Preventing Fleas and Heart-worms From Effecting Pets

Heartworms and fleas are parasites that can result in critical problems in pets. The good news is that it is now possible to prevent these parasites by utilizing safe, effective and easy-to-administer treatments. It is a well-known fact that heartworm disease can damage the lungs, heart, and other related blood vessels. This disease is spread through an infected mosquito bite. In dogs, heartworm disease is treatable, but it is very painful and expensive. While there are no authorized products for heartworm treatments in cats. Fleas are bloodsucking parasites that transmit tapeworms can result in flea allergy dermatitis (FAD). Hence, it is advised to prevent heartworms and fleas in pets.

Some facts about Heartworms

Heartworm disease affects dogs, cats and a maximum of thirty other mammal species.
This disease spreads through parasitic worms residing in the major lung vessels and at times in the hearts.
This disease can cause wide array of problems affecting the heart, liver, lungs and kidneys of the pets. In some extreme cases, it can even lead to death.
In cats, heartworms can result in respiratory disorder that imitates feline asthma. But there is no approved treatment of heartworms in cats.
Heartworm disease is 100% preventable but still there are many pets who are diagnosed with this disease every year.
There are more than 25% heartworm infected cats that live indoors.

Prevention of Heartworm disease

It is recommended to give Sentinel Spectrum as a heartworm preventive treatment for dogs. It is one of the best treatments available for dogs that provides 100% heartworm prevention guarantee, along with prevention of four other intestinal parasites including: hookworms, roundworms, tapeworms and whipworms. It even aids in preventing fleas from laying eggs, thus controlling flea infestations.

Fleas can lead to critical problems in dogs and cats. Some of the adverse reactions of fleas on pets include: continuous itching and scratching, hair loss, scabs, skin damage and skin infection. It is also known as Flea Allergy Dermatitis (FAD).

Some facts about fleas

Fleas can not only affect pets, but also human beings.
Fleas can transmit tapeworms to pets and people.
They play a significant role in spreading cat-scratch fever disease between cats and humans.
Fleas can suck lots of blood from the pets that it can result in weakening and even life-grievous anemia.
Fleas can be seen nearly anywhere in the year. But they are less prevalent in colder months.

Prevention of fleas

Advantage is one of the best flea preventive treatment available in the market. It is completely waterproof monthly treatment which enables dogs from going into the water without the effect of the treatment to wear out. It aids in preventing flea allergy dermatitis (FAD). Flea bites are prevented within 5 minutes of administration of the treatment. It also kills 100% chewing lice within a week of administration and is effective for a full month. It kills adult fleas within half a day of administration and 99% flea larvae within 20 minutes of administration.

The combination of Advantage and Sentinel Spectrum is the easiest way to safeguard your pets from these pesky parasites.

Travel Website Dictionary

For the benefit and convenience of the traveler and adventure lover travel dictionary is compiled. This dictionary provided a complete guide to all the aspects of traveling. You might be a regular business traveler looking for some discount on travel cost or the wanderlust looking out for a vacation that many travelers do not take. For every kind of traveler with whatever their requirements, website dictionary is the solution.

There are a number of things that go into planning a vacation and without a good travel dictionary this is impossible on your own. The road map has to be conceptualized and the itinerary must be sorted out. While you can get a customized itinerary for you self you can also select one suitable to your travel destination from an array of great tours travel website dictionaries boast of.

Only a travel website dictionary will be able to get you the latest updates on prices of tours, discount packages and the umpteen frills all travelers look out for. You can get them right in your inbox by signing up with them. The latest fares and the festivals are all listed on travel website dictionaries.

Before spending your hard earned money on a lavished tour it’s always a good idea to sample its preview. And what better way to do that than through the eyes of experienced travelers and their travelogues. On a travel website dictionary you get the opportunity to communicate with there travelers who have been to the sites where you plan to go. Get the best tips and cultural information on the food habits, dress code and religious customs before you arrive.

