#Home Nursing in Frankfort

[helpinghandshomecare]

Helping Hands Home Nursing Agency is owned & operated by a Registered Nurse with over 16 years of nursing experience that includes: In-patient; Cardiac/Telemetry, ICU/Critical Care & leadership roles in the hospital. Outpatient experience includes; Home Health Care, Group Home Medication Administration Visits and Urgent Care.

[neonthoughtsforever]

I had a feeling I wouldn’t be able to go to Frankfort fest today but it still sucks seeing that I’m still positive. It sucks I’m sick and off work and it sucks I can’t taste anything. Like why can’t I have covid when I have work as a staff nurse so I can at least be making money while I’m miserable at home? I hope my dad and Tyler have fun, but I wish I could have gone with

[skgway]

1832 Nov., Tues. 6

8 50/..

12 1/2

Fine morning – Fahrenheit 49º at 9 20/.. a.m. – Called up to Wilson the joiner come about the library passage up and down stairs in 1/2 hour – Till 9 giving orders – Then breakfast with my father – Waited for Marian to order about flannel for waistcoats and drawers. Determined to have all ready to be off in January –

Had Washington – To have all the bills next week for wearing, mystal at Southolme etc. etc. – Just saw my aunt for a few minutes – Very kind 2 1/2 pages Letter from Miss McL– [MacLean] (Coll house aros) to say the bay on laurel leaved willows were sent off to Glasgow yesterday week with orders to be forwarded here immediately –

Off at 11 1/4 with Marian to call at the vicarage – There in 20 minutes and sat 1/2 hour with Mrs. Musgrave – Then went with Marian to Walker’s shop to order flannel etc. for things for me in readiness for being off – Hoped I really should be on route in January – Then parted with Marian –

Went to Whitley’s. Bought Hooper’s medical dictionary 25 /. [shillings] published at 28 /. [shillings] and in 50 minutes at Lidgate (at 1 1/2).  Miss W– [Walker] very glad to see me, I having said I should not go till tomorrow – Sat 1/2 hour with her and home at 2 1/2 –

Met Mr. Samuel Waterhouse junior (ætatis 17) at her gate – Stood talking a few minutes while Mr. and Mrs. Lockwood left Miss Walker – Mr. S[amuel] W[aterhouse] just came to her door to ask how she did – She said she should have me to nurse [her] now and really seemed much better and in good spirits. 

Talked of the agreeable surprise of seeing [me] but yet seemed more inclined to talk of business than love. I appeared in more than good spirits. She would think them all put on. And perhaps believe me feeling more acutely than I really did. I kissed her, but in a common way, and she did not push herself to me as yesterday and was more guarded.

She will not give me much reason now either to hope or despair. Her self possession will probably be undisturbed enough. I left her with no pleasant feeling, saying to myself, ‘Damn her. It is an arrow and perhaps a lucky escape.’ I dont think her answer will be yes.  And the more easily reconciled I am the better. Shall I dislike her by and by? At least I shall be more at liberty without her –

Fred Wilson, the joiner, and his man in the library passage at 2 1/2 – 26 or 27 inches lower than my blue room closet but determined not to be beaten with it, and went on – Dusty job to get the studding down –

Had only just managed and given orders what was to be done when James Holt came at 4 5/.. and had him till 6 – Something must be wrong that Mr. Jeremiah Rawson will not let go into their works – Probably they are stealing my coal already – Holt says I should not take less than £200 per acre but if he was in their place he would not give £250 per acre –  

Said I had at 1st asked the price between the 2 leases (£205 and £230) = £217.[pounds] 10. [shillings]. 0 [pence] but had said I should be worse to deal with now – Proposed asking £220 per acre but Holt owned the coal was worth as much now as when sold to Oates and Green and worth quite as much or more to Rawsons than to them (∴ [therefore] I ought to have £230 per acre) –

Owned too that I ought to have more for the coal at the top of the land, for it would make that at the bottom of less value. He thought they had a hundred yards plumbing dip i.e. could get with the water head a hundred yards breadth on this side and alongside the present waterhead driven by Oates and Company – Should shew Mr. J[eremiah] R– [Rawson] the coal plan – Ask him what fields he wanted and might let him Hugh grave field and the coal ungot to the north west of it and to the north east down in a straight line under the cunnery plantation down to the road but not to let him come lower down – 

Owned afterwards it would be as well not to let him come lower than the Cunnery houses, for if he got down to the brook he could throw such a quantity of water upon us – If he did not come lower down than Cunnery houses or the present Wakefield road, I might leave or fence of coal or turn the water, and not be so much injured –

Holt would meet J[eremiah] R– [Rawson] on the ground and see what he wanted – No air pit necessary for the lower bed coal, and not to sell any upper bed but by a separate agreement – Upper bed costs 6 d [pence] a score (corves) more getting than lower bed, and not being able to get it all, obliged to leave posts, makes it not work so much by £50 an acre as lower bed –

If J[eremiah] R– [Rawson] would not let Holt go into his works, I might propose either of the 2 brothers Squire or Tom Lassey of Thornhill, the former steward to Mr. Ingham of Misfield – In making the agreement to have surface measure, and the power to send down people into the works whenever I liked, and to have a clause to prevent J[eremiah] R– [Rawson] damming or turning any water back into the old works after he had got the coal (Had I not better have a bond of indemnity against this?) otherwise he might drown me in water and prevent my getting the coal below where he had been getting and had turned the water –

