Literature Review

State-level initiatives tackle language-based barriers to worker training, testing McKnights Senior Living; by Kimberly Bonvissuto; 5/20/24Foreign-born workers account for 27% of the nation’s direct care workforce, but many states maintain strict, English-only testing and training requirements that can prevent some immigrants from entering the workforce, according to the results of a new analysis. PHI looked at five state initiatives working to address those language-based barriers to workforce training and certification with a goal of expanding opportunities for workers who do not speak English as their primary language. PHI highlighted initiatives in five states — California, Massachusetts, New York, Washington and Wisconsin — using approaches deemed innnovative to make progress in addressing language access barriers for direct care workers. [Click on the title's link for solutions these five states are using.]

Healthcare sees highest Chapter 11 bankruptcy filings in 15 years: reportMcKnights Senior Living; by Kathleen Steele Gaivin; 5/20/24Chapter 11 bankruptcies in healthcare, including senior living reached a multiyear high in the first quarter of 2024. That’s according to the newest Polsinelli-TrBK Distress Indices Report, published Wednesday. “We continue to see intense stress in senior living,” Jeremy R. Johnson, a bankruptcy and restructuring attorney at Polsinelli and co-author of the report, said in a press release issued in conjunction with the report. ... The Southeast continues to outpace the rest of the country as the busiest region for bankruptcy filings, according to the report. The Southeast region reported 33.4% of the filings in the first quarter, followed by Northeast and Delaware at 30.8% and 16.1%, respectively. Since the benchmark period of 2020, the Northeast has shown the biggest increase in filings.

Vitas’ acquisition pipeline likely growing Hospice News; by Jim Parker; 5/15/24 Vitas Healthcare, a subsidiary of Chemed Corp. is gearing up for potential acquisitions. ... VITAS is targeting its home state of Florida and other Certificate of Need (CON) states for potential deals, Michael Witzeman, vice president, CFO and controller at Chemed said during the Bank of America Securities Health Care Conference. “We certainly think that there’s a pipeline growing, and we have the resources on our balance sheet with cash and no debt to be able to really be a player in any of these,” Witzeman said. “We would like to be in states that have CON restrictions much more than an unrestricted state, but we certainly have the interesting inability when things come available to be able to jump on them.” ...

The human side of AI: Insights on balancing automation and empathy Innovation & Tech Today; by Enrico Palmerino; 5/20/24 ... As AI automates more tasks with clinical precision, empathy is a critical human element we cannot overlook. That intangible ability to understand and share the feelings of another isn’t just a soft skill — it’s an essential catalyst for trust, loyalty, and genuine connection. Consider the healthcare industry, where empathy is (quite literally) often a matter of life and death. Can an AI-powered diagnostic system truly grasp a patient’s fear and vulnerability when facing a serious illness? ... Finding the delicate balance between leveraging AI automation and preserving human empathy is the new challenge before us. It’s a duality that will shape how businesses operate and how we interact with technology. ... Let the machines optimize processes while we optimize the ability to connect and inspire. In this harmonious future, AI is a tool that elevates us — not replaces us.Editor's Note: Is AI a hot topic among your leaders and interdisciplinary clinicians? Often, "empathy" and "communication" are cited as key cautions and conflicts. See the previous article, "Nurses don't trust employers to safely implement AI tools, survey shows."

Psychological trauma can worsen symptom burden at end-of-life Hospice News; by Holly Vossel; 5/15/24 Recent research has found that traumatic experiences can lead to increased pain and symptom burden at the end of life, along with a greater likelihood of emotional suffering and isolation. Collective trauma experiences have been associated with higher instances of pain and dyspnea among more than half of seniors nationwide, a recent study found, published in the Journal of Pain and Symptom Management. Traumatized seniors are also more likely to experience loneliness, dissatisfaction with their life and depression. ... Hospices need a greater understanding of both the depth of these patients’ suffering and the scope of their unique needs to improve trauma-informed care delivery, [Dr. Ashwin] Kotwal said, assistant professor of medicine at the University of California San Francisco’s (UCSF) Division of Geriatrics.

