Literature Review

Hawaiʻi is the first state to provide palliative care coverage EIN Presswire; by Governor Josh Green, MD; 6/4/24 Governor Josh Green, M.D., and the Department of Human Services (DHS) Med-QUEST Division are pleased to announce that the Centers for Medicare and Medicaid Services (CMS) approved a new State Plan Amendment (SPA) to cover community palliative care services through Medicaid, making Hawaiʻi the first state in the nation to do so.  ... “After several years of hard work and collaboration with many community members and experts in the field, I am proud to announce that Med-QUEST is the first Medicaid program in the country to get this benefit approved,” said Governor Green. “This will greatly improve the quality of life and health outcomes for thousands of people who face serious medical conditions in our state. Hawaiʻi continues to lead the nation in innovations in health and health care.”  

Oregon reviews UnitedHealth deal for Amedisys home health, hospice The Lund Report; by Nick Budnick; 6/4/24State officials are asking members of the public to weigh on the proposed acquisition of Amedisys — a hospice and home health and company that operates in Roseburg, Salem and Portland — by an increasingly controversial health care giant called UnitedHealth Group. Inc.  UnitedHealth operates Optum, a subsidiary whose takeover of a clinic chain in the Eugene area has sparked numerous complaints. The state recently approved the company's acquisition of  The Corvallis Clinic, an 11-clinic company operating in three counties. Now, it proposes to take over the Oregon offices of a Amedisys, a publicly traded firm, and the transaction has federal officials contemplating a lawsuit to block it. UnitedHealth and Optum are under increasing scrutiny for their market dominance and allegations of anticompetitive conduct.

Behavioral health patients a challenge to nursing homesModern Healthcare; by Diane Eastabrook; 6/4/24Challenges providing care for nursing home patients with mental health and behavioral health issues are adding to discharge bottlenecks for hospitals, and the demand for such care has led some facilities to set up specialized units with additional staff just for those patients.Editor's Note: Hospice and palliative care leaders, what end-of-life, mental health and behavioral health specific education do you provide for your clinical teams, your volunteers, and family caregivers? For starters, you need to include dementia care training such as "Validation Therapy" by Naomi Feil and/or the "Positive Approach to Care" by Teepa Snow. For mental illness, examine the journal article "End-of-Life Care in Individuals with Serious Mental Illness." Click here to "Get Involved with Your Local Chapter" of the national Alzheimer's Association.

Normandy Welcomes World War II Heroes - 80th AnniversaryU.S. Department of Defense; 6/4/24World War II veterans met with cheers and applause from throngs of well-wishers as they arrived in Normandy, France, for events commemorating the 80th anniversary of D-Day. ... The number of these heroes at D-Day anniversary events in Normandy each year is diminishing, but the gratitude and awe for their service and sacrifice endures.We Honor Veterans - NHPCONHPCO; retrieved from the internet on 6/5/24We Honor Veterans empowers end-of-life care partners to meet the unique needs of America’s Veterans and their families. Our guidance and resources are focused on respectful inquiry, compassionate listening and grateful acknowledgment so that veterans can be guided through their life stories toward a more peaceful ending.Editor's Note: Thank you NHPCO for your foresight in developing this program! You identified the massive generation of WWII veterans we would lose within a window of two decades. You educated hospice organizations nation-wide and equipped us with relevant resources, while we still had time to provide meaningful support.  (Today's average age of surviving WWII veterans is 100.) 

Stepped palliative care for patients with advanced lung cancer: A randomized clinical trialJAMA; by Jennifer S. Temel, MD, Vicki A. Jackson, MPH, MD, Areej El-Jawahri, MD, Simone P. Rinaldi, MSN, ANP-BC, ACHPN, Laura A. Petrillo, MD, Pallavi Kumar, MD, Kathryn A. McGrath, MD, Thomas W. LeBlanc, MD, Arif H. Kamal, MD, Christopher A. Jones, MD, Dustin J. Rabideau, PhD, Nora Horick, MS, Kedie Pintro, MS, Emily R. Gallagher Medeiros, RN, Kathryn E. Post, PhD, RN, ANP-BC, Joseph A. Greer, PhD; 6/24A stepped-care model, with palliative care visits occurring only at key points in patients’ cancer trajectories and using a decrement in QOL to trigger more intensive palliative care exposure, resulted in fewer palliative care visits without diminishing the benefits for patients’ QOL. While stepped palliative care was associated with fewer days in hospice, it is a more scalable way to deliver early palliative care to enhance patient-reported outcomes.Publisher's note: This article was reference earlier this week in Palliative care for cancer patients is found to be as effective given virtually as in person.

National Nurses Honor Guard CoalitionJournal of Hospice and Palliative Nursing; by Betty Ferrell; 6/24As hospice and palliative care nurses, we are very familiar with the importance of rituals at the end of life or after death, which helps us to honor this sacred time. We know that funeral or memorial services offer a time to honor lives and to provide comfort to families. But how often do we pause to honor our own nursing colleagues for their lives of service?I recently learned of an incredible organization, the National Nurses Honor Guard Coalition, which is doing just this—honoring nurses through participation in their funeral services to celebrate these lives well lived and lives dedicated to our profession. ... Hearing about the Honor Guard Coalition brought tears to my eyes to think about this incredible tribute to nurses.Publisher's Note: Thanks for writing about this important group Betty! I also recently learned about the National (and state-specific) Nurses Honor Guard Coalition at the Nebraska Hospice & Palliative Care Association annual conference. A great group with a fantastic mission. 

