From The Tennessean
But it does not change the dangerous hospital “admission for observation” practice.
In 2008 the state of Tennessee passed The Tennessee Condominium Act. This act set the legal ground rules for condominium sales, association rules and ownership. This is a copy of the act: http://www.bpjlaw.com/upl_docs/tncondoact.pdf
The Catholic Dioceses and Cloister Home Owners Association reached an agreement within the new law which allowed new owners to obtain a mortgage and title insurance when they bought a Cloister Condominium. The former leasehold arrangement made sale of a Cloister Condo nearly impossible as the future life of the individual condo leases became shorter than 30 years.
A small group of mostly confused old ladies, apparently frightened of any change in their lives, objected to the purchase arrangement and declined to purchase “Fee Simple” ownership. They were advised that the cost of ownership would increase over time. So far it has increased from $12,000 to $14,000 and will continue to increase according to the notices we have been given from the Catholic Dioceses.
Recently we have seen news coverage in both The Tennessean and The West Side News. Here are what appear to me to be the real facts. (I have bought the Fee Simple ownership and am familiar with the situation. I feel I have made a good investment.)
I’m not surprised…
Recently I had several disturbing experiences with Doctors, Clinics, various healthcare employees, and Hospitals.
For years I have gone to the same heart doctor, taken tests at the same clinic, and went to the same Emergency Room affiliated with the MD and Hospital Clinic. Times have changed and healthcare has changed. I need to consider making some changes myself.
Recently a great deal was made about name changes of several local hospitals.
Do the name changes improve the health care we receive? I think not.
The harsh fact is that the health care situation is changing all around us but I have failed to notice and I changed nothing.
What has happened recently?
My recent experiences suggests that Emergency room practices at Saint Thomas facilities are no longer decided by doctors and nurses on site but rather by standardized “Standing Orders” most likely issued by lawyers and administrators. Are they followed for primarily legal reasons rather than that they are necessarily the best medical practices?
I am disturbed that many hospital and clinic employees walk around with their ID badges reversed so we can see neither their name nor the credentials of the person who is involved in procedures or testing. “Is the person a nurse, a technician, a clerk? Are the people working in their area of expertise and training, or are they doing on-the-job training outside the area in which they have been trained?”
I have recently gone through two tests which I had done several times before. In both cases the so-called technicians had difficulty in skillfully performing routine procedures like inserting an IV (he was more concerned about wiping the blood soaked chair arm rather than stopping the blood flow poring from a vein in my arm) or performing an ultrasound test (after much fumbling she found it necessary to call for a nurse to help her complete the procedure).
A major medical center can’t possibly function with 1000 less healthcare providers so their clear intention is to replace them with temporary, contract employees thus saving the cost of benefits packages for the original employees along with paying less for contract employees.
I have a lot of interaction with various health providers and their organizations. I am sometimes aware that they suggest behavior on my part that only makes their jobs easier and benefits their organization rather than improving my health. My hard earned experience suggests some actions I can take about the healthcare I receive.:
Hidden, just two blocks from The Cloister, at the first traffic light past St Henry Catholic Church towards Bellevue is the Gordon Jewish Community Center. 
The GJCC complex includes a day care, an elementary school, and the Community Center building with meeting rooms, a large auditorium/theater, organized children, adult, and senior programs, a large group exercise room, a superbly equipped exercise/conditioning center, and indoor and outdoor swimming pools. The indoor pool has four swim lanes and a two lane area dedicated for aquatics exercise groups and individual water walking and water exercises.
Just as you don’t need to be a Catholic to own a home at The Cloister at Saint Henry, you don’t need to be Jewish to be a member at the GJCC.
The senior rate is : $45 for a single and $63 for a couple. Senior age starts at 70 but if you are eligible for Silver Sneakers, that is 65. Silver Sneakers is a health facility subsidization program from Healthways that is covered by six different insurance companies. Those companies include: AARP Medicare Complete/Secure Horizons, AARP Supplement/Medicare Medigap, AmeriGroup, HealthSpring, Humana, and BCBS 65+. Silver Sneakers members’ enrollment is paid for by their insurance companies.
