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Home and community-based services (HCBS) are grabbing the attention of senior living providers, and a growing number are entering the sector, data show.

Today, more than half, or 52% of the largest not-for-profit system providers offer some sort of home and community-based service off-campus to non-residents, according to a recent Zieglerarticle citing research from the LeadingAge Ziegler 150 publication. And 32.5% of senior living providers are considering offering a Continuing Care at-Home (CCaH) program in the next two years.

The senior living sector is also observing a number of joint ventures and partnerships being developed in the HCBS marketplace, particularly with regard to PACE, home health and home care.

The percentage of overall annual revenue from HCBS from non-residents was 3.4%, and 2.4% from residents for senior living providers, data show.

Speaking at a recent Ziegler conference, Lynne Giacobbe, executive director of Ohio-based Kendal at Home, said the program’s success is due to critical factors including strong, pre-development market research before launching the program, offering multiple plans to prospective members, effective and strict underwriting, robust actuarial assumptions, and aggressive market strategies among others.

A CCaH program differs from a bricks-and-mortar CCRC, from the lower cost of entry, to less healthcare utilization and younger age demographics among Kendal at Home members, Giacobbe said.

There are both benefits and risks of a CCaH program, which is still an evolving business model with few programs over 20 years old.

Ultimately, the ability of the program to expand the mission to serve older adults and touch a segment of the local market who would not otherwise consider moving into a Continuing Care Retirement Community (CCRC) is attractive for operators. 

Westminster Canterbury on Chesapeake Bay, a single-site CCRC with more than 630 units located in Virginia Beach, Va., elected to offer home health, home care and hospice services to control quality of care and outcomes, grow and diversify revenue streams, prepare for post-acute strategies and payment and more, said President and CEO Ben Unkle.

“The [17th Annual Ziegler conference] conveyed that there are multiple ways providers can expand into home and community-based services,” says Lisa McCracken, senior vice president of Senior Living Research and Development at Ziegler, in the article. “What each presenter clearly communicated is that it is important to fully understand the market and what expertise is needed for each business line and, where partnership opportunities exist, they should be explored.”


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Do you believe your grandparents are the best grandparents? In South Carolina, six grandparents are rewarded and honored with the greatest grandparent award yearly. Nominations from children and teenagers across the state are received in the form of a written letter and then the judges at the state fair make their decisions of the winners. Below is an article found in the newspaper called The State that describes this competition.

Shaniya Huiett has many reasons for thinking her grandmother, Shirley Huiett, is great.

There’s her help with homework and life lessons, her model as an independent woman and her general everyday kindness.

“She might have her days but she still loves me. That’s why I think she should be Grandmother of the Year,” the 10-year Columbia youngster wrote in her nomination essay for year’s State Fair Greatest Grandparents competition.

And her message was not lost on the judges.

The elder Huiett, also of Columbia, was among the six winners in this year’s competition who were honored during ceremonies Sunday afternoon in the Grandstand.

The 28th annual event selected two winners from three age divisions – 7-10, 11-13 and 14-18 – from several thousand entries submitted by grandchildren in this year’s event.

Huiett was chosen the greatest grandmother in the 7-10 age division. Eugene Wilson Jr. of Turbeville, nominated by Zymere Wheeler of Lynchburg, was named greatest grandfather in the age 7-10 age division.

Mary Shelley of West Columbia, nominated by Micaela Riley of Lexington, was named greatest grandmother in the 11-13 age division.

“Mema bakes, runs errands, and spends time with her kin and many of her best friends, including me,” Micaela wrote in her nomination essay. “She has a trait of supporting others during difficult times.”

Milbert “Doc” McKenzie of Hemingway, nominated by Kennedy Belle of Lake City, was named greatest grandfather in the age 11-13 division.

Alice Bailey of Greer, nominated by Alice Kathryn Bridgeman of Inman, was named greatest grandmother in the age 14-18 group. And Donald Nordin of Saluda, nominated by Riley Nordin of Saluda, was named greatest grandfather in the age 14-18 group.

All six grandparents receive a flat-screen television and plaque and the winners celebrated their selections with family members who had come along to support them on Sunday.

State Fair assistant manager Nancy Smith said the letters were evidence of the strong relationships many children share with their grandparents across the state.

“The fair is a family tradition so it’s only appropriate that we honor these special family connections while continuing to promote education, another priority of the fair,” Smith said. “It was a delight to hear some of these heartwarming stories.”

The greatest grandparents should receive the greatest care as they age. Grandkids can’t keep care of their grandparents forever, especially with school and work of their own that takes up majority of their time. A time like this is when hiring a home care agency is the best option. Home care agencies provide the care needed in the home of the elderly in times when family can’t be there. The important thing to do is find a reliable home care agency. Reliable home care agencies have home care management software to help them manage their schedules, billing, and client/caregiver information. Kinnser ADL is the best home care management software and will help any home care agency of any size become more reliable and efficient.

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Actor Seth Rogen’s Hilarity for Charity event is teaming up with Home Instead Senior Care to provide in-home grants to families living with Alzheimer’s Disease.

The event and Hilarity for Charity Fund, established as part of the Alzheimer’s Associatoin, is also led by Rogen’s wife and actor Lauren Miller Rogen.

The movement is meant to raise awareness of Alzheimer’s disease among the millennial generation to offer grants for in-home care services to eligible U.S. and Canadian families through the Alzheimer’s and Dementia Care Relief Grant Program. Care will be provided by professionals trained in how to assist individuals with Alzheimer’s disease and other dementias.

