McKnight's Long-Term Care News articles from July 2005

McKnight's Long-Term Care News archives from July 2005

HCB push has flaws: AHCA.(home- and community-based care)(American Health Care Association)(Brief Article)
July 1, 2005... As states and policy makers again promote home- and community-based platforms for eldercare services, the nursing home industry is delivering a familiar retort: not so fast. The American Health Care Association questioned whether such a...

Providers catching thrust of IT wave.(information technology)(Brief Article)
July 1, 2005... The signs have become too numerous and too large for providers to ignore any longer. More technical expertise must be developed--and used. Senate Majority Leader Bill Frist (R-TN) and Sen. Hillary Rodham Clinton (D-NY) introduced a bill...

SNFs get win on rehab pay.(skilled nursing facilities)(Brief Article)
July 1, 2005... The government will enforce a rule that limits admissions into inpatient rehabilitation facilities (IRFs). As a result, skilled nursing facilities stand to gain an influx of rehab residents. The Centers for Medicare & Medicaid Services will...

CMS expands drug coverage.(NEWS)(United States. Centers for Medicare and Medicaid Services)(Brief Article)
July 1, 2005... Medicare's new Part D prescription drug plans must include in their formularies most drugs in the antidepressant, antipsychotic, anticonvulsant, anticancer, immunosuppressant and HIV/ AIDS categories, the Centers for Medicare & Medicaid...

Antipsychotic drug overuse.(NEWS)(Brief Article)
July 1, 2005... Doctors may be prescribing antipsychotic drugs to nursing home residents in dosages that are too high or prescribing them for the wrong ailments, a new study suggests. Based on an unweighted sample of 1,096 Medicare residents, the...

White House tactic zaps panel interest.(NEWS)(Brief Article)
July 1, 2005... When the person who pushed hardest to get a panel enacted doesn't want to be part of it, something's up. In the case of a national advisory Medicaid commission, many potential panelists are essentially boycotting. Their none-too-subtle message...

SEIU vote could fuel campaigns.(Service Employees International Union)(Brief Article)
July 1, 2005... In a move that could lead to more focused organizing efforts in nursing homes, the board of the Service Employees International Union has authorized a possible defection from its parent group. Currently, SEIU is part of the AFL-CIO....

The 10th Circuit Court of Appeals ruled in June.(social security disability income )(Brief Article)
July 1, 2005... Court of Appeals ruled in June that states do not violate federal law if they make residents use Social Security disability income in a "special needs trust" as a Medicaid copayment for nursing home care.

Proposed Medicare.(At deadline)
July 1, 2005... SNF rates contain therapy index calculation problems and other mistakes, CMS has acknowledged. The government plans to address the issue shortly.

CMS will struggle to educate Medicare beneficiaries about the new drug benefit.(Centers for Medicare and Medicaid Services)(Brief Article)
July 1, 2005... CMS will struggle to educate Medicare beneficiaries about the new drug benefit, as "outreach proved relatively ineffective" in enrolling beneficiaries in the temporary drug discount card program, according to the Medicare Payment Advisory...

A change in the memory-making region of the brain may reveal Alzheimer's disease.(hippocampus (brain))(Brief Article)
July 1, 2005... A change in the memory-making region of the brain may reveal Alzheimer's disease a decade before symptoms appear, researchers say.

Most people between the ages of 59 and 71 feel they have enough money to live comfortably until at least age 85.(At deadline)
July 1, 2005... Most people between the ages of 59 and 71 feel they have enough money to live comfortably until at least age 85, according to a MetLife study.

60 seconds with ... Theresa Bourdon.(NEWS)
July 1, 2005... Q: Beyond showing a doubling of liability cases and tripling of settlement dollar amounts, what else struck you about your recent report on nursing-home liability costs? A: The liability crisis has really expanded across the country....

Providers look to feds for service-based incentives.(NEWS)(Brief Article)
July 1, 2005... Nursing home advocates are asking federal regulators to create a new way of screening and assessing post-acute care patients. A change to the system generally could help increase nursing homes occupancy levels. Pushing individuals away from...

Treatment teams expect drug problems.(NEWS)(Brief Article)
July 1, 2005... Key treatment team members expect to see more medication-related problems once a new Medicare law takes effect next year, a major report has found. Among the likely medication challenges they anticipate are more limited access, an...