A travel website directory is one that gives you the chance to sit back in your easy chair and book a travel guide over the net. Isn’t it a better proposition to have your travel guide waiting for you on arrival than to scout the alien city seeking one out. Travel agents who register on travel website dictionaries have a name for themselves, and can give you the right information which many guide books are unable off.

A travel website dictionary is also regularly updated and you will get all the latest information about new sites to visit, the recent change in hotel room tariffs and what is new in town. You can source contact numbers and get more information from their websites and agencies that have been listed. A Travel dictionary has a huge list of hotels, taxi services, insurance companies, travel guides and travel tips that you cannot expect to find any where else.

4 Things to Know Before Buying an Engagement Ring

Engagement ring shopping is without a doubt one of the most stressful experiences you can face. What adds to the stress is the overwhelming variety of options to choose from. Someone who knows next to nothing about jewelry is usually taken aback by how much effort goes into choosing and buying the perfect engagement ring. However, after taking into consideration the following 4 factors, convincing your one-and-only to say “yes” will be a piece of cake.

Your Budget

Prior to starting the hunt for designs, you need to first figure out your spending power, something that will greatly impact your final decision. It doesn’t make sense to set your heart on the perfect ring only to find out that you can’t afford it. The “right” amount to spend on an engagement ring is whatever the buyer feels comfortable with, not what the internet or other people claim it should be. Even though one may find it tempting to splurge and go overboard, it is important to remember that starting a new chapter in life in debt may not be the best idea.

Your Woman

The last thing you want to see is that gloomy and unsatisfied look on your woman’s face after slipping the ring on her finger. The key to avoiding this situation is actually knowing exactly what she wants. Is she more of a traditionalist looking for delicate jewelry or someone with a more modern fashion sense? Or does she have a specific design in her mind from that TV show she watches or the magazine she reads?

A good tip is to take note of the kind of jewelry she currently owns and wears on a daily basis. If her collection mostly comprises of yellow gold then getting her a white gold or platinum engagement ring might not be a good idea. If nothing helps then bringing her along for ring shopping may spare you the stress of making the wrong choice.

The Four Cs

The four Cs comprise of: color, cut, clarity, and carat. They are used to measure, assess, and rank the value of a diamond. Colorless diamonds are regarded as top-notch, and they are quite expensive. The cut of a diamond refers to how the stone has been carved. Diamonds with an optimal cut are valued higher as compared to those that don’t. The clarity of the diamond takes into account the perfection of its interior and exterior; any blemishes, scratches, or inclusions go against the quality. Finally, carat refers to the weight of a diamond; the more weight, the higher the diamond’s value.

The Ring Size

Not every ring can be resized for a perfect fitting, which is why you must have the right size in mind when choosing a ring. To stealthily check your partner’s ring size, all you need to do is swipe a frequently worn ring from their jewelry box and take it to the jeweler.

Bottom Line

So there you have it – all the important factors you need to buy that perfect engagement ring for your significant other. Choose wisely!

Organic Gardening Tips – 5 Tips to Successful Organic Gardens

Unlike the popular theories that state that the space shuttle could miraculously appear if blown up enough times, an organic garden is usually not the result of an accident. People that have a successful garden have created one based upon their consistent upkeep, planning, and a desire to make their garden grow. Regardless of the therapeutic value the gardening has, relaxation has little to do with the steps that it takes to ensure the success of your gardening endeavor. Here are a few organic gardening tips on how to make sure that your organic garden goals are reached by looking at planning, soil preparation, fertilizers, irrigation, and insect and disease control.

Tip #1 – a plan is always needed. Not something that is thought of and reconsidered over time intermittently, but a specified plan of action that leads to a specified end result. When you decide to grow your garden, and you choose to do it in an organic matter, you will need to take a few things into consideration such as location, the environment that the plants will grow it, the time that it will take in order for you to properly take care of your garden, how much effort will be involved and are there any resources that you may or may not be able to acquire in order to reach your final goals.