“My wife and I have experienced firsthand the devastating toll Alzheimer’s takes on all members of a family,” says Seth Rogen, whose mother-in-law was diagnosed with early onset Alzheimer’s at the age of 55. “While we continue to raise money that will hopefully, one day, lead to a cure, we want to be able to improve the quality of life for families who are struggling to cope with its many challenges today. Even just a few hours of help a week can provide a welcome break and peace of mind for families.”

Nearly 60% of Alzheimer’s and dementia caregivers rate the emotional stress of caregiving as high or very high, and more than one-third report symptoms of depression, according to the Alzheimer’s Association. More than 70% of working caregivers suffer work-related difficulties, and more than half of caregivers report declining health since they’ve prioritized the care of their loved ones and neglected their own health.

“As a result, many chronic conditions such as heart disease, cancer and diabetes occur at nearly twice the rate among family caregivers,” says Home Instead Senior Care.

As part of the partnership, United States- and Canada-based Home Instead Senior Care franchise owners have pledged more than 37,000 hours of in-home care services, valued at $740,000, to supplement the monetary funding provided by Hilarity for Charity for the Alzheimer’s Care Grant Program.

“Care support is a critical component of a comprehensive care plan for the nearly 6 million North American’s living with Alzheimer’s disease today,” says Jeff Huber, president of Home Instead Senior Care. “Together with Hilarity for Charity and the Alzheimer’s Association, we are connecting families with our professional [caregivers] who are equipped with specialized training and deep expertise in caring for Alzheimer’s patients. This program will have a substantial impact on the millions of families living with this disease.”

Introducing this disease to a new generation is important for those impacted with the disease today and for future progress, says Angela Geiger, chief strategy officer of the Alzheimer’s Association.

“Care support for families is critical and can make an enormous difference,” Geiger says.

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Our grandparents take care of us more than one would think. According to Forbes, grandparents were a huge source of financing college for students across the country. The article below written by Robert Farrington from describes the details behind the study.

Grandparents are a rising source of funding for students and families looking for help paying for college. According to Sallie Mae’s How America Pays For College 2014, 17% of families relied on relatives to help pay for college. This number is expected to rise as grandparents create estate plans that look to benefit their families.

However, it’s important that grandparents are smart about the way in which they help their grandchildren. Helping with college could be a blessing for a lot of families, but it could quickly turn into a curse if grandparents don’t follow the right steps.

Here’s how grandparents can help pay for college the smart way.

Understand The Gift Tax Rules

The first thing that grandparents need to understand is how gifts are treated by the IRS. This can impact both the grandparent and the student.

The 2014 gift tax exclusion is currently $14,000. This means that each grandparent cannot gift more than $14,000 to a single individual. If grandma and grandpa both want to give $14,000, the couple could gift $28,000 to one grandchild.

However, there is a special exemption to the gift tax for the purpose of contributing to a 529 plan. Five years of the gift tax exemption may be contributed at once if paid directly into a 529 plan. That means that each grandparent could contribute a one-time gift of $70,000.

Realize The Financial Aid Implications

Understanding what a grandparent can contribute is only half the equation. The second half is understanding how the gift could impact future financial aid awards. Financial aid is calculated on a formula called Expected Family Contribution (EFC), which takes into consideration both the student’s and parent’s assets. If gifts are given by grandparents incorrectly, it could reduce potential financial aid and make college a lot more expensive.

For example, some grandparents may want to directly pay the college for the student’s education expenses. This could make sense for a grandparent, because if the grandparent pays the money directly to the school (and it never goes to the grandchild first), the gift tax will not apply. However, this could hurt the student’s future financial aid because the Financial Aid Office reports that income as “Other Income”, which may disqualify the student from future aid.

Similarly, if the grandparent gifts the money directly to the student, even over time, those assets will count on the student’s FAFSA and it could lower the amount of aid the grandchild qualifies for.  The EFC calculation takes into consideration 20-25% of the student’s savings, which could significantly lower the aid amount of the grandparents have provided the student with large gifts over time.

Setting Up A 529 Plan Is Typically Best

That’s why setting up a 529 account is typically the best route to take for grandparents who want to help their grandchildren pay for college. According to Stuart L. Ritter CFP, Vice President at T. Rowe Price, “the most effective account to use for college savings is a 529 account.  It’s important to emphasize with grandparents because 529s did not exist when they were saving for their children’s education. Likewise, it is also helpful to point out that the rules for UGMA (Uniform Gift to Minors Act) accounts, which were used extensively a generation ago, have changed dramatically.  The tax benefits those accounts used to receive have been all but eliminated.”

For those grandparents that still want to maintain control of the accounts, they can setup a 529 Account with the grandchild as the beneficiary but where they are still the account owner. This helps the grandparent because it allows them to transfer assets out of their estate for estate planning purposes. However, it’s important that grandparents transfer the account into the parent’s name prior to the student applying for college.

If the grandparent owns the 529 account, this account is treated as a student asset and is assessed accordingly. Furthermore, for the FAFSA, the income from the 529 account is assessed as student income at 50%. That seriously reduces the aid formula. However, if the grandparent simply transfer this 529 account into the parent’s name before the student applies for aid, all of these problems are avoided. The account is now considered a parent asset, and will be assessed at the parental rate of roughly 5%.

Before you consider the grandparent-ownership strategy, realize that a dozen states prohibit the transfer of a 529 account unless the account owner dies or there is a court order, including New York State. In this situation, it may make sense for the parent to simply retain control of the account and the grandparent simply gift the money into it.

