Literature Review

2 Ketamine palliative care projects explore interdisciplinary collaborationHospice News; by Holly Vossel; 6/29/24Two ketamine-assisted therapy projects are examining ways to develop training and collaboration models for utilization among palliative care patient populations. A growing body of research is uncovering the potential benefits of ketamine therapies to help with symptom management. But greater understanding of the drug and its impacts is needed to help palliative care providers and other health professionals guide patient experiences, according to Dr. Michael Fratkin, board president of the Institute for Rural Psychedelic Care. Fratkin is also a palliative care specialist at Humboldt Center for New Growth.

Advanced practice providers have an important role in kidney supportive care Healio; by Christine Corbett, DNP, FNP-BC, CNN-NP, FNKF; 7/15/24For more than 2 decades, nephrologists and patients have recognized the key role nephrology advanced practice providers have played in the care of patients with chronic kidney disease. ... With its attention to the psychosocial and spiritual aspects of care in addition to the physical, it is expected that nephrology nurse practitioners would also play a major role in the palliative care for patients with kidney disease. ... As part of the kidney care team, APPs [advanced practice practitionsers] educate patients about kidney failure treatment options, including palliative dialysis and active medical management without dialysis. Also, nurse practitioners have been noted to play a significant role in the palliative care skills of goals-of-care conversations, advance care planning and Portable Orders for Life-Sustaining Treatment (POLST, or similar term depending on the state) completion.

Fifth of UK hospices cutting services amid funding crisis, finds report The Guardian, UK; by Andrew Gregory; 7/16/24 One in five hospices in the UK are cutting services amid the worst funding crisis in two decades, a report has warned, with soaring numbers of patients being pushed back into the NHS. Research by Hospice UK found “small and wildly varying” state funding had failed to keep pace with growing demand and rising running costs. That means inpatient beds are being cut, staff made redundant and community services restricted, with fewer visits to dying patients in their own homes, according to the charity, which represents more than 200 hospices across the country.

AccentCare unveils new hospice care center in Miami-Dade County accentCare, Miami, FL; 7/10/24 AccentCare, a nationwide leader in home health, hospice and personal care services, ... announced the opening of a new inpatient hospice center in Miami. Expanding its footprint in South Florida, AccentCare’s new facility aims to address the region’s diverse population and growing need for greater access to personal and high-quality hospice care. “We are thrilled to expand our presence in the Miami area, offering compassionate and personalized hospice care for more patients and their families in Florida’s diverse communities,” said Andy Johnston, President of Hospice & Personal Care Services, AccentCare. ... AccentCare’s new 30,000-square-foot hospice center offers a range of services, including nursing care, pastoral care, medical social work, respite services, 24-hour critical home care and bereavement support for families. 

Rural hospitals built during Baby Boom now face Baby Bust KFF Health News; by Tony Leys; 7/15/24 ... Many of the U.S. hospitals that are now dropping obstetrics units were built or expanded in the mid-1900s, when America went on a rural-hospital building spree, thanks to federal funding from the Hill-Burton Act. “It was an amazing program,” said Brock Slabach, chief operations officer for the National Rural Health Association. “Basically, if you were a county that wanted a hospital, they gave you the money.”Editor's Note: Mark Cohen has discussed the Hilburton Act with Chris Comeaux in their monthly TCN podcasts. Closures of rural hospital services continue to increase, impacting end-of-life care awareness, referrals, and utilization throughout our nation's rural areas. 

Senior CommUnity Care of NKY Program announces opening of PACE senior care program Northern Kentucky Tribune; 7/16/24 Senior CommUnity Care of Northern Kentucky is celebrating the opening of the Program of All-Inclusive Care for the Elderly (PACE) serving eligible participants residing in Northern Kentucky — including Boone, Campbell, Kenton, Gallatin, Carroll, Owen, Grant and Pendleton counties. ... Senior CommUnity Care of Northern Kentucky is a partnership of Volunteers of America National Services (VOANS) PACE Holding Company, a recognized PACE operator, and St. Elizabeth Healthcare.

Mayo Clinic Minute: How extreme heat, humidity affect your health News Tribune; by Tribune News Service; 7/16/24 Many parts of the U.S. continue to grapple with oppressive heat and humidity. This can prevent the body from cooling down, increasing the risk of heat cramps, exhaustion and heatstroke. Dr. Jesse Bracamonte, a Mayo Clinic family medicine physician, said the extreme heat and high humidity can be a dangerous mix. "High heat and high humidity can place one at risk for serious illness if people aren't careful. The heat can affect people's bodies by increasing the core body temperature and ability to sweat, and cause dehydration that can cause further medical problems and ensuing issues, and eventually can lead to heat exhaustion, in some cases, severe heat illness, known as heatstroke," Bracamonte said. Editor's Note: What information and support are you providing for your clinicians who travel between visits and for your patients who might be affected by extreme heat and humidity? What simple, practical adaptations might you create, like disposable water bottles for staff as they leave your building (with a sign of support and basic info)?

