Archive for November, 2009
Waves of new fund cuts imperil US nursing homes
November 23rd, 2009 | 
Author: Janitorial Supplies Michigan – Amerisource Industrial Supply
US nursing homes pushed to brink: fund cuts, recession force layoffs, cutbacks, closings
- By Dave Collins, Associated Press Writer
- Sunday October 4, 2009
HARTFORD, Conn. (AP) — The nation’s nursing homes are perilously close to laying off workers, cutting services — possibly even closing — because of a perfect storm wallop from the recession and deep federal and state government spending cuts, industry experts say.
A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at week’s end by the federal Centers for Medicare and Medicaid Services — on top of state-level cuts or flat-funding that already had the industry reeling.
And Congress is debating slashing billions more in Medicare funding as part of health care reform.
Add it all up, and the nursing home industry is headed for a crisis, industry officials say.
“We can foresee the possibility of nursing homes having to close their doors,” said David Hebert, a senior vice president at the American Health Care Association. “I certainly foresee that we’ll have to let staff go.”
The funding crisis comes as the nation’s baby boomers age ever closer toward needing nursing home care. The nation’s 16,000 nursing homes housed 1.85 million people last year, up from 1.79 million in 2007, U.S. Census Bureau figures show.
Already this year, 24 states have cut funding for nursing home care and other health services needed by low-income people who are elderly or disabled, according to the Center on Budget and Policy Priorities, a nonprofit research firm based in Washington, D.C.
Some facilities are now closed because of money problems — including four in Connecticut — and others have laid off workers because of what industry officials say are inadequate Medicaid reimbursement rates. Medicare cuts are troubling, they say, because the higher Medicare reimbursements have been used to compensate for the lower Medicaid rates.
In Griswold, Conn., the community’s only nursing home shut down earlier this year because of rising costs and an inability to pay for $4.9 million in needed renovations for the 90-bed facility.
“A 92-year-old woman was screaming and crying as she was loaded into the ambulance, saying ‘This is my home,’” Griswold First Selectman Philip Anthony said. His 88-year-old mother was a resident of the same home at the time.
Anthony sought and found a new facility for his mother, but she died of pneumonia before the Griswold Health and Rehabilitation Center closed in the spring.
“To be hit with a sudden and deliberate closure like this, it just drained the heart right out of you,” Anthony said.
Connecticut Gov. M. Jodi Rell and state lawmakers gave no Medicaid rate increases to nursing homes in the state last fiscal year and kept the funding flat for the next two years.
The Griswold home was one of four nursing homes in the state that have closed since December because of financial problems, a higher rate than usual, said Deborah Chernoff, a spokeswoman for District 1199 of the New England Health Care Employees Union in Connecticut, which represents more than 20,000 health care workers in the state.
“We’re really teetering on the edge of what we see as the collapse of the long-term care system,” she said.
Chernoff said many of Connecticut’s 240 or so nursing homes have been reducing workers’ hours to deal with money problems, while two are in bankruptcy now.
Also this year across the country:
– The Motion Picture & Television Fund said in January it would close a hospital and nursing home in Woodland Hills, Calif., founded to care for actors and other entertainment industry workers, because of financial losses.
– The Westchester Medical Center in suburban New York said it would close a nursing home and cut 400 jobs to deal with Medicaid and other fund cuts.
– The Dove Health Care nursing home in Glendale, Wis., near Milwaukee, closed this summer because of heavy debt.
– Medicaid reimbursement rates to nursing homes were cut this year by Rhode Island (5 percent); Michigan (4 percent) and Florida (3 percent).
– Washington state legislators whacked nursing home funding by $93 million for the next two fiscal years.
Gary Weeks, executive director of the Washington Health Care Association, said some of the organization’s 400 assisted living and nursing homes have laid off workers. Some will not survive, he said.
At the request of Weeks’ association, a federal judge in July issued a temporary restraining order blocking the cuts because state officials didn’t do a required analysis of how the reductions would affect care quality and access.
“There’s a lot of pain going on everywhere, but it’s clearly a crisis in long-term care,” Weeks said.
“You’re going to find that some folks go out of business,” he said. “Some will look for more Medicare patients — Medicare pays more than Medicaid.”
In Washington, D.C., health care interests are resisting President Barack Obama’s plan to pay for his health care overhaul by slowing Medicaid and Medicare spending. Obama wants to trim $313 billion from the two programs over 10 years.
It’s not clear exactly how all the health spending cuts will affect nursing homes.
A University of Pittsburgh study earlier this year found nearly 1,800 nursing homes nationwide closed from 1999 to 2005, about 2 percent each year.