We cannot thank our grandparents enough for what they sacrifice for us. We can, however, try to repay the favor in any way possible. As our grandparents age, they need someone to take care of them and always be there for them. In many cases it is not possible to do it yourself because of work, school or other reasons. You can still help them get the care they need and keep them in their own homes at the same time. Home care agencies are the perfect choice in getting your loved ones the care they need at an affordable price.

Kinnser ADL is the best home care management software in order to help home care agencies run their business in the most professional and effective way possible. If the agency you chose is not using Kinnser ADL, then inform them about Kinnser ADL. They can see for themselves how it will save them money and help them run more efficiently. In the end, by them going with Kinnser ADL, you will ultimately be rewarded with better care.

Contact Kinnser ADL today to schedule a free demo of the home care management software!

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The recent merger of Kinnser Software and ADLware has been an exciting time for all of us, both providers and customers.  One of our biggest goals is to not only maintain the excellent relationship we have with clients, but also to continually improve the end user customer experience dramatically as we improve our product virtually every day.  

With this goal in mind, we have re-doubled our efforts to document customer interaction to better service your needs.  As we document each individual call and email to our support team, we can more readily be brought up to speed if ever a new agent responds to your questions or concerns when you call back in.  We can historically view your previous requests and or challenges, and work to better assist you going forward.  This necessitates a lot more interaction via our Support tab (which can be found as a hyperlink in your main ADL account by the “log out” and “help” hyperlinks at the top header of your main log-in page within Kinnser ADL).  As always, the more information you can provide us with, the better we can assist you in troubleshooting your challenge or problem.  

To learn more about how our Support Team is an integral part of the success of Kinnser ADL, contact us today to view a demo of our system and how it can improve your office functionality and productivity virtually overnight.


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Deb Walters is trying to change lives one paddle at a time. She is kayaking from Maine to Guatemala over the next year. Why is she doing this? The article below, published by the Asbury Park Press, explains the reason for her trip:

What could inspire a 63-year-old grandmother to paddle a kayak 2,500 miles, on a yearlong trip from Maine to Guatemala?

For Deb Walters, the motivation for the journey came from her experiences with some of the world's most impoverished people: the thousands of residents of a gritty neighborhood perched at the edge of a festering garbage dump in the heart of Guatemala City, Guatemala.

Nearly 10,000 people, including about 1,000 children, live alongside the dump, where they scavenge and recycle trash for a living, and sleep in crude huts made of scavenged metal, bits of cloth and plastic tarps. They are called "guajeros," or recyclers.

There are no sanitation facilities, and water flows in the neighborhood only a couple of hours per day. Gangs thrive there, and there are frequent accidents, as people clamber on top of mounds of unstable garbage, which sometimes collapse. The 40-acre dump, the largest in Central America, contains not only recyclable goods, but toxic chemicals and medical waste. There are no regulations that prevent people from discarding dangerous waste there.

Their plight — and the resilience they show in spite of incredible hardship — is the reason Walters, a retired cognitive scientist and former university professor from Troy, Maine, began her kayaking odyssey in mid-July, leaving from Yarmouth, Maine. This week, she stopped for several days at the Jersey Shore.

"These people, you would expect them to be downtrodden, but they are smiling, they are happy, they are thankful for every little thing," Walters said of the guajeros.

Walters, who paddled from Oceanport to Seaside Heights on Sept. 30, is raising money for Safe Passage (Camino Seguro in Spanish), a Maine-based charity that provides educational opportunities for about 600 children who live next to the garbage dump in Guatemala City, as well as social services for 100 mothers who also live in the impoverished and violence-prone neighborhood.

Before Safe Passage, children who lived at the garbage dump did not attend school, and instead worked alongside adult family members, retrieving recyclable items from the dump, then cleaning and sorting them for resale. In spite of the appalling conditions, more people are continuing to move to the garbage dump neighborhood because of the scarcity of available land and economic opportunity in the surrounding countryside, Walters said.

The charity was founded by Maine native Hanley Denning, a teacher who went to Guatemala to learn Spanish but was appalled by the plight of the guajeros. She sold her car and computer to raise money and opened a school that initially enrolled 46 of the poorest children. Denning was killed in a car accident in Guatemala in 2007, but in spite of the tragedy, Safe Passage has continued to grow, expanding its programs from education for children to support services for their mothers.

Walters, an active Rotary Club member, first visited the garbage dump neighborhood nine years ago with fellow Rotarians. Amazed by the resilience and spirit of the people there, she began visiting regularly, and eventually served as president of Safe Passage's board.

But she wanted to do more.

"I have a passion for the kids in the dump, and I have a passion for long-distance kayaking," said Walters, who has been leading kayaking adventures for years, and once paddled a kayak solo from through the Northwest Passage in the Arctic Sea to Hudson Bay.

She hopes to raise $150,000, which will help expand an early childhood education program at a school Safe Passage has built. That much money will allow the school to add third and fourth-grade classes.

Her yellow kayak is packed with supplies, including a week's worth of food, navigational charts, a compass and a radio to contact the Coast Guard and boaters. It's also outfitted with video cameras to record her journey.

She paddles an average of 15 miles a day and stops every night to sleep. While she has a tent and camping equipment on board, Walters so far has been able to stay with host families along the way, many of them fellow Rotary Club members. At each stop, she speaks to Rotary Clubs and other groups, explaining the reason for her journey and telling people the story of the guajeros.

