Literature Review

Hospice update: March goes out like a lion Morgan Lewis - Health Law Scan, by Howard J. Young; 4/2/24 The old adage—March comes in like a lion and goes out like a lamb—didn’t quite hold true for the hospice sector, which experienced a late-month flurry of activity. The government gave the hospice sector a lot to consider, from MedPAC’s suggested freeze on hospice rates to CMS’s 2025 Proposed Hospice Rule (public comments due May 28, 2024) that, if finalized as is, would include a 2.6% payment bump. CMS’s Proposed Hospice Rule lays the groundwork for the long-anticipated Hospice Outcomes and Patient Evaluation (HOPE) quality measures data collection instrument, which will be used to collect data at various points during the hospice stay, not just at admission and discharge.  

Changes coming to Long Beach homeless center where 20 enrolled diedNBC TV 4 Los Angeles, by Mekahlo Medina; 4/3/24... Mayor Rex Richardson addresses the death of 20 residents at the Homekey Hotel, a transitional housing facility in Long Beach, where many employees say was understaffed to attend medical needs. Mekahlo Medina reports for the NBC4 News on March 26, 2024. ... Long Beach said in its statement that “they will be continuing onsite partnerships with Healthcare in Action, Long Beach Community College nursing students, Wellbe Health, and Echo Hospice (palliative care). 

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.

Code status discussions; difficult but necessary The Hospitalist, by Mark Menet, MD, MPH; 4/1/24 I thought it was just where I practiced, but it turns out that, in the medical field, we’re really bad about having code discussions, which is a significant issue. When some of my patients revealed that no one had ever asked them about their code status before, I decided to conduct some research on this topic. It turns out that, at most, 41% of patients recall discussions about their code status, however, the 10.3% as documented by another study seems much more accurate.

Hospice care for those with dementia falls far short of meeting people’s needs at the end of life ArcaMax, Maria J Silveira, University of Michigan; 4/1/24... Strikingly, only 12% of Americans with dementia ever enroll in hospice. Among those who do, one-third are near death. This is in stark contrast to the cancer population: Patients over 60 with cancer enroll in hospice 70% of the time. In my experience caring for dementia patients, the underuse of hospice by dementia patients has more to do with how hospice is structured and paid for in the U.S. than it does patient preference or differences between cancer and dementia.

Hospice providers serving assisted living residents: Association of higher volume with lower qualityJournal of American Geriatrics Society; by Wenhan Guo MS, MA, Helena Temkin-Greener Phd, Brian E. McGarry PT, PhD; 3/27/24Background: Assisted living (AL) community caregivers are known to report lower quality of hospice care. However, little is known about hospice providers serving AL residents and factors that may contribute to, and explain, differences in quality. We examined the association between hospice providers' AL patient-day volume and their quality ratings based on Hospice Item Set (HIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Surveys.

New Federal Health IT Strategy sets sights on a heathier, more innovative, and more equitable health care experienceU.S. Department of Health and Human Services; 3/28/24The U.S. Department of Health and Human Services (HHS) through the Office of the National Coordinator for Health Information Technology (ONC), today released the draft 2024–2030 Federal Health IT Strategic Plan (the draft Plan) for public comment. The draft Plan: 

High intensity of end-of-life care for minority patients with lung cancerU.S. Medicine; 3/27/24While disparities in lung cancer mortality among racial and ethnic minorities are well documented, not as much is understood about how racial and ethnic minority patients with lung cancer are treated at the end of life. A study led by researchers from the Indiana University School of Medicine and the Richard L. Roudebush VAMC, both in Indianapolis, sought to determine if those patients experience higher rates of intensity of care at the end of life (EOL) compared with non-Hispanic white (NHW) patients.

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

Hospitalists more likely to recommend hospice than specialists: Study Becker's Hospital Review, by Mariah Taylor; 3/27/24 A New Haven, CT-based Yale School of Medicine study [published in the American Cancer Society Journals] suggests oncology hospitalists have better hospice utilization and reduce hospital stays for cancer patients compared to oncologists. Researchers compared referrals for hospice settings from hospitalist-led services and oncologist-led services. Hospitalist-led services referred 11.8% of patients to inpatient hospice settings, nearly double the referral rate of oncologist-led services (5.8%). The adjusted average length of stay before inpatient hospice care was 6.83 days for hospitalist-led care and 16.29 days for oncologist-led care. 

[Pediatrics] North Dakota Health and Human Services announces new pilot program CBS KX News, by Nathaniel House; 3/26/24 North Dakota Health and Human Services (HHS) has announced that family members who provide extraordinary care to either a child or adult enrolled in an eligible North Dakota (ND) Medicaid 1915(c) waiver may receive payments from the state through the new Family Paid Caregiver pilot program. State funding for the pilot program was approved from the passage of Senate Bill 2276 during the 2023 legislative session. Eligible ND Medicaid 1915(c) waivers include the Autism Spectrum Disorder Birth Through 17 Waiver, Children with Medically Fragile Needs Home and Community-Based Services Waiver, Children’s Hospice Home and Community-Based Services Waiver and the Traditional Individual with Intellectual Disabilities and Developmental Disabilities Home and Community-Based Services Waiver. 

What is the FAST scale for Alzheimer's?MedicalNewsToday, by Charlotte Lillis and medically reviewed by Shilpa Amin, MD, CAQ, FAAFP; 3/25/24The Reisberg Functional Assessment Screening Tool (FAST) is a scale that doctors use to diagnose and evaluate aspects of Alzheimer’s disease. ... This article provides an overview of the FAST tool, including a breakdown of its individual stages. It also outlines what to expect from the FAST evaluation, what the scale means for hospice care, and more.

Researchers advocate for more home-based options for end-of-life care McKnights Home Care, by Adam Healy; 3/25/24 As older adults increasingly prefer to receive end-of-life care in their homes, new, community-based options will be critical to help patients achieve a home death, according to a new research review published in Palliative Care and Social Practice. ... The researchers analyzed 28 studies conducted between 2002 and 2023 related to factors that affect patients’ abilities to achieve a home death. One persistent issue, they found, was a lack of available home palliative care services.