A new ruling by the Justice Department restricts the government's ability to prosecute those who violate the law protecting the privacy of medical records.(Regulatory Update)(Brief Article)
July 1, 2005... A new ruling by the Justice Department restricts the government's ability to prosecute those who violate the law protecting the privacy of medical records. While criminal penalties would apply to insurers, doctors, hospitals and other...

The Centers for Medicare & Medicaid Services has proposed a new rule.(Regulatory Update)(Brief Article)
July 1, 2005... The Centers for Medicare & Medicaid Services has proposed a new rule that would ease the regulatory burden for hospice providers and improve the quality of care for all hospice patients.

Sens. Chuck Grassley (R-IA) and Blanche Lincoln (D-AR) introduced a bill to create tax deductions for long-term care insurance.(Bill Watch)(Brief Article)
July 1, 2005... Sens. Chuck Grassley (R-IA) and Blanche Lincoln (D-AR) introduced a bill to create tax deductions for long-term care insurance. The House Ways and Means Committee was expected to hear companion legislation.

Sen. Hillary Rodham Clinton (D-NY) and Senate Majority Leader Bill Frist (R-TN) are sponsoring a bill creating a health information technology network to improve access to medical information.(Bill Watch)(Brief Article)
July 1, 2005... Sen. Hillary Rodham Clinton (D-NY) and Senate Majority Leader Bill Frist (R-TN) are sponsoring a bill creating a health information technology network to improve access to medical information. The bill would authorize $125 million grants...

Ask the care expert.(NEWS / Resident Care)
July 1, 2005... Some nurses really struggle to find proper ways to work with/around non-verbalizing or non-communicative residents, What can we tell them to help them do, and enjoy, their job? Caregivers need to respect the fact that their presence is just...

Intensive rehab may be better than back surgery.(NEWS / Resident Care)(Brief Article)
July 1, 2005... Rehabilitation may be better than surgery, for those afflicted with back pain, a new online study published by the British Medical Journal reports. "This is strong evidence that intensive rehabilitation is a good thing to do for people...

Vaccine cuts risk of shingles in elderly.(NEWS / Resident Care)(Brief Article)
July 1, 2005... Elderly people living in fear of shingles can now find a measure of relief in a new vaccine. The Oka/Merck VZV vaccine reduces the rate of occurrence and severity of shingles, as well as the resulting nerve pain, according to a report from...

Transcendental meditation could lead to a longer life.(Caregiving Update)(Brief Article)
July 1, 2005... Transcendental meditation could lead to a longer life. Older adults with high blood pressure who practice it see a lowering of their blood pressure over time and longer life spans, according to a report in the American Journal of Cardiology.

Elderly people with atherosclerosis are more likely to have symptoms of depression, a new study says.(Caregiving Update)(Brief Article)
July 1, 2005... Elderly people with atherosclerosis are more likely to have symptoms of depression, a new study says. Participants had a 50% to 90% increased risk of depression if they had any risk factors for vascular disease, including hardening of the...

Long-term stress could result in memory loss and poor brain function in some older people.(Caregiving Update)(Brief Article)
July 1, 2005... Long-term stress could result in memory loss and poor brain function in some older people. Continuous high levels of the stress hormone cortisol lead to memory impairment in the elderly, according to a study published in the scientific journal...

Public health officials are concerned about flu vaccine supply levels for the upcoming season, especially after last year's unexpected production shortage.(Caregiving Update)(Brief Article)
July 1, 2005... Public health officials are concerned about flu vaccine supply levels for the upcoming season, especially after last year's unexpected production shortage. They expressed their worries during a two-day conference in May. They also fear some...

Ask the treatment expert.(NEWS / Wound Care)
July 1, 2005... What is the most-often misused or misunderstood diagnostic process nurses employ regarding pressure ulcers? Despite years of use and extensive training, the pressure ulcer staging system developed by the National Pressure Advisory Panel...

Study: infection-causing bugs can live for weeks.(NEWS / Wound Care)(Brief Article)
July 1, 2005... Infection-causing "super bugs" may live in common places for weeks, investigators have found. Their study shows strict hygiene is needed to battle the bacteria, some of which are now nearly impossible to kill even with the strongest...