For three nights last week, she stayed at the Lavallette home of Pam Maguire, a member of the Seaside Rotary Club. Her kayak was stored at Hobby Lobby Marine in Toms River, owned by Seaside Rotary President Bob Tweer.

"They took me to the Crab's Claw," Walters said, recounting an evening spent eating seafood with fellow Rotary members at the iconic Lavallette restaurant. Her husband, Chris Percival, came to visit her briefly in New Jersey before heading back home to Maine.

On Friday morning, she left Hobby Lobby about 10 a.m. to continue her journey south.

Walters expects to arrive in Key West in April, and from there she will take a sailboat to Belize, since armed attacks on small craft are possible in the waters off Mexico. After that, she will kayak across a barrier reef to arrive in Rio Dulce, Guatemala, before the start of the May rainy season.

So far, she has avoided hurricanes and severe storms, but has had a couple of frightening moments, including when the kayak briefly turned sideways when she got too close to shore in rough surf in Long Island Sound, and when she inadvertently paddled too close to the Leonardo pier of Naval Weapons Station Earle, which juts out 2.9 miles into Sandy Hook Bay.

"I missed one security beacon and all of a sudden I saw a gray boat with all these guys dressed all in black with guns," Walters said. They let her paddle on, after receiving a warning.

Through it all, she's been touched by the kindness of the Rotary Club members she's stayed with, who have opened their homes and fed her so much food that "I think I'm actually gaining weight on this trip," she said.

Her inspiration remains the families who live and work in the garbage dump, including one woman who said: "If you believe you can do it, then you can do it," Walters said. "She lives at the garbage dump. That's my inspiration."

It would be great if everyone showed the love for others that Deb Walters shows to those children in Guatemala. Home care agencies try to show that same level of love to all the aging population that they take care of on a daily basis. Running a home care agency is much easier and smoother when using Kinnser ADL as their home care management software.

Kinnser ADL will help manage all different aspects of running an agency from scheduling to billing. Contact Kinnser ADL today to set up your own free demo of the software.

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Growing older does not mean we have to lose our personal interest. Bob Jorgenson was a fighter pilot in WWII, and he absolutely loves flying high in the sky. With the love and support from his grandson, he was able to experience that thrill again. The article below describes this sacred experience for the both of them. The aticle was written by Boyde Huppert and can be found on

ST. LOUIS PARK, Minn. - Rockefellers inherit fortunes from their Grandparents. Nick Atkins is heir to his grandfather's stories.

As far back as Nick can remember he's been hearing about his Grandpa Bob Jorgenson's 35 missions as a WWII fighter pilot.

"We hit Berlin with about 1500 bombers that day," Bob tells Nick as his grandson listens intently to an oft repeated story.

The conversation continues as Bob tells of an engine failure at 12,000 feet - and a rescue from Belgium. "Somehow they passed the word that if we're going to win that war, I had to get back to England," he tells his grandson as the two share a laugh together.

Their attention turns to the military medals that hang in a display case in Bob's apartment.

One medal is missing, but for the faded outline of the wings Bob was awarded when he began his flying service in WWII.

The wings are no longer in the display case because last month Bob pinned them on his grandson. It was Nick's graduation day from flight school at Laughlin Air Force Base in Texas.

On his first trip back to the Twin Cities since graduation, Second Lt. Nick Atkins stopped with his grandpa at the Minnesota Air National Guard Museum, which has in its collection a vintage fighter plane just like the one Bob flew on his European missions.

"I had six hours in the cockpit in England when I went on my first mission," Bob tells Nick as the newly graduated Air Force pilot climbs into the cockpit of the P-51.

"P" could just as well stand for proud.

"He got real good grades in college," Bob tells a reporter watching the exchange. "He would have had a lucrative career in civilian life and he chose to sign up for ten years with the Air Force.

Nick, who grew up in Edina, says his career choice is no coincidence. "I'm very proud of my grandpa; he's the reason I'm here today."

In fact, Nick is the descendent of two WWII pilots. His other grandpa, the late William Atkins, was an instructor pilot during the war, who later embarked on a long career with Northwest Airlines.

Before returning to his base, Nick planned one more stop: the Anoka County-Blaine Airport.

"It's not every day you get to take your 92-year-old grandpa up flying," smiled Nick as grandson and grandpa climbed into the small rented plane.

As the engine fires up, Bob launches into song. "Off we go, into the wild blue yonder."

The plane accelerates and lifts off. Sixty-five years since Bob Jorgenson last sat in a cockpit, life has come full circle.

Nick keys the plane's intercom. "Having fun grandpa?" he asks.

Bob cannot contain his glee. "Like old times," he laughs.

Independence is a part of ourselves. If we are put into a nursing home, we lose that independence. Home care agencies help the aging population stay independent and continue to be happy.

Kinnser ADL is the top rated home care software in helping home care agencies manage their caregivers, clients, finances, etc. Contact Kinnser ADL today to receive a free demo of our home care software!

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A Republican Senatorial candidate from Virginia Beach, Virginia is supporting an idea to help repeal the cuts that have been imposed to the home health care industry. Ed Gillespie is making repealing the Affordable Care Act, passed in 2010 and more commonly referred to as Obamacare, a major focus of his campaign.

Tied in with his focus on repealing this legislation is his effort to help retain the funding that the home health care industry, especially personal caregivers and agencies, require in order to continue to provide the best care to elderly and disabled individuals across the country.