One of the study’s authors, health policy and management professor Nick Castle, said the annual closure rate is rising, for reasons that include inadequate Medicaid reimbursement rates and the push for more home and community care.
“It’s come to a head recently with state budgets being in such jeopardy that they’re cutting in all areas,” Castle said.
The federal stimulus package approved in February includes $87 billion in Medicaid funding to help states. But Connecticut and several other states are using a loophole in the legislation to divert the money to budget items unrelated to health care, according to a congressional study.
On average, Medicaid payments by states to nursing homes fell short by $12 per patient, per day last year — nearly $4.2 billion in unreimbursed costs for Medicaid-allowed expenses, according to the AHCA.
In New York City, the Metropolitan Jewish Health System laid off about 200 of its 1,000 employees at three nursing homes in Brooklyn because the state cut Medicaid funding by 10 percent to 14 percent, said President and Chief Executive Eli Feldman.
“We understand there’s a recession/depression,” Feldman said. “But this is not health reform … and the victims are basically the people who live in the facilities. The Legislature basically says, ‘Too sick, too old, too bad.”
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Tension Bolts
Industrial Supplies Michigan Tennessee Wisconsin – Fasteners
Tension Bolt Assemblies
Tension Fasteners systems are designed to be installed with various types of lightweight portable electric wrenches specifically intended for use with this style of structural fasteners. They can be utilized for any applications where A325 or A490 – Type I or Type III (weathering steel) hex bolts are specified. The installation tool has an inner socket which engages the spline tip of the bolt, while the outer socket engages the nut. The outer socket rotates the nut relative to the bolt spline, and when the tension is sufficient in the fastener, the spline tip simply twists-off, leaving the tightened bolt correctly installed in the connection.
The key advantage of this type of bolt is the installation time savings by eliminating the torque and tension testing requirements of hex bolt installation.
Dipped Glove Selection Guide
Industrial Supplies Michigan Tennessee Wisconsin Dipped Gloves – Amerisource Industrial Supply
Dipped Glove Selection Guide
Flat Nitrile Coated
- Strength – Non-porous high chemical resistance; high abrasion resistance; great for dry applications
- Weakness – Poor wet grip; no coating breathability; slightly stiff; low cust and heat resistance
- Applications – Automotive assembly, food packaging, furniture mfg, electronics, pesticides, oil refining
Foam Nitrile Coated
- Strengths – Flexible; porous; tacky coating for better grip; water permeable; excellent grip in all applications; excellent breathability
- Weakness – Will abrade faster than flat nitrile; low cut and heat resistance
- Applications – Automotive, construction, material handling, engineering, assembly, inspection
Lunar Foam Coated
- Strengths – Good grip; water permeable
- Weakness – Will abrade faster than flat nitrile
- Applications – Automotive, construction, material handling, engineering, assembly, inspection
Latex Coated
- Strengths – Flexible; comfortable; good tensile strength
- Weakness – May cause allergic reaction; low heat protection; does not provide adequate protection from oils or fules
- Applications – Agriculture, material handling, packing, construction, furniture mfg, glass handling, bottling operations
Urethane Coated
- Strengths – Strong; durable; lightweight; thin; flexible; can be silicone and DMF free; high resistance to abrasion; breathable; excellent grip in all applications: wet, oily, and dry
- Weakness – Porous coating makes it highly permeable; very low cut resistance
- Applications – Detailed assembly, inspection, light fabrication and small parts handling, dirt barrier
Bi-Polymer Coated
- Strengths – Good flexibility; breathable; good grip
- Weakness – Low abrasion resistance; high permeability
- Applications – Automotive, engineering, electronices, inspection, packaging
Air Infused PVC
- Strengths – Excellent wet and dry grip; good abrasion resistance
- Weakness – Permeable; low cut resisitance; no heat resistance
- Applications – Bottling, canning, recycling, manufacturing, assembly
Dipped Gloves Questions Answered
Industrial Supplies Michigan Tennessee Wisconsin Safety Products Gloves – Amerisource Industrial Supply
Frequently Asked Questions for Dipped Gloves
1. What are the benefits of a nylon shell glove?
a. Nylon gloves are preferred for many reasons. They provide excellent strength, flexibility, toughness, elasticity, abrasion resistance, washability, and ease of drying.
2. What are the benefits of a poly/cotton shell glove?
a. Poly/cotton shell gloves offer flexibility along with comfort allowing for high dexterity without hand fatigue. The poly/cotton yarn reduces shrinkage allowing the glove to fit correctly longer.