Light therapy helps nerves.(NEWS / Wound Care)(Brief Article)
July 1, 2005... Recent studies suggest monochromatic infrared energy treatment--or MIRE--may help nursing home residents with peripheral neuropathy. The light therapy treatment works by opening blood vessels and increasing circulation. It also improves...

The Food and Drug Administration (FDA) has given Oculus Inc. approval to market its Dermacyn wound care product.(Treatment Update)(Brief Article)
July 1, 2005... The Food and Drug Administration (FDA) has given Oculus Inc. approval to market its Dermacyn wound care product. The product will be used for moistening, lubricating and debriding wounds and burns.

The FDA has given Celleration, Inc. second clearance for its Mist Therapy System 5.0.(Treatment Update)(Brief Article)
July 1, 2005... The FDA has given Celleration, Inc. second clearance for its Mist Therapy System 5.0. The product produces a low energy ultrasound-generated mist used to promote wound healing through wound cleansing and maintenance debridement by the removal...

Johnson & Johnson Wound Management recently introducted Promogran Prisma Matrix for the treatment of exuding wounds.(Treatment Update)(Brief Article)
July 1, 2005... Johnson & Johnson Wound Management recently introducted Promogran Prisma Matrix for the treatment of exuding wounds. The product absorbs destructive components of wound exudate while promoting healthy tissue healing. It may be used for the...

The Joint Commission International Center for Patient Safety announced the launch of its new Web site: www.jcipatientsafety.org.(Treatment Update)(Brief Article)
July 1, 2005... The Joint Commission International Center for Patient Safety announced the launch of its new Web site: www.jci patientsafety.org. The site was designed to be a repository of resources and information related to wound care and other aspects of...

The FDA has given Misoni Inc. approval to market its ultrasound wound debridement system.(Treatment Update)(Brief Article)
July 1, 2005... The FDA has given Misoni Inc. approval to market its ultrasound wound debridement system. The product has already been approved for soft tissue respiration, the company said.

Ask the nursing expert.(NEWS / Nursing)(Brief Article)
July 1, 2005... How important is it to have a written nursing department philosophy? Many years ago, while preparing for a Joint Commission tri-annual review, I was asked to develop a written nursing department philosophy. The importance of this...

Providers must take lead against nursing shortage.(NEWS / Nursing)(Brief Article)
July 1, 2005... Causes and possible remedies for a nationwide nursing shortage appear in the inaugural report from the National Commission on Nursing Workforce for Long-Term Care. Better and integrated efforts at recruiting and retaining qualified nurses...

Nursing home injuries now rank No. 3.(NEWS / Nursing)(Brief Article)
July 1, 2005... The Department of Labor has confirmed what many nurses already know: Nursing home employment can be hazardous. The industry's worker-injury rate ranked third highest among 84 industry groups in 2003, the most recent year for which data are...

The benefits of a daily baby-aspirin in preventing heart attacks and stroke may be offset by bleeding risks for people over the age of 70, according to research published online in the British Medical Journal.(Medication Update)(Brief Article)
July 1, 2005... The benefits of a daily baby-aspirin in preventing heart attacks and stroke may be offset by bleeding risks for people over the age of 70, according to research published online in the British Medical Journal. Trial data based on a group of...

A recent study found that heart disease patients taking aspirin, a cholesterol-lowering statin, and a beta blocker designed to lower blood pressure have an 83% lower risk of dying than patients taking just one of these medicines.(Medication Update)(Brief Article)
July 1, 2005... A recent study found that heart disease patients taking aspirin, a cholesterol-lowering statin, and a beta blocker designed to lower blood pressure have an 83% lower risk of dying than patients taking just one of these medicines. Heart disease...

When physicians prescribe medications to patients 75 and older.(Medication Update)(Brief Article)
July 1, 2005... When physicians prescribe medications to patients 75 and older, they often must base decisions partly on results from studies in younger patients, partly on their clinical experience and partly on guesswork because seniors often can't qualify...

Ask the payment expert.(NEWS / Payment & Policy)
July 1, 2005... I've heard a lot of discussion lately about No Pay Bills. What should I submit? That is a great question, it seems that there is more confusion than understanding in the provider sector. According to the Centers for Medicare & Medicaid...

Ending Medicare service? Two-day notice is in effect.(NEWS / Payment & Policy)(Brief Article)
July 1, 2005... Providers must now give residents taro days notice before taking them off Medicare. The change is a clarification of the Advanced Beneficiary Notice (ABN) process that has been on hold for the past year. The Centers for Medicare &...

