70 million elderly by 2030…NY Times excerpt

With a nudge from the new health care law and pressure from Medicare, hospitals, doctors and nurses are struggling to prepare for explosive growth in the numbers of high-risk elderly patients. More than 40 percent of adult patients in acute care hospital beds are 65 or older. Seventy million Americans will have turned 65 by 2030. They include the 85-and-older cohort, the nation’s fastest-growing age group. The New York Times Milt Freudenheim sums it up best. Click here for the whole story

Health Reform Would Help America’s Seniors

Health Reform Would Help America’s Seniors- from the Future of Aging Blog

March 4, 2010

President Barack Obama yesterday renewed his call for Congress to enact real health reform this year. I hope the members of Congress heed his challenge.

America’s seniors should hope so, too. The health care proposal under consideration would increase funding for the Medicare drug benefit, create more options for seniors who rely on home and community-based care and strengthen the safety net for those who require long-term services and supports. These initiatives would benefit seniors enormously.

read Larry Minnix’s entire post

Reverse Your Outlook On Healthcare

A palindrome reads the same backwards as forward. This video reads the exact opposite backwards as forward. Not only does it read the opposite, the meaning is the exact opposite. This is only a 1 minute, 44 second video and it is brilliant. Make sure you read as well as listen…forward and backward.

This is a video that was submitted in a contest by a 20-year old. The contest was titled “u @ 50″ by AARP. This video won second place. When they showed it, everyone in the room was awe-struck and broke into spontaneous applause. So simple and yet so brilliant. Take a minute and watch it. Then apply the concept to healthcare reform? Enjoy!

Kissito Post Acute Annouces New Relationship with MHealth and Tricare

Kissito Post Acute, a division of Kissito Healthcare, is proud to announce a new relationship with MHealth and Tricare. These two new plans add to the growing list of Managed Care Plans currently accepted at its flagship facility, Kissito Post Acute Cane Island, which include, but are not limited to, BCBS, UHC, Humana, USFH&P, Aetna, and Cigna.

Mhealth, a plan developed by Kissito Post Acute’s collaborative hospital partner, Memorial Hermann Healthcare System in Houston, Texas is one of several ongoing projects between Kissito Post Acute and Memorial Hermann aimed at reducing costs and preserving benefits while enhancing patient outcomes. Rob Turner, Director of ACO Integration states, “We expect great things from this partnership and are honored to participate in this plan.”

Tricare is a plan afforded to Military Retirees and their families. Having several employees on the management team who are Veterans, Kissito is excited to be a part of the lives of those who have served this great nation and with great appreciation is ready to meet their healthcare needs.

The addition of these plans comes at the hands of newly appointed Director of ACO Integration, Rob Turner. Recently promoted from Kissito Post Acute Cane Island Facility, Rob is working closely with Physicians, Hospitals, Managed Care Organizations, and Patients in preparation for the establishment of Accountable Care Organizations and the possibility of Bundled Payments. The need for innovation in these areas will be critical with the forthcoming challenges brought on by Healthcare/Insurance Reform.

Given Kissito’s four-tiered approach to healthcare delivery, which establishes collaborative partnerships with Physicians, Payors, Patients, and Hospitals, these new affiliations enable Kissito Post Acute to continue to redefine the road to recovery.

Care Transitions, a Key to Reducing Hospital Readmissions

Kissito Alerts May 4

Source: Health Care Finance News

Title: Medicare hospital payment rates increase slightly in 2010, will decrease in following years

Date: 5/4/09

URL: www.healthcarefinancenews.com/news/medicare-hospital-payment-rates-increase-slightly-2010-will-decrease-following-years

• CMS has proposed 2010 payment rate updates for acute care hospitals that will not please hospital officials.
• CMS plans to update acute care hospital payment rates by 2.1% for inflation, less an adjustment of 1.9 percentage points to remove the effect of increases in aggregate payments due to changes in hospital coding practices that do not reflect increases in patient’s severity of illness.
• The projected 2.1% update for inflation in patient acute care payment rates is lower than the updates applied in recent years and reflects the slowing rate of inflation in the economy.
• Hospitals say they cannot sustain the additional cuts in already exceptionally underfunded system.

