Alternative Long-Term Care Options Growing

By Erin McAuliffe and Daniel O’Boyle
The Milton Home in South Bend has been cited by Medicare 27 times in the last two years. These citations include poor food preparation, substandard care giving, bedsores, infection control, subpar hiring practices and lack in protection from abuse, physical punishment and involuntary separation from others.

But the Milton Home is not an isolated case in the state: According to Nursing Home Report Cards, 94 percent of nursing homes in Indiana had deficiencies in 2014.

The amount of people in the United States over 65 years old will nearly double by 2050, according to the United States Census Bureau.

Before the vote in 2015 to endorse a three-year moratorium on new nursing home licenses in Indiana counties with nursing home occupancy rates lower than 90 percent, Indiana nursing homes sat at an average 76 percent occupancy rate with more than 12,000 empty beds, according to according to a December 2014 report from the state Family and Social Services Administration.

The state was given an “F” rating in both 2014 and 2015 by Nursing Home Report Cards.

According to Medicare, the most rampant nursing home deficiencies in South Bend currently involve the screening, hiring and training of staff, infection and bed sore prevention, accident hazards and safe food preparation.

Recurring South Bend nursing home deficiencies.

Jack Mueller, chief operating officer at Holy Cross Village, a nursing home and senior living community located near Holy Cross College and the University of Notre Dame campuses, spoke to the prevalence of nursing home deficiencies in South Bend leading to its low national ranking.

“Everybody has stuff they can work on,” Mueller said. “[Food preparation] is always the big one, always number one on the hit list. I’ve been doing this for 30-some years, I don’t know if [nursing homes] just haven’t gotten better at that or what, but it seems to be one that reoccurs every year.”

The kitchen area at Holy Cross Village. Mueller emphasized the prevalence of deficiencies in nursing home food preparation across the industry.
Photo by Erin McAuliffe.

A sample of a lunch menu at Holy Cross Village.
Photo by Erin McAuliffe.

On the topic of inadequate staffing, Mueller stressed that homes need to be careful throughout the hiring process.

“That shouldn’t happen, but I know it does … sometimes people aren’t careful about checking the references or the criminal history,” he said.

Mueller applauded the steps the Community Foundation of St. Joseph’s County has taken to improve nursing home quality, noting the collaboration fostered through the Foundation’s educational programs and funding for administrator round tables.

Angela Workman, program director for the Foundation, said she was impressed with the way administrators from competing homes were able to cooperate.

“It’s interesting because at first glance, from an outsider’s perspective, that group may define themselves as competitors,” Workman said. “So maybe they wouldn’t want to get together in a group and share ideas about what’s working and what’s not. But I definitely have not found that to be the case at all. Those who have participated long-term have really valued the community of people and the support they can give to one another.

“We just want to come along with things that don’t feel like more work, but feel like things that would be valuable to them. We’re not interested in creating more work and making their lives more difficult — it’s already difficult.”

Mueller added that there has also been a recent national push toward nursing home improvements, initiated by the Center for Medicare Services.

“There were new rules put into effect [by the Center for Medicare Services] in November that we’re working on right now … They’ve expanded the resident rights for people in nursing homes.”

Later stages of CMS implementations for nursing homes include requiring Quality Assurance & Performance Improvement and disaster plans from each home. These rules will affect nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in Medicare and Medicaid programs, according to CMS.

Mueller said the new regulations were the most significant changes to federal law surrounding long-term care since 1989. However, the moves may be too little too late as new options present opportunities for elderly people to live more independent lifestyles.

“We’re all scrambling for people, for clients,” Mueller said of South Bend’s nursing homes. “None of us are full,”

It seems like a growing elderly population would directly coincide with more populated nursing homes, but as people age healthier they are turning towards assisted living. The trend is evident locally; Vermillion announced that it would build four assisted living complexes with one location in Mishawaka. Assisted living provides desired independence with a desired price tag: the average cost of a private room in an assisted living facility is $43,470, compared to $98,550 in a nursing home.

