Congestive Heart Failure Symptoms and Causes

Congestive Heart Failure Causes and Symptoms

Causes

Heart failure is most often a long-term chronic condition. The most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure is present when your heart muscle is no longer able to pump enough oxygen-rich blood out to the rest of your body. As the heart pumping becomes less effective, blood may back up in other areas of the body. Fluid may build up in the lungs, liver, gastrointestinal tract, and the arms and legs.

Cough
Need to urinate at night
Fatigue, weakness, faintness
Loss of appetite
Pulse that feels fast or irregular
Shortness of breath
Swollen liver or abdomen
Swollen feet and ankles
Waking up from sleep
Weight gain

Monitoring and Self Care

If you have heart failure, your doctor will monitor you closely. You will have follow-up appointments at least every 3 to 6 months, as well as, tests to check your heart function. Knowing your body and the symptoms that your heart failure is getting worse will help you stay healthier and out of the hospital.

Watch for changes in your heart rate, pulse, blood pressure and weight/li>
Limit how much salt you eat
Limit how much fluid you drink if recommended by your doctor
Ask your doctor how much alcohol you may drink
Do not smoke
Stay active, walk or ride a stationary bike
Ask your doctor to provide a safe and effective exercise plan for you
Do not exercise on days when your weight has gone up from fluid or you are not feeling well
Lose weight if you are overweight
Lower your cholesterol by changing your lifestyle
Get enough rest, including after exercise, eating, or other activities

When to Contact a Medical Professional

Call your health care provider if you develop:

Increased cough or phlegm
Sudden weight gain or swelling
Weakness or light-headedness
Other new or unexplained symptoms

New Senior Living Consortium to Launch Medicare Advantage Network

IN THE NEWS

New Senior Living Consortium to Launch Medicare Advantage Network

In a bold move that could give senior housing operators a template for increasing their revenue and power within the care continuum, four companies are teaming up for a big bet on Medicare Advantage.

Operators Christian Living Communities (of Englewood, Colorado), Juniper Communities (Bloomfield, New Jersey) and Ohio Living (Columbus, Ohio), and managed services partner and risk management company AllyAlign Health (Glen Allen, Virginia) are joining forces to form The Perennial Consortium, an operator-owned Medicare Advantage (MA) network, launching in 2021.

Through the Consortium, these four organizations will launch MA special needs plans on a state-by-state basis, and then sell ownership interest to senior living operators in each state, starting with Colorado and Ohio. The Consortium will own 51% of the MA plan in a given state, with each of the four organizations owning an even 25%. The owner-operators in that state’s plan will share ownership of the other 49%.

“The only way (senior living) can really capture the value (of providing health care) is to control the health care dollar, and the only way really to do that is to become an insurer, and the best way to do that is through the Medicare Advantage program,” Juniper Communities founder and CEO Lynne Katzmann (pictured above), who is spearheading the Consortium, told Senior Housing News.

The number of residents that the Consortium could end up serving is unknown, as it will depend on the number of operators that buy an owning interest in a given state’s plan.

Laurence Gumina, CEO of Ohio Living, estimates that the Consortium will seek 10 operators for the Ohio plan, for instance. In its first year, the Ohio plan alone could enroll 2,000 to 5,000 seniors.

How the Consortium will move operators upstream in Medicare Advantage

Under Medicare Advantage, private-sector companies can collect federal dollars in exchange for offering benefit packages to seniors as an alternative to traditional, government-run Medicare. MA plans can also include some benefits outside of Medicare, most notably dental and vision.

As of 2019, these plans can also fund certain types of non-medical, in-home care services, opening up the possibility for direct reimbursement of some services frequently delivered by senior living providers.

MA plan providers are therefore taking on risk as a bet that they can offer better care at lower cost, thus turning the profit from the premiums into a new revenue stream. The government gets better health outcomes at lower cost to the system, while consumers receive better care at a potentially lower cost to themselves, on a plan that can be tailored to their individual needs.

