Ideal Home Care Logo Our Family is Part of Your Family

Articles for Doctors

Healing & Preventing Pressure Ulcers among Community-Dwelling Patients

The National Health and Nutrition Examination Survey finds that community-dwelling seniors account for 20% of all pressure ulcers – more than 600,000 cases per year.  A 2006 publication by the Agency for Healthcare Research and Quality found that treating pressure ulcers in the hospital takes 13 days and costs $37,800 on average.  Treating pressure ulcers using Ideal Home Care would typically cost Medicare 6% to 12% of that amount with reduced or no cost-sharing to the patient.

Hypertension Management for the Elderly

In recent decades, there existed a view that hypertension must be an adaptive response to aging, and an age-based formula for appropriate systolic blood pressure (SBP) was often used: 100 + age.2,3   Today, we know that systolic blood pressure is a strong, independent  risk factor for cardiovascular events in all decades of life4,5 and that treatment of elevated SBP reduces cardiovascular risk among the elderly.6-9  The American College of Cardiology and the American Heart Association now recommend <140/90 mm Hg as the blood pressure goal for elderly patients with uncomplicated hypertension.10 Of course, management of prehypertension and hypertension among the elderly proves more challenging.

Timed Up and Go vs. Gait Speed: An Opportunity for Clinicians to Save Time on Senior Exams?

Both Medicare and the American Geriatrics Society recommend that each annual exam for seniors age 65+ include assessments for fall risk.  Based on previous research, the American Geriatrics Society and the American Academy of Orthopaedic Surgeons have specifically recommended the Timed Up and Go Test for fall risk assessment.1   In a recent study from  the Division of Geriatric Medicine, University of Pittsburgh, Laura Vicaro and colleagues suggest that a more efficient test may be just as useful.2 

Patient Characteristics Associated with
Poor Glycemic Control

A recent CDC report shows that 12.6% of adults with diabetes exhibit poor glycemic control.1  The authors state that the majority of adults with diabetes would benefit from reduction of A1c levels to ≤ 7%, and that an A1c level of 9% represents a modifiable, high level of risk that usually merits additional intervention.  When glycemic control is poor (A1c > 9%), diabetes levies additional health-care costs, higher risk of hospitalization / re-hospitalization, and high risk of disabling complications.  Poor glycemic control creates higher risk of diabetic retinopathy, chronic kidney disease, and cardiovascular disease.2-4  When you have homebound patients exhibiting poor glycemic control, please consider Ideal Home Care as a strong ally in your diabetes management plan.

The Research on Home-Based Physical Therapy for Patients with COPD

COPD affects the lives of roughly 10% of the American population.1  Those patients with declining health status, recent hospital discharges, or moderate disability due to COPD may be good candidates for additional programs designed to improve their quality of life and reduce overall health care spending / reutilization.  When patients are homebound, refer to Ideal Home Care for such programs.  We can provide care plans involving physical therapy, occupational therapy, nursing management, and more.

Cardiac Rehab Utilization Rates Less Than 13% Among Medicare Beneficiaries

A study published recently in the Journal of the American College of Cardiology followed 601,099 Medicare beneficiaries who were hospitalized for coronary conditions or cardiac revascularization.1  Despite strong evidence showing the positive effects of cardiac rehabilitation, only 12.2% of these Medicare beneficiaries used such a program.  Those who did use cardiac rehabilitation experienced 21% to 34% improvements in mortality rates.  Unfortunately, even those who received cardiac rehabilitation tended to receive the service at suboptimal levels.  The cardiac rehabilitation received by these Medicare beneficiaries averaged 24 sessions.  However, when the researchers compared those receiving 25+ sessions of rehabilitation to those receiving shorter programs, the longer programs correlated with a 19% greater survival. 

Surgical Site Infections: Triple the Mortality Rate among Elderly Patients

A study published recently in the Journal of the American Geriatrics Society examined the effects of surgical site infections (SSI) on patients age 65+.1  Dr. Kaye and colleagues performed a retrospective, matched outcome study with 1,337 subjects.  Tracking results for only 90 days post-surgery, they found that SSI triples the mortality rate (15.3% vs. 5.2%), increases hospital expenses by an average of $41,124, and increases the rate of hospital re-admission by more than 400%.  The authors conclude that because outcomes attributable to SSI are severe, proactive management of SSI is particularly important among elderly patients.

Primary Non-Adherence: Greatest for New Prescriptions Treating Chronic Disease

Michael Fischer, MD and colleagues followed 195,930 e-prescriptions made by 1,217 prescribers.1  On average, 22% were not even filled.  The rate was highest among prescriptions for new medications treating chronic diseases: hypertension (28.4%), hyperlipidemia (28.2%), and diabetes (31.4%).  A study by the insurance company Aetna found even worse primary non-adherence rates among patients recently discharged from the hospital after an episode of acute myocardial infarction. Sixty-four to forty-nine percent of those patients did not fill their prescriptions.2   Of course, filling the prescription is only the first part of adherence, so it is likely that overall non-adherence rates are much higher. 




We Don’t Cap Visit Numbers

If you have experienced a home health agency saying that Medicare only pays for a certain number of visits, you may want to consider sending more of your referrals to Ideal Home Care. Medicare does not cap visit numbers. Medicare pays home health a set fee based on how sick your patient appears. Ideal Home Care provides care for as long as needed until your patients reach their skilled need goals.


TOP 100 Home Health Agency

Out of all Medicare-certified home health agencies, OCS named Ideal Home Care as one of the TOP 100 agencies in the nation. TOP 100 means Ideal Home Care is in the top 1% of the home health industry. This distinction is based on better patient outcomes, better processes, and better patient and family satisfaction.

When you need home health services from an agency you can trust, consider an agency that is ranked top in the nation by industry experts.



Home of the One-Nurse Policy

At Ideal Home Care, we go out of our way to schedule the same nurse for each of your home health visits. The same goes for your therapist and home health aide if you receive those services. Ideal's One-Nurse Policy allows you to have better relationships with your caregivers and ensures that you receive better, more personalized, and more comprehensive healthcare.