Source: Health Care Finance News

Title: New health care reform report focuses on rural America

Date: 5/4/09

URL: www.healthcarefinancenews.com/news/new-health-care-reform-report-focuses-rural-america

• Sebelius released a report outlining the health care challenges facing rural communities.
• The report indicates that nearly 50 million people in rural America face challenges accessing health care; nearly one in five uninsured -8.5M ppl- live in rural areas, rural residents pay on average for 40% of their health care costs out of their own pocket, compared with the urban share of one third, in a multi-state survey, one in five insured farmers has medical debt.

Source: Health Care Finance News

Title: CMS proposes reduced payment rates for skilled nursing facilities

Date: 5/4/09

URL: www.healthcarefinancenews.com/news/cms-proposes-reduced-payment-rates-skilled-nursing-facilities

• CMS has proposed adjustments to FY 2010 payment rates to better reflect the cost of caring for Medicare beneficiaries in nursing homes.
• The rule calls for payments to Medicare SNFs to be reduced by $390M, or 1.2% lower than payments for FY 2009.
• The proposed FY 2010 recalibration of the CMIs would result in a reduction in payments to nursing homes of $1.050B or 3.3%.

Source: McKnights

Title: Nursing home operators howl as government proposes slashing medicare payments by 1B

Date: 5/4/09

URL: www.mcknights.com/nursing-home-operators-howl-as-government-proposes-slashing-medicare-payments-by-1-billion/article/136063/?DCMP=MCK_Daily

• CMS set off a backlash from nursing home operators late Friday afternoon when its proposed adjustments that would cut Medicare payments by $1.050B in FY 2010.
• The 3.3% reduction will largely be offset by a 2.1% market basket increase, officials said.
• Bruce Yarwood, president and CEO of the AHCA, said the implementation of the regulation will undermine senior’s future access to quality care in the setting of their choice and sidetrack the sector’s ongoing ability to create good-paying health jobs.

Source: McKnights

Title: First report of swine flu at nursing homes surface, professionals council issues guidelines

Date: 5/4/09

URL: www.mcknights.com/first-report-of-swine-flu-at-nursing-homes-surface-professionals-council-issues-guidelines

• Reports circulated Friday about 3 NY nursing homer residents suspected of having contracted H1N1 and a nursing aide was believed to have contracted the sickness after visiting Mexico and returning to work before symptoms surfaced.
• Recommendations for dealing with swine flu include: staff should be trained to recognize flu symptoms before they hit, and any person who develops flu type symptoms should be considered a possible cause, until proven otherwise.

Source: State of the Division

Title: SFC bungling, I mean bundling health care #3

Date: 5/2/09

URL: www.stateofthedivision.blogspot.com/2009/05/sfc-bungling-i-mean-bundling-health.html

• By bundling payments for acute and post acute services, hospitals will fight with rehab facilities, nursing homes, and long term acute care hospitals over federal payments.
• Accountable Care Organization’s (ACO) would be eligible to share in 50% of the savings generated to the Medicare program.
• Other advantages for ACO’s include targeted relief from legal or regulatory impediments to provider cooperation.

Uganda

Ethiopia -  The Philippines -  Uganda

Bugobelo Hospital and Medical University – Bugobelo, Uganda

The Bugobelo Hospital and Medical University is the result of Sam Mumia’s vision and dedication.  A native of Uganda with a passion to serve his home country. Sam graduated from Makerere University in Uganda with degrees in Law and Psychology. After immigrating to the United States several years ago Sam has continued to serve Uganda through a variety of initiatives, including a successful program that provides computers to the school system.

