Characteristics of patients enrolled in hospice presenting to the emergency department 
American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print 
Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for <30 days, enrolled with a hospice diagnosis of cancer, or admitted to the hospital. Understanding the care patients enrolled in hospice receive in the ED can help prevent avoidable visits and ensure care aligns with patients' goals.
Editor's note: Compare this data to your hospice patients' ED visits (and associated hastened "short-term mortality") to assess strengths and gaps in your patient care. Will a QAPI project reduce patients' needs for ED care? For example:

• Strengthen your patients' falls prevention and caregiver education to reduce traumatic events.
• Improve pain assessments, timely delivery of medications, and caregiver education.
• Strengthen education about catheter/tube care for nurses, aides, and caregivers.

Ultimately, use this information to improve your patient care, reduce preventable ED visits that can also result in "shortened mortality," reduce costs, and prevent extreme stress for caregivers (including potentially more difficult grief from these traumatic events and hastened deaths).

Agency Information Collection Activities: Proposed collection; Comment request 
Federal Register - United States Government; A Notice by the Centers for Medicare & Medicaid Services, Health  and Human Services; 12/16/24 
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information (including each proposed extension or reinstatement of an existing collection of information) and to allow 60 days for public comment on the proposed action. Interested persons are invited to send comments regarding our burden estimates or any other aspect of this collection of information, including the necessity and utility of the proposed information collection for the proper performance of the agency's functions, the accuracy of the estimated burden, ways to enhance the quality, utility, and clarity of the information to be collected, and the use of automated collection techniques or other forms of information technology to minimize the information collection burden.

'You will NEVER be forgotten': 26-year-old Savannah mom in hospice care has died 
ABC WJCL-22 News, Savannah, GA; by Graham Cawthon; 12/13/24 
A young Savannah mother who entered hospice care earlier this month has died. WJCL began following the story of 26-year-old Sara Long last year. Long was diagnosed with a rare kidney disease at the age of 13. Six years later, her mother donated a kidney to her. But the new organ failed.“We were expecting to have more time, you know," Sara told WJCL earlier this month. "I was just hoping to make it through the holidays, honestly." ... "I would rather have 26 really good years full of adventure and full of meaning and full of love and just the most beautiful people and I'm so glad that I got that instead of 100 mediocre ones," she added.
On Friday, Sara's husband Justin confirmed that she had passed away. "December 12, 2024 at 10:20pm Sara Long passed away. I held her in my arms and told her I loved her as she took her last breath. Her kind and loving nature continues through our daughter Riley and me as she has shown me that men can be calm and loving. She has shown me that I can be the greatest dad and has shown everyone around her what true love and kindness is. I'm glad she lived a great 26 years instead of 100 mediocre ones. Thank you, Sara for giving me the absolute best 7 years of my life and the most beautiful daughter. You will NEVER be forgotten. I love you." 
Editor's note: We posted Sara's powerful video and quote in our newsletter on 12/6/24. Click here for her profound, inspirational video.

2023 hospice index scores, by state 
Becker's Hospital Review; by Elizabeth Gregerson; 12/11/24 
In 2023, the District of Columbia had the lowest hospice care index score among states while Maryland had the highest, according to CMS data released Nov. 26.  CMS collected state data between Jan. 1 and Dec. 31, 2023, on the quality of patient care measures, including facility observed rates of hospice care. Hospices earn points for each of the 10 claims-based indicators they meet between admission and discharge. Here are the hospice care index overall scores for each state: [listed in alphabetical order].

Anvoi Hospice now serving Tangipahoa Parish 
The Daily Star, Hammond, LA; 12/13/24 
Anvoi Hospice has announced that they are bringing their specialized hospice care to Hammond, Ponchatoula and the surrounding area. Their goal is to provide care for the patient and the whole family with an emphasis on dignity, compassion and comfort, according to a press release. Anvoi Hospice was founded in 2013 and serves the Greater New Orleans area, including Tangipahoa and St. Tammany parishes. “We are honored to bring our services to this community,” said Angelique Richardson, Anvoi Health Care CEO. ... Anvoi Hospice has been named one of the “Best Places to Work” by New Orleans City Business Magazine.