This is an opportunity for us to get upstream in the payment model.
Laurence Gumina, CEO of Ohio Living

While big insurance companies — including giants such as UnitedHealthcare (NYSE: UNH) and Humana (NYSE: HUM) — are major providers of MA plans, more senior housing operators are realizing the value they hold for the system.

Due in large part to their ability to efficiently manage a patient pool — namely, their residents — senior living providers perceive that they can play a significant role in keeping high-risk beneficiaries out of costly settings such as hospitals, while enhancing their quality of life.

With this in mind, some proactive senior living operators are making investments in care management capabilities, including through onsite primary care delivery.

It’s a natural extension for some senior living providers to not only work more closely with MA plans in their markets, but become insurers themselves. They typically are doing this by starting Medicare Advantage special needs plans targeted to beneficiaries living in their senior housing and care settings. Special needs plans have been around for many years, but were just permanently authorized in 2018.

“In order for us to continue to sustain our missions, whether they be for-profit or not-for-profit, we have to put more of our care outcomes at risk for more of a return,” Gumina says.

“As a result of our — and again, I say this respectfully — as a result of the great care we’re providing, we’re adding balance sheet and P&L (profit and loss) strength to the insurance companies’ P&L, and not our own. So this is an opportunity for us to get upstream in the payment model.”

What each organization brings to the Consortium

The four organizations that will own the Perennial Consortium offer the following value:

Juniper Communities: Five communities in Colorado and a successful model for providing onsite primary care to seniors, called its Connect4Life model. Juniper’s portfolio comprises 22 communities.
Ohio Living: Thirteen life-plan communities in Ohio (the largest operator in Ohio), with institutional experience delivering primary care onsite and a certified home health business, including hospice, all of which brings care and support to about 73,000 Ohio residents per year.
Christian Living Communities: Nine communities in Colorado with two under construction. Gumina calls CLC “an Ohio Living-like organization” with “mirrored values and mirrored outcomes,” such as reduced ER visits and resident turnover.
AllyAlign Health: Deep MA knowledge and know-how, by virtue of its 19 provider-owned MA plans across the U.S.

Juniper’s Connect4Life model provides the analytical centerpiece, proving senior housing’s ability to contribute to the success of MA plans. Since partnering with Redwood Health Partners in 2015 to bring primary care onsite to its residents, Juniper has seen staggering results touching on hospitalization and occupancy.

As seen in a 2017 joint report from Juniper and Anne Tumlinson Innovations on Connect4Life:

Hospitalization rates among Juniper residents in the Connect4Life modelhave dropped more than 50% compared to a similarly profiled population of about 6.5 million Americans
Move-outs at Juniper have dropped 27%

The study shows that integrating service-enriched housing with chronic care management can reduce the cost to Medicare by $10 billion to $15 billion a year, if applied to those 6.5 million Americans. That model will be at the heart of the Perennial Consortium.

To succeed, Medicare Advantage plans require a critical mass of enrollees; this is one reason why a consortium approach makes sense for small and mid-size senior living providers that are looking to launch plans. But there are other reasons why the Perennial Consortium organizations decided to work together.

“My belief was that a single company like Juniper doing it on its own did not have not only the economies of scale, but we would not have as much influence on public policy if we did it alone,” Katzmann says about the Consortium’s team-first approach.

“My view is that senior housing really is part of the solution to health care reform, and that senior housing deserves a piece of that pie to do more of what we do well. And the only way to make that happen is to do it collectively.”

This article draws from the new report, “The Primary Care Opportunity In Senior Living.” Click here to access the complete report, which digs deep into the future of direct primary care delivery in senior housing, and hears from the innovators moving senior living upstream for Medicare dollars in 2019 and beyond.

For original article, click here

Why All in One Senior Living, Primary Care is a Winning Bet

IN THE NEWS

Why All in One Senior Living, Primary Care is a Winning Bet

Senior Housing News: Is traveling to a doctor’s appointment a thing of the past? When it comes to all in one senior living, one senior housing operator seems to think so.

