Literature Review

After Helene, clinician teams brought critical care to isolated WNC communities NC Health News; by Jaymie Baxley; 11/25/24 After the remnants of Hurricane Helene wreaked havoc on western North Carolina’s health care infrastructure, the N.C. Office of Emergency Medical Services deployed nine multidisciplinary teams of clinicians to waterlogged communities where residents were cut off from providers. It was a complex undertaking that required the state to set up mobile treatment centers, medical support shelters and pop-up emergency departments in places with limited — or no — access to clean water and electricity. One team was forced to take a long detour through Tennessee just to reach the flooded county it had been assigned to. Kimberly Clement, manager of NCEMS’ Healthcare Preparedness Program, said more than 1,000 patients were treated across the federally declared disaster area for issues ranging from respiratory illness to injuries suffered while clearing debris from their storm-battered homes. Some of the visiting clinicians stayed for nearly two months, leaving only after the situation had improved enough for local emergency agencies to resume regular operations. The state recently deactivated its last medical unit in western North Carolina, a mobile clinic in McDowell County that stayed open for seven weeks after Helene blew through. Clement described the site’s closure as a milestone in the region’s long road to recovery. ... NCEMS has responded to multiple hurricanes through the years, but Clement said Helene was “very different and very extreme.” 

[United Kingdom] Hospice urges people to recycle Christmas trees BBC News; by Holly Phillips; 11/23/24 A charity is asking the public to recycle their Christmas trees this year. St. Barnabas Hospice, in Lincoln, is inviting people to take part in their "tree-cycle" initiative, by disposing of their tree in an eco-friendly way while supporting the charity. People who have bought a real tree can register for it to be collected so it can be recycled or replanted in the new year. Volunteers from the hospice will be picking up trees between 7 and 12 January in return for a voluntary donation. 

Hospice expands compassionate care for nursing home residents McKnights Long-Term Care News; by Liz Barnett and Mat Zucker; 11/22/24 Nursing homes are places of care, community and compassion, particularly for residents in their final stages of life. As we recognize National Hospice and Palliative Care Month, it’s an opportune time to consider how nursing homes can broaden the support they provide by better incorporating hospice services. Hospice offers a path to comfort and dignity at the end of life, yet many families have insufficient information about these services. Our mother, Leslie, benefited from hospice care early this year when her gallbladder cancer no longer responded to treatment. This journey revealed just how powerful hospice can be, not only for the patient but for our entire family. Nursing home staff and administrators can play a crucial role in helping families like ours make informed, compassionate choices like this for their loved ones.

Gratitude can transform common days into thanksgivings, turn routine jobs into joy, and change ordinary opportunities into blessings. ~ William Arthur Ward

National Alliance for Care at Home lays out 2024, 2025 priorities HomeCare, Washington, DC; 11/21/24 As 2024 starts to wind down and a new administration and Congress begins to take over in Washington, home health advocates are focused on two primary priorities: reversing planned reimbursement cuts for home health and reforming plans that target underperforming hospices. As Americans gather for Thanksgiving, “these are major family issues and also major national public policy issues of the highest level of strategic importance for our country,” said Dr. Steve Landers, CEO of the National Alliance for Care at Home, the organization formed by the recent merger of the National Association for Homecare and Hopsice and the National Hospice and Palliative Care Organization. “We’re not done with 2024 yet,” Landers said Thursday, Nov. 21. “We’ve got a lot that we want to accomplish right now, this year—and we’re looking to the future.” The number one priority, he said, is for Congress to intervene and stop home health payment cuts as outlined in a final rule from the Centers for Medicare and Medicaid Services (CMS). He said that the cuts would impact patient outcomes, reduce visits and hurt providers—and that they were implemented based on a Congressional mandate saying CMS should support home health.

