Literature Review
Report: More than one-third of nursing homes don’t have required medical director
09/09/24 at 03:00 AMReport: More than one-third of nursing homes don’t have required medical director McKnights Long-Term Care News; by Kristen Fischer; 9/3/24Though all nursing homes must have a medical director under federal law, a new study shows that some nursing homes don’t meet the requirement. Facilities that do have a medical director report that the medical director spends just a few hours per week on site, according to the study. Medical directors are charged with overseeing medical care. They manage resident care policies and procedures to align with current standards of practice, including infection control protocols, educational programs and performance reviews for healthcare workers. The report was published on [9/2/24] in the Journal of the American Geriatrics Society. The authors reviewed the practices of nearly 15,000 nursing homes in the United States, using federal Payroll-Based Journal (PBJ) data on staffing positions for the period of 2017–2023, as well as federal nursing home ownership data and deficiencies data for 2023.
Today's Encouragement: This is your Monday morning reminder ...
09/09/24 at 03:00 AMThis is your Monday morning reminder that you can handle whatever this week throws at you. ~ Anonymous
The biggest threat in health IT and RCM
09/09/24 at 03:00 AMThe biggest threat in health IT and RCM Becker's Hospital Review; by Randi Haseman; 9/6/24 Are organizations adopting AI technology too quickly or too slowly? And what's the future of payer relationships? ... As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. ... Question: What is the biggest threat in health IT and RCM right now? [Responses from 47 executives featured in this article address the following and more: payer programs; modernizing legacy systems while ensuring data security and compliance; cyber-crime / cybersecurity; relieving provider and staff burden thgouth clinical workflows; state and federal legislation; human error; Gen AI 'mission-creep'; extended systems downtimes; the velocity of technical disruption; more ...]
Providence, hospice workers agree to resolve NLRB complaint
09/09/24 at 03:00 AMProvidence, hospice workers agree to resolve NLRB complaint Becker's Hospital Review; by Kelly Gooch; 9/5/24 Renton, WA-based Providence and caregivers of Providence Hospice in Sonoma County, Calif., agreed to resolve allegations that workers were required to take on additional work and responsibilities without appropriate compensation. The agreement resolves allegations filed with the National Labor Relations Board in June 2023 by approximately 130 registered nurses, social workers and other staff at the hospice care provider, according to the National Union of Healthcare Workers. ... [Click here to read the terms.] ... Both sides agreed the deal is a win for the caregivers and for hospice. "This agreement is good for us and for the families we serve because it means instead of racing in our cars from one family to another, our agency will have to staff appropriately so we can devote ourselves fully to our patients," Kristina Nauheimer, a nurse case manager at the hospice, said in the union release.
Hospice of the Valley student volunteers gain insight into dementia
09/09/24 at 03:00 AMHospice of the Valley student volunteers gain insight into dementiaCity Sun Times [AZ]; by Lin Sue Flood; 9/4/24... Hospice of the Valley [has a] College Partners Program, an innovative collaboration with Maricopa Community Colleges, Arizona State University and other schools to provide socialization to people living with dementia and a much-needed break to family caregivers... Hospice of the Valley’s dementia and volunteer departments spearheaded this intergenerational program to help inspire careers in dementia care. Incentives include scholarship opportunities, monthly education and letters of recommendation. To date, 106 students have been trained and paired with 123 patients since College Partners launched in 2021 with a grant from Community Care Corps. Now, the program is funded by Hospice of the Valley and community donations.
Death Cafe' creates safe space to talk about death, dying and beyond in Missoula
09/09/24 at 03:00 AMDeath Cafe' creates safe space to talk about death, dying and beyond in Missoula KPAX-8 Missoula & Western Montana; by Jill Valley; 9/5/24 Sometimes, the most important conversations we can have involve topics we don’t really want to talk about — such as money, politics, or death. We recently went to have coffee with a group of people who are talking about some of life’s scariest issues. It was the last Thursday in August and about a dozen people were enjoying coffee and talking about death. This is Death Café. Maurika Moore — the CEO and owner of Hestia Advantage, a locally-owned hospice and palliative care provider — told MTN, “I think it’s something we all want to talk about but don’t often get to." The Death Café was founded decades ago. Now, there are meetings worldwide to create a safe space to talk about all aspects of death and dying. Its objective is "to increase awareness of death to help people make the most of their (finite) lives."
