The Differences Between SodaStream Models

Many people want to get a SodaStream but have no idea which model is best for them. It can be difficult to choose, especially when the SodaStream company has no information highlighting the differences between the models. Here is a brief overview explaining which features are unique to the models.

There are currently eight SodaStream models available. They are The Revolution, The Source, The Fizz, The Crystal, The Pure, The Fountain Jet, The Dynamo and The Genesis. First, let's address the similarities of all eight types. All of the eight models can make soda or sparkling water in the convenience of your home. All come with "stay fizzy" bottle closures that keep the carbonation in longer. All are compatible with the standard 14.5 ounce carbonation cylinder which is capable of carbonating up to sixty liters of soda or sparkling water.

There are four models which are capable of using either the 14.5 ounce carbonation cylinder or the larger 33 ounce cylinder, which is capable of carbonating up to 130 liters of soda or sparkling water. These four models are The Revolution, The Dynamo, The Fountain Jet and The Fizz.

All eight models use the CO2 tank as a power source to carbonate. The Crystal, The Pure, The Dynamo, The Fountain Jet and The Genesis require no additional power source to operate. The Fizz and The Source do require a battery to operate the display components. That battery is included. The Revolution is the only model which requires electricity to work. Keep this in mind, as it will need to be near an outlet when used.

The Crystal comes with a dishwasher safe glass carafe. The other seven models come with BPA-free plastic bottles that are not dishwasher safe. You can buy dishwasher safe bottles separately that are compatible with those seven models, but you can not use the glass carafe with any model other than the Crystal.

The Dynamo, The Fountain Jet, The Pure, The Fizz and The Genesis all require the user to twist the bottle into place. The Crystal, The Revolution and The Source all lock the bottle into place without twisting, making them a little easier to use.

There is only one fully automated SodaStream available at this time. That is The Revolution. You simply press a button to tell it how carbonated you would like your drink and it does the rest for you. It also measures the CO2 levels to let you know how much is left in your carbonation cylinder. The Fizz is not automated but it does monitor and display the amount of carbonation in your drink as well as the level of CO2 in your cylinder. The Source has three LED lights to let you know how much carbonation is in your drink, but does not monitor the CO2 left in your cylinder.

I hope I have shed some light on what makes each SodaStream model unique. Click HERE for more information on SodaStreams and to see how the different models look. Remember, this will probably sit on your counter at all times, so you'll want something that looks good in your kitchen.

Baby boomers not exempt from Alzheimer’s Disease

SIOUX FALLS, S.D. (KSFY) – With the passing of country music legend Glen Campbell, Alzheimer’s Disease is back in the spotlight, especially as it affects adults in an age group that might not normally think they’re susceptible.

The Alzheimer’s Association in Sioux Falls said having Campbell let cameras follow him after his diagnosis brought major awareness to the disease. State Executive Director Leslie Morrow said it was an important step against a stigma that still exists today.

“A lot of families still suffer in silence and I think because Glen was so beloved for so many years people could see, ‘Well this could happen to him, it could happen to anyone,'” said Morrow. “But he showed how a family could persevere, he stayed positive and he stayed connected to his music until the very end.”

Campbell’s wife Kim was his primary caregiver after his diagnosis, and has been outspoken about admitting you can’t do it all.

One couple in Sioux Falls is in a similar situation.

“He was always on top of everything numbers-wise and financially,” said Sandi Vietor, about her husband Ken. “And those are the things that started to slip away from him first and so I think he was very, very confused about what these changes were.”

Ken Vietor was diagnosed at age 58, two years ago this week. He started to have trouble doing his daily work in sales and accounting. When every day tasks were confusing, they made a visit to the doctor.

“It as kind of, ‘Well, gosh, we’re kind of not really in the category that people associate with this disease,'” Sandi Vietor said. “On the other hand we do know another person, a couple of people who are younger, that are also in this situation.”

Advocates say the biggest challenge they face is people who say they’d rather not know they have the disease.

“There is great peace in being able to plan out how you’d like to live the rest of your days,” Morrow said.

Because it can be a big lifestyle change. Ken’s cognitive abilities — in the work he did — and the way he speaks, are how his Alzheimer’s became apparent.

“Well, I was working … and so that’s … and I can’t speak real well, so that’s one of them,” Ken said.

For the Vietors, Ken and Sandi are retired and now are living out their dreams — just a little earlier than they’d originally planned. Last year, they went to Paris and Greece with a large group of friends and this fall are planning a trip to London with some of the same group.