CMS issues RUGs tools.(Centers for Medicare and Medicaid Services )(resource utilization groups)(Brief Article)
July 1, 2005... Federal regulators have issued two online resources to help nursing homes calculate the impact of the new resource utilization groups (RUGs) proposed rule. Both can be found at www. cms.hhs.gov/providers/snfpps/. The first, the "RUG-58...

Go figure.(NEWS / Payment & Policy)(Brief Article)
July 1, 2005... 9.5 The percentage that the population of Americans 65 or older increased by over the last decade. The number jumped to 35.9 million in 2003 from 32.8 million in 1993, according to new federal data. 15 Billions of dollars nursing homes will...

Extendicare Inc. earned $18 million.(Business Briefs)(Brief Article)
July 1, 2005... Extendicare Inc. earned $18 million in the first quarter ended March 31, a 35% decrease compared to profits in 2004. Revenue rose by 13.6% to $488 million. Medicare patient census on a same-facility basis increased to 18.8% of total nursing...

Advocate Inc.'s first quarter earnings nearly doubled to $9 million from $5 million in the same period last year.(Business Briefs)(Brief Article)
July 1, 2005... Advocate Inc.'s first quarter earnings nearly doubled to $9 million from $5 million in the same period last year. But the company said it does not have cash or resources to pay its current debt obligations of $45 million or its liability of...

Sun Healthcare Group Inc.(Business Briefs)(Brief Article)
July 1, 2005... Sun Healthcare Group Inc. narrowed its first quarter loss to $1.2 million compared to $10.4 million last year. Revenues rose to $207.2 million from $204.6 million in the first quarter of 2004. Net revenues from the inpatient services operations...

National Healthcare Corp. increased.(Business Briefs)(Brief Article)
July 1, 2005... National Healthcare Corp. increased its quarterly dividend by 20% to 15 cents per share. It paid the second quarter dividend to shareholders of record on June 30, payable on Sept, 1, 2005.

Neighborcare Inc. earned $10 million.(Business Briefs)(Brief Article)
July 1, 2005... Neighborcare Inc. earned $10 million in the second fiscal quarter, an increase of 18% compared to last year. Revenues expanded by 13% to $404 million. For the six months ended March 31, the long term care pharmacy provider's earnings...

Ventas Inc. priced a private offering.(Business Briefs)(Brief Article)
July 1, 2005... Ventas Inc. priced a private offering of $175 million of 6 3/4% Senior Notes due 2010 and $175 million of 7 1/8% Senior Notes due 2015. The sale of the notes extended through June 7. The company's operating partnership, Ventas Realty, Limited...

Harborside leaps into top 15 with new acquisitions.(NEWS / Companies)(Brief Article)
July 1, 2005... Harborside Healthcare Corp. of Boston moved into the 15th spot in bed volume among nursing homes in the U.S. after acquiring the operations of nine new long-term care facilities in Kentucky. Harborside this month plans to take over the...

NeighborCare mulls offer.(NEWS / Companies)(Onmicare)(Brief Article)
July 1, 2005... The largest long-term care pharmacy provider in the country is a step closer to taking over the second-largest. Baltimore-based NeighborCare agreed in June to consider the latest offer from Onmicare, which values NeighborCare at about $1.7...

Safety practices.(patient safety)(Brief Article)
July 1, 2005... Safety practices: HHS' Agency for Healthcare Research and Quality will award more than $8 million to encourage evidence-based patient safety practices.

Tunnell vision.(Good month)(Paul David Tunnell)(Brief Article)
July 1, 2005... Tunnell vision: Kindred renamed one of its San Francisco nursing centers in memory of Paul David Tunnell, 49, who died April 23 after a battle with non-Hodgkin's lymphoma. Tunnell worked for Kindred for almost 24 years and also was the chairman...

Milk drinkers.(Good month)(Brief Article)
July 1, 2005... Milk drinkers: A study of more than 400,000 adults worldwide found that those who drank the most milk had a 13% lower risk of heart disease and 17% lower chance of stroke than those who drank little or no milk.

Heart conditions.(Bad month)(Brief Article)
July 1, 2005... Heart conditions: The Agency for Healthcare Research and Quality announced in June that heart conditions are the most expensive medical condition. Rounding out the top five: cancer, accidents and other trauma, mental disorders, and lung...

K-Street limits.(Bad month)(Brief Article)
July 1, 2005... K-Street limits: The number of Washington-based lobbyists has more than doubled since 2000 to more than 37,000, according to a recent Washington Post report.

IRFs.(Bad month)(Inpatient Rehabilitation Facility)(Brief Article)
July 1, 2005... IRFs: The government's decision to finally enforce the-so-called 75% rule means that many inpatient rehabilitation facilities will lose rehabilitation-care residents to nursing facilities. Enforcement of the rule had temporarily been delayed.

A free online HIPAA security course is now available for providers.(IT Update)(Health Insurance Portability and Accountability Act)(Brief Article)
July 1, 2005... A free online HIPAA security course is now available for providers. The class emphasizes awareness and training, and can be viewed in either English or Spanish. The American Health Care Association/National Center for Assisted Living and...

The Centers for Medicare & Medicaid Services released three more HIPAA educational papers.(IT Update)(Health Insurance Portability and Accountability Act)(Brief Article)
July 1, 2005... The Centers for Medicare & Medicaid Services released three more HIPAA educational papers. Administrative safeguards, technical safeguards and policies, procedures and documentation requirements are covered. They can be seen at...

More employers are monitoring outbound e-mails, according to a new report from Proofpoint, Cupertino, CA.(IT Update)(Brief Article)
July 1, 2005... More employers are monitoring outbound e-mails, according to a new report from Proofpoint, Cupertino, CA. More than a third of the surveyed firms employ staff to read or analyze sent e-mails. Many of the companies that said they don't currently...

The Markle Foundation has launched a prototype that allows residents and authorized physicians to share personal health information electronically.(IT Update)(Brief Article)
July 1, 2005... The Markle Foundation has launched a prototype that allows residents and authorized physicians to share personal health information electronically. The foundation also announced that its new initiative for electronic health data sharing will be...

A new CMS program makes it easier for Medicare beneficiaries to get prescription drugs from local pharmacies.(IT Update)(Brief Article)
July 1, 2005... A new CMS program makes it easier for Medicare beneficiaries to get prescription drugs from local pharmacies. Under the initiative, pharmacists can use their existing computer systems to determine which Medicare drug p an to bill and whether...

Feds work to establish new health data network.(NEWS / Technology)(Brief Article)
July 1, 2005... The Department of Health and Human Services is attempting to fix key deficiencies that have delayed the development of a national health network. Specifically, the department issued requests in June for proposals in four areas: *...

"I couldn't live without ...".(NEWS / Technology)(Brief Article)
July 1, 2005... Marion C. Neuhaus knew her nurses were sold on their new Web-based records system when one of the hurricanes struck Florida last fall. As soon as the power went out, they went searching for outlets for their computers. "That's when I knew we...

Owner faces fraud charges.(MIDWEST)(Brief Article)
July 1, 2005... IOWA -- Iowa Attorney General Tom Miller has filed a lawsuit against the owners of a Des Moines nursing home, alleging consumer fraud. Miller is asking for a judicial review of the finances of Heather Manor in Des Moines. He is accusing...

Court OKs plan cuts.(SOUTHEAST)(Medicaid laws )(Brief Article)
July 1, 2005... A U.S. Court of Appeals ruled that Tennessee's plans for cutting enrollment in TennCare are not a violation of either Medicaid laws or regulations and do not infringe on constitutional due process requirements. This, the latest in a series...

Fewer cuts to homes in new budget.(MIDWEST)(Brief Article)
July 1, 2005... ILLINOIS -- Payment cuts to Illinois nursing homes were reduced from $80 million to $23 million in the fiscal year 2006 budget approved by lawmakers in the Illinois General Assembly. State officials had proposed hefty cuts, but a...

'Employer gag law' out.(NORTHEAST)(Brief Article)
July 1, 2005... NEW YORK -- A federal court judge in New York has thrown out the state's "employer gag law" that had prohibited nursing homes and other healthcare providers from speaking with their workers during a union campaign. The ruling will allow...

Veterans home sues Rumsfeld.(NORTHEAST)(Donald H. Rumsfeld)(Brief Article)
July 1, 2005... DISTRICT OF COLUMBIA -- Sixteen residents of the U.S. Armed Forces Retirement Home in Washington have flied a class-action suit against the government and the facility, alleging budget cuts by the Defense Department have resulted in poor...

