Literature Review

How the downfall of the ‘Chevron Doctrine’ could affect hospices in the courts Hospice News; by Holly Vossel; 12/16/24 Recent court rulings have the potential to make significant differences in the landscape of hospice regulatory oversight in coming years, particularly when it comes to audits and the forthcoming Special Focus Program (SFP). In June the U.S. Supreme Court overturned a ruling that in 1984 established the “Chevron Doctrine,” which instructed lower courts to defer to executive branch agencies to resolve ambiguities in laws passed by Congress. The decision marked the end of the practice known as “Chevron deference,” which required that courts must defer to regulatory agencies’ interpretations of “ambiguous” statutes within federal legislation as long as the enforcement activity is deemed “reasonable.” Hospices could potentially see a vastly different outlook in regulatory enforcement activity during a time of tremendous changes already taking place in the industry, [Bryan Nowicki, partner at the law firm Husch Blackwell] said.

Convicted trio jailed for elder abuse Inland News Today, Riverside, CA; 12/18/24 A 7-year prison sentence has been meted out for the neglect and abuse of six severely disabled residents at an unlicensed Riverside care facility. Ronnel Tiburcio was convicted of six counts of elder abuse likely to produce great bodily harm. Earlier, co-defendants Joel Ombao and registered nurse Nimfa Molina were handed jail sentences. Ombao owned several hospice companies, including the unlicensed Secure Hands board and care facility where the victims were housed. Ombao, his assistant Tiburcio, and registered nurse Molina, were responsible for operating the facility and caring for the residents. When investigators first checked out the care facility, residents were being housed in squalor. Many of them were emaciated and dehydrated.

Michigan Center for Rural Health announces new program focused on improving rural based palliative care PRLOG - Press Release Distribution, East Lansing, MI; by Michigan Center for Rural Health - Amanda St. Martin; 12/16/24 The Michigan Center for Rural Health (MCRH) has announced Phase Two of its palliative care programming. Palliative care provides relief from symptoms, pain, and stress associated with serious illnesses and can be administered alongside curative treatments. It is suitable for patients of any age or illness stage. The program titled "Cultivating Comfort: Enhancing Palliative Care in Rural Michigan," funded by the Michigan Health Endowment Fund, will launch on January 1, 2025, and continue through December 2026. ...  Rural adults tend to experience a higher prevalence of chronic conditions compared to their urban counterparts, as they are often older, poorer, and more likely to have multiple chronic illnesses. MCRH's new program seeks to address this need through a community driven approach.

VITAS Healthcare unveils inpatient hospice unit at Lee Memorial Hospital South Florida Hospital News and Healthcare Report, fort Myers, FL; by cfelixcpa; 12/16/24 Residents of Lee County now have access to dedicated end-of-life care at the new VITAS Healthcare Inpatient Hospice Unit at Lee Memorial Hospital, offering expert, patient-centered hospice services in the comfort of a homelike setting. This inpatient unit (IPU) is the only hospital-based hospice facility in the county and is the first VITAS IPU in Lee County and second in Southwest Florida. It is expected to serve more than 400 patients annually. ... The VITAS hospice unit at Lee Memorial features eight private patient rooms with internet access, flatscreen TVs, private bathrooms and overnight accommodations for loved ones. A shared family room provides space for visiting guests, and children’s activities keep little ones occupied.

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!

The Joy of brightening other lives, bearing each others’ burdens, easing each other’s loads and supplanting empty hearts and lives with generous gifts becomes for us the magic of the holidays. ~ W. C. Jones

[Australia] Why mental health clinicians are not engaging in advance care planning with older people with schizophrenia and other psychotic illnessesPsychology Research and Behavior Management; Anne P F Wand, Aspasia Karageorge, Yucheng Zeng, Roisin Browne, Megan B Sands, Daniella Kanareck, Vasi Naganathan, Anne Meller, Carolyn M Smith, Carmelle Peisah; 12/24These clinician-identified attitudes, experiences, and barriers to engagement in ACP [advance care planning] with older people with psychotic illnesses highlight avenues of potential intervention to facilitate ACP in this cohort. Given the complexity of issues, clinicians need education and training in ACP combined with clear processes and policies to support practice. Clinician insights should be combined with the perspectives of older consumers with psychotic illnesses and their families to inform implementation of ACP. 

US FDA approval of pediatric artificial intelligence and machine learning–enabled medical devicesJAMA Pediatrics; Ryan C. L. Brewster, MD; Matthew Nagy, MD, MPH; Susmitha Wunnava, PhD; Florence T. Bourgeois, MD, MPH; 12/24Despite rapid growth in the availability of AI/ML [artificial intelligence and machine learning]-enabled devices in recent years, only a small number have been authorized for pediatric use. The current regulatory framework may expose children to off-label use, differential performance of algorithms, and safety risks. Additionally, the lack of standardized reporting of pediatric device characteristics precludes informed decision-making by health care clinicians on appropriate device use. Pediatric AI/ML-enabled devices should be validated using representative datasets and should include complete and standard documentation on pediatric testing and authorization. Such changes will require cooperation across regulatory and industry stakeholders with a commitment to safe, equitable, and effective AI/ML development for children. 

