DAVENPORT, Iowa - Oct. 5, 2015 -- Healthcare terms and technology can be confusing and frightening in any language, creating possible gaps in vital communication between healthcare providers and patients. As the local patient population becomes more global, Genesis Health System is responding with a global solution.

Genesis is working with Stratus Video Interpreting of Clearwater, FL. to bridge communication gaps with patients, no matter what language is their "first'' language. Video Remote Interpreters (VRI) will be available throughout the health system.  When fully implemented, Genesis will have 44 Video Remote Interpreters available at the medical centers, convenient care locations, physician offices and outpatient care offices.

"These video interpreters will go a long way in bridging the gaps we had identified,'' said Tyne Rieck, service excellence coordinator, Genesis Health System. "Communicating with patients is an issue throughout healthcare. "We identified our needs and started researching solutions.'' Stratus is working with more than 600 hospitals and healthcare systems across the country.''

Video Remote Interpreters work like this:

If important information needs to be explained to a patient whose first language is a language other than English, the healthcare provider taps on an icon on the iPad screen to activate the language translation service.  From a list of 27 available video languages and 200 more languages available from Stratus with audio only, the provider selects the appropriate language.  Within 30 seconds to a minute an interpreter appears on the screen.

Accurate Information

The interpreter and healthcare provider exchange information such as department and patient name, and then the healthcare provider speaks. They pause after every sentence or two, to allow the interpreter to give the information in the patient's preferred language.  It's a little slower than a normal conversation, but the extra effort is worth it when a patient receives all of the necessary information and their questions are answered accurately. The iPad-based devices are mobile and adjustable to give a patient who is lying in a hospital bed a face-to-face look at the interpreter.

Genesis was already using a face-to-face language interpreter service and continues to use that service but in emergent situations or during non-business hours, it can take a period of time to get an interpreter where they are needed. "Live interpreters on site will always be best, and their use will not diminish. This is the next best thing,'' Rieck explained.  "The mobility and quick response we've experienced have really been a benefit to the patients.  We can get care started right away.  The response from patients has been good so far.''

Rieck explained that Stratus has call centers scattered throughout the country. If one area of the country was experiencing a loss of power, the service would still be available from other call centers.

Sign Language, Spanish Most Common Requests

Rieck said American Sign Language and Spanish are the interpreter services Genesis has used most often since introducing the devices a month ago. "One of the reasons we looked for new solutions is that in talking with the deaf community, we knew we needed something better,'' Rieck said. "That was what they were telling us. That started our research and search for a solution.''

Among the other video services available are Arabic, Bosnian, Burmese, Cantonese, French, Haitian Creole, Hmong, Korean, Mandarin, Nepali, Polish, Portuguese, Russian, Somali and Vietnamese.

Rieck demonstrated the system by activating a session in American Sign Language. A pleasant woman introduced herself as Aralyn and explained by voice and ASL how the system works. "Both of my parents were deaf and we didn't have anything like this,'' Aralyn explained.  "My parents either had to write down what they needed or we had to use sign language.  This is so much better.

"Most of us with Stratus have been translating for a long time ... in my case about 40 years ... and we have all received training in medical terms and procedures.'' Rieck said using family to interpret to a family member is usually a last resort and shouldn't  be necessary with the mobile video translators. "By using interpreters who are not family, we are making sure there is a literal interpretation of the information we need to share,'' said Rieck. "There is not as much paraphrasing going on this way. A family member might protect a loved one and tell them what they think the patient should know to make them feel better instead of what they really need to know.''

Genesis Health System continues to explore new technologies for the benefit of patients. Genesis has been named one of the nation's Most Wired Hospitals and Health Systems for 12 consecutive years.


DAVENPORT, Iowa - Oct. 1, 2015 -- Betsey Tibbitts recalls first looking over ICD-10 medical codes in the early 1990s when they were already being used in some countries.

Nearly 25 years later, Thursday was launch day across the United States for tenth revision of the International Classification of Diseases (ICD).

"Other countries have been using ICD-10 for many years but they don't use it for reimbursement purposes the way we will in U.S.,'' explained Tibbitts, information services administrator and corporate privacy officer, Genesis Health System. "The version we will use in this country had to be much more complex and took much more time to get implemented.''

There have been numerous delays to implementation in the U.S. Implementation was finally set at Oct. 1, 2015 after a number of extensions in the deadline.