Hospital at home saves lives and money: CMS report American Medical Association; by Jennifer Lubell; 11/22/24 A federal report to Congress on the Acute Hospital Care at Home initiative shows that at-home acute care produces lower mortality rates and post-discharge spending than traditional inpatient care while also yielding positive feedback from patients and caregivers. The Centers for Medicare & Medicaid Services (CMS) launched the home-care initiative in response to the COVID-19 public health emergency, granting waivers to individual hospitals to provide Medicare patients with inpatient-level home care. With 358 approved hospitals across 137 health systems in 39 states since its start in November 2020, this innovation in care delivery has become an important feature of the Medicare program. ... Importantly, these programs demonstrate clinically, and often more cost-effective care. “Numerous studies have demonstrated that many types of care that are currently delivered in an office or facility could be provided at home, with clinically appropriate, high quality, and cost-effective outcomes,” wrote the authors of the AMA report. About 15–20% of emergency and urgent care services and up to 35% of hospice services are capable of being administered at home. As home care continues to evolve, this service could provide up to 25% of post-acute and long-term care in the home. 

Caring for all stages of life: The legacy of VNA Health Good for Santa Barbara, CA; by Noozhawk; 11/21/24 VNA Health provides Home Health Care, Palliative Care, Hospice Care, Bereavement Care, and more. The holiday season is more than just a time for celebrations—it’s a chance to make a real difference. This Giving Tuesday, let’s focus on the power of local generosity and how it can transform lives in our community. At Noozhawk, we believe that every act of kindness counts. Our Giving Guide is your gateway to discovering local organizations doing incredible work and in need of support. Whether it’s a small donation or volunteering your time, your contribution can spark positive change as we wrap up the year. ... In this interview, Noozhawk spoke with Easter Moorman, Director of Marketing & Communications at VNA Health, to learn more about the nonprofit’s mission to care for our community with compassion and integrity. ...Editor's note: This article provides a great example of community outreach for Giving Tuesday, December 3rd, 2024.

Why the DOJ’s lawsuit against the UGH-Amedisys merger may not go anywhere MedCityNews; by Marissa Plescia; 11/21/24 Experts aren’t sure what the outcome of the DOJ’s recent lawsuit against the proposed UnitedHealth Group/Amedisys merger will be under the incoming Trump administration. The Biden administration has focused more on supporting clinicians, while the previous Trump administration favored corporations. ...  But even aside from the differences in governing philosophy, one expert noted that the main reason for antitrust lawsuits — prices would rise as a result of the transaction, hurting consumers and patients — seems to be missing from the equation here. That’s because of the outsized role Medicare and Medicaid play in the home health industry. ... By acquiring Amedisys, UHG would grow its home health and hospice footprint to five more states, as well as receive 500 additional locations across 32 states it already operates in. The deal would also give UHG control of at least 30% of the home health or hospice services in eight states. ... Will the DOJ succeed? It's hard to say for sure what the outcome of the DOJ’s lawsuit will be, particularly with the change in administration. ... 

South Jersey organization helps families caring for ailing loved ones by delivering Thanksgiving meals Fox 29 Philadelphia; by Marcus Espinoza; 11/23/24 Haddonfield, N.J. - The holiday season and stress go hand-in-hand for many, but for some, like the Esposito family, holidays like Thanksgiving can be especially challenging. Thankfully, organizations like Samaritan step up with efforts like a food drive in South Jersey. "Samaritan for years has been delivering meals to hospice, palliative and bereaved families all around our five-county area," explained Volunteer Coordinator Lisa DiCerto. DiCerto is a long-time Volunteer Coordinator and says give back days really highlight their mission as an organization to provide not just a hot meal during Thanksgiving, but a chance for families to worry about one less thing. ... It’s a large operation full of volunteers committed to helping their neighbors. "We are delivering to about 140 different locations today," DiCerto said. Editor's note: Giving thanks year-round, Samaritan Hospice (and its other services) provides a beautiful, simple way to thank their staff: click here to view. "Fill out the form to send us a message. We welcome your thoughts about the care you and your loved one received. We’ll make sure to share it with the hospice team, palliative care professionals, or grief counselors who took care of you, your family member, or friend." 