Loneliness and social and emotional support among sexual and gender minority caregiversJAMA Network Open; Zhigang Xie, PhD; Hanadi Hamadi, PhD; Kassie Terrell, PhD; Laggy George, MPH; Jennifer Wells, BA; Jiaming Liang, PhD; 12/24In the current landscape of US health care, informal unpaid caregiving provided by family members and friends is indispensable for managing diseases and ensuring long-term care in residential settings. Sexual and gender minority (SGM) adults in the US are more likely than their non-SGM counterparts to provide informal care to their family members and/or friends. Caregiving can impose substantial physical, mental, and social connection issues on caregivers.Conclusions and Relevance In this cross-sectional study of social connections, SGM adults experienced significantly higher levels of loneliness compared with straight adults, irrespective of caregiving status. 

Mobile app–facilitated collaborative palliative care intervention for critically ill older adults-A randomized clinical trialJAMA Internal Medicine; Christopher E. Cox, MD, MPH; Deepshikha C. Ashana, MD, MBA, MS; Katelyn Dempsey, MPH; Maren K. Olsen, PhD; Alice Parish, MSPH; David Casarett, MD; Kimberly S. Johnson, MD; Krista L. Haines, DO; Colleen Naglee, MD; Jason N. Katz, MD, MHS; Mashael Al-Hegelan, MD, MBA; Isaretta L. Riley, MD, MPH; Sharron L. Docherty, RN, PNP, PhD; 12/24An automated electronic health record–integrated, mobile application–based communication platform that displayed family-reported needs over 7 days, coached ICU attending physicians on addressing needs, and prompted palliative care consultation if needs were not reduced within 3 study days. In this randomized clinical trial, a collaborative, person-centered, ICU-based palliative care intervention had no effect on palliative care needs or psychological distress compared to usual care despite a higher frequency of palliative care consultations and family meetings among intervention participants.

A scoping review of end-of-life discussions and palliative care: Implications for neurological intensive care in Latin America and the CaribbeanJournal of Palliative Medicine; Monica M Diaz, Lesley A Guareña, Bettsie Garcia, Christoper A Alarcon-Ruiz, Stella M Seal, Clio Rubinos, Dulce Cruz-Oliver, J Ricardo Carhuapoma; 12/24Palliative care (PC) is essential to improve quality of life for individuals with life-limiting acute neurological conditions, particularly in resource-limited settings. In Latin America and the Caribbean (LAC), there is limited health care professional training and education on PC. Our review demonstrates a need to improve PC knowledge and access to end-of-life care resources. Regional educational efforts are needed to improve PC knowledge among health care providers who care for patients with acute neurological conditions in LAC. 

Quality of hospices used by Medicare Advantage and traditional fee-for-service beneficiariesJAMA Network Open; Lindsay L. Y. White, PhD, MPH; Chuxuan Sun, MPA; Norma B. Coe, PhD; 12/24In this cross-sectional study including 4 215 648 decedents and 2 211 826 hospice enrollees, regular Medicare Advantage and fee-for-service beneficiaries enrolled in hospices of similar quality. However, beneficiaries in Medicare Advantage special needs plans were significantly more likely than fee-for-service beneficiaries to use hospices of inferior quality, with referral networks playing an important role in hospice quality choice. These results suggest that policymakers should consider incentivizing referrals to high-quality hospices and approaches to educating beneficiaries on identifying high-quality hospice care. 

Caregiver-Reported Quality in Hospices Owned by Private Equity Firms and Publicly Traded CompaniesJAMA; by Alexander E. Soltoff, Mark Aaron Unruh, David G. Stevenson, Dio Kavalieratos, Robert Tyler Braun; 12/17/24The US hospice industry has shifted from not-for-profit to for-profit ownership models, producing concerns aboutcare quality... Hospices owned by private equity firms (PEFs) or publicly traded companies (PTCs) performed significantly worse across CAHPS measures relative to not-for-profit and non-PEF/PTC for-profit agencies... These findings raise questions as to how patients are affected when PEFs and PTCs own hospices and suggest the need for greater transparency and accountability of hospice ownership.Publisher's note: Also see related articles by these authors: Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations, JAMA Internal Medicine, 8/21; Changes in Diagnoses and Site of Care for Patients Receiving Hospice Care From Agencies Acquired by Private Equity Firms and Publicly Traded Companies; JAMA Network Open, 9/23.