Literature Review

Bucket list art show being held for hospice patient in Tabor CityWWAY-TV (Wilmington, NC)December 12, 2023Tabor City, NC—A very special art show is taking place next week in Columbus County. Lower Cape Fear LifeCare is helping one of its patients fulfill her bucket wish list of holding an art show. Susan Sapinsley worked as a graphic artist and journalist throughout her life and wants the opportunity to share her life’s work during a showing of her work. 

Thrice-rebuffed suitor StoneBridge Healthcare is once again involved in a bid to buy Tower HealthPhiladelphia Business JournalDecember 12, 2023Bucks County-based hospital turnaround firm StoneBridge Healthcare is taking yet another stab at Tower Health, this time potentially entering into a management contract with an affiliated nonprofit organization that is interested in acquiring the Berks County health system. The nonprofit, called WoodBridge Inc., was expected to send Tower Health a non-binding agreement in principle Tuesday morning under which it would purchase substantially all of Tower’s assets for $706 million. 

Long-term care deal volume down as 2024 approachesMcKnight’s Senior LivingDecember 13, 2023As long-term care operators prepare for 2024, the volume of senior living and care deals is down, Paul Branin, vice president of business development at management and consulting firm Health Dimensions Group, said Tuesday. He was one of the experts who during a webinar shared predictions of trends that will shape aging services providers in the coming year. 

Aveanna Healthcare Appoints Matt Buckhalter as New CFOHospice NewsDecember 11, 2023Aveanna Healthcare Holdings Inc. has appointed Matt Buckhalter as its new CFO effective Jan 1. Buckhalter has served as CFO in an interim capacity since July 2023, when his predecessor, David Afshar, left the company. Afshar moved on to pursue “other opportunities,” and his departure was not a result of any disagreements with Aveanna management, policies or practices, the company indicated in a press release. ... Buckhalter joined Aveanna in 2016 ...

Best Buy to expand health offerings with new partnerModern HealthcareDecember 11, 2023Best Buy plans to expand its healthcare offerings through a new partnership with Biobeat, a remote patient monitoring company. The partnership is the latest effort by the retailer’s Best Buy Health unit to bolster its at-home health strategy. Best Buy Health aims to provide the technology side of at-home care through its Current Health subsidiary, which Best Buy acquired in 2021 for $400 million. ... Terms of the partnership were not disclosed. ... Biobeat allows patients to remotely view several health metrics, including cuffless blood pressure, pulse rate, respiratory rate, blood oxygen saturation, stroke volume and cardiac output through wearable devices. 

Hospices face ‘existential threat’ amid budget fearsBBCDecember 11, 2023Hospices in the north of England face an “existential threat” due to a “funding crisis”, according to a hospice leader. Paul Marriott, chair of Hospices North East and North Cumbria, said all of its members were running budget deficits. He warned hospices may have to make staffing cuts without more funding. ... Hospices receive most of their funding from charitable donations, but get some some from the NHS [National Health Service] too. The average adult hospice receives about a third of its income from the NHS, according to charity Hospice UK. Paul Marriott said all members of the Hospices North East and North Cumbria group were running budget deficits. ... He said: “I do think it is an existential threat. Every hospice is drawing on reserves currently and that’s not sustainable.” Hospices could close or make serious staffing cuts next financial year without more funding, he added.

Study uncovers racial inequalities in hospice utilization, length of stayMcKnight’s Home Care DailyDecember 12, 2023Blacks and Hispanics are less likely to use hospice services, and those who do often have shorter lengths of stay than white patients, according to a new study published in JAMA Health Forum. ... Minority patients also generally experienced shorter hospice lengths of stay. Hispanic patients in particular were more than twice as likely to stay in hospice care for seven days or less, compared to the average white Medicaid beneficiary. Still, short length of stay was relatively common across the board at about 40%, which suggests “room for improvement in referring all Medicaid recipients to hospice earlier in the course of terminal illness,” the study’s authors wrote. As to possible reasons for these disparities, the researchers noted that language barriers, mistrust of hospice programs or cultural differences might be at play. But also, the inequity might also reflect “potential racial biases that affect who a physician is more likely to refer to hospice,” according to the study. Specific, targeted efforts to encourage hospice services for Medicaid and dual-eligible beneficiaries who show low rates of utilization may help to overcome these disparities.

Fix needed now—America’s long-term care financing system is brokenBy Katie Smith SloanThe HillDecember 11, 2023Nonprofit providers of aging services have been warning for decades that America’s system for financing long-term care is dangerously broken. The dedicated professionals serving older adults in nursing homes, home health agencies, hospice programs, and senior living communities have toiled side-by-side with families across the country to cobble together care and services for parents, friends, and neighbors—connecting the tattered pieces of our patchwork long-term care system in an effort to ensure dignity, comfort and independence as the needs of our loved ones change. The New York Times KFF Health News’ series “Dying Broke” aptly illustrates the impact of the United States’ insufficient approach to financing of long-term services and supports. It’s an important and unflinching look at how our country is failing us. ... We can do better. A comprehensive and equitable long-term care financing system would make all the difference. The longer lives that many Americans will enjoy offers enormous potential for our nation. We must seize this opportunity and ensure that potential isn’t squelched by an oppressive and unfair long-term care financing system. The solutions are complicated—but smart approaches abound. The variable is political will. ... I urge our leaders to listen to the voices of their constituents, and join us in creating solutions. All of our futures depend on it.