After learning about our post acute care initiative in Ethiopia, Sam sought to establish a hospital and university in the eastern Manafwa District of Uganda, beginning by selecting local students to begin their nursing training. Kissito is sponsoring two Ugandan students at the Lyceum-St. Cabrini College of Allied Medicine, a Kissito affiliated university in the Philippines. Additional students will receive training at the Morris Cerullo Kamashi Teaching Hospital and University in Ethiopia when it opens in 2010.

As Kissito completes the Ethiopian hospital the knowledge, personnel, and construction equipment will be used to develop the development of the Bugobelo project. Sam and Kissito are currently seeking support for the actual construction which is expected to commence in 2010.

Commencement Speech

Lyceum-St. Cabrini College of Allied Medicine
3rd Commencement Exercises
April 16, 2008
Commencement Address

Ma Gan Dang Hapon to all of you. President Torres, members of the Board of Directors, Lyceum Technical Institute President Laurel, Executive Vice President Jimenez, nurturing and proud parents and grandparents, members of the family and friends, and a very hard working graduating class it is a great honor for me to be the Commencement Speaker for the 2008 graduating class of the Lyceum-St. Cabrini College of Allied Medicine Bachelor of Science in Nursing. I must confess when Ms. Jimenez the schools Executive Vice President first asked me to speak I mistakenly interpreted her invitation to be but one of several guest speakers and share maybe a few words about our Affiliation with St. Cabrini Medical Center. It was only on Monday when I learned that I was going to give the Commencement Address. You can imagine the honor I felt as commencement speakers are normally politicians, important citizens, and other noted speakers not hospital managers.

I am truly grateful for this honor. Somewhat overwhelmed, I immediately turned to the internet for research and guidance in fulfilling my duty as your Commencement Speaker. The research centered on the critical role in bridging the gap between your four years of dedicated study and the future that stands before you. The research also suggested length of the speech was very important, something which caught my attention as I recalled the many staff members who have commented on my tendency to engage in long winded speeches. Surprisingly, I noted the most remember and famous Commencement Speech given contained only 5 words. The speech was given at Oxford University one of England’s most prestigious universities by the nations treasured hero Sir Winston Churchill. Sir Churchill, himself a terrible student who took three years to finish the 8th grade simply directed the graduating class to, “Never, Never, Never Give Up!” The simplicity of this message holds true today and is at the center of all great success stories, rather they be of individual triumphs or those of organizations or great countries. With this message in mind, I will keep my speech short but relevant to what lies ahead as you leave your Alma Mater Lyceum-St. Cabrini.

While conventional wisdom suggest I should be politically correct and not venture into areas of controversy, this would not be the face of reality. Playing it safe and avoiding controversial issues does not meet the test of truth, and most importantly it does nothing to prepare you for meeting the challenges of Philippine and Multi-Cultural Nursing. Only through a brutal confrontation of the facts can we ever hope to improve both ourselves and our profession. So while my speech may be controversial it is designed to stimulate thought on solving the problems we all face and it is certainly not my intention to offend anyone.

Today’s message is not just for the graduate but also for her or his entire family as well. Getting to this point was the work of many people and I know the sacrifice and suffering many families have gone through to invest in your future. Please allow me to share with you experiences from my past and from our organization Kissito Healthcare in the hope that one of these experiences might give you guidance and be of benefit as your career begins.

But first we must face the Nursing Examination which most of you are planning to take in June. I want you to approach this examination with confidence. Lyceum-St. Cabrini has prepared you well! The results from the December examination were certainly disappointing with only 43.4 percent of the 67,000+ candidates achieving a passing score. To fully understand why the pass rates have been declining in the Philippines we need to look at the credentialing process for schools of nursing. In the 1970’s we had about 40 schools of nursing in the Philippines. This number has expanded rapidly to the point were we had 350 some schools by 2005. Then literally overnight the number mushroomed to today’s total of 460!

