your hands get contaminated during gown or glove removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp the gown in the front and pull away from your body so that the ties break, touching outside of gown only with gloved hands
    • While removing the gown, fold or roll the gown inside-out into a bundle
    • As you are removing the gown, peel off your gloves at the same time, only touching the inside of the gloves and gown with your bare hands. Place the gown and gloves into a waste container
  2. GOGGLES OR FACE SHIELD
    • Outside of goggles or face shield are contaminated!
    • If your hands get contaminated during goggle or face shield removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Remove goggles or face shield from the back by lifting head band and without touching the front of the goggles or face shield
    • If the item is reusable, place in designated receptacle for reprocessing. Otherwise, discard in a waste container
  3. MASK OR RESPIRATOR
    • Front of mask/respirator is contaminated — DO NOT TOUCH!
    • If your hands get contaminated during mask/respirator removal, immediately wash your hands or use an alcohol-based hand sanitizer
    • Grasp bottom ties or elastics of the mask/respirator, then the ones at the top, and remove without touching the front
    • Discard in a waste container
  4. WASH HANDS OR USE AN ALCOHOL-BASED HAND SANITIZER IMMEDIATELY AFTER REMOVING ALL PPE

PERFORM HAND HYGIENE BETWEEN STEPS IF HANDS BECOME CONTAMINATED AND IMMEDIATELY AFTER REMOVING ALL PPE

 

Click here to view the pdf.

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Pulmonary Therapy Interventions for COVID-19 Patients

HTS is excited to launch Breathe: A Pulmonary Intervention Program supported and directed by physical and occupational therapists. Breathe is focused on Percussion and Postural Drainage Therapy also known as chest physical therapy. Therapy interventions can be beneficial in the respiratory treatment and physical rehabilitation of patients with COVID-19, COPD, Pneumonia, Bronchitis, Asthma, ARDS, Lung Cancer and many other respiratory conditions.

Postural Drainage Can Help Patients Breathe Better!

Postural drainage can help treat breathing problems due to inflammation and mucus in the airways of the lungs. Postural Drainage Therapy uses percussion, gravity, vibration, and deep breathing to loosen and drain mucus from the lungs and stimulate a productive cough to clear airways. Unclogging the airways is vital to keeping lungs healthy.

  • Promote Drainage of Mucus and Secretions
  • Stimulate a Productive Cough
  • Optimize the Efficacy of Adjunctive Treatments, such as Inhaled Bronchodilators or Antibiotics
  • Improve Oxygen in the Body
  • Decrease the Risk of Chest Infection, such as Pneumonia

 

HTS Therapists are equipped with the knowledge and training to provide this critical treatment intervention to help patients breathe better!

For more information about the HTS Breathe Pulmonary Program, please contact your HTS Regional Director.

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COVID-19 Clinical Tips for Respiratory Assessment

Blog by Sherry Roberts, RN, Clinical Consultant, Proactive Medical Review

COVID-19 is an acute, sometimes severe, respiratory illness caused by a novel coronavirus SARS-CoV2. Person-to-person spread occurs through contact with infected secretions, mainly via contact with large respiratory droplets, but can also occur via contact with a surface contaminated by respiratory droplets. Nursing facilities face higher risk of transmission due to high population density creating difficulty in maintaining avoidance precautions. Significantly, residents of nursing homes are at high risk for more severe disease because of age and underlying medical disorders.

Clinical Presentation

People with COVID-19 may have few to no symptoms, although some become severely ill and die. Symptoms can include fever, cough, and shortness of breath. The exact incubation time is not certain with estimates ranging from 1 to 14 days. The risk of serious disease and death in COVID-19 cases increases with age. COVID-19 can cause Pneumonia and ARDS (Acute Respiratory Distress Syndrome), Severe Acute Respiratory Syndrome (SARS), Acute Respiratory Failure and several other conditions.

Respiratory Assessment

If COVID-19 disease is suspected as part of the screening process, a  thorough respiratory assessment is essential, including careful auscultation to identify residents with a risk of significant lower respiratory illness.

