Literature Review
Nurse resilience, decompression off balance: Press Ganey
05/21/24 at 03:00 AMNurse resilience, decompression off balance: Press GaneyBecker's Clinical Leadership; by Erica Carbajal; 5/14/24Nurses have a hard time disconnecting from work, and may benefit from additional workplace resources that support them in doing so, according to findings from a new Press Ganey report on nurse resiliency. ... Below are four key findings from the report:
Biden announces ‘major step’ toward reclassifying marijuana
05/21/24 at 03:00 AMBiden announces ‘major step’ toward reclassifying marijuanaThe Hill; by Joseph Choi; 5/16/24The Biden administration announced Thursday it had initiated the formal rulemaking process to reschedule marijuana to Schedule III from its Schedule I designation that it has held for more than 50 years. CBS website maps states where marijuana is legal for recreational and / or medical use.
Today's Encouragement
05/20/24 at 03:00 AMIf you get up in the morning and think the future is going to be better, it is a bright day. Otherwise it is not. ~ Elon Musk
[Old but important news] Consumer alerts added to the Nursing Home Compare website and the Five Star Quality Rating System
05/20/24 at 03:00 AM[Old news] Consumer Alerts added to the Nursing Home Compare website and the Five Star Quality Rating SystemCMS; 10/7/19Adding an “abuse icon” to facilities cited for abuse: Every nursing home resident deserves be treated with respect at all times. Abuse is never acceptable and CMS is very concerned about incidents related to abuse (including neglect and exploitation) in nursing homes. ... As part of this strategy, we want to make it easier for consumers to identify facilities with instances of non-compliance related to abuse. To do this, in October 2019, we are adding an icon to highlight facilities that meet the following criteria: 1) Facilities cited for abuse where residents were found to be harmed (Scope/Severity of G or higher) on the most recent standard survey, or on a complaint survey within the past 12 months; or 2) Facilities cited for abuse where residents were found to be potentially harmed (Scope/Severity of D or higher) on the most recent standard survey or a complaint survey within the past 12 months, and on the previous (i.e., second most recent) standard survey or on a complaint survey in the prior 12 months (i.e., from 24 months ago to 12 months ago).Publisher's Note: With apologies for "old news", this was "new news" to me - i.e., that Care Compare for Nursing Facilities includes a "red stop hand" and a "yellow triangle warning" to warn consumers of poor performers. When might this be added to Care Compare for Hospice, and what criteria might be used?
I kept crying
05/20/24 at 03:00 AMI Kept CryingJAMA Network; by Alexis Harmon; 4/15[Opinion] “The patient is a 31-week infant born via crash C-section in the setting of placental abruption.” How many times have I said that sentence as a physician? It seems like a million, or at least enough times that it became routine. At one point during my intern year, my colleagues and I cared for 3 sets of twin neonates all born between 30 and 31 weeks’ gestation. I remember finishing that rotation and feeling like caring for this population no longer felt “scary.” As pediatric residents, we knew how to prepare for these newborns and fully expected that they would have excellent outcomes medically. All this changed when I was curled in the fetal position, midcontraction, my thigh throbbing from a betamethasone injection and my spine burning from a lidocaine injection...Publisher's Note: A reminder that personal experience changes everything...
Compassus taps Fresenius veteran Michael Asselta as next CEO
05/20/24 at 03:00 AMCompassus Taps Fresenius Veteran Michael Asselta As Next CEOHome Health Care News; by Joyce Famakinwa; 5/7/24There’s a new leader at the helm of Compassus. The company’s board of directors has named Michael J. Asselta as CEO. Compassus is one of the largest home-based care providers in the country. The Brentwood, Tennessee-based company provides home health, hospice, palliative and home infusion services across more than 270 locations in 30 states.
‘Bodacious’ mentorship, honesty needed to retain LTC leaders of tomorrow, experts say
05/20/24 at 03:00 AM‘Bodacious’ mentorship, honesty needed to retain LTC leaders of tomorrow, experts sayMcKnight's Long-Term Care News; by Josh Henreckson; 5/17/24Cultivating mentorships in long-term care is vital to bringing up and retaining the next generation of sector leaders, a group of six prominent women leaders said this week at a McKnight’s Women of Distinction Forum panel. The speakers ... repeatedly emphasized the core needs of honesty, humility and an ongoing commitment to learning for successful mentors.
