Literature Review

LeadingAge: Diverting patients from SNF to home health does more harm than good McKnights Home Care; by Adam Healy; 10/28/24 Mounting evidence suggests that Medicare Advantage plans are directing beneficiaries to home health when they should receive skilled nursing facility care, which is negatively affecting providers’ care quality, according to LeadingAge. The Senate Committee Permanent Subcommittee on Investigations recently reported that MA plans may be diverting patients in need of SNF care to home health as a means of saving money. In an Oct. 25 letter, LeadingAge said this practice damages care quality and patient health outcomes, and asked the Medicare Payment Advisory Commission (MedPAC) to investigate the issue further. 

Less activity, more sitting linked with higher death risks: study McKnights Long-Term Care News; by Kristen Fischer; 10/28/24 Low physical activity is associated with a higher risk of dying from all causes as well as from cardiovascular disease, diabetes, and kidney disease. In addition, the combination of reduced activity and longer sitting time every day is linked with a higher risk of death from any cause, a new study finds. Staying active and reducing sitting time may lower the risks, authors of the report wrote. The report was published Oct. 26 in BMC Geriatrics.Editor's note: Calling all leaders who have desk-bound employees, and who sit too long (yourselves) ... What creative ways do you encourage healthy work habits, movement, and more? Do you provide ergonomic sit/stand desks? Healthy chairs? More? Read this and remember that as we will age, today's habits impact tomorrow's health.

Terminally ill Illinois woman meets her idol, Jelly Roll NBC WETM 18, Elmira, IL; by Taylor Harris; 10/27/24 An Illinois woman battling terminal cancer fulfilled the dream of a lifetime Wednesday — meeting country music sensation Jelly Roll. Keita Miller, of Granite City, was diagnosed with a terminal illness in February 2022 and given just months to live. She has defined the odds, and now she’s been able to meet her musical hero, country star Jelly Roll. Her favorite Jelly Roll song is “Son Of A Sinner,” and she says his music has been a source of comfort during her illness. But more than just meeting the artist, Miller had one special request. ... The James Bess Foundation, a nonprofit that grants dreams to adults from 21 to 65 years old who are battling terminal illness, is making this dream come true.

Top 5 workforce priorities for leaders in 2025 Forbes; by Brent Gleeson; 10/26/24 As organizations evolve and face new challenges, leaders and managers are preparing to tackle pressing workforce priorities that will shape the future of work. Based on our data and experience at EXCELR8, and supported by extensive research conducted by Gartner, these priorities reflect the most significant areas HR leaders (and all leaders in the organization) need to focus on to remain competitive, retain top talent, and drive business outcomes. Below are the top five workforce priorities leaders must incorporate into their strategic imperatives for 2025. We highlight the key trends that will influence human resources strategies moving forward.

How today’s hospice fraud could warp tomorrow’s reimbursement outlook Hospice News; by Holly Vossel; 10/28/24 This is the second of a two-part Hospice News series that explores how fraud, waste and abuse in the hospice space could create headwinds for the industry at large. Fraudsters misspend millions of Medicare dollars annually, though the actual hospice-specific amounts are difficult to determine, regulators previously told Hospice News. Industry stakeholders have questioned whether the malfeasance will stymie the U.S. Centers for Medicare & Medicaid Services’ (CMS) ability to justify future reimbursement rate increases, which many hospice providers already consider insufficient to support the full range of their interdisciplinary services in today’s economic climate.

After extensive renovation, original Wright-Patt Fisher House expected to reopen soon Dayton Daily News, Dayton, OH; by Thomas Gnau; 10/28/24 Renovation ends in time to mark home’s 30th anniversary. The original Fisher-Nightingale house at Wright-Patterson Air Force Base has been renovated, and an open house in December is expected to mark its reopening, the executive director of the Fisher-Nightingale Houses in the Dayton area said. The house itself is expected to reopen to serve families in a few weeks. ... The Fisher House Foundation is a national organization, building comfortable homes where active-duty military and veteran families can stay free of charge, while a loved one is in a hospital or in nearby hospice care.

I'm so glad I live in a world where there are Octobers. ~ L.M. Montgomery

Palm Harbor family suffers flood after Milton, less than month after mother dies from breast cancer ABC WFTS Tampa Bay, FL; by Jessica De Leon; 10/26/24 One Palm Harbor family is gutting the first floor of their home, destroyed by flood waters after Hurricane Milton. Cali Gignac’s childhood home is not in a flood zone or near any large bodies of water, yet more than two feet of water entered her parents' townhome and destroyed everything just a month after her mother died. “We haven’t had a chance to sort her mementos. We haven’t had a chance to grieve her or anything. And now it’s like... everything is garbage.” Now, they are trying to save what they can, sometimes stopping to take a snapshot of notes or photos that they find. But as tears come, they quickly move on, knowing they have so much to do.“Our photo albums are just, like, melting.”Editor's note: Click here for a public service educational video, "Community Crisis and Grief," with a significant section devoted to coping with "normal" bereavement in the midst of a community crisis. Disclosure, provided by Composing Life Out of Loss, a sponsor of this newsletter.

