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Jwheel86

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Posts posted by Jwheel86

  1. 5 minutes ago, TUFKAK said:

    That’s fine in theory but how’s it paid for? What providers are gonna do it? It’s like saying my ER needs more nurses when nobody is applying and nobody is staying.

     

    Same payer that's covered her hospital stay, Medicaid. That's a huge issue and if it isn't addressed the acute care hospitals are going to be the long term care providers of last resort. This girl's care in the hospital likely cost NC Medicaid several million dollars over 5 years. The money is there, and the service models within Medicaid are there, the trick is untethering it from the most expensive service models while drastically raising rates for those community based service models to get the work force. Maybe I'm wrong but I'm betting that hospital nurses would rather do Private Duty Nursing and CNA in nursing homes would rather do home care. The problem is wages and benefits are under the community models. 

    • Halal 1
  2. 1 hour ago, Slug said:

    It sucks, but I kinda get where the hospital is coming from.  She's been occupying an ICU room for going on 5 years.

     

    "...a nursing home it found in Virginia after no nursing home in North Carolina would take her."

     

    ^^^ Why won't places in NC take her?  I wasn't clear on this.  It seems like payment isn't a problem.

     

    28 minutes ago, CitizenVectron said:

     

    If I had to guess, because there simply aren't enough beds/rooms? Long-term care is basically maxed out continent-wide right now...it's going to be a disaster over the next 10-20 years as boomers all start needing places to go.

     

    It's this. Likely contributing is they couldn't find a nursing home in NC that's contracted with NC Medicaid, a problem that's going get worse as states (which NC has ~90% completed) privatize their Medicaid programs with much more limited networks of providers (NC Medicaid has gone from basically one easy state ran fee for service model to 6 different private plans each requiring contract negotiations with providers, that'll be increasing to 10 different plans this summer, as a result a bunch of big providers are refusing to sign with all 10).

     

    The demographic cliff is already hitting, untrained caregivers are already demanding $20-$25/hr starting wage and I don't think $30-$40 is going to be crazy in the next decade. All that boomer wealth is going to be sucked up by long term care costs. 

     

    2 hours ago, TUFKAK said:

    Hospitals shouldn’t be long term care solutions, I just have no clue what a feasible option here is.

     

    In her case the best option would be Medicaid Private Duty Nursing combined with a Medicaid Home and Community Based Services waiver living in a college dorm. That'll give her the skills to manage her independence while surrounded by college kids who can jump in to help. That's basically what the Muscular Dystrophy community does along with older quads. 

    • True 1
  3. WWW.NPR.ORG

    A young North Carolina woman has refused to go to a nursing home in another state. While she wants to leave the hospital, she asks to live in her own home, close to family and her school.

     

    Cliff notes:

    • Quad since she was a young child in a car accident, raised by her grand father until she was 13.
    • Has been in the hospital since she was 13 years old.
    • She's graduated high school with a high GPA and has been admitted to a small liberal arts college in her home town.
    • Hospital wants send her to a nursing home out of state away from family. 
    • Hospital threatened to not let her return if she left to attend her high school graduation, a judge had to issue a order letting her attend graduation.
    • Guillotine 1
  4. Speaking of the Yakuza.....

     

    WWW.JUSTICE.GOV

    Damian Williams, the United States Attorney for the Southern District of New York; Matthew G. Olsen, the Assistant Attorney General of the Justice Department’s National Security Division; and Anne Milgram, the Administrator of the U.S. Drug Enforcement Administration (“DEA”), announced the issuance today of a Superseding Indictment charging TAKESHI EBISAWA with conspiring with a network of associates to traffic nuclear materials from...

     

    • Sicko Sherman 1
  5. Oh, cool, the Houthis have unmanned suicide submarines now. 

     

    US Central Command 

    Quote

    Feb. 17 Summary of Red Sea activities TAMPA, Fla. – Between the hours of 3:00 p.m. to 8:00 p.m. (Sanaa time), Feb. 17, CENTCOM successfully conducted five self-defense strikes against three mobile anti-ship cruise missiles, one unmanned underwater vessel (UUV), and one unmanned surface vessel (USV) in Iranian-backed Houthi-controlled areas of Yemen.

     

    This is the first observed Houthi employment of a UUV since attacks began in Oct. 23. CENTCOM identified the anti-ship cruise missiles, unmanned underwater vessel, and the unmanned surface vessel in Houthi-controlled areas of Yemen and determined they presented an imminent threat to U.S. Navy ships and merchant vessels in the region. These actions will protect freedom of navigation and make international waters safer and more secure for U.S. Navy and merchant vessels.

     

  6. 11 minutes ago, Commissar SFLUFAN said:

    Like @Jwheel86, I'm also one episode away from being caught up and am genuinely enjoying the living heck out of this season and its well-paced (at least so far!) narrative momentum...except when anything involving the American hostess is on-screen.  This continues to be the least-engaging part of the show for me and could easily have been excised to give more space for something like @Greatoneshere's suggestion of a greater "episodic" approach of Jake covering individual stories apart from the overarching yakuza narrative through-line. 

     

     

     

    If you read the real guy's wiki and the book's wiki you'll kind of understand why they included that entire plot in the show. There is 1 major and 1 spoilers in it fyi. 

  7. On 2/15/2024 at 9:58 AM, mclumber1 said:

    Russia knows how to build nuclear weapons, and they know how to build spacecraft.  It isn't hard to imagine them being able to integrate the two into one platform.  My biggest worry (if it is never used) is what happens to it after the satellite that carries the weapon fails?  The object that everyone is currently tracking is in low earth orbit.  Eventually, the orbit will decay and the payload will reenter the atmosphere. 

     

    We have a plan. 

     

     

  8. WWW.NYTIMES.COM

    The inquiry found that the president had willfully retained material after finishing his term as vice president and had shared sensitive information with a ghostwriter.

     

    Republican Special Counsel turned the report into a case for the 25th Amendment. 

     

    Quote

    “Mr. Biden would likely present himself to a jury, as he did during our interview with him, as a sympathetic, well-meaning, elderly man with a poor memory,” Mr. Hur wrote.

     

    “He did not remember when he was vice president, forgetting on the first day of the interview when his term ended (‘if it was 2013 — when did I stop being Vice President?’), and forgetting on the second day of the interview when his term began (‘in 2009, am I still Vice President?’),” the report said.

     

    The report recounts that Biden did not remember “even within several years” when his son Beau died. It says his memory appeared “hazy” in recounting even the debate over Afghanistan that “was once so important to him.”

     

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