‘Hospice is more about living better’ transitional care director says of misunderstood programTribune-Review (Pittsburgh, PA)December 11, 2023... There is an assumption a patient entering hospice care is not expected to live beyond six months, a guideline that is tied to Medicare coverage. But the experience of individual patients can vary widely, as evidenced by [senior living residents] the Pattersons [Robert, 97, and Joyce, 90,] and by former president Jimmy Carter and his late wife, Rosalynn. Like many who elect to receive hospice care, Rosalynn Carter entered the program toward the very end of her life—just days before her death Nov. 19, at 96. But it’s also possible for patients to beat the odds and have hospice care extended. Jimmy Carter was 98 when he entered hospice in February and continues to endure. 

Passions run high during hospice talksDaily Gate City (Keokuk, IA)December 12, 2023Keokuk, IA—Emotions ran high as Lee County Supervisors and Lee County Health Department staff discussed the future of LCHD-Hospice and home health care services at a work session Monday. Supervisor Chairman Garry Seyb said all departments and services are being scrutinized in light of the new state legislation that calls on counties to reduce general tax levies to $3.50 per $1,000 assessed property valuation. Lee County is currently at $5.85—the second highest in the state. In response, Seyb has asked all department heads to look over their budgets and list any services that are not mandated by state code, but are offered elsewhere through the private sector. 

MedPAC draws fire with draft recommendations for massive home health cut, hospice rate freezeMcKnight’s Home Care DailyDecember 12, 2023The Medicare Payment Advisory Commission offered initial recommendations for Congress to cut home health reimbursement by 7% and pause hospice payment updates in 2025. “The 2022 [home health] margins remain above 20%, higher than the long-run average of 16.8% since 2001,” Evan Christman, senior analyst at MedPAC, said during last Friday’s public meeting, according to a transcript. “Overall, these margins indicate that Medicare fee-for-service continues to pay well in excess of cost.” Part of the reason home health agencies reportedly saw margins of 22.2%, on average, according to Christman, is a decline in the number of visits per 30-day period. Since the implementation of the Patient-Driven Groupings Model in 2020, these visits have declined more than 15%; between 2021 and 2022, visits per 30 days declined 3.5%. Home health advocates were quick to dispute MedPAC’s claims. “There are many shortfalls in MedPAC’s home health margins report—starting with the fact that MedPAC’s analysis only captures a declining fraction of the Medicare home health population, ignoring that overall margins are low,” Joanne Cunningham, chief executive officer of the Partnership for Quality Home Healthcare, said in a statement. ... The Partnership and National Association for Home Care & Hospice cited poor methodology and data in the recent home health final rule, which contained a Medicare cut related to PDGM. MedPAC also recommended that Congress eliminate any payment updates for hospice providers in 2025. 

Is ‘medical aid in dying’ an ethical, moral choice?By Richard Feldman, MD, ColumnistCourier & Press (Evansville, IN)December 11, 2023One of my best friends, Jim, in South Bend died of an unusual intestinal cancer. This experience moved me to explore the issue of “medical aid in dying,” or MAID. Is MAID ethical and moral? Is it the right and justified choice for some individuals? After a time, unfortunately, Jim’s cancer progressed with a vengeance leaving him with extensive intestinal obstructions. Further chemo would be of little help, and further surgery was impossible. Toward the end, my friend couldn’t receive any real nutrition and could only tolerate water. He lost 65 pounds in 10 weeks and was essentially skin over bone. Jim was Catholic and religious. He was a splendid husband and father to his nine children. He worked hard, was responsible, and was a good citizen. He was a good man. The best. When I last saw him, I told him that I envied both his courage and his faith. Jim had no doubt that in passing, he was entering the next phase of his life and that he would be with God. Jim’s character and faith sustained him. His religious beliefs would not allow him to consider anything but a natural death. So, he never would have considered MAID. And of course, it’s not legal in Indiana. ... Although unmanageable symptoms despite optimal hospice care is a reason to utilize MAID, autonomy and maintaining dignity are the primary reasons MAID is chosen. These patients want control, without dependence on others for care. ... MAID is controversial, but dynamic, in the medical community. ... Although it will be a long time before Indiana considers MAID legislation, the majority of the Americans support MAID for terminal illness. Is MAID a slippery slope, an unconscionable act, or a caring act of compassion? Difficult questions.