Ken said the key is staying active. He’s always out working in the yard and if he isn’t, he said Sandi is always keeping him doing something.

‘We bike, we walk, we travel, go to movies, have friends over,” Sandi said.

“So we’re good partners, real good partners,” Ken said.

The Alzheimer’s Association said research has made great strides over the last 30-40 years, but Alzheimer’s is still the only top 10 deadly disease without a cure. They also said many people think they only fundraise for research, but the Alzheimer’s Association also provides free support both for those diagnosed as well as their caregivers — and dollars raised in South Dakota — go right back into the local chapter of the organization.

The South Dakota chapter is planning its annual “Walk to End Alzheimer’s” in Sioux Falls for Saturday, Sept. 16 at 8th and Railroad Center. It’s a new location this year because the walk outgrew its previous home at Sertoma Park. The walk will travel on the Greenway toward Falls Park and loop back around to 8th and Railroad.

All of the information for the walk is under “Related Links.”

Uñas Acrilicas punta Coffin / baby boomer 2017



Mi correo
[email protected]

Mi Instagram
Carolina.jara.73

Tiendita donde compro mi material
Cv Nails
Www.cvnailsupply.com
951-7464854

❤❤❤❤❤❤❤❤❤❤❤❤❤

7 Top Family Bonding Road Trip Games

Family Interaction Game #1. “I Spy” – with variations

No road trip would be complete without a (many) games of “I Spy”.

This works well for younger kids especially. Take turns to look for something the other players have to guess correctly. You begin your turn by saying “I spy with my little eye something beginning with a (letter)_____”. The other player tries to guess it from the surrounding items or countryside. The person who correctly guesses gets to have the next turn.

Variations. How about I spy with my little eye something with a colour of_______, or I spy with my little eye something that is associated with_______ eg flying (bird, plane), milking, ploughing, riding (horse, bike, car etc)

Family Interaction Games #2. Geography Game

This is a great game for players (old and young) to brush up on their world knowledge.

The first player thinks of a place or country (say London). The next player has to think of a place or town or city with the last letter of the previous place mentioned. In this case it would be N, (for Naples), being the last letter of London, and so on. The game continues until someone gets stumped and cannot think of an appropriate place. Each place, town or city can only be used once.

Family Interaction Games #3. When I was Young / When you were born

From experience, kids love to hear about 2 things especially – when they were born and when their parents were young, like themselves.

The game is started by one or both the parents retelling stories of their childhood and events surrounding the birth of the children. Tales relating to the parents schooling, how they travelled to school, how far they walked to school and favourite/worst teachers.

Events at the birth relating to the dash to the hospital, first impressions at the birth, some major character traits and first words are all great conversation starters.

Family Interaction Games #4. Math – Number Plate Bingo

Good game for learning number recognition skills.

Each player lists out numbers 1-50. Then they are to look for those numbers on number plates. The one who completes their list first is the winner. To make this game spin out a little longer only number plates of a certain state or color can be used.

Family Interaction Games #5. My best, my most scary, my best…

Each child (and the parents) try to remember a certain event in their lives (or from their imagination) from the choices below or make your own: (each choice represents 1 round). Players agree on the type of event before each round.

My most scary moment My best time My favorite holiday My most stressful event

Each player then recounts the event in their life (actual or imagined). After each round the family members vote whose story is best, based on on originality and graphic detail The one with the most votes wins the round. The one with the most winning rounds after 5 rounds wins.

Family Interaction Games #6. Maths – Number Search

Each player (kids and adults included) lists 1 – 100 in a column and the winner is the first player that finds all the numbers on the list by finding the number words or symbols on advertisements, road speed signs and distance signposts. Write each occurrence against the item on your list as you find it.

Family Interaction Games #7. Car Make/Model Reversii

This will have the whole car in fits of laughter…guaranteed! If you see a Cadillac Eldorado (for instance) whiz past the players try and quickly say the make and model spelled BACKWARDS. So for this example the kids will be trying to say “Callidac” (Cadillac spelled backwards) and the pronunciation would be something like Call-i-dac.

Then for the model Odarodle (Eldorado spelled backwards) they would try to say O-dar-odle. Once people are trying to say these words quickly, as other cars zoom past, it quickly turns into a real laugh… you’ll remember this game for years. (I don’t know of anyone else who has played this game apart from our family – so you could say it’s exclusive.)