Stabilizing local hospice and home health services celebrated as a gift at holiday gathering 
Juneau Empire, Juneau, AK; by Mark Sabbatini; 12/14/24 
Heather Richter says she’s optimistic about the long-term prognosis for hospice and home health services in Juneau, a little more than two years after they were on life support when the agency that had provided them for 20 years suddenly shut down and sent officials into a lengthy struggle to establish a new program. Richter, director of the Home Health and Hospice Program at Bartlett Regional Hospital, said 68 families have been participants since the hospital officially took over the program in July of 2023. Funding for the program, a key concern raised this spring due to a massive budget shortfall at the hospital, now appears more stable due to Juneau Assembly members supporting a five-year operating plan and support from the Juneau Community Foundation. “We’re in the clear,” she said during a “Light Up a Life” Community Celebration hosted by the program at the hospital on Friday evening. ...

Teleios announces Teleios University graduates 
Teleios Collaborative Network (TCN), Hendersonville, NC; by Tina Gentry; 12/16/24 
Teleios Collaborative Network (TCN) announced its 2024 Teleios University (TU) graduates. Nine individuals successfully completed the year-long program, earning their certificates in leadership excellence. TU’s Leadership Excellence program is unlike any other. This one-year course is provided through monthly webinars, experiential monthly activities, quarterly challenges and more. It culminates with a capstone project and earns each participant who completes the assignments a certification in leadership excellence. This year’s graduates include the following leaders in the Hospice and Serious Illness Sector:

• Justin Bryant, National Director of Payer Engagement, Teleios Collaborative Network
• Sue Ann Hamby, Chief Quality Officer, Four Seasons, the Care You Trust
• Alicia McKinnon, CNA Team Lead, Tillery Compassionate Care
• Kayla Oboyle, Team Leader Support Services, ANCORA Compassionate Care
• Lauren Purdy, Vice President of Employee and Volunteer Solutions, Four Seasons, the Care You Trust
• Robin Rose, Intake/Access Coordinator, Tillery Compassionate Care
• Jeanne Slayton, Growth Team Leader, ANCORA Compassionate Care
• Emily Stamey, Palliative Care Nurse Practitioner, Regional Director Palliative Care (West), Four Seasons, the Care You Trust
• Melissa Williams, Director of Social Services, Hospice of Eastern Idaho

Editor's note: Teleios Collaborative Network (TCN) is a sponsor for our newsletter.

MedPAC advises cutting home health payments by 7 percent, freezing hospice payments in ’26 
McKnights Home Care; by Liza Berger; 12/16/24 
The Medicare Payment Advisory Commission (MedPAC) on Friday issued draft recommendations that entail cutting payments to home health agencies by 7% and freezing hospice payments in 2026. The body, which advises Congress on Medicare payment issues, issued the same recommendations last year. Providers, once again, were not pleased. “The recent recommendations by MedPAC regarding Medicare home health and hospice policy are misguided and deeply troubling,” Steve Landers, MD, CEO of the National Alliance for Care at Home, said in a statement to McKnight’s Home Care Daily Pulse. “Medicare hospice spending has not kept up with labor inflation in the past five years and the typical length of stay and proportion of beneficiaries accessing hospice has stagnated. With respect to home health, the recommendation for drastic cuts is based on a flawed analysis of agency margins that fails to account for all payers and the true financial health of the home health system.”

Palliative care may improve quality of life for stroke survivors and their family members 
American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 
Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

Supporting grieving kids during the holiday season: Susan Hamme 
Cleveland.com, Cleveland, OH; Guest columnist Susan Hamme, director of grief services for Hospice of the Western Reserve 
... Childhood grief is tricky no matter the time of year, but the holidays can be a time of especially heightened emotion. The sights and sounds of the season can be triggers for children and adults alike. Combine that with an awareness that things will be very different without your special person, and you have the perfect recipe for emotional meltdowns and miscommunication all around. While it may be impossible to avoid this altogether, there are things you can do to lessen the stress and build in moments of peace and celebration.

