Literature Review

16 large health systems growing bigger Becker's Hospital Review; by Alan Condon; 9/20/24 Merger and acquisition activity is rebounding after a drop in deal volume during the pandemic, with many large health systems growing their hospital portfolios or planning to add more hospitals in the coming quarters. Sixteen health systems growing bigger: ... This is not an exhaustive list.

NY home care agency pays $400K in racial prejudice lawsuit A home care agency in Brooklyn, NY, was ordered to pay $400,000 to settle a race and national origin discrimination lawsuit filed by the US Equal Employment Opportunity Commission. ACARE HHC Inc., doing business as Four Seasons Licensed Home Health Care Agency, routinely assigned home health aides based on clients’ racial preferences, according to a consent order filed with the US District Court for the Eastern District of New York. These workers, which included Black and Hispanic aides, would either be transferred to new client assignments based on clients’ wishes or lose their employment entirely, EEOC found. These practices were a violation of the Civil Rights Act, which prohibits employers from making job assignments based on workers’ race or national origin. Four Seasons will pay $400,000 in monetary relief for the home health aides affected, according to the consent order. It will also update its internal policies and training processes related to Civil Rights Act requirements, cease making home health aide assignments based on clients’ race or nationality preferences, and provide semi-annual reports to the EEOC regarding any reports or complaints surrounding race discrimination.

The crisp air of September is a reminder to embrace change like the trees embrace new colors. 

Clearing a path for diverse leadership Becker's Hospital Review; by Mariah Taylor; 9/20/24 Creating a diverse nurse workforce and leadership team takes intentionality. "Diversity doesn't happen by itself. It takes effort, thought and planning," Jesus Cepero, PhD, RN, chief nursing officer, senior vice president patient care services at Palo Alto, Calif.-based Stanford Medicine Children's Health, told Becker's. Dr. Cepero first joined Lucile Packard Children's Hospital Stanford four years ago and said part of what made him comfortable joining was seeing the diverse team of executives already at the hospital. "Since then, our diversity at the executive level has grown," he said. "This shift has transformed our culture, promoting a sense of safety and belonging, which is key to fostering a diverse and inclusive workforce." Now, he oversees 3,500 employees and one of his priorities is to further diversity work at the system. Here are his three guidelines for building a more diverse workforce and leadership team:

The growing, troublesome issues around non-solicitation agreements in home care Home Health Care News; by Audrie Martin; 9/23/24 In August, Comfort Keepers was fined $500,000 and forced to remove language from its contracts restricting caregivers from accepting positions with home care clients up to one year after terminating employment. That contract language, dubbed a non-solicitation agreement, is a widely used clause in home care contracts to protect providers’ businesses. On its end, the Irvine, California-based Comfort Keepers is a large franchise that offers non-medical in-home support, including meal preparation, companionship and personal assistance. The company required each client to execute a care agreement containing this language before receiving services. California Attorney General Rob Bonta concluded that this agreement violated California law by restraining worker mobility, as caregivers could not be hired by any Comfort Keepers client, not just the client to whom they were assigned to provide services. ... 

HopeHealth CMO: Hospice rules for ‘unrelated care’ getting stricter Hospice News; by Jim Parker; 9/25/24 Dr. Ed Martin began working in hospice in 1987 after hearing families talk about their experiences with those services. Today, he is chief medical officer of Rhode Island-based HopeHealth. The more than 50-year-old nonprofit organization also serves parts of Massachusetts. Martin recently spoke about the complicated issue of care that is deemed “unrelated” to a patient’s terminal diagnosis at the National Hospice and Palliative Care Organization’s Annual Leadership Conference in Denver. Hospice News sat down with Martin at the conference to discuss how he and his organization are addressing the matter of unrelated care, as well as the efficacy of requirements for an addendum to the election statement. [Click on the title's link to continue reading this interview.]

Hospital mergers and health care price increases: A primer for reporters Association of Health Care Journalists (AHCG); by AHCG Staff; 9/24/24 Hospital mergers — market consolidation — can lead to health care price increases of anywhere from 3% to 65%, according to a 2022 RAND Corporation review. The FTC’s director of the Bureau of Economics has said hospitals that merge may charge 40% to 50% more than if they hadn’t merged. Mergers can also result in layoffs and lower tax revenues and have a negative impact on patient care by reducing access to some health care services. With so much research confirming negative effects and as health care prices continue to rise, what — if anything — can be done to slow market consolidation and/or reduce the harms to patients and local economies?

2 years after its rebrand, CenterWell Home Health is set on tackling big goals Home Health Care News; by Andrew Donlan; 9/24/24 Kirk Allen, the president of home solutions at Humana Inc., is living a home health veteran’s dream. Right now, he is heads down on helping create a value-based home health model within CenterWell, Humana’s provider services arm. Home health leaders have always touted the extraordinary health and monetary value that can be derived from their services. Not many have had the opportunity to prove that out, however. Allen does. Humana owns CenterWell Home Health, which is one of the largest providers in the country. CenterWell also includes CenterWell Pharmacy and CenterWell Primary Care. Eventually, CenterWell Home Health wants to have 80,000 home health patients under its value-based model. ... After Humana fully acquired Kindred at Home, it divested the home care and hospice assets. With the large and remaining home health footprint, Humana created CenterWell Home Health.

