Literature Review
1st state passes law to decriminalize medical errors
04/29/24 at 02:15 AM1st state passes law to decriminalize medical errors Becker's Hospital Review; by Erica Carbajal; 4/25/24Kentucky Gov. Andy Beshear recently signed a bill into law that shields healthcare providers from being criminally charged for medical errors, making it the first state to do so. HB 159 ensures that healthcare providers, including nurses, "shall be immune from criminal liability for any harm or damages alleged to arise from an act or omission relating to the provision of health services." It includes exceptions for negligence and intentional harm. ... In wake of [this article's cited] case, nurses and medical groups nationwide — including the American Nurses Association and the Institute for Healthcare Improvement — have called for systemwide workforce and safety reforms to focus on harm prevention, arguing that the criminalization of errors would discourage workers from reporting mistakes. ... The Kentucky Hospital Association said it supports the new law.
Palliative care’s value-based future
04/29/24 at 02:00 AMPalliative care’s value-based future Hospice News; by Jim Parker; 4/24/24 Many believe that the fee-for-service model does not sufficiently support a robust palliative care program, meaning that providers must turn to value-based systems for sustainable reimbursement. But primarily, Medicare still reimburses for palliative care through fee-for-service payment programs that cover physician and licensed independent practitioner services. That model does not sufficiently cover the full range of interdisciplinary care, Dr. Julia Friedman, palliative care medical director at Thyme Care, said at the Home Health Care News Cap+Strat Conference.
The Dos and Don’ts of enhanced service contracts
04/29/24 at 02:00 AMThe Dos and Don’ts of enhanced service contractsSpecialty Pharmacy Continuum; by Marcus A. Banks; 4/25/24 ... Any pharmacy that interacts with patients—an independent pharmacy, an ambulatory infusion clinic, a health system or specialty pharmacy—can enter an enhanced service contract with a pharmaceutical company. All services offered under these contracts should be documented, auditable and offered at fair prices. Before approaching the company about partnering, Mr. Suchanek advised understanding the distinction between basic and enhanced services. ... “Pharmacy leaders need to demonstrate that they are credible partners,” [David] Suchanek said [Executive Vice President for Biotech & Specialty Services at D2 Solutions].
Across the nation, the fight’s on to protect physician-led care
04/29/24 at 02:00 AMAcross the nation, the fight’s on to protect physician-led careAmerican Medical Association - AMA; by Kevin B. O'Reilly; 4/25/24After helping state medical associations and national specialty societies defeat more than 100 bills to inappropriately expand nonphysicians’ scope of practice in 2023, the AMA is again relentlessly joining its allies in organized medicine to continue the fight for physician-led, team-based care in this year’s legislative session. This intensive and effective advocacy effort has ranged across the country, as the AMA has helped battle scope creep in Alaska, Connecticut, Georgia, Oklahoma, New Hampshire and elsewhere.
Hospice fraud must be stopped!
04/29/24 at 02:00 AMHospice fraud must be stopped!Hospice Action Network; via email; 4/26/24Across multiple states, the same story is playing out: Criminals are defrauding Medicare, getting licensed and certified to operate as hospices when they have no intent of providing care. This flagrant abuse of vulnerable patients and our healthcare system must be stopped in its tracks. We need your help! Ask your representatives to support a letter demanding answers from CMS. We need as many signatures as possible to keep the pressure on CMS.Take action today!
Home care industry slams finalized 80-20 Rule, warns agency closures are coming
04/28/24 at 03:45 AMHome care industry slams finalized 80-20 Rule, warns agency closures are coming Home Health Care News; by Andrew Donlan; 4/22/24 The “Ensuring Access to Medicaid Services” rule has been finalized. Most importantly, the bemoaned “80-20” provision has gone through as proposed, meaning providers will eventually be forced to direct 80% of reimbursement for home- and community-based services (HCBS) to caregiver wages. ... Organizations like the National Association for Home Care & Hospice (NAHC) and LeadingAge immediately condemned the rule being finalized on Monday. ...
Breaking News: Labor Department announces final overtime rule
04/28/24 at 03:40 AMBreaking News: Labor Department announces final overtime rule McKnights Senior Living; by Kimberly Bonvissuto; 4/23/24 The Department of Labor on Tuesday announced a final rule that expands overtime protections to millions of salaried workers beginning this summer. The overtime rule increases the salary thresholds necessary to exempt a salaried executive, administrative or professional employee from federal overtime pay requirements. Effective July 1, the salary threshold will increase to the equivalent of an annual salary of $43,888 and will increase to $58,656 on Jan. 1. The July 1 increase updates the current annual salary threshold of $35,568, which is based on a 2019 overtime rule update.