In order to help fund the Affordable Care Act, the federal government, under the direction of the Obama Administration, sought to find ways to cut current expenses. One of those cuts was 14 percent across the board to Medicare and Medicaid reimbursement, which is one of the driving funding properties of the home health care industry.

The cuts began to be implemented in increments starting at the beginning of this year and will be completely rolled out by January 2017. For in home care agencies that provide essential services to elderly and disabled patients, those cuts stand to be devastating to many of them. Some independent estimates claim that nearly 40 percent of all home health care agencies in the country could be forced to shutter their doors and stop providing services as a result. “Among broad changes brought about by the Affordable Care Act, Medicare has reduced its payments to agencies or individuals providing home health care services, arguing that they can still make a profit at lower rates. Beginning this year, payments for home health care services are being cut 3.5 percent annually through 2017, with the money being used for other health care services (Hampton Roads).”

During an atmosphere across the country in which people are fighting for better wages and working conditions, these cuts could hamper the home health care industry. As the Affordable Care Act continues to be rolled out, it is expected that the demand for home health care workers will be high.

“This is among the many reasons why we need to replace the Affordable Care Act with policies that work,” Gillespie told about 50 home health advocates in a Crowne Plaza hotel meeting room. “We need to make sure that people can keep their home health care (Hampton Roads).”

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Ai-jen Poo jumped into a taxi after her flight from Chicago touched down at La Guardia Airport last week, hurtling straight into Manhattan for four days of back-to-back meetings devoted to improving the lives of domestic workers.

Soon, she was hammering out strategies to help expand access to health care for undocumented immigrants. She was planning a state-by-state legislative push to provide tax credits to people who pay living wages to home health care aides. She was discussing potential pathways to legal status for millions of foreign-born nannies, babysitters and housekeepers.

All the while, Ms. Poo managed to keep her secret. No one knew. Not her staff, not her donors and not her partners at other nonprofit organizations.

“I felt like a pipe that was going to burst,” recalled Ms. Poo, the director of the National Domestic Workers Alliance, the advocacy group based in New York that represents 43 affiliates in 26 cities across the country.

Within minutes, the calls, texts, emails and tweets started pouring in. “It was wonderful and overwhelming,” said Ms. Poo, 40, who got her start as a volunteer working with immigrant women on the Lower East Side of Manhattan.Just after midnight on Wednesday, the news finally broke: Ms. Poo had won a 2014 MacArthur “genius” grant. The fellowships, presented by the John D. and Catherine T. MacArthur Foundation, come with a stipend of $625,000 and are among the nation’s most prestigious prizes for artists, scholars and professionals.

She learned about the honor this month. “At first, I thought it was the dry cleaner,” she said of the call from the MacArthur Foundation. “Then I thought that perhaps they were calling me for a reference for someone else.”

But, no: The foundation wanted to shine a national spotlight on Ms. Poo, who has dedicated her life to organizing domestic workers, marshaling their energy into a movement that has improved working conditions and created new labor standards for women who have long worked without the job protections that most of us take for granted.

In 2010, Ms. Poo’s campaign resulted in the passage of the nation’s firstDomestic Workers’ Bill of Rights, a state law that entitles domestic workers in New York to overtime pay, one day off per week and three days of paid leave per year, among other benefits. Since then, her organization has helped to pave the way for similar laws in California, Hawaii andMassachusetts.

She also mobilized thousands of domestic workers to lobby the federal Department of Labor last year to include caregivers for older adults and disabled people in federal minimum wage and overtime protections.

It is the kind of success that was unimaginable when Ms. Poo, the soft-spoken daughter of Taiwanese immigrants, started reaching out to nannies on New York City’s playgrounds 16 years ago, trying to organize women who were scattered, isolated and often fearful of stepping forward.

“She’s a pioneer,” said Ruth Milkman, a sociologist and labor expert at the City University of New York Graduate Center, adding that Ms. Poo differs considerably from the more conventional break-the-barricades type of labor leader. “She’s very measured, calm, intellectual. She just sort of tells the story that leads people to action.”

It was not the kind life that Ms. Poo had envisioned. As a young woman, she dreamed of becoming a potter and then settled on women’s studies at Columbia University. Her parents arrived in the United States as graduate students — her father is a molecular neurobiologist, her mother an oncologist — and there were no nannies, no housekeepers in her household.

It was her volunteer work in college with an Asian community organization in Manhattan that first put her in touch with the workers she would champion when she created Domestic Workers United in 2000, which is now an affiliate of her umbrella group.

She was moved by the women’s accounts of being underpaid and exploited, and by the pride they took in their work.

“I didn’t think much then about what kind of organization it was going to be,” said Ms. Poo, who plans to use her MacArthur grant to endow a fellowship for domestic workers to do organizing and policy work. “I just knew we needed one. There was such a hunger for it.”

These days, Ms. Poo is also focusing on building alliances between home health aides and the patients they care for, working to ensure that a better paid, better trained work force is in place to support aging Americans. She is adjusting to new rhythms in her own life, as well.

In June, Ms. Poo moved to Chicago, where she lives with her boyfriend. For the first time in decades, she has a house, not an apartment, to care for. So, is she considering hiring any household help?

She hesitated before answering.

“I often think it would be great to have some support,” said Ms. Poo, who commutes to her Manhattan office several times a month. “But I haven’t crossed that bridge yet.”

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We should all thanks our grandmothers every once in a while, even if it costs us something. For Alessandro Florenzi, it cost him money and a penalty in his professional soccer game. The Article below was shared on Newsday and written by Jenny Earl.

