Literature Review

CarePoint Health submits plans for layoffsModern Healthcare; by Hayley DeSilva; 9/18/24CarePoint Health submitted plans with New Jersey authorities to lay off more than 2,600 workers at three of its hospitals in the state. The layoffs would take effect Dec. 12, according to a Worker Adjustment and Retraining Notification notice filed with the state.

CMS revises instructions for AOs conducting initial certification surveysNAHC Report; 9/20/24... The revision clarifies initial certification processes for providers/suppliers seeking deemed status via a CMS-approved Accrediting Organization (AO). Specifically, for home health and hospice providers, the AO must not conduct an initial survey until the state agency has provided approval to the AO.Publisher's notes: 1) NAHC article may require member login; 2) CMS Admin Info: 24-22-ALL posted here.

Fraud losses among older adults reached $3.4 billion last yearMcKnight's Senior Living; by Kimberly Bonvissuto; 9/20/24The types of scams being reported to the federal government haven’t changed much from last year, but losses are on the rise, with the Federal Trade Commission reporting $10 billion in losses to consumers in 2023, $1 billion more than 2022 losses and the highest losses ever reported, according to a new fraud book. During a Thursday hearing on fighting fraud held by the Senate Special Committee on Aging, US Sen. Bob Casey (D-PA), committee chairman, released the group’s ninth annual fraud book, “Fighting Fraud: Scams to Watch Out For,” capturing the most common scams targeting older adults and resources to protect against fraud reported to various sources. FBI data show that fraud losses among older adults reached $3.4 billion in 2023, Casey said.

From pigs to payouts, weighing solutions for the US kidney shortageHealthcare Brew; by Caroline Catherman; 9/18/24About one out of every 20 people waiting for a kidney transplant die each year, according to the United Network for Organ Sharing. Scientists, policymakers, and other experts are scrambling to find a solution. Kidneys are currently the most needed organ in the country, and an ongoing crisis has left tens of thousands in limbo. As of September, nearly 90,000 people in the US are waiting for kidneys, but only around 27,000 transplants were performed in 2024, according to data from the Organ Procurement and Transplantation Network (OPTN).Publisher's note: Hospice Analytics, a Hospice & Palliative Care Today sponsor, posted this blog and has given presentations on opportunities and challenges for hospices to honor patient wishes regarding organ and tissue donation.

New red flags emerge in hospice UPIC auditing Hospice News; by Holly Vossel; 9/20/24 Unified Program Integrity Contractor (UPIC) auditors are taking a sharper look at nursing home room-and-board for hospice patients. Hospices have increasingly faced more regulatory scrutiny in recent years amid rising program integrity concerns, including ramped up UPIC audits, among various others. These audits are designed to instill oversight measures aimed at safeguarding against bad actors in the hospice industry. Regulators have been zeroing in around hospices’ data when it comes to patient interviews and Medicaid skilled nursing room-and-board payments, among other aspects of care delivery. These data could give UPIC auditors clues as to potential malfeasance. However, auditors’ data extrapolation methodology is flawed and poses risks for quality hospice providers, according to Bryan Nowicki, partner at the law firm Husch Blackwell.

Wind phones help the bereaved deal with death, loss and grief − a clinical social worker explains the vital role of the old-fashioned rotary phone The Conversation; by Taryn Lindhorst; 9/20/24 My mother died in my home in hospice in 2020, on the day my state of Washington went into COVID-19 lockdown. Her body was taken away, but none of the usual touchstones for grief were available to our family. ... As a clinical social worker and health scholar with 40 years of experience in end-of-life care and bereavement, I knew that I needed some way to tend to my grief for my mother. While in lockdown, I began looking for resources to help me. Then I heard about the wind phone. What is a wind phone? At its simplest, a wind phone is a rotary or push-button phone located in a secluded spot in nature, usually within a booth-type structure and often next to a chair or bench. The phone line is disconnected. People use the wind phone to “call” and have a one-way conversation with deceased loved ones. Here they can say the things left unsaid. Wind phones offer a setting for the person to tell the story of their grief, to reminiscence and to continue to connect to the person who is gone. For many, it is a deeply moving, life-affirming experience. About 200 wind phones are scattered throughout the United States. Editor's note: This creative tool is similar to common clinical tools of writing a letter to the deceased person, and the "Empty Chair" technique. Caution: This should never be used as a gimmick. This can be terribly confusing and upsetting for persons with dementia, or supportive if used with professional sensitivity for the patient's awareness and experience. For persons with dementia, be familiar with the ground-breaking "Validation Therapy" techniques by Naomi Feil. 