Through an innovative partnership, the company has primary care providers – specifically trained to care for senior living residents (all in one senior living) – keeping regular office hours at its communities’ on-site clinics, cutting transportation arrangements and other hassles out of the picture entirely.

Bloomfield, New Jersey-based Juniper Communities operates 18 long-term care communities in New Jersey, Colorado, Pennsylvania and Florida. The provider recently partnered with Redwood Health Partners, an on-site primary care provider that solely operates within assisted and senior living residences, skilled nursing and rehabilitation centers, and special-purpose memory care communities. Juniper previously piloted its first on-site Redwood Health Partners clinic at Juniper Village-The Spearly Center in Denver in December 2013.

The partnership between Juniper and Redwood was forged in part because Juniper recognized the permanence of the Affordable Care Act (ACA), Juniper CEO Lynne Katzmann told Senior Housing News.

“We’re one of the few providers that’s really said, okay, the ACA is here to stay,” Katzmann said. When the ACA began, Juniper started to look seriously at care transitions and realized that the primary care doctor “is really critical” for preventing readmissions to hospitals.

“Having primary care on-site made sense,” Katzmann said.

all-in-one senior living clinic interior — Juniper Village at Aurora

Redwood Health Partners, like Juniper, is based in Bloomfield, and was willing to be part of Juniper’s communication protocols—that is, it was willing to use Juniper’s existing electronic health record.

This agreement enables Redwood physicians to provide cohesive, quality care, because they can both enter their own notes into residents’ EHRs and see notes from staff and additional ancillary providers, Katzmann told SHN. Redwood practitioners will also take part in Juniper’s care planning process.

To Katzmann’s knowledge, no other senior housing providers in Juniper’s markets are offering similar health care services.

“We’ve become known as an innovator,” Katzmann said.

Boosting Life Expectancy, Boosting Profit

Standing out from the competition has benefitted Juniper Communities’ bottom line, plain and simple.

Offering primary care on-site in a residential care setting has been proven to reduce hospital readmissions, as well as extend life expectancy, Katzmann told SHN. Longer life expectancy translates into longer length of stay—which, in turn, translates into more profit.

“The integrated model really works,” Katzmann explained. Juniper’s readmission rate in the second quarter of 2015 across 18 buildings was only 2%.

Partnering with Redwood is part of Juniper’s larger Connect 4 Life strategy, which is intended to make Juniper a preferred provider with accountable care organizations and hospital discharge planners, Katzmann said. The low readmission rate makes Juniper especially attractive, given that under ACA policies, hospitals face Medicare penalties if too many patients return soon after discharge.

“A referral source sees us as a place to send people,” she added.

Plus, the return on investment potential involved in such partnerships is enormous, especially when the services are Medicare-billed, like they are at Juniper.

“It’s effectively no cost to the facility, and more convenient for the facility and for the residents,” Katzmann told SHN. “It’s simple, it’s easy, and it doesn’t cost a provider anything.”

Not Done Yet

Looking ahead, Juniper has big plans for its Redwood partnership.

At present, Redwood Health Partners provides services in five Juniper Village communities: two in New Jersey and three in Colorado. This month, two communities in Pennsylvania are scheduled to begin participating in the Redwood partnership, according to a company blog post.

All Juniper communities are anticipated to have all-in-one Senior Living Redwood clinics by early 2016, Cindy Longfellow, national director of sales and marketing for Juniper Communities, said in the same post.

Although residents are legally free to choose their own doctor, right now, in some communities, 96% of residents use Redwood primary care physicians. The goal, Katzmann told SHN, is to eventually have this number reach 80% across all Juniper communities.

The families of Juniper residents, as well as Juniper employees, are also free to join Redwood as “members” and use Redwood for their primary care needs, further extending the benefits of a program that already seems to be paying off in myriad ways.

