Paced by the lowest smoking rate ever recorded, Oklahoma moved up three spots to 43rd in America’s Health Rankings, issued by the United Health Foundation. The improvement was the second highest among all states, trailing only Florida and Utah, which improved their ranking by four spots. America’s Health Rankings are based on four components or aspects of health – behaviors, community & environment, policy and clinical care. Health outcomes are also used to rank states.
“Despite the many challenges facing us, I am encouraged that our employees and our partners across the state continue to work toward improving the health of all Oklahomans and that their efforts are producing results,” said Interim OSDH Commissioner Preston Doerflinger. “We know where our focus must be in providing the core services that will make a difference in the lives of all our citizens going forward.”
In smoking rates, Oklahoma improved to 36th nationally – an improvement of nine spots. Oklahoma’s smoking rate has declined 25 percent in the past five years. That is the largest improvement for any state since 2012 but is still 2.5 percent higher than the national average of 17.1 percent.
An area in which Oklahoma is better than the national average, low birthweight, saw the state improve to 7.9 percent. Oklahoma has improved 11 spots to 22nd in the past five years, one of the best advances in the nation.
The best ratings for the state were in the low occurrence of excessive drinking (2nd), pertussis rates (2nd) and the number of mental health providers (5th). Oklahoma also had improvements in obesity rates, the number of people who are physically active, and drug deaths, but still ranks well below the national average.
Areas of concern include lack of health insurance, diabetes rates, and children’s immunization rates.
While Oklahoma’s uninsured rate has decreased the past three years to 13.9 percent, the national ranking dropped another two spots to 48th and the rate lags far behind the national rate of nine percent.
Following a national trend that saw an all-time high in diabetes rates of 10.5 percent nationally, Oklahoma is ranked 41st with a rate of 12 percent. The rate of immunization among children 19 to 35 months dropped significantly (75.4 percent to 67 percent) moving the state ranking to 42nd while overall adolescent immunization rates improved by six places (40th to 34th).
The complete rankings and summaries for Oklahoma and all states can be seen at https://www.americashealthrankings.org

What do you hope the new year has in store for you? Cleveland County Habitat for Humanity

Health, health and more good health. Eileen Checorski

For Habitat I want us to build three houses and complete five mortgages. Tambra Gowin

That I don’t lose my sanity along the way. Susan Pearson

To deepen my relationship with Habitat through raising money to build more homes. Andrea Marler

Dear Savvy Senior,

What are some financial factors to consider when retiring abroad? My husband and I will be retiring in a few years and are interested in living in a foreign country that’s cheaper than the U.S.

Frugal Couple

Dear Frugal,

Retiring abroad has become a growing trend for millions of U.S. retirees who are looking to stretch their retirement savings. Here are some tips and resources to consider that can help you prepare.
Researching Tools
For starters, you can find lots of information and articles on the countries and cities you’re interested in retiring to at websites like InternationalLiving.com and EscapeArtist.com.
Another good tip is to talk or network with some expatriates who have already made the move you’re thinking about making. They can give you tips and suggestions on many issues, as well as the advantages and disadvantages and day-to-day reality of living in a particular country. Some popular sites for finding expat resources are ExpatExchange.com and ExpatForum.com.
But before committing to location, most experts recommend that you visit multiple times during different seasons to see whether you can envision yourself living there and not just exploring the place as a tourist. Also, consider these financial factors:
Cost of living: Retiring abroad used to be seen as a surefire way to live beyond your means, and for some countries it still is. But the U.S. dollar isn’t what it used to be, so your money may not stretch as far as you think. See Numbeo.com for a country-by-country cost of living comparison.
Taxes: No matter what foreign country you decide to retire in, as long as you’re a U.S. citizen you must file an annual tax return reporting all income above certain minimums, not matter where it’s earned. For details see the IRS publication 54, “Tax Guide for U.S. Citizens and Resident Aliens Abroad” at IRS.gov/pub/irs-pdf/p54.pdf.
Health care: Most U.S. health insurance companies do not provide coverage outside the U.S., nor does Medicare. Check with the embassy (see USembassy.state.gov) of your destination country to see how you can be covered as a foreign resident. Many countries provide government-sponsored health care that’s inexpensive, accessible and just as good as what you get in the states, or you may want to buy a policy through Medibroker (Medibroker.com) or Bupa Global (BupaGlobal.com).
Also know that most people who retire abroad eventually return to the U.S., so you should consider paying your Medicare Part B premiums. If you drop and resume Part B, or delay initial enrollment, you’ll pay a 10 percent premium penalty for every 12-month period in which you could have been enrolled.
Banking: Opening or maintaining a bank account abroad has become more difficult because of the Foreign Account Tax Compliance Act, a U.S. law designed to prevent Americans from hiding assets abroad. So, you may have to establish a savings and checking account with an institution that has international reach like Citibank. And/or consider maintaining your U.S. bank account that you can access online, and get U.S. credit and debit cards that don’t charge foreign transaction fees.
Rent versus buy: Buying a home in a foreign country can be complicated, so it’s usually cheaper and simpler to rent, unless you know you’re going to live there for a long time.
Social Security: You can receive your monthly Social Security benefits almost anywhere you live around the world (see SSA.gov/international/payments.html). Your benefits can be deposited into your bank account either in the U.S. or in your new home country, but there are some exceptions.
The U.S. State Department offers a handy checklist that can help you think through all the issues on retiring abroad. To access it visit Travel.state.gov and search for “retirement abroad.”
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