Assisted living will only become a more prevalent option with technologies like telemedicine and autonomous vehicles on the horizon.

Telemedicine, remote diagnosis and treatment of patients through telecommunications, is already practiced in South Bend. Indiana passed a telemedicine-focused law in July that made it legal for medical authorities to prescribe medication without an in-person visitation. In January, Beacon Health Systems launched a secure video doctor visit program to care for patients with minor ailments.

Mueller mentioned that CMS is currently pushing to have doctor visits done through telemedicine at nursing homes and assisted living facilities, noting its capabilities to save residents and staff expensive trips to the hospital.

Tim Balko, assistant professional specialist teaching Foresight in Business and Society at Notre Dame, said the trend has staying power.

“If you can reduce the amount of time that seniors take up in their day dealing with their health issues,” he said. “If you can take out some of that travel and time in-between with telemedicine, I think that’s going to balloon.”

Balko also predicted the industry-shifting effects autonomous vehicles could have on the elderly care industry, granting them the freedom to complete trips to the grocery without a valid license.

Currently, the most common reason elderly people enter nursing homes is some type of disability with activities of daily living, according to Health in Aging. Technologies that allow seniors to receive medical care at home and safely complete trips without driving delay the need for 24/7 assistance. Combine these trends with the rampant industry deficiencies and new assisted living facilities being built locally and the future doesn’t look so promising for nursing homes.

Workman worried about potential staffing crises threatening nursing homes’ futures as the aging population increases.

“That’s not even the question of quality, but having enough staff to take care of our community’s aging population,” she said.

A map of South Bend nursing homes ranked best (green) to worst (red).

Have you or a family member experienced nursing home deficiencies first-hand? Please comment below.

Continue reading “Alternative Long-Term Care Options Growing”

Google Timelapse: Uganda-DRC Border Changes With Semliki River

The Semliki River forms the border between Uganda and the Democratic Republic of the Congo,. Its frequently-changing course . Photo from Fortune of Africa.

By Daniel O’Boyle

 

 

Natural features such as rivers often seem like obvious points for political borders.

However, nature is often subject to change, which can cause huge problems around border areas.

Much of the border between Uganda and the Democratic Republic of the Congo is set along the Semliki River, a meandering river that has changed course over 100 times since the DRC gained independence in 1960. The river was set as the border between the Belgian Congo and British Ugandan Protectorate by the two colonial powers  and despite the variable course, it remains the border to this day.

The issue of the border has been complicated in recent years, as the discovery of oil around nearby Lake Albert, and the possibility of more oil to be discovered near the river’s path, has increased the stakes of the dispute, while recent wars in the region have also added to the river’s contentious status.

Increasing snowmelt on nearby mountains and overgrazing on land in the area have both caused the discharge of the river to increase, which has led to the river quickly eroding its banks and creating new courses. As it breaks through narrow points of meanders, the river creates oxbow lakes — lakes that were once bends in rivers — which eventually dry up. Meanwhile, in other formerly straight parts of the river, new bends form.

While both nations gain and lose land in places, Uganda has lost far more area as the river changes course, with many Ugandan farmers finding their lands have moved across the border.

It is unusual to be able to see a changing border in satellite pictures, but the unique situation of the Semliki River means the changes can be viewed via Google Timelapse.

Graph: Paul George’s Importance to the Pacers in the Postseason is Unparallelled

By Daniel O’Boyle

It’s an oft-repeated fact that to succeed in the NBA you need stars who will perform in the postseason.

But which NBA star has been the most important to their team when it counts?

According to on/off stats, it’s not LeBron James, Kevin Durant or Steph Curry. Nor is it Russell Westbrook, Kawhi Leonard or James Harden.

It’s Indiana Pacers small forward Paul George. And by quite some distance.

George is certainly a a top player in the NBA, and he is known for his ability to step up his game in the postseason, but the extent to which the Pacers have relied on the former Fresno State product in the playoffs may surprise you.