‘Think like a reviewer’: How hospices can use communication, documentation to boost quality McKnights Home Care; by Adam Healy; 9/24/24 Regulators are tightening their scrutiny of the hospice industry, so providers must prioritize the documentation and communication practices that help them obtain higher quality scores. That’s according to hospice industry experts who spoke during an educational session at the National Hospice and Palliative Care Organization’s annual meeting in Denver. “They’re looking closely at the hospice industry,” Angela Huff, senior managing consultant at Forvis Mazars, said last week during the conference. “They have increasing concerns about fraud, waste and abuse in this space. … Don’t think this is going to stop.” ... A key part of hospice quality assurance is communication, Gallarneau said. Providers should support open, friendly channels of communication. This helps staff and clients feel comfortable raising concerns, making quality issues easier to tackle quickly and effectively. Also, prioritizing accuracy in documentation will help providers stay ready for any surveys or audits, Gallarneau noted. Hospices should ensure patient consent and election of benefit forms are properly filled out, signed and dated, and staff should all be trained to do so accordingly. 

Hospital nurse turnover, vacancy rates by year Becker's Clinical Leadership; by Mackenzie Bean; 9/24/24 Nurse turnover and vacancy rates have declined since their pandemic-era peaks but remain elevated, according to data from the "2024 NSI National Health Care Retention & RN Staffing Report." The report, released in April, includes survey findings from 400 hospitals in 36 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies. Survey data covers more than 194,000 nurses and was collected in 2023. ... Below are the average rates of registered nurse turnover and vacancy in hospitals between 2019 and 2024, according to the report. The data suggests hospitals have made progress in reducing nurse turnover and vacancy rates since their peak during the pandemic. However, sustained efforts to stabilize the workforce, improve working conditions and address burnout are needed to fully recover.

Building a clinic-based palliative care program Hospice News; by Jennifer Murtoff; 9/25/24 Palliative care is often delivered in the hospital setting or in the home, but a number of organizations have set up clinics to deliver those services. These locations often assist patients by offering a variety of services beyond symptom management. While they offer an alternative to home-based services, they present their own unique benefits and challenges. One of the agencies that uses the clinic model is Hospice of Northwest Ohio, which serves both Ohio and Michigan. Their palliative care subsidiary, Sincera — Supportive Care and Symptom Relief, launched in 2008 and recently opened a location in Oregon City, Ohio. At Sincera clinics, patients of any age who have chronic, serious illnesses can receive expert palliative care services. Creating the clinic-based model was a challenge, according to Richard Russell, president and CEO of Hospice of Northwest Ohio.

Pay cuts, layoffs hit the C-suite Becker's Hospital CFO Report; by Alan Condon; 9/25/24 Health systems are increasingly trimming executive positions and pay to stabilize their financial footing amid rising operational costs, workforce shortages and inflationary pressures. Springfield, Mass.-based Baystate Health will see three top leaders depart, effective Oct. 23, including Chief Quality Officer Doug Salvador, MD, Chief Information and Digital Officer Kevin Conway and Chief Human Resources Officer Kristin Morales-Lemieux. ... Similarly, Providence, R.I.-based Lifespan has cut 20% of its executive roles as part of a broader restructuring effort aimed at reducing overhead costs and directing more resources to patient care. The restructuring has led to the departure of key figures, including Crista Durand, who served as president of Newport (R.I.) Hospital since 2014. ... Corvallis, Ore.-based Samaritan Health Services recently laid off 1% of its workforce and temporarily reduced executive pay to counteract financial losses. ... For hospital executives across the country, these cuts serve as a stark reminder that restructuring may be inevitable to maintain operational viability. As the healthcare landscape evolves, systems will continue to seek ways to reduce overhead, streamline decision-making, and focus on financial sustainability.

A night with the stars: Soldout event raises nearly $100,000 for Richmond County Hospice Richmond County Daily Journal, Richmond County, NC; by Jimmy Potts; 9/24/24 Last Saturday’s Dancing with the Stars fundraiser generated nearly $100,000 for Richmond County Hospice during the gala event hosted by the Cole Auditorium. The $95,000 raised last Saturday eclipsed the $83,000 raised last year, which Richmond County Commission President Jeff Smart attributed to growing support for the event year after year. “I couldn’t be more proud of that. Did y’all hear sold out? In Richmond County, that doesn’t happen folks. I had people calling me today wanting tickets, and I couldn’t sneak them through the back door,” Smart said. “… Last year, we topped around $83,000. The good news is we had more sponsors. We sold out, which is the most ticket sales you can have. We had a record number of sales from our dancers.” Along with performances from the dancers, the event also featured a slew of restaurants putting their confections to the test as part of a contest. The event also featured performances multiple area dances troupes as well as more than 18 contestants performing in the competition.