Compared to other countries, the U.S. was late in introducing ICD-10. Australia has been using ICD-10 with its own modifications since 1998. Canada introduced ICD-10-CA, its modification, in 2000. Tibbitts said it has been eight years since the last country transitioned to ICD-10.

"The reimbursement piece is something that other countries aren't using ICD-10 for. That made it much more difficult to switch over to ICD-10 in this country,'' she added.

Genesis hired a consultant in 2012 to evaluate a successful transition to ICD-10. Ten teams have been working on implementation. Last spring, Genesis began dual-coding - using both ICD-9 and ICD-10 - to prepare for Thursday.

The transition to ICD-10 was necessary because ICD-9 was exhausting code possibilities with a five-character alphanumeric system to describe diagnoses. ICD-10 is based on a seven-character system.

Instead of about 18,000 codes for ICD-9, there are now about 139,000 with ICD-10.

"It has certainly made coding much more difficult and there are more jobs for new and experienced coders, which is a good thing for coders,'' Tibbitts said. "It is kind of like nursing positions right now. There is competition for experienced coders and they are being paid better.

"Each patient will take longer to code. There will be a loss of productivity, requiring more coders to handle the same volumes.''

What does ICD-10 mean to patients?

"There may be some initial delays from the time of care to the time when the patient receives a bill,'' Tibbitts added. "We expect the claims process to slow down.''

Patients and the general public may also be amused by the specificity of codes. A team at the World Health Organization, which develops ICD, must have had fun thinking of every possible diagnosis.

For example, code W56.22xA is Struck by orca, initial encounter.

V97.33XD is sucked into a jet engine, subsequent encounter.

V06.00xA is Pedestrian on foot injured in collision with other nonmotor vehicle in nontraffic accident, initial encounter. In other words, "Grandma Got Run Over by a Reindeer.''


Genesis Receives Federal Enrollment Grants

DAVENPORT,  Iowa - September 2, 2015 - Genesis Health System was awarded two federal grants today to assist in enrolling Quad City area residents in insurance coverage for the 2015-2016 Affordable Care Act enrollment period.

"These grants will help us reinforce our commitment to the communities we serve in making sure they have access to health care coverage," said Michele Cullen, community health manager, Genesis Health System. "We are excited to get back out in the community for the coming enrollment period and help our neighbors access new coverage options."

This marks the third consecutive year that Genesis Health System has received federal funds to administrate its enrollment program. The grants help pay for the enrollment assisters, also known as "navigators," and their work in the community.

Genesis received $118,631 and $79,181 in Iowa and Illinois, respectively. Counties served will be Scott, Clinton, and Jackson in Iowa; and Rock Island and Mercer in Illinois.

Genesis Health System is one of only three organizations in the state of Iowa, one of only seven organizations in Illinois, and the only health care system serving the Quad City area, to receive federal grants to assist in enrollment.

Open enrollment, the period in which most people will qualify to shop for new health coverage plans on the state exchanges, will begin on November 15, 2015 and run until February 15, 2016. Some people who have had a life-changing event - job loss, death, birth in the family are examples -- or qualify for expanded Medicaid, may not have to wait for the open enrollment period.

To speak to a Genesis enrollment navigator about coverage options, call (563) 421-ENRL (3675) or send email to enrollment@genesishealth.com.

For more information, contact Austin Bird at (563) 421-9276 or birda@genesishealth.com.


DAVENPORT, Iowa - August 11, 2015 -- Registration will close Sunday, August 16 for the Metabolic Syndrome (MetS) program being offered to residents of the Quad Cities. To apply for the free program, go to www.genesisphilanthropy.org.

If clinically qualified, selected registrants can participate in a free 10-week intervention. Individuals participating in the 10-week program need to have access to a computer with high speed Internet (many libraries offer this service).

The MetS initiative includes a program called Naturally Slim™ and has been offered to employees of Genesis Health System since 2009.  Since 2009, more than 55% of the Genesis employees who had MetS in 2009 no longer have metabolic syndrome because of the healthy lifestyle techniques taught by the Naturally Slim™ class.

Each weekly session is about 30 minutes long (the first "kick-off" session is 90 minutes), which can be viewed via the web at any time throughout the week.  The value of this program is $500.  Only those who can commit to completing the 10-week program will be accepted.

