Swallowing is a basic function that we all take for granted

Jeanne R. Seliskar, MA, CCC-SLP
Corporate Director of Rehabilitation
Vrable Healthcare Companies

Swallowing is a basic function that we all take for granted

Swallowing VitalStim PlusOnce it becomes difficult to swallow or a person is at risk for aspiration, then the speech pathologist becomes an important expert in remediation of this process.  At The GRAND of Dublin, our speech pathologists have the expertise and the latest technology at hand to treat even the most difficult cases.  VitalStim Plus is an electrotherapy and sEMG Biofeedback System designed for interactive therapy dynamics allowing patients to receive visual and audible feedback leading to enhanced patient engagement during swallowing exercises.  Supplementing a standard therapy program with sEMG biofeedback facilitates functional swallowing recovery.

This device allows the speech pathologist to guide patients through personalized targeted swallowing exercises.  Programs allow the clinician to truly customize treatments while biofeedback and visuals create a patient-focused experience that encourages participation and achievement of goals.

VitalStim Plus neuromuscular electrical stimulation helps recruit and re-educate the muscles critical in the process of swallowing.  The muscle strengthening, targeted in this process, rehabilitates swallowing, leading to increased effort and duration of the swallowing attempts as well as improved coordination.  Improvements in swallowing lead to upgrades in diet resulting in improved nutrition and quality of life for our patients.

About The GRAND of Dublin

THE GRAND offers luxury accommodations in a premier resort style community. Our Clinical Professionals provide first-class healthcare inspired to elevate the quality of life in a country-club style environment. THE GRAND defines the art of luxury living, coupled with the security of Post Acute Care and Rehabilitation Services with the ambience of a resort hotel.

Your skilled nursing and post-hospital medical and rehabilitation services are an important part of your recovery. Our interdisciplinary team of trained medical professionals treat each person holistically in order to provide the greatest opportunity for you to achieve your discharge goals. Working together, the team creates a customized plan of care to deliver the necessary support for a successful discharge back home. Your quality of life is important to us. It is our goal to ensure everyone feels at home and is being provided the highest quality of care and services.

The Difference Between Rx and OTC Meds

Andrea Hartley, CPhT
Pharmacy Technician/Central Supply Manager
The GRAND of Dublin

The Difference Between Rx and OTC Meds:
Why some medications are prescription, some are OTC (and some are a little of both).

Have you ever wondered why some medications are prescription only, some are sold over-the-counter, and some are a little of both?  During your stay at The Grand, you don’t need to worry about it: we provide you with all standard medications you are taking, whether prescription or OTC.  While at home however, you may be confused about what you can purchase, and what you need a prescription for, and why.

medicationsLet’s start with the reasons a drug has been designated as Prescription Only.  These medications are also known as Legend drugs, because of the required presence of the Federal Legend: “Caution: Federal Law

Prohibits Dispensing Without a Prescription”, on the label.  In 1997, this was shortened to simply, “Rx Only”.  The foremost reason for an Rx Only designation is safety.  If a product is known to have the potential for harmful effects or is unsafe without the supervision of a physician, it may not be sold without a prescription.  These medications may require diagnosis of a specific illness by a healthcare professional as well.  A drug may also be Rx only because it has the potential for abuse.

Now, on to medications designated as OTC.  An OTC product almost always begins its life as Rx Only.  In order to make the switch, manufacturers must provide proof to the FDA that a medication is very safe and effective and whether the labeling can be written in such a way that consumers can use the products safely without the intervention of a healthcare provider.  Of course the company which developed the drug for prescription use must also be willing to provide this proof, or “sponsor” the transition.

Finally, what about the medications which are sold behind-the-counter (BTC); and the medications that are sold as both Rx only and OTC?  This is where things get a bit more complicated.

Let’s talk about BTC items first.  These items are actually considered over-the-counter because a prescription is not needed, but they can only be purchased from a pharmacy.  Items vary based on location, but chances are you have purchased one of these items before:  pseudoephedrine, codeine-containing cough syrups, syringes and needles, emergency contraceptives, and some insulin.  BTC is not an official classification of drugs in the US, yet it still exists for various reasons.  Pseudoephedrine and codeine cough syrups have quantity restrictions and pharmacies must track who purchases them, and how much; this is required to reduce abuse and diversion.  Emergency contraceptives require age verification; human insulin is OTC because it was thought to be less dangerous than modern formulations but sold behind the counter due to its refrigerated storage requirements.  As for the syringes and needles, some states require proof of need, age and/or records of purchase.