• Choose an old tradition that can be continued ...
• Plan -- even the simple things: Young people love to feel in control of the things happening in their world. ...
• Schedule “down time” ...
• Try something new ...
• Let fun and laughter have its space ...

The loved ones we are missing often brought joy to our lives. That is why we miss them. Wishing you and the kids in your life a season of comfort, joy and memories.

Weekly US Map: Influenza summary update
CDC - U.S. Centers for Disease Control and Prevention; ongoing, retrieved from the internet 12/16/24
A Weekly Influenza Surveillance Report Prepared by the Influenza Division 
Editor's note: Bookmark this page to your web browser to monitor flu activity in your service areas through these more vulnerable winter months. Click on the map's "State" button for macro data at the state level. Click on the map's "CBSA" to drill down to counties.

Why private equity healthcare investment may rise in 2025 
Modern Healthcare - Mergers & Acquisitions; by Alex Kacik; 12/12/24 
Private equity investment in healthcare is expected to pick up in 2025 but still fall short of the highs of 2021, merger and acquisition advisers said. Private equity-linked healthcare transaction volume is poised to rebound after a sluggish 2024 as interest rates cool, state-led oversight bills lose momentum and a new presidential administration begins. Corporate investors will likely prioritize deals that involve healthcare information technology and other administrative support services over physician practices, industry observers said. 

Health gap at end of life is now wider in US than any other country 
Science Alert - Health; by Carly Cassella; 12/16/24 
A data-crunching survey covering 183 member nations of the World Health Organization has now confirmed what some scientists feared: while years are being added to most people's lives, healthy life is not being added to most people's year. Researchers at the Mayo Clinic found that people around the world in 2019 were living 9.6 years of life burdened by disability or disease – an increase of 13 percent from 2000. In that same time frame, global life expectancy has increased 6.5 years, and yet health-adjusted life expectancy has only increased 5.4 years. In the US, the gap between lifespan and 'healthspan' is growing particularly wide. Between 2000 and 2019, life expectancy in the US increased from 79.2 to 80.7 years for women, and from 74.1 to 76.3 years for men. When adjusting for healthy years of added life, however, the span only increased by 0.6 years among men. And among women, while health-adjusted life expectancy fluctuated slightly over time, in 2019 it matched the figure seen in 2000. The expanding gap means if an American woman lived to the expected 80.7 years of age, the last 12.4 years of her life would on average be impacted by disease or disability.

Navigating the Generative AI journey: A strategic roadmap for healthcare organizations 
Perficient; by Felix Bradbury; 12/13/24 
The healthcare industry stands at a transformative crossroads with generative AI (GenAI) poised to revolutionize care delivery, operational efficiency, and patient outcomes. Recent MIT Technology Review research indicates that while 88% of organizations are using or experimenting with GenAI, healthcare organizations face unique challenges in implementation. Let’s explore a comprehensive approach to successful GenAI adoption in healthcare. ... The journey to GenAI adoption requires careful consideration of three key dimensions: organizational readiness, use case prioritization, and infrastructure capabilities, [Click on the title's link to continue reading.]

Tips for older adults and caregivers this holiday season
Acantha Choteau, Choteau, MT; 12/16/24 
The holidays are coming up, and many people will be celebrating with family and friends. The start of colder months also means flu, COVID-19 and RSV can surge. That can be dangerous for older adults. “Holidays are a time to gather with family and friends,” said Charlene Wong, MD, MSHP, senior advisor for health strategy at the Centers for Disease Control and Prevention (CDC), “but for older people, this can come with risk of serious respiratory illness. Get your updated flu, COVID-19 and RSV vaccines to reduce your risk and do more together.” 
Editor's note: Pair this with other posts in our newslettter today: Characteristics of patients enrolled in hospice presenting to the emergency department and Weekly US Map: Influenza summary update.

I wish you music to help with the burdens of life, and to help you release your happiness to others. ~ Ludwig van Beethoven
Editor's note: Honoring Ludwig van Beethoven's birthday, 1770. What music helps you "with the burdens of life" and/or helps you "release your happiness to others"? I'd love to hear. Email me, Dr. Joy Berger, Editor in Chief; Author, Music of the Soul - Composing Life Out of Loss.