Literature Review

Poetry, again, confronts death JAMA; by Rafael CAmpo, MD, MA; 10/16/24Poetry can help physicians in many ways at the border between life and death. Though we might think first of the consoling power of elegy in confronting mortality, other poems, like “Again,” [referenced] aid us in wrestling with what death is in the first place—and are even more useful when research falls short in attempting to demystify it. One such scientific controversy surrounds in-hospital resuscitation, especially for older adults, with studies showing inconsistent rates of meaningful survival after these potentially life-saving interventions, confounded by the physical and emotional trauma that accompanies them, poor understanding of patients’ and families’ wishes, unclear definitions of “meaningful,” and varying patient selection criteria. [The poem titled] “Again” distills some sense out of this complexity as only poetry can, with the urgent repetition of “again” expressing the ingrained imperative to act when patients experience cardiac arrest while echoing both the many previous resuscitations hospital staff well remember, along with the 2-beat, up-down muscle memory of performing chest compressions. ... Thus, a reflexive, futile endeavor becomes a human being’s dying moment, allowing us to feel closure. Debates around in-hospital resuscitation suddenly quieted, we recognize life’s inevitable finality, underscored by the poem’s ironically dignified resignation in its concluding line: “Never again did you wake.”Editor's note: Click here to access the poem, "Again."

Why home health providers want employees working at top of license Home Health Care News; by Audrie Martin; 10/17/24 As home health organizations fight for a margin in tough labor and payment environments, they are increasingly seeking ways to help employees practice at the top of their licenses. By applying top-of-license assignments in organizations, less complex work is handed off to the level below. This allows organizations to see more patients, bill for more services, reduce burnout and provide better care. The process helps employees feel more satisfied, and also could help with recruitment. “What we’ve got to do is improve our margins,” Pinnacle Home Care CEO Shane Donaldson recently said at Home Health Care News’ FUTURE conference. “That means we’ve got to get evaluating clinicians to do as many evaluations and assessments as possible, and we’ve got to get the non-evaluating clinicians doing the majority of straight visits.” 

6 Essential leadership skills — and how to develop themHarvard Business Review; by Rebecca Knight; 10/18/24The way we work has changed — and so has leadership. Leaders are under new pressures to perform at higher levels and adapt quickly to changing demands. In this article, the author shares advice from three leadership experts and outlines the six skills leaders need to succeed: 1) emotional aperture; 2) adaptive communication; 3) flexible thinking; 4) perspective seeking, taking, and coordinating; 5) strategic disruption skills; and 6) resilient self-awareness. Developing these six key leadership skills isn’t just about your personal growth, it’s about shaping the future of work and inspiring those around you.

Pink Ribbon Ride in Houlton raises over $9,000 for local hospice home WAGM-8, Presque Isle, ME; by Rothery Sullivan and Karri Triplett; 10/16/24 Over 64 Jeeps came out to participate in the annual Pink Ribbon Ride held in Houlton this past Sunday. The event consisted of a silent auction, raffle, and jeep ride throughout Southern Aroostook. The County Jeep Riders of Hope hosted the event to raise money for the Aroostook House of Comfort, which is a six-bed in-patient hospice home in Presque Isle. Abbey Clair, the executive director of Aroostook Hospice Foundation, says she is very grateful to have been chosen as this year’s charity.

Nonprofit endeavors to facilitate food justice Towne Post Network; by Julie Yate; 10/17/24 Bringing Justice Home [in Louisville, KY] is a nonprofit organization committed to alleviating hunger caused by food insecurity for those facing disabilities and chronic or serious illnesses. Now in its fourth year, the completely volunteer-run initiative seeks to facilitate food justice by delivering groceries and household supplies to health-compromised families and individuals who fall below the poverty line. Equally important is the relationship building that occurs as resources are shared and volunteers open their hearts to bringing justice closer to home. ... “Bringing Justice Home is a new kind of neighborhood that goes beyond zip codes, race, disabilities, health labels or status,” says Constance Merritt, who co-founded the organization along with her wife, Maria Accardi. Merritt is a published writer and a licensed social worker with a master’s degree from the University of Louisville. She has worked with older adults in low-income senior housing, patients and families in hospital palliative care, and individuals receiving HIV and AIDS services. 

HealthRev Partners and Trella Health announce partnership to empower home health and hospice agencies The Warren Record; by Trella Health; 10/17/24HealthRev Partners, [a] revenue cycle management partner specializing in innovative, tech-driven solutions for home health and hospice agencies, and Trella Health, [a] provider of market intelligence and Customer Relationship Management (CRM) solutions for the post-acute care industry, have announced a new partnership. HealthRev Partners and Trella Health will collaborate to help agencies reach their full potential by cultivating stronger relationships with referral sources and optimizing their revenue cycle through complementary solutions.

