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June 2012
of 2010 and into the first half of 2011 with weak but persistent half-speed real GDP and job gains. Highlights: Capital Spending, Sales, Hiring The survey, which gauges the mood and sentiment of small and medium sized business owners, found almost two-thirds (63 percent) plan to increase capital spending during the next six months. This is a significant increase from 49 percent in the spring. Technology equipment spending leads the list of priorities as owners look to maintain their operations without adding additional employees. Other findings about the next six months include: Improved Access to Credit: While three out of four owners (76 percent compared to 78 percent in the spring) do not intend to seek a new loan or line of credit, they do see greater access to financing. Thirteen percent (vs. 9 percent in the spring) says its easier to obtain credit while 44 percent (vs. 38 percent in the spring) say its neither easy nor difficult compared to three months ago. Stalled Sales and Profits: Fewer than half (42 percent) expect their sales to increase compared to 47 percent in the spring. In terms of profits, 31 percent expect an increase, down from 37 percent in the spring. Hiring Outlook Improved: 22 percent expect to hire full-time employees, the same as spring and significantly better than one year ago (17 percent). Only 12 percent plan to reduce their workforce compared to 14 percent in the spring and 18 percent one year ago. Manufacturing companies are most likely to hire followed by the service industry. Still Waiting for U.S. Recovery: The overwhelming majority (91 percent) say the U.S. economy has yet to noticeably improve. Seven out of 10 (71 percent) feel the recovery is more than one year away compared to 20 percent who expect improvement within the next 12 months. Local View Is Better: The sentiment is slightly less negative closer to home as 57 percent are optimistic and 42 percent are pessimistic about the prospects for their local economy. This compares to 41 percent opti-

Ohio business owners delay hiring

Six out of 10 small business owners nationwide intend to increase capital spending but delay hiring in a defensive move that reflects their lingering concerns about the U.S. economy, according to the PNC Economic Outlook surveys newest findings. The fall findings of the biannual survey, which began in 2003, also found one out of 10 owners hired or plan to hire qualified employees due to the tax credit offered by the HIRE Act passed by Congress in the spring. Overall, the outlook of small business owners has improved slightly as eight out of 10 (compared to 76 percent in the spring) are moderately to greatly optimistic about their own companys prospects today while 20 percent are pessimistic (vs. 23 percent). Until we see a solid pattern of small business hiring and investments re-established, the economic recovery will be a bumpy road, but not another ride over a cliff, said Stuart Hoffman, chief economist for The PNC Financial Services Group, Inc. (NYSE: PNC). These findings support PNCs view that the economy will remain transitional for the rest

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mistic and 58 percent pessimistic for the U.S. economy. Whats Your Worry?: One out of three (34 percent) say weak sales/demand for service is the most important challenge facing their business today. Their second concern at 21 percent is changes in government policy that affect my business. These far outdistanced health insurance (12 percent) and taxes (11 percent). An online media kit containing national and regional survey results is available on PNCs website at The PNC Financial Services Group, Inc. ( is one of the nations largest diversified financial services organizations providing retail and business banking; residential mortgage banking; specialized services for corporations and government entities, including corporate banking, real estate finance and asset-based lending; wealth management and asset management. Follow @PNCNews on Twitter for breaking news and announcements from PNC.

Construction materials prices inch up 0.1 percent in April

The trajectory of prices may become more volatile in the months ahead with financial markets being impacted by ongoing bad news from both Europe and the United States. --ABC Chief Economist Anirban Basu. In a sign of easing inflation pressure, the nations construction materials prices increased 0.1 percent in April, according to the May 11 Producer Price Index report by the U.S. Labor Department. Construction materials prices are up 2.5 percent compared to the same time last year. Nonresidential construction materials prices were unchanged for the month, but are 2.4 percent higher from one year ago. Nonferrous wire and cable prices rose 0.7 percent for the month, but are down 5.2 percent from April 2011. Prices for fabricated structural metal products were up 0.5 percent for the month and are up 2 percent year over year. Prices for concrete products increased 0.2 percent in April and are up 2 percent compared to the same time last year. Prices for steel mill See MATERIALS, page 7B

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Architecture Architect job outlook

Employment is expected to grow faster than the average for all occupations. Competition is expected, especially for positions at the most prestigious firms, and opportunities will be best for those architects who are able to distinguish themselves with their