Once you have a clear written outline of what it is you need to do and what you need to acquire to reach your garden goals, it is time to start the plan into action. Action is everything once the goals are defined. If you set your goals but neglect factors such as good seed, compost, or even a source of good water for your plants, you will fail in your attempt because any compromise will lead to an overall failure.

Tip #2 – prepare your soil. Soil preparation is the foundation of the growth of any and all plants that you have. From the soil, the plants will be able to get their nutrients. Soil that is hard or dense will be almost impossible to aerate and therefore the plants will not get enough oxygen through the root system in order to thrive and flourish. Likewise, if there is no way for the water to evenly percolate to the plants roots in your garden, some plants will make it while others will die without consistent moisture, and some will be oversaturated and get root rot.

Another organic gardening tip is that you must also consider the consistency of the soil in regard to the amount of compost and nutrients that will be accessible to the seeds that will grow into the plants in the garden that you desire. By adding natural compost or other fertilizers to enhance the nutrients within the soil such as nitrogen or potassium, you will need to prepare this ahead of time, specifically as you are preparing the soil and getting ready to plant your seeds.

Tip #3 – Add compost. With reference to fertilizer, if you are doing this in an organic matter, some of the best fertilizer that you can get can either come from your compost pile or from a worm bin that you have created through your vermicomposting efforts. This needs to be prepared several weeks in advance so that it is ready to use when you are ready to plant. Compost that has not had time to properly finish will be detrimental to your soil and therefore proper preparation is always mandatory before getting ready to add these nutrients to the soil that will bear the fruit of your labor.

Tip #4 – Consistently water your garden. The consideration of water is also paramount in your success. You must have a way for your organic garden to get enough water on a regular basis so that it can grow unimpeded by the periods of droughts that are self induced by someone to did not plan ahead of time and create an optimal situation for the gardens irrigation needs. This includes having enough access to water, easy access through an irrigation system or hose system, and potentially a sprinkler system on a timer which can ensure that the garden is receiving water on a regular basis.

Tip #5 – Beware of insects. One final organic gardening tip that you should consider is that when your plants begin to grow, insects will appear. Weeds will also appear as well as potential diseases that can kill off your crop. This will take some wisdom on your part knowing the types of plants you are growing and finding natural alternatives to pesticides that may inhibit or deter the natural growth processes of your plants. If you are an organic gardener, you will not want to use these anyway and therefore finding beneficial insects that attack bad insects or natural scents or plants that will deter weed growth or disease is paramount in ensuring the healthy growth of your garden.

When considering all of these things together in a big picture, you realize that gardening cannot possibly be the result of an accident. There must be proper preparation and access to all of the tools necessary in order to make a garden successful and to make your efforts worthwhile. Take some time and use these five organic gardening tips to your benefit and make your garden one of the best you have ever had.

The Basics of Acquiring a US Visa

It’s not uncommon to dream of visiting places you see in the movies. Let me guess, most of them are in the United States. To name a few, New York, LA, Miami, Washington and Chicago are some of the common tourist destinations in the US. You have the resources but you harbor this apprehension of being denied.

This should not stop you from making your travel plans a reality. If you have relatives in the US or you would like to travel solo, the key is to know what type of visa you must apply for, the necessary documents you must fill out, and more importantly, the purpose of your visit to the US.

First things first, know the difference between a US Visitor Visa (B-2) and a US Visa Sponsorship.

These two things are not the same.

The visitor visa often known as B-1/B-2 visa is a non-immigrant visa for people wishing to enter United States temporarily for pleasure, medical treatment, and business. In this case, you apply for your US Visa with the US Embassy or Consulate. Whereas, a U.S. visa sponsorship is applied for by the employer or close family member by filing an immigration petition with the U.S. government for getting a residency card (Green card) for their employee or close family member. This is also known as non-immigrant petitions such as work visa (e.g., H, L visa) as well as family visa (e.g., Fiancé or K visa).