Among players with 2000 playoff minutes played, George leads all players in net on/off rating, with a rating of 19.0. That means that the Pacers are better off by 19 points per 100 possessions when George is on the court compared to when he sits on the bench.  That stat is driven mostly by his astonishing defensive on/off rating of 15.4 — the Pacers’ opponents score 15.4 less points per game when they have to face Paul George compared to facing lineups without him. Yet with an offensive on/off rating of 3.6, George helps his team score too, as shown by his career total of 18.4 playoff points per game.

In second place is Warriors power forward Draymond Green, who has proven invaluable to the most successful team of recent years, yet with a net rating of 14.6, he still sits far behind George. In third is point guard George Hill, formerly of the Pacers, which perhaps shows that a lack of depth in Indiana is behind George’s on/off stats.

With the playoffs approaching and the Pacers currently 7th in the Eastern Conference, history suggests Paul George will again be the key to how the team performs. Though if the Pacers can find a way to perform with George off the court, they may become a dark horse candidate to make a deep playoff run.

See the graphic on datawrapper.

A Graph Showing the offensive rating, defensive rating and net rating of all NBA players with 2000 playoff minutes played.
By Daniel O’Boyle. Made using datawrapper.

Indiana: The Midwest’s Tech Capital

An infographic detailing the growth and success of Indiana’s tech industry in recent years. Made using Venngage.

By Daniel O’Boyle

When asked to think of cities associated with technology, one usually thinks of the coasts. Areas like Silicon Valley in California and Charlotte, North Carolina are usually seen as the key locations behind the modern industries of the 21st century.

But in recent years, Indianapolis and the state of Indiana as a whole have become major players in the industry too. Just last month, Forbes placed Indianapolis fifth among cities creating the most tech jobs, while Governing Magazine commented on the city’s surprise success in the tech industry. Echoing a similar sentiment expressed in his State of the State address, Governor Eric Holcomb called on Hoosiers to embrace Indiana’s potential as a tech state in a recent letter to the Indianapolis Star.

This Infographic, created using Venngage, shows the success of Indiana — and Indianapolis in particular — as a key location for tech jobs.

Time Capsule: A History of the World Cup

By Daniel O’Boyle

 

England defender and captain Bobby Moore lifts the Jules Rimet trophy in 1966 after a 4-2 extra-time win over West Germany in the final. The trophy had been stolen only weeks earlier before being found by a dog named Pickles.

The 2018 FIFA World Cup is looming closer, as Brazil has a chance tomorrow to become the first team to join Russia, the automatically-qualifying hosts, and guarantee a place at the competition, should enough results across in South America’s qualifying group go their way.

The previous 20 tournaments that have been held since 1930 have seen great matches and great goals as well as more than their share of controversy and bizarre events. While players like Pele, Johann Cruyff and Diego Maradona enthralled fans on the field, off-the-field politics and other events have often dominated headlines as much as the games themselves.

Click here to see a timeline of some of the World Cup’s most memorable moments, both on and off the field, from the inaugural tournament in 1930 all the way up to the 21st century.

America’s 10 Cities Dealing With a Drinking Problem

 

By Daniel O’Boyle

According to the National Institute on Alcohol Abuse and Alcoholism, 86.4% of Americans aged 18 or older reported that they had drunk alcohol at some point in their lifetime, while 6.2% of adults have Alcohol Use Disorder.

This unsurprisingly has many negative consequences, such as liver disease and alcohol-related road accidents. However, despite the fact that alcoholism affects people throughout the country, its impact is greater in some areas that others.

Men’s Health Magazine ranked the cities in America with the most serious alcohol issues, based on criteria including DUI arrests and deaths from liver disease.

The city with the worst drinking problem was Fresno, California, with Reno, Nevada in second. Texas and California were the most represented states, with three cities each.

StoryMap showing the full list of cities.