It was right enough that I should make no allowance for gauls or jumbles or ruttle – Great difference between drawing out at the day and pulling up thro’ a shaft – At their (Holt’s) pit on Swales moor 150 yards deep pulling costs them 18 pence a score; and ropes cost them £15 or £16 a year – One collier may be reckoned to get 25 corves a day for five days in a week – If J[eremiah] R– [Rawson] gets £100 profit per acre it will be quite enough –

Then see according to the following what to ask an acre for the coal –

Making all sufficient allowances there will come out of one square yard 5 corves, which (as J[eremiah] R– [Rawson] sells at 7 d [pence] and 8 d [pence] a corve, average at 7 1/2 d [pence] a corve –

Expense of getting 20 corves (or one score) 4 /. [shillings] to the colliers –

Banksman 1 /. [shilling] a score – wear and tear say 6 d [pence] a score, certainly enough –

Lower bed 18 inches thick – Lightcliffe bed 25 inches thick – Billy stocks paid £260 an acre 5 or 6 years ago for what he bought – This that Hinscliffe is taking must be worth as much – He will have very little to sink – 14 or 16 yards and coals worth less as nearer the surface – But not for being dry – But there is a gaul that throws up the coal near Lidgate (breaks out in the road going up the hill) and there cannot be any coal on this side that gaul near more than a daywork or 2 to get in that field next below the Smith (Hinscliffe’s) –

Speaking of Godley, wished Holt not to let it go for nothing but said I had mentioned it to Mr. Samuel Freeman – Holt said I could employ no one better – He said it was North £80 a daywork but £ a daywork was the outside – ∴ [therefore] the 20 dayworks = £2000 

Carr has been arrested several times lately – Speaking of the cottages on Godley land, Holt knows that the 4 belonging to his uncle George Holdsworth would be sold – Cost £50 each building and £40 the ground – But might be had he thinks for £ 200 – Will inquire and let me know –

Speaking of his farm, some people might buy it at 3 1/2 percent Rent £66 per anum but it would not suit him to buy land at that price – He explained the manner of working coal pits – Asked him to give me an underground plan of a pit in working and asked him to let me know when I could go down with him into one of his pits. I must understand coal-getting before I have done with it – Holts pit at Binns bottom will be ready for working in 2 months from this and I can go in at the day –

Dinner at 6 3/4 – In 1/2 hour wrote and sent at 7 35/.. 3 pages to “Dr. Belcombe York” or rather 2 pages and 3 or 4 lines to him and the rest to his wife, to be torn off and given to her, thanks for her letter and to say yes! I thought black velvet properly garni au blonde (white) would be very becoming to her –

Told him wished I could give a better account of his patient, but she was not worse on his hands, which was marvellous considering the affliction she had had on account of the sudden death of her most particular friend, the news of which had arrived the day after our leaving York – No pills last Thursday – Begged to have them next Thursday – Ask how long they are to be gone on with without interruption – She thought at 1st, but not afterwards, they gave her much physicky pain in her bowels – These last had behaved very well considering the affliction she had been in –

In fact, she believed she could not have been so well now, had she not had his advice – He is ‘in très bonne odeur’ and his patient has faith enough in him – Mr. Day has been and, I suppose, would not let her believe in her own existence without the use of his ointment but ‘ce nous est égal’ – Ask him to write a letter I can shew. Not to spare a little anxiety and to ask whatever questions he knows will be proper. ‘Indeed not say I have the good of your reputation at heart’ –

John’s son Joseph Booth came over with Scott’s head groom to bring 2 perfect horses to Mr. Thomas Dyson of Willow field – Had him (Joseph B– [Booth]) in and spoke to him – He is grown, and improved – Perhaps I shall take him with me abroad – Then writing journal of today – Had John in – He is much pleased and satisfied with his son – Talked to him about his family – To send Charlotte for my aunt, to hear her read and see her sewing so as to be able to judge what she can do and be fit for –

Then my father and Marian just gone to bed. A few minutes with my aunt – Then came back to the drawing room – Read my letter from Vere dated Turin 24 October 3 pages and ends of small sheet (Frankfort paper) – Very nice chit chat amusing letter –

And read my letter from Lady Stuart (Richmond park) enclosing Vere’s 2 last to her – A kind 1/2 sheet full and a few lines on the envelope (franked by Lord Goderich) from Lady S– [Stuart]. These letters put me in spirits. I am better without Miss W[alker] – 

11 1/2 before I had read my letters and written so far of today –

5 corves at 7 1/2 d pence = 37 1/2 d [pence] = 3 1 1/2 per square yard

One score or 20 corves = 12/6 [shillings/pence] expense of getting which = 4 /. [shillings] to the colliers. 

∴ [therefore] 12/6 - 5/6 = 7 /. [shillings] clear gain per score = 1 /. [shilling] to the banksman or per 4 square yards = ./6 [shilling/pence] wear and tear (quite enough) –

At the forgoing rate, 5 corves or 1 square yard = clear gain of 1/9 [pound/shillings], 1 score (20 corves) or 4 square yards = clear gain of 7 /. [shillings] ∴ [therefore]

1 acre or 4840 square yards = at 1/9 [pound/shillings] per square yard or 7 /. [shillings] p[e]r 4 square yards = £423. [pounds] 10. [shillings] 0 [pence]

Now Holt said this calculation would do, and that £100 clear gain per acre was enough ∴ [therefore] if I have £250 per acre J[eremiah] R– [Rawson] has a profit of 423. [pounds] 10. [shillings]. 0 [pence] – 250 = £173. [pounds] 10. [shillings] 0 [pence]