I have been a member for over 5 years. Besides aquatic exercise in the indoor pool my wife and I enjoyed the Bridge group and TGIT(Thank God It’s Thursday) Lunch and Learn programs featuring some interesting speakers.
The most welcoming group at the GJCC is The Prime Time Group for active senior adults. They host a huge variety of activities including monthly dinners with interesting programs, monthly meetings, day and overnight trips, parties, brunches and lunches, monthly casino day trips, overnight casino trips, holiday programs, varied classes, cultural events including plays and the TPAC Broadway series, concerts, pot luck dinners with original entertainment, and opportunities for group participation in community events. The Prime Time group also hosts a yearly retreat or trip.
The GJCC people welcome Cloister residents to drop by and use the facility with a free trial guest pass..
According to the SRES Council (Seniors Real Estate Specialist), here are some low-cost options for your current home for aging in place.
Flooring: carpeting is better than area rugs because it is continuous and reduces tripping hazards. It also provides a cushion if a fall occurs.
Handrails: many stairways have a handrail on only one side. Adding a second handrail on the opposite wall improves stability.
Footwear: non-slip shoes, as opposed to slippers or socks, help prevent falls.
Non-skid safety strips: non-skid strips that are adhered to the floor of a tub / shower are preferred to removable bath mats.
Bathroom grab bars: locating them in places where bending and sitting occur (i.e. by a toilet; on a tub wall) provides stability. It’s best to anchor them into the wall.
Quality step ladder: a broad-based heavy-duty step ladder for items stored out of reach. A hand-hold bar across the top improves stability and safety.
Lighting: better lighting helps prevent falls. Motion-activated lights improve visibility in pass-thru areas such as hallways. Brighter lighting makes reading or doing tasks more enjoyable.
Hand shower: install a hand-held system with a flexible hose where a fixed shower head currently exists.
Raised toilet seats: a removable seat fits most toilets. No need to replace that expensive toilet with a taller one.
Knobs: lever-style handles are easier to turn than round handles.
Cooking utensils: many light-weight and ergonomically designed utensils are now available. Many have non-slip handles, some are even oven-proof..
Often-used items: keep them handy in easy to access locations.
Eliminate excess: having fewer items to store and sort through makes most-often items easy to find and retrieve.
The September 30, 2013, issue of Elder Law FAX is now available for viewing on www.ElderLawEducation.com.Elder Law FAX is a free newsletter published every other week by Elder Law Practice of Timothy L. Takacs.
Medicare beneficiaries were lawfully denied skilled nursing facility coverage after spending more than three nights in a hospital while under observation status, a federal district court in Connecticut has ruled.
The suit was brought by 14 plaintiffs who alleged that the U.S. Department of Health and Human Services (HHS), the defendant in the case, failed in its duty to force hospitals to comply with Medicare obligations.
The plaintiffs had sought to eliminate observation status altogether; or, in the alternative, require HHS to order hospitals to inform Medicare beneficiaries that they are in observation status and provide them a process to appeal the hospital’s decision.
“Observation status” means that a Medicare beneficiary is not formally admitted as a hospital inpatient. Once the patient is admitted and spent three nights, the patient will be eligible for Medicare coverage in a skilled nursing facility (SNF).
Even after spending three or four days in a hospital, some Medicare beneficiaries are not aware that some of those days were spent in observation status, thereby not qualifying them for Medicare SNF coverage.
In his opinion, Judge Michael P. Shea acknowledged that observation patients “have a greater financial responsibility for the hospital services they received – and for any subsequent SNF stay — than if they had been admitted as inpatients,” and cited the case of a Connecticut woman who paid $30,000 for nursing home care that Medicare would not cover.
Judge Shea held that HHS was acting in accordance with the law by allowing hospitals and doctors to determine whether the patient should be admitted to the hospital.
Since 2008, the use of observation status has increased significantly. Under Medicare rules, a hospital that decides incorrectly on admitting the Medicare beneficiary as an inpatient must refund its Part A payment to the government. However, the hospital can bill Medicare under Part B for services provided to a person on observation status, even if not admitted. Medicare rules prohibit the hospital from reclassifying the patient from Part A to Part B.
