Christine Lutrario

Sunday Morning Bathroom Read: Connecticut HB 5320 ( a/k/a the “Connecticut Public Defender and Risk Transfer Bill”) which recently passed the CT House of Representatives, creates a uniform application process and ELIGIBILITY criteria for financial assistance that requires not for profit hospitals to provide all medically necessary and emergency care services at the hospital’s full risk solely based upon an income level at 250% of the FPL ( $78,000 for a family of four) and without an asset test. Letterman Top 10 Market and CAA Implications: 1. The overall percentage of the US that earns an income level of 250% of the FPL is roughly 44%. I assume CT is similar; 2. Oscar and CIGNA recently announced that both will be leaving the CT small group market (https://lnkd.in/gmhH-gtd. ): 40% of the population effectively does not need insurance; 3. Plan design for CT employers moving forward: a) <250% of the FPL: MEC + CT Public Defender Plan; b) >251% of the FPL: RBR at the AGB% or ICHRA + fully funded HRA/HSA; c) Or depending upon the overall financial makeup of the group, ICHRA +CT Public Defender Plan; 4. Estate plan design (Risk Transfer): Ex):Business owner is diagnosed with cancer and has $1mm in cash and an income level of $500,000: Strategy: Slash income to 250% of the FPL and move this individual to the CT Public Defender Plan. There is a full risk transfer to facility and personal and business assets are unequivocally protected; 5. Joe lunch bucket (who has chronic back problems) is awarded a $100 a month raise which puts him above 250% of the FPL and on the company health plan. Maybe he declines the raise until his back gets better because the pay increase COSTS him more by being insured and paying premium; 6. Stop loss: For policies issued to plans in CT, I would include a provision that provides that claims are not subject to reimbursement in the event that an individual was eligible for financial assistance; 7. CAA Fiduciary Compliance: If the facility is "charging” FAP eligible patients its AGB percentage (40% of the CT market), shouldn’t everyone else get that rate? Medicaid, Medicare, Percentage of Walmart and CASH; 8. Claims data= medical, RX AND member financial information provided at the time of enrollment; 9. Office Linebacker: The Connecticut Health Systems Planning Unit; 10.Families that earn <250% of the FPL might just get a nice raise… . Happy Mother's Day to all of the mom's.

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New York State DOH recently released this advisory regarding Monkey Pox. Be aware of the identification and review your Infection Control policies. Money Pox, also known as Mpox, can be transmitted through several methods (1,2): 1. Direct Contact: Mpox can spread through direct skin-to-skin contact with an Mpox rash or scabs from a person with Mpox1. This includes intimate or sexual contact (1). 2. Bodily Fluids: Contact with saliva, upper respiratory secretions (snot, mucus), and bodily fluids or lesions around the anus, rectum, or vagina from a person with Mpox can also lead to transmission (1). 3. Pregnancy and Birth: Pregnant people with Mpox can pass the virus to the fetus during pregnancy or to the newborn during and after birth (1). 4. Contaminated Objects: Mpox virus can spread through contact with objects, fabrics, and surfaces that have not been disinfected after use by someone with Mpox. This includes items like clothing, bedding, towels, fetish gear, or sex toys (1). 5. Infected Animals: Mpox can spread from animals to people through direct close contact with an infected animal, fluids or waste, or getting bitten or scratched (1). It's important to note that the virus can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed (1). Some people can spread Mpox to others from 1 to 4 days before they have symptoms (1). Currently, no evidence suggests that people who never have symptoms can spread the virus to someone else (1). Scientists are still researching other possible modes of transmission, such as through semen, vaginal fluids, urine, or feces(1). Please follow the latest updates from trusted health organizations like the CDC for the most accurate information. Source(s) 1. How It Spreads | Mpox | Poxvirus | CDC 2. CDC Monkeypox Response: Transmission | CDC Online Newsroom | CDC

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UAlbany's Jean Moore discusses the nursing shortage in New York and identifies strategies for improving the recruitment and retention of patient care RNs in this episode of The Engagement Ring podcast:

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ATTENTION: Nurse Practitioners(NP) and Physician Assistants(PA). ABTC is asking for your time and participation in a survey on Transplant Certification. Your insights are invaluable in understanding the perspectives and experiences surrounding this essential aspect of healthcare. https://lnkd.in/gn_wB8Q7