Today there are approximately 80,000 students in nursing schools in the Philippines. This compares with a current workforce of 128,000 nurses. As reported recently in the Manila Times, nursing schools have been selling dreams not education. The evidence is clear when 7.2 percent of all schools did not even have a single graduate who passed the December 2007 examination. It is simply not possible to expand the number of nursing schools in the Philippines that rapidly while maintaining the standard of excellence in education. The number of qualified faculty and staff members simply does not exist. Furthermore, the clinical practice sites do not exist in sufficient number to ensure each student has the hands on experience which is so critical in developing nursing judgment and knowledge.

Here at Lyceum-St. Cabrini the facts are very different. First, Lyceum as an organization has been engaged in education for over 6 decades and the school of nursing has been in existence for 6 years now. More importantly the founders of the school had the foresight to affiliate with St. Cabrini Medical Center to ensure each student had the critical exposure to clinical nursing practice. As a result Lyceum Alumnae have exceeded the national median pass rates. So consider yourself well prepared to sit for the examination at this point compared with many of the graduates around the country.

This being said you still need to rigorously prepare yourself for the examination. I recommend attending the coaching courses and studying with a partner or group. You must be disciplined. Studying can never be accomplished in the final days of preparation. Set aside a certain number of hours each day starting tomorrow through the examination for studying. Remember the old adage, “The harder I work the luckier I get.” Your hard work will pay off in the end and the two months of preparation is nothing compared to the length of your career. I ask that parents and family be supportive during this process and to the best of their ability provide the time and structure needed for this preparation.

Please! Do not put undo pressure on yourself over the examination. We can only do our best and if we do not pass it the first time we will follow the advice of Winston Churchill, and never give up. Five years from now you will not even be thinking about rather you passed the examination on the first or the third attempt. Families and parents I know your expectations are high but you must support your daughter and son more than ever through this process. A student who does not pass the examination will need your support and reassurance more than ever. Remember, only through disappointments or outright failure can we truly learn as is demonstrated by people like Sam Walton who founded Wal-Mart the worlds largest employer after losing his first store and being turned down by bank after bank as he tried to promote his concept for retailing. But like Churchill demanded he never gave up!

The next critical path for you will be your first working position and building your experience. When we first interviewed candidates in Manila two years ago I was surprised at how many people had been unable to find nursing positions since graduating. With 80,000+ nursing students enrolled today this is easy to understand and I am sympathetic to the problem of finding your first setting to gain the experience everyone is demanding. Again, I challenge you that we have 359 hospitals in the Philippines. Until you have applied to each one of them then you can not say that you truly have not been able to find a first position. Look for the setting with the most needs. Government hospitals may pay less than private hospitals but the needs may be greater. Certainly rural locations have a greater need for nurses than urban. Again, the sacrifice of being away from home and friends will be but a small part of your career and will serve you well. Find a friend to go with you if you are seeking employment away from family. Study the hospital you are applying to. Discuss the benefit of your education at Lyceum and share with prospective employers the clinical experiences that you had at St. Cabrini, all of which will have meaning for any new employer. At Kissito Healthcare we value the candidate who has studied the data available on our company and brings knowledge to the interview process. Always be sure to send a thank you letter to anyone who interviews with you or assists you in the process of seeking employment. Build a network of contacts that will stay with you throughout your career. These will include your professors here at Lyceum-St. Cabrini and you classmates. Keep in contact with your network as together you will share information and support each other as you build your careers.

Because a hospital or other healthcare provider is not hiring, this should not stop you from applying! Our company and many like us value a passionate employee who has a desire to be a part of our organization and is assertive in asking to join us. Offer to volunteer with any health care organization. Remember the key to finding employment is having the right attitude and the aptitude to learn. Many employers will tell you if someone has the ability to learn we can teach them, what we can not do is change their attitude. Which brings us to what are the characteristics most desirable to an employer and us as health care professionals?

