It is supposed to be the gold standard.

"The Nursing Home Reform Act" (click here)

The original reform act was passed in 1989. There hasn't been much more enacted since them.

Amendment of Subsection (d)(1) (click here)

The Joint Commission (click here) on Accreditation of Healthcare Organizations or JCAHO is a nonprofit organization based in the United States that accredits over 20,000 healthcare organizations and programs in the country. The JCAHO commonly is referred to as the Joint Commission in the healthcare industry and among governmental industry regulators on the federal and state levels. The Joint Commission is the successor of an organization established in 1951.

Is your organization (click here) ready to implement the standards? You can assess your readiness in a variety of ways, including:

- Conduct mock surveys. Walk through your facility and see how well you meet the requirements.

- Identify gaps in compliance. Document areas where improvement is needed. This will help target your efforts and prioritize where resources need to be allocated.

- Develop timetable for compliance. Once you've identified areas for improvement, assign completion dates for each gap identified. This will help you formulate a readiness date for your on-site survey.

Regardless of the name of the nursing home, it is probably owned by a corporate company. 

"Facts about long term care accreditation" (click here)

The Joint Commission’s Long Term Care Accreditation Program was launched in 1966. Today, nearly 1,000 organizations offering long term care services are accredited. Organizations eligible for long term care accreditation include those with: 

Beds licensed by the state as nursing home beds, excluding intermediate care facilities specializing in care for individuals with mental retardation and other developmental disabilities. 

Beds designated as long term care beds under a hospital license, excluding beds belonging to a long term acute care hospital and hospital swing beds. 

Beds, units or facilities certified by Medicare or Medicaid as skilled nursing facility beds. 

Beds, units or facilities designated as long term care by a governmental entity, such as the Department of Veterans’ Affairs or a state authority....

The Republicans don't care about the people of this country.

US Senate Majority Leader Mitch McConnell has many names for very valid reasons, including sidling up to Russia and the money of an oligarch, therefore, "Moscow Mitch." But, one of his identities that he proudly touts is "The Grime Reaper." The picture below shows why "Moscow" Mitch enjoys the title of being the Grim Reaper. But, the issue that occurred with Wisconsin and exposing Americans to a known killer virus is an astounding development.


April 9, 2020
By Linda Greenhouse

The Supreme Court (click here) just met its first test of the coronavirus era. It failed, spectacularly.

I was hoping not to have to write those sentences. All day Monday, I kept refreshing my computer’s link to the court’s website.

I was anxious to see how the justices would respond to the urgent request from the Republican National Committee and Wisconsin’s Republican-controlled Legislature to stop the state from counting absentee ballots postmarked not by Tuesday’s election but during the following few days.

A federal district judge, noting that Wisconsin’s election apparatus was overwhelmed by the “avalanche of absentee ballots” sought by voters afraid to show up at crowded polling places, had ordered the extra time last Thursday, with the full support of the state’s election officials. Was I the only one left in suspense on Monday, holding out hope that the five Republican-appointed Supreme Court justices would put partisanship aside and let the District Court order stand?

In early evening, the answer landed with a thud. No, they would not.

In more than four decades of studying and writing about the Supreme Court, I’ve seen a lot (and yes, I’m thinking of Bush v. Gore). But I’ve rarely seen a development as disheartening as this one: a squirrelly, intellectually dishonest lecture in the form of an unsigned majority opinion, addressed to the four dissenting justices (Need I name them? Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan), about how “this court has repeatedly emphasized that lower federal courts should ordinarily not alter the election rules on the eve of an election.”

Yes, the Supreme Court was absolutely myopic with their heads in the academic clouds by five of the conservative judges; but; don't' lose sight of the sincere evil within the Republican Party.

April 8, 2020
By Garrett Eps

...In Wisconsin, (click here) the Democratic governor called a special session to consider a delay; the Republican legislative majority refused even to convene. They calculated that a lower turnout would be good for them, and walked away from their duty to the voters. Applications for absentee ballots surged—an understandable response to the looming danger at the polls—until the numbers overwhelmed state officials.