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Are you a newly minted nurse ready to make a difference but unsure where to start your job search? Don’t worry – we've got you covered! Here’s how to land your dream nursing job: 1. Polish Your Resume 📄 Highlight Clinical Experience: Showcase your clinical rotations, internships, and volunteer work. Certifications: Make sure all relevant certifications are listed prominently. Tailor for Each Job: Customize your resume to match the job description. 2. Build Your Network 🤝 Leverage LinkedIn: Connect with nursing professionals, join nursing groups, and engage with healthcare content. Attend Nursing Events: Participate in job fairs, webinars, and networking events. Reach Out to Mentors: Seek advice and referrals from your nursing school instructors and professional mentors. 3. Research Potential Employers 🏥 Company Culture: Look for hospitals and clinics that align with your values and career goals. Career Growth: Check for opportunities for professional development and advancement. Employee Reviews: Read reviews on platforms like Glassdoor to get a sense of the work environment. 4. Ace the Interview 🎤 Prepare Your Stories: Be ready to discuss your experiences, challenges, and successes during clinical rotations. Know the Common Questions: Practice responses to common nursing interview questions. Show Your Passion: Convey your enthusiasm for nursing and your eagerness to contribute. 5. Stay Persistent 💪 Don’t Get Discouraged: Rejections are part of the journey. Use them as learning experiences. Keep Improving: Continuously refine your resume, cover letter, and interview skills. Follow Up: Always send a thank-you note after interviews and keep in touch with potential employers. 6. Consider All Options 🌐 Be Open: Look beyond hospitals – consider clinics, long-term care facilities, schools, and community health centers. Temporary Positions: Consider per diem or travel nursing to gain experience and make connections. Your journey to finding the perfect nursing job might be challenging, but every step brings you closer to making a real impact in healthcare. Stay positive, stay persistent, and remember – your dream job is out there waiting for you! #NewNurses #NursingJobs #CareerTips #JobHunt #NursingCareer #NurseNetworking #NurseMentors

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Clinical Audit program improvment KPIs. that help you to improve your department.

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https://lnkd.in/eeFPi-9B An update from my home state of Pennsylvania. Unfortunately, many of these state collaborative agreements between nurse practitioners and physicians turn into what the medical anthropologist Elena Buch called a "paradox of inequality" when one vulnerable population is created to address the needs of another vulnerable population. While collaboration with physicians sounds wonderful for patient care, they are busy with their case loads and charge thousands for "collaboration" that is often over the phone, scant, and quite brief. I once couldn't track my collaborative physician down for five weeks when he was marking my calls and texts as spam. This hurts the APRN run practices who can't afford thousands for a document that represents very little in terms of true collaboration. For the sake of this legal document we become the next vulnerable population paying money we don't have for collaboration that doesn't happen to abide by the laws that don't recognize full practice authority. It took a medical anthropologist to describe the phenomenon, she wrote a wonderful book describing this phenomenon in the American homecare industry: Buch, E. D. (2018). Inequalities of aging: paradoxes of independence in American Home Care. In Inequalities of Aging. New York University Press. Dr. Lynn Rapsilber DNP ANP-BC FAANP Christina Mukon

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From the heart of the Keystone State, Pennsylvania, we're proud to spotlight the remarkable 67 certified Registered Nurse First Assistants (RNFAs) blazing a trail in healthcare excellence! 🌟 Like this post if you love Pennsylvania! If you practice in Pennsylvania, post a comment to introduce yourself! #RNFirstAssist #SurgicalAssistancePA #PennsylvaniaNurse #PerioperativeNursing #SurgicalTeamPA 4

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Regarding HHA and PCA Training and In-Services in New York State: In addition to the initial training, HHAs and PCAs are required to participate in in-service education programs to enhance their knowledge and skills continuously. These in-service programs ensure that aides stay updated with the latest practices and regulations in home care. 6 clock hours for PCAs, and 12 clock hours for HHAs annually. What are “clock hours?” In-class, in-person training. No on-line training is counted in the State of New York by the NY State Department of Health or the New York State Education Department. Clock-hours requires the RN trainer to have the aides sign in (not electronically), with date, time, subject of in-service and RN signature. Both state agencies are clamping down on in-service matters, including the annual mandates, such as HIPAA, fire/safety/infection control, sexual harassment, etc. If OSHA, DOL or the state requires these to be performed annually, these can be counted as clock-hours. The RN has to sign off on all of this, so don’t get caught short when applying these mandatory standards. HHA/PCA training is also by clock-hours as well. Only during COVID did the state allow for virtual/online training, followed by skills competency in the classroom. New York State also does not allow on-line training either for either course. The agency and the nurse can lose their licenses. Recent on-site surveys have found many deficiencies in these areas, calling for the employee to be re-trained in the classroom. Repeat violators can lose their training approvals. Always finish the in-service with a competency quiz to assure their retained knowledge meets the content of the topic you are providing. This must be graded by the RN, counter-signed and saved in their personnel file. There is no online initial training allowed for PCAs and HHAs either. 