Efforts are being made in Congress and by the American Medical Association to eliminate observation status.
And in a 2013 rulemaking, HHS sought to clarify observation status; but the new rule has disappointed observers who had hoped that the government would eliminate or severely restrict its use.
Bagnall v. Sebelius, Sept. 25, 2013.
Tennessee’s Stand Your Ground Law is similar to Florida’s where the Zimmerman trial was held. This information may be of interest to those Cloister neighbors who keep, or are considering, firearms in their home for self-protection.
Friday, April 20, 2012
“Self-defense is the clearest of all laws, and for this reason: lawyers didn’t make it.”~ Douglas William Jerrold, English writer and playwright (1803-1857)
On April 11, a special prosecutor charged 28-year-old George Zimmerman, a self-appointed neighborhood watch volunteer in Sanford, Florida, with second degree murder for the February 26 and killing of 17-year-old Trayvon Martin.
The 7-week-delay in charging Zimmerman with murder was primarily due to the initial determination by local law enforcement that Zimmerman’s actions fell under Florida’s “Stand Your Ground” law – which allows people to use deadly force anywhere they feel a reasonable threat of death or serious injury. The special prosecutor determined that the facts of the case caused Florida’s Stand Your Ground law not to apply. (The Governor’s appointed Special Prosecutor tried the case in Sanford near Orlando )
The Hendersonville Standard is a once a week community newspaper serving Hendersonville, Tennessee. This is what they say…..
Tennessee also has a “Stand Your Ground” law. The Tennessee Legislature passed a version of such law in 2007. Part 1 of this column discussed the creation and passage of the law. Part 2 takes a look at the language and operation of the law.
Q. What exactly does Tennessee’s Stand Your Ground law say and mean?
First, the words “stand your ground” do not actually appear in the law, which is simply titled “Self-defense” as it appears at Tennessee Code Annotated section 39-11-611.
Until the passage of Tennessee’s “Stand Your Ground” law in 2007, state law historically required that persons who were legally at home must not use deadly force on an illegal intruder if he or she could safely retreat.
As of 2007, Tennessee’s “Self-defense” law now expressly states as follows:
- A person who is not engaged in unlawful activity, and
- Who is in a place where the person has a right to be,
- Legally has no duty to retreat before threatening or using force against another person
- When and to the degree the person reasonably believes the force is immediately necessary to protect against the other’s use or attempted use of unlawful force.”
Q. Does the law have a special provision in the case of forced entry into a residence, business, dwelling or vehicle?
Yes. Tennessee’s “Stand Your Ground” law also says:
- An occupant of a residence, business, dwelling, or vehicle is legally protected
- And is allowed to use force intended or likely to cause death or serious bodily injury
- Against another person who unlawfully and forcibly enters or has unlawfully and forcibly entered the residence, business, dwelling or vehicle
- When the person using defensive force knew or had reason to believe that an unlawful and forcible entry occurred.
The law states that the person who is using defensive force in such a situation “is presumed to have held a reasonable belief of imminent death or serious bodily injury.”
The law also expands the physical areas where the law applies:
- The term “business” includes the interior and exterior of the business.
- The term “dwelling” means a building or conveyance of any kind that is designed for an capable of use by people, such as an “RV” (recreational vehicle used for camping or travel lodging), and any attached porch to a building or conveyance.
- The term “residence” also includes any dwelling, building or other structure within the yard, or “curtilage” of the residence. (“Curtilage” means “the area surrounding a dwelling that is necessary, convenient and habitually used for family purposes and for those activities associated with the sanctity of a person’s home.”)
IMPORTANT NOTE: The law does NOT allow defensive force to be used in several key situations:
Against a person who has the right to be in or is a lawful resident of the dwelling, business, residence, or vehicle; or
Against a person who is attempting to remove his or her child or grandchild, or who is attempting to remove a child for whom he or she has lawful custody or guardianship; or
Against a law enforcement officer who enters or attempts to enter a dwelling, business, residence, or vehicle in the performance of the officer’s official duties. James B. (Jim) Hawkins is a general practice and public interest law attorney based in Gallatin. This column represents legal information, and is not intended to take the place of legal advice. All cases are different and need individual attention. Consult with a private attorney of your choice to review the facts and law specific to your case.