3. What type of coating is the best to use for dry and oil grip applications?
a. Polyurethane and Nitrile offer the best options when you need both dry and oil grip applications. Both polyurethane and nitrile allow flexibility which means an easier grip and dexterity during use. Nitrile has good water permeability that absorbs liquids in just seconds to provide better grip in wet applications.
4. What’s the difference between foam nitrile and sponge nitrile?
a. Foam nitrile is a very thin coating while sponge nitrile is slightly thicker. Both offer a tacky coating and good durability. Less abrasion resistance than flat nitrile coating. Foam and sponge nitrile coating offer excellent grip with dry, wet and oily applications. Both are flexible and porous. Foam nitrile will channel oil and water away from surface quickly (within 10 seconds) and sponge nitrile will also channel oil and water away but will take much longer.
5. Why use flat nitrile vs. polyurethane coating?
a. If you need a glove that has high resistance to abrasion and high resistance to chemicals and solvents, then flat nitrile is the type of glove to use. A flat nitrile coated glove is non-porous, less flexible and not breathable. If you need a glove that has an excellent dry, wet & oil grip with a flexible, breathable coating, then a polyurethane coated glove is the best choice. It is also porous and has high resistance to abrasion.
6. What is a bi-polymer coating?
a. A bi-polymer coating is a nitrile and polyurethane blend. The benefits of a bi-polymer coating is that it is flexible, thin, smooth, light-weight and porous. It has good oil & water grip and offers the best flexibility of all coating types. However, it has a low resistance to abrasion.
7. What are the benefits of a latex coating?
a. Latex coating is the most inexpensive coating type. Some of its strengths are that it offers good flexibility and tensile strength. Tensile strength is the resistance to stretch or deformation of glove over time. Latex is non-porous but offers good elasticity and comfort. On the downside, latex can be sensitive to heat and is not good for oily applications. Can cause allergic reactions to some. Less abrasion resistance than PU and nitrile.
8. What are the benefits of a Kevlar® shell glove?
a. Kevlar® is a good selection of a shell if you are looking for a glove that provides good cut resistance. Kevlar gloves easily reach EN388 cut level 3 but heavyweight products can achieve a cut level 4. Kevlar also offers the addition of heat resistance.
9. What are the benefits of a Dyneema® shell glove?
a. Dyneema® is one of the strongest fibers available in gloves. It offers exceptional protection against cuts and abrasion, as well as being light weight and comfortable. Dyneema yarns can provide cut resistance levels up to 3 or 4 (EN388). Other benefits of a Dyneema shell are that it is chemical resistant to both acid and alkaline chemicals therefore can be laundered many times without adversely affecting its performance and it also has the ability to disperse body heat quickly keeping hands cool and dry. And finally, Dyneema offers high dexterity due to the smoothness of the yarns surface.
10. Why is cut level important?
a. Cut level indicates the cut-resistance which determines how well a glove protects hands from direct contact with sharp edges such as glass, metal or other materials. Cut resistance can increase by increasing the material weight or buy using high-performance materials such as Spectra®, Kevlar® or Dyneema® among others.
11. What fibers or materials are cut resistant?
a. West Chester has cut resistant gloves available in Kevlar®, Dyneema® and Taeki 5™. Each of these cut resistant fibers is available with palm coatings including nitrile, latex and polyurethane.
12. I’ve seen gloves that say they are antibacterial or contain Actifresh®. What is Actifresh®?
a. Actifresh treatment guards against gram positive and gram negative bacteria, fungi and mildew. It prevents the development of bacteria and guards against the development of odors.
13. How long does Actifresh® last on a glove?
a. The Actifresh® treatment withstands repeated washings and is permanent in rubber and plastics.
Frequently Asked Questions for Dipped Gloves cont.
14. What does it mean to be “silicone free”?
a. Silicon compounds are classified as Organic and Inorganic. Organic silicones include compounds called Siloxanes which are oils that can cause problems in metal processing – leaving a “fingerprint”. This causes paint to improperly adhere to metal. Inorganic silicon compounds do not possess this undesirable property so do not have the effects as described above. Our new dipped gloves do not contain the problem-causing Siloxane oils therefore, they are “Silicone Free”.
15. What does DMF-free mean?
a. Dimethylformamide is a common solvent for chemical reactions. DMF has been linked to cancer in humans, and it is thought to cause birth defects. Our new dipped gloves do not contain DMF and therefore are DMF Free.
16. Why does a white foam-like substance come from my nitrile glove when I first get it wet?
a. During the process of manufacturing these gloves, washing them will increase their permeability. If they are not washed and only leached then a salt residue will be present on the surface which will hinder water permeability. With repeated washings, this residue should dissipate and the gloves should become even more permeable.
