Literature Review

Alphabet soup: replacing BMI with BRI The Courier, Findlay, OH; by Aidan Hester and Karen Kier; 7/12/25 ... A recent change in how we measure obesity involves a new acronym. Most medical professionals use body mass index (BMI) to assess weight and obesity. ... BMI considers a patient’s weight and height but does not account for fat distribution. It does not take into consideration a person’s muscle mass or different types of fat throughout the body. ... A recent study published by JAMA Open Network used a patient’s BRI to measure potential mortality. ... Patients in the Q1 group were considered underweight and Q4 and Q5 were evaluated as overweight. Patients in the Q1, Q4, and Q5 groups were found to have an increased risk of death. So, both being underweight and overweight were risk factors for death. Those in Q5 were 50% more likely to pass away, while Q1 and Q4 were 25% more likely when compared to Q2 and Q3.

Why people resist embracing AI: The five main obstacles - and how to overcome themHarvard Business Review; by Julian De Freitas; Jan-Feb 2025In concluding more than a decase of research on adoption of the technology, inlcuding in-depth qualitative interviews and experiments with some 2,500 users, I have uncovered what's driving this resistance to AI: fundamental human perceptions that AI is too opaque, emotionless, rigid, and independent, and that interacting with humans is far more preferable... In this article I will delve into them in detail and explain what you can do as a manager to counter them.Publisher's note: Accessing article may require subscription or purchasing the issue.

[Germany] A Berlin doctor goes on trial, accused of murdering 15 patients who were under palliative care U.S. News & World Report; by Associated Press; 7/14/25 A German doctor went on trial in Berlin Monday, accused of murdering 15 of his patients who were under palliative care. The prosecutor’s office brought charges against the 40-year-old doctor “for 15 counts of murder with premeditated malice and other base motives” before a Berlin state court. The prosecutor’s office is seeking not only a conviction and a finding of “particularly serious” guilt, but also a lifetime ban on practicing medicine and subsequent preventive detention. ... Parallel to the trial, the prosecutor’s office is investigating dozens of other suspected cases in separate proceedings. The man, who has only been identified as Johannes M. in line with Germany privacy rules, is also accused of trying to cover up evidence of the murders by starting fires in the victims' homes. He has been in custody since Aug. 6.

Hospice group seeks $500K to avoid closure after facility shutdown Ottumwa Courier, Ottumwa, IO; by Kyle Ocker; 7/14/25 Hospice House has now permanently closed, and the nonprofit that ran it — along with in-home services — may shutter as well without an immediate cash infusion of at least a half-million dollars. Tara Conley, executive director of Hospice Serving Davis and Wapello Counties, told The Courier the nonprofit urgently needs donations in the next 30 days to remain operational. She said a phased approach is planned to eventually find a new home and grow the service area to build a sustainable future for the organization, which has served the region since 1982. But for now, the group is calling on the community for help.

How rising tariffs could affect hospice M&A Hospice News; by Jim Parker; 7/11/25 ... Tariffs tend to raise prices and often trigger interest rate increases by the Federal Reserve. This makes financing debt more expensive, and many buyers in the M&A market rely on borrowing to make acquisitions. This can have a “ripple effect” on the M&A landscape, including in hospice, according to Cory Mertz, managing partner of the M&A advisory firm Mertz Taggart. “Tariffs raise costs, which can tighten debt markets and make capital more expensive,” Mertz told Hospice News in an email. “Since M&A is largely driven by both debt and equity investors, a higher cost of capital tends to put downward pressure on valuations. This can lead some buyers to pause or redirect their investment elsewhere, while some potential sellers may hold off on going to market.”

Medicare fraud has gone global. It’ll take a nationwide effort to stop itLos Angeles Times; by Mehmet Oz, Kim Brandt; 7/15/25Federal law enforcement recently announced a $14-billion fraud takedown — the largest healthcare fraud action in U.S. history, involving many crimes orchestrated by foreign nationals. Every American taxpayer should be alarmed not just because of the dollars at stake, but also because it reveals how vulnerable Medicare and Medicaid have become to large-scale, international exploitation... Fraud is a national problem, but it starts locally. Drive around certain neighborhoods in Los Angeles and you’ll pass what appear to be empty office buildings, which unbeknownst to neighbors could serve as hubs of criminal activity. There are more than 1,000 potentially fraudulent hospice operations identified in Los Angeles.Publisher's note: Medicare fraud is tragic - and that hospice is the highighted provider in this story is also tragic. This article includes steps that can be taken to stop this fraud. Also, thanks to Sheila Clark, President-CEO of the California Hospice & Palliative Care Association (CHAPCA) for forwarding this article.