Since 1920 Since 1920

creativity. Employment change. Employment of architects is expected to increase by 16 percent between 2008 and 2018, which is faster than the average for all occupations. Current demographic trends will lead to an increase in demand for architects. As the population of Sunbelt States continues to grow, the people living there will need new places to live and work. As the population continues to live longer and baby boomers retire, there will be a need for more healthcare facilities, nursing homes, and retirement communities. In education, buildings at all levels are getting older and enrollments continue to increase, which will require many school districts and universities to build new facilities

and renovate existing ones. In recent years, some architecture firms have outsourced the drafting of construction documents and basic design for large-scale commercial and residential projects to architecture firms overseas. This trend is expected to continue and may have a negative impact on employment growth for lowerlevel architects and interns who would normally gain experience by producing these drawings. Job prospects. Besides employment growth, additional job openings will arise from the need to replace architects who transfer to other occupations or stop working for other reasons. A growing number of See ARCHITECT, page 7B

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2B TheBusinessJournal June 2012

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A shift from nursing homes to managed care at home

Faced with soaring health care costs and shrinking Medicare and Medicaid financing, nursing home operators are closing some facilities and embracing an emerging model of care that allows many elderly patients to remain in their homes and still receive the medical and social services available in institutions. The rapid expansion of this new type of care comes at a time when health care experts argue that for many aged patients, the nursing home model is no longer financially viable or medically justified. In the newer model, a team of doctors, social workers, physical and occupational therapists and other specialists provides managed care for individual patients at home, at adult day-care centers and in visits to specialists. Studies suggest that it can be less expensive than traditional nursing homes while providing better medical outcomes. The number of such programs has expanded rapidly, growing from 42 programs in 22 states in 2007 to 84 in 29 states today. In New York City, a program run by a division of CenterLight Health System, formerly known as the Beth Abraham Family of Health Services, has over 2,500 participants at 12 sites in the metropolitan area. It used to be that if you needed some kind of long-term care, the only way you could get that service was in a nursing home, with 24-hour nursing care, said Jason A. Helgerson, the Medicaid director for New York State. That meant we were institutionalizing service for people, many of whom didnt need 24-hour nursing care. If a person can get a service like home health care or Meals on Wheels, they can stay in an apartment and thrive in that environment, and its a lower cost to taxpayers. The recent influx of adult day-care centers and other managed care plans for the frail elderly is being driven by financial constraints as President Obama and Congressional leaders seek hundreds of billions of dollars in savings in Medicare and Medicaid. Nursing homes, which tend to rely heavily on Medicare and Medicaid dollars, are facing enormous financial pressure Mr. Obamas proposed budget includes a $56 billion Medicare cut over 10 years achieved by restricting payments to nursing homes and other long-term care providers. Nationally, the number of nursing homes has declined by nearly 350 in the past six years, according to the American Health Care Association. In New York, the number of nursing homes declined to 634 this January from 649 in October 2007, and the number of beds to 116,514 from 119,691. Over the next three years, New York State plans to shift 70,000 to 80,000 people who need more than 120 days of Medicaidreimbursed long-term care services and are not in nursing homes into managed care models, Mr. Helgerson said. The move away from nursing homes was highlighted on Thursday when Cardinal Timothy M. Dolan announced that the Archdiocese of New York, one of the states largest providers of nursing home care, is selling two of its seven nursing homes and opening or planning to open seven new adult day-care centers over the next three years. Seniors and others who have chronic health needs should not have to give up their homes and independence just to get the medical care and other attention they need to live safely and comfortably, Cardinal See CARE, page 4B