Very fine day – Went up to my room at 11 50/.. at which hour Fahrenheit 49º

[sideways in margin] Sunday 23 December 1832 vide page 231, suppose Messieurs R– [Rawson] to sell at 7 1/2 per corve or 12/6 per score and allow half for expenses, then 48040/4 or 1210 x 6 shillings x 3 d [pence] = £363 + 15. [pounds] 2. [shillings] 6 [pence] = £378. [pounds] 2. [shillings]. 6 [pence], so that paying me £230. [pounds] 10. [shillings] 0 [pence] per acre then remains to Messieurs a profit per acre of £147. [pounds] 12. [shillings] 6 [pence]

[denimbrace11-blog]

Can You Be Denied A Job Because Of Bad Credit Scores? Find Out

That permits them to quest deer, turkey and also other animals in the timbers while carrying a weapon. It's not simply Pennsylvania regulation that may influence your gun rights if you are convicted of a criminal offense. When you need to learn the truth concerning somebody from Kentucky, ASG Investigations can help. hazmat background check kentucky have a Kentucky background check that fits every level of requirement and that will offer you the ideal data to make informed, fact based decisions. AOCFastCheck is a new process that will substantially decrease the moment required to offer criminal record reports. Background Checks.org is operated as a civil service to individuals. We are not a customer coverage company as defined by the Fair Credit Scores Reporting Act, and also you may not use any type of info for any kind of "allowed purpose". Each company of the Kentucky government has particular rules for accessing public records. kentucky board of nursing background check restricts extremely few documents from coming to the general public. Many fees do not have a state-mandated time frame and also might appear forever without expungement. Driving Record-- Kentucky law allows anybody to demand three years of driving history without permission. You might request a rap sheet report personally by drive-thru home window at the Administrative Workplace of the Courts, 1001 Vandalay Drive, Frankfort. When your demand has actually been processed, aocfastcheck lets you order criminal document reports and get the results online.

Federal regulation additionally can prohibit you from purchasing, transferring, or possessing a weapon. Our criminal defense attorneys at Czekaj Dusharm LLC are here to explain all of the possibilities during a criminal instance. We will certainly review the prospective results with you as well as how a criminal sentence can influence your legal rights as well as privileges in the future, consisting of whether or not you can remain to possess a firearm. A video game warden will place a lawbreaker under arrest for searching with a firearm. However, that does not imply the person will shed his or her permit. Due to the fact that there's no background check, the person might apply as well as hunt again the list below year if he or she hasn't devoted any type of video game as well as wildlife offenses. In Maine, there is no check to validate people can possess a weapon when they look for a searching certificate, but they have to disclose whether they are a founded guilty offender. They might encounter charges of unsworn falsification as well as fraudulently acquiring a certificate if they lie. The area lawyer or district attorney's workplace must additionally be offered with notification of your demand. Their office will certainly evaluate the application, confirm if you are eligible for the requested relief and afterwards file any kind of objections or resistance that they may have. After the court has actually received the application and any objections, a hearing day might be arranged. At the hearing, the court will listen to disagreements by both sides as well as make a decision whether the instance will certainly be removed. If your denial was based on a "wobbler" conviction, such as getting taken building, you might be eligible to have this felony conviction reduced to a misdemeanor by means of getting a movement provided by the court. When taking into consideration candidates, employers in Kentucky are free to use all way of background check info. The AOC webpage can be located on the Kentucky Court of Justice internet site. 3 sorts of criminal background requests are offered; online (" Actions 2-- 5"), in-person (" Step 6"), as well as mail-service (" Step 6"). We get settlement from some of the companies that we assess or who are or else featured on this website. Just how far back documents are offered, as well as partnership demands rely on the sort of record being asked for. Ranked as the 26th most populated state, Kentucky has 4.4 million locals and does make provisions for sharing its public records. Marriage records are offered with the Kentucky Office of Essential Stats. You will require to supply the full names of both people, the date of the marital relationship, and the county where the marital relationship occurred. Scheduling documents are public info as well as can be discovered on the Kentucky Division of Corrections internet site. You will need to recognize which firms in Kentucky have records that you intend to discover.

[techcrunchappcom]

New Post has been published on https://techcrunchapp.com/the-latest-italy-orders-strict-new-anti-virus-measures-national-news/

The Latest: Italy orders strict new anti-virus measures | National News

ROME — Italian Premiere Giuseppe Conte has ordered strict new anti-coronavirus measures, including limits on private gatherings and a ban on casual pickup sports.

Conte negotiated with the country’s regions to win limits on private gatherings, over the objections of some governors. Parties in closed spaces are banned, but the measures, imposed Tuesday, are limited to “strong recommendations” against private gatherings in homes with more than six people who don’t live under the same roof.

Bars and restaurants must close by midnight, and drinks can only be consumed at tables — not while standing at the bar or outside — after 9 p.m. Also banned are any contact sports that are not organized by an association that can maintain distancing rules. That means no casual games of Italy’s beloved soccer in local parks.

After mandating the wearing of masks outdoors last week, the government sought the additional measures, with the number of new cases rising to around 5,000 a day in the past week.

———

HERE’S WHAT YOU NEED TO KNOW ABOUT THE VIRUS OUTBREAK:

— Second COVID-19 vaccine trial paused over unexplained illness

— Takeaways: Coronavirus at center of Supreme Court hearings

— Defiant Trump defends virus record at his first post-COVID rally

— As the pandemic presses on, waves of grief follow its path

———

— Follow AP’s pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

———

HERE’S WHAT ELSE IS HAPPENING:

JERUSALEM — Israel has now recorded more than 2,000 deaths from the coronavirus as the country remains under lockdown for a fourth week to quell the outbreak.

The Health Ministry reported Monday night that the country had surpassed 2,000 deaths. It reported five more fatalities on Tuesday, raising the toll to 2,021.

