Literature Review

Families, volunteers share stories of finding peace through hospice Salina Post; by Cristina Janney, Hays Post; 6/29/24 This is a two-part series on hospice care in northwest Kansas. Dalene Juenemann and her father, Dean, had to make the difficult decision to enter hospice care after he was diagnosed with bladder cancer. “He was just such a social guy and someone was in a couple times a week,” she said. “They were checking in on him and it was that security blanket he had.” ... He didn’t want to go through aggressive chemo and he didn’t qualify for a bladder removal because of his age. “He chose quality of life,” she said. "It was that final decision that we are done with everyone wanting a piece of me. I'm just going to enjoy life," she said. Dalene's father, Dean Shearer, was a patient of NWKareS, Hospice of Northwest Kansas, which serves 16 counties from Interstate 70 to the Nebraska border and Trego County to the Colorado border. ... She said the extra care hospice offered allowed her to just be a daughter to her father as he was dying. [Click on the title's link to continue reading stories from families and volunteers at NWKAreS.]

Q&A: What is the ID clinician’s role in end-of-life care? Healio; by Caitlyn Stulpin; 6/27/24 Patients receiving infectious diseases (ID) consultation over the past decade were increasingly complex, generally sicker and more likely to die soon after a consultation was performed, according to a study. Researchers said that the rate of infectious diseases (ID) consultation relative to hospital admissions doubled during that time, suggesting that ID physicians are more often being faced with the challenge of caring for complex patients. Because of this, Alison G.C. Smith, MD, MSC, and Jason E. Stout, MD, MHS, and colleagues aimed to assess the role of these physicians when it came to end-of-life care, leading them to conduct a retrospective cohort study of all patients with an ID consult at the Duke University Health System between Jan. 1, 2014, and Dec. 31, 2023.

The Program of All-Inclusive Care for the Elderly will begin in July at Jordan Valley Community Health Center KSMU Ozarks Public Radio; by Michele Skalicky; 6/24/24 A new program at Jordan Valley Community Health Center in Springfield will allow those 55 and older to age in their own homes. The Program of All-Inclusive Care for the Elderly is the first PACE program in southwest Missouri. "We'll do home assessments to make improvements that will allow them to live in their homes safely so we don't have potentials for trips and falls or if somebody has a need to have a built, we'll take care of all of that through our home assessment and allow them to have the safest possible home," said Ryan Kruger, vice-president of operations for PACE and pharmacy at the health center. The PACE model uses an interdisciplinary team of professionals that provide coordinated care. PACE care includes medical and personal care, rehabilitation, social interaction, medications, transportation and more.

20 most socially responsible hospitals, per Lown Institute Becker's Hospital Review; by Mackenzie Bean; 6/25/24 Duke Regional Hospital in Durham, N.C., is the most socially responsible acute care hospital in the U.S., according to a June 25 ranking from Lown Institute. The nonpartisan healthcare think tank assessed more than 2,700 acute care hospitals and 800 critical access hospitals nationwide across 54 metrics related to health equity, value of care and patient outcomes. ... The 20 most socially responsible acute care hospitals in the U.S., per Lown Institute:

Jimmy Carter’s long stay in hospice dispels myths about end-of-life care Miami Herald; by Brian Dunleavy; 6/24/24 Former President Jimmy Carter's being in hospice for 16 months makes him an "outlier," but it also highlights the multifaceted nature of end-of-life care and dispels myths about that care, experts told UPI. ... [Dr. Joan Teno, a former hospice provider and an expert in geriatric care said,] "President Carter is an outlier in that only a small percentage of hospice patients survive more than 15 months," she told UPI in an email. "The fact that he has lived so long on hospice is testament to his excellent medical care at home and, if I had to guess, his will to live." It also illustrates the core focus of hospice, which is typically geared toward people with an anticipated life expectancy of 6 months or less, for whom curing their underlying illness isn't an option, Teno added. Defying the odds: More than 90% of patients who enter hospice care die within the first six months, and nearly 40% die within the first week, according to the National Institutes of Health.Editor's Note: Too many hospice organizations and news outlets have used former President Jimmy Carter's longer-than-normal hospice stay to discount and ignore core "hospice" care. Rarely--if ever--have any of these news article been transparent to mention the CMS Hospice Face-to-Face Encounter Requirement. This article is more transparent by describing his hospice stay of 16 months as being as "outlier." Still, its headline can be misleading with its phrase "... dispels myths about end-of-life care."

Column: Hospice offers redirection of care The Andalusia Star News; by Vickie Wacaster; 6/22/24 Watching someone you love grow weaker and weaker with each passing day is challenging. Yet, sadly, many of us experience this. In my own life, when my late husband was diagnosed with a terminal, non-curable, yet treatable disease, I felt we were living on a roller coaster of emotions, appointments, and treatment options. ... Every day was a journey into uncharted territory for both of us. ... It was only during the last few days that we found the strength to say “no more treatments” and asked for hospice. ... Physicians recognize that hospice is not a withdrawal of care but a redirection of care to meet the needs of patients with an advanced terminal illness/disease. ...Editor's Note: The word "redirection" powerfully, easily shifts the course of care. The person remains at the center, with the focus being the person, not the disease. This is not a denial of dying and death, but rather a signpost, a gentle way to open the difficult conversation for providing information and asking "what matters most to you, now?" 