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Check out this article featuring 11G Manger Kerryanna Elhage as she addresses the topic of nurse burnout! https://lnkd.in/e9q4WACK

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It's National Thrombosis Week (May 6-12), and at The Montefiore Hospital we are highlighting the importance of understanding thrombosis! Did you know that it is one of the leading causes of preventable deaths worldwide? We spreading awareness about the risks and prevention of this serious condition. What is Thrombosis?  Thrombosis occurs when blood clots block your blood vessels, potentially leading to critical health issues like stroke, heart attack, or pulmonary embolism. Who is at risk?  Anyone can be at risk, but certain factors like immobility, surgery, certain medications, and chronic conditions increase the chances. How can we prevent it? - Stay active and exercise regularly. - Maintain a healthy diet and hydration. - Follow medical advice on medication and treatments. If you want to find out more, come to our stand at the hospital's reception where you can talk to Vicky, one of our registered nurses, about anything related to the topic. #NationalThrombosisWeek #ThrombosisAwareness #HealthMatters #PreventThrombosis #StayInformed

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Want to join the Greater NY Nursing team? Here’s a few tips and tricks to build a resume that shines: ⚡Start strong with a clear objective statement that grabs attention from the get-go. Make it concise yet compelling! 🏆 Don't be shy! Show off your skills and accomplishments. Let your resume shout out your value loud and clear. 🩺 Highlight your clinical experience and expertise. Let them know you're not just good; you're great at what you do! 🎓 Education matters! Include your level of education and graduation date to showcase your dedication and qualifications. 📝Attention to detail is key! Ensure your grammar is spot on. Little mistakes can make a big difference. Ready to take your nursing career to the next level? Craft that winning resume and land your dream job at Greater NY Nursing! #NursingJobs

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From Masonicare, Connecticut’s largest not-for-profit integrated senior care continuum, an article entitled, “Can Moving to a Senior Living Community Prolong Your Life? It Just Might.” @ https://lnkd.in/eTEMn79E. Here’s a snippet… Here is what we know: Individuals who move into senior living communities are more physically, mentally and emotionally fit than people their same age who choose not to, or don’t have the means to, move into a community. Here are key factors that senior living communities promote, which can lead to a longer life: Mental Stimulation Social isolation is a killer. There are numerous studies that point to social isolation leading to early mortality, including a comprehensive meta-analysis of 90 studies published in June 2023 by Nature Portfolio @ https://lnkd.in/e8T6Hxhp They found that individuals who were socially isolated have a 32% greater risk of dying early compared to their peers who weren’t socially isolated. Senior living communities provide the perfect setting for camaraderie and connection. Even if you’re living alone, there are opportunities every day to interact with other residents thanks to numerous events and other activities organized within the community. Additionally, meals can be shared with your peers in a communal setting, which leads us to… Nutrition and Diet Eating a healthy, balanced diet is critical for anyone who wants to live a happy, long life. Sadly, many seniors are unable to maintain a well-rounded diet due to a variety of social and health determinants. In a community, however, what can be a daily struggle for seniors living on their own, is remedied by nutritious, beautifully prepared meals provided by community chefs. Malnutrition is a serious concern; one that can lead to weakness, decreased immune system, as well as decreased muscle and/or bone mass. In seniors, this can in turn lead to illness or injury. These are exactly the outcomes senior living communities are working so hard to prevent. Physical Fitness The events and activities that many senior living communities offer not only provide a place to stave off social isolation, but they also provide residents with the exercise they need. Naturally, seniors who are more physically fit tend to have fewer health complications and as a result live longer than those who are not. Additionally, according to the National Institutes of Health @ https://lnkd.in/ePnJB9if people who live an active lifestyle and pursue activities they enjoy are far less likely to develop a chronic disease. Safety and Access to Medical Care Lastly, and most importantly, senior living communities provide a safe environment where access to medical care is readily available. Do senior living communities prolong one’s life? With a supportive community, regular events and activities, healthy, prepared meals and a secure environment, one can perhaps live a longer life in a senior living community

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Happy to be back in the classroom today with our NP students at Hofstra School of Nursing, presenting "The Conversation" as a vital element of #healthcare. Advance care planning and setting goals of care are more important than ever especially as medical complexity increases. More and more #nursepractitioners will encounter complicated treatment decisions, relying on the fundamentals of medical ethics to guide their discussions but never forgetting the goal of honoring our patients wishes. Prognostic conversations, honoring patient wishes, and discussing end-of-life care are not just important—they are essential to providing patient-centered healthcare. By focusing on these critical components, we ensure that our patients receive care that aligns with their values and preferences. A special thank you to Barbara Callahan, DNP, MS, ANP-BC, GCNS-BC for supporting this body of work and inviting me to deliver this lecture. #HealthcareEducation #AdvanceCarePlanning #PatientCenteredCare #MedicalEthics #NursePractitioners #Passionandpurpose

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