Tag Archives: medicare

Nebraska Masonic Home

October 14, 2016 by
Photography by Bill Sitzmann

The building known as “The Castle” is hard to miss while driving through Plattsmouth on Webster Boulevard. Its imposing grey stone structure boasts Elizabethan towers and arched doorways fit for a Scottish king. For its 100 or so residents, however, The Nebraska Masonic Home is a warm and caring place to spend their retirement years.

“This is their home,” executive director Mary Stockton says. “And the Masonic Home is like a home to me after working here 12 years.”

As a continuing care retirement community, the facility provides a range of options that can change with the needs of residents: independent apartment living, assisted living, nursing care, and special care for residents with Alzheimer’s and other types of dementia. Residents enjoy a range of activities and outings as well as amenities and services from housekeeping to state-of-the-art dining facilities.
nebraska-masonic-home-2But not just anyone can take up residence at the Nebraska Masonic Home. It has exclusively served eligible members of Masonic organizations—like Scottish Rite, York Rite, and Shriners International—and their eligible female relatives (wives, widows, mothers, daughters, sisters, grandmothers, and granddaughters) since 1903. It is the only Masonic retirement facility in the state.

“Masons support their brothers, and Masons take care of their families,” Stockton says. “Masons, on the whole, are a very generous, caring group of gentlemen. They are the most philanthropic that I’ve ever seen…Whatever they can do to help, they’re there.”

nebraska-masonic-home-3

That generosity manifests through The Nebraska Masonic Home Foundation, which provides support for both the facility and individual residents who require financial assistance; the facility does not participate in government funding through Medicare and Medicaid.

Employee turnover is unusually low compared to the norm for retirement communities and nursing homes, Stockton says, and the staff includes employees at all levels who have reached 10, 15, or 20-year anniversaries. Some have been on the job even longer.


nebraska-masonic-home-1Marilyn McLaughlin, a CNA/CMA, will reach 30 years with the Nebraska Masonic Home next spring.

“The staff and residents are nice, considerate, and respectful. You feel as soon as you walk in that you just want to be here and help,” McLaughlin says, adding that a manageable workload allows direct care staff like herself to provide quality care. “I couldn’t go and work anywhere else after working here.”

Chris Abbott, the facility’s administrative assistant and admissions coordinator, joined the Nebraska Masonic Home 26 years ago and says she had a positive impression immediately.

“I had never been in a nursing home, and I was just amazed when I walked in the door. I could smell good food cooking. The people were wonderful, the residents were well-dressed and clean…26 years later I’m still at it and I’m not going anywhere,” Abbott says. “Residents get care not like anyplace else; it’s a place where people are made to feel wanted. We care about residents, and we care about their families.”

Stockton agrees: “It really is a privilege to know and care for them.”

Visit thenebraskamasonichome.org for more information. Sixty Plus

Geriatric Nurses

April 21, 2016 by
Photography by Bill Sitzmann

Some people just don’t get it when it comes to the health of older adults. Many believe that elderly people are always tired. But that’s a myth.

“It’s also not true that an older person doesn’t have a brain that works as well,” says Sara Wolfson, geriatric nurse practitioner for the University of Nebraska Medical Center (UNMC) Home Instead Center for Successful Aging.

Myths such as these lead to ageism that can affect how older adults are treated (or under-treated) for illnesses.

A geriatric nurse can sort it out. This registered nurse specialist has the skills to recognize what’s normal for older adults versus what’s abnormal.

Beth Culross

Beth Culross

“We are really focused on looking at the process of aging and how we can help older adults maintain their  health and prevent health problems as they age. What is normal at age 80 might not be normal for 40 or 50,” says Dr. Beth Culross, an R.N. with a Ph.D. in gerontology. She teaches undergraduate gerontology at the UNMC College of Nursing in Omaha.

Geriatric nurses often function as case managers who help patients live with chronic illnesses, giving them a greater chance of staying independent and active.

“With case management, there are a lot of phone calls, checking on them, answering questions about medication, seeing how a visit to the ER went,” Wolfson explains.

She says it’s important to keep older adults out of hospitals. “Being in the hospital weakens people. It takes longer to recover. Some get confused. Older people have less reserve when they get sick.”

Geriatric nurses can be found working in hospitals, clinics, physicians’ offices, long-term care facilities—and in patients’ homes.

Senior Assist, a home-visit program for patients ages 65 and older whose primary care physician is with Nebraska Medicine, is available at no cost through the Home Instead Center for Successful Aging. Home visits give the nurse a look at the person’s living environment, and consequently gives them a clue to what is going on with their physical and mental health. 

“One nurse went to the home of a patient who was constantly coming here because of congestion and found she wasn’t using her nebulizer,” says Wolfson. “Home visits give a heads-up if someone is having a problem.”

UNMC’s Home Instead Center for Successful Aging offers seniors a wellness center, outpatient clinic, assessment, and education in topics as diverse as fall prevention,  nutrition, arthritis, and tai chi. Nurses provide education as mandated by Medicare—information about medications, like blood thinners, or about general health and nutrition, like cutting back on sodium.

“We’re a center for people who are aging well and people who have a lot of chronic illnesses that need to be managed,” Wolfson says. “We take walk-in patients. They might have a cold, feel dizzy or tired.”

The center also provides dementia evaluation and diagnosis.

“We wouldn’t diagnose dementia on the fact that their memory is bad. It’s based on function. Are they still independent?  Taking medications?  Or are they not bathing? Are their clothes tattered?” says Wolfson, who points out that there are other geriatric clinics available in the area.

As people live longer and the number of people over age 65 increases, more nurses specializing in geriatrics are needed.