Israel — which has confirmed more than 295,000 cases — had garnered praise earlier this year for its swift imposition of travel restrictions to limit the pandemic’s spread, but after lifting the first nationwide lockdown in May, new cases quickly increased.

Prime Minister Benjamin Netanyahu’s government imposed a second blanket lockdown on Sept. 18 as the infection rate per capita grew to one of the highest in the world.

Israel’s infection rate is gradually decreasing, and the Cabinet is deliberating how and when the government will start to lift restrictions.

———

ISLAMABAD — With Pakistan’s coronavirus caseload inching upward, the government has increased lockdowns across the country, targeting markets and neighborhoods with increasing numbers.

At a meeting of top government officials from across the country Tuesday, Planning and Development Minister Asad Umar said 3,497 so-called “smart” lockdowns have been imposed in districts across the country of 220 million people.

Pakistan has recorded 319,848 cases, including 531 new ones reported Tuesday.

———

NEW DELHI — India has registered 55,342 new coronavirus cases, its lowest single-day tally since mid-August.

The Health Ministry raised India’s confirmed total to more than 7.17 million cases on Tuesday but said the country was showing a trend of declining daily cases over the last five weeks.

The ministry also reported 706 deaths in the past 24 hours, raising the toll to 109,856.

According to data shared by the Health Ministry, the average number of daily cases from Sept. 9-15 was 92,830. The average has steadily declined since then, falling to under 73,000 per day over the last week.

Meanwhile, India’s testing rate has remained constant, with almost 1.1. million tests being carried out every day.

India, a country of nearly 1.4 billion people, is second in the world in total cases, behind only the U.S., which has confirmed over 7.8 million infections.

———

BEIJING — Authorities in the eastern Chinese port city of Qingdao say they have completed coronavirus tests on more than 3 million people following the country’s first reported local outbreak of the virus in nearly two months.

The city’s health department said Tuesday that no new positive cases had been found among the more than 1.1 million test results returned thus far. The city said it had a total of 12 cases, six with symptoms and six without, since the new outbreak was first spotted over the weekend at a hospital.

The National Health Commission, however, said Tuesday that at least six new cases of the virus were found in Qingdao in the past 24 hours.

The reason for the discrepancy was not immediately clear.

The National Health Commission numbers released Tuesday reported a total of 30 new virus cases in the previous 24 hours nationwide. It broke down those numbers into 13 cases in which people had symptoms and 17 cases in which they had no symptoms. The total number of locally transmitted cases, both with and without symptoms, was 11, while the rest were listed as imported.

———

SEOUL, South Korea — South Korea has reported 102 new cases of the coronavirus, its first daily increase over 100 in six days. The steady rise is a cause of concern as officials have lowered social distancing restrictions this week after concluding that the viral spread was slowing after a spike in mid-August.

The figures released by the Korea Disease Control and Prevention Agency brought the national caseload to 24,805, including 434 deaths.

Fifty-eight of the new cases was reported from the densely populated Seoul metropolitan area, where transmissions have been linked to hospitals, sports facilities, a funeral home and an army unit.

Thirty-three of the new cases have been linked to international arrivals, including passengers from Russia, Nepal, Japan and the United States.

South Korea relaxed its social distancing guidelines beginning Monday, which allowed high-risk businesses like nightclubs and karaoke bars to reopen and for professional sports leagues to proceed with plans to bring back fans in the stands.

———

AUSTIN, Texas — An ongoing wave of COVID-19 cases in the El Paso area prompted Gov. Greg Abbott to announce Monday that a surge team of medical professionals would be dispatched to the area.

The 75 doctors, nurses and respiratory therapists being dispatched will be accompanied by a supply of extra personal protective equipment to support efforts by El Paso hospitals to meet the surge of coronavirus infections. The team will be in addition to the 169 professionals the state previously sent to the area.

As of Monday, 313 people were hospitalized with COVID-19 in El Paso, Hudspeth and Culberson counties of West Texas. The state estimated that active COVID-19 cases in El Paso County alone soared from almost 4,000 on Oct. 1 to just over 6,000 Monday. Seven cases were fatal during that period.

———

FRANKFORT, Ky. — Kentucky’s governor said Monday that he kept up a busy work schedule despite being confined to the governor’s mansion after being around someone who later tested positive for COVID-19.

Gov. Andy Beshear said he will follow the advice of state public health officials in determining how long he and his family remain quarantined at the mansion. His next COVID test is expected to be Tuesday and then Friday, he said. He added he tested negative last week.

“I’ve asked them (health officials) to treat me like anybody else out there,” the Democratic said. “So I’m going to follow all the rules and all the guidelines.”

Beshear said he had one of his busiest Mondays in a while, and that the biggest challenge of working in quarantine — away from his staff — was all the time he spent “staring at a screen.”

“I’m working,” he said. “I’m just having to do it like many other families are having to do — remotely with sometimes my kids bouncing in and out, or a vacuum cleaner going.”

In his virtual briefing, the governor reported Kentucky’s highest number of coronavirus cases on a Monday since the pandemic began. He said that offers more evidence that the outbreak continues its recent escalation in the Bluegrass State.

[smallcollegebasketball]

My Kentucky State Experience

I drove from Kansas City to Frankfort, Kentucky, to visit Kentucky State University on Saturday night.....and then drove back today.

Several weeks ago, Kentucky State Vice President, Rick Smith, called.  He told me that Kentucky State was going to honor two of their legends, Travis Grant and Elmore Smith, for their induction into the Small College Basketball Hall of Fame.  He asked me to attend the celebration......and so I got in the car and went.....and I’m sure glad I went.