Asset transfer law in effect.(NORTHEAST)(Brief Article)
July 1, 2005... NEW HAMPSHIRE -- The state Senate has passed a bill that would expand the time period during which seniors would be unable to transfer assets and still qualify for Medicaid. The bill, which already passed in the House, would expand the...

New three-state purchasing pool.(NORTHEAST)(of prescription drugs)(Brief Article)
July 1, 2005... MARYLAND -- Federal officials gave permission for the state, along with Louisiana and West Virginia, to form a purchasing pool for prescription drugs for Medicaid recipients. The pool will cover a total of 1.3 million low-income Americans and...

Nursing home bill fails.(SOUTHEAST)(Brief Article)
July 1, 2005... LOUISIANA -- The Louisiana House recently rejected a bill that would have permitted nursing home residents to sue for damages as a result of certain violations of their rights. While residents can sue to get facilities to stop violations,...

Governor signs Medicaid bill.(SOUTHEAST)(Brief Article)
July 1, 2005... FLORIDA -- Gov. Jeb Bush (R) has signed into law a bill to allow the state to begin phasing in his ambitious Medicaid reform plan. The plan attempts to offer Medicaid recipients choices in their own health care services while encouraging...

Nurse shortage hits facilities.(WEST)(Brief Article)
July 1, 2005... CALIFORNIA -- A shortage of long-term care nurses is growing as hospitals tap into this population to meet state-mandated nurse staffing regulations. Hospitals are luring nurses away from nursing homes and assisted living facilities with...

Ask the legal expert.(personal records management)(Brief Article)
July 1, 2005... How long should we keep employee records? Generally, the retention of personnel files is covered by federal employment statutes and regulations and the time periods depend on the type of record. Payroll records, 1-9 and required...

Studies: states with tort reforms keep more docs.(NEWS / Legal Matters)(Brief Article)
July 1, 2005... Physicians are practicing defensive medicine and flocking to states that limit awards, according to several new studies. But competing reports take issue with runaway malpractice premium assertions. States that adopted malpractice reforms...

Court offers incident report safeguards.(NEWS / Legal Matters)(Brief Article)
July 1, 2005... A recent Florida ruling makes it more difficult for plaintiffs to obtain incident reports related to resident falls. The reports are not considered "discoverable" without a showing of need and an inability to obtain equivalent information from...

Building the business.(Business & Marketing)(Beechwood Nursing Home, Getzville, New York)(Brief Article)
July 1, 2005... Challenge: Falls, wounds Response: ACTT program Result: Better care RESIDENT CARE and safety is a perennial issue in long-term care. But few facilities have shown as strong a commitment to resident safety as Beechwood Nursing...

Cluster approach brings residents together.(Design Decisions)(Brief Article)
July 1, 2005... THE MAITLAND (FL) SENIOR LIVING CAMPUS uses a clustering design approach to help its residents age in a less institutionalized setting. The cluster concept helps break down nursing units into several clusters with varying spaces, waypoints,...

Having the REIT stuff.(Profile)(Biography)
July 1, 2005... Debra Cafaro CEO, Ventas Inc. AT A TIME WHEN the healthcare real estate investment trust was on the brink of bankruptcy, leading many industry executives to contemplate their next career move, Debra Cafaro made a leap all right. She rolled...

A lesson on making reform work.(health care reform)
July 1, 2005... All sides agree things never should have reached this point. Too often, the product appears to be substandard. Regulatory oversight tends to be heavy-handed, if- not harmful. Keeping committed professionals is a growing challenge. Union issues...

Winning a battle is nice, but don't ignore the war.(Editor's DESK)(Editorial)
July 1, 2005... It may be time to amend that popular saying, "News of my death has been greatly exaggerated." I'm thinking that when it comes to the ballyhooed new Medicaid reform panel, "News of my successful birth has been greatly exaggerated" would be...

"What moment in your career has made you the proudest?".(Reader Poll)
July 1, 2005... "I was giving a tour of our facility. As I was walking down the hall one of our dishwashers greeted me. She then turned to the group and proudly announced to them, 'This is the lady who told me that I am not 'just' a dishwasher. She told me...