Addus CEO: Hospice headwinds starting to abate
05/20/24 at 03:00 AMAddus CEO: Hospice Headwinds Starting to AbateHospice News; by Jim Parker; 5/16/24Addus Homecare Corp. (NASDAQ: ADUS) is seeing constrictions on growth start to ease in its hospice business. Many of those headwinds were associated with lingering effects of the pandemic. Like many hospice providers, Addus has faced COVID-19 challenges that include reduced patient volumes and shorter length of stays. Now, the company’s hospice rebound is starting to accelerate, CEO Dirk Allison said during the Bank of America Securities Health Care Conference.
Hospitals are refusing to do surgeries unless you pay in full first
05/20/24 at 03:00 AMHospitals Are Refusing to Do Surgeries Unless You Pay in Full FirstWall Street Journal; by Melanie Evans; 5/9/24Now, more hospitals and surgery centers are demanding patients pay in advance. Advance billing helps the facilities avoid hounding patients to settle up. Yet it is distressing patients who must come up with thousands of dollars while struggling with serious conditions. Heather Miconi has seven weeks to come up with $2,000 to pay for surgery her daughter needs to breathe more easily. Merritt Island Surgery Center in Merritt Island, Fla., billed Miconi in advance of the adenoid and tonsil surgery. If she can’t pay for the surgery before it is scheduled to take place next month, the procedure will be put off. Miconi, whose insurance won’t cover the cost because she has a high deductible, works three jobs and doesn’t have savings to cover the cost. She is now appealing to strangers through a GoFundMe campaign for help. For years, hospitals and surgery centers waited to perform procedures before sending bills to patients. That often left them chasing after patients for payment, repeatedly sending invoices and enlisting debt collectors. Those who can’t come up with the sums have been forced to put off procedures. Some who paid up discovered later they were overcharged, then had to fight for refunds. Among the procedures that hospitals and surgery centers are seeking prepayments for are knee replacements, CT scans and births.
Caring for young caregivers, a hidden population
05/20/24 at 03:00 AMCaring for young caregivers, a hidden populationSTAT; by Kimia Heydari, Romila Santra; 5/9/24Of the estimated 48 million caregivers in the U.S., an estimated 14 million are under the age of 24. The growing burden of unpaid caregiving is increasingly falling on young people.
‘Great Resignation’ becomes ‘Great Reshuffle’ of American jobs
05/20/24 at 03:00 AM‘Great Resignation’ becomes ‘Great Reshuffle’ of American jobsMcKnight's Senior Living; by Kathleen Steele Gaivin; 5/16/24After a record number of workers left their jobs in the early part of the decade in what was known as the “Great Resignation,” the American workforce has entered a period now dubbed the “Great Reshuffle,” according to the World Economic Forum. “While quit rates remain high, hiring rates continue to outpace them as many workers have been transitioning to other jobs in search of an improved work-life balance and flexibility, increased compensation, or a strong company culture,” the US Chamber of Commerce reported.
Connecticut hospices obtain carveout from sweeping safety bill
05/20/24 at 03:00 AMConnecticut hospices obtain carveout from sweeping safety billMcKnight's Home Care; by Adam Healy; 5/15/24Grassroots advocacy paid off for Connecticut’s hospice providers. Last week, they successfully obtained a carveout from Senate Bill 1, which requires home-based healthcare providers to run background checks on all potential clients. “It was basically a total victory,” Barbara Pearce, chief executive officer of The Connecticut Hospice and the main proponent calling for a carveout, told McKnight’s Home Care Daily Pulse. “You’re never going to defeat Senate Bill One, because they said - in naming it - it’s their top priority. We just tried to take hospice off, and we did.” ... The bill would have unintentionally limited patients’ access to hospice care, Pearce said. By the time a background check could be conducted on a client, it may be too late to provide effective care for the patient. Furthermore, current staffing challenges hospices face would make compliance even harder, she noted.
Teleios recognized as one of the best places to work in healthcare in 2024
05/20/24 at 03:00 AMTeleios recognized as one of the best places to work in healthcare in 2024Press release; by Claudia Polancich; 5/14/24Hendersonville, NC May 14, 2024: Teleios Collaborative Network (TCN) has been selected by Modern Healthcare as one of the 2024 Best Places to Work in Healthcare. The complete list of this year’s winners, in alphabetical order, is available at ModernHealthcare.com/BestPlacesList.