What is the purpose of your visit?

You will be asked this question by the US consul who you will meet when you get to the embassy. But before that, determine the purpose of your trip. If the purpose of your trip is to visit USA for a short duration for pleasure, tourism, and visit relatives, family, or friends, then visitor visa known as Tourist visa to USA or B-2 visa is the right visa for you.

However, keep in mind that you if apply for a visitor’s visa, among other things, you must show to the US Consular officer that they have strong ties to the Philippines as you home country and they intend return after their temporary stay in the U.S. You must also show that you have enough money available to take care your expenses for your U.S. trip such as air tickets, visitors insurance, lodging/boarding, transportation expenses, tourism expenses and all other expenses.

What if I don’t have enough resources but my friends and relatives in the US are willing to shoulder my stay there?

Then this is where sponsorship sets in.

Who can sponsor my trip?

Any US-based person can sponsor visa for his/her parents, relatives, and friends. This means that he/she must either be a holder of an I-94 (US Green card) or a US Citizen. Your sponsor should provide an affidavit of support (form I-134). The form is a confirmation that the sponsor is ready to undertake the financial liability of the applicant during the visit.

What documents do I need to submit?

Must have Documents for US Visitor Visa interview:

  1. A valid passport that does not expire prior to 6 months beyond of your intended stay.
  2. Printout of your confirmation page from the form DS-160
  3. Fee receipt US Visa Fees
  4. One photograph
  5. Original/Copy of Visa interview appointment letter

Supporting documents to show your Ties with your home country include:

You must demonstrate strong economic, social, and familial ties with your home country. You must also show that you will not become a burden on US by proving your financial stability to cover the expenses in US. These facts will ensure the interviewing officer that you will return to your home country after the authorized period of stay in USA. The required documents are:
1. Evidence of sufficient funds for the visit to US (Bank statement and passbook, etc.)
2. Evidence to show that you have strong ties to your home country. Documents related to the property you own and your employment are good evidence
a. If you are employed get a verification letter of employment
b. If you are self-employed get a financial and other documentary proof of the ownership
c. If you are a government employee get a Certificate of Employment and an Authority to Travel Certification
d. Tax ID, and recent tax-related documents
e. Original property papers like house, shop or business ownership documents etc. which you own in the Philippines/home country. If no papers available, make a notarized affidavit for the same
f. Documentary evidence of running any business or organization
g. Evidence of family ties like unmarried children, old aged parents and other family responsibilities
h. If person is an employee, other than proof of employment and proof of leave granted from the office, any such document that would show proof that you have reasons to come back

Documents and other proofs aside, the assistance of an immigration counsel/consultant who would facilitate your application and better your chances of getting approved is strongly suggested and highly encouraged.

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Black Friday: The Best Time To Get Discount Home Furniture and New Kitchen Appliances?

Ah, November. That time of year when (in most places) the air takes on a pre-snow chill, the last of the leaves start to crinkle and fall from the trees and, most importantly, the Shopper Monsters in us begin to poke their heads out and sniff the air.

It started on the very first day of the month. All through October you saw Christmas-y things peeking out from store corners — a roll of wrapping paper here, a sprig of holly there — but you didn’t really think about it. Maybe you didn’t want to think about it. You were still deciding on what candy to hand out to trick-or-theaters, after all.

Then, without warning, November hit, and with it, the holiday season. As you browsed department stores looking for day-after-Halloween candy deals, you couldn’t help but notice it looked as if the North Pole exploded all over. Your Shopper Monster growled and wagged its tail eagerly. You gently tugged at its leash and got into the checkout line, where you saw that they were already selling Christmas-themed candy, at three times the price of the discounted bag you were getting ready to purchase. The days have passed, growing shorter all the while, along with the patience of your Shopper Monster.