It was a special night, as I got to spend time with Travis and Elmore.  I’ve known each of them for quite a while now, and they are such genuinely good people.  I mean, these were two of the greatest/most accomplished players in college basketball history, yet they are just so down-to-earth, nice people.  

Additionally, I enjoyed spending time with Rick Smith, Lacy Rice, Randy Williams and Kentucky State President Chris Brown.  I probably spent the most time with SIAC Commissioner, Greg Moore.  I hadn’t met Greg before, but I was highly impressed.  He’s a basketball junkie, and he’s highly knowledgeable.  He’s immensely proud of the SIAC, and the tremendous progress that they’ve made during his nine years as Commissioner.  With the way that we were rolling with our basketball talk, I think that we could still be talking.....

A big kudos to Kentucky State University for the wonderful halftime celebration for Travis and Elmore.....and for a job well done for the whole weekend.  They had a media session, an autograph/photo session, and a social event after the game.  Additionally, Elmore and Travis spoke to the men’s and women’s basketball teams during their visit back to Frankfort. They did a really nice job with the halftime presentation, and included some classy gifts for each of them.  Well done, KSU!

After the game (and, by the way, it was a fantastic atmosphere!), I went to a suite at the hotel, and had the opportunity to spend time with the members of the 1970, 1971 and 1972 NAIA National Championship teams.  What a wonderful group of guys that all came back for the celebration at their Alma Mater.  As a note, this whole group of guys is very close.  They lift each other up, and speak very highly of each other.  After all these years, their bond is incredibly strong.  Truly, they love each other, and it’s a joy to be around these guys.

Two notes in this regard:  One of the players told me stories about some of his health challenges.  Without using a name or telling about his specific health issues, he ended up in a nursing home for about a month.  During that time, he told me that he heard from at least one member of the team every single day.  Every day!  The other note is this:  This group of guys, from the teams that won three consecutive NAIA National Championships, still gets together every year for a reunion.  Each and every year!

I thank the Rick Smith for the invitation, and I thank all of the members of the 1970-72 NAIA National Championship teams from Kentucky State for making me feel like I belonged......truly, a special group of men, and for some reason, they’ve always been very good to me.

As I drove back to Kansas City today, I thought about how fortunate I am.....

[nnamdiabana]

#Kentucky sees highest spike in #coronavirus cases after protests against lockdown This comes after a Louisville church filed a lawsuit against the state’s stay-at-home orders. Kentucky Gov. Andy Beshear (D) announced in a press conference Sunday that 273 new cases of #COVID-19 had emerged, the highest Beshear has announced so far. This brings the current state case count to 2,960, per the Kentucky Department of Health. And 148 fatalities have been reported.  In response to this figure, Beshear determined that the state will not reopen economic sectors or relax restrictions until there is a downward trajectory of reported cases for 14 days, in accordance with White House guidelines.  “We’re still in the midst of the fight,” Beshear said.   This comes after protests surged in Frankfort last week against Beshear’s restrictions, disrupting an evening news conference. The Lexington Herald-Leader noted that about 100 Kentuckians joined the protest, arguing that businesses needed to reopen after more than 500,000 Kentuckians filed for unemployment in March.  Local outlets report that at least 13 percent, or roughly 385, of COVID-19 cases have been recorded in nursing home residents. Beshear also told reporters Sunday that 33 additional residents have tested positive for the virus, as well as eight nursing home staffers.  Beshear noted that the state will need to increase testing and obtain more personal protective equipment (PPE) even if case numbers decline.  This follows news that Pastor Jack Roberts of the Maryville Baptist Church in Louisville filed a lawsuit against Beshear, claiming that enforcing a stay-at-home order on Easter violates the constitutional right to religious freedom. The church argued for Kentucky to allow in-person Christian services provided social distancing and hygienic rules are observed.  Beshear’s office put out a press release stating that anyone attending an in-person religious service during the coronavirus pandemic will be notified that it is a misdemeanor violation.   Source: thehill.com https://www.instagram.com/p/B_PTQ_GJGKz/?igshid=gjrakmf3eowe

[nekocreations]

Hi wonderful people! While we are trying to adjust whatever this new normal is, don't forget there are vulnerable people (like those in nursing homes) that can't currently have visitors because of the coronavirus. Here's a few that would appreciate a card or a note or a kiddos drawing while they are home from school. The facilities below have approved of this idea and are ready for some mail! Resident %The Homesteader 7953 Love Rd. Benzonia, MI 49616 LTC-Resident %Paul Oliver Living and Rehabilitation Center 224 Park Avenue Frankfort, MI 49635 Resident %The Maples 210 Maple Ave. Frankfort, MI 49635 Home Delivered Meal Client %Benzie Senior Resources 10542 Main St. Honor, MI 49640 Resident %Frankfort Senior Care Home 216 West Cox Rd Frankfort, MI 49635 Feel free to share and add more if you know of any. Thank you, stay safe and healthy and wash your paws kittens! https://www.facebook.com/NekoCreations/photos/a.626696464041807/3031237963587633/?type=3

[elderperfect]

2020 Best Nursing Homes - Illinois

ElderPerfect a leading publisher on senior healthcare across the United States, today announced the recipients of the Best Nursing Homes in Illinois for 2020. These awards are designed to recognize providers based on their ability to consistently deliver excellence in the areas of Health Inspections, Quality of Residence Care, Penalties and Staffing. We’ve evaluated over 725 facilities, of which 147 (20%) met our top rating. This report marks the Gold Standard in terms of care for seniors. 0 Ranked Best Facilities  5/5