In Pictures: Palliative care nurses give a peek into their work journeying with patients at the last mileChannel News Asia (CNA) Today; by Raj Nadarajan; 10/18/24[Powerful photo essay.]

The Tesla Bot is the future of at-home care, but not the way Elon wants you to think AndroidCentral; by Nicholas Sutrich; 10/17/24 Imagine waking up on your 91st birthday to a friendly robot companion that brings your morning coffee and a nice warm robe to start the day in. After making you breakfast, it bids you good day and heads back into the closet for a quick charge-up. At around 11 a.m., you realize there's a new pain in your leg that you haven't experienced before, so you make a quick phone call to the doctor, and, in a minute, your robot companion emerges from the closet, entirely remote-controlled by your doctor. They can run scans, have a full conversation, and even perform exams, all without you having to leave your home and go through the irritating task of trying to find transportation across town. ... Nothing replaces full face-to-face human interaction, but the ability for a fully remote-controlled robot that can be embodied by anyone with a VR headset like the Meta Quest 3 is a future I want to fully embrace.

OIG's top unimplemented recommendationsOIG press release; updated 10/17/24Comprising monetary, programmatic, legislative, and procedural recommendations related to HHS Operating Divisions, full implementation of these recommendations could produce substantial savings for the Federal Government and taxpayers and improve the operation of HHS programs.Publisher's note: Of 33 unimplemented recommendations, #3 is Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio recommending "CMS should modify the payments for hospice care in nursing facilities." This recommendation was issued 7/30/18 in report OEI-02-16-00570.

Managing the hospice payment cap by balancing length of stay Hospice News; by Jim Parker; 10/15/24 Careful management of the hospice aggregate cap is key to providers’ sustainability as regulatory scrutiny continues to heat up. The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. For Fiscal Year 2024, the U.S. Centers for Medicare & Medicaid Services set the cap at $33,394. In 2025, this will rise to $34,465. “While the cap is a beneficiary driven cap, meaning the reimbursement allowed per Medicare beneficiary, it is not assessed at the beneficiary level, but rather in the aggregate at the agency provider number level for all beneficiaries served by the agency in the cap,” Rochelle Salinas, vice president of operations for CommonSpirit Health at Home, said. “This allows for greater flexibility in providing care to those in need.” ... [Click on the title's link to continue reading.]

How poor health literacy can diminish access to palliative care Hospice News; by Jim Parker; 10/11/24 Low health literacy among seriously ill patients can impede access to palliative care and complicate efforts to improve health equity. Health literacy is the degree to which individuals can obtain, process and understand basic health information and services needed to make appropriate health decisions, according to the Institute of Medicine. A health illiterate patient may have a strong overall ability to read or have an advanced education but have a limited understanding of information specific to health care. ... The issue deepens when it comes to palliative care. An estimated 71% of adults in the United States are unaware that palliative care exists, studies have shown, even though nearly 80% of consumers who received background information on palliative care say they would choose it for themselves or their loved ones. 

Exploding physician union membership signals a significant labor market shift NJToday.net; 10/16/24 As of 2022, about 70,000 medical doctors in the United States, or about 8% of the physician workforce, belonged to a union—a notable increase of 26.8% since 2014. This shift reflects significant changes in the employment landscape for doctors, with nearly half of all physicians now working for health systems or large medical groups. The rise in union membership comes amidst broader labor movements in healthcare, highlighted by the 2023 Kaiser Permanente strike, recognized as the largest healthcare worker strike in U.S. history. While nurses have typically led these efforts, physicians and residents are increasingly exploring unionization as a means to advocate for improved pay, benefits, and working conditions. 

Dozens of CarePartners patients in Asheville transferred to other facilities after HCA temporarily shuts down rehab, hospice center Asheville Watchdog; by Andrew R. Jones; 10/14/24 Hundreds of employees uncertain about their jobs after facility is closed to ease pressure on Mission Hospital. Mission Health’s CarePartners Health Services is temporarily closed following the pressures Hurricane Helene put on Asheville’s health care system, disrupting rehabilitative care for more than 50 patients and forcing more than 250 employees to take temporary jobs elsewhere in the system, according to employees and internal emails obtained by Asheville Watchdog.  ... The closing affected nearly 50 inpatient rehab patients, several long-term acute care patients, and eight hospice patients, all of whom were sent to home caregivers, skilled nursing facilities, other inpatient rehab programs, and UNC Health Caldwell in Lenoir, more than an hour’s drive to the east, according to one employee.