Soon it will be here. The most magical day of the year for your Shopper Monster: Black Friday. Just as it did in years’ past, by now the Shopper Monster will have wriggled its way out and started hauling you around, while all you can do is flail behind helplessly, holding onto the leash for dear life, pretending you have some semblance of power over the beast.

Other people’s Shopper Monsters are even worse; more than once they’ve been driven to go straight to bed after Thanksgiving dinner so they can wake up at an ungodly hour and spend the day fully energized, racing from store to store, finding the best deals on this mp3 player and that blender. Others have powered through the day aided by espresso shot after espresso shot. Still others waited for midnight to hit, refreshing their Internet browsers over and over so they can get first dibs on the online deals.

And what for? All in the name of discount home furniture and new kitchen appliances. The truth is that Black Friday can save you a lot of money, but being a smart consumer all year round can do the same thing. Black Friday is just one day out of the year stores have big sales — most will have at least one other big blowout at some point in the year, and will always have a few things on sale throughout the year.

Checking online frequently is the easiest way to check for discounts on home furniture, kitchen appliances and everything else you don’t want to pay full price for. You might be able to save a lot of money on Black Friday — your sanity is a whole other story. Keep your eyes and ears open for deals 365 days a year, and you’ll be able to keep that Shopper Monster happy all year.

Details About Working With an Online Travel Agency

When you are looking to book your next vacation or your next business trip, you may be considering using an online travel agency. Before you decide to do so, however, you should be aware of what to expect from an online travel agency so you can determine how best to match that to your own unique needs. There are several different levels of service in which to classify online travel agencies, the level you need depends on your trip requirements as well as your personal travel and leisure preferences or desires.

Quite simply, you should be able to find an online travel agency that can fulfill any expectation you may have. Whether you prefer self-service travel plans where you do all of your own searching and booking, or a full-service online agency that handles every detail on your behalf, there are many options available. Depending on the type of travel you will be undertaking, there are also various options that you can consider among online travel agencies. Some specialize only in travel packages, while others offer a la carte menus of travel services for you to pick and choose.

There are several expectations, however, that are universal to all online travel agencies. These have to do with the minimum level of service provided and the quality and competitiveness of the types of travel being sold. It is best to qualify the online travel agency on all of these expectations before you choose to enter into partnership with them for the travel you are seeking to plan.

The first universal expectation that you should have for your online travel agency is having a variety of destinations and packages available to choose from. It does not matter what specialty the agency might have, from full-service travel to niche travel such as cruises or unusual destinations. No matter what is being sold, you always want to partner with an agency that provides options. While the first option you see may very well end up being the best choice or the best value, you will have no means of determining that unless other options are available for comparison. Good self-service travel sites will readily offer you comparison information. Full-service online travel agencies should compile that same information and present it to you when you are in the process of making a decision.

The second universal expectation you should have when using an online travel agency is that they offer the same basic types of vacations from more than one carrier or provider. For example, you can choose between two major airlines for the same New York-to-Miami flight leg of your trip. If an online travel agency represents only one brand, they are not truly a travel agency; instead, they are a representative of that brand. If only one brand were offered, customers would have no means of evaluating whether the services and products offered were of value or were worthless. Having a number of providers to choose from when selecting hotel or airfare or cruise line shows that the travel agency is actively updating its site with the best prices and options currently available.

The third universal expectation that you should have for your online travel agency is price competitiveness. Although travel agencies sometimes charge fees to travelers in order to off-set their cost of doing business, those fees must be fair. The charges for the actual travel services you see published through online travel agencies should be no more than what you would pay if you went directly through the provider, and, in fact, less if bundled with other services.