US Standard vs. Best Facilities

Average Number of Beds: 106 vs 95 Average Occupancy: 81% vs 83% Average Health Inspection Rating: 2.82 / 5.00 vs. 3.90 / 5.00 Average Government Rating: 3.01 / 5.00 vs. 4.49 / 5.00

Rating Methodology

Health Inspections Every year, the government assigns inspectors to conduct a formal review of nursing homes for regulatory purposes to meet the mandates outlined for Medicare and Medicaid, this aims to measure and improve the safety of residents across providers. Facilities may also be inspected when complaints are submitted or based on a reported incident. When noncompliance is identified, the facility is served a citation that indicates which regulation that was identified, along with the severity of the incident. Nursing homes are subsequently required to execute a program of resolution in order to meet compliance. Some scenarios require enforcement actions to be applied, such as a civil monetary penalty or withholding of payment(s), to incentivize resolution in a timely manner. Penalties Facilities are applied 2 types of penalties due to non-compliance / accumulation of incidents. Civil penalties are monetary fines that may be applied to a facility based on citations / infractions identified during a review. The severity of a penalty is defined primarily by the size and frequency of the infraction. Quality of Residence Care There are 3 types of resident care ratings, but for this exercise, we primarily focused on the overall quality measure rating. The quality measures (QMs) include 17 data points that are derived from clinical information reported by the respective nursing home and also from Medicare claims data submitted for payment. Ratings are calculated for the QM domain using the 4 most recent quarters for which data are available. A nursing home receives points contingent on performance on each measure (weighting distribution is not equal). Staffing Staffing research is submitted regularly by the facility and is adjusted for the requirement of the facilities residents. For each of registered nurse staff and total staffing, a 1 - 5 rating is applied according to definitions established for each category. These ratings are subsequently combined to assign an overall staffing rating. As an example, to get an overall staffing rating of 5 stars, nursing homes must earn a rating of 5 stars for both registered nurses and total staffing. Nursing homes could also be assigned a 1 star rating should they not have a registered nurse on-site daily, and do not submit staffing data, or which the data cannot be verified.

Best Nursing Homes in Illinois

PINECREST MANOR WESTMINSTER PLACE MEMORIAL CARE CENTER EUNICE C SMITH NURSING HOME DOBSON PLAZA ALDEN LINCOLN REHAB & H C CTR GLEN OAKS NRSG & REHAB CTR MANORCARE OF ARLINGTON HEIGHTS WYNSCAPE HEALTH & REHAB BURGESS SQUARE HEALTHCARE CTR GLENVIEW TERRACE NURSING CTR HERITAGE HEALTH-LITCHFIELD BUCKINGHAM PAVILION PRAIRIE VILLAGE HEALTHCARE CTR HERITAGE HEALTH-EL PASO PRESENCE RESURRECTION N & R FRIENDSHIP VILLAGE-SCHAUMBURG LIBERTYVILLE MANOR EXT CARE LUTHERAN CARE CENTER CLARK-LINDSEY VILLAGE FARMINGTON COUNTRY MANOR MICHAELSEN HEALTH CENTER BREESE NURSING HOME APOSTOLIC CHRISTIAN RESTMOR ROLLING HILLS MANOR OAK HILL HERITAGE HEALTH-ELGIN OAK BROOK CARE HAMMOND-HENRY DISTRICT HSP MONTGOMERY NURSING & REHAB CTR BEACON HILL GOTTLIEB MEMORIAL HOSPITAL BRANDEL HEALTH AND REHAB PRESENCE SAINTS MARY & ELIZABETH MEDICAL CENTER COMMUNITY FIRST MEDICAL CENTER FAIRFIELD MEMORIAL HOSPITAL PRESENCE ST JOSEPH HOSPITAL - CHICAGO SWEDISH COVENANT HOSPITAL PROCTOR COM HSP SK N CENTER RUSH OAK PARK HSP SKILLED CARE UNIT SEMINARY MANOR HEARTLAND OF HENRY COVENANT LIVING - WINDSOR PARK SPRINGS AT CRYSTAL LAKE, THE MASON CITY AREA NURSING HOME GENERATIONS OAKTON PAVILLION ASTORIA PLACE LIVING & REHAB ST JOSEPH VILLAGE OF CHICAGO CHURCH CREEK BLESSING HOSPITAL SNU VALLEY HI NURSING HOME CENTRALIA MANOR AVANTARA PARK RIDGE APOSTOLIC CHRISTIAN HOME OF EUREKA MOUNT VERNON COUNTRYSIDE MANOR APOSTOLIC CHRISTIAN HOME ADDOLORATA VILLA PRESENCE SAINT BENEDICT N & R LEXINGTON OF LAGRANGE PRESENCE MARYHAVEN NSG & REHAB WEST SUBURBAN MEDICAL CTR HERITAGE HEALTH-MINONK FAIRVIEW HAVEN PLEASANT VIEW LUTHER HOME OAK TRACE NEWTON CARE CENTER GROVE OF NORTHBROOK,THE BRITISH HOME, THE TABOR HILLS HEALTH CARE FAC MILLER HEALTH CARE CENTER MACNEAL HOSPITAL SNF BROOKDALE PROSPECT HEIGHTS CENTRAL BAPTIST VILLAGE ALDEN ESTATES OF SKOKIE