Divorce rates among older adults have almost tripled since 1990McKnight's Senior Living; by Lois A. Bowers; 10/23/24New research finds an almost threefold increase in the percentage of divorced older adults compared with three decades ago. And an increasing number of older adults never have married. The investigators at the National Center for Family and Marriage Research at the Bowling Green, OH, educational institution found that the divorce rate among people aged 65 or more years increased from 5.2% in 1990 to 15.2% in 2022. Or, put another way, one in every 10 people divorcing in the United States today is aged 65 or more years. Although reasons for the increase in divorce were beyond the scope of the study, Brown theorized that contributing factors could include increased life expectancy and the fragility of remarriages.Publisher's note: Interesting implications for hospice care and caregivers.

Nonprofit organizes free home cleanings for cancer patients The Dallas Express, Dallas, TX; by Patti Villegas; 10/27/24 When facing a serious illness, even simple tasks can become overwhelming. However, one nonprofit organization is stepping in to help alleviate some of that burden for individuals with cancer. Cleaning for a Reason, founded in 2006, has facilitated free home cleaning services for more than 57,133 cancer patients in the U.S. and Canada, providing services valued at a total of more than $19 million. The non-profit organization partners with residential cleaning companies and community volunteers to “clean the homes of cancer patients to provide hope, relief, control, and cleanliness,” the group’s website states. The volunteers’ work not only enhances the patients’ physical environment but uplifts their spirits as well.

Delivering palliative care by telehealth meets the needs of people with cancer National Institutes of Health (NIH) - National Cancer Institute; by Linda Wang; 10/28/24 The use of telehealth in cancer care surged during the COVID-19 pandemic, when, for a period of time, in-person medical care was limited and many visits to the doctor went virtual. Despite some recent pullbacks in telehealth flexibilities, many experts believe that telehealth will continue to have a role in cancer care. But how well does telehealth perform when it comes to delivering palliative care for people with cancer, which can rely on a deeper level of connection between patients and providers than may be possible with a virtual visit? A study of 1,250 people with advanced lung cancer has now provided some insights into that question. The study found that virtual and in-person palliative care were similarly effective in improving patients’ quality of life and other important measures of well-being, according to findings published September 11 in JAMA. It also found benefits for caregivers. The results show that “we can successfully deliver … high-quality [palliative] care in person and virtually,” said Joseph A. Greer, Ph.D., of Massachusetts General Hospital, who led the study. 

A moral code: Ethical dilemmas in medicine — three physicians face crossroads in patient care MedPage Today; podcast by Genevieve Friedman, Perspectives Editor; 10/25/24 We are back for another episode of our medical podcast, which we hope isn't really a podcast about medicine, but a podcast about life, death, dilemma, the challenges, and sometimes the joys of medicine. ... Now, medicine is complicated because a lot of times there aren't hard and fast rules ... One treatment isn't always right or wrong for someone. One surgery isn't always successful or unsuccessful, and one diagnosis isn't always correct. Decisions aren't black and white, they're varying shades of gray. So we come up with principles to help handle this -- codes if you will. But even those get a bit marred by complexity at times. As you'll hear in this episode of Anamnesis with the theme of "A Moral Code: Ethical Dilemmas in Medicine," one of our biggest codes is "do no harm." But what is harm? Who decides what harm is, what happens if we disagree?

Medicare Part D paid millions for drugs for which payment was available under the Medicare Part A Skilled Nursing Facility Benefit HHS Office of Inspector General; Report Highlights; 10/27/24 What OIG Found: ... On the basis of our sample results, for 2018 through 2020, we estimated that up to the entire Part D total cost of $465.1 million was improperly paid for drugs for which payment was available under the Part A SNF benefit. Of that amount, we estimated that approximately $245.4 million was for drugs that the medical records showed were administered to Part D enrollees during their Part A SNF stays.What OIG Recommends: We made five recommendations, including that CMS work with its plan sponsors to adjust or delete PDEs, as necessary, and determine the impact to the Federal Government related to the Part D total costs of $953,370 for drugs associated with our sample items for which payment was available under the Part A SNF benefit; work with its plan sponsors to identify similar instances of noncompliance that occurred during our audit period and determine the impact to the Federal Government, which could have amounted up to an estimated $465.1 million in Part D total cost; and provide plan sponsors with timely and accurate information, such as dates of covered Part A SNF stays, to reduce instances of inappropriate Part D payment for drugs for which payment is available under the Part A SNF benefit. ... CMS concurred with all five recommendations.