The private-equity deal that flattened a hospital chain and its landlord
05/20/24 at 03:00 AMThe Private-Equity Deal That Flattened a Hospital Chain and Its LandlordWall Street Journal; by Jonathan WeilFollow; 5/7/24Cerberus made a big profit, but Steward went bankrupt and its landlord suffered big losses. In the spring of 2020, Cerberus Capital Management was faced with a tricky financial situation. It owned a struggling hospital chain that needed $400 million to dig out of a deep financial hole, but Cerberus wanted to sell rather than invest more. The deal helped shape much of what followed for Steward Health Care System over the next four years, culminating this week in the Chapter 11 filing of Steward, one of the biggest hospital bankruptcies in U.S. history. ... The 2020 deal paved the way for Cerberus to sell its majority stake in Steward to the hospital chain’s chief executive and others and lock in an eventual $800 million profit. It bought time for the CEO and new majority owner, Dr. Ralph de la Torre, who received a big cash payout himself the next year.
Surging hospital prices are helping keep inflation high
05/20/24 at 03:00 AMSurging hospital prices are helping keep inflation highWall Street Journal; by Melanie Evans; 5/16/24A 7.7% increase in prices at hospitals last month was the highest in 13 years. ... Hospitals didn’t raise prices as early in the pandemic as supermarkets, retailers and restaurants. But they have been making up ground since then. Their increases have contributed to stubbornly high inflation readings from the consumer-price index, which in April increased 3.4% from a year ago. Hospital prices specifically jumped 7.7% last month from a year ago, the highest increase in any month since October 2010, the Labor Department said Wednesday. ... Hospitals sat out the first waves of inflation that swept through the economy in recent years, though not by choice. Their prices were locked in under contracts with health insurers, for more than a year in some cases. As hospitals have renegotiated prices, inflation has taken hold.
Big Bend Hospice, Tallahassee Memorial HealthCare plan to build value-based network, offer palliative care
05/20/24 at 03:00 AMBig Bend Hospice, Tallahassee Memorial HealthCare Plan to Build Value-Based Network, Offer Palliative CareHospice News; by Jim Parker; 5/14/24A new collaboration for transitional care between Florida-based Big Bend Hospice (BBH) and the Tallahassee Memorial HealthCare (TMH) system has more going on behind the scenes. Big Bend, a nonprofit provider, in 2021 formed a new parent company called Seven Oaks Health. TMH has entered into an affiliation agreement with Seven Oaks Health, as the new organization works over the next five years to build a larger value-based network to provide transitional and palliative care, social determinants support, as well as care navigation and other services. Looking to the future, the organizations’ plans to engage in value-based care could manifest through participation in the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model.
‘Cuddle therapy’ ponies help bring joy to patients and staff at local hospice
05/20/24 at 03:00 AM‘Cuddle therapy’ ponies help bring joy to patients and staff at local hospice[London] Bedford Independent; by Emily Moriarty-Jones; 5/18/24The patients and staff of Sue Ryder St John’s Hospice in Moggerhanger were excited to be greeted by two very special guests recently, when Teddy and Mouse, a pair of ‘cuddle therapy ponies’ came for a visit. Those being cared for at the hospice, as well as their families and Sue Ryder staff were given the chance to pet, brush and interact with the placid pair.
Upskilling and retraining for talent innovation in the AI era
05/19/24 at 03:50 AMUpskilling and retraining for talent innovation in the AI era Tech Trends Post; 5/13/24 According to a report from the IBM Institute for Business Value, more than 60% of executives say generative AI will disrupt the way their organizations design customer and employee experiences. Employees must change to meet these demands. Many are turning to AI upskilling – the act of providing the workforce with the skills and training to use AI to do their jobs. ... A 2024 Gallup poll found that about 25% of workers worry that their jobs could become obsolete due to AI. ... [This article outlines the following:]
Beyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying
05/19/24 at 03:45 AMBeyond medicine: 'Being Mortal' challenges healthcare's approach to death and dying SwiftTelecast; by Shawn Butlere; 5/11/24 This video from the “Frontline” series, titled “Being Mortal,” follows Dr. Atul Gawande as he explores the complex relationships between doctors, patients, and end-of-life decisions. Based on his best-selling book “Being Mortal,” Gawande discusses how medical training often falls short in preparing doctors for the realities of death and dying. The documentary highlights personal stories, including Gawande’s own experiences with his father’s illness and death, to illustrate the challenges in balancing hope with realistic outcomes and the importance of quality life in the face of terminal illness.