Drugs sold as both prescription and OTC are usually done so due to small differences in either the medication or the way it is packaged.  For example, the FDA has approved the OTC sale of Prilosec only as treatment for frequent heartburn, whereas the Rx Only version is approved for more serious conditions such as such as inflammation of the esophagus and ulcers.  On the other hand, the reasons the FDA approved Miralax for OTC sales, yet still allows the sale of Rx Only PEG 3350 are unclear.  Both medications are identical with nearly identical indications for use.

When you stay with us at The Grand, the nursing staff and I are here to answer your medication questions; if you want to know something, just ask!

Hiring – Nurse Aide Training Instructor (RN)

Hiring – Nurse Aide Training Instructor (RN)

Great Hours, Pay and Benefits!!

We are currently looking for a Nurse Aide Training Instructor to join our team in Columbus, Ohio.

The Grand has 143 beds consisting of Skilled Nursing, Assisted Living and Independent Living and you will be working at a one of a kind, state of the art facility in Central Ohio.

Our Mission:

Our every action must advance our mission: To improve the Quality of Life & Health of those we serve.

Company Overview

Vrable Healthcare is a growing Ohio company privately and locally owned with the vision of providing exceptional care across Ohio. We believe our first responsibility is to the patients we serve. We respect the physical, emotional and spiritual needs of our patients and find that compassion is essential to fostering healing and wholeness. Teaching and learning are fundamental in our efforts. We believe our employees are the source of our success.


  • Must be an RN
  • “Train the Trainer” certified STRONGLY preferred
  • 3 years of LTC experience required.
  • Knowledge of local, state and federal regulations pertaining to facility functions.
  • Excellent communication and interpersonal skills.

Vrable Healthcare is a trusted name providing skilled nursing and rehabilitation services throughout Ohio.  We offer competitive wages and benefits including 401k, tuition assistance, and paid vacations.

Visit us online at www.vrablehealthcare.com

Interested in joining our team?  Qualified candidates should send a resume along with salary requirements to www.vrablehealthcareinc.appone.com


September 2018 Activity Calendars

Skilled Nursing Activity Calendar

Activity Calendar
GRAND of Dublin September 2018 Skilled Nursing Activity Calendar


















Assisted Living Activity Calendar

Activity Calendar
GRAND of Dublin September 2018 Assisted Living Activity Calendar


















Memory Care Activity Calendar

Activity Calendar
GRAND of Dublin September 2018 Memory Care Activity Calendar

Resident Rights

Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

Resident Rights

This SSS (Social Services Series) will be a continuation of Ohio & Federal Nursing Home Residents’ Bill of Rights. During our last series we looked at resident rights six to fifteen.  We will resume summarizing the resident rights continuing with number sixteen.

  1. Residents have the right to pursue opportunities at their own expense to achieve their fullest potential including but not limited to social, recreational, vocational, habilitation and/or educational programs.
  2. Residents have the right to consume a reasonable amount of alcohol at their own expense unless not medically advisable in writing by physician. The Grand has a pub that serves alcoholic and nonalcoholic beverages during our happy hour.
  3. Residents have the right to use tobacco at their own expense unless not medically advisable in writing by physician. The Grand is a nonsmoking center.
  4. Residents have the right to wake up and go to bed per their preference as long as they do not disturb others or the posted meal schedules and/or unless not medically advisable in writing by physician.
  5. Residents have the right to attend/observe/participate in religious activities, the right to maintain individual and cultural identity and the right to participate in activities of their choosing.
  6. Residents have the right to private communication with family, social worker and/or any other persons unless not medically advisable in writing by physician. Resident further have the right to receive, send and mail sealed, unopened correspondence, access to a telephone for private communications, and/or private visits at any reasonable hour.  The Grand has all private rooms and private phones with individual phone numbers.
  7. Residents have the right to privacy of his/her spouse and/or if both reside at the same center, to share a room unless not medically advisable in writing by physician.
  8. Residents have the right to have privacy by having their doors closed and to be knocked upon prior to opening, unless not medically advisable in writing by physician and/or in the case of an emergency.
  9. Residents have the right to have their personal clothing and to have their own possessions at the center unless not medically advisable in writing by physician.