Glitzy Scottsdale couple jailed in $900M fraud Gilbert Sun News; by Tom Scanlon; 7/14/24 ... According to a federal indictment, “Alexandra Gehrke and Jeffrey King were charged for targeting elderly Medicare patients, many of whom were terminally ill in hospice care, for medically unnecessary wound grafts.” Gehrke – known to friends and associates as “Lexie” – and King allegedly filed $900 million in fraudulent claims, pocketing “$330 million in illegal kickbacks as a result of their fraudulent scheme.” According to the indictment, they were responsible for “allograft” bandages being applied frivolously to hundreds of patients, many of them dying. According to Gehrke’s LinkedIn profile, “APEX Medical is a national medical device distribution company. 

Lewiston community honors shooting and hospice victims with butterfly release celebration CBS WGME TV13, Lewston, Maine; by Aysia Reed; 7/13/24 Hundreds of butterflies took flight in Lewiston on Saturday for the 15th annual Butterfly Release Celebration hosted by Andwell Health Partners.  Hundreds of names were read off Saturday at the Geiger Elementary School in Lewiston to honor those who have died in hospice. And this year the names of Lewiston mass shooting victims were honored too. The event is put on by Andwell Health Partners, a Maine healthcare nonprofit providing services for hospice patients and their families. Once names were read, one thousand monarch butterflies were released- a symbol of transformation and hope.Editor's Note: On October 25, 2023 in Lewiston, Maine, 18 individuals died and and 13 others were injured by a shooter at a bowling alley and restaurant.   

Palliative care training initiative launches to improve quality among incarcerated populations Hospice News; by Holly Vossel; 7/12/24 The California Department of Corrections & Rehabilitation’s Medical Facility (CMF) has launched a new palliative spiritual care training program aimed at improving services for incarcerated individuals. The new two-week spiritual training program was recently provided to palliative care service workers and volunteers to assist CMF’s clinical and nursing staff caring for patients at the facility’s hospice, correctional treatment center and memory care units. A dozen trainees recently completed the program, with CMF planning to provide an annual refresher course to all of its palliative care service workers, according to California Correctional Health Care Services CEO Joseph Garland. 

The Medicare Post-Acute Care and Hospice Provider Public Use File (PAC PUF)CMS press release; 7/10/24[This file] provides information on services provided to Medicare beneficiaries by home health agencies (HHAs), hospices, skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).  It contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, submitted charges, and payments at the provider, state, and national levels.  Additionally, the PAC PUF includes payment information at the case-mix grouping level for HHAs, SNFs, and IRFs.

Cherokee nation: Closing gap in health care disparities Native News Online; by Churck Hoskin, Jr.; 7/14/24 ... American Indians in Oklahoma die on average 17 years earlier than their non-Indigenous neighbors. While this finding is alarming, it comes as no surprise to the Cherokee Nation or to the nearly 40 other tribal nations in Oklahoma. ... Even as we continue our advocacy efforts, we cannot afford to wait for the federal government to fulfill its responsibilities. That's why the Cherokee Nation, which operates the largest Native American health care system in the country, is taking unprecedented steps to address this crisis head-on. ... [We] are confident our historic investments in health care and wellness are improving health outcomes for our Cherokee citizens. Construction continues on the Cherokee Nation’s new $400 million, 400,000-square-foot state-of-the-art hospital being built in the capital city of Tahlequah. The new hospital will include an ER, surgery, ICU, imaging, pharmacy and lab, neo-natal ICU, hospice, dietary and acute care, and many other services. 

Hospice CARES Act would update medical reviews, seek to reduce audits Hospice News; by Jim Parker; 7/12/24 The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Rep. Earl Blumenaur (D-Oregon), if enacted, would implement a number of changes to medical review processes. ... Though the bill language is still in development, it will likely contain proposed updates to payment mechanisms for high-acuity palliative services, changes to the per-diem payment process and actions to improve quality and combat fraud. The bill would also implement a temporary, national moratorium on the enrollment of new hospices into Medicare, to help stem the tide of fraudulent activities among recently established providers concentrated primarily in California, Arizona, Texas and Nevada. ... Among the anticipated provisions of the bill would be an item requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to use documentation in a patient’s medical record as supporting material. The documentation would include the reasons that an attending physician certified a patient for hospice and establish a six-month terminal prognosis.