SYNERGY HomeCare provides hope and help to seniors and their families

by Traci Chapman

Kassem always knew she had a calling to serve – it was a calling that became a beacon of light for seniors and their families who needed help.
“Caring for people and providing hospitality are my natural passions, and part of my culture is to care for seniors,” Kassem said.
Kassem’s passion lit the beacon that became SYNERGY HomeCare, a flame that began to burn in 2011.
It was in 2011 Kassem graduated with an MBA from University of Central Oklahoma. That graduation marked a turning point for her – Kassem said she saw a void when it came to compassionate senior care and was determined to do something about it.
Kassem had a unique approach – fusing her drive to care for people with her love for hospitality, she did extensive research on senior care franchises. When she found SYNERGY, Kassem knew exactly where she was meant to be, she said.
“My heart just connected with the mission and values of SYNERGY HomeCare,” she said.
Kassem’s philosophy quickly took hold, spurring growth for the local franchise. Today, Kassem’s SYNERGY operation includes two offices – the original in Edmond and a second location, opened in December 2016 in Norman – employing 10 staff members and more than 100 caregivers. The company has a 5-mile service area and also provides referrals to clients in other locales, Kassem said.
“Although the metro area is geographically widespread, the small-town culture naturally evolved into relationships extending southward down the Interstae-35 corridor, allowing SYNERGY to begin penetrating the Moore/Norman market,” Kassem said.
While about five percent of Kassem’s caregivers provide live-in care, most do not, offering services to clients that take anywhere from an hour and up to 24 hours, at any given time, she said. Those caregivers tend to a myriad of needs, from the most personal – like bathing and dressing, feeding, dealing with incontinence and other issues – to companionship, coordinating outside appointments and services, meal planning and preparation, transportation, light housekeeping and running errands.
Those, of course, are necessities and things seniors need assistance with every day. But, there is so much more to it – and, that’s where post-hospitalization care comes in, Kassem said.
“It’s difficult for anyone to come home after a hospital stay, but for seniors it can be much more challenging – they might suffer from memory loss, their health depends on remembering and following hospital discharge instructions, keeping follow-up doctor’s appointments and other matters,” she said. “They also face trying to take care of day-to-day tasks while they’re recuperating.”
According to the Agency for Healthcare Research and Quality, almost a quarter of seniors hospitalized are readmitted within 30 days of discharge, many times for conditions unrelated to the initial illness or injury. That’s one reason why SYNERGY moves beyond daily assistance, with coworkers providing medical and emotional issue care, including care management, recovery assistance, difficult behavior management and more. Caregivers provide help, and hope, not only to senior clients, but may also provide relief for family members who need respite from taking care of a loved one, Kassem said. It’s assistance that can mean all the difference to everyone involved, she said.
All Kassem SYNERGY caregivers are employees, not contract labor – something somewhat unusual in the senior home care industry, and management is always a phone call away, including on-staff supervising registered nurses, she said. Care assessments are always provided on a complimentary basis, Kassem said.
Veterans are an integral part of SYNERGY’s mission – in fact, she said the organization is one of the largest veteran home care providers in the state.
“Veterans call us directly, and we can even help get them through the paperwork process,” Kassem said. “At times we work with the VA Center in Norman and with the Dale K. Graham Foundation in Norman.”
As SYNERGY continues to grow, Kassem said she hopes to provide even more services, including expanding a program started in 2017 – Dine & Discuss, an event hosted at SYNERGY’s Edmond location, which also served as an Alzheimer’s Association fundraiser.
“We partnered with the Alzheimer’s Association, where we provided complimentary dinner and two free hours of respite care while the topic was discussed,” she said. “The topics change each month, and the speaker also varies – we hope to create the same opportunity to the public going into 2018, but working towards creating a calendar of speakers further in advance and promoting it more so the word is spread.”

More information is available by calling or reviewing SYNERGY HomeCare’s websites, both for its Edmond and Norman locations:
SYNERGY HomeCare Edmond
13720 N Bryant Ave
Edmond, Oklahoma 73013
405-254-3046
www.synergyhomecareedmond.com
SYNERGY HomeCareNorman
1272 N Interstate Drive
Norman, Oklahoma 73072
405-701-0791
www.synergyhomecarenorman.com

by Traci Chapman
Staff Writer

For Karen McKeever, nursing is about helping the most vulnerable, those who might struggle with getting the help they need.
It’s a philosophy that’s led her to treat thousands of patients and help spearhead an ever-expanding effort to lead patients having difficulty finding their to way discover the right path.
“It just seemed like the people who might need help the most are often overlooked – it’s the people without insurance or who are struggling not only with physical issues, but also mental health challenges,” McKeever said. “They need someone who can be there for them in their corner, to let them know they’re not facing this all alone.”
That kind of nurturing spirit comes easy to McKeever, a mother of six who now has nine grandchildren – and a nurse who worked in pediatrics and as a Yukon Public Schools nurse, concentrating on severely disabled students. Looking out not only for the young, but also the disabled and those who might not have an advocate became McKeever’s life work, a passion that led to an organization aimed at doing just that.
It was originally Canadian County Health Access Network, started in 2011 by McKeever and fellow nurse Rosemary Klepper.
“So many Sooner Care patients don’t know where to go or how to best address their health issues – you see many going to the emergency room when there are better avenues available, and you find families that are dealing with problems that go far beyond basic health or physical disease or distress,” McKeever said.
“There was just a huge gap in service, a real need for these patients and for their families, who were not being taken care of or served,” she said. “We knew how important it was for them to have someone they could turn to – as nurses, we needed to be there not only to treat them but to guide them and help with whatever challenges they were facing.”
It wasn’t long, however, before McKeever and Klepper’s philosophy caught on, and patients beyond El Reno, Yukon, Mustang and other area communities began to ask for assistance. That’s why CC-HAN’s “CC” soon transitioned from Canadian County to , Central Communities, with co-founder and care manager McKeever and fellow care manager Rhonda Chronister now available to SoonerCare patients and their families across south central Oklahoma, working to improve their health and healthcare options and much more.
“Rosemary (Klepper) decided it was time to retire, to explore other things, but my heart is here, I didn’t want to walk away,” McKeever said. “That’s when Rhonda came onboard, and it’s been a great arrangement.”
For her part, Chronister said she views McKeever not only as a co-worker, fellow care manager and nurse, but also as a mentor who has spurred on Chronister’s own love of nursing and helping patients far beyond regular nursing duties.
“Karen is an amazing person and an amazing nurse, and it’s a remarkable opportunity to work with her and learn from her,” Chronister said. “Her capacity for love and how she gives of herself is inspirational to everyone who knows her, particularly the people we serve.”
McKeever has always envisioned something bigger for CC-HAN, which led to the agency helping patients not only locate the right caregiver and treatment, but also issues that might aggravate physical ailments. That’s why CC-HAN provides care management to patients not only facing financial constraints that can limit their ability to get the medical treatment they might need, but also those who deal with complex health issues, as well as providing a proactive approach – guiding patients to the right resources for well child examinations and care, injury and accident prevention, diet and nutrition and accessible medical and dental care.
“What the patient might need at any particular moment might not be ‘nursing’ services, but rather they might not have gas money to get to an appointment or they might not have any food in the cupboards – and that disrupts the treatment they need,” McKeever said. “That’s the bottom line – making sure they are healthy and able to live their lives and do what they need to do, because someone who’s dealing with a mental health issue can have a ripple effect on their entire family, and that family might need guidance in how to help and to make sure it doesn’t negatively impact others, either mentally or physically.”
It’s a philosophy that’s not only challenging and fulfilling, but also always interesting, McKeever said. She never knows what she might face in any given day – whether it will be assisting patients with medical care options, educating families about CC-HAN’s resources or even delivering food to someone who is hungry and doesn’t know where to turn.
“What we do is everything that’s the best of nursing – helping people who truly need it and giving that care, that guidance – as a nurse, it’s so fulfilling and inspirational, and to me it’s what our profession is all about,” McKeever said. “To me, if you’re a nurse, you’re always a nurse – it’s not something you do, it’s something you are.”
For more information about Central Communities Health Access Network, its services or philosophy, look online at www.cc-han.com.