Written by Mary Kate Nelson

For original article, click here

Juniper Communities brings onsite healthcare to senior living communities Joins forces with Redwood Health Partners

IN THE NEWS

Juniper Communities brings onsite healthcare to senior living communities Joins forces with Redwood Health Partners

Bloomfield, NJ – In a bold strategic move, Juniper Communities has signed on with Redwood Health Partners to provide onsite healthcare to its residents. By providing patient-centered care in its senior living communities – Juniper Villages – residents will experience a dramatic improvement in the healthcare delivery method. No more waiting for appointments, making transportation arrangements, or lack of communication among the residents’ healthcare providers.

“Integrated primary care, provided on-site, benefits our residents and their families in many ways – ease of communication, convenience, coordination of care, and much more. It allows residents to feel more in control of their care and more involved in care decisions,” stated Lynne Katzmann, founder and CEO of Juniper Communities.

In addition to resident care, Juniper Communities residents’ families and employees can also become a Redwood ‘member’. “Delivery of service in a convenient, accessible location will improve outcomes and increase quality of life for each member” says Cindy Longfellow, national director of sales and marketing for Juniper Communities. “We look forward to developing this partnership further, and extend it to all of our communities by early 2016.”

Currently, Redwood can be found in the following Juniper Village communities: Aurora, Louisville and the Spearly Center in Colorado; Chatham and Williamstown Village and Wellspring in New Jersey. Lebanon and Mount Joy in Pennsylvania will be the next communities to benefit from the Redwood partnership. Redwood Health Partners will be serving patients there beginning in November.

About Juniper Communities

Juniper Communities, founded in 1988 operates long-term care communities in NJ, FL, PA and CO. Juniper is dedicated to Nurturing the Spirit of Life in each individual served and believes the keys to healthy aging are an active body, an engaged mind, and a fulfilled spirit. The company’s mission is to serve its stakeholders, residents, families, employee associates, and investors with excellence and strong dedication to the company’s hallmarks of quality, value and innovation. Juniper Communities is located at 400 Broadacres Drive, Bloomfield, NJ 07003.For more information on Juniper call 973.661.8300 or visit www.junipercommunities.com.

Redwood Health Partners

What about seniors living at home? Our communities will soon be introduced to Redwood Health Partners, a new primary care practice located on site at Juniper Village. The goal of Redwood Health Partners is to provide easily accessible care and service from credentialed providers. Instead of the doctor coming when it is convenient for him or her, the Redwood Health Partners practitioners will have regular hours right in your community. They will use our electronic health record and will participate in care plan development and care conferences. They offer another resource for addressing chronic or emergent health issues.Redwood Health Partners will help us “nurture the spirit of life” by keeping people in their home doing the things they love as long as possible.

We will be describing this effort to coordinate many levels of care for you in your home over the next several months. In the meantime, if you want to learn more about Redwood Health Partners, ask your Wellness team for a brochure!

Care Transitions: Better Access to Care Means Better Health

IN THE NEWS

Care Transitions: Better Access to Care Means Better Health

Recently, Walmart announced that it would open primary care clinics in its stores. The centers are staffed largely with physician extenders, the umbrella term for nurse practitioners and physician assistants. Services are limited to preventive care, minor treatments, diagnosis of non-complex conditions and monitoring for chronic conditions.

Shortly thereafter, CVS Caremark, a national pharmacy chain changed its name to CVS Health. This coincided with its decision to stop selling tobacco products. CVS Health is also opening walk-in primary care offices; these started with providing flu and other vaccines and are expanding to provide services similar to the Walmart clinics.

I think this is just the beginning. Many retail stores, particularly those that have been involved in pharmacy, will be doing the same thing as will large employers like General Electric. Providing access to care and service early can improve quality, satisfaction and lower insurance costs. These clinics are geared to a society on the go. We want care when we need it or have the time to get it, not when our doctor has office hours!