Hospice boss warns of funding challenges
04/28/24 at 03:35 AMHospice boss warns of funding challenges BBC News; Josh Sandiford; 4/28/24[United Kingdom] A West Midlands hospice boss has warned it faces a "huge challenge" under the current funding model. Acorns Children's Hospice, which is based in Birmingham, told the BBC the situation was not sustainable despite demand for its services growing. It came after Hospice UK said there was a £77m funding deficit at centres across the UK. Editor's Note: We highlighted this recurring theme from the United Kingdom in posts on 4/16/24 and 4/17/24 in our "International" section. Pairing this critical, ongoing financial crisis with our article on 4/19/24, "Will Assisted Dying in Europe Impact Living With Dignity?", how might these potential losses of effective hospice care impact patients' desires for assisted dying? What similar trends are we seeing in the United States?
Kisco Senior Living data breach could affect more than 26,000
04/28/24 at 03:30 AMKisco Senior Living data breach could affect more than 26,000 McKnights Senior Living; by Lois A. Bowers; 4/22/24 More than 26,000 Kisco Senior Living residents and others could have been affected by a June hacking incident, legal counsel for the company said last week. The Carlsbad, CA-based operator, which manages 25 senior living communities across eight states and Washington, DC, said in an April 16 letter to those potentially affected that the data breach occurred around June 6. Names and Social Security numbers could have been revealed in the incident, according to counsel.
States lack resources to support new Medicaid waiver programs, association asserts
04/28/24 at 03:25 AMStates lack resources to support new Medicaid waiver programs, association asserts McKnights Home Care; by Adam Healy; 4/22/24Medicaid 1115 waivers, which are commonly used to improve or expand home- and community-based services, face serious challenges as understaffed state programs are increasingly incapable of moving proposals through the administrative “pipeline,” the National Association of Medicaid Directors said in a recent letter. “The tough reality is that the Center for Medicaid and CHIP Services, which has taken many steps to streamline its administrative processes, simply does not have the staff resources to move forward all of the waivers in its pipeline,” Kate McEvoy, executive director of NAMD, wrote in the letter.
New York State Bar Association backs expansion of end-of-life-options
04/28/24 at 03:20 AMNew York State Bar Association backs expansion of end-of-life-options Brooklyn Daily Eagle - Courts and Law; by Robert Abruzzese; 4/23/24 The New York State Bar Association (NYSBA) has endorsed the Medical Society of the State of New York's recent support for medical aid in dying. ... The proposed New York bill (A995a/S2445), which will be considered in the 2024 legislative session, includes comprehensive safeguards to ensure that the process is voluntary, informed and free from coercion. These include the confirmation of terminal illness by two independent physicians, mandatory mental health evaluations if needed and detailed counseling on all available end-of-life care options. ...
Remote access technologies expose home care firms to cybersecurity vulnerabilities, experts say
04/28/24 at 03:15 AMRemote access technologies expose home care firms to cybersecurity vulnerabilities, experts sayMcKnights Home Care; by Adam Healy; 4/18/24 Some of the most commonly used technologies in home care are also among the easiest for criminals to exploit. ... Remote access systems include any technology that allows users to connect to and access a computer, server or network remotely. Within home care, this could be tools such as remote patient monitoring devices, secure messaging apps, telehealth platforms, cloud-based applications or systems that allow users to remotely access patient data, according to the Department of Health and Human Services. And while these technologies bring efficiency, they can also expose providers and their patients to risk.
CMS increases hours to 3.48 in final staffing rule
04/28/24 at 03:10 AMCMS increases hours to 3.48 in final staffing rule McKnights Long-Term Care News; by Kimberly Marselas; 4/22/24 Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning. A White House statement on the rule [4/22] said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.
Extra: CMS publishes rule outlining final staffing requirements
04/28/24 at 03:05 AMExtra: CMS publishes rule outlining final staffing requirements McKnights Long-Term Care News; by Kimberly Marselas; 4/22/24 The Centers for Medicare & Medicaid Services said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances,” unveiling a critical new detail in the second part of today’s staffing rule rollout. A director of nursing also can count toward the rule’s 24/7 RN requirement, CMS said, noting a change that providers will likely appreciate given their persistent challenges hiring RNs across the country. “The RN onsite 24 hours a day, seven days a week requirement ensures that there is an RN available to help mitigate, and ultimately reduce, the likelihood of preventable safety events, particularly during evenings, nights, weekends, and holidays,” CMS said. ...
Examining how improper payments cost taxpayers billions and weaken Medicare and Medicaid
04/28/24 at 03:00 AMExamining how improper payments cost taxpayers billions and weaken Medicare and Medicaid HHS-OIG; by Christi A. Grimm, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services; 4/16/24 HHS Inspector General Christi A. Grimm Testifies Before the U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations on April 16, 2024. IG Grimm briefs members on HHS-OIG's work to address improper payments in Medicare and Medicaid managed care programs. Click here to watch the testimony.