By 2030, one in five adults—88 million people—will be 65 or older, according to the U.S. Census. About 10,000 adults turn 65 every day.

Sara Wolfson

Sara Wolfson

“Most of the hospitals in the Omaha area have started recognizing this,” Culross says. “These hospitals have special designations around the need for care for older adults.”

There is a shortage of nurses in general and—because the number of aging adults is increasing—there is especially a need for certified geriatric nurses.

Almost half of all patients admitted to hospitals are over 65, but only 1 percent of registered nurses and 3 percent of advanced practice registered nurses are certified in geriatrics, reports the American Geriatric Society.

Adults over 65 account for nearly 26 percent of all physician visits, 47 percent of all hospital stays, 34 percent of all prescriptions, 34 percent of all physical therapy patients, and 90 percent of all nursing home stays, according to the Eldercare Workforce Alliance.

By 2030, 7.7 million people will have Alzheimer’s disease, up from 4.9 million in 2007.

“The fastest growing segment of the population in the United States are people 85 and over,” Culross says.

Recognizing what’s normal and what’s not for an aging adult is important for a geriatric nurse. So is listening. Allowing patients to talk about their experiences and life stories tells where they are now and how she can help, says Culross.

“I learn as much from my patients as they do from me. My husband tells me I’m really good at it because I like to talk.”

The Affordable Care Act

August 26, 2013 by
Photography by Bill Sitzmann

The Patient Protection and Affordable Care Act (PPACA), better known as the Affordable Care Act (ACA), is a federal statute signed into law in 2010. The objective of the Act is to increase affordability and rate of coverage for health insurance and reduce the overall costs of health care, which will be executed through mandates, subsidies, tax credits, and other means. The ACA is divided into 10 titles with some provisions that became effective immediately, while others are phasing in over a 10-year period.

But what does this mean for most seniors?

“If you don’t have insurance between age 60 and 65, that’s a concern.” – Andrea Skolkin, OneWorld Community Health Centers, Inc.

Individuals over 65 will likely find that not much will change as far as Medicare is concerned, says Andrea Skolkin, chief executive officer for OneWorld Community Health Centers, Inc. More preventive care is covered and prescription drug coverage will improve, she says, but most facets of Medicare will carry on as before.

“People who have Medicare, other than the little bit of expansion in the ‘donut hole’ [Medicare Part D coverage gap between the initial coverage limit and the catastrophic-coverage threshold for prescription drugs], should be secure in their coverage,” she explains. “The new marketplace isn’t for people who have Medicare.”

Sixty-plus individuals who will definitely be affected by ACA are those seniors who haven’t reached the Medicare eligibility age of 65 and are without medical insurance. In January 2014, uninsured individuals will be required to buy health insurance, available through an exchange, or pay a penalty tax. Some people will certainly struggle to finance the premiums, but currently, seniors who don’t yet qualify for Medicare and can’t get covered through an employer are likely to take their chances and go without health insurance altogether, Skolkin says.

EJ Militti, financial advisor with The Militti Group at Morgan Stanley Wealth Management

EJ Militti, financial advisor with The Militti Group at Morgan Stanley Wealth Management

“If you don’t have insurance between age 60 and 65, that’s a concern,” she says. “We see a lot of it—people 55 and up—who are being ‘right-sized,’ if you will, out of their jobs and are left without anything until they are eligible for Medicare. Especially at our new clinic in West Omaha, we see a lot of uninsured adults.”

From a financial standpoint, it’s fair to say that ACA will not spell good news for everyone’s pocketbook, says EJ Militti, a financial advisor with The Militti Group at Morgan Stanley Wealth Management.

“[For] the wealthy and those who have properly saved for health care and other retirement costs, there is less to like and greater confusion about government-mandated health care. Moreover, those considered wealthy will be helping foot the bill of this epic legislation,” he says, explaining that a Medicare tax increase and additional taxes on taxable investment income have been instated, and other proposals are pending. “In my opinion, there is little doubt higher-income earners are going to be paying more in taxes. Higher-income earners need to be aware of future tax proposals on the table.”

On the other hand, Militti points out, some Americans will clearly benefit financially from the legislation.

“[For] the wealthy and those who have properly saved for health care and other retirement costs, there is less to like and greater confusion about government-mandated health care.” – EJ Militti, The Militti Group at Morgan Stanley Wealth Management

“The poor, the lower middle class, the long-term unemployed, and those with pre-existing conditions will benefit the most, and that’s by design,” Militti says. “The entire premise for government-mandated health care is to provide taxpayer-financed subsidies for those who, otherwise, cannot provide for themselves.”

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EJ Militti is a Financial Advisor with The Militti Group at Morgan Stanley Wealth Management. The information contained in this article is not a solicitation to purchase or sell investments. Any information presented is general in nature and not intended to provide individually tailored investment advice. The strategies and/or investments referenced may not be suitable for all investors as the appropriateness of a particular investment or strategy will depend on an investor’s individual circumstances and objectives. Investing involves risks and there is always the potential of losing money when you invest. The views expressed herein are those of the author and may not necessarily reflect the views of Morgan Stanley Smith Barney LLC, Member SIPC, or its affiliates. 

Morgan Stanley Smith Barney LLC (“Morgan Stanley”), its affiliates, and Morgan Stanley Financial Advisors or Private Wealth Advisors do not provide tax or legal advice. This material was not intended or written to be used, and it cannot be used, for the purpose of avoiding tax penalties that may be imposed on the taxpayer. Clients should consult their tax advisor for matters involving taxation and tax planning and their attorney for matters involving trust and estate planning and other legal matters.