I sincerely hope that these games will help the whole family have a great holiday…

Here are 10 things millennials do better than baby boomers

Image: europa newswire/gado/Getty Images

If there’s one thing that annoying people all across the internet can agree on, it’s this: millennials will be the downfall of civilization. 

Of course, there’s almost always no data to back up their very authoritative pronouncements, but that doesn’t stop certain overinflated pontificators from crapping out their hot takes and blaming millennials for ruining everything from J. Crew to the great American dream to napkins (seriously). 

There are few sociological comparisons more meaningless (maybe Meyers-Briggs tests) than ones comparing millennials like myself and baby boomers. And I tend to believe we’re all terrible, in our special unique generational ways.

I’m no millennial apologist. But if certain boomer pundits are going to blame us for everything, it’s time we stood up for ourselves the best way we know how: by writing a passive-aggressive listicle.

Here are just a few things millennials are supposed to be better at than baby boomers, thanks. 

1. We take less vacation so we can work more, not less

According to a 2016 study by Project:Time Off and GfK, millennials are more likely to forfeit vacation days than other groups: 24 percent of millennials reported forfeiting vacation time, compared to 19 percent of Gen-Xers and just 17 percent of boomers.

2. We’re better educated.

Even though educational costs are skyrocketing, millennials are the most educated generation in history: 27 percent of women and 21 percent of men have bachelor’s degrees, compared to just 12 percent of men and 7 percent of women from the baby boomer generation. They’re taking on debt that generation just didn’t.

3. We really love libraries!

A recent study by the Pew Research Center found that 53 percent of supposedly smartphone-addicted millennials used libraries in the past year, compared to just 43 percent of baby boomers.

4. Millennials and Gen-Xers actually outvoted Boomers and the Silent Generation in the 2016 election

For the first time in decades, boomers and older voters represented fewer than half of all votes. Millennials and Gen-Xers eclipsed them by approximately two still pretty sad percentage points. 

5. They didn’t vote for a raving kitchen mop to be president

55 percent of millennials voted for Clinton, compared to just 37 percent for Trump. Among baby boomers, approximately 53 percent voted for Trump, compared to just 45 percent for Clinton. 

6. They have far more financial hardships than baby boomers but they’re still more optimistic about their future.

More than 8 in 10 feel confident about their finances, even though they face higher rates of unemployment, poverty and debt than baby boomers did at their age

7. They believe, in far greater numbers, that we shouldn’t be assholes to gay people.

72 percent of millennials say that Americans should embrace and accept gay people, compared to just to just 46 percent of boomers. 

Approximately 51.5 percent of millennials are white, the lowest of all the adult generations.

9. Millennials are disproportionately likely to understand all my references to TGIF shows and Don’t Tell Mom The Babysitter’s Dead.

That matters!

10. We largely don’t identify as millennials because we believe these divides are mostly meaningless crap 

Just 40 percent of millennials actually identify as millennials, compared to 79 percent of baby boomers. For so many folks from both of these demographics, however, these alleged generational divides can feel hyperbolic. Many will argue that generational differences have more to do with the natural process of aging and the demands of the hot take economy, than they do with any real transformations in character.

And anyways, we all know the real source of all our problems: Generation Z. 

WATCH: Rogue deer tackles innocent man in a parking lot

Https%3a%2f%2fvdist.aws.mashable.com%2fjw%2f2017%2f5%2f8626d13e 61cd eb55%2fthumb%2f00001

NY Times: Mass Immigration Necessary for Baby Boomers to Retire



you can donate through this site
paypal email account [email protected]
Martin Brodel
36248 HWY 133
Hotchkiss, Colorado
81419

Pension jackpot for many baby boomers

Older coupleImage copyright
Getty Images

Older people’s income has received a massive boost from private and workplace pensions in the last 40 years, official statistics show.

In 1977, only 45% of retired households received income from a private pension, compared with 80% last year, the Office for National Statistics (ONS) said.

As a result, the income gap between those only getting the state pension and others had grown.

Overall, incomes have grown faster for older people than for the young.

The disposable income of retired households grew at 2.8% a year since 1977 after accounting for the rising cost of living and changes to household composition, compared with growth of 2.1% in non-retired households.

Much of the recent debate over a generational divide has centred on the future of the state pension and the fairness of its “triple-lock” guarantee of annual rises. This ensures an increase in line with earnings, inflation, or 2.5%.

