Year's End Notables

Gwen B. Turnbull, RN, BS, CETN

Index: Ostomy Wound Manage 2001;47(12):10,51

Terrorist Attack Highlights Nursing Shortage
  Representatives and Senators recently joined nurses who treated World Trade Center victims for a press conference to highlight the importance of passing the Nurse Reinvestment Act (HR 1436 and S 06). This legislation is designed to help address the nursing shortage and ensure that our health system has enough nurses to be prepared for any future crisis. The Nurse Reinvestment Act establishes a National Nurse Service Corps to provide educational scholarships to nurses that commit to serving where a critical nursing shortage exists. It also would make grants available to any level of the nursing profession (from nursing aides to nurse practitioners) to obtain more education. In addition, the bill is designed to provide funding for public service announcements and nursing recruitment grants for educational facilities.

  An interesting sideline is the bill’s expansion of Medicare and Medicaid funding for clinical nursing education as well as reimbursement to some home health agencies, hospices, and nursing homes for nurse training. Hopefully, action will be taken to move this legislation forward by the end of the year.

CMS Establishes Penalties for Certain Acts of Noncompliance
  The Centers for Medicare and Medicaid (CMS) issued a final rule with a comment period, updating some of the civil monetary penalty regulations under the Balanced Budget Act of 1997 (BBA 97). Two items under this revised rule may potentially affect home health agencies (HHA). Under BBA97, HHAs are required to provide an itemized statement for Medicare items and services within 30 days of a request from a Medicare beneficiary. Any provider who knowingly or willingly fails to do so is subject to a penalty of $100 for each incident. However, the penalty is not inflicted if the provider merely neglects to meet the deadline, as punishment is based upon deliberate intent. Additionally, if a person or entity willfully bills for outpatient therapy other than on an assignment-related basis, CMS, the Department of Health and Human Services Office of Inspector General, is authorized to impose a penalty of not more than $10,000 for each violation. The revised rule can be viewed in the September 28, 2001 edition of the Federal Register on page 49544; regulations are effective October 29, 2002 with the comment period open until November 27, 2001.

Kennedy Terminal Ulcer Website Announced
  Karen L. Kennedy, RN, CS, FNP, the developer of the concept of a terminal pressure ulcer, has announced the debut of her website devoted to ongoing investigation and information about what have been termed Kennedy Terminal Ulcers. More than 20 years ago, Karen, a family practice nurse practitioner, began noticing similarities in the appearance of certain pressure ulcers in a particular population of patients in her clinical practice at Byron Health Center, a 500-bed long-term-care facility in Fort Wayne, Indiana. Perplexed by the fact that development of pressure ulcers of a certain appearance often resulted in the death of patients, Karen began to record her observations and clinical findings. After several years of data collection and patient analysis, a definitive pattern became clearly evident. The development of a pear-, butterfly- or irregularly-shaped pressure ulcer with certain color characteristics, which presents superficially but progresses rapidly on certain areas on the body, seemed to be an indicator that death was imminent – usually within 2 weeks. Karen presented the results of her research to the physicians at the facility who, in turn, named this ulcer after her, in recognition of her work in observing and quantifying the sequela.

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