NASHVILLE, Tenn. –
Officers in South Precinct are contacting all apartment communities to encourage them to start neighborhood watch groups.
George Zimmerman was a Coordinator for the community “Neighborhood Watch Program” sponsored by the local Sanford Sheriff’s department. Here’s more about that program.
Neighborhood Watch Program
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A friend recently told me; “If I knew I would live this long I would have taken better care of my body.” I agree with him because of my own experiences. Viet Nam injuries along with a motorcycle wreck while riding … Continue reading
Last month I had my right shoulder joint replaced. A serious but a somewhat routine surgery, except for a complication I faced, I am right handed and additional arthritis prevents me from reaching behind myself with my left arm. Toileting becomes difficult when the only arm I can use is locked in an immobilizer sling tied to my body.
I made test trials with various options prior to surgery and was unhappy with the results. There simply had to be a better, cleaner way. My travels throughout the world proved that there is more than one way to skin a cat….or clean a behind!
Homes and hotels in most countries in Europe, Latin America and Japan have bathrooms equipped with either a bidet, or in Japan, specially equipped toilets and seats.
Bidets are hardly used at all in the U.S. while most hotel rooms in Europe had a bidet and commode like this:
Some hotel bathrooms even post instructions for use:
My visits to Japan surprised me with the many variations of toilet equipment which allowed cleaning with a water stream and even air drying after a water cleanse, they include electronic controls….. 
So….I was left with the question; what can I do to retain my dignity and take care of my own toileting? I discussed this problem with an Occupational Therapist. The Occupational Therapist equipped me with two choices, both required I attach toilet paper to a stick to poke between my legs and wipe with a scrubbing motion. Each device held the toilet paper differently but both had a release mechanism to drop the soiled paper into the toilet. The routine was; attach clean paper, scrub, release, attach fresh paper, etc. etc. etc…no better choices were offered.
I was not happy with any of these options. Unfortunately there was not enough room to install an additional bidet unit, or time and money enough to buy and have a plumber install a Japanese Deluxe toilet.
After a great deal of searching on the internet I found a number of portable products, most attached to the cold water supply to the toilet tank, all had spray attachments suitable for female hygiene use but not good for use for toileting. Finally I found something that looked like it would do the job….it is called HydraWand.
I ordered it, installed it in five minutes. It was a portable device that worked as well as any bidet I used in hotels throughout Europe, Japan, Korea and Hong Kong. The faucet attachment allows me to control the water temperature for total comfort. I will use this even after my arm is out of the sling because it is far superior to toilet paper and every bit as good, if not better, than the bidets found outside the United States.
I sure wish we had something like this in the outhouses we used in Vietnam.
Recent Newspaper Article….Mobile Meals, another non- profit meals service, has been operating in Green Hills and surrounding neighborhoods for almost four decades. The service supported by several churches has recently begun a push to attract more clients.
“Our numbers are diminishing, we’d like to serve more,” said Judy David. Mobile Meals has no eligibility restrictions. Its. Clients include older residents, those with permanent disabilities and those recuperating from a short-term illness or injury:
“Anyone can call and request their friend or loved one be helped,” Davis said. “We just want to serve the need.” Meals are delivered Monday through Friday: The cost is $2.75 per meal. Each meal includes a meat, two vegetables, fruit or cookie, bread and milk.
The service area roughly extends from West End Avenue to Franklin Road, from the Edgehill neighborhood to Forest Hills. Some of the large complexes served are the Retired Teachers Apartments in Green Hills, Lea Rose in Hillsboro Village and Wedgewood Tower on 12th Avenue South.
Churches assisting include Calvary Methodist, Woodmont Christian, First Baptist, First Presbyterian, Harpeth Presbyterian, Hillsboro Presbyterian, Forest Hills Baptist and Christ Presbyterian. For information, call Judy Davis 615-297- 3049 or e-mail jd-ed@comcast.net
Cloister Living 