Alessandro Florenzi takes risks both on the field and off. The Roma midfielder shocked soccer fans Sunday when he hopped a fence and ran into the stands to celebrate a goal with his 82-year-old grandmother. The team shared a picture of the heartwarming moment during the game against Cagliari shortly after.

"@AleFlorenzi gives his grandmother Aurora a hug after making it 2-0 #RomaCagliari," the team tweeted along with the picture, which was then retweeted more than 1,000 times.

The 23-year-old headed for the bleachers immediately after scoring his first goal of the season to fulfill a promise he made to his grandma.

"She told me: 'I'm only coming to see you but only if you come over and say: 'Hi,'" Florenzi told freelance sports reporter James Horncastle.

His grandma was seen on camera wiping away tears as he headed back to the field.

"Florenzi scored and he celebrated by running into the crowd and giving his Nonna a hug - he's a good kid!" one fan tweeted.

"The video of Alessandro Florenzi running to hug his grandmother after his goal is the cutest soccer celebration ever," another tweeted.

No matter how "cute" the celebration was, it didn't prevent referees from giving him a yellow card.

Florenzi will pay a fine, but he's happy to do so, the team stated on Twitter.

"Ale's hug with his grandmother was a lovely moment," the team said.

At least this story has a happy ending: Roma ended up beating Cagliari 2-0.

One of the greatest ways to say thank you to our grandparents is to make sure they are taken care of as they age. Home care agencies do just that and provide necessary care for senior citizens around the world. Kinnser ADL is the leading and fastest growing home care management software to help these home care agencies. Agencies are able to provide the best care to their clients when they use Kinnser ADL because it takes the stress away from managing the company and lets them focus on the care.

Contact Kinnser ADL today to view a free online demo of our software and see how it can help your company or the company that provides the care for you!

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This week, Apple announced its long-rumored entry into the wearable device market with the launch of Apple Watch. And while the device wasn’t created specifically for healthcare use, it could have serious application in the home care space.

The market for healthcare technology is rife with devices that record and monitor physical activity, vital signs, among other health-related metrics. And now it appears that Apple is joining the club, albeit on the outskirts, with the creation of Watch.

The device incorporates several technologies and functions that play into the healthcare arena.

For one, Watch has a digital touch feature that provides a new way to connect intimately with others, whether it’s getting another watch-user’s attention with a simple tap on the device or even sharing something as personal as a heartbeat, said Jony Ive, Apple’s senior vice president of design.

“These are subtle ways to communicate that technology often inhibits rather than enables,” he said during a video detailing the Watch’s complete features.

At the heart of the watch is a chip that integrates many subsystems the technology encompasses into one compact module, which essentially minimizes an entire computer system onto a single chip, Ive added.

Adding to this technology, the Watch’s zirconia back contains four lenses crafted from crytsal sapphire that, along with infrared invisible light LEDs and photo sensors, are able to detect the wearer’s pulse rate.

Designed particularly with fitness and exercise in mind, these components work in tandem with a built-in gyroscope and accelerometer that help provide a comprehensive picture of an individual’s phsycial activity using GPS location services and Wi-Fi from an iPhone.

The device also makes calling family and friends easy. Watch senses when its wearer is raising his or her wrist, upon which it activates the display screen. Users can then push a button located on the side of the device that instantly brings up the individual’s contacts, enabling them to connect with them, either via text or standard call, in seconds, Ive said.

Though the device has yet to be put into the circumstantial application, for example, in the event of an emergency such as a fall, contacting help in a matter of seconds, in theory, is the premise of all personal emergency response systems out there today.

Another aspect where Apple taps into the essence of senior care lies in the Watch’s robust customization.

The company has designed a variety of watch “faces,” or displays, and bands to choose from that are easily interchangeable. Users can choose from a range of styles, including a classic leather buckle design, a stainless steel link bracelet, a loop that comes in a soft, quilted leather, or for the sporty types, a chemical- and sweat-resistant sport band made from a durable high-performance elsatic material.

“We know that wearing something all day and everyday becomes as much about personal preference and self-expression as functionality,” Ive said.

Though it isn’t targeting seniors specifically, the need to personalize and self-express is an inherent human desire, and one that Apple plans to capitalize upon.

“Creating beautiful objects that are as simple and pure as they are functional, well that’s always been our goal at Apple,” said Ive. “I think we’re now at a compelling beginning of actually designing technology to be worn, to be truly personal.”


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It’s another Fun Fact Friday! Did you know that on this very day in 490 BC, the Battle of Marathon took place? This 26 mile and 385 yard race actually gets its name from a battle that occurred long ago between the Athenians and the Persians, which was a great turning point in the Greco-Persian wars. One myth states that Pheidippides, a soldier in the war, ran from Marathon to Athens to announce the victory over the Persians. He covered the distance of what we now call a marathon, and died of exhaustion shortly after sharing the good news. 

Despite Pheidippides’ fateful end, Amy McCall, wife to Kinnser ADL Product Owner Steve McCall, survived the Big Cotton Wood Marathon in September, 2012. She won the entire race for women with a time of 3:08—no doubt faster than the time it took Pheidippides to make his victorious journey.

At Kinnser ADL we believe in the importance of staying active and healthy and know that it starts with us. We hope to motivate you to promote a healthy lifestyle as well and encourage our seniors to do the same!