10 ways to improve cancer patients' transition to skilled nursing facilities: Viewpoint
09/09/24 at 03:00 AM10 ways to improve cancer patients' transition to skilled nursing facilities: Viewpoint Becker's Hospital Review; by Elizabeth Gregerson; 9/5/24Physicians from the New York City-based Memorial Sloan Kettering Cancer Center have shared insights on how to better manage care when an oncology patient transfers from the hospital to a skilled nursing facility setting. ... The authors are oncologist Daniel Lage, MD, palliative care physician Craig Blinderman, MD, and emergency medicine physician Corita Grudzen, MD. ... [Among the] 10 recommendations from the editorial: ... Documentation should be provided to the skilled nursing facility team if an oncologist believes harm from future cancer treatment outweighs potential benefits or believes the patient has a poor prognosis. This will allow palliative care or hospice conversations to occur more urgently. Oncologists and palliative care clinicians can schedule, with hopeful reimbursement for, telehealth visits for patients in skilled nursing facilities.
Our Hospice raises $80,000 from Labor Day weekend concert
09/09/24 at 02:20 AMOur Hospice raises $80,000 from Labor Day weekend concert Local News Digital, Columbus, IN; by LND Staff; 9/5/24 Our Hospice of South Central Indiana says the 2024 Our Hospice Summer Concert held last Saturday at the Circle K Fieldhouse at NexusPark, netted $80,000 for the support of patients and families served by Our Hospice and Palliative Care. “We are incredibly grateful to everyone who attended the concert and contributed to this amazing cause,” said Steph Cain, President, of Our Hospice and Palliative Care. “The funds raised will directly support our mission of providing compassionate care to patients and their families during their most difficult times.” The Our Hospice Summer Concert is the year’s largest fundraiser, providing support for the almost 300 patients and their families cared for in 22 counties in south-central Indiana.
Inclusive leadership: Fostering diversity and inclusion
09/09/24 at 02:10 AMInclusive leadership: Fostering diversity and inclusion Forbes; by Lynda Silsbee and the Forbes Coaches Council; 9/5/24 In today's work world, diversity and inclusion are more than just buzzwords—they are essential components of a successful and innovative organization. Inclusive leadership, which actively seeks to embrace diversity and create an environment where all individuals feel valued and empowered, is critical to fostering this philosophy. Leaders who prioritize inclusion can harness the full potential of their teams, driving creativity, engagement and productivity. ... A study by Bersin by Deloitte shows that inclusive and diverse companies have "2.3 times higher cash flow per employee" and smaller businesses enjoyed 13 times higher cash flow. In addition, these companies had greater readiness for change and innovation. Inclusive leadership goes beyond the representation of different demographics within an organization. It involves creating a culture where diverse perspectives are actively sought out, respected and integrated into decision-making processes. Such leadership fosters a sense of belonging, where everyone feels valued for their unique contributions.
Growing private equity involvement suggests rapid consolidation in hospice industry: study
09/09/24 at 02:00 AMGrowing private equity involvement suggests rapid consolidation in hospice industry: studyMcKnight's Home Care; by Adam Healy; 9/4/24Increasingly, many hospices are being acquired by private equity firms, which may indicate growing consolidation of the industry, according to a new study. Between 2015 and 2022, 47 PE firms were responsible for 124 US hospice acquisitions. The larger share of these transactions occurred in more recent years, the researchers found. Fewer than 10 PE-backed acquisitions were made each year from 2015 to 2017, but from 2018 and beyond, PE firms acquired between roughly 15 and 35 hospices per year. Some of these acquisitions involved a large number of agencies, a sign of PE-fueled consolidation in the hospice sector, the researchers noted.Publisher's note: We first covered this story in The Guardian 9/5/24 (Private equity ownership of US hospice centers boomed in recent years – study) and include McKnight's story to highlight the impact this study is having.
Flourishing at the end of life
09/09/24 at 02:00 AMFlourishing at the end of life Public Discourse - The Journal of the Witherspoon Institute; by Xavier Symons, John Rhee and Tyler VanderWeele; 9/5/24 Dying is part of life, but most people dread their final days. The end of life, which often takes the form of protracted terminal illness, can involve significant pain and suffering as well as functional limits in day-to-day living. Is it still possible for human beings to flourish at the end of life? ... While dying may be a time when agency and quality of life are limited, the end of life also presents unique possibilities for the realization of human goods. Some dying patients discover meaning by reflecting on the events of their lives and come to a deeper appreciation of their own life legacy. Terminal illness also presents opportunities for a deepening of close social relationships and the fulfillment of relationship commitments. Paradoxically, the end of life can be a catalyst for gratitude and self-transcendence. It is worth asking, then: can we flourish even as we approach death? And how can we help our loved ones flourish in their final days? Editor's note: Take your time with this excellent essay, as it gets to our collective, core hospice mission, as described by Dame Cicely Saunders: "You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully but also to live until you die."