The final universal expectation that you should have for your online travel agency is a service-level guarantee that ensures you get what you pay for and are treated in a courteous and appropriate manner. Online travel agencies should also offer some form of a guarantee for your purchases that no foreseeable action on their part or the part of the service provider will interrupt your travel. They cannot warrant against freak or random occurrences, but they can ensure that their own offerings are solid before offered.

Perhaps the best thing about using an online agency is the availability of customer reviews and feedback you can read before making a final purchase. Another nice convenience, for repeat customers, is the ability to create your own customer profile that allows you to save certain options in your preferences that will streamline future vacation planning. You can save time and hassle by storing any corporate or membership discount numbers, frequent flyer numbers and other pertinent information on your customer profile.

The expectations you hold for the online travel agency you select as a partner may be varied. If they can uphold these four basic standards of quality, you can be assured that you are getting sound representation and the best deals available.

Finding a Great Job

Many businesses have high turnover rates due to unhappy, unsatisfied, and/or unappreciated employees. There are several ways a company can create loyalty, happiness, and more positive attitudes towards employee’s jobs. One such approach is through increased company functions and gatherings that help develop office friendships throughout the company. Also, the creation of management teams and developing a teamwork mentality will help employees gain the feeling of ownership in their company. Instead of an us versus them attitude between departments, friendships throughout the company will also help build a complete team attitude. Many prominent companies create outlets for their employees to volunteer, fundraising, and help their community. The following suggestions will also increase employee pride, happiness, and ownership of their responsibilities at work.

• Family Atmosphere – This type of environment creates a climate of fairness, equality, respect, and makes it safe to express dissent. This atmosphere is welcoming and creates a friendly environment to introduce new ideas. Employees teams may encourage a challenging but supportive environment and strengthen loyalty and teamwork throughout the organization.

• Recognition Programs – Company programs that recognize hard work, commitment, effort, and contributions breed organizational success and loyalty. The recognition program should include monthly awards and gift cards or a free lunch. Recognition from a supervisor at least two ranks above an employee makes a meaningful, engaging difference in employee morale.

• Organizational Pride and Belonging – Promote activities that development and establish pride and loyalty which is the backbone of any businesses long-term success. Employee turnover is extremely expensive and productivity and product or service development suffers. An engaged employee is a person who is enthusiastic about their work. Improving employee engagement directly impacts measurable business outcomes. Employees who are committed to success, emotionally attached, and socially involved with a company demonstrate qualities that business managers thirst to have. Engaged employees are more productive at work, take less sick days and exhibit other favorable behavior, promote the business to others and show their happiness to customers.

• Mentor Programs – Thinking long-term for future company success. A mentor is an experienced and trusted adviser that assists in developing competent employees and future leaders. Mentoring program train and encourage seasoned employees to be mentors. A mentoring program can facilitate dynamic skill growth throughout an organization. Informal learning can be as important as formal learning programs.

• Volunteering Options – Look for opportunities for your company employees to get involved in the community. Allow your employees to volunteer their time or fundraising for a good cause. It is good public relations for companies to show their communities they care about their customers. These activities will create good-will among the local community and your employees. Create a team to decide what cause your company will offer financial support for a charity or cause.

Employee engagement can be improved by aligning the goals of individual with the goals of the business. Employee motivation should be associated with traditional rewards, such as pay and compensation, but also with emotional rewards such as personal growth, working for a common cause, being part of a high-performance team, and being recognized for achievements.

The Benefits Of uPVC For Your Home Or Office

As far as building materials is concerned, you may have heard of uPVC. But what exactly is it? This article will give you the answer to this question in addition to shedding some light on the benefits of uPVC. After reading this article, you will come to know why local builders go for this material instead of other stuff out there. Read on to know more.

uPVC

Actually, uPVC is a short form of unplasticised polyvinyl chloride, which is commonly known as a high quality rigid PVC. Since it hard but won’t flex, it falls under the category of PVC. The beauty of the product is that it leaves out BPA or phthalates, so it is quite safe. Apart from this, it is safe and stable and can be used to manufacture mouth guards and dental retainers as well.