Nursing has a time honored tradition of patient Care and Compassion the two basic hallmarks of your chosen profession. I can not imagine a career, except maybe teaching, were you have at this early stage of your career the ability to change peoples lives through demonstrating your caring and compassion. At our hospitals I regularly receive letters and expressions of gratitude for the acts of a particular nurse who made the difference in a patient’s life or helped a family confront end of life issues in a caring and compassionate way. At your young age you have the ability to make a difference, use that ability. Truly, what a great calling you have been drawn to. The technical aspects of nursing demand sound judgment and articulation. These skills will only come through experience and questioning. I implore you to ask as many questions as you have. You want to be known as the nurse who will not stop asking questions. The charge nurse might joke about your ongoing questioning but inside she will be proud of your passion and interest. Physicians depend on the nursing staff for current and comprehensive assessments of all patients. Do not be reserved, always know the status of your patients and be ready to share your assessment and concerns with other members of the Interdisciplinary Team.

Now we must turn our attention to a highly controversial part of Philippine nursing. The employment of Filipino nurses overseas. The Philippine Department of Health reports 85 percent of all nurses licensed in the Philippines are now practicing overseas. While 128,000 nurses are currently in the Philippine workforce another 100,000 are estimated to be working around the world. In fact nursing has become the most popular college degree in the Philippines. The so called Talent Drain has sparked a strong debate for mandatory service in the Philippines for graduates of government sponsored institutions. The so called Philippine National Health Service Act if implemented would require service in the Philippines for nurses graduating from these programs prior to having the ability to leave the Philippines. Despite these debates the numbers continue to rise with the most recent Philippine Overseas Employment Administration figures showing record employment of all classes of Pilipino workers exceeding 1,000,000 workers in 197 countries. Of this amount 317,000+ were new deployments of which nurses accounted for 8,528 new deployments.

Understandably economics is driving many of these decisions. The US Department of Labor recently published data suggesting that while the national average wage for RN’s was $48,000 USD annually, FNG actually earned a little more in Acute Hospitals at $49,000+ annually. But since this publication RN shortages have pushed the current wage of a US RN to over $60,000 annually for a 40 hour work week. The vast majority of nurses leaving expressed the need to support the education of a brother or sister or assist family members at home. Many nurses have little choice but to consider overseas employment. I would argue that Filipinos do not leave because they want to but because circumstances force them to.

Ironically, the two countries which draw a significant percentage of the Filipino nurses, the United States and Canada have over 9.0 nurses per population of 1,000 while the Philippines have 1.69 nurses per population of 1,000. A factor of 5.3 times more nurse staffing. The health impact is clear with the probability of a Pilipino female age 15-60 being 2.9 times more likely to die than a Canadian. The infant death rate is even greater with a Pilipino infant 5.5 times more likely to die than a Canadian infant in the first five years of life. While the funding to hire more nurses in the Philippines may not exist and therefore outmigration does not truly affect our health status, clearly when the more experienced and knowledgeable nurses leave all Filipinos suffer. An even more disturbing trend reported recently in the San Francisco Chronicle was the presence of over 3,000 physicians in Philippine schools of nursing. This represent 6.8 percent of the countries physicians and surgeons and should they leave their profession it would be critical for the countries already low ratio of .58 physicians per 1,000 population again an indicator which is a mere 22.7 percent of the US ratio.

I share all of this not to dampen the spirits of this great day but to implore you the new class of graduates to take action both for yourself and also for your country. The needs for Multi-Cultural nursing will continue to expand. The US alone projects the shortage of 111,000 RN’s in 2000 will grow to 275,000 by 2010 and 800,000 by 2020. FNG licenses issued in the US represented 10 percent of all licenses in 1995 and have climbed to 14 percent in 2003 despite major increases in the number of US nursing school graduates. The percentage of Filipino FNG has however declined in the US from 75 percent in the mid 1980’s to 43 percent as of 2000. This in part is due to the US recruitment of Canadian, UK, Korean, Nigerian, and Indian nurses on a larger scale with Filipinos just as likely to be migrating to Saudi Arabia, UAE, Hong Kong, and Kuwait.

