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.

Bereaved Parent Support Study: Seeking Participants Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Cancer, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; 4/2/24This program is offered as a research study examining three types of support for bereaved parents who have lost a child to cancer. The study is jointly sponsored by Sylvester Comprehensive Cancer Center/University of Miami Miller School of Medicine, Memorial Sloan Kettering Cancer Cancer, St. Jude Children's Hospital, and Children's Hospital of Philadelphia; however, families need not have received care from one of these institutions. ...The counseling will be provided through videoconferencing and all activities for this study can be completed in [the participant's] home. ... There will be no charge for any support offered through the study. [Click on the title's link for more information.] 

Home care providers hail bill establishing standard classification for direct support workers McKnights Home Care, by Adam Healy; 4/3/24 The Senate last week passed legislation that would address the dire shortage of direct support workers with the establishment of a classification to help stakeholders collect workforce data. Specifically, if signed into law, the Recognizing the Role of Direct Support Professionals Act would require the Office of Management and Budget to consider establishing a standard occupational classification (SOC) for direct support professionals (DSPs). This classification would make it easier for policymakers to gather useful data about these workers and help them better address critical workforce challenges.

Blue Shield's Palliative Care Program wins national recognition for improving lives Blue Shield California; 3/28/24 During the first quarter of this year, the Journal of Palliative Medicine published results of a study entitled “Cost and Utilization Implications of a Health Plan’s Home-Based Palliative Care Program” from leaders at Blue Shield and researchers from West Health Research Institute that garnered attention from industry publications. ...  Major findings from the study were that home-based palliative care delivered to people not yet eligible for hospice reduced their hospital and emergency room use, showed trends towards an increased length of life, and extended the continuum of care for people with serious illness and their caregivers.

Lutheran Senior Services/Diakon agreement forms one of largest US nonprofit LTC organizations McKnights Senior Living, by Kathleen Steele Gaivin; 3/29/24 Diakon Senior Living operations and its four continuing care retirement / life plan communities will become part of Lutheran Senior Services under an agreement ... that the organizations say will create one of the largest nonprofit senior living and care organizations in the country. The transaction is pending regulatory approvals and is expected to close this summer.

Meet the women who give end-of-life care to Utah’s homelessGood Things Utah, by Nicea DeGering; 4/2/24A Utah non-profit’s mission is to provide medical help and end-of-life care to those in our community experiencing homelessness. The Inn Between has been providing unique services in Salt Lake City for eight years.  ... [The] mission of The Inn Between is to end the tragedy of vulnerable people dying on the streets of our community by providing medical respite and end-of-life care to those experiencing homelessness.The group provides a home environment that enables adults experiencing homelessness to gain access to professional hospice care from State-licensed hospice agencies; undergo life-saving medical treatment; stabilize in preparation for surgery; or recuperate from serious illness, injury, or surgery. Editor's Note: Read more to meet Jillian Olmsted, Executive Director and Kellie Mierement, Community Engagement Manager.

Man with chainsaw assaults Vermont hospital workers, destroys property Becker's Hospital Review, by Madeline Ashley; 4/1/24 A man was taken into custody by Vermont State Police after assaulting staff and destroying property with a chainsaw at St. Johnsbury-based Northeastern Vermont Regional Hospital. State troopers apprehended Tyler Roy, 27, on March 25 in the hospital parking lot "actively assaulting staff," according to a March 31 Vermont State Police news release. Mr. Roy was taken into custody and is cited to appear in Caledonia County Superior Court on April 6.

FTC continues to challenge $320M Novant, CHS deal Becker's Hospital Review; by Naomi Diaz; 3/29/24The Federal Trade Commission filed court documents on March 25 seeking a preliminary injunction to bar Winston-Salem, NC-based Novant Health from its $320 million acquisition of two North Carolina hospitals from Franklin, TN-based Community Health Systems. According to court documents filed in the U.S. District Court for the Western District of North Carolina, the FTC alleged that Novant Health's proposed acquisition ... would "irreversibly consolidate the market for hospital services in the Eastern Lake Norman Area in the northern suburbs of Charlotte."

CMS finalizes 2025 Medicare Advantage rates Becker's Payer Issues, by Rylee Wilson; 4/1/24 CMS finalized a slight decrease in Medicare Advantage benchmark payments for 2025. The agency published its final rate notice for 2025 April 1. The final rule was largely similar to CMS' proposed payment rates issued in January. The agency will cut benchmark payments by 0.16% from 2024 to 2025. CMS estimated plans will see 3.7% higher revenue overall in 2025. MA risk score trend of 3.86% — the average increase in risk adjustment payments year over year — will offset risk model revisions that will lead to a 2.45% decline in revenue and a projected decline in star rating bonuses, according to the agency. 

Some prepaid funeral expenses to southern Colorado funeral home being investigated CBS TV 11 News, by Melissa Henry; 3/29/24A man and his wife wonder whether or not they will ever get more than $7,000 dollars back for prepaid funeral expenses after paying Return to Nature Funeral Home. Jon and Carie Hallford are at the center of an investigation in which they are accused of abuse of a corpse, money laundering, theft, and forgery after officials say 189 bodies were found improperly stored at a building tied to the couple’s business in Penrose.

Northwell hospital nurses cancel strike Becker's Hospital Review, by Kelly Gooch; 4/1/24Members of the New York State Nurses Association have called off a planned April 2 strike at New York City-based Staten Island University Hospital after reaching a tentative agreement with management on a new labor contract. The union represents 1,300 workers at the facility. ... SIUH is part of New Hyde Park, NY-based Northwell Health, a 21-hospital system with more than 85,000 employees total. ... The agreement "adds nurse staffing on units that need help"; includes an expedited process for creating staffing standards in new units; and features wage increases that total 22.12% over three years and include annual pay increases, market adjustment pay, and experience pay, the union said.

Should we be using palliative care for scleroderma? The Medical Republic, by Karina Bray; 4/2/24Almost three-quarters of systemic sclerosis patients could benefit from specialist palliative care, according to Australian research. The first-of-a-kind study, published in Arthritis Care & Research, set out to examine and quantify the need for palliative care to address high symptom burden as an integrated part of systemic sclerosis management. ... “Almost 75% of SSc patients may benefit from specialist palliative care input to manage specific severe symptoms, and the overlapping nature of such symptoms highlights the complex symptom management needs of SSc patients,” the authors wrote. 

The Workforce Management Playbook: How Mercy is empowering nurses, saving premium labor costs + improving care Becker's Hospital Review in collaboration with Trusted Health; 3/29/24 At Becker’s 11th Annual CEO + CFO Roundtable, in a session sponsored by Trusted Health, two leaders from Mercy (St. Louis) — Cheryl Matejka, CFO, and Betty Jo Rocchio, DNP, senior vice president and system chief nursing officer — discussed how the right workforce management platform can help organizations redesign their staffing models in tune with nurses’ evolving needs, while saving costs and improving operational efficiency. In Mercy’s presentation to over roughly 100 hospital executives there were three major themes.