Literature Review

Owner of home health care company convicted of multimillion dollar health care fraud schemeDOJ press release; 7/22/24[Boston] Faith Newton, 56, was convicted of one count of conspiracy to commit health care fraud, one count of health care fraud, and three counts of money laundering. The jury found the defendant not guilty on one count of money laundering conspiracy... “Newton orchestrated a massive $100 million health care fraud scheme that targeted the Medicaid program, funding her lavish lifestyle at the expense of the American taxpayers,” said Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). “Today’s guilty verdict underscores the commitment of HHS-OIG and our partners to protecting the integrity of our federal health care system, and it should also serve as a stern warning to criminals who contemplate engaging in similar illegal schemes.”

End-of-life decisions are difficult and distressing. Could AI help?MIT Technology Review; by Jessica Hamzelouarchive;8/1/24Ethicists say a “digital psychological twin” could help doctors and family members make decisions for people who can’t speak themselves. End-of-life decisions can be extremely upsetting for surrogates, the people who have to make those calls on behalf of another person, says David Wendler, a bioethicist at the US National Institutes of Health. Wendler and his colleagues have been working on an idea for something that could make things easier: an artificial-intelligence-based tool that can help surrogates predict what patients themselves would want in any given situation. The tool hasn’t been built yet. But Wendler plans to train it on a person’s own medical data, personal messages, and social media posts. He hopes it could not only be more accurate at working out what the patient would want, but also alleviate the stress and emotional burden of difficult decision-making for family members.

Winning doesn’t always mean being first. Winning means you’re doing better than you’ve ever done before. ~Bonnie Blair, American speed skater and five-time gold medalist

Preventing the prescribing cascade: Lessons from hospice and palliative careMcKnight's Home Care; by Caren McHenry Martin; 7/24/24More than 2 in 5 seniors experience polypharmacy, meaning they are prescribed five or more drugs. Polypharmacy is a persistent issue in elder care, particularly for patients with chronic or advanced disease. The medication burden increases as patients near the end of life, with an average of more than 10 drugs per patient. As a pharmacist serving the hospice community, I often find myself asking a simple question: Is this medication treating a symptom or a side effect?

Florida Blue Boosts Local Bereavement Support with DonationAvow Hospice press release; 7/18/24In May 2024, Florida Blue Foundation announced a $20,000 grant in support of Avow’s bereavement programs, which are available at no cost to individuals of all ages. With this grant, Avow is able to pursue its mission of providing compassionate care through life’s hardest transitions. Florida Blue awarded this grant on the basis of promoting mental well-being for all individuals, one of the foundation’s strategic pillars, as grief counseling is essential for maintaining and advancing the mental well-being of individuals and families.

How the Hospice CARE Act could change respite services Hospice News; by Jim Parker; 8/1/24 The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion draft phase, which has been circulated among the nation’s major industry trade associations and their members for feedback. ... “There’s evidence that people who take advantage of hospice care delivered properly, actually have a higher quality of life. Oftentimes, they live longer,” Blumenauer said at Elevate. “This is an opportunity to do something in this Congress that is concrete, specific, that will save money and improve the quality of care for some of our most vulnerable people.”

PharMerica reaches $100 million settlement over alleged SNF pharmacy kickbacksMcKnight's Long-Term Care News; by Josh Henreckson; 7/18/24One of the nation’s leading pharmacy companies has agreed to pay $100 million to resolve allegations of false claims and kickbacks in its dealings with long-term care providers. The legal claims against PharMerica have been ongoing in the District Court of New Jersey since 2011, when whistleblower Marc Silver accused the company of undercharging skilled nursing facilities for their Medicare Part A patients in order to secure more lucrative Medicare Part D and Medicaid contracts.

10 tips for working with the mediaMcKnight's Senior Living; by Lois A. Bowers; 7/15/24Publisher's Note: Mark Cohen, Publisher of Hospice News Today, has also discussed several of these points. Please see full article for additional detail.

National plan on aging ‘essential’ to addressing key issues: AARPMcKnight's Senior Living; by Kimberly Bonvissuto; 7/18/24Aging, itself, isn’t a challenge - but being unprepared for aging is, according to AARP, which on Wednesday released a white paper that lays out a blueprint for developing a national plan on aging. The paper marks the launch of the organization’s Aging Well in America Initiative, for which the AARP took best practices from federal, state and local initiatives to create a blueprint for the development of a “robust” national plan to foster the well-being, quality of life and dignity of older Americans.

Teleios’ Clinically Integrated Network Sets Benchmark for Healthcare ExcellenceTeleios press release; 7/31/24Teleios Collaborative Network (TCN) recently announced that its Clinically Integrated Network (CIN) is setting the benchmark for healthcare excellence in the serious illness space. The data from the most recent reporting period again demonstrates that the members of the CIN are delivering exceptional patient care. One hundred percent of the CIN members achieved a 4- or 5-star rating on the CAHPS Hospice Survey Star Ratings by CMS. In addition, all the members identified and documented a healthcare surrogate for hospice within the first 5 days after admission at least 90% of the time with the network average being 97% and upon the time of admission for Palliative Care patients with the average being 99.8% of the time. This was the result of the members reviewing and revising their processes to ensure that a healthcare surrogate was identified and documented.

Providers, patients would benefit from hospice telehealth extension, doc offers McKnights Senior Living; by Rachael Zimlich; 7/31/24 The COVID-19 pandemic triggered many changes in healthcare, and not all were bad. In the years since the coronavirus forced worldwide lockdowns and limited access to care, the healthcare industry increasingly has embraced measures such as remote care and telehealth. One surprising area that has benefitted from those changes is hospice care. Hospice care by telehealth provides an obvious convenience for patients, but [Sean Oser, MD, MPH] shared his surprise at how much the increased frequency and ease of visits — plus better insight into the patient’s home environment —could improve his own experience as the provider. ... The latest extension of rules to allow hospice provided via telehealth to be paid through Medicare will end in December. ... Representatives called out the need to extend the hospital-at-home waiver, which is set to expire at the end of 2024.

Hospice Coalition Questions and Answers: June 20, 2024Palmetto GBA; 7/15/2024Meeting Q&A and these attachments: Attachment A: Hospice Appeals Report 2024; Attachment B: Hospice CAP Updates.

Hospices build community partnerships to better serve patients, employees Hospice News; by Jim Parker; 7/29/24 Hospice care does not occur in a vacuum, and many operators find themselves building partnerships with other community organizations to better serve patients and support their staff. Providers work with other institutions to provide general inpatient and respite care, address social determinants of health and improve health equity, among other initiatives. Some also partner with medical and nursing schools to ensure students in health care fields gain exposure to hospice and palliative care principles. Notable Mentions: Skelly Wingard, CEO of By the Bay Health; Mary Shankster, Chief Development Officer at Stillwater Hospice; Altonia Garrett, COO of Blue Ridge Hospice