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The transitions coach ducks into your mother’s hospital room for a brief introduction before she’s discharged. The coach explains that her job is to help keep patients safe at home and asks if she can call to set up a home visit.

Health researchers know that transitions — the hand-offs from one setting to another, as in hospital to home — often go awry.

“It’s so abrupt,” said Dr. Eric Coleman, a geriatrician at the University of Colorado, Denver (and a certified McArthur Foundation genius). “For three days people do everything for you, and then, 11 minutes before you leave, they turn the tables. ‘Nowyou take over.’ ”

Your parent is often sleep deprived and medicated at the time; little wonder that nationally, about one Medicare patient in five returns to the hospital within a month. (Judith Graham wrote about re-hospitalizations last year.)

To lower that figure, Dr. Coleman began developing the Care Transitions Intervention Program 15 years ago. If patients agree, a coach comes to their homes two to four days after discharge. She’s not there to change dressings or help them bathe; home health nurses or aides do that. Instead, over 45 minutes to an hour, the coach — generally a nurse, sometimes a social worker or other health care professional — asks about patients’ goals as they recover.

She will discuss the medications your mother takes and symptoms that might indicate a problem requiring medical attention. She’ll help your father strategize about whom to call if he needs help and rehearses what he’ll say. She phones twice over the next few weeks to see if your parent has gotten his questions answered and needs met.

Dr. Coleman’s brainchild has spread to over 900 hospitals, care organizations, Medicare Advantage plans and area agencies on aging around the country. The pace of adoption has picked up sharply since Medicare started imposing financial penalties on hospitals with high readmission rates in 2012.

The Care Transitions Intervention sounds so simple and commonsensical that it’s hard to believe it has major impact. But the evidence, starting with Dr. Coleman’s own pilot program and then a larger randomized trial in Colorado, shows that this coaching approach has reduced readmissions by 20 percent to 40 percent, depending on hospital location. Its costs are modest — $300 to $450 per patient to train and pay coaches — but the cost savings can be substantial and long lasting.

In a study published in the Archives of Internal Medicine in 2011, researchers at Brown University and Healthcentric Advisors of Rhode Island demonstrated that the Care Transitions program reduced 30-day admissions to less than 13 percent from 20 percent among Medicare beneficiaries.

In the latest study, published in the Journal of General Internal Medicine, these researchers looked not only at readmissions to six hospitals, but at all health care costs except drugs among Medicare patients hospitalized between 2009 and 2011 who were discharged home (not to a nursing facility).

The researchers compared 321 patients who received coaching with two control groups: 919 who were eligible to participate but declined or didn’t cooperate in arranging a home visit, and an external group of more than 11,000 patients in the same hospitals who weren’t approached for coaching. In all three groups, the patients’ average age was in the mid-70s, and the researchers matched them by health status, sex, race and poverty indicators.

Over six months, the coached patients had fewer emergency room visits, observation stays, doctors’ visits and nursing home stays — but those differences weren’t statistically significant. What drove cost savings, said Stefan Gravenstein, senior author of the study, was significantly reduced hospital readmissions.

Coached patients had a 30 percent lower readmission rate. “We believe that when something came up, they got help before they got so sick they needed to be hospitalized,” said Dr. Gravenstein, a geriatrician now at University Hospitals Case Medical Center in Ohio.

After allowing for the costs of coaching, Medicare spent an average of $3,752 over six months for coached patients, compared with the internal control group, and $6,221 less compared with the external control group (which may have included more dementia patients, among other factors).

“Patients are often passive recipients of health care, especially in a hospital,” Dr. Gravenstein said. Transitions coaches work to give them more confidence about navigating an often bewildering system.

“When they discover that the things that worry them also have an urgency, it removes the hurdle,” he added. “It gives them permission to ‘bother the doctor.’ ” And that apparently pays off in more ways than one.

Let’s not forget the other kinds of costs, after all. Hospitals, their starched white reputations notwithstanding, aren’t safe or friendly places for vulnerable older people. You don’t want to be there, or bounce back there, if you can avoid it. It looks as if transitions coaches can help you stay away.

Kinnser ADL can help you make sure that your clients are receiving the attention they need by keeping track of hospitalization dates and notes.


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Steve Jobs, the brilliant co-founder of Apple Inc. once said, “Everything is important. Success is in the details.” He was talking about the computer business, but he might as well have been talking about home health and home care agencies. 

Think about it… Are your back office processes optimized so that patients, families, and referral sources will have a smooth admission experience? Have you maximized every opportunity for efficiency to ensure that clinical and office staff can complete their roles in a timely, competent matter? It's complex... and every detail matters.

Kinnser-ADL is offering a free lunchtime CEU seminar with home healthcare executive and consultant Jill Dyer, BSN, RN, HCS-D, HCS-O will reveal how to organize an efficient and compliant back office so your agency can work smarter.

In the seminar, you will learn:

  • Processes that will support patients, families, and referral sources during admission and referral
  • Key management areas and their role in success
  • Strategies to assess, plan, and implement a successful back office

Approved for 3 Nursing Continuing Education Units by the Texas Nurse Association, an ANCC accredited approver.

Seats fill quickly, so register now by clicking here.

