Literature Review

From doctor to family: Witnessing both sides of end-of-life care MedPage Today's KevinMD.com, by Jessica Bloom, MD; 3/27/24We all have those moments in medicine when we know that care has become more futile. Then we do everything in our power to educate, support, gently guide, and give permission to patients and families. There are moments that treating for a cure goes against our tenet to “first do no harm.” ... Specialists and his regular physicians sat with us, listened to my family’s questions, and offered kindness along with medical advice. They gently helped my siblings let go of futile searching for treatments. ...

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

The absolute heart of loyalty is to value those people who tell you the truth, not just those people who tell you what you want to hear. In fact, you should value them most. Because they have paid you the compliment of leveling with you and assuming you can handle it. - Pat Summitt, Head Coach, University of Tennessee Lady Volunteers (1974-2012)

Enhancing interoperability in home health and hospice careMcKnights Home Care, by Tim Smokoff; 3/26/24In the dynamic realm of home health and hospice care, the seamless flow of information across care settings stands as a crucial element for ensuring quality patient outcomes and efficient workflows. Recent advancements in electronic health record (EHR) solutions within this sector have not only fostered enhanced care-team collaboration, but have also addressed challenges posed by evolving reimbursement models and workforce shortages.

20 states facing acute nursing shortages Becker's Hospital Review, by Kelly Gooch; 3/25/24 ... On March 1, Medical Solutions, a healthcare staffing company, released the 20 states where nurses are needed the most based on the most current nurse-to-state population ratios and projected need by 2030. Ratios in the report were from Census and Bureau of Labor Statistics data published in NurseJournal. Projected need by 2030 is from Projections Central, a site sponsored by the Labor Department. Here are the 20 states where nurses are needed the most, per the Medical Solutions article: ... 

Medicare, Medicaid made $100B in improper payments in 2023 Becker's Hospital Review - Legal & Regulatory Issues, by Andrew Cass; 3/27/24 The federal government reported an estimated $235.8 billion in improper payments in fiscal year 2023, with more than $100 billion coming from Medicare and Medicaid, according to a March 26 report from the U.S. Government Accountability Office. The $235.8 billion in improper payments reported by 14 agencies across 71 programs is a decrease from the $247 billion reported in 2022, but the figure remains higher than pre-pandemic levels, according to the report. 

How healthcare AI is regulated by the FDA, HHS, state laws Modern Healthcare, by Gabriel Perna; 3/26/24 Widespread oversight of artificial intelligence in healthcare is still a work in progress but that doesn’t mean the technology is completely unregulated. ... There are areas where developers, providers and insurers are regulated in how they use AI. Federal agencies like the Food and Drug Administration and Health and Human Services Department have some oversight authority. Also, a few states have enacted laws governing use of AI within clinical care.

Home care unionization efforts beginning to tick back up Home Health Care News, by Andrew Donlan; 3/25/24 The home care workforce has traditionally been a tough one to organize. But efforts have ramped up over recent years, leading to more workers opting into unions across the country. Recently, University of Rochester Medicine Home Care (URMHC) workers “overwhelmingly” chose to join a labor union. They aligned themselves with 1199SEIU United Healthcare Workers East, which is one of the largest health care worker unions in the country. 

Fall prevention for the elderly: 13 strategies to keep them safe U.S. News & World Report, by Claire Wolters, ed. by Christine Comizion, MPH; 3/26/24Falls are the leading cause of injury in adults 65 and older – with reports showing about 14 million adults fall each year, according to the Centers for Disease Control and Prevention. ... According to the CDC, falls are also the leading cause of injury-related death in the 65-and-older population – and the fall death rate is growing.Here's what to know about what increases risk for falls in older adults, and get familiar with fall prevention tips and safety measures that can help reduce the risk.Editor's Note: This U.S. News article primes the pump. Preventing falls matters especially for vulnerable hospice patients as their disease progresses, and as they and/or family want the person to be as mobile as possible. What do your Incident Reports tell you about falls? What falls-specific education do you provide for your interdisciplinary teams? On-call staff? Family caregivers? Volunteers? What QAPI programs have addressed falls? 

Hospice nurse plays instrumental role in patient’s joyCity Sun Times, by Lin Sue Flood; 3/27/24You see it at every symphony performance - people so enraptured by the music that their eyes close and their fingers dance in the air. Stuart Brown is one of those people. But as illness began to limit his mobility, the 81-year-old relinquished the thought of ever attending a live concert again. That’s when his Hospice of the Valley nurse secretly reached out to the Phoenix Symphony with a request to hold a small private concert in his Scottsdale home. “We absolutely can make this happen for him and his family,“ said Valerie Bontrager, director of community engagement. Editor's Note: Need some inspiration? Read this heart-warming story.

Fiscal Year (FY) 2025 Hospice Payment Rate Update Proposed Rule (CMS-1810-P)CMS email; 3/28/24The FY 2025 hospice payment update percentage is 2.6% (an estimated increase of $705 million in payments from FY 2024). ... The proposed FY 2025 rates for hospices that do not submit the required quality data would be updated by the proposed FY 2025 hospice payment update percentage of 2.6% minus four percentage points, which results in a -1.4% update. ... The proposed hospice cap amount for the 2025 fiscal year is $34,364.85 (FY 2024 cap amount of $33,494.01 increased by the FY 2025 hospice payment update percentage of 2.6%). The proposed rule can be viewed at the Federal Register at https://www.federalregister.gov/public-inspection.

How home-based care providers are leveraging palliative care in hospital partnerships Home Health Care News, by Patrick Filbin; 3/26/24 Oftentimes, talks between home health providers and their many referral partners are an exercise in education. For providers offering palliative care, that education usually starts at a 101-level. Part of that conversation with hospital and health system partners includes convincing case managers that patients will be better suited at home. Editor's Note: Features Choice Health at Home CEO David Jackson; Kaiser Permanente Senior Director of Care Hospice and Palliative Care Gina Andres

The burden of getting medical care can exhaust older patients Navigating Aging, by Judith Graham; 3/27/24 [Ishani Ganguli] is the author of a new study showing that Medicare patients spend about three weeks a year having medical tests, visiting doctors, undergoing treatments or medical procedures, seeking care in emergency rooms, or spending time in the hospital or rehabilitation facilities. ... [Additionally,] more than 1 in 10 seniors, including those recovering from or managing serious illnesses, spent a much larger portion of their lives getting care — at least 50 days a year. ... When [treatment burden becomes overwhelming], people stop following medical advice and report having a poorer quality of life, the researchers found.