  ST PATRICK'S RESIDENCE WAUCONDA CARE SUNNY HILL NURSING HOME OF WILL COUNTY LEMONT NURSING & REHAB CENTER SMITH VILLAGE ALDEN ESTATES OF EVANSTON APERION CARE BURBANK CITADEL CARE CENTER-WILMETTE APOSTOLIC CHRISTIAN SKYLINES PRESENCE MCAULEY MANOR HILLCREST HOME PRAIRIEVIEW LUTHERAN HOME PRESENCE VILLA SCALABRINI N&R PRESENCE RESURRECTION LIFE CTR MCLEANSBORO REHAB & HLTH C CTR SCHWAB REHABILITATION CTR SNU ALDEN NORTH SHORE REHAB & HCC LAKE FOREST PLACE MAPLE CREST CARE CENTRE COULTERVILLE REHAB & HCC MOORINGS OF ARLINGTON HEIGHTS SELFHELP HOME OF CHICAGO MERCY HARVARD HOSPITAL CARE CENTER NATURE TRAIL HEALTH CARE CENTER GREEK AMERICAN REHAB CARE CTR HELIA HEALTHCARE OF ENERGY WESLEY VILLAGE PRESENCE HERITAGE VILLAGE FRANKFORT HEALTHCARE & REHAB CENTER TUSCOLA HEALTH CARE CENTER HELIA HEALTHCARE OF BENTON HAWTHORNE INN OF DANVILLE WILLOWS HEALTH CENTER OAK CREST SCOTT COUNTY NURSING CENTER VI AT THE GLEN SMITH CROSSING GOLDEN GOOD SHEPHERD HOME LA SALLE COUNTY NURSING HOME PRAIRIEVIEW AT THE GARLANDS ASSISI HEALTHCARE OF CLARE OAKS PLYMOUTH PLACE MARIANJOY REHABILITATION HOSPITAL-SNF CISNE REHABILITATION & HEALTH CENTER RADFORD GREEN REGENCY CARE GALENA STAUSS NURSING HOME TERRACES AT THE CLARE MERIDIAN VILLAGE CARE CENTER SYMPHONY OF HANOVER PARK MATHER, THE HICKORY POINT CHRISTIAN VILLAGE CRAWFORD MEMORIAL HOSPITAL LTC PARK PLACE CHRISTIAN COMMUNITY ADMIRAL AT THE LAKE, THE GREENFIELDS OF GENEVA FOSTER HEALTH & REHAB CENTER PINCKNEYVILLE NURSING & REHAB GLEN SAINT ANDREW LIVING COMM TRANSITIONAL CARE OF ARL HTS PRESENCE NAZARETHVILLE AVONDALE ESTATES OF ELGIN ALDEN COURTS OF WATERFORD LITTLE SISTERS OF THE POOR ALDEN ESTATES CTS OF HUNTLEY ST JOSEPH'S HOME F/T ELDERLY HERITAGE SQUARE HIGHLAND OAKS UNION COUNTY HOSPITAL L T C WINSTON MANOR CNV & NURSING ELIZABETH NURSING HOME SHELDON HEALTH CARE CENTER APERION CARE SPRINGFIELD

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New story in Politics from Time: Sen. Rand Paul Undergoes Lung Surgery Related to 2017 ‘Lawn Maintenance’ Assault Injuries

(FRANKFORT, Ky) — U.S. Sen. Rand Paul underwent lung surgery in a procedure he says stems from injuries suffered when a neighbor tackled him outside his Kentucky home in 2017.

The Republican lawmaker and former presidential candidate tweeted Monday that part of his lung damaged in the assault was removed during the weekend surgery in Tennessee. The senator is continuing his recovery at home, a Paul spokeswoman said.

“I will have to limit my August activities,” the 56-year-old Paul said in the tweet, adding that he “should” be able to return to the Senate in September. “Sen. Paul will need to recover from his surgery for a few weeks, which will limit his travel and events,” his spokeswoman, Kelsey Cooper, said in a statement. “He will continue to work on diplomacy, legislative and constituent issues during that time.”

Paul, an ally of President Donald Trump, was tapped for mediation efforts to potentially open a back channel for restarting nuclear talks between the U.S. and Iran.

Both of Kentucky’s senators are laid up with health issues during Congress’ August break.

Senate Majority Leader Mitch McConnell suffered a shoulder fracture Sunday when tripping on his outdoor patio at his Louisville home. The 77-year-old Republican leader also is recovering and working from home.

Paul underwent the lung surgery at Vanderbilt University Medical Center in Nashville, Tennessee. In his tweet, he thanked the doctors, nurses and staff.

It’s his latest surgery for injuries suffered from being tackled by Rene Boucher when the neighbor became angry over lawn maintenance at Paul’s home in Bowling Green, Kentucky. The assault broke several of Paul’s ribs. Earlier this year, Paul had hernia surgery at a hospital in Canada.

Boucher pleaded guilty to assaulting a member of Congress and received a 30-day prison sentence. Federal prosecutors have appealed, saying 21 months would have been appropriate. Paul has also sued Boucher, and a jury in Bowling Green awarded him more than $580,000 in damages and medical expenses.

Boucher has since sold his home next door to the senator.

Paul testified during the civil trial that he feared for his life as he struggled to breathe after Boucher, an anesthesiologist by trade, slammed into him in their upscale Bowling Green neighborhood. Paul testified that he got off his riding mower to pick up a stick and was straightening up when Boucher hit him from behind. Paul said he was wearing noise-canceling headphones and didn’t hear Boucher coming toward him.

Paul said that for a moment, he had a flashback to the 2017 shooting at a baseball field when members of Congress were practicing for a game. Rep. Steve Scalise of Louisiana suffered serious injuries in that shooting.

During his testimony, Boucher acknowledged he wasn’t thinking rationally and called it “two minutes of my life I wish I could take back.”

By Bruce Schreiner / AP on August 05, 2019 at 12:30PM

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Anthem faces legal challenges over ER, medical imaging policies

You may recall an article that we shared previously regarding insurance companies attempting to reign in ER utilization by not covering ER visits if they are not for true emergencies. As with many things, this policy had the potential to work well to reduce high cost care for non-emergencies but the devil is in the details. Now, companies are being sued for denying legitimate ER claims. 