The Alliance applauds Gerald’s Law passing through Congress National Alliance for Care at Home (the Alliance; formerly NAHC and NHPCO); Press Release; 11/19/24 The National Alliance for Care at Home (the Alliance) celebrates the historic passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act in the U.S. House of Representatives last night with a bipartisan vote of 389-9. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits impacting seriously-ill veterans and their families receiving hospice care. The story of Gerald “Jerry” Elliott, a U.S. Army veteran, underscores the importance of this legislative achievement. Diagnosed with cancer, Jerry was admitted to his local Veterans Affairs (VA) hospital in 2019 before transitioning to VA hospice care at home to be surrounded by his family. After his passing, his family discovered they were ineligible for full burial and funeral financial support because Jerry died outside of a VA facility.

Navigating the aftermath of natural disasters Teleios Collaborative Network (TCN); by Lara McKinnis; 11/15/24 This morning I woke up to two bears outside, a little cub sitting on our front steps eating the pumpkin that my daughter recently carved, the mom nearby completely sprawled out lounging in the sun in a bed of freshly fallen yellow and orange oak leaves.  This is the “fall” that I look forward to every year in Asheville. I wanted to hold onto this feeling, all of us standing at our screened-in window talking to the bears as if they understood us, our dog enthusiastically joining in the conversation.  This feeling is alive and vibrant; however, so is the visceral awareness of the horrific despair that has engulfed my beloved community and so many communities in Western North Carolina. ...  Adjusting to a natural disaster is nuanced and layered.  [Click on the title's link to continue reading this hospice leader's reflections and professional guidance.]Editor's note: We thank Lara McKinnis for raising our awareness to what matters most--large and small. We alert you to the needs of hospice and other healthcare needs as the Associated Press reports "Wildfire threat continues in much of the US Northeast as dry conditions persist."

Alzheimer Disease—What’s in a name?JAMA Neurology; Ronald C. Petersen, PhD, MD; Elizabeth Mormino, PhD; Julie A. Schneider, MD, MS; 11/24Back in 2018, the National Institute on Aging (NIA)–AA [Alzheimer Association] group proposed a biological definition of AD [Alzheimer Disease] stating that if a person had the biomarker evidence of brain amyloid (A) and tau (T), the pathologic hallmarks of the disease, the patient had AD irrespective of the person’s clinical state. In their recent 2024 revision, they maintain a biological definition but have extended it to incorporate more recent biomarkers for AD; ... positivity on core 1 biomarkers that indicate the crossing of a specific amyloid threshold on amyloid positron emission tomography (PET), cerebrospinal fluid, and foreseeably, plasma biomarkers. A major question pertains to the requirement for tau in the definition [as] the AA group argues that the vast majority of individuals who have amyloid-positive PET scans have some tau pathology. Furthermore, the AA group proposes a clinical staging scheme that provides a framework to define the frequent mismatch between AD biomarker positivity (and underlying neuropathology) and the clinical expression of the disease, often an indicator of mixed pathologies or resilience. Importantly, although the AA group does base the AD diagnosis on biomarker positivity, they do not currently advise testing in asymptomatic persons in a clinical setting.

Hospices leaders: ‘Vigilant’ compliance pivotal in MAC auditing climate Hospice News; by Holly Vossel; 11/18/24 e auditing environment has heated up in the hospice industry, with inconsistencies reportedly proliferating among the various types of regulatory enforcement activity — particularly those performed by Medicare Administrative Contractors (MACs). The issue has some hospice providers delving deeper into a range of compliance strategies. ... Hospices in recent years have seen a plethora of auditing types picking up steam in frequency, including MACs, Targeted Probe and Education (TPE), Supplemental Medical Review Contractors (SMRC), Unified Program Integrity Contractors (UPIC) and Recovery Audit Contractors (RAC). A main purpose of most audit types is to identify hospice providers with frequent errors on their billing claims or other activity that the U.S. Centers for Medicare & Medicaid Services (CMS) considers to be unusual.