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Today, I thought I would spice things up a bit and list a few quotes that celebrities and other famous people said about their grandparents. You can find these quotes and others at

“I phoned my grandparents and my grandfather said 'We saw your movie.' 'Which one?' I said. He shouted 'Betty, what was the name of that movie I didn't like?” –Brad Pitt

“I'm very proud of my gold pocket watch. My grandfather, on his deathbed, sold me this watch.” –Woody Allen

“When people say 'Charlie Chaplin' I still think now of the guy in the moustache and bowler hat and funny walk - I don't think of an old man who was my grandfather.” - Oona Chaplin

“I've been called a moron since I was about four. My father called me a moron. My grandfather said I was a moron. And a lot of times when I'm driving, I hear I'm a moron. I like being a moron.” – Adam Sandler

“You have to do your own growing no matter how tall your grandfather was.” - Abraham Lincoln


 Can you imagine a life without our grandparents? I know the people that said the quotes above would not be able to imagine life without their grandparents. Grandparents can have such a deep impact on our lives and teach us amazing things. It is important for us to look after and take care of our grandparents as they age.

Home care agencies provide the necessary tools to look after your grandparents in times when it is impossible for you to do the care yourself. Kinnser ADL has developed and been providing home care agencies with the best home care management software in order to ensure that families are getting the best and most professional care around.

Contact Kinnser ADL today to see how Kinnser Software can provide the best home care software for any home care agency in the US, Canada and Australia!

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1. Be clear and concise.
Overwriting and using technical jargon will lead to confusion and misunderstanding.

2. Set the tone at the top.
CEOs and senior leaders need to set the tone. They need to be visible and accessible, and they need to understand that there's a correlation between strategic employee communication and the achievement of organizational goals.

3. Understand your employees.
You may need to communicate differently with different audiences. For custodians who don't use computers at work, email is ineffective. To determine your employees' needs and perceptions, consider surveying them regularly: Are they getting the information they need?

4. Use many channels.
Most people need to hear or see a message multiple times, in multiple ways, to understand it completely. Distribute your messages electronically, in writing, face to face, and at forums and meetings. Your message should be consistent across all these channels.

5. Provide context.
Employees need to hear information at multiple levels. Provide context (what external factors are at play?); explain strategy (why did we decide to respond this way?); and make it personal (how will this affect me?).

6. Be timely: Notify employees first!
When you prioritize your communications, always think of your internal people first. Your employees should hear it from you before they hear it from anyone else; they shouldn't be surprised by a media report.

7. Be forthcoming, and be continuous.
Always communicate, and communicate both good and bad news. If you are honest and candid in sharing bad news, your good news is more credible.

8. Match actions with words.
If you say you will address a situation in a certain way, do it. If you don't, you're undermining your credibility.

9. Emphasize face-to-face communications.
Although today's employees may be more tech-savvy than ever, nothing beats human interaction. Most employees want to hear news and information from their supervisors. Managers need to be trained in how to communicate, and they need to have the right tools at hand. If you are expecting your managers to help explain a complicated change to the organization's pension plan, you'd better provide them with talking points and handouts.

10. Create an organizational habit for communications.
You know you need to communicate about policies; health and safety; benefits; and how a job should be carried out. But remember that you also need to share information about your organization—what our your objectives? How are you performing? What are your plans and prospects? How can employees help?

11. Plan.
Be systematic and strategic. Have an editorial calendar that spells out what you'll say, and when, where, and how you'll say it. Develop a checklist of what needs to be communicated.

12. Measure effectiveness.
Set objectives, and be prepared to assess whether you have met them, as well as whether they are employee engagement goals or perception goals. You might want to regularly assess engagement levels and ask employees whether the organization has communicated its strategy well. Do they understand how their daily work helps the organization meet its goals?

13. Facilitate conversation.
One-way communication is a thing of the past. Individuals are empowered to talk back, and feeling "listened to" enhances feelings of trust. There are many ways to facilitate two-way communication, including face-to-face meetings; "town hall" meetings; interactive video interviews; Twitter questions; employee surveys; Q&A features on the employee intranet; and anonymous suggestions via email or suggestion boxes.

14. Be objective.
Don't "spin," or try to dictate or assume how people should feel about the news you're sharing.

15. Say "thank you" as much as possible.
If an employee feels appreciated, she's more likely to feel engaged.

Don't take shortcuts, or make a half-hearted effort. If you do, you're likely to fall short of your goals or be met with a crisis down the road. As George Bernard Shaw said, "The single biggest problem in communication is the illusion that it has taken place."

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The Centers for Medicare & Medicaid Services (CMS) has updated its Medicare hospice manual, which includes instructions for diagnosis reporting, filling hospice notice of election (NOE) and termination or revocation of election.

The updates go into effect Oct. 1.

The new editing instructions for hospice primary diagnoses and newly required timeframes for submitting information to Home Health & Hospice Medicare Administrative Contractors (MACs)  might impact providers’ reimbursement, a Medicare Learning Network (MLN) memo states.

“The principal diagnosis reported on the claim should be the diagnosis most contributory to the terminal prognosis,” the MLN says. “The coding guidelines state that when the provider has established, or confirmed, a related definitive diagnosis, codes listed under the classification of Symptoms, Signs, and Ill-defined Conditions are not to be used as principal diagnoses.”

Additionally, there are several dementia diagnosis codes that cannot be used as the principal diagnosis.

Hospice NOEs must be filed within five calendar days after the effective date of hospice election, otherwise Medicare will not cover and pay for the days of hospice care from the effective date of election to the date of NOE filing. However, the update does provide for exceptions to this rule, including natural disasters.

The updated manual also provides a clarification of the differences between Healthcare Common Procedure Coding System (HCPCS) site of service codes Q5003 and Q5004.

Official instructions:

Original memo:


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