17. What are the applications where polyurethane coated gloves can be used?
a. Detailed assembly, inspection, light fabrication and small parts handling. Safe for food contact but porous properties will allow bacteria to develop.
18. What are the applications where bi-polymer coated gloves can be used?
a. Automotive, engineering, electronics, maintenance, inspection, packaging. Safe for food contact but porous properties will allow bacteria to develop.
19. What are the applications where flat/non-foam nitrile coated gloves can be used?
a. Automotive, assembly, food packing, furniture manufacturing, electronics, pesticides, oil refining. Safe for food contact.
20. What are the applications where foam/sponge nitrile coated gloves can be used?
a. Automotive, construction, material handling, engineering, assembly, inspection/examination. Safe for food contact but porous properties will allow bacteria to develop.
21. What are the applications where latex coated gloves can be used?
a. Agriculture, material handling, packing, construction, furniture manufacturing, glass handling, bottling operations. Safe for food contact.
22. What is the best covering for chemical resistance?
a. Flat/non-foam nitrile offers the highest resistance to chemicals and solvents compared to other coatings.
Aerosol Flammability
Industrial Supplies Michigan Tennessee Wisconsin Amerisource
Aerosol Flammability Explanation
One issue that we are often asked to explain is aerosol flammability. The following was taken from a white paper we published a number of years ago.
Aerosol flammability is something of a difficult and quirky subject to discuss. The easiest and most accurate statement that can be made is that the more flammable an aerosol formulation is, the greater the propensity for an issue to occur relating to a fire event. Aerosol products have their flammability rated on a zero to four scale with zero being the least flammable and four being the highest flammable rating. Products with a zero rating generally contain no flammable ingredients, while those with a four rating are required to utilize an “Extremely Flammable” warning and designation.
The flammability rating for an aerosol product is determined by a simple test named the Aerosol Flame Projection Test. This test has the spray from an aerosol directed at the base of a lit paraffin candle from a distance of 6 inches. The length of any subsequent flame extension is then measured. That extension length then determines the flammability level for that particular product. The generally accepted scale is:
- 0 – will not burn (contains no flammable ingredients)
- 1 – possible to burn (contains flammable ingredients but no flame extension)
- 2 – burns if heated (contains flammable ingredients but less than 18 inch flame extension)
- 3 – easily burns (contains flammable ingredients with a flame extension greater than 18 inches)
- 4 – very easily burns (contains flammable ingredients and flame draws back toward the aerosol can)
Only aerosol products with a flame extension greater than 18 inches long are required to be labeled as “Flammable”. And only those aerosol products that have a flame extension that moves backwards up the spray toward the aerosol can are required to be labeled as “Extremely Flammable”.
An “Extremely Flammable” aerosol product is inherently more dangerous since that flame extension has the ability to move back up toward the can and the operator spraying the product. It is conceivable that the flame could potentially move up the spray pattern and even back into the aerosol can, causing a catastrophic can failure and dangerous situation. This is true only for cans labeled as “Extremely Flammable” and having the 4 designation for flammability on the HMIS warning section of the MSDS.
One more word about flammability; any aerosol product, no matter how flammable, can safely be used as long as there is no ignition source present. But any ignition source (open flame, welding spark, static discharge, etc.) needs be to considered and properly managed when using any aerosol formulation, especially those rated as “Extremely Flammable” and having the propensity for a flame to travel backup toward the can and operator.
Mold Release Product Focus
Industrial Supplies Michigan Tennessee Wisconsin Mold Release
Knock Out Release Agent
Knock Out Mold Release (#46612N) is a non-silicone, paintable, and food-approved release utilizing a highly versatile lubricating oil. This is a mold release that will help to knock out all production problems. This release has been tested on and proved effective with both thermoplastic and rubber materials.
We formulated the Knock Out Mold Release as a direct alternative to some competitive products that have proven formidable over the years. Specifically, we envision this new Slide release as a competitive offering against the Stoner Rocket Release product (E-302). So keep the Slide Knock Out Mold Release in mind as an option when you see a customer using this competitive product.
Knock Out Mold Release has been priced aggressively to compete with the offerings from the other suppliers. This is a high productive release formulation that will provide more cycles and parts before reapplication is needed. So get a sample can out to your molders looking for a release agent that is fully paintable and food-approved. As always, free samples are available.
Ice Melt Recommendations
Janitorial Supplies Michigan Tennessee Wisconsin Amerisource
How do I know which ice melter product is best to use?
