Giving Tuesday is tomorrow! [There's still time!]
We'd like to highlight several ways you can particpate in Giving Tuesday tomorrow, including:

• Ongoing Emergency & Disaster Relief
• Hurricane Helene:
• Donate funds - Amorem, Compassionate Care of Western North Carolina, Four Seasons; Amazon wish lists: Amorem, Compassionate Care of Western North Carolina, Four Seasons, all three hospices
• Volunteer: Contact Chris Comeaux at Teleios, who is coordinating hospice staffing volunteer efforts
• Housing: Samaritan’s Purse and the Cajun Navy Relief
• California wildfires:
• Butte Home Health & Hospice
• Hawaii wildfires:
• Hospice Maui
• Local
• Support your local hospices and their foundations
• State
• Support your state hospice organization
• National
• Give to a hospice--different from your own--that took great care of your family member or friend
• National Alliance for Home Care & Hospice
• American Academy of Hospice & Palliative Medicine
• International
• Worldwide Hospice Palliative Care Alliance
• Association for Death Education & Counseling
  

[CAPC] 2024 Serious Illness Scorecard
Center to Advance Palliative Care press release; 12/4/24
America’s readiness to meet the needs of people with serious illness. A state-by-state look at palliative care capacity. How does your state rate? How can I improve my state’s rating? Download the full report.

Access our new search engine from the top of our home page, www.hospicepalliativecaretoday.com. Searches go back through December 2023. Note: The search engine does not show up in your daily email, you must go to our website. Our home page displays the newsletter for that current date. 

All-inclusive elder care for aging at home: This nursing home alternative is on the rise 
Caring.com; by Dom DiFurio; 11/25/2024 
... PACE centers, or Programs of All-Inclusive Care for the Elderly. As of August 2024, 177 programs across 33 states and the District of Columbia are in operation, allowing aging people to stay within their home communities while still receiving the elevated care they would need as older adults living with disabilities or chronic illnesses. A PACE facility is a kind of "one-stop shop" that offers services like dental care, social services, occupational therapy, prescription medication, and nutritional counseling. ... Caring.com examined data maintained by the National PACE Association to see which states have the most programs available to serve their aging populations and how they can impact the quality of care for adults who want to live independently outside a clinical setting for as long as possible. ... Several states are also undergoing trials, expansion, or establishing new PACE programs for their aging residents. Minnesota and South Dakota are considering starting PACE programs. Nevada is in the process of establishing its own program after using COVID-19 funding to experiment with the system to address the health needs of people ages 55 and older who need nursing facility-level care but can still live safely in their communities. Georgia's governor also signed a bill into law earlier this year creating the state's first PACE.

705 hospitals at risk of closure, state by state
Becker's Hospital CFO Report; by Molly Gamble; 11/22/24 
More than 700 rural U.S. hospitals are at risk of closure due to financial problems, with more than half of those hospitals at immediate risk of closure. The count comes from the latest analysis from the Center for Healthcare Quality and Payment Reform, which is based on CMS's October 2024 hospital financial information. The center's analysis reveals two distinct levels of vulnerability among rural healthcare facilities: risk of closure and immediate risk of closure. ... The report also analyzes hospitals facing immediate threat of closure meaning financial reserves could offset losses on patient services for two to three years at most. Currently, 364 rural hospitals are at immediate risk of shutting down due to severe financial difficulties. [Click on the title's link for] a state-by-state listing of the number of rural hospitals at risk of closure in the next six to seven years and at immediate risk of closure over the next two to three years. 
Editor's note: Consider how these closures impact patients' trajectories of serious illness, timely treatment plans, referrals to home health, nursing facilities, and hospice care. How do these impact your service areas? What are the root causes for so many potential closures?