story and photos by Betty Thompson

Pawnee – It has been said that a picture is worth a thousand words. The framed photo of young Virginia Norris Rogers sitting horseback, dressed in her boots, jeans, button up and cowboy hat, is no exception. The photo is a mere glimpse of the woman she would become, strongly rooted in agriculture.
“I tell people my outfit never changed, I just buy bigger sizes,” laughs Rogers.
Rogers said she began working on the ranch at a very young age with her father and their long-time ranch hand Albert. She even had a horse before she was born, which she later named “Chicken,” because of his yellow color.
“I was out at the crack of dawn getting cattle in,” Rogers recalled. “We would work until noon or so, and then my dad would go off to auction.”
Her father, Cecil “Whitey” Norris, started trading cattle at the age of 16 and became an auctioneer at age 23. Rogers said he went to an auction just about everyday.
After marrying Avis, Rogers’ mother, in 1933, Cecil bought 160 acres of land and used every opportunity from trading and auctions to buy more land. Together, they built a ranch of nearly 5,000 acres with horses and Hereford cattle.
Rogers is proud to be a fourth-generation farmer in Pawnee County and deeply rooted in agriculture. Family photos and keepsakes fill her walls and shelves, including her parents’ spurs, which hang above the front door. Her grandfather’s brand was the first brand ever registered in the state of Oklahoma and is still used today by her cousin John Henry.
“I think it’s [agriculture] been more fulfilling than shaping,” said Rogers. “It’s hard to describe what’s in your blood. You don’t know anything else.”
Rogers was no stranger to the hardships that ranch life brought: drought, cattle prices, finding reliable help, and more, but her love for ranching never faltered. After marrying her husband Olin, she said “it was just natural” for them to start their own ranching operation, Rogers Ranches, LLC, and have been running the operation ever since.
Rogers and Olin have been married for 42 years and have been running their commercial Angus herd on the farm Olin grew up on since 1986.
“It’s not a lot, but it’s enough to keep us busy,” laughed Rogers.
Busy is an understatement.
Not long after marrying, they bought an insurance agency which they worked while running their cattle operation, and only just sold it in November 2011.
Rogers was also very active in Oklahoma Extension Homemakers, now known as Oklahoma Home and Community Educators, a service designed to provide homemakers with resources similar to the resources farmers receive from the extension service. Rogers served as the county secretary/treasurer under Martha Waters, who was the first woman to be a director of an Oklahoma county extension.
A few years later, she was appointed to serve on the Pawnee County Health Department Board.
Like her father, Rogers and Olin have always been active in the Pawnee County Cattlemen’s Association (PCCA). Olin served as PCCA president in the early 1970s, and Rogers served as president from 2009 to 2011. During Rogers’ time as PCCA president, PCCA became a unified county under the Oklahoma Cattlemen’s Association (OCA). Rogers went on to serve for three years as a district director for the OCA before being elected as the North Central District vice president, putting her on the Executive Board of Directors. She also makes it a priority to be involved in the Oklahoma Cattlewomen’s Association as well.
“It has been very rewarding,” Rogers said. “I love it. Olin and I both enjoy meeting other people and learning about ranches across Oklahoma.”
Rogers was recently appointed to serve as the president of the Pawnee County Economic Development Foundation by the chairman of the Pawnee County Commissioners. The Foundation is actively involved in trying to bring new businesses to the community, and recently awarded a $75,000 grant to the city of Pawnee to refurbish an old building.
In addition to her leadership positions, Rogers writes a column for the local newspaper addressing concerns for farmers and ranchers.
“I just had this wild hair idea one day to start writing about issues in the cattle industry,” Rogers said. “Every now and then I throw in a column about my upbringing, experiences on the ranch as a child, or encourage membership and participation in the OCA.”
If you think she cannot make time for any other commitments, think again.
Rogers also serves as Chairman of the Board for her church, as well as staying busy with four grandchildren and two great-grandchildren.
She attributes this desire to give back to her upbringing.
“I learned early from my family that caring for people was important,” Rogers said. “You have to do what you can for others. I hope to relate to others that agriculture is vital to our state.”
Another important lesson she learned on the ranch is that you can be caring and giving, but also a tough fighter.
Rogers laughed recalling that she woke up to her father saying “Get up boys!” even though it was only her sister and her. Perhaps that oftentimes hard upbringing is what made her so strong when she was diagnosed four years ago with breast cancer.
However, cancer picked the wrong cowgirl. Today, she is cancer-free and proud to be called a survivor.
“I never had a ‘straight path’ in life,” Rogers said, “but I love doing what I am doing now—trying to be one of the best representatives for agriculture I can be.”