Today's Encouragement
04/28/24 at 03:00 AMPeople who have come to know the joy of God do not deny the darkness, but they choose not to live in it. They claim that the light that shines in the darkness can be trusted more than the darkness itself and that a little bit of light can dispel a lot of darkness. They point each other to flashes of light here and there, and remind each other that they reveal the hidden but real presence of God. ~Henri Nouwen, The Return of the Prodigal Son.
Sunday newsletters
04/28/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!
Textures of Black sound and affect: Life and death in New Orleans
04/27/24 at 03:00 AMTextures of Black sound and affect: Life and death in New OrleansAmerican Anthropologist; by Matt Sakakeeny; 6/24In a traditional New Orleans jazz funeral, the characteristic shift from mourning to joy is propelled by brass band musicians weaving melodies and rhythms together. This article is about how these thickly layered textures of sound elicit shared sentiments of lament and of joy.
Environmental comfort in promoting sleep in critically ill patients: A scoping review
04/27/24 at 03:00 AMEnvironmental comfort in promoting sleep in critically ill patients: A scoping review[Portugal] Dimensions of Critical Care Nursing; by Derek Braga Moura, Débora de Fátima Sousa Andrade, Carla Rodrigues Silva, Igor Emanuel Soares-Pinto; 5/24It is important to understand the concept of comfort as a whole to build an assistance intervention plan that meets the person's needs. Therefore, it is necessary to monitor and assess the person's sleep by considering the surrounding environment, to provide a comfortable environment that is quiet and provides privacy, especially in contexts of difficult management of environmental factors in the approach to the person in critical condition.Publisher's note:
Keeping life in our patients’ years toward the end of our patients’ lives
04/27/24 at 03:00 AMKeeping life in our patients’ years toward the end of our patients’ livesAnnals of Surgery; by Courtney Collins, Ronnie A Rosenthal; 5/24As surgeons we are trained, some may say indoctrinated, to care about traditional benchmarks like wound infections, the need for critical care, 30-day readmissions, and (of course) mortality. These factors are obsessively collected and analyzed looking for any and all possible opportunities to move the needle of surgical quality by even the tiniest amount (as long as it is statistically significant). To be sure, this approach has yielded vast improvements in how we care for our patients and correspondingly, surgical outcomes have continued to improve over time. This intriguing analysis by Keney et al asks us to consider that in our pursuit of perfection by standard definitions, we may be missing something even more critical: what “good” looks like from the patient’s point of view.
Time to rethink assisted dying?
04/27/24 at 03:00 AMTime to rethink assisted dying?Bioethics; by Udo Schuklenk; 5/24... But who should be tasked with the provision of such services [assisted suicide and / or voluntary euthanasia], given that it would no longer be the case that only people defined as patients would be eligible for an assisted death. Healthcare professionals might object to providing such services to people who aren't patients. Different societies could decide to introduce permissive assisted dying regimes tasking different professionals with the provision of such services. If doctors are the profession tasked with the provision of such services in a particular jurisdiction, they ought to provide it to those eligible in that society. However, it is worth considering whether a newly created assisted dying profession, that is equally tightly regulated, may be a preferable way forward.
End-of-life and palliative care for lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity older adults
04/27/24 at 03:00 AMEnd-of-life and palliative care for lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity older adultsClinics in Geriatric Medicine; by Evie Kalmar MD, MS, Jeffrey Mariano MD; 5/24Lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) people are more likely to have alternative family structures. It is important to engage in advance care planning to understand their values, clarify surrogate decision makers, and contribute to goal-concordant care at the end of life. Clinicians can follow recommendations in this article to ensure they are providing LGBTQ-inclusive palliative and hospice care.
Making end-of-life health disparities in the U.S. visible through family bereavement narratives
04/27/24 at 03:00 AMMaking end-of-life health disparities in the U.S. visible through family bereavement narrativesPEC Innovation; by Cassidy Taladay-Carter; 4/24End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. ... Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond.
Saturday newsletters
04/27/24 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
Eleology‐ A modest proposal
04/27/24 at 03:00 AMEleology‐ A modest proposalAmerican Journal of Hospice and Palliative Medicine; by Caleb Knisley, MD, Steven J. Baumrucker, MD; 6/24Words matter. This is a simple but profound truth. ... Since the titles we are known by carry so much weight, misunderstanding and misnomers can be incredibly frustrating. Practitioners of Hospice and Palliative Medicine (HPM) (more on that mouthful in a moment) are uniquely aware of this frustration. ... The name “Hospice and Palliative Medicine” is therefore not an entirely accurate representation of the specialty it represents. ... Eleos is the word for “mercy” in both classical Greek authors and the writings that make up the Greek New Testament of the Christian Bible. ... Eleology, therefore, is a fitting name for the medical specialty uniquely dedicated to relieving suffering through mercy and compassion.