Guidelines for supporting the dying and their families Psychiatric Times; by Ken Druck, PhD; 9/19/24 There are few subjects that most of us, including those who work in mental health, avoid more than death and dying. Meeting the needs of the dying and their families requires a deep and clear understanding of competent and compassionate care for health care professionals and caregivers. Since the death of my 21-year-old daughter several decades ago, I have had the honor and privilege of helping countless individuals, families, and communities that have suffered losses. I have also been given the opportunity to teach and train mental health professionals and developed several programs and guidelines for supporting the dying and their families. My top 7 guidelines to share with patients and their families are as follows:

Families value flexibility and compassion in end-of-life care for children with cancerOncology Nurse Advisor; by Megan Garlapow, PhD; 9/18/24 Bereaved families of children who died of cancer expressed a strong desire for high-quality end-of-life care that balanced comfort with continued treatment efforts, particularly chemotherapy, according to results from a study published in Cancer. Families did not perceive a conflict between comfort care and the pursuit of chemotherapy, seeking both as integral parts of their child’s final days. Despite variations in race and location, there was no clear preference for home or hospital deaths, with the median preference score being neutral at 3.0 on a 5-point Likert scale, ... Instead, decisions surrounding the location of death were often driven by the child’s preferences, medical needs, the impact on other family members, and prior experiences with death. ... Family decision-making was centered on maintaining hope, avoiding harm, and doing what was best for their child and themselves, with religious beliefs playing a significant role.

CVS' Oak Street Health to pay $60M to settle Medicare Advantage kickback allegations Becker's Health IT; by Naomi Diaz; 9/19/24 CVS subsidiary Oak Street Health has agreed to pay $60 million to settle accusations that it violated the False Claims Act by offering kickbacks to third-party insurance agents in return for referring older adults to its primary care clinics. ... The settlement addresses allegations that, between September 2020 and December 2022, Oak Street Health knowingly submitted false claims to Medicare by offering illegal payments to agents, violating the Anti-Kickback Statute. CVS acquired Oak Street Health for $10.6 billion in May 2023. 

AI shouldn't decide who dies. It's neither human nor humane Fox News; by John Paul Kolcun and Anthony Digiorgio; 9/20/24 [Opinion] As we write this, PubMed ... indexes 4,018 publications with the keyword "ChatGPT." Indeed, researchers have been using AI and large-language models (LLMs) for everything from reading pathology slides to answering patient messages. However, a recent paper in the Journal of the American Medical Association suggests that AI can act as a surrogate in end-of-life discussions. This goes too far. The authors of the paper propose creating an AI "chatbot" to speak for an otherwise incapacitated patient. To quote, "Combining individual-level behavioral data—inputs such as social media posts, church attendance, donations, travel records, and historical health care decisions—AI could learn what is important to patients and predict what they might choose in a specific circumstance." Then, the AI could express in conversant language what that patient "would have wanted," to inform end-of-life decisions. We are both neurosurgeons who routinely have these end-of-life conversations with patients’ families, as we care for those with traumatic brain injuries, strokes and brain tumors. These gut-wrenching experiences are a common, challenging and rewarding part of our job. Our experience teaches us how to connect and bond with families as we guide them through a life-changing ordeal. In some cases, we shed tears together as they navigate their emotional journey and determine what their loved one would tell us to do if they could speak. 

Ascension posts $1.8B annual loss; liquidity 'remains strong,' CFO says Becker's Hospital CFO Report; by Alan Condon; 9/18/24 St.Louis-based Ascension reported a $79 million operating loss (-0.3% margin) for the 10 months ending April 30, a substantial improvement on the $1.2 billion operating loss in the previous 10-month period. The results include $402 million in one-time, non-cash write-downs and non-recurring losses. In May and June 2024, operations were hampered by the May ransomware attack, resulting in reduced revenues from the associated business interruption along with costs incurred to address the issues and other business-related expenses. Despite this incident, Ascension drove a $1.2 billion operational improvement year over year for the 10 months ending April 30. The 136-hospital system's economic improvement plans focused on volume growth, rates and pricing, and cost levers. 

New data explores trust gap between execs and employees HR Daily Advisor; by Lin Grensing-Pophal; 9/19/24Creating a harmonious workplace where trust flourishes between employers and employees is crucial for aligning incentives and driving employee engagement. Unfortunately, that trust is often hard to find in the business world. ... Consider, for example, these data points from the PwC survey:

How can we make dementia care more human? Practical insights for providers. CHAP - Community Health Accreditation Partner; by Jennifer Kennedy, PhD; 9/20/24 This year’s World Alzheimer’s Day brings a renewed focus on advancing dementia care, especially with the recent launch of the CMS GUIDE Model. This groundbreaking approach emphasizes comprehensive, coordinated care, not only improving the lives of patients but also significantly easing the burden on caregivers. As healthcare providers, there’s a critical opportunity to adopt strategies that go beyond clinical treatment, focusing on the human experience and addressing the emotional, physical, and financial challenges that dementia brings. ... As we reflect on the progress made in dementia care, there are several actionable strategies healthcare providers can implement to enhance their programs: