The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper – PubMed (nih.gov)
- ASPEN = American Society for Parenteral and Enteral Nutrition
- Albumin and prealbumin characterize inflammation.
- There is a strong association between albumin/prealbumin and the Acute/Chronic inflammatory state
- Albumin and prealbumin do not describe nutritional status or protein-energy malnutrition.
- Can be low in hypermetabolic and hypercatabolic states
- Can be low in inflammatory states regardless of nutritional status
- Low albumin and prealbumin are inflammatory markers that MAY be indicators of risk for developing malnutrition
- Low albumin and prealbumin do NOT define malnutrition
“These proteins correlate well with patients’ risk for adverse outcomes rather than with protein-energy malnutrition. Therefore, serum albumin and prealbumin should not serve as proxy measures of total body protein or total muscle mass and should not be used as nutrition markers.”
Slideshow: Should We Be Using Albumin to Assess Nutritional Status in LTC?
‘A Nightmare’: AHCA Files Lawsuit Against Federal Nursing Home Staffing Mandate – Skilled Nursing News
“The American Health Care Association (AHCA) filed a lawsuit late Thursday against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) for exceeding their statutory authority and “arbitrarily and capriciously issuing” a final minimum staffing rule.”
Progress is Not Required for Therapy to Continue
Medicare has ALWAYS allowed maintenance therapy.
Medicare Advantage may not
Coverage of nursing care and/or therapy to perform a maintenance program does not rely
on the presence or absence of an individual’s potential for improvement from the nursing
care or therapy, but rather on the beneficiary’s need for skilled care.
‘Plateaued’ is not a medical description – McKnight’s Long-Term Care News (mcknights.com)
Medicare Benefit Policy Manual (cms.gov)
Jimmo v. Sebelius Settlement Agreement (cms.gov)
PACE
- Please email Dr. Ogden and Dr. Urioste any pharmacy recs. I think that the response rate will be better with a direct email to the physicians and NP/PA.
New Help for Dealing With Aggression in People With Dementia
New Help for Dealing With Aggression in People With Dementia – KFF Health News
“How did you come up with The DICE Approach?” “Out of frustration with the status quo of sedating people with dementia for any type of ‘behavior’ that is deemed unacceptable.”
Video Training – Training | The DICE Approach
Home | The DICE Approach
Recent Tags
700 — lipped mattresses are considered restraints. Anything attached to the bed may be considered a restraint.
TB vials — make sure they are all dated when opened and audit them.
Supplements (boost, ensure) cannot be in the med fridge.
880 – watched nurse do wound care and did not keep dirty and clean areas separated.
880 – Legionella testing