18 questions for CEOs to ask themselves 
Becker's Hospital Review; by Molly Gamble; 11/25/24 
McKinsey senior partners developed a CEO performance questionnaire informed by in-depth interviews with more than 70 successful chief executives across industries. The checklist is meant to assess CEOs' performance in six dimensions: setting direction, aligning the organization, mobilizing through leaders, engaging the board, connecting with stakeholders and managing personal effectiveness. "Sure, CEOs have an abundance of financial, operational, and organizational metrics to look at, but what CEOs should be doing to influence those metrics wasn't exactly clear," the authors noted. The checklist serves as both a self-assessment tool and a framework for gathering honest feedback from board members, executives and trusted advisors. [Click on the title's link for] a condensed list of the questions, with commentary and more explanation of each available in the full article from McKinsey here. [Questions address:] 1. Vision. ... 2. Strategy. ... 3. Resource allocation. ... 4. Culture. ... 5. Organizational Design. ... 6. Talent. ... 7. Team composition. ... 8. Teamwork. ... [More]

Guidelines for the prevention, diagnosis, and management of urinary tract infections in pediatrics and adults-A WikiGuidelines group consensus statement
JAMA Network Open; Zachary Nelson, PharmD, MPH; Abdullah Tarık Aslan, MD; Nathan P. Beahm, PharmD; Michelle Blyth, MD, MSPH; Matthew Cappiello, MD; Danielle Casaus, PharmD; Fernando Dominguez, MD; Susan Egbert, PharmD; Alexandra Hanretty, PharmD; Tina Khadem, PharmD; Katie Olney, PharmD; Ahmed Abdul-Azim, MD; Gloria Aggrey, MD; Daniel T. Anderson, PharmD; Mariana Barosa, MD, MSc; Michael Bosco, PharmD; Elias B. Chahine, PharmD; Souradeep Chowdhury, MBBS; Alyssa Christensen, PharmD; Daniela de Lima Corvino, MD; Margaret Fitzpatrick, MD, MS; Molly Fleece, MD; Brent Footer, PharmD; Emily Fox, PharmD; Bassam Ghanem, PharmD, MS; Fergus Hamilton, MRCP, PhD; Justin Hayes, MD, MPH; Boris Jegorovic, MD, PhD; Philipp Jent, MD; Rodolfo Norberto Jimenez-Juarez, MD; Annie Joseph, MBBS; Minji Kang, MD; Geena Kludjian, PharmD; Sarah Kurz, MD; Rachael A. Lee, MD, MSPH; Todd C. Lee, MD, MPH; Timothy Li, MBChB; Alberto Enrico Maraolo, MD, MSc; Mira Maximos, PharmD, MSc, ACPR; Emily G. McDonald, MD, MSc; Dhara Mehta, PharmD; Justin William Moore, PharmD, MS; Cynthia T. Nguyen, PharmD; Cihan Papan, MD; Akshatha Ravindra, MD; Brad Spellberg, MD; Robert Taylor, PhD; Alexis Thumann, PharmD; Steven Y. C. Tong, MBBS (Hons), PhD; Michael Veve, PharmD, MPH; James Wilson, DO; Arsheena Yassin, PharmD; Veronica Zafonte, PharmD; Alfredo J. Mena Lora, MD; 11/24
Urinary tract infections (UTIs) are among the most common infections globally, notably impacting patient quality of life and posing substantial clinical and economic challenges. In this third WikiGuidelines consensus statement, we provide an evidence-based approach to UTI management developed by a global network of experts for practical use across diverse clinical settings. This guideline fills a critical gap by providing pragmatic, broadly applicable recommendations tailored for generalist care and systems-based practice. Our guidance is rooted in the best available evidence and is designed for clinicians from various backgrounds and health care environments. It emphasizes a patient-centered approach to the diagnosis, prevention and treatment of UTIs and related genitourinary infections.

Court Orders VitalCaring to place 43% of profits into trust for Encompass Health 
Hospice News; by Jim Parker; 12/3/24 
A federal judge in Delaware has ordered home health and hospice provider VitalCaring Group and its private equity backers to share future profits with Encompass Health (NYSE: EHC). The case has a long circuitous history that dates back to 2022 when Encompass Health spinned off its home health and hospice business as a standalone company, now known as Enhabit Inc. (NYSE: EHAB) brand. At the time, VitalCaring CEO April Anthony was CEO of the Encompass home-based case segment. “Encompass is entitled to one recovery,” a court opinion indicated. “That recovery takes the form of an equitable payment stream of VitalCaring’s future profits to be administered via a constructive trust, certain mitigation damages, and attorneys’ fee.” The court ordered that 43% of VitalCaring’s future profits be placed in trust to benefit Encompass. The remaining 57% would go to VitalCaring’s private equity backers, the Vistria Group and Nautic Partners.

