Literature Review

What home health providers need to know about the Medicare TPE Audit ProcessHome Health Care News, by Joyce Famakinwa;  4/2/24... TPE is a medical review program that began for the home health and hospice settings in December 2017. The goal of the program is to weed out improper payments by zeroing-in on providers with high claims denial rates or unusual billing practices. ... TPE has three pillars. Target refers to errors or mistakes that are identified through data in comparison to providers or peers. Probe is the examination of 20 to 40 claims. ... Education means helping providers reduce claim denials and appeals through one-on-one individualized education. 

Fostering respect and appreciation seen as keys to retaining direct care workersMcKnights Online Forum, by Kimberly Bonvissuto; 3/27/24 Expressions of appreciation and respect can go a long way in addressing senior living’s direct care workforce crisis, according to a panel of direct workers and employers who addressed what makes employees want to stay — or go. ... Nate Hamme, president and executive director of the Ceca Foundation, ... said that the most important part of employee recognition is listening to people. ... He added that there is a science to recognition backed by research into what motivates people and implementing programs around that. ... Recognition programs, Hamme added, should focus on IMPACT: inclusive, mission-aligned, public, authentic, consistent and timely. 

Mortality, hospice use rates differ in assisted living communities depending on whether memory care is offeredMcKnights Senior Living, by Kimberly Bonvissuto; 4/4/24Assisted living communities that provide memory care services may attract residents closer to the end of life or promote hospice use at the end of life compared with assisted living communities without such services, according to the findings of a new study. ... Researchers from the Brown University School of Public Health, the University of Melbourne and the Johns Hopkins University School of Nursing examined whether end-of-life outcomes — mortality and hospice use — differed between assisted living facilities with and without memory care services among 15,152 residents who moved into larger communities between 2016 and 2018.Editor's Note: Click here for the source article, "Do end-of-life outcomes differ by assisted living memory-care designation?"

Too soon or too late: Rethinking the significance of six months when dementia is a primary diagnosisThe Hastings Center Report, by Cindy L. Cain, Timothy E. Quill; 1/24In the case of people living with advanced dementia, six months is both too early in the trajectory to facilitate conversations and too late in the trajectory to ensure decision-making capacity. This essay encourages scholars and policy-makers to consider how cultural narratives may limit what they think is possible in care for people living with dementia.

HPNA and HPNF President's message : My path to leadershipJournal of Hospice & Palliative Nursing, by Lynn Reinke; 4/24Reflecting on my professional life, I recall several seminal experiences that made me believe I possessed basic leadership skills and that encouraged me to develop them. I advanced my skills in 3 ways:

When dying does not go well: a qualitative studyBMC Palliative Care, by Christof Breitsameter; 3/24Several studies deal with the question of what constitutes a "satisfactory death". A smaller number of studies deal with unsatisfactory dying processes. And only a few shed light on unsatisfactory deaths that take place in hospices and palliative care units, which see themselves as places conducive to a "good" death. What also remains largely undiscussed are the ethical aspects that accompany the observation of an unsatisfactory course of death.

It’s the truth I’m after, and the truth never harmed anyone. What harms us is to persist in self-deceit and ignorance. ~Marcus Aurelius

Where you begin is not necessarily where you end: the mental and physical health trajectories of cancer caregivers over timeSupportive Care in Cancer, by Maureen Wilson Genderson, Maria D. Thomson, Laura A. Siminoff; 10/23Cancer caregiving, a critical component in the cancer-care model, has deleterious effects on the caregiver’s physical and mental health. The degree to which these negative effects are uniformly experienced by caregivers is unclear; effects may be exacerbated at the end of life when caregiving is intensified. Not all caregivers have the support of an additional involved support person (secondary caregiver). The impact of the secondary caregiver’s absence on the primary caregiver’s well-being is understudied.

Neuropsychiatric effects associated with opioid-based management for palliative care patientsCurrent Pain and Headache Reports, by Alan D Kaye, Kylie Dufrene, Jada Cooley, Madeline Walker, Shivam Shah, Alex Hollander, Sahar Shekoohi, Christopher L Robinson; 4/24The abundance of opioids administered in the palliative care setting that was once considered a standard of care is at present necessitating that providers evaluate patients for unintentional and deleterious symptomology related to aberrant opioid use and addiction. ... By having an increased understanding and awareness of potential opioid neuropsychiatric effects, patient quality of life can be improved, healthcare system costs can be decreased, and patient outcomes can be met and exceeded.

Community Hospice & Palliative Care recognizes National Volunteer MonthJAX Chamber, Press Release; 4/3/24 As April marks National Volunteer Month, Community Hospice & Palliative Care reaffirms its dedication to promoting and celebrating the invaluable contributions of volunteers. Volunteers are the heart and soul of our organization, providing companionship and a compassionate presence to patients and their families during challenging times. Throughout the month, Community Hospice & Palliative Care will spotlight individual volunteers and their inspiring stories through various social media platforms. These narratives will highlight the profound impact that volunteers have on the lives of those they serve and showcase the diverse ways in which they enrich our community. Editor's Note: Use this spark your own planning and recognition for your all-important hospice and palliative care volunteers!

Neuropsychiatric effects associated with opioid-based management for palliative care patients

RNs are moving away from home health and hospice, federal survey reveals McKnights Home Care, by Adam Healy; 4/2/24 Though the number of registered nurses continues to grow, fewer are working in home healthcare and hospice compared to years past, according to the latest national sample survey collected by the Health Resources & Services Administration. In 2018, there were 179,509 RNs working in home health and hospice, representing about 6% of the nursing workforce, according to an earlier national survey. HRSA’s latest count estimated that there were 173,808 RNs in home health and hospice in 2022, or only 5% of the workforce. 

5 most challenging requirements in 2023 [for hospitals]: Joint Commission Becker's Clinical Leadership, by Mackenzie Bean; 4/3/24Maintaining infection prevention and control during disinfection and sterilization activities was the most challenging compliance standard for hospitals in 2023, according to The Joint Commission. The organization identified the top five requirements for which hospitals were most frequently out of compliance, based on surveys and reviews from Jan. 1 through Dec. 31. ... [Click on the title's article for the 5 top challenges.]