Hospice executives: Value-based care, regulation will shape hospices’ future
09/08/24 at 03:55 AMHospice executives: Value-based care, regulation will shape hospices’ futureHospice News; by Holly Vossel; 9/3/24Disruptive reimbursement and regulatory challenges are top of mind for today’s hospice c-suite executives, who recently sat down with Hospice News to discuss what they see as the largest hurdles to sustainable end-of-life care delivery. Reimbursement pressures and changes among the most significant concerns for today’s hospices, according to Kristen Yntema, president and CEO of AuthoraCare Collective. The North Carolina-based nonprofit provides hospice and palliative care, among other services.
Modeling nursing home harms from COVID-19 staff furlough policies
09/08/24 at 03:50 AMModeling nursing home harms from COVID-19 staff furlough policiesJAMA Open Network; by Sarah M Bartsch, Colleen Weatherwax, Bruce Leff, Michael R Wasserman, Raveena D Singh, Kavya Velmurugan, Danielle C John, Kevin L Chin, Kelly J O'Shea, Gabrielle M Gussin, Marie F Martinez, Jessie L Heneghan, Sheryl A Scannell, Tej D Shah, Susan S Huang, Bruce Y Lee; 8/24What is the tradeoff between COVID-19–related harms and non–COVID-19–related harms when allowing nursing home staff with mild COVID-19 to work while masked? The findings of this study suggest that allowing nursing home staff who were mildly ill with COVID-19 to work while masked was associated with less harm from alleviated missed tasks, outweighing increasing harm from COVID-19 transmission.
Patient-Reported outcome measures help patients with cancer
09/08/24 at 03:45 AMPatient-Reported outcome measures help patients with cancerMichael J. Hassett, MD, MPH; Christine Cronin, BS; 8/24Outside of cancer medicine, there is ample evidence that care management interventions improve patient-related, therapy-related, and health care utilization outcomes, especially when PROMs [patient recorded outcome measures] are incorporated. Altogether, these findings led to the hypothesis that symptom-focused care management programs that rely on PROMs could have a substantial positive impact for patients with cancer. Over the past 2 decades, dozens of clinical trials have explored this question. The analysis by Balitsky and colleagues adds further support to the argument that PROMs should be used routinely in oncology practice.
Trends in post-acute care use in Medicare Advantage versus Traditional Medicare: A retrospective cohort analysis
09/08/24 at 03:40 AMTrends in post-acute care use in Medicare Advantage versus Traditional Medicare: A retrospective cohort analysisJournal of the American Medical Directors Association; by Robert E Burke, Indrakshi Roy, Franya Hutchins, Song Zhong, Syama Patel, Liam Rose, Amit Kumar, Rachel M Werner; 8/24We sought to describe national trends in hospitalization and post-acute care utilization rates in skilled nursing facilities (SNFs) and home health (HH) for both Medicare Advantage (MA) and Traditional Medicare (TM) beneficiaries, reaching up to the COVID-19 pandemic (2015-2019). We found hospitalizations, SNF stays, and HH stays were all decreasing over time in both populations. Although similar proportions of MA and TM beneficiaries received SNF or HH care, MA beneficiaries received fewer days. The largest difference we found was in the number of post-acute care providers used in TM and MA, with MA using far fewer; however, quality ratings were similar among post-acute care providers used in each program.
Respiratory patients less likely to get palliative care
09/08/24 at 03:35 AMRespiratory patients less likely to get palliative care Hospice News; by Jim Parker; 9/3/24 Patients with some respiratory conditions often do not receive outpatient palliative care and have relatively higher rates of intensive care admissions than those with other illnesses. This includes patients with lung cancer, chronic obstructive pulmonary disease (COPD) and a condition called idiopathic pulmonary fibrosis (IPF), according to a recent study published in the pulmonology journal CHEST. These patients tend to have high symptom burden, diminished quality of life and aggressive health care utilization at the end of life, the study found.
OhioHealth and Compassus finalize partnership for home health and hospice
09/08/24 at 03:30 AMOhioHealth and Compassus finalize partnership for home health and hospice PR Newswire, Columbus, OH and Brentwood, TN; by Compassus / OhioHealth; 9/4/24 Compassus, a leading national provider of integrated home-based care services, and OhioHealth, a nationally recognized, not-for-profit, charitable healthcare outreach of the United Methodist Church, are pleased to announce the finalization of their partnership for home health and hospice services to be called OhioHealth at Home in partnership with Compassus. Under this partnership, Compassus has acquired ownership interest in three hospice locations and four home health locations that were formerly led by OhioHealth. Compassus will manage the operations of these agencies, leveraging its extensive experience in home-based care, while OhioHealth will continue to play a key role in delivering high-quality care in Ohio. OhioHealth's Athens hospice services and the Kobacker House in Columbus, Ohio, are excluded from the partnership. Editor's note: This finalizes the announcement we posted on 6/12/24: Compassus announces new partnership for home care and hospice.