Addus closes $350M Gentiva Personal Care deal 
Hospice News; by Jim Parker; 12/2/24 
Addus HomeCare Corporation (Nasdaq: ADUS) has closed its $350 million acquisition of Gentiva’s personal care business. Gentiva’s personal care segment brings in annual revenues of close to $280.0 million. Post-transaction, Addus will continue with a leverage ratio of less than 3x, with the ability to further that amount with the influx of revenue resulting from this deal, Addus Chairman and CEO Dirk Allision said in a statement. ... Addus provides personal care, home health and hospice to more than 48,500 patients across 22 states. Its total revenue reached $289.8 million in the Q3 of 2024, a 7% year-over-year increase. Its personal care revenues reached $215.4 million that period.

[KY] Attorney General Russell Coleman files lawsuit against Optum Rx for role in opioid epidemic 
Northern Kentucky Tribune - Kentucky Center for Public Service Journalism; 12/1/24 
The Kentucky Attorney General’s Office has announced its latest lawsuit against a corporation behind the worst man-made epidemic in modern medical history. Attorney General Russell Coleman added Optum Rx and its affiliates to the list of those responsible for the opioid crisis. ... According to the Attorney General’s lawsuit, Optum Rx played a central role in the reckless promotion, dispensing, and oversupply of opioids. ... “Defendants have hidden their conduct through non-transparent business practices and by requiring each entity with whom they conduct business, such as opioid manufacturers, to enter into confidentiality agreements or otherwise keep their agreements confidential,” said the lawsuit. “No state has been harder hit by the drug crisis than Kentucky. Last year alone, nearly 2,000 Kentuckians died of a drug overdose,” Attorney General Coleman said. “These groups pushed a profit-fueled agenda at the expense of Kentucky families, who are left with empty seats at the dinner table. Our Office will continue to hold those behind the drug crisis accountable for their devastating actions.”

CGS Administrators, LLC, did not reopen and recalculate most selected hospices’ caps for years prior to 2020 
USA HHS Ofice of Inspector General (OIG), Washington, DC; issued 11/27/24, posted 12/4/24
Why OIG Did This Audit: ... Our audit determined whether CGS accurately calculated cap amounts and collected cap overpayments in accordance with CMS requirements. This audit is part of a series that reviewed MAC calculations and collections of hospice aggregate and inpatient cap overpayments.
What OID Recommends: [... that CGS] 

• discontinue its practices that limited the reopening of prior years’ cap calculations and start reopening all prior years’ cap calculations,
• revise policies and procedures so that it meets the reopening deadlines established in the Federal requirements, and
• conduct the prior years’ hospice cap calculations for the five hospices with UPIC recoupments and collect any additional overpayments.

CGS concurred with our second and third recommendations and partially concurred with our first recommendation.

• Click here for HHS OIG's Full Report
• Click here for HHS OIG's Report Highlights

AI can’t worry about patients, and a clinical ethicist says that matters
JAMA; Yulin Hswen, ScD, MPH; Jennifer Abbasi; 11/24
This conversation is part of a series of interviews in which JAMA Network editors and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine. Today, Hull is an associate professor and serves as associate director of the biomedical ethics program at Yale, where her clinical practice focuses on echocardiography and cardiac care of patients with cancer. She spoke about ethical boundaries for using AI in the clinic in a recent conversation with Yulin Hswen, ScD, MPH, an associate editor at JAMA and the newly launched JAMA+ AI and an assistant professor of epidemiology and biostatistics at the University of California, San Francisco. Medicine is, they remind the reader, “as much art as science, as much a moral endeavor as a technical one.”

A wise man once said, “Be careful who you let on your ship, because some people will sink the whole ship just because they can’t be the captain.” ~Unknown