We believe the growth in Multi-Cultural nursing will continue to expand due to the globalization of the world. Kissito Healthcare has taken a unique approach to the dual problems faced in the Philippines and in the US. Through our affiliation with St. Cabrini Medical Center we are structuring our own form of National Health Service Act. Our candidates will have extensive training and support in preparation for immigration to a Kissito Healthcare facility in the US. But in exchange, candidates must commit to returning to the Philippines for specified periods of time to share their knowledge and experience. This is but a baby step which we hope will ensure the rotation of skilled and experienced nurses back to St. Cabrini. We of course are hopeful other hospital systems in the US and other benefitting countries will adopt similar practices. But most importantly we hope you the next generation of Philippine leaders will have the conviction to venture out as circumstances may dictate but that you will return to meet the needs of this great Nation.

As we leave today lets remember the great calling and profession we have chosen. With the responsibility of caring for the sick and infirm comes the duty of service and self sacrifice. A consensus among histories great philosophers holds that happiness is highly correlated with the gaining of knowledge and service to others. Through service to those in need and a deep relationship with your family and God you will experience joys that will last your entire life. May God Bless you and guide you in your new career as a nurse!

Ethiopia

Ethiopia – The Philippines – Uganda

Morris Cerullo Kamashi Teaching Hospital – Kamashi, Ethiopia

Dr. Charles E. Blair has dedicated the last 27 years of his life to advancing the Christian Faith in Ethiopia through church planting and community development programs. Most recently, the Blair Foundation has focused on the rural region of Benishangul-Gumuz bordering Sudan. The Foundation has planted over 1,300 churches and provided resources for regional development. Regional State President Yaregal Aysheshim and Dr. Blair have long dreamed of building a hospital in the Kamashi Zone of the region, an area of 70,000+ people without access to any healthcare services. Through their vision and the generosity of Morris Cerullo World Evangelism, the Morris Cerullo Kamashi Teaching Hospital and University is now becoming a reality. Kissito Post Acute is undertaking the construction and operation of the 60-bed medical and surgical hospital. Construction is underway and we anticipate serving the region soon. The staff is working diligently to develop the protocols and training for running a hospital in such a remote location. At first, the hospital will initially be staffed by members of the Kissito team and mission volunteers from the Philippines. Our commitment to and passion for excellence will make it possible for this to become the first Joint Commission International (“JCI”) accredited hospital in Sub-Saharan Africa.

Status Update 09.09 ~ Project Photo Gallery ~ Floor Plans

Kissito International

Ethiopia -  The Philippines -  Uganda

Since 2004 our staff members have actively participated in Kissito International’s medical volunteer work around the world. This work has sensitized us to the needs of millions who lack or are denied access to even the most basic of healthcare services. As a 501 (C) (3) charitable organization we seek ways to share our knowledge and expertise in some small way to help those in need.

As part of our commitment, we will construct and operate the Morris Cerullo Kamashi Teaching Hospital and University in Ethiopia. This 60-bed medical and surgical hospital will serve more than 70,000 people who currently lack healthcare services. Our employees are aggressively committed to making this the first Sub-Saharan African hospital to obtain Joint Commission International (JCI) accreditation!

We also maintains a close working affiliation with St. Cabrini Medical Center and the Lyceum – St. Cabrini College of Allied Medicine in the Batangas region of the Philippines. Through this formal affiliation, we recruit and train post- graduate students for practice in our US-based and International divisions. Together, Kissito Healthcare and St. Cabrini plan to develop and operate the first post acute care center in the Philippines. The Kissito Healthcare clinical information system is being implemented throughout the Medical Center and the College of Allied Medicine in Sto. Tomas, Batangas.

The development of a healthcare delivery system starts with education. To this end, we are dedicated to working with the community of Bugobelo, Uganda to educate its promising young students in healthcare professions. Bugobelo students will be sponsored at Lyceum  St. Cabrini and Morris Cerullo Kamashi to undertake studies in various healthcare professions. We are working with the local community together to develop its first hospital which will be staffed by the students upon their return to Bugobelo.

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