Now, let’s take a look at some of the benefits you can enjoy if you go for this material.

Low Maintenance

Windows and doors made from uPVC don’t need to be sealed or painted. As a result, the cost of maintenance is not that much with the passage of time. The reason is that these windows and doors are easy to clean with water and detergent.

Tough And Durable

Due to the durability of the material, it has been used for making sewer and water pipes for more than 100 years. You can get the idea from the fact that vinyl windows that were installed more than two decades back are still in use. Moreover, quality uPVC doors and windows go through different rests for ultraviolet resistance to make sure that they don’t fade in the sun.

Rot Resistant

Unlike other materials, uPVC is not prone to corrosion or rotting as time goes by. So, this is another great benefit of opting for this product instead of many others available in the market.

Thermal Comfort

You know metals are conductive. But uPVC doesn’t fall under this category. Therefore, windows and doors don’t transfer heat. As a result, you can enjoy consistent temperature in your rooms. As a matter of fact, the windows of your rooms will be a lot more efficient provided they are made of this material.

Tilt And Turn

These windows can be opened in two directions in order to allow you benefit from the cross ventilation, which is another great benefit.

Acoustic Insulation

With double glazed doors and windows, you can reduce the noise by up to 70%. So, you can have peace of mind especially if there is a lot of noise outside your house all the time.

Salt Erosion

You won’t have corrosion problem caused by salt-filled air. So, they are an ideal choice as far as coastal properties is concerned.

High Security

As far safety and security is concerned, these windows feature multi-locking systems that provides higher security for your house or office.

Long story short, if you are looking for the best doors and windows for your office or home, we suggest that you give a go to uPVC doors and windows due to the many benefits they offer.

Centers For Medicare and Medicaid Services – Home Health Quality Measures Explained

The Centers for Medicare & Medicaid Services (CMS) is part of the federal government’s Department of Health and Human Services. Because many Medicare and Medicaid recipients are elderly, much of the funding goes to nursing homes or eldercare services. Health agencies that receive certifications from Medicare undergo an assessment every three years. CMS assesses these home health agencies via quality measures and publishes each agency’s results.

CMS & Home Health

CMS provides scoring for all Medicare-certified home health agencies via Health Compare. The quality measures take into account: (1) the patient’s improvement in performing a variety of activities of daily living (ADLs), and (2) whether the patient’s health improves or stabilizes over time.

It is important to note that the quality measures should only be used as a general guide. Many home health care recipients are elderly, and each patient’s needs are different. Some patients are recovering from surgery or a medical emergency. Others have chronic and worsening medical conditions. Therefore, the lack of improvement in some home health care recipients is not due to poor standards or substandard care, but rather due to declining health. In addition, Medicare’s quality measures for home health are fairly recent and are still being refined. Currently, the quality measures provide a baseline to help consumers see how a local agency compares to both state and national averages.

CMS Quality Measures

CMS quality measures are used in Medicare-certified home health care agencies in order to come up with the final scoring. Medicare details the following quality measures:

* Three measures related to improvement in getting around:
– Percentage of patients who get better at walking or moving around
– Percentage of patients who get better at getting in and out of bed
– Percentage of patients who have less pain when moving around

* Four measures related to meeting the patient’s activities of daily living:
– Percentage of patients whose bladder control improves
– Percentage of patients who get better at bathing
– Percentage of patients who get better at taking their medicines correctly (by mouth)
– Percentage of patients who are short of breath less often

* Two measures about how health care ends:
– Percentage of patients who stay at home after an episode of home health care ends
– Percentage of patients whose wounds improved or healed after an operation

* Three measures related to patient medical emergencies:
– Percentage of patients who had to be admitted to the hospital
– Percentage of patients who need urgent, unplanned medical care
– Percentage of patients who need unplanned medical care related to a wound that is new, is worse, or has become infected