Anthem faces legal challenges over ER, medical imaging policies

by  Kristie Rearick

In 2017, insurance company Anthem, Inc. began implementing new medical coverage policies that affect emergency services and medical imaging. As to the former, Anthem’s new policy allows it to reduce coverage for emergency services provided if Anthem later determines that the situation giving rise to the services was not, after all, an emergency. As to the latter, Anthem is denying certain claims for medical imaging performed at hospitals rather than at clinics.

In March of this year, Senators Claire McCaskill (D-Mo.) and Ben Cardin (D-Md.) sent a letter to the Department of Health and Human Services and the Department of Labor asking that the departments investigate whether Anthem’s emergency services policy violates the Prudent Layperson Standard. That standard was introduced by the Senate in 1997 related to Medicare and Medicaid managed care plans. It has since been codified in the Affordable Care Act and in 47 state statutes. Sen. McCaskill also sent a letter directly to Anthem asking how it was complying with the standard and sought documents from Anthem related to how the new policies may represent a cost savings benefitting the insurer.

The Prudent Layperson Standard sought to address an issue whereby insurance companies determined coverage based on the diagnosis rather than the symptoms. For example, if a patient sought emergency services related to severe chest pain that the doctor later diagnosed as nothing more than indigestion, then insurance companies would not pay for the emergency services. That example is courtesy of the American College of Emergency Physicians (ACEP), which fought for the Senate to implement the standard and is now fighting against Anthem’s new emergency services policy. As part of its campaign against Anthem, ACEP released two videos criticizing Anthem’s move. The videos call Anthem’s move unlawful and warn viewers that an unchallenged Anthem will embolden other insurers to adopt similar policies.

More than critical videos, Anthem faces state-level lawsuits. Piedmont Hospital in Georgia filed a complaint against Anthem alleging breach of contract and false advertising. In its complaint, Piedmont discusses Anthem’s implementation of the policy changes in the states where Anthem operates: California, Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin, and Piedmont’s home state of Georgia. Piedmont’s complaint alleges that Anthem, through its emergency services policy, makes its determination of coverages based on a “black box” of codes for what it deems nonemergencies. According to the complaint, Anthem and Piedmont engaged in an unsuccessful mediation in January 2018. According to a press release dated April 25, Anthem announced that it had settled with Piedmont.

Another suit, filed by Sentara Healthcare, focuses on the medical imaging policy and alleges that it likewise constitutes a breach of contract. That policy states more specifically that claims must satisfy certain criteria for coverage of radiologic imaging performed in a hospital outpatient setting, while the same imaging performed in a less expensive clinic setting would be covered despite those criteria. The spokesperson for the Missouri Hospital Association (MHA), David Dillon, provided Bloomberg Law with an example of how the imaging policy can render manageable situations fatal: A patient in rural Missouri went to an emergency room complaining of stomach pain. She was directed to drive 60 miles to an outpatient facility for imaging that Anthem would cover. As it turned out, the patient had appendicitis and the delay necessitated by the drive could have proved problematic indeed.

MHA also cites data from the Hospital Industry Data Institute to support the claim that the emergency room denials disproportionately affect women and minorities. Specifically, MHA points out that 10.5 percent of all deniable Anthem emergency department claims are female-specific, while fewer than 1 percent are male-specific. Further, applying Anthem’s 2017 policies to 2016 data in Missouri, MHA presents a counterfactual where 61 percent of denied claims would be for female patients and 20 percent of denied claims would be for nonwhite patients (though such patients represented only 16 percent of Missouri’s nonelderly insured population in 2016).

A Vox article published Jan. 29, put a human face on Anthem’s policies, see Kliff, Sarah. “An ER visit, a $12,000 bill—and a health insurer that wouldn’t pay.” Vox. Jan. 29, 2018. A mid-20s Kentucky resident named Brittany Cloyd entered the Frankfort Regional Medical Center’s emergency room on July 21, 2017, with severe stomach pain and a fever. The hospital promptly put her in a wheelchair and wheeled her back to a room. Her mother, a former nurse, urged her to go to the hospital because the symptoms sounded like appendicitis.

As it turned out, Cloyd was suffering from ovarian cysts for which the hospital gave her pain medication and instructions to follow up with a gynecologist. Cloyd was insured through Anthem. Though this sounds like precisely the good faith situation that the Prudent Layperson Standard was meant to address, Cloyd received an invoice for $12,596 that Anthem refused to cover. The denial letter that Anthem sent to Cloyd stated that it would not cover emergency services related to pelvic pain that was, ultimately, not an emergency. Anthem’s letter listed examples of issues that would be considered emergencies such as stroke, heart attack and severe bleeding. Cloyd states in the Vox article that with a mortgage and student loans, she did not have $1,000 in available savings, much less $12,000.

Though Anthem is getting the most attention, the idea underlying the emergency services policy appears to have originated with Medicaid. In 2015, Indiana implemented a policy that Kentucky more recently adopted whereby Medicaid enrollees are charged $20 for the first unnecessary emergency room visit, $50 for a second and $75 for a third. While this Medicaid policy is clearly aimed at curbing the inappropriate use of emergency rooms, it also places a serious responsibility in the hands of patients: assessing their own medical conditions before seeking care.

While Anthem’s cost-saving efforts are understandable and may, in certain circumstances, prevent the abuse of medical resources, it is important for providers, patients and their attorneys to understand Anthem’s new policies and keep an eye out for similar efforts elsewhere in the health care insurance industry.