Private equity ownership of US hospice centers boomed in recent years – study
09/08/24 at 03:25 AMPrivate equity ownership of US hospice centers boomed in recent years – studyThe Guardian; by Jessica Glenza; 9/3/24Investors spent about $1tn buying healthcare facilities over last decade, leading to reports of worsening patient care. Private equity investors are increasingly buying up hospice centers – healthcare facilities meant to focus on pain relief and emotional support for people near the end of their lives. The new study was published in the journal Health Affairs [Private equity acquisitions of hospices are increasing; Ownership remains opaque, by Melissa D. Aldridge, Lauren J. Hunt, Zelle Halloran, and Krista L. Harrison] and provides more evidence of how private equity have acquired firms using often sophisticated and opaque ownership structures. Although for-profit ownership is not new in US healthcare, the surge of private equity ownership is. Such investment groups have spent an estimated $1tn over the last decade, buying up hospitals and doctors’ offices.
“Rehabbed to Death” in oncology: Where do we go from here?
09/08/24 at 03:20 AM“Rehabbed to Death” in oncology: Where do we go from here?JCO Oncology Practice; by Daniel E. Lage, Craig D. Blinderman, Corita R. Grudzen; 9/3/24You can go to rehab to see if you get stronger for chemo. These are words that every clinician caring for hospitalized patients with cancer has heard or said countless times. And yet, especially when it comes to older adults with advanced solid tumors, less than a third of these patients will ever receive systemic therapy again. Furthermore, their symptom profile is more similar to those discharged to hospice than to those discharged home, and they face debilitating functional decline and early mortality—leading some to coin the term “rehabbed to death” to describe this phenomenon. We suggest a few keys area of focus: (1) reframing hospital discharge conversations, including incorporating practices of disclosing prognoses using validated tools or other algorithms; (2) empowering team-based care and inclusion of palliative care clinicians in the SNF setting; and (3) identifying patients failing to make functional progress early. [Also see accompanying article: Respect for the patient-oncologist relationship may limit serious illness communication by acute and postacute care clinicians after discharge to a skilled nursing facility by Sarguni Singh, Ashley Dafoe, John Cagle, Elizabeth R. Kessler, Hillary D. Lum, Brooke Dorsey Holliman, Stacy Fischer.]
Awards and Recognitions: August 2024
09/08/24 at 03:15 AMAwards and Recognitions: August 2024 We congratulate these honorees and celebrate their contributions to our collective hospice and palliative care mission, vision, and compassionate care throughout our world. Do you know any of these leaders? We encourage you to forward this to them or to find another way to celebrate their success.
Hospice leaders: Culture the key to sustaining the workforce
09/08/24 at 03:10 AMHospice leaders: Culture the key to sustaining the workforceHospice News; by Jim Parker; 8/30/24In a time of workforce shortages, hospices are seeking the “secret sauce” that will help keep employees on board and bring new people into their fold. To find the right mix, hospice providers that have achieved national recognition for employer best practices point to a particular secret ingredient — a supportive culture with open lines of communication, a career path with room to grow and competitive compensation. For the California-based YoloCares, culture is critical, according to the nonprofit’s CEO Craig Dresang.Notable mentions: YoloCares, Vitas, Jennifer Blades of Haven Hospice.
Two Illinois hospices expand to new counties
09/08/24 at 03:05 AMTwo Illinois hospices expand to new countiesHospice News; by Jim Parker; 8/29/24Two Illinois-headquartered hospice operators have stretched their footprints into additional counties. Transitions Care has expanded its service region to include the Rock Island community in its home state... Meanwhile, Unity Hospice has also moved into two additional counties in the Land of Lincoln, effective Sept. 1.Notable mentions: Trish Benson, CEO of Transitions Care; Alisa Gerke, Executive Director of Unity Hospice
Today's Encouragement
09/08/24 at 03:00 AMNothing can be loved or hated unless it is first understood. ~Leonardo da Vinci
Matters of life and death: Our health (and lack thereof) is worth talking about
09/08/24 at 03:00 AMMatters of life and death: Our health (and lack thereof) is worth talking aboutPsychology Today; by Samantha Stein; 8/29/24In his book Being Mortal, Dr. Atul Gawande, a practicing surgeon, discusses how having the hard conversations about end-of-life medical interventions (or not) may lead to a shorter life but a more fulfilling one. In his book Telltale Hearts, Dr. Dean-David Schillinger, a physician and public health advocate, discusses how accurate diagnosis, treatment, and true healing come from listening deeply to patients and their stories. Medical advances in the past century have been astounding. We live significantly longer and are able to survive repeated health crises that once would have killed us. Nearly everyone would agree that in many, if not most, cases that’s a positive thing. However, many would argue that our hyperfocus on prolonging life at all costs, along with our tendency to treat symptoms rather than looking for underlying causes, has caused us to lose sight of the importance of quality of life and true health.
Sunday newsletters
09/08/24 at 03:00 AMSunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!