The last group participating in the MetS initiative and Naturally Slim™ lost a total of 1,015.3 pounds. There was an average weight loss of 14.6 pounds and 47 participants lost more than 10 pounds. Other highlights from the last MetS Initiative group were a 63 percent reduction of high blood pressure and a 48 percent reduction in triglycerides.

Genesis Philanthropy MetS Initiative is now accepting applications from individuals interested in participating in the program who live or work in the greater Quad Cities. Financial need will be a consideration for selection.

To learn more about the regional impact of a charitable investment in Genesis Philanthropy, contact Missy Gowey, Executive Director, (563) 421-6860.


WASHINGTON, D.C. -- July 21, 2015 -- Genesis Medical Center, Davenport has been rated as the top community hospital in Iowa for the second consecutive year by U.S. News Media & World Report's 2015-16 Best Hospitals ratings.

Genesis Medical Center, Davenport was recognized as "High Performing'' in three Common Care measures.  Genesis was rated as "High Performing'' in chronic obstructive pulmonary disease (COPD), heart failure and hip replacement.

The University of Iowa Hospitals and Clinics, an academic center, was rated No. 1 overall in Iowa. Genesis Medical Center, Davenport shares the No. 2 overall rating in Iowa with Alegent Creighton Mercy Hospital in Council Bluffs.

"The important message from the high Iowa rating for the second consecutive year is that Genesis Medical Center, Davenport is consistently providing high quality care,'' said Doug Cropper, President and CEO, Genesis Health System. "We want patients to expect a high quality of care and excellent patient outcomes when they are Genesis patients.

"This is a tribute to the quality and safety of care provided by our doctors, nurses and everyone who is part of the patient experience at Genesis.  In these Common Care conditions ... treatment of COPD, heart failure and hip replacement ... Genesis Medical Center, Davenport met high standards for patient safety and survival.

"Patients have better access than ever before to information about safety and quality of care at hospitals.  Information in the hands of our patients is a valuable tool.  We value their research and evaluation of Genesis."

Of the 4,665 hospitals that were considered as possible Best Hospitals for Common Care, only 16% achieved a "High Performing'' rating in any of the five procedures being evaluated.

Genesis Medical Center, Davenport was the only Quad Cities hospital receiving a "High Performing'' rating in any of the five Common Care procedures.

U.S. News also evaluates hospitals in 16 adult specialties and 10 pediatrics specialties.  In most specialties, U.S. News ranks the nation's top 50 hospitals. Only 3 percent of the nearly 5,000 hospitals that were analyzed for "Best Hospitals 2015-2016'' were nationally ranked in even one specialty.

The 2015-2016 national top five were: 1. Massachusetts General Hospital, Boston; 2. Mayo Clinic, Rochester, Mn.; 3. Tie, Johns Hopkins, Baltimore and UCLA Medical Center, Los Angeles; 5. Cleveland Clinic.

"This annual report by U.S. News is considered to be an objective, credible resource for how hospitals are caring for patients,'' Cropper added.  "The next step for Genesis is to make the highly selective honor roll of hospitals ranked in the top 50 nationally in at least one specialty.  We're getting closer to that goal.''

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they face particularly difficult surgery, a challenging condition, or added risk because of other health problems or age.  Objective measures such as patient survival and safety data, the adequacy of nurse staffing levels, and, other data largely determined the rankings in most specialties.

The regional hospital rankings complement the national rankings by including hospitals with solid performance nearly at the level of nationally ranked institutions. The regional rankings are aimed primarily at consumers whose care may not demand the special expertise found only at a nationally ranked Best Hospital or who may not be willing or able to travel long distances for medical care. The U.S. News metro rankings give many such patients and their families more options of hospitals within their community and in their health insurance network.


TUCSON, Az. - July 21, 2015 - Genesis Medical Center, Silvis has earned the No. 1 ranking of 600 hospitals in the U.S. based on outstanding patient safety and outcomes.

Genesis Medical Center, Silvis earned the top ranking from Midas+ by being at the 99th percentile for hospitals in low readmission rates, core measures, low mortality and average length of stay.

The Silvis hospital also earned a Platinum Quality Award from Midas+ for the fourth time in five years. GMC, Silvis earned the recognition in the category of hospitals with fewer than 100 patients each day.

GMC, Silvis was presented the recognitions recently at the Midas+ annual symposium in Tucson.

