Literature Review

Janey Godley says it's important to 'talk about death' in hospice update STV News; 10/8/24 Janey Godley has said it is important to “talk about death” as she shared an update on her condition from her hospice.The Scottish comedian is currently receiving end-of-life care after receiving the news that her cancer had spread, after initially being diagnosed with ovarian cancer in 2021. She shared the “devastating news” in September after cancelling her upcoming autumn tour, adding that her “chemo ran out of options” and she couldn’t take anymore. In a video from the hospice, Godley thanked everybody as she confirmed she has had some issues with sickness – and said it is “hard” to speak about death but these are conversations we “all have to have.”

Home health providers, CMS raise red flags over delayed access Modern Healthcare; by Diane Eastabrook; 10/11/24 Delayed home health access for Medicare beneficiaries is increasingly raising alarms from the Centers for Medicare and Medicaid Services and the home health industry as providers place blame on staff shortages and the program's reimbursement rates. More than a third of Medicare fee-for-service beneficiaries referred to home health following hospitalizations did not receive services within seven days of discharge, according to an analysis of 2023 Medicare claims from healthcare analytics company CareJourney. The report echoes a similar study published by the Commonwealth Fund in July, as well as concerns CMS raised about access in its proposed 2025 home health pay rule. ... Years of low Medicare reimbursements are taking a toll on the home health companies trade groups represent, said William Dombi, president emeritus of the National Association of Home Care and Hospice, which is part of the National Alliance for Care at Home, and Cunningham.

National Health Investors announces $121.3 million acquisition, largest deal since 2020; pipeline at $305 million McKnights Senior Living; by Lois A. Bowers; 10/10/24 National Health Investors is acquiring a portfolio of 10 assisted living and memory care communities in North Carolina for $121.3 million in what the real estate investment trust says is its largest deal since 2020, the year the COVID-19 pandemic started. The Murfreesboro, TN, REIT announced the transaction Thursday morning in a business update. The properties, which have a combined 522 units, will continue to be managed by Spring Arbor. NHI says that the portfolio bears “no material impact” from Hurricane Helene.

Why recent outages are a wake-up call for healthcare and regulators Forbes; by Chris Bowen; 10/11/24 When the CrowdStrike outage first started to show itself in the early hours of that hazy July morning, it was hard to believe that this wasn’t a hack or cyberattack. I was driving in my car that morning and looked up to see a digital billboard glitch into the "blue screen of death" before my eyes. Flights were grounded, travel was delayed, and nearly every Windows machine in the world was unusable. It was total mayhem. Clearly, this was an outage of major proportions, as millions of Windows systems worldwide essentially cratered. Caused by a faulty misconfiguration, we saw firsthand how the very digital advancements that have helped transform and modernize our world also expose us to more vulnerabilities than ever. ... In healthcare, this event laid bare the vulnerabilities we cannot overlook—the gaps that directly threaten patient care and safety. It’s a clear reminder of our industry’s utmost responsibility to patient privacy and well-being. ...

Integration of palliative care in the management of multiple chronic conditions: An expert consensus paper with policy implications George Washington University; by Kim Kuebler, DNP, ANP-BC, FAAN, Todd Monroe, PhD, RN, FAAN, Richard Ricciardi, PhD, CRNP, FAAN, Cheryl Westlake, PhD, ACNS-BC, FAAN, Matthew Sorenson, PhD, ANP-C, FAAN, Jane Pederson, MD, MS, Michael Neft, PhD, CRNA, FAAN, Sandra A. Mitchell, PhD, CRNP, FAAN, Kathryn Daniel, PhD, AGNP, FAAN, Susan De Santo-Madeya, PhD, APRN-CNS, FAAN, Susan Renda, DNP, ANP-BC, FAAN, Elizabeth Henneman, PhD, RN, FAAN, Eduardo Bruera, MD; 10/10/24 This paper was jointly developed from members of the American Academy of Nursing Expert Panels on Palliative and End of Life Care, Primary Care, Aging, Acute and Critical Care, and two expert physicians. Purpose: The overarching goal is to promote the integration of palliative care as symptom management into the primary care setting to transform care for patients living with multiple chronic conditions. ... Discussion: Earlier palliative interventions reduce disease exacerbation, prevent hospitalization, maintain physical functioning, and support health-related quality of life. Conclusion: This is a needed paradigm shift as the nation’s aging population escalates, Americans are living longer, and the healthcare costs for the nation are unprecedented. [Click on the title's link for this full description; then scroll down to "Download PDF" for the actual paper.]

Caring for the family caregivers made ill by their work Penn LDI; by Hoag Levins; 10/11/24 A randomized controlled trial (RCT) led by LDI Senior Fellow Barbara Riegel, PhD, RN, of the University of Pennsylvania School of Nursing has identified a virtual health coaching intervention that helped lessen stress for unpaid family caregivers who often neglect their own care. Published in Circulation: Heart Failure, the study focused on unpaid family caregivers providing care to adults with chronic heart failure (HF)—a condition that occurs when the heart can’t pump enough blood for the body’s minimal needs. Because the disease has a variety of symptoms and manifestations that limit palliative care and respite services, it places a heavy burden on home caregivers who are “are commonly overwhelmed and face emotional, psychosocial, and financial risks that result in a decline in their own health and wellness.”Editor's note: Family Support Through Serious Illness is an online video library of 30 brief, state-of-the-art videos for family caregivers, used upstream in the trajectory of serious illness and through palliative/hospice care. These pair with a staff video training, "Empathy for Hospice Professionals."  These are designed and provided by Composing Life Out of Loss, a sponsor for this newsletter.

