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We all know summer is a great time for outdoor activities. With so much going on, it’s easy to forget how much ultraviolet (UV) rays from the sun we’re exposed to during the warmer months. For our senior population, it is vital to keep this in mind when planning your next outdoor outing. According to the CDC, seniors make up most cases of skin cancer in the United States due to our skin becoming less resilient from UV rays as we age.

In order to protect our seniors:

  • Enjoy the shade
  • Limit direct sun exposure, especially from 10 am and 4 pm – this is when UV rays are strongest
  • Use sunscreen – reapply every two hours and immediately after pool time
  • Wear the proper clothing – long-sleeved shirts, long pants
  • Wear wide-brimmed hats

Did You Know?

Providers can check the status of Medicare appeals at any time during the process.

First-level appeals (Redetermination) status can be checked using claim information via each specifically assigned Medicare Administrative Contractor (MAC). Sites with contact and access information for each are listed below (per

Second-level appeals (Reconsideration) status can be checked using the reconsideration appeal
number from the acknowledgment letter sent upon receipt of the reconsideration appeal via Q2A at:


Third-level appeals (the Administrative Law Judge (ALJ) phase), can be checked using the reconsideration appeal number or the ALJ appeal number present on the acknowledgment of request for ALJ, at the Office of Medicare Hearings and Appeals (OMHA) E-Appeal Portal at:


Summertime and the Importance of Hydration

As we move into the warm summer months, whether spending time indoors or in the fresh air and sunshine, we need to keep in mind the importance of hydration in our senior population. Hydration is so important that CMS has included it as one of their Critical Element Pathways.

Hydration pertains to various sections within the MDS assessment, requires care planning, and is reviewed by State Surveyors for compliance within Skilled Nursing Facilities.

Signs that indicate altered hydration status:

  • Decreased, absent, or concentrated urine output
  • Complaints of dry eyes
  • Poor skin elasticity
  • Rapid pulse or a slow, weak pulse
  • Dry, chapped lips, tongue dryness, longitudinal tongue furrows, dryness of mucous membranes
  • Fainting, headache, dizziness, or nausea
  • A change in behavior – confusion, agitation, being grouchy, or acting strangely
What we can do to ensure our seniors are staying hydrated this summer:

  • Monitor fluid intake
  •  Act on reports of persistent fatigue, muscle weakness, headaches, and dizziness
  • Encourage residents to drink during meals and throughout the day
  • Take multiple sips of liquid between bites of food
  • Consume water with medications
  • Intake fluids after toilet use
  • When residents refuse to drink, offer different forms of liquids such as popsicles, soup, melon, strawberries, or watermelon
  • Keep water nearby for easy access
  • Start a “sip and go” program that encourages residents to hydrate before participating in activities

In addition to all of the previously mentioned ideas, utilizing a Hydration Program in your community can help identify residents who may be at risk for dehydration, have difficulty with oral intake, or would benefit from advancement in diet texture or education in assuring a safe swallow.

Hydration Programs can bring interdisciplinary team members together to enrich residents’ quality of life and maintain high levels of health and wellness. Be sure to connect with your therapy team and begin a Hydration Program today.

Rehab Roundtable:

The Toll of Ageism on Residents’ Physical and Mental Health

During this Rehab Roundtable we discussed:

  • What is Ageism?
  • Ageism in senior communities
  • Staff education and training
  • Ageism’s impact on residents
  • Combatting Ageism

Did You Know?

PHE Extension

  • HHS has committed to providing a 60-day notice before terminating the Public Health Emergency (PHE).
  • That 60-day window for the current PHE set to expire July 15th passed by last month, and as such, we fully anticipate another renewal come July, taking us through mid-October, at minimum.

Engaging with our Geriatric Population to Maintain INDEPENDENCE 

The definition of “independence” can have various meanings based on the context. Referencing recent holidays, independence can mean having complete autonomy from a body of government or group of people. To our geriatric population, independence can have an entirely different meaning.

Imagine living in the same house for 30+ years. You lose your balance while getting the mail and fall. When your family insists you go to the hospital, you discover that you’ve broken a hip and will need to go to a rehab facility to stay and heal. Additionally, imagine after this fall you can’t move your legs like you used to and now have to put on a call light to get someone to help you to the bathroom. Consider the emotions our patients must go through when they come through our doors. From the hospital admission, it’s been decided what your immediate future may hold, and their levels of independence can change drastically in just a few hours after an event such as this.

Studies have shown that residents who enter Assisted Living Facilities and the like continue to lose their independence even while the facility may have good intentions. While we as caregivers do our best to support and engage the Residents who enter our facilities, they’re still not at “home”. They may suffer the physical loss of independence and the social aspect. Perhaps a once social person is admitted to a facility where family and friends simply cannot make the trip to visit. In many cases, this person who is now in our care no longer has to manage their medications, retrieve their mail, make their own meals, manage finances or complete daily tasks that they were once responsible for.

How can we continue to engage our geriatric population? Strive for person-centered care! Remember that the Residents who come through our doors are individuals who have a goal of having the BEST quality of life. Where they reside should be a comfortable residence in which they feel safe and also provided with opportunities to interact and stimulate not only their physical well-being, but mental and social well-being.

To further support our Residents, remember:
Their feelings are valid – What may not seem important to us as we’re completing our job tasks may seem like the only important thing of their day. Acknowledge it and support them in that.
Listen – Look for even subtle ways your Residents are trying to communicate. Be aware of those small cues they’re giving that may tell us they are stressed, feeling anxious, or are in pain even if they can’t verbalize it.
Empathize – Remember they’re individuals with families and real concerns and are going through a loss of independence and change in environment.
Respond – Support our Residents by engaging them in activities that are important to them. Ask what they love and set them up with resources they need to engage. If they’re feeling down, or have a new issue with pain make sure to refer them to the correct resource to address that issue.

Striving to make each individual who enters our facilities more “independent” may look different for each person based on their history and needs for quality of life. It is our job as health professionals to engage and promote independence for each Resident through patient-centered approaches.

How do you want YOUR changes in independence addressed as you age?


-Encore Rehabilitation’s monthly publication, designed to give you updates on trends we are seeing in the Post-Acute Care industry.-