Things work out best for those who make the best of how things work out. ~ John Wooden

Tracking the Medicaid Provisions in the 2025 Reconciliation Bill | KFF KFF; updated 7/8/25The chart tracking the Medicaid provisions in the House and Senate-passed version of the bill includes the following topics:  Medicaid Expansion, Eligibility Policies, Financing, Long-term Care, Access, and Prescription Drugs. The chart outlines details of the current law, House-passed bill, Senate-passed bill (enacted into law) and KFF Resources. Of particular note are the final work requirements in the statute, prohibiting the implementation, administration, or enforcement of certain provisions in both the CMS “Eligibility and Enrollment” final rules until October 1, 2034, and limits retroactive coverage to one month prior to application for expansion enrollees and two months prior to application for coverage for traditional enrollees, effective January 1, 2027. On July 1, 2025, KFF posted a CBO estimate of federal Medicaid spending reductions across the states including charts for components of the federal Medicaid cuts in the Senate reconciliation bill and a map of federal Medicaid cuts by state. Guest Editor’s Note, Judi Lund Person: While the details of the Medicaid provisions are daunting to understand and then apply to Medicaid enrollees in your area, I found this chart to at least organize the issues and track what happened between the House and Senate-passed versions, including what was enacted into law. More will likely unfold as we hear more from HHS and CMS about implementation.

HOPE Summer SchoolProvider Insights communication; by Annette Lee; 7/11/25Provider Insights Inc. has created a "HOPE Summer School" series, an 8-course microlearning program for our busy hospice professionals. This series is specifically designed to help hospice teams master the upcoming CMS HOPE Data Set, ensuring staff are confident and compliant. The program covers four core objectives: understanding HOPE's purpose and structure, navigating CMS documentation and reporting, building confidence in completing HOPE items with real-life examples, and meeting the Symptom Follow-Up Visit Measure. The 8 bite-sized modules (5-20 minutes each), interactive quizzes, a post -test, and 14 downloadable tools, this mobile-friendly training is perfect for busy nurses on the go. Download the HOPE Section A tool for a free sneak peek of the simple tool kit, and head over to providerinsights.com for more information and to get your organization enrolled.

9 dead, dozens hurt in fire at assisted-living facility in Fall River, Massachusetts: Officials ABC News; by Kevin Shalvey and Emily Shapiro; 7/14/25 Nine people have been killed and dozens are hurt after a five-alarm fire tore through an assisted-living facility in Fall River, Massachusetts, officials said. Firefighters, police and other responders descended on the scene of the Sunday night fire at the Gabriel House assisted-living facility, where they found multiple people "hanging out of the windows, screaming and begging to be rescued," Fall River Fire Chief Jeffrey Bacon said. The front of the building was covered in heavy smoke and flames, Bristol County District Attorney Thomas Quinn III said. "This was not a situation where teams arrived and people were able to get out easily -- all of these people needed assistance," Massachusetts Gov. Maura Healey said. "Many were in wheelchairs, many were immobile, many had oxygen tanks." About 12 "non-ambulatory residents were physically carried out by our officers," according to Fall River police. 

CDC reports rise in unintentional fall deaths among older adults JAMA; by Samantha Anderer; 7/11/25 The US Centers for Disease Control and Prevention (CDC) reported that deaths from unintentional falls among adults aged 65 years or older increased over the past 2 decades. Falls are currently the leading cause of injury for older adults, reaching 70 per 100 000 in 2023. As age increases, so does the likelihood of death due to a fall. And data from the National Vital Statistics System indicate that from 2003 to 2023, adults aged 85 years or older experienced the greatest increase in fall deaths. Rates for men, who are more likely to die from an unintentional fall, doubled from 178 to 373 per 100 000 people among those 85 years or older. For women in the same age group, deaths from falls increased 2.5 times, from 129 to 320 per 100 000. 

Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. when you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping may be the work of the ego, and service the work of the soul. ~ Rachel Naomi Remen

Family of brain-dead mom, Adriana Smith, inspires Georgia bill to protect pregnant patients BET*; by Jasmine Browley; 7/7/25 During a memorial to Adriana Smith, state Rep. Park Cannon unveiled new legislation aimed at giving patients and their families more control over Georgia's severe abortion law. ... Smith's case received global attention due to its unique and contentious circumstances. On February 9, Smith began complaining about headaches. The young nurse and her mother sought assistance at two separate hospitals before being discharged with medicine but no CT scan. A week later, Smith was discovered unresponsive at home, and on February 19, she was formally pronounced brain-dead and placed on life support. Her mother, April Newkirk, told WXIA that doctors at Emory Hospital claimed they couldn't legally examine any additional choices. ... In June, a few days after doctors performed an emergency cesarean surgery to prematurely deliver her baby, the young mother of two was taken off life support. ... Smith's son Chance, born at six months, weighed only one pound and thirteen ounces.  ... Cannon's proposed new law would have returned control of Smith's end-of-life care to her family, who were not consulted before physicians put her on life support to save her six-week-old fetus. ... Adriana's Law would take precedence over Georgia's LIFE ACT, ...