Midas+ Solutions recognizes excellence in clinical healthcare. The Platinum Quality Award reflects achievement in quality outcomes, care efficiency, and consistent delivery of evidence-based best practices in healthcare delivery.

"To be the top-ranked of 600 hospitals across the country for patient safety and outstanding outcomes is a testament to the quality of care provided on a daily basis by physicians, nurses and other clinical staff at the hospital,'' said Kevin Youmans, president of Genesis Medical Center, Silvis. "And, Genesis Medical Center, Silvis has consistently maintained a high standard of quality by earning a Platinum Quality Award for the fourth time in five years. "What it means for patients is that they can expect an outstanding level of care delivered consistently at Genesis Medical Center, Silvis.''

Youmans explained that a hospital with fewer than 100 patients per day must be extremely consistent in its quality of care to win the Platinum Quality Award because there is more variation when just one patient doesn't receive the quality of care expected.

Genesis Medical Center, Silvis had a mean percentage score of 81 percent, the highest of the 27 hospitals of all sizes receiving Platinum Quality Awards.

Among the measurements used to determine award winners are acute care readmissions, myocardial infarction care, heart failure care and pneumonia care. Mortality rates and average lengths of stay are also factors.


DAVENPORT, Iowa - July 15, 2015 -- The health professionals providing patient care at Genesis Medical Center hospitals have education, experience, critical-thinking skills and one more important tool.

They also have nationally recognized information technology available to improve quality and safety of care, resulting in better patient outcomes.

For the 12th consecutive year, Genesis Health System has been named Most Wired by Hospitals & Health Networks magazine based on the use of information technology to accomplish key goals, including safety and quality objectives.

Genesis Health System is the only Iowa hospital or health system to be recognized as Most Wired 12 consecutive years.

Genesis has consistently adopted innovative technologies to accomplish key goals of safety and quality.

In the past year, Genesis has expanded the reach of MyGenesis, a patient portal allowing patients to have convenient access to their health records through a secured website.  No matter where a Genesis patient may be, they have access to their health records, including medication records and records from previous physician appointments and hospitalizations.

The MyGenesis portal for access to the physicians of Genesis Health Group is connected with 16,716 patients.  The MyGenesis portal for access to Genesis Medical Center records had 9,219 connections.

In the coming months, patients connected to MyGenesis will also have access to radiology and pathology documents.

MyGenesis is also available via smart phone.

"Genesis continues to stand well ahead of most health care organizations in the country in its use of technology to benefit our patients,'' said Rob Frieden, Vice President of Information Services, Genesis Health System. "Genesis leadership has been very supportive of the purchase and implementation of new technology benefitting patient care.''

Health Care's Most Wired Survey asked hospitals and health systems nationwide to answer questions regarding their IT initiatives.  Respondents completed 741 surveys, representing more than 2,200 hospitals, or more than 39 percent of U.S. Hospitals.

According to the survey, hospitals are taking more aggressive privacy and security measures to protect and safeguard patient data. Top growth areas in security among this year's Most Wired organizations include privacy audit systems, provisioning systems, data loss prevention, single sign-on and identity management. The survey also found:

• 96 percent of Most Wired organizations, including Genesis, use intrusion detection systems compared to 85 percent of the all respondents. Privacy audit systems (94 percent) and security incident event management (93 percent) are also widely used.

•79 percent of Most Wired organizations conduct incident response exercises or tabletop tests annually, a high-level estimate of the current potential for success of a cybersecurity incident response plan, compared to 37 percent of all responding hospitals.

•83 percent of Most Wired organizations report that hospital board oversight of risk management and reduction includes cybersecurity risk.

"We continue to move toward a seamless and secure approach to medical records, which makes health care safer, more convenient and less stressful for patients,'' Frieden said.

The nation's Most Wired hospitals and health systems demonstrate better outcomes in patient safety, risk-adjusted mortality rates and other key quality measures through the use of information technology, according to analysis.

"Our focus is always patient safety and quality of care,'' Frieden said.  "Will the new technology make our patients safer? Will it provide them with a better patient experience?

"And finally, will the new technology also create efficiencies for our caregivers and staff?''

The Most Wired winners are featured in the July edition of Hospitals and Health Networks (H&HN) magazine, the publication of the American Hospital Association.

