Influenza hit most of the United States by early January, government officials said.

‘‘This is the first year we have had the entire continental US be the same color on the graph, meaning there is widespread activity in all of the continental US at this point,” said Dan Jernigan, director of the influenza division at the national Center for Immunization and Respiratory Diseases.

The highest hospitalization rates were among those over age 65. A strain of influenza A called H3N2 was causing most of the illness, the Centers for Disease Control and Prevention said.

The flu season lasts into the spring. A new AARP and University of Michigan survey found close to three-quarters of respondents said all staff in long-term care facilities should be required to receive the vaccine. If one-third or more of a facility’s staff weren’t vaccinated, 40% of those polled said they’d be “much less” likely to choose it for them- selves or loved ones. Another third of respondents said that fact would make them “slightly less” likely to choose it.

But creating mandatory flu vaccination policies in healthcare settings has created controversy and even led to firings in some locations. 

Providers and Medicare Part B beneficiaries were hoping for a reprieve at press time from therapy caps that kicked into full effect when Congress failed to repeal them or extend a broad exceptions process by Jan. 1.

Optimism for a repeal of the 20-year-old therapy caps faded in December as Congress and the White House wrangled with the tax system overhaul.

A bipartisan, bicameral deal to repeal the therapy caps and replace them with a review policy had been agreed to weeks before by healthcare committees, leading to a positive forecast. Although Congress didn’t act, however, there was still reason for optimism. On several occasions previously, the caps kicked into effect only to be erased by retroactive legislation.

The odds of another such deal were favorable at press time as Congressional leaders expressed a preference to deal with healthcare issues like the therapy caps and the Children’s Health Insurance Program and move onto other priorities, said Cynthia Morton, executive vice president of the National Association for the Support of Long Term Care.

“I believe the prospects are good for Congress to repeal the caps this year. It’s a matter of when it’s ready to act on the healthcare legislation including the caps and the other issues,” Morton said.  

Providers have been put on alert that a specific sugar added to hundreds of foods could fuel outbreaks of Clostridium difficile.

Trehalose is a naturally occurring sugar used an additive for taste and shelf-stability, scientists report in the journal Nature.

Easily and cheaply extracted from corn starch, it helps feed certain strains of C. diff. It was approved by the Food and Drug Administration in 2000, which corresponds to an upswing of C. diff outbreaks, researchers found. Trehalose, also known as mycose or tremalose, is used in everything from ground beef to ice cream.

“If a hospital or long-term nursing care facility has an outbreak of C. difficile caused by a RT027 or RT078 strain, then patients’ diets should be modi ed to restrict trehalose consumption,” said Robert A. Britton, Ph.D., of Baylor College of Medicine.

At press time, President Trump’s State of the Union message was shaping up as one that long-term care operators would fondly remember.

The White House has embarked on a pro-business agenda that tar- gets taxes and regulatory oversight. A debt plan passed in December will address the former by trim- ming corporate tax rates from 35% to 21%. And there is every indication policymakers in Washington will take up the cudgels this year for fewer rules and regulations.

In December, Trump announced that federal agencies had actually beat the regulatory goal he established when taking office: to eliminate two rules for every new one proposed.

“We blew our target out of the water,” Trump said. He has also called on his cabinet members to make deregulation a bigger priority.

“I don’t know if we’ll have any left to cut, but we’ll always find them,” he said.

The 2018 address to Congress was expected to address three of his campaign themes: a strong national defense, reduced taxes and a wall along the Mexican border. 

Visiting the emergency room can signal the beginning of serious health challenges for an older person even when he or she is not admitted, researchers from the Yale University School of Medicine contend.

Six months after visiting an ER, seniors in a Yale study were 14% more likely to have acquired a disability affecting activities of daily living than older adults of the same age with a similar illness who didn’t end up in the ER.

The ER visits often reflected a decline in quality of life and eventual nursing home placement, experts said.

Results appeared in the Annals of Emergency Medicine. 

Anxiety symptoms that increase over time have been linked to elevated amyloid beta levels and the early signs of Alzheimer’s, according to Brigham and Women’s Hospital researchers.

The study used data from the Harvard Aging Brain study and cognitively normal men and women between ages 62 and 90. The researchers said what they found supports the theory that emerging neuropsychiatric symptoms represent an early manifestation of Alzheimer’s disease.

Findings were published in The American Journal of Psychiatry in January. 

How low can it go? That’s a question many operators are ask- ing in the wake of a report by the National Investment Center for Seniors Housing & Care that reveals declining census numbers.

Investigators noted that occupancy levels between July and August dipped to 81.6%, a five-year low.

“Historically, there has been some variability in the occupancy trend in the third quarter in any given year, so it is difficult to gauge the impact of seasonality,” said Bill Kauffman, senior principal at NIC. “Occupancy did set a new low within this time series in the third quarter as pressure continues on the Medicare mix. However, it did decline at a slower pace from the prior quarter.”

While Medicare patient mix sank to 12.2%, Medicaid share rose to a five-year high of 66.8%.

“Not only is it important to see how the patient mix is changing, but we really need to see how the revenue mix is changing in con- junction with patient days, which is why NIC will be expanding this data set to include revenue mix next year,” said Beth Burnham Mace, NIC’s chief economist.  

Nursing home critics are driving for deeper investigation into how operators “reward” themselves with lucrative self-dealing contracts while allegedly keeping staffing levels low.

A Kaiser Health News review of federal inspection and quality records found that nearly three- quarters of U.S. nursing homes are involved in “related party transactions,” often routing proceeds to sister companies, a legal practice.

Nursing homes that outsource to related organizations often have fewer nurses and aides per patient, higher patient injury rates and almost twice the number of complaints as independent facilities, the Dec. 31 report said.

“Almost every single one of these chains is doing the same thing,” said Charlene Harrington, RN, Ph.D., a long-time nursing home staffing critic and professor emeritus of the School of Nursing at the University of California-San Francisco. “They’re just pulling money away from staffing.”

Providers have long struggled with offering telehealth due to reimbursement limitations. But the landscape is changing.

Emily H. Wein, partner at Baker Donelson, will discuss common uses of telehealth in long-term care, coverage and reimbursement options, and potential legislative changes during the spring McKnight’s Online Expo technology session. The webinar begins at 2:30 p.m. ET on Wednesday, March 14.

The expo, now in its 12th year, offers up to five continuing education credits through each of the webinars March 14 and 15.

Also, participants can visit the virtual expo hall and talk with vendors, as well as download information and be eligible for prizes.

Since winning bronze from the McKnight’s Tech Awards in 2014 for its use of an in-room communication system, Southminster in Charlotte, NC, has embraced increased uses of technology.

Three and a half years later the communication system known as CATIE from Status Solutions is being used by all independent living residents, says executive assistant Donna Peters. The devices have moved with those residents as they transition in the continuing care retirement community.

“We really use it to the extent of what we hope we would,” she says. “We can communicate about things like, ‘there is going to be snow tonight,’ or changes in meal or programming.”