This report by the ONS instead puts a spotlight on the effect of other forms of pension for household incomes, particularly revealing the benefits of final-salary pensions.

Excluding the state pension, it shows that those with a private pension had average pre-tax income of £19,000, which is 14 times higher than those who did not receive any private or workplace pension income.

Adding the state pension and the effect of taxation cuts the gap. However, the disposable income of retired households with a private pension in 2016 was still £27,800 – higher than the £17,200 of those without a private pension.


Image copyright
Getty Images

State pension calculator – check your age and entitlement


Pension poverty was rife in the 1970s. The ONS said that four-fifths of retired households had an income that was the equivalent of less than £10,000 now. Only 4% of retired households now have an income of less than £10,000.

Workplace and private pensions have been key to that shift, but so have pensioner benefits including the state pension.

Anna Dixon, chief executive at the Centre for Ageing Better, said: “We have seen a dramatic and necessary reduction in pensioner poverty since the 1970s. Being financially secure is a key part of a good later life.

“However, these averages mask inequalities. In particular, the growing disparity between those who have been able to save into a private pension and those who have not.”

Outlook for the younger generation

So, incomes in the last 40 years have grown thanks to final-salary pensions, yet the next generations of pensioners are unlikely to have access to this type of pension. Separate figures published on Tuesday show that final-salary pension funds were in a collective deficit of £180bn by the end of July.

Instead of being linked to their salary, their pension is much more likely to depend on the success of how savings are invested.

Automatic enrolment means that workers aged 22 and over and earning at least £10,000 are signed up to a workplace pension. By the end of March, nearly 7.7 million people had been automatically enrolled into a pension scheme.

Patrick Bloomfield, of Hymans Robertson, said that this was a good platform for pensioners of the future, but it currently ensured “thoroughly inadequate levels of saving”.

He said politicians’ eyes were open to the need to increase this saving, but he argued that the state pension age needed to go up, and working lives extended, as we were all living for longer.

My Relationship with my Parents

I truly value my relationship with my parents. The role of my parents and my siblings in my life can hardly ever be overstated. To begin with, I should state that my parents have always provided me with support. Their opinion has always played a significant role in my decision making process. Whenever I had a problematic situation over the course of my life I would necessarily talk to my parents about an issue that generated a seemingly irresolvable dilemma. I could go talk to my father about almost anything. When I was in high school and actually all my way through college my parents used to give my valuable advices as to what kind of men I should choose for relationships, what classes I should take and what cloths I should put on. They always taught me something. I cannot say that I necessarily followed their advice. The ultimate source that I always refer to when I have to make an important decision is my own brain. I believe that I am smart enough as well as experienced enough to make my own decisions. However, it is always important to consult my parents simply because they might give me a different perspective that I would never think of on my own. Even though their opinion might not be exactly what I am looking for at a particular point in my life, their contribution is extremely valuable. It is hard to explain but sometimes when I get in a really complex position and I feel that I know the answer to a question that torments me I go talk to my parents anyway. Most of the time I am totally positive that I will not take their advice and that my own decision will the one that I will take eventually but it is just important for me to have my parents hear my story and contribute to my decision. In other words there are times when I need someone to talk to. My parents and my siblings are the only people that I will select for that role.

My parents and siblings provide a great deal of moral support at times of trouble. However, the role of those people in my life is not confined to comforting me when I cannot find a way out of a complex situation. My relationship with my brother and sister is somewhat different. Of course my brother and sister support me a lot in almost any situation and I am sure that they are the people that I can count on in case I have a dilemma to deal with. However, there has always been tremendous competition among us in the family. It was always vital for me to excel my siblings in almost every aspect of life. Back when I was a high school student I felt like I needed to pick better grades in all the classes that we took together. When it was time for me to pick a university to apply to I always had to know what schools my brother and sister applied to so that I could apply to a better one. That ultimate desire to be the best in the family has always dominated my personality. At this point I cannot say for sure whether it is a good or bad thing. Sometimes I happened to excel in something and that brought me enormous satisfaction. Other times I would sustain a considerable failure and that would just devastate me completely. Nevertheless, now that I can take a look back at my entire life and consciously evaluation everything I ever did I can confidently state that I would not have accomplished most of the things that I have ever done in my life had I not have my siblings. They were the source of my energy and my drive that motivated and inspired me to persevere and keep going even when a situation was bleak and hopeless. My brother and sister are that people that I have to thank for almost everything that I have achieved over the course of my life. I did not realize that when I was younger. Now I can clearly see their role in my life.

Deviated Septum- Think Twice About an Operation

The first of my two sinus operations was to correct a deviated septum. The operation, or more precisely, the post-operative recovery period, was very painful. I had splints in my nose to help support it since the septum had been rebuilt, and my nose was “packed”. This means that a large amount of gauze was pressed into the nose to stop bleeding.

Since no air can pass through the nostrils for the week or so that the packing is in place, things like eating became a challenge. You cannot eat and breathe at the same time, so small bites and lots of soups and other liquids are favored. The splints were awful. When I tried to lie down normally in bed, the pressure on either side was very painful, and I couldn’t sleep normally. My doctor suggested I get a Lazy Boy chair which reclined somewhat and sleep on that. In fact I did this, but sleep was difficult, and it was a long week.

Actually it was only about 5 days, as I begged my doctor to take out the splints and packing because the pain was so bad. One reason for this was that I had developed an infection as a result of the surgery and then had to deal with that as well. As for taking out the packing gauze, my surgeon said “This will feel like I’m pulling your brains out through your nose”. He was right.

Normally I would be willing to suffer for a while in order to “fix” whatever problem was being addressed once and for all. The problem with operations for a deviated septum is that oftentimes it simply does not work for very long and people continue to come down with sinus infections after about six months or so. That is exactly what happened to me, and then I also had a second sinus operation, by a different surgeon, about 18 months after the first. He told me my septum had been straightened out, so there must have been other things causing my sinusitis. In other words, all the pain I went through the first time was for nothing.

Therein lies the problem. There are many reasons for the onset of sinus infections. There could be allergies, yeast infections causing candida, blockage by polyps, rhinitis or chronic rhinitis, etc. Ongoing research is looking at other causes as well, and new treatments such as antifungal therapy are being developed, along with new medications to implement them. There are also new and less invasive operations being done, like sinuplasty.

Some people are lucky and respond well to standard treatments and medication. Many people, myself included, have tried all the standard treatments, medications and even operations, and still keep coming down with sinus infections. Something else is obviously in the mix.

It is said that 80% of the population has a deviated septum to some degree. There are about 300,000 sinus operations performed each year in the U.S., and a good number of these are to fix a deviated septum. I’m sure that some of these have cured sinusitis in a number of people, but personally I’ve never met anyone who has said the operation “worked” for them. Another downside to this operation is that surgeons will sometimes also cut out some of the turbinates in the nose to help clear the nasal cavities and ostensibly make drainage easier. In the past it was felt that removing some or most of the turbinates had no harmful effects. Surgeons and especially patients who have had this done are now finding out that this can be a catastrophic after about 5 years or so. The condition is now referred to as ENS, or Empty Nose Syndrome. This condition is irreversible, since the turbinate and cilia-bearing tissue which has been cut away cannot grow back or be transplanted from elsewhere in the body. If your mucosal/cilia system ceases to function, you are in big trouble. In extreme cases some patients with ENS were so miserable and depressed with their lives that they committed suicide!!

I’m sure my first and second surgeons meant well and thought they were helping me by recommending surgery for a deviated septum and for other reasons. The fact is, however, that the operations simply didn’t produce good results, as I kept coming down with sinus infections not long after both of them. What has helped me since then is pulsating sinus irrigation, and I have addressed that in other articles.

If your ENT specialist is recommending surgery to fix your deviated septum, I would recommend caution and skepticism. You need to educate yourself thoroughly and understand precisely what tissue will be cut or more importantly removed from your nose. Don’t just trust the word of someone else, even if he is a specialist. Learn about new operations being developed, like sinuplasty, and the research that is going on with antifungal therapy. This treatment is not widespread as yet since it is new, but you may not need to correct your deviated septum. Remember, your deviated septum has probably been there for years before your sinus problems became an issue, so maybe that isn’t the real cause of your problems. In any event, don’t let a surgeon cut out your turbinates or mucosal tissue. If you need convincing about that issue, just go to the web site of the ENS Symposium and read some forum entries by people who have had this done to them.

Era of aging baby boomers to ignite explosion in jobs in health care, housing for seniors

But young people may not be fully aware of the “great opportunities” that await them in this sector of the job market, said Gisi, whose company owns and operates senior living facilities across the Upper Midwest.