Start with the outside temperature. Rock salt, is great for melting ice at moderately cold temperatures (works down to 5°F). When the temperature falls below that, you should consider a blended product such as a specially formulated blend of magnesium chloride and sodium chloride (works down to -5°F) or a Calcium Chloride pellet (works down to -25°F). Other factors include activation speed, ease of handling and application, and desired features.
Do I really need the package instructions?
Yes. Proper application is important for the optimal performance and safety of any ice melting product. More product does not necessarily mean better performance.
What if my pet eats some ice melter?
Most ice melters are not produced under food grade conditions and therefore are not intended for human or animal consumption. If ingestion occurs, make sure your pet has water available to drink, which is usually all that’s needed. Ingesting large amounts, however, can result in gastrointestinal irritation. If your pet shows signs of distress, contact your veterinarian. Always store any ice melter out of reach of children and pets. (Refer to ice melter Material Safety Data Sheets for more information).
Will my pet be harmed if it walks where an ice melter has been applied?
Generally, no. If an animal picks up too much ice melter material in its paws, it may experience some irritation–especially if it has dry, cracked skin–so it’s advisable to brush or wash off encrusted product residue. Also, since ice melters lower the water temperature, the mix of melting snow, ice and ice melters can be uncomfortably cold to an animal’s feet. To help protect your pet, follow application instructions by clearing the snow and ice from pavement once it’s melted, and/or covering paws with pet booties to avoid possible frostbite.
How does Calcium Chloride differ from other ice melters?
Calcium chloride, which melts ice down to -25#176;F. It is exothermic, which means it gives off heat as it works, accelerating melting. Because of that, it is important to brush or wash off ice melter residue from your pet’s paws and coat to avoid possible skin and mouth irritation or burn. Calcium chloride is low in toxicity, but if ingested in small amounts, make water available, and contact your veterinarian if your pet shows signs of distress. As with other ice melters, store out of reach of children and pets. (Refer to ice melter Material Safety Data Sheets for more information).
What else can I do to minimize winter risk and discomfort to my pet?
Practice good grooming of your pet, such as trimming excess hair from footpads and toes to reduce ice, snow and salt accumulation and make cleaning easier. Keep pets away from treated surfaces until snow, ice and ice melters have been cleared away. Doing so promptly will also prevent re-freezing. If your pet gets wet, dry its coat, and especially its paws, to prevent cracking.
What if my child eats some ice melter?
Most ice melters are not intended for human or animal consumption. If a few grams of ice melter are accidentally ingested, drinking water is usually all that is needed. Ingesting large amounts can result in gastrointestinal irritation. If your child shows signs of discomfort, contact your doctor. Always store ice melters out of reach of children and pets. (Refer to ice melter Material Safety Data Sheets for more information).
Will ice melters damage my grass and shrubs?
Because ice melters transform snow and ice into liquid, there is run-off. Too high a rate of application results in excess run-off from the driveway or sidewalk surface area, which is the most common cause of injury to bordering lawn or vegetation. Soil type, vegetation species and climate are also factors in runoff effect. Published university field tests indicate there may be slight differences between the tendency of the common deicing chemicals to harm grass, but excessive application with any of them will harm vegetation. To reduce risk of this damage, apply ice melters according to package instructions and promptly remove snow, ice and slush from the sidewalk or driveway surface after application.
Will ice melters damage my concrete?
Poured concrete needs time to cure and seal, so do not apply ice melters to first-year concrete. Do not use on porous or improperly cured concrete, precast concrete items, masonry, mortar, wood or other porous materials. Use only on properly placed, cured and sealed, air-entrained concrete. To reduce risk of damage, apply ice melters according to package instructions. You may also apply a quality water-repelling sealant to the surface prior to winter. Finally, promptly remove snow, ice and slush that develops on the concrete after any ice melter application.
Will ice melters hurt my carpeting or wood floor?
With proper application and ice removal, ice melter should leave little film or residue. Any extra residue carried in from people’s boots and shoes should be either sponged up with water before it dries or vacuumed promptly once dry.
Can I use ice melters on my deck?
Prior to using any ice melter, you should contact the manufacturer of your decking or sidewalk materials for its recommendation. We do not recommend using ice melters on wood decks, brick sidewalks, patios or the relatively new, non-wood decking material.
Can deicing salt be used on roofs to remove ice dams?
For obvious safety reasons, we recommend you do not use ice melters for ice dam removal from roofs. The best solution is to consult a roof expert to prevent heat loss and ice dams from developing. Because there are a variety of ice removal options and roofing materials, you should consult your homeowners insurance or a professional roofer to determine the best method of removal for your type of roof.