As of last week, thousands had not yet received their ballot, and so could not mail it to be received by Election Day, April 7. To vote, they would have to risk infection and journey to the polls. A federal district judge found this to be a burden on the right to vote, and ordered the state to accept ballots that arrived by April 13. A federal appeals court approved the order...

This was planned and the Republican Party would not be budged. They were the people that refused to attend to the needs of the people of the State of Wisconsin.

In Congress today, the Republican Party wants to go forward with more funding when they aren't even interested in having an oversight committee in place to monitor the $2.2 trillion for the "CARES" law.

Congress is out of session until Monday. How can McConnell actually expect reasonable people to trust him with more money when the people aren't even sure how the first law was carried out by the Republican executive branch?

The politics in the country are hideous and ridiculous and lack the truth. The people are supposed to be the focus of government, including the Supreme Court, and part of that is the reassurance that their government is working as it is expected.

After this episode of Republican disregard of the people, I have to believe when McConnell embraces the identity of "The Grim Reaper," he really means it. 

The people of this country are not at the center of the Republicans currently in government. Wisconsin is proof. And the complete disregard of reality that Americans are facing on election day by the Supreme Court's ruling, allows the declaration of "Robert's Politically Activist Court."

Never in my wildest imagination would I expect a political party to completely disregard the safety of the lives of the American people and their future. 

The next spending bill cannot be passed until the oversight is in place and certainly not without making provisions to allow elections to go forward with safety built into the elections of this country when facing dangers to Americans' health.

Advice post recovery from COVID-19.

Shortness of breath is a common complaint about this terrible virus. Shortness of breath requires treatment.

My sincerest advice to anyone recovering from COVID-19 is to also make an appointment with a pulmonologist as a follow-up. It is not unusual to have EPISODIC shortness of breath with illnesses that involved the lungs.

ie: Stepping into a shower with mist in the air, shortness of breath sets in and the person feels the need to set down to recover from that moment.

ALBUTEROL is considered a rescue inhaler. It works quickly as opposed to others that are taken long term inhalers that have to be taken once or twice a day, every day. Such a rescue inhaler is also used as a prophylactic. Instead of risking shortness of breath and feeling poorly; BEFORE getting in the shower take a rescue inhaler like albuterol with two puffs.

It takes a little skill that has to be acquired to properly use a rescue inhaler. But, in using it think of it as a PRE-shortness of breath medication as well. Usually, albuterol is taken as two puffs at a time and ordered by an MD up to 6 times a day for rescue breathing. Albuterol is always good to start the day and be the last inhaler at bedtime.

Please see a pulmonologist as an outpatient if recovered or recovering from COVID-19. Don't simply think about suffering quietly as if there is nothing that can help. It is not okay to feel poorly. Always seek help and there is usually something that will help with a simple prescription by a qualified doctor.
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This medication was mentioned in an update from the White House. It is still in trials. No one should be getting their hopes up. The trials are not over.

Remdesivir is an investigational antiviral compound (click here) undergoing clinical trials in China, the United States, and the United Kingdom as a potential treatment for COVID-19.

• Remdesivir is not yet licensed or approved anywhere globally and has not been demonstrated to be safe or effective for any use.
• Remdesivir has demonstrated in vitro and in vivo activity in animal models against the viral pathogens that cause MERS and SARS, which are coronaviruses structurally similar to SARS-CoV-2, the coronavirus that causes COVID-19.
• Novel Coronavirus (2019-nCoV) was first identified in the city of Wuhan, in China's Hubei province, in December 2019. On February 11, 2020, the World Health Organization (WHO) renamed the disease caused by the virus as COVID-19

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April 6, 2020

Dubai/London/Moscow (Reuters) - Major oil producers (click here) including Saudi Arabia and Russia are likely to agree to cut production at a Thursday meeting but only if the United States joins the effort, aimed at coping with the disastrous effect of the coronavirus on fuel demand, three OPEC+ sources told Reuters on Monday....
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Updated April 9, 2020 (click here)

Public Health Laboratory Testing for COVID-19

This page will be updated daily at noon. Numbers close out at 4 p.m. the day before reporting.

CDC is responding to an outbreak of respiratory illness caused by a novel (new) coronavirus. The outbreak first started in Wuhan, China, but cases have been identified in a growing number of other locations internationally, including the United States....