“People realize that there will be a lot more people in old age, but they don’t see the lack of workers available to care for those people, what with the birth rate collapsing in the early ’70s,” said Gisi. Edgewood owns and operates assisted-living and memory-care facilities in 55 communities.

“There’ll be a significant need for health care workers in all of our communities,” he said. “The demand will continue to grow.”

The time frame of 2020 to 2040 will be a period of significant aging of the population, based on U.S. Census data, which will dramatically increase the demand for senior housing and health care.

In that time period, the number of people who are 65 or older will increase by 46 percent, he said. “There will be 10,000 people turning 65 each day.”

The need will be particularly intense for nurses, nurse practitioners, physicians, and physical and occupational therapists, Gisi said.

“If you’re trained, and a good worker, the sky’s the limit.”

And he’s just talking about workers who interact with patients or residents one-on-one.

“Not everyone wants to be a direct caregiver,” he said. There also will be opportunities in management, accounting, human resources and other occupations.

“We have a lot of accountants who are working for us,” he said. “They are easy to find compared to CNAs (certified nurse assistants) and therapists.”

‘Huge need’

Dr. Gayle Roux, dean of the University of North Dakota’s College of Nursing and Professional Disciplines, agrees.

The approaching wave of baby boomers “produces a huge need for people who are certified in caring for the needs of baby boomers and the aging population,” she said.

It’s a nationwide concern, but may be especially problematic in North Dakota where people tend to live longer.

“North Dakota certainly could be very hard hit,” she said. “We have kind of a double whammy … and part of that is good. People here tend to ‘age well in place’—meaning, in their homes—and we have a higher ratio of the ‘older old,’ those who are 85 and older, than almost any other state.”

The country is dealing with a nursing shortage, said Roux, although “some experts feel it’s somewhat of a maldistribution.”

“The need for nurse practitioners, physician assistants, physical therapists and occupational therapists is significant, particularly in smaller cities and rural areas,” she said.

Studies show the impact of the glut of boomers will be felt in various settings—from hospital to outpatient care to home health services, Roux said. But “we will need more care providers in the outpatient settings and clinics.”

The challenge for universities, in responding to pressure to increase enrollment, will be “to balance all the variables to maintain the quality of the program, to advance our curriculum to match the high-tech environment, but also so we can recruit and retain faculty and clinical preceptors who are willing to work with the student population,” Roux said.

“So there are multiple variables we have to look at.”

It’s also important that students be exposed to nursing as an “exciting, rewarding and very scientific” career, she said.

Sustained shortage

Janice Hamscher, Altru Health System’s chief nursing officer, sees the looming demand for nurse practitioners contributing to the nursing shortage.

“This shortage will be different that other shortages, and it will be sustained,” she said, “because of the demand for services—because of the large number of patients—and workforce shortages, such as physicians.”

More nurse practitioners and physician assistants will be needed to take on some responsibilities that typically have been handled by doctors.

Although hospital stays are decreasing, due in part to advances in technology, patients are more seriously ill than in the past, producing a greater demand for highly skilled nurses, she said.

After a hospital stay, more patients are returning to their homes sooner to continue the recovery process.

“We’ve learned that it’s better to be at home,” Hamscher said. “Patients are more comfortable at home. They’re less likely to fall, because they’re in a familiar setting and they’re not strapped to equipment.”

That will affect the need for more home health services.

In-home health care

In senior living facilities, health care services—and coordination of those services—are an increasingly important aspect of their mission, along with providing housing, social activities and good meals, Gisi said.

“We offer needs-based senior housing. It’s more than just social—living in an apartment and having activities,” he said. “Health care is part of it now, it’s much more important. That’s been a change in the last 10 years—and in the last three to four years especially.”

This is due, at least in part, to hospitals’ preference to discharge patients to the home, with home health services, he said. That “home” may be an assisted living facility, which will provide more services such as physical therapy, outpatient therapy, speech therapy and hospice care.

Facilities are being designed to include space where doctors, nurse practitioners and other providers can see patients.

More employees are managing residents’ chronic diseases and medications.

“We doubled the size of our quality assurance team—registered nurses with degrees—in the fall of 2016,” Gisi said.

The trend can also be traced to Medicare policies that tie reimbursement to quality of care.

The federal government’s pressure to reduce hospital readmissions is an example.

“It matters what happens to people after they are discharged from the hospital,” Gisi said. “If you’re not providing quality care, Medicare is not going to pay you.”