by Traci Chapman
Staff Writer

As Russell-Murray Hospice prepares to commemorate its 30th year in business, those associated with it are celebrating a new home and new levels of care to those who need it most.
“It’s appropriate we are here today, holding our board of directors and annual advisory board meeting, in our new building,” RMH Executive Director – and the organization’s first RN – Vicki Myers said. “It’s peaceful, it’s efficient, it’s just perfect for everything, and if Russell-Murray is here for 30 more years, this building is perfect for us.”
Myers made her remarks during the Nov. 15 annual meeting of the two boards at Russell-Murray’s new home, located at 2001 Park View Drive in El Reno. The new building, recently purchased by the longtime hospice care organization, is more than triple the space of its previous offices, located in historic downtown El Reno, Myers said.
“As we’ve grown, the staff really has had to try to work in a situation that just wasn’t feasible,” she said. “They were just crammed in with each other, and while everyone handled it very well, it just wasn’t working the way we wanted it to.”
That meant when a former medical office building located adjacent to Mercy Hospital El Reno came on the market, the organization jumped at it. The space meant not only plenty of room for a growing staff, but also room to grow and a more prominent location, headquartered not only near the hospital, but also other medical providers. That’s good news for the staff, but also for Russell-Murray’s patients, said Melodie Duff, RN, patient care coordinator. As RMH closes out the year and heads into 2018 – its 30th anniversary – Duff said staff and those associated with its success have a lot to be proud of, including 4,440 patients who have been treated and cared for by the organization’s nurses and caregivers.
“We currently have patients from infants days old to patients over 100,” Duff said. “We serve without care about their ability to pay, and we’re always there for them, no matter what.”
That’s something unique in Oklahoma hospice – and elsewhere – Russell-Murray Clinical Supervisor Missy Ellard said.
“If a patient qualifies and desires hospice care, we do not turn patients away based on their reimbursement status,” she said. “Many hospices, even not for profit hospices, have a ‘quota’ of non-reimbursable patients and will decline patients if they don’t have a payer source – RMH has never done that.”
That assistance totaled about $400,000 last year, Administrator Christina Ketter said. With $3.8 million in revenues and a $2.6 million payroll, Russell-Murray saw a jump in helping those who could not afford it.
“It might be younger people who lost their job and didn’t have insurance and, of course, the seniors who might not have access to Medicare or something like that,” Ketter said. “To me, our charity care, the way we look at our patients and how we treatment them shows what kind of an organization, what kind of people we are.” Russell-Murray’s approach has worked – from its roots as a small El Reno hospice care provider to an organization with offices also located in Kingfisher, Weatherford and Oklahoma City. In October, those sites combined served 118 patients through the work of 25 full-time RNs and LPNs, as well as several per diem PRN nurses, across RMH’s four offices.
“We serve approximately 75-mile radius surrounding each of the four offices,” Myers said. Even before the move, Russell-Murray was working to expand its services, not only to patients, but also their families. In March, the organization celebrated the opening of the Virginia E. Olds Resource Library, coordinated originally by Carol Russell Davis and Evan Davis and Vicky Joyner. When RMH began looking at moving, Carol Davis undertook the transfer of the library’s books to the new site, while Sue Pennington-Unsell is director of bereavement. Named for retired University of Oklahoma School of Social Work professor and longtime Russell-Murray counselor Virginia Olds, the library is unique among hospice organizations, Myers said – and is something that can help not only patients and their families, but also nurses who deal daily with end-of-life care and the emotional toll it can take. “We wanted to accumulate information related to social issues involved in bereavement, emotional and psychological resources, coping with these kinds of illnesses and more,” Myers said. “It’s important to remember that the patient isn’t the only person who suffers through an end-of-life illness – it’s incredibly difficult and stressful for their family, their friends and their caregivers.”
Those caregivers are the backbone of Russell-Murray’s nearly 30-year success, and they make those who work with them proud every day, Duff said.
“I can’t tell you how many thank you cards and calls we get, talking about how our staff treats their patients, and particularly those who can’t afford it,” she said. “We hear all the time that our nurses never judge and are always there to do everything they possibly can do – and that’s an accomplishment in itself.”