Open House – Immediate Interviews

Open House – Immediate Interviews

August 16, August 23 and August 30
9am to 3pm
THE GRAND of Dublin 

Now Hiring LPNs and STNAs

$500 Sign On Bonus for full time STNAs

Stop in for an immediate interview and be entered into a drawing for a $25 gas card

Refreshments will be provided


Scams, Don’t Be Taken

Corey J. Ohalek
Associate General Counsel
Vrable Healthcare, Inc.

Don’t Be Taken By Scams

As technology continues to evolve at breakneck speeds, so do the criminals who want to scam the elderly out of their hard earned money. Criminals continue to prey on unsuspecting seniors by various means including exploiting a person’s emotions. “The con man’s first and really only goal is to get you away from logic and into emotion and keep you there as long as possible,” explained Doug Shadel, AARP Washington’s state director. https://www.aarp.org/money/scams-fraud/info-2018/senate-scam-list-fd.html.


The most common complaint of seniors in 2017 was scams in which fraudsters pretend to be employees of the Internal Revenue Service. “In IRS scams, criminals impersonate IRS staff and demand payment for back taxes,” Sen. Susan Collins (R-Maine), committee chair, explained at the hearing. “These scammers are absolutely ruthless when it comes to swindling seniors out of their money.”  These type of scams have targeted upwards of 2.1 million people and caused over 12,000 people to lose over $60 million between 2013 and 2017. https://www.aarp.org/money/scams-fraud/info-2018/senate-scam-list-fd.html.


Another common scam that heartless criminals will attempt on seniors is the “grandparent scam.” This scam plays on a person’s heart by impersonating a loved one who is stuck in a terrible situation such as being in jail, robbed, injured, or in the hospital. The criminal’s hope is the person on the phone will hastily send money out of concern for their loved one’s well-being. As one victim stated “We like to think we are sophisticated people…..but when it comes to people we love, reason can go out the door.”  Sen. Bob Casey (D-Pa.) said studies estimate that seniors lose $3 billion each year in savings: “Our sacred responsibility is to take action so not one more senior loses one more penny.” https://www.aarp.org/money/scams-fraud/info-2018/senate-scam-list-fd.html.


In addition to the scams mentioned above, the IRS recently listed its “Dirty Dozen” list of the potential scams for 2018, including:


  1. Phishing: Taxpayers should be alert to potential fake emails or websites looking to steal personal information. The IRS will never initiate contact with taxpayers via email about a bill or tax refund. Don’t click on one claiming to be from the IRS. Be wary of emails and websites that may be nothing more than scams to steal personal information.
  2. Phone Scams: Phone calls from criminals impersonating IRS agents remain an ongoing threat to taxpayers. The IRS has seen a surge of these phone scams in recent years as con artists threaten taxpayers with police arrest, deportation and license revocation, among other things.
  3. Identity Theft: Taxpayers should be alert to tactics aimed at stealing their identities, not just during the tax filing season, but all year long. The IRS, working in the Security Summit partnership with the states and the tax industry, has made major improvements in detecting tax return related identity theft during the last two years.
  4. Return Preparer Fraud: Be on the lookout for unscrupulous return preparers. The vast majority of tax professionals provide honest, high-quality service. There are some dishonest preparers who operate each filing season to scam clients, perpetuating refund fraud, identity theft and other scams that hurt taxpayers.
  5. Fake Charities: Groups masquerading as charitable organizations solicit donations from unsuspecting contributors. Be wary of charities with names similar to familiar or nationally-known organizations. Contributors should take a few extra minutes to ensure their hard-earned money goes to legitimate charities. IRS.gov has the tools taxpayers need to check out the status of charitable organizations.
  6. Inflated Refund Claims: Taxpayers should take note of anyone promising inflated tax refunds. Those preparers who ask clients to sign a blank return, promise a big refund before looking at taxpayer records or charge fees based on a percentage of the refund are probably up to no good. To find victims, fraudsters may use flyers, phony storefronts or word of mouth via community groups where trust is high.
  7. Excessive Claims for Business Credits: Avoid improperly claiming the fuel tax credit, a tax benefit generally not available to most taxpayers. The credit is usually limited to off-highway business use, including use in farming. Improper claims often involve failures to participate in or substantiate qualified research activities or satisfy the requirements related to qualified research expenses.
  8. Falsely Padding Deductions on Returns: Taxpayers should avoid the temptation to falsely inflate deductions or expenses on their tax returns to pay less than what they owe or potentially receive larger refunds.
  9. Falsifying Income to Claim Credits: Con artists may convince unsuspecting taxpayers to invent income to erroneously qualify for tax credits, such as the Earned Income Tax Credit.
  10. Frivolous Tax Arguments: Frivolous tax arguments may be used to avoid paying tax. Promoters of frivolous schemes encourage taxpayers to make unreasonable and outlandish claims about the legality of paying taxes despite being repeatedly thrown out in court.
  11. Abusive Tax Shelters: Abusive tax structures are sometimes used to avoid paying taxes. The IRS is committed to stopping complex tax avoidance schemes and the people who create and sell them.
  12. Offshore Tax Avoidance: Successful enforcement actions against offshore cheating show it’s a bad bet to hide money and income offshore