About Genesis Health System

Genesis Health System, its affiliates and partners offer a full continuum of health care services in a 12-county region of Eastern Iowa and Western Illinois. Our affiliates include : acute and tertiary hospital care at Genesis Medical Centers in Davenport, DeWitt, Iowa, Silvis, Ill., and Aledo, Ill.; home health and hospice services through Genesis VNA and Hospice; Genesis Workplace Services, including occupational health, employee assistance program and wellness services for employers and their employees; the Clarissa C. Cook Hospice House; senior living communities offering rehabilitation and long-term care; Genesis Health Group, with more than 170 primary care physicians and specialists; the Genesis Quad Cities Family Medicine Residency Program; Genesis Psychology Associates; three Convenient Care clinics; and Genesis Home Medical Equipment.  Partners include the Genesis Medical Park, Crow Valley and Spring Street Surgical Center, Davenport. Genesis Health System also manages Jackson County Regional Health Center, Maquoketa, Iowa.  For more information, visit our Web site at www.genesishealth.com.


DAVENPORT, Iowa -- July 10, 2015 -- Over the years, land at 10th and Gaines Streets in central Davenport has had at least a few names. On the good days it is called Goose Hollow. Other days it is called by a less-affectionate name, and referred to simply as "The Pit."

Until 2001, Goose Hollow was home to the Davenport Central High School tennis teams.  Central needed facilities closer to the school and decided to build courts directly across Harrison Street from the high school.  While the school district continued to maintain the Goose Hollow property for the next decade, liability issues and the burden of maintenance became too much for the district. The City of Davenport acquired the property in 2013.

The city now is working to improve the property.

The first improvement that the city is making is fixing a highly eroded slope on the east side of the property. This slope presents a safety issue to those walking or driving along Gaines Street. To fix this slope, the city will use approved fill consisting of soil, brick, and broken concrete to recreate the slope.

The fill is coming from Genesis Health System, which is working on a $138.5 million expansion and renovation of the hospital campus of 1227 E. Rusholme Street.

According to Ken Croken, Genesis Vice President of Marketing and Community Relations, Genesis will be providing the City of Davenport with 25,000 cubic yards of fill.

"That is enough to fill six-and-a-half Olympic-sized swimming pools,'' Croken said.

Once the slope is completed, it will be topped with clean soil and planted with native vegetation to provide a prairie-style ground cover.

"Genesis is thrilled these materials from the Campus Optimization Project can be recycled and put to such good use for our city and our neighbors," Croken added.


DAVENPORT, Iowa - June 30, 2015 - Genesis will offer four CarFit® events for older drivers in July and August.

CarFit® is a national educational program offering older adults the opportunity to evaluate how well their personal vehicles "fit" them.  Health professionals work with older drivers and review 12 key areas to ensure they "fit" their vehicle properly for maximum safety.  A CarFit® check takes approximately 20 minutes to complete.

CarFit® is not a driving test or driving evaluation.

The CarFit® events schedule includes:

July 17 - Genesis Medical Center, Silvis, 801 Illini Drive, Silvis, 10 a.m.-2 p.m.

July 24 - Arnold's Automotive, 2500 52nd Ave., Moline, 10 a.m.-1 p.m.

August 6 - Church of the Open Door, 816 13th Ave. North, Clinton, 10 a.m.-2 p.m.

August 21 - Genesis Medical Center, 1227 East Rusholme Street, Davenport 9 a.m.-1 p.m.

Older drivers are statistically among the safest drivers because they're more likely to wear their seatbelts and less likely to speed or drink and drive. However, they are also more likely to be seriously injured in a crash because their bodies are more fragile.

"Older drivers can improve their safety by ensuring their cars are properly adjusted for them," explained Gretchen Cluff, an occupational therapist at Genesis and a Certified Driving Rehabilitation Specialist.  "A proper fit in their car can greatly increase not only the driver's safety but also the safety of others.

"Once seniors arrive for their check, they will be asked basic information and then we will evaluate how they fit in their car. For example, are they sitting too close to the airbag?  Are their mirrors adjusted appropriately to maximize their view?  Is their seat in the best position to reach the brake and gas pedals?

"We can only make recommendations.  We can, however, provide the senior drivers with important information that could increase their driving safety."

Three examples underscore the importance of road safety to the CarFit® program:

  • Knowing how to properly adjust one's mirrors can greatly minimize blind spots for drivers when changing lanes.