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May is Better Hearing & Speech Awareness Month

 

May is Better Hearing & Speech Awareness Month. Speech-Language Pathologists play an important role in working with the aging population. Speech-Language Pathologists are highly trained to help older adults with communication, cognitive and swallowing impairments due to illness, trauma or disease.

Signs of Speech and Language Disorders:

    • Having Difficulty Communicating to Others
    • Struggling with Speaking Clearly
    • Having Problems with Expressing Your Thoughts
    • Hoarse or Raspy Voice
    • Trouble Swallowing
    • Frequent Coughing or Choking During Meals
    • Extra Effort or Time Needed to Chew or Swallow
    • Saying Words in the Wrong Order
    • Avoiding Social Activities

If you or a loved one is experiencing any of the above signs, talk to your doctor about Speech Therapy. Speech-Language Pathologists can help older adults communicate their needs better, boost their memory and thinking skills, and improve their ability to swallow.

Speech Therapy can help you have a better quality of life!

Source: www.asha.org

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Homemade Cloth Masks: Proper Washing Guide

Proper Washing Guide for Homemade/Donated Cloth Masks

  • Before Your First Wear, Wash or Soak in Vinegar to Preserve the Color—Since They will be Washed Often
  • Washing Machine Recommended Versus Handwashing
  • If You Wash Multiple Masks Together, Tie the Strings Beforehand to Prevent Tangling
  • Feel Free to Throw in Regular Wash or Use a Garment Bag
  • Wash on Warm to Hot with Detergent: Click here to see a list of approved detergents to fight the Novel Coronavirus.
  • Dry in a Dryer
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Occupational Therapy Helps People Enjoy Life

Occupational therapists enable people of all ages to live life to its fullest by helping them promote health, and prevent (or live better with) injury, illness, or disability. Occupational therapy interventions include helping people learn how to compensate and/or regain skills in order to lead a full and productive life.

Occupational Therapy Interventions Include:

  • Guidance on how to make daily life activities easier
  • Therapeutic exercises to improve range of motion and strength
  • Learning new ways of doing things after an illness or injury
  • Modifying your home/living environment
  • Techniques to manage pain
  • Recommendations on equipment and assistive devices
  • Strategies to manage forgetfulness and memory problems
  • Caregiver education and support

Celebrate Occupational Therapy Month

April 2020

Occupational therapists dedicate their lives to helping others achieve their best life by helping them overcome life changes after an injury or illness or due to aging. If you think you or a loved one could benefit from the help of an occupational therapist talk to your doctor today!

 

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Improve Brain Health & Memory

As we age, our bodies go through a lot of changes including the brain. Aging often causes us to experience normal changes in memory such as losing our car keys, recalling someone’s name and forgetting an appointment. Although subtle memory changes are normal, if memory loss disrupts your daily life or ability to function this could be a warning sign of a more serious problem such as Alzheimer’s or other dementia.

While there is no surefire way or magic pill to prevent cognitive decline, research suggests certain activities do play a role in improving overall brain function and health.

Simple Tips to Improve Your Memory:

  • Physical Exercise:  Physical activity can lower your risk of memory loss by increasing blood flow throughout your body including your brain. Older adults should get at least 2.5 hours of moderate aerobic exercise every week.
  • Mental Exercise:  Stimulate your brain with challenging activities at least once or twice a week. Learn a new language, play a new instrument, try a new hobby or craft.
  • Diet:  Maintain a healthy diet that includes fruits, leafy green vegetables, whole grains, and Omega-3 fatty acids like fish, walnuts and soy beans.
  • Stress:  Protect yourself from stress which can negatively impair memory and cognitive function in the brain. Focus on ways to relax such as yoga, tai chi, deep breathing, and meditation.
  • Sleep:  Quality sleep is the most important thing you can do to reset your brain and allow it to heal and restore mental health. (7-8 hrs of sleep recommended for people age 65+)

If you are having problems with completing daily tasks, comprehending and/or expressing thoughts, please talk to your doctor. Ask your doctor if therapy could benefit you. Our therapy team can discuss the role of therapy in dementia and benefits of physical, occupational and speech therapy.

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