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3B David Watkins, Amy Mench


(Continued from page 3B) pant and manage their entire care, including visits to specialists, hospitalizations, home care and even placement in a nursing home. Because Medicare and Medicaid pay set fees instead of paying for specific procedures, center operators are motivated to provide preventive care to avoid costly hospitalizations or nursing home care. Some elderly people, however, spurn PACE programs because under managed care, they would have to switch their physicians to those at the PACE center or in its network. Most elderly people want to live out their lives at home, a desire evident in interviews in the PACE center the archdiocese opened in 2009 in Harlem, which has a staff of three doctors and is visited regularly by a dentist, a podiatrist and a psychiatrist. Edna Blandon, 74, a diabetic weakened on her left side by a stroke who relies on a wheelchair, is transported by specialized van to the Harlem PACE center three days a week and appreciates that it provides not only a home care attendant but sends a nurse every two weeks to change pills in her pillbox and load a 14-day supply of insulin into syringes that she will inject. My spirits would drop if I went to a nursing home, she said. I love the fact that I can go home at night. Theres no place like home. I can sit down, look at the TV and go to bed when I want. James Harper, 70, a retired bank employee who spent 10 months at the archdioceses Kateri Residence, a nursing home on the Upper West Side, after a stroke paralyzed his right side, enjoys yoga breathing classes and discussions about black history. Yet he gets to spend nights and weekends with his wife, Albertene, and daughter, Traci, both of whom work during the day and are not around to care for him. This way Im around people, he said. Dr. Fredrick T. Sherman, the Harlem PACE medical director, said that a 2009 study showed that PACE programs reduce lengths of stays in hospitals and delay assignments to nursing homes. The archdiocese, whose new centers will serve a total of 1,500 people, receives an average of $4,000 a month from Medicaid for each participant and $3,300 from Medicare. By comparison, said Scott LaRue, the chief executive of ArchCare, the archdiocesan health care network, a month of nursing home care can cost the government $9,000. Ultimately, the archdiocese hopes that half of its elderly clients will be served in community settings rather than in nursing homes, which currently serve about 90 percent of the archdioceses clients. Forprofit companies have not yet moved into the managed care market, in part because of uncertainties about reimbursement formulas and the risks of taking on a nursing home population. The PACE population tends to be younger than that at nursing homes, which raises the question of whether many PACE clients would really need nursing homes without PACE. Dr. Sherman replies to such skepticism by saying that his clients need that level of service the question is where theyre going to get it. Without PACE, he said, theyre going to end up in nursing homes.

Dolan said in a statement before he opened a 250-patient program at Saint Vincent de Paul Catholic Healthcare Center in the South Bronx. These new adult day-care centers, known around the nation by the acronym PACE Program of All-Inclusive Care for the Elderly provide almost all the services a nursing home might, including periodic examinations by doctors and nurses, daytime social activities like sing-alongs and lectures, physical and occupational therapy and two or three daily meals. All the participants are considered eligible for nursing homes because they cannot perform two or more essential activities on their own like bathing, dressing and going to the toilet. But they get to sleep in their own beds at night, often with a home health care aide or relative nearby. The nonprofit groups that operate them receive a fixed monthly fee for each partici-

Putnam County Home Care, Hospice & Palliative Care

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Home Care
Since 1966, Putnam County Home Care has delivered high quality health care to recovering, disabled and chronically ill individuals. Using our Friends Helping Friends philosophy, these services have allowed our clients to remain in the comfort and security of their homes. Putnam County Home Care provides nursing, therapy, aide services and specialty care to our clients in Putnam County and surrounding areas.
Love begins by taking CARE of the closest ones the ones at HOME

The philosophy of Putnam County Hospice is the belief that dying is an integral part of living. Hospice affirms life and neither hastens death nor prolongs life. It allows one to live each day fully and as alert and pain free as possible. Putnam County Hospice provides emotional, physical, spiritual and social support to the patient and their family throughout the process of both illness and bereavement. Family members are encouraged to be actively involved in their loved ones care.
Hospice treats the person, not the disease

Palliative Care
Palliative Care is a medical care that focuses on pain and symptom management for patients with life altering illnesses. The goal of palliative care is to prevent and relieve suffering and to support the best quality of life for patients and their families. Palliative Care is centered on the patients physical, emotional, social and spiritual care. Palliative Care is appropriate at any age and at any stage of an illness, and it can be provided along with treatments that are meant to cure.
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4B TheBusinessJournal

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Community Bank Advantages

Commercial Banking

Community banks focus attention on the needs of local families, businesses and farmers. Conversely, many of the nations megabanks are structured to place a priority on serving large corporations. Unlike many larger banks that may take deposits in one state and lend in others, community banks channel most of their loans to the neighborhoods where their depositors live and work, helping to keep local communities vibrant and growing. Community bank officers are generally accessible to their customers on-site. CEOs at megabanks are often headquartered in office suites, away from daily customer dealings. Community bank officers are typically deeply involved in local community affairs, while large-bank officers are likely to be detached physically and emotionally from the communities where their branches are located. Many community banks are willing to consider character, family history and discretionary spending in making loans. Megabanks, on the other hand, often apply impersonal qualification criteria, such as credit scoring, to all loan decisions without regard to individual circumstances. Community banks offer nimble decision-making on business loans because decisions are made locally. Megabanks must often convene loan-approval committees in another state. Because community banks are themselves small businesses, they understand the needs of small-business owners. Their core concern is lending to small businesses and farms. The core concern of the mega banks is corporate America.
June 2012 TheBusinessJournal 5B