A Review of "Heartwood: The Art of Living with the End in Mind" by Barbara Becker CU Anschutz; by Darcy Campbell, AGNP-D, ACHPN; 5/14/24 This year, one of our [small group] readings was the book, Heartwood; The Art of Living with the End in Mind, by interfaith pastor Barbara Becker. The book is composed of small vignettes from her life that explore death and dying. Many of her experiences as a hospice volunteer are captured as well. Her book was to be about death, but she learned that in writing about death she really explored what it means to live. Heartwood is the inner core of a tree. While dead it does not decay as it is supported by the outer living rings of the tree. Becker, describes Heartwood as the ideal metaphor for our life, “where life and death cannot exist separately from each other.” ... Working in palliative care, we too are forced to look at our own mortality.

Breaking down walls: The other care models marking their territory in home-based careHome Health News; by Joyce Famakinwa; 5/17/24Traditional home-based care companies aren’t the only ones serving seniors, while helping shift care away from brick-and-mortar settings. Adult day, PACE and continuing care retirement communities (CCRCs) without walls are a few of the care models working to meet the needs of seniors that want to age in place. In many ways, these care models are natural allies to home-based care providers.

Emerging leaders in hospice and palliative care AAHPM - American Academy of Hospice and Palliative Medicine; webpage source for various press releeases of individuals; 5/24AAHPM developed the Emerging Leaders in Hospice and Palliative Care program to recognize the exceptional work accomplished by the next generation of leaders and bring increased exposure to the specialty of hospice and palliative medicine. In 2014, the first class of Emerging Leaders was named. AAHPM seeks to recognize accomplished early career professionals and the next generation of hospice and palliative care leaders. This award recognizes new Emerging Leaders in recognition of their career accomplishments, involvement in the Academy, mentoring of residents and students, and participation in charitable work. [Click on the title's link for the list of 36 honorees.]Editor's Note: Do you work with or know any of these honorees? If so, please share this with them and your colleagues, along with congratulations from Hospice & Palliative Care Today! (Invite them to register for free--no strings attached--to our daily newsletter.)

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

Did COVID-19 ICU patient mortality risk increase as Colorado hospitals filled? A retrospective cohort studyBMJ Open; by David R Johnson, Debashis Ghosh, Brandie D Wagner, Elizabeth J Carlton; 5/24Overall, and especially during the Delta era (when most Colorado facilities were at their fullest), increasing exposure to a fuller hospital was associated with an increasing mortality hazard for COVID-19 ICU patients.

Physician Group Practices Accrued Large Bonuses Under Medicare’s Bundled Payment Model, 2018–20Health Affairs; by Sukruth A. Shashikumar, Zoey Chopra, Jason D. Buxbaum, Karen E. Joynt Maddox, Andrew M. Ryan; 5/24The Bundled Payments for Care Improvement Advanced Model (BPCI-A), a voluntary Alternative Payment Model for Medicare, incentivizes hospitals and physician group practices to reduce spending for patient care episodes below preset target prices. The experience of physician groups in BPCI-A is not well understood. We found that physician groups earned $421 million in incentive payments during BPCI-A’s first four performance periods (2018–20). Target prices were positively associated with bonuses, with a mean reconciliation payment of $139 per episode in the lowest decile of target prices and $2,775 in the highest decile. In the first year of the COVID-19 pandemic, mean bonuses increased from $815 per episode to $2,736 per episode. These findings suggest that further policy changes, such as improving target price accuracy and refining participation rules, will be important as the Centers for Medicare and Medicaid Services continues to expand BPCI-A and develop other bundled payment models.Publisher's Note: For those keeping an eye on alternative payment models...

Antipsychotics for Dementia Tied to More Serious Harms Than ExpectedJAMA; by Emily Harris; 5/24Prior research has suggested that antipsychotic drugs might be overprescribed for people with dementia, despite known risks of stroke and sudden cardiac death. Now, findings from a new study in The BMJ indicate that the range of serious adverse outcomes associated with antipsychotics in these patients might be broader than previously thought.

An age group comparison of concurrent hospice care: A cost-effectiveness analysisJournal of Hospice and Palliative Nursing; by Radion Svynarenko, Melanie J Cozad, Lisa C Lindley; 5/24This study