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Giving Thanks

We have much to be thankful for this year, believe it or not.

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Today is the last day most of us will work this week because of Thanksgiving.  I looked back over the last couple of years to see if there was any inspiration in prior Thanksgiving posts and there wasn’t a whole lot.  Medicare still seems to be working against us and we are still fighting hard to stay in the game.  We are tough and we will survive.  It’s a given.

It isn’t that I am ungrateful.  I am grateful most days when I wake up and take note of my life.  Compared to about 90 percent of the world, I have everything; a home, a family and a son with a dog I love dearly.  Who could want more?

Maybe you could want more.  Maybe some of your patients could want more.

So this year I choose to not make a big deal about all I have to be grateful for as other people are coping with illness or the loss of a loved one.  Being grateful is good.  Flaunting my good fortune in the face of others who are not so fortunate does not tell a story about me that I like.

At some point between the Turkey and the doors opening for Black Friday, maybe we should all pause and consider how we can give something to those who do not have a warm family and home to celebrate with on Thanksgiving Day.  Maybe we can give someone something to be grateful for if only for a minute.

If you live in an urban area, consider keeping some Karma Bags in your car.  Cheap, easy and versatile, if all home health and hospice nurses making home visits carried a half dozen of these, that would make for a lot of meals.  This is what I do for less than ten bucks.

Hit the Dollar Store and go through extra stuff at your house and on your desk to come up with useful things.  Consider some of the following.

Karma 1

  • Juice
  • Mints
  • Peanutbutter
  • crackers
  • Advil or Tylenol
  • Toothbrushes/toothpaste
  • A printed prayer or poem
  • socks!
  • list of local resources
  • razors
  • soap
  • canned tuna or sausages
  • stamped postcard
  • ink pens

The list is endless and I choose what goes into the bags based upon what is available and priced so I can buy multiples.

Assemble the Karma Bags in whatever handy container you have available.  I have used zip lock bags, sports water bottles (a client had some left over from previous owners with the name of an agency that was no longer in business and burlap bags from the Kraft store that were on sale.  The best part of this kind of giving is that it isn’t limited to the holidays.

karma 2

Not everyone feels their heart reach out to the homeless people.  That’s okay.  Some people are drawn to other causes and there are so many worthy causes.  I personally am useless around sick kids but that doesn’t mean that I don’t care and I am very grateful for those who can provide care and attention to them.

If you have another idea that you think could brighten the day of someone whose day really needs brightening, please share.  And if you do Karma Bags, please send us photos.

If you are someone who will be missing someone or has otherwise been disappointed by life, try Karma Bag therapy. You might find that your day is brightened as well.


Giving Thanks



Wow.  What a challenge.  Thanksgiving is this week and it is only proper that I share with you all the ways we should be thankful.  I’m really struggling.

I could be grateful because I am appealing.  I spend most days at my computer appealing denials for clients.  I enjoy a good argument but the craziness of all these denials for claims for reasonable and necessary care given to eligible patients is overwhelming.  Worse than the financial hit is the overall disrespect of home health and hospice agencies.  If anyone wants to feel like a criminal, all they have to do is work for a home health or hospice. So I may be appealing but I am not grateful.  I would much rather be teaching and doing something – anything – that worked towards better care of patients.  Keep that in mind if you need an inservice or two.

I could be grateful that the Face-to-Face documentation burden has been lightened but I am not.  I guess I’d rather it be lightened than not but I just got ten or so denials this morning related to the requirement.  The Medicare Contractors are going to suck dry the opportunity to withhold money from my clients – and you, too if you do not happen t be a client– until the very last minute.  The regulations taking effect in January have no effect on past denials. 

I could be grateful that more Americans than ever will be able to afford insurance with the ACA but I am not.  The law is so complicated that I think there are only a handful of people who fully understand it and they are not elected officials.  Since nobody really understands it, it has become a dividing line between democrats and republicans who are voting with their party with no idea of how it will play out.  So, no, thank you.  I am not grateful for the ACA.

This doesn’t mean I am not grateful though – even at work.  Home health and hospice have been taken on a ride these past couple of years and you survived. 

I am so very thankful that I know people who are willing to get up and drive to a stranger’s house to adjust pain medications at 3:00 am. 

I know the houses where the water gets cut off for lack of payment located next to the crack house and you find it in you to smile warmly at the patient and show them the same respect that you would if you saw a patient at a $20M Manhattan apartment.

I know your kids are left without a parent during a special football game or school play because you cannot leave a patient in need but I am grateful for the lessen you are teaching to the next generation.  Taking care of others is an important job.  Compassion is a value that should be passed along to the next generation.

I am thankful for those of you who contribute to this blog and The Coders’; even when I don’t agree with you.  I appreciate that you have ideas you are willing to call your own and speak up about them.  You are prime material for patient advocacy.  I like that. 

I love the laughs, the occasional tears and how you make me feel as though I am one of you.  Because I am.

Thank you.

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