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Characteristics of a community bank are Local Decisions, Local Commitment and Local Investment. Community Bank Advantages Community banks focus attention on the needs of local families, businesses, and farmers. Community banks balance the needs of customers, employees and shareholders. Community banks use local deposits to make loans to the neighborhoods where their depositors live and work. Community bank officers are generally accessible to their customers on site with decisions on loans being made locally. Community bank employees are typically deeply involved in local community affairs. Community banks are willing to consider important attributes such as a persons character when making loans. Community banks are themselves small businesses, so they understand the needs of small business owners. Community banks boards of directors are made up of local citizens who want to advance the interests of the towns and cities where they live and the bank does business.

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6B TheBusinessJournal June 2012

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Architect (Continued from page 2B)

students are graduating with architectural degrees and some competition for entrylevel jobs can be anticipated. Competition will be especially keen for jobs at the most prestigious architectural firms as prospective architects try to build their reputation. Prospective architects who have had internships while in school will have an advantage in obtaining positions after graduation. Opportunities will be best for those architects who are able to distinguish themselves from others with their creativity. There should be demand for architects with knowledge of green design. Green design, also known as sustainable design, emphasizes the efficient use of resources such as energy and water, waste and pollution reduction, conservation, and environmentally friendly design, specifications, and materials. Rising energy costs and increased concern about the environment has led to many new buildings being built green. Employment of architects is strongly tied to the activity of the construction industry and some types of construction are sensitive to cyclical changes in the economy. For example, during recessions nonresidential construction of office and retail space tends to fall as funding for these projects becomes harder to obtain and the demand for these spaces falls. Firms involved in the design of institutional buildings, such as schools, hospitals, nursing homes, and correctional facilities, will be less affected by fluctuations in the economy. Residential construction makes up a small portion of work for architects, so major changes in the housing market would not be as significant as fluctuations in the nonresidential market. Opportunities are also geographically sensitive, and some parts of the Nation may have fewer new building projects. Also, many firms specialize in specific buildings, such as hospitals or office towers, and demand for these buildings may vary by region. Architects may find it increasingly necessary to gain reciprocity in order to compete for the best jobs and projects in other States. Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition

Unemployment (Continued from page 1B)

products inched up 0.2 percent in April, but are down 1.9 percent year over year. In contrast, prices for prepared asphalt, tar roofing and siding fell 2.6 percent in April and are down 3.3 percent from one year ago. Prices for plumbing fixtures and fittings decreased 0.7 percent for the month, but are up 2.5 percent compared to the same time last year. Softwood lumber prices fell 0.4 percent compared to March, but are still 3 percent higher than the same time last year. Iron and steel prices slipped 0.3 percent in April and are down 1.8 percent year over year. Crude energy materials prices dropped 6.8 percent in April as crude petroleum prices fell 7.9 percent. Crude energy materials prices are down 16.3 percent compared to the same time last year. Overall, the nations wholesale goods prices slipped 0.2 percent for the month, but are 1.9 percent higher than April 2011. Analysis Recent news pertaining to the U.S. nonresidential construction industry has been somehat disheartening of late, said Associated Builders and Contractors Chief Economist Anirban Basu. Still, at the very least, contractors have been enjoying the benefits of stable materials prices. Construction materials prices are now up just 2.5 percent on a year-over-year basis, and hardly moved in April, Basu said. However, the trajectory of prices may become more volatile in the months ahead with financial markets being impacted by ongoing bad news from both Europe and the United States regarding near-term economic prospect. While that should lead to a decline in materials prices due to softening demand, commodity markets are often impacted when equity and bond investors reduce their exposure to other assets and move into commodities, said Basu. This is what happened during the early months of 2008, and it has occurred on occasion since then. At this point in time, there are two scenarios, Basu said. One would be a moderation of prices with inflation kept in check. The other worse outcome would be one in which the economy continued to disappoint and materials prices rose.

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June 2012