If you suspect you’ve been the victim of fraud, you can report it to AARP’s fraud hotline at 800-222-4444. Volunteers can refer you to the appropriate agency for filing a complaint. Also, you may report the fraudulent misuse of the IRS name, logo, forms or other IRS property by calling the TIGTA toll-free hotline at 1-800-366-4484 or visiting the TIGTA Web site.

Employee of the Month

Jason Goodwin, GRAND of Dublin Employee of the Month

Employee of the Month

Employee Name: Jason Goodwin

Position: LPN

Length of Service: 8 months

Reason they won EOM: dedicated employee that goes above and beyond call of duty to make sure his residents are well taken care of. Staff, families, and the residents always compliment on what a great job he does!

Favorite Sports Team: OSU, Lakers, Bengals

Favorite Food: steak

Hobbies/Interests: hunting, fishing, video games

Family: wife-Monica , kids- Niyah, Zavier, Alyssa

August 2018 Newsletter

Weather or Not

As the summer nears its end and we inch closer to fall, let’s use some August weather lore to try to predict what the next winter will be like!

Pay attention to the first week of this month— if it is unusually warm, it means that the coming winter will be snowy and long.

Was this month cold? If so, it means that the following winter will be harsh and dry.


Special Days

  • Watermelon Day August 3
  • Friendship Day August 5
  • Civic Holiday (Canada) August 6
  • Lefthanders Day August 13
  • Full Sturgeon Moon August 26
  • Women’s Equality Day August 26

Full Newsletter

PPIs: Something To Think About

Andrea M. Hartley CPhT
Pharmacy Technician / Central Supply Manager
The GRAND of Dublin

PPIs: Something To Think About

Do you have one of these PPIs in your medicine cabinet?

  • Prilosec (omeprazole), available as an OTC and prescription
  • Nexium (esomeprazole), available as an OTC and prescription
  • Prevacid (lansoprazole), available as an OTC and prescription
  • Zegerid (omeprazole & sodium bicarbonate), OTC only
  • Protonix (pantoprazole), prescription only
  • Aciphex (rabeprazole), prescription only
  • Dexilant (dexlansoprazole), prescription only

20-30% of Americans use a PPI (proton Pump Inhibitor) to manage symptoms of GERD (gastroesophageal reflux disease), acid reflux, frequent heartburn and ulcer symptoms, and several other indications.  These medications have been a mainstay in treatment of stomach acid-related disorders since their introduction in 1989.  In layman’s terms, they work by binding to the proton pumps in the cells of our gastric glands and causing them to reduce acid secretion.

Their safety and efficacy have made PPIs one of the most prescribed medications.  The first PPI was approved for over-the-counter sales in 2003, allowing the convenience of self-treatment.  However, the approval for OTC sales has also contributed to the overuse & misuse of PPIs.

Many people who don’t necessarily need PPIs are using them and this can lead to problems due to a higher risk of bone fracture and higher risk of obtaining certain bacterial infections, among other things.

If you use a PPI, consider talking to your doctor about it at your next appointment. Some of the questions that patients need to ask their physicians are:  Should I be taking this?  Would a lower dose be effective? Is there an alternative to this medication?  Do the risks outweigh the benefits in my situation? Find out if another medication, such as an antacid (Tums, Mylanta, Maalox etc.) or H2 blocker (Tagamet, Pepcid, Zantac, Axid) might be better for you to use.  Or there may be some lifestyle changes you could try to reduce your symptoms.

If you use a PPI, it’s definitely something to think about.