  • Good foot positioning on the gas and brake pedals is important. Drivers who reach with their toes to press on the pedals can cause fatigue in their legs and slow reaction time.

  • Drivers run a risk of serious injury if they are sitting closer than 10 inches from the steering wheel.

CarFit® events have shown that more than one-third of seniors had at least one critical safety issue.  One in 10 sat too close to the steering wheel, and 20 percent did not have a line of sight at least 3 inches over the steering wheel.

To reserve a time for an evaluation at the CarFit® event on Friday, call (563) 421-1480.


Enjoy The Show ... From a Safe Distance


DAVENPORT,  Iowa - June 29, 2015 -- In a flash, about 10,000 Americans  will be injured by fireworks while enjoying one of the traditions of Fourth of July celebrations. In 2014, eleven Americans died in fireworks-related incidents.

According to the U.S. Consumer Product Safety Commission, about 60 percent of those injuries are sustained between June 22 and July 22.

David Dierks, D.O., emergency department physician, said the best way to avoid a trip to the emergency department is to leave fireworks displays to the professionals.

Again this year, Genesis Health System is sponsoring the spectacular Red, White and Boom! fireworks display on Saturday, July 4. The show will be bigger and brighter than ever before with more than two tons of fireworks shot from two barges in the Mississippi River.

Prime viewing locations will be Schwiebert Park in Rock Island, the Genesis Family Viewing Area in LeClaire Park in Davenport and Modern Woodmen Park in Davenport.

"The professional fireworks displays are safer, bigger and better than anything we can do in our backyards,'' Dr. Dierks said.  "Even sparklers burn at 1,800 degrees (Fahrenheit) and can be dangerous.  Used improperly, they can cause burns and burn clothing.

"If kids use sparklers, we urge close parental supervision and urge kids to stay in one place and not run with sparklers.''

Sparklers account for 19 percent of the total fireworks-related injuries seen in emergency departments each year.  About one-quarter of all fireworks-related injuries are sustained by children nine years old and younger.

Firecrackers, illegal for use in Iowa and Illinois, account for about 20 percent of injuries.

Dierks said that people in the Quad Cities are listening to the messages about fireworks safety.  Genesis Medical Center has had very few hospital admissions related to fireworks injuries in recent years.  There is a similar trend of fewer fireworks injuries being reported across the country.

"Fireworks accidents happen, however, we have fewer injuries locally than in many other areas,'' Dierks said. "I think this is due, in part, because of the high quality of our local professional fireworks displays.

"Thousands of people in the Quad Cities attend these public shows and these shows have safety records that are outstanding.  Most  injuries locally happen when people use fireworks at home.''

Dierks said the most disturbing statistic is that children under age 15 account for about 35 percent of the injuries.

"A child will tell parents, 'I can do it myself, I don't need help.'  Often the child can't do it themselves and there are injuries,'' Dierks said.  "Those injuries can be severe.

"One of the reasons we continue to see fireworks injuries, some of them severe or fatal, is that people don't recognize how dangerous these devices can be.  Children often lack the physical coordination to handle any fireworks safely.  Even with a sparkler, they can fall and suffer burns.''

Here are recommendations from Genesis and from the U.S. Consumer Produc Safety Commission to prevent fireworks injuries at home:

  • Make sure the fireworks you want to buy are legal in your area before buying or using them.

  • Never allow young children to play with or ignite fireworks, including sparklers. Sparklers burn at temperatures of about 1,800 degrees?hot enough to melt some metals.

  • Do not buy fireworks that are packaged in brown paper, which is often a sign that the fireworks were made for professional displays.

  • Never place any part of your body directly over a fireworks device when lighting the fuse. Back up to a safe distance immediately after lighting fireworks.

  • Keep a bucket of water or a garden hose handy, in case of fire or other mishap.

  • Never try to relight or handle malfunctioning fireworks. Soak them with water and throw them away.

  • Never point or throw fireworks at another person.

  • Light fireworks one at a time, then move away from them quickly.

  • After fireworks complete their burning, douse the spent device with plenty of water from a bucket or hose before discarding the device to prevent a trash fire.

  • Light fireworks outdoors in areas clear of houses, dry leaves, grass or flammable materials.

  • Do not smoke while handling fireworks.

  • Ignite fireworks only smooth, flat surfaces.

  • Don't place fireworks in containers before lighting.

  • Alcohol and fireworks are a dangerous combination.