Industry professionals reflect on five years of medical marijuana in Arkansas
05/19/24 at 03:40 AMIndustry professionals reflect on five years of medical marijuana in Arkansas Arkansas Advocate; by Mary Hennigan; 5/13/24Since the launch of medical marijuana in Arkansas in 2019, more than three dozen storefronts have opened, at least 102,000 residents have registered for patient cards and revenue has topped $1.1 billion. The latest card count exceeds 102,000, and there’s no indication of a letup in new applications, ... As of June 2023, one in three Arkansans with a patient card listed post-traumatic stress disorder as their qualifying condition, ... The next highest qualifying condition was intractable pain, or pain that has not responded to ordinary medications for more than six months, at nearly 30%.
Addus HomeCare expects 2024 acquisitions
05/19/24 at 03:35 AMAddus HomeCare expects 2024 acquisitions Hospice News; by Jim Parker; 5/7/24Addus HomeCare Corp. is poised for further acquisitions, potentially including some hospice deals. The company is seeking to pair its clinical services with its personal business in its existing markets. This is a cornerstone of its acquisition strategy. But Addus Chairman and CEO Dirk Allison does not rule out the possibility of moving into new markets if circumstances are right. ... When examining new markets, Addus focuses on regions where they can quickly become the largest or second-largest provider by market share, according to CFO Brian Poff. ... Addus’ roughly 33,000 employees provide hospice, home health and private duty nursing services across more than 200 locations in 22 states.
Utah man angry: "Why am I still alive?"
05/19/24 at 03:30 AMUtah man angry: "Why am I still alive?" Cat Country 107.3/94.9; by Andy Griffin; 5/10/24 George Ball (not his real name) is angry. He's dying soon, he knows that. But what he's really mad about is that he's still alive. "I signed the paper. I made the request," he said. "So, why am I still alive?" ... The 72-year-old Utahn recently had a heart attack (cardiac arrest), and was essentially dead for a few minutes before being resuscitated at a Utah hospital. Life-saving measures were taken, including shooting adrenaline into his heart. He was gone, but they brought him back. Happy ending, right? The only problem was, Ball had signed and certified a DNR -- a do not resuscitate order -- so that if he, well, died, heroic measures would not be taken to bring him back to life. ...
At age 99, Jimmy Carter is still exercising his right to vote
05/19/24 at 03:25 AMAt age 99, Jimmy Carter is still exercising his right to vote Story by CNN and Atlanta News First; 5/10/24 Former President Jimmy Carter, age 99, is still exercising his right to vote. Carter’s grandson, Jason Carter, said the nation’s 39th president cast a mail-in ballot this week for the May 21 Georgia primary, emphasizing his grandfather is not going to miss an election. The former president entered hospice care more than a year ago in his hometown of Plains, Georgia. Since then he celebrated his 99th birthday last October and attended the annual Peanut Festival, which celebrates the region’s cash crop. He also mourned the loss of his wife, Rosalynn Carter, who died in November at the age of 96. To date, that has been Jimmy Carter’s last public appearance.
Nurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia
05/19/24 at 03:20 AMNurse Practitioner care, scope of practice, and end-of-life outcomes for nursing home residents with dementia JAMA Health Forum - JAMA Network; by Cyrus M. Kosar, PhD; Bishnu B. Thapa, MPA, PhD; Ulrike Muench, RN, PhD; Christopher Santostefano, RN, MPH; Emily A. Gadbois, PhD; Hyesung Oh, MA, MBA; Pedro L. Gozalo, PhD; Momotazur Rahman, PhD; Elizabeth M. White, APRN, PhD; 5/10/24 Question: Is nurse practitioner (NP) care associated with end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias (ADRD), and do these associations differ between states with full vs restrictive NP scope of practice regulations? Findings: The results of this cohort study including 334 ,618 US nursing home residents with ADRD indicated that decedents with greater NP involvement at end of life had fewer hospitalizations and higher hospice use. The adjusted differences in outcomes between decedents with extensive vs minimal NP care were larger in states with full scope of practice regulations than in states with restrictive regulations.
In praise of hospice
05/19/24 at 03:15 AMIn praise of hospiceJAMA; by James R. Nicholas, MD; 4/24In this narrative medicine essay, a retired physician describes the kindness, companionship, and skill of the hospice workers who helped his wife and him prepare for her death. ... Joan did what she wanted to do: she, with the help of hospice, made her dying as easy as possible for me and our children. I have the same wish for myself. I doubt if I will achieve it as well as did Joan, but I will have her as a guide. And I hope I will have the kind of hospice team that Joan had.