Exposure to a loved one’s death and advance care planning: Moderating effects of ageAmerican Journal of Hospice and Palliative Medicine; by Peiyuan Zhang, MS, Sarah Clem, MSW, Roderick Rose, PhD, John G. Cagle, PhD; 6/24Despite documented benefits of Advance Care Planning (ACP), it is still under-utilized in the U.S. Our study aimed to examine whether experiencing a loved one’s death is associated with one’s own ACP behavior among adults in the U.S. and the potential moderating effect of age. ... Exploring an individual’s previous experience with a loved one’s death might be an effective way to broach the concept of ACP among adults of all ages. This strategy may be particularly useful in facilitating discussions of end-of-life medical wishes with doctors among younger adults than older adults.

A moratorium on the euphemism MAIDJournal of the American Medical Directors Association; by Richard W. Sams II MD, MA (Ethics), CMD, Peter Jaggard MD, CMD; 6/24It is essential for high-quality health care for providers to adhere to the principle of truth telling, speaking with clarity and honesty. The euphemism medical aid in dying, MAID, is being mainstreamed in the medical literature by proponents of physician-assisted suicide and euthanasia. ... We recommend standardized language that accurately denotes the context and process. Provider Assisted Death by Prescription (PAD-P) and Provider Assisted Death by Administration (PAD-A) are terms that most accurately describe the process, taking into account who is prescribing or administering a lethal substance and the outcome of the actions. ... The standardized language needs to be used on death certificates so we can most accurately assess the impact that provider-assisted death is having on society. Emphasizing truth telling in morally controversial practices will foster trust among health care providers and with patients.

Geriatric End-of-Life Screening Tool prediction of 6-month mortality in older patientsJAMA Open Network; by Adrian D. Haimovich, MD, PhD, Ryan C. Burke, PhD, MPH, Larry A. Nathanson, MD, David Rubins, MD, R. Andrew Taylor, MD, MHS, Erin K. Kross, MD, Kei Ouchi, MD, MPH, Nathan I. Shapiro, MD, MPH, Mara A. Schonberg, MD, MPH; 5/31/24In this prognostic study of 82,371 ED encounters within a tertiary care emergency department, the Geriatric End-of-Life Screening Tool (GEST) performed robustly on external validation, identifying 11.6% of the population as having a 30% or greater mortality risk. Compared with serious illness diagnoses, GEST provided a greater net benefit as a screening tool using decision curve analysis. The findings of this prognostic external validation study highlight the opportunity to use pragmatic, prognostic electronic health record algorithms to identify older adults in the emergency department for end-of-life care interventions.Publisher's Note: See related article posted earlier this week from McKnight's Long-Term Care News, Screening tool predicts older adults’ need for end-of-life care intervention.

Kickbacks and medically unnecessary treatments: Five major qui tam settlements from May 2024 JD Supra; by Geoff Schweller; 6/5/24 Under the FCA’s qui tam provisions, a crucial tool in combating healthcare fraud, whistleblowers have the power to file suits on behalf of the federal government if they possess the knowledge of an individual or company defrauding the government. The government may choose to intervene and take over the suit, but if a qui tam lawsuit results in a successful settlement, the whistleblower is eligible to receive between 15-30% of the monies collected. The settlements announced in May cover a wide range of alleged misconduct that violates the FCA, including cases concerning kickbacks and the billing of federal healthcare programs for medically unnecessary treatments. Each settlement represents a victory in the ongoing battle against fraud. ... [Non-hospice examples followed by this hospice case] $4.2 Million Settlement with Elara Claring for Allegedly Billing Medicare for Ineligible Hospice Patients ...

How fraudulent hospices evade regulators Hospice News; by Jim Parker; 6/5/24A slew of fraudulent hospices in California are dodging consequences by shuffling patients around between provider numbers. That’s according to multiple sources who spoke with Hospice News, expressing their concerns about patterns of fraud continuing even as government regulators crack down on the sector. Since 2021, numerous media and government reports have emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona. Despite the best efforts of regulators and law enforcement, hospice leaders are concerned that many bad actors are slipping through the cracks. 

Registration open for 2024 Home Health and Hospice Medicare Administrative Collaborative SummitPalmetto email; 6/6/24Registration is now open for the 2024 Home Health and Hospice (HHH) Medicare Administrative Contractor (MAC) Collaborative Summit! This national Medicare event includes all three HHH MACs, more than 40 live speakers, presenting a rigorous, three-day comprehensive conference. This event is being held live, in-person at the Flamingo Hotel and Casino in Las Vegas, Nevada, on October 2-4, 2024. Please review this announcement and share it with your staff.

Dover Health acquires Chicago-area hospice, home health agencies Hospice News; by Jim Parker; 6/6/24St. Louis-based Dover Health has expanded into the Chicago region with the purchase of Centered Care Hospice and Palliative Care and Cornerstone Home Health. With this deal, Dover expands to nine Illinois counties to complement its five-county footprint in Missouri. The transaction will enable Dover Health to expand its scale and offer enhanced benefits and technology to clinical staff and patients, according to a press release. “We are committed to giving our caregiving team the time and resources needed to truly engage with each patient,” said Steven Burghart, president of Dover Health, in a statement. “Our mission is to help every senior and their family thrive through personalized, holistic health and wellness.”