United States Power Outage Tracker: Updates automatically every 15 minutes Retrieved from the internet 10/9/24 As severe weather or blizzards threaten, this database aggregates power outage information from more than 1,000 companies nationwide. It will automatically update every 15 minutes. [Click here.]Companion article: Florida power outage map: Track where power is out as Hurricane Milton approaches landfall. USA Today; by Julia Gomez and C.A. Bridges; 10/9/24 Utility providers were preparing for over a million power outages when Hurricane Milton hits Florida, which comes as the state is still recovering from Hurricane Helene. More than 25,000 outages had already been reported in Florida by 1:15 p.m. ET Wednesday, according to the USA TODAY power outage tracker, with many more expected as Milton approaches landfall late Wednesday night or early Thursday morning. [You can follow the latest outage numbers by clicking here.]Editor's note: For all affected by Hurricane Milton--evacuees, first responders, long distance family members and friends, colleagues, businesses, more. Stay informed about power outages in areas impacted by both Milton and Helene. The companion article provides important safety information about downed power lines, reporting outages, and more. (We are highlighting the map for your fast, easy access.) See "Today's Encouragement."

Hurricane Helene Disaster Relief Fund for home care & hospice employees in the CarolinasAssociation for Home & Hospice Care of North Carolina (AHHC of NC); by Judy Penn, Executive Director; 10/3/24 Click here to DONATE. Click here to APPLY for Assistance. Hurricane Helene has severely impacted our community, with many lives already lost in the Carolinas, and countless missing with no means of communication.  The Carolinas Foundation for Hospice & Home Care is accepting donations to distribute directly to hospice and home care employees devastated by this storm. Agencies are facing tremendous challenges, including displacement and/or evacuation of staff and patients, collapsed roads, failing infrastructure, lack of water, and the inability to communicate with downed lines. There is a major need for gas to continue to power generators for oxygen dependent patients both in home settings and hospice inpatient facilities. The Association staff has been in contact with government agencies to us keep up-to-date on the situation as it unfolds. Our industry is comprised of caring, compassionate individuals who help those in need. Please consider donating to the Hurricane Helene Relief Fund to help home care and hospice employees hit the hardest. ... 100% of ALL ADMINISTRATIVE COSTS are being borne by the Association and the Foundation. 100% of your donation (tax-deductible) comes in, and 100% of your donation goes out.

[Free] COVID-19 testingHHS.gov press release; 10/3/24Order Your 4 Free At-⁠home COVID-⁠19 Tests. Every U.S. household is eligible to order 4 free at-home tests. COVID-19 testing can help you know if you have COVID-19 so you can decide what to do next.

University of Maryland bolstering palliative care workforce via master’s degree, certification program Hospice News; by Molly Bookner; 10/7/24 The University of Maryland, Baltimore (UMB) School of Pharmacy is seeking to address the dearth of palliative care-trained clinicians and improve care among seriously ill patients. By 2060, the demand for palliative care is expected to nearly double, according to the World Health Organization. Yet, despite this need, significant gaps in training remain, with many professionals lacking exposure to hospice or palliative care during their schooling. UMB seeks to bolster the palliative care workforce through its online Graduate Studies in Palliative Care program, launched in 2017. While most palliative care clinical education programs see small cohorts of five or fewer students, UMB is seeing a larger crowd of professionals enter the workforce. Of the Class of 2024, 36 students received their Master of Science degree and seven received a graduate certificate. “We have an amazing diversity of students,” Mary Lynn McPherson, professor in the Department of Practice, Sciences, and Health Outcomes Research at the School of Pharmacy and executive program director of Graduate Studies in Palliative Care, told Palliative Care News. 

Court rules False Claims Act Provisions unconstitutional, with implications for hospice cases Hospice News; by Jim Parker; 10/7/24 A federal judge has struck down the whistleblower provisions of the False Claims Act, with broad implications for hospice and other health care enforcement actions. The ruling centers on the law’s qui tam clauses, which the court found unconstitutional. In a qui tam action, a whistleblower, called a “relator” by the courts, files a False Claims Act suit on behalf of the government and possibly receives a portion of any funds recovered by the government via the lawsuit, typically ranging from 15% to 25%. The overwhelming majority of False Claims Act cases involve qui tam whistleblowers. In Fiscal Year 2023, for example, these cases recovered $2.3 billion of the total $2.68 billion recouped by the government in FCA settlements and judgements, according to a report from the law firm Polsinelli. ... FCA cases have been rampant in the hospice space during the last several years. Many of the major cases and settlements that have occurred during that time have been qui tam actions, including two major actions this year. ...

Hospital-at-home care’s future still hangs in the balance Home Health Care News; by Joyce Famakinwa; 10/7/24 Even with a proven track record for clinical effectiveness and cost savings, the hospital-at-home model’s future hangs in the balance. “The data suggests that, for the populations that have been studied in multiple different places, it’s a very safe service to be done and with high-quality care, low readmission rates, low escalation rates, low infection rates,” Dr. Adam Groff, co-founder Maribel Health, told Home Health Care News. “The bottom line is people love it, patients love it and it’s a high-quality care experience.” ... In 2020, the hospital-at-home model had its breakthrough. Though the model was common internationally, it was considered niche in the U.S. This changed with the introduction of the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home program. A recent report from CMS found that the program has been largely successful. ... Despite the momentum the model has seen in recent years, challenges still exist when it comes to operations and scalability. Specifically, less than 9% of waiver-approved hospitals accounted for more than 70% of all U.S. admissions, according to data from MedPAC’s June 2024 report to Congress. ... 

Between what is said and not meant, and what is meant and not said, most love is lost. ~Gibran Khalil