ASTHO and NAMD call on Congress to fully fund Medicaid and CHIP in U.S. territories ASTHO - Association of State and Territorial Health Officials; by Jane Esworthy and Stephanie Rhodes; 6/20/24 In a joint letter to Congress, the Association of State and Territorial Health Officials (ASTHO) and the National Association of Medicaid Directors (NAMD) urged Congress to fully fund Medicaid and Children's Health Insurance Programs (CHIP) in the U.S. territories. ASTHO and NAMD request that Congress lift the annual Section 1108(g) allotment cap for all territories and authorize a permanent 83% Federal Medical Assistance Percentage (FMAP) for Puerto Rico. ... “ASTHO recognizes the importance of permanent, sustainable, and equitable Medicaid financing for all U.S. territories,” says Joseph Kanter, MD, MPH, ASTHO CEO. ... “Unlike the states, the U.S. territories face an annual cap on their Medicaid funding,” says Kate McEvoy, Executive Director of NAMD. “This has impaired the territories’ capacity to provide needed health care to Medicaid-eligible U.S. citizens and nationals. It has also held the territories back from making the structural investments in care delivery and value-based payment reform, workforce, IT systems, and program integrity that are crucial to high performing and innovative Medicaid programs.”

Tapestry Hospice settles healthcare kickback claims for $1.4 million United States Attorney's Office - Northern District of Georgia; Press Release; 6/20/24 Tapestry Hospice of Northwest Georgia, LLC, and its owners and managers, David Lovell, MD, Stephanie Harbour, Ben Harbour, and Andrew Nall (collectively “Tapestry”), agreed to pay $1.4 million to resolve allegations that they violated the False Claims Act by entering into kickback arrangements with medical directors in exchange for referrals of hospice patients to Tapestry. “By entering into kickback arrangements, health care providers can cause doctors to make medical decisions that are motivated by financial gain, rather than the patient’s best interest,” said U.S. Attorney Ryan K. Buchanan. “Our office is committed to ensuring the accountability of health care providers who put their own financial needs ahead of their patients.” “The False Claims Act settlement in this case will hopefully be a deterrent to those who selfishly evade our federal healthcare programs for their own benefit,” said Keri Farley, Special Agent in Charge of FBI Atlanta. “The message is clear, the FBI will not tolerate companies operating corporate-wide schemes to illegally line their pockets.” 

Children’s hospices risk being ‘hugely reduced’ due to funding and cost issues Jersey Evening Post - UK News; by UK News; 6/19/24 Children’s hospice services are at risk of being “hugely reduced” amid a lack of long-term sustainable funding and rising costs, a charity has warned. ... Some 66.7% of children’s hospices said this was due to a hike in energy bills, while 86.1% said it was due to higher costs associated with recruiting and retaining staff. According to the report, some 54% of children’s hospices in the UK ended the 2023/24 financial year in a net deficit. Together for Short Lives extrapolated the figure across all 39 hospice organisations to estimate a total shortfall of £8.5 million.

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

CMS - Roadmap to Better Care: Tribal Version CMS; 6/17/24This version of the Roadmap has been updated to help members of the American Indian and Alaskan Native community connect to their health care, including benefits provided through the Indian Health Service (IHS), Medicare, Medicaid, Marketplaces, or private insurance. Unlike Medicare, Medicaid, the IHS is not an insurance program or an established benefits package. IHS cannot guarantee funds are available each year, and as a result sometimes needs to prioritize patients of greatest need. The preservation of legacy, heritage, and traditions is vital. This roadmap is designed to help sustain cultural richness and strengthen the well-being of present and future American Indian and Alaska Natives for generations. To learn more about enrollment in Marketplace, Medicare, or Medicaid see pages 4 and 5 or visit ihs.gov/forpatients.

East Anglia's Childrens Hospice releases heartwarming film: Ten-year-old "wants to show other children that hospice isn't a scarey place." EACH - East Anglia's Children's Hospices, United Kingdom; 6/17/24 "What's particularly special is that it was initiated by Charlotte. She told us she wanted to be part of a film, to show other children that a hospice isn't a scary place." ... A powerful new film has been released to showcase the work of a children’s hospice through the eyes of a spirited ten-year-old receiving care. Charlotte Freegard stars in the three-minute production, speaking about her experiences at The Treehouse, in Ipswich. “What’s particularly special is that it was initiated by Charlotte. “She told us she wanted to be part of a film, to show other children that a hospice isn’t a scary place. Instead, it’s somewhere they can have fun and create special memories.

AAHPM CMO Joe Rotella: Hospice does not exist to save money Hospice News; by Jim Parker; 6/17/24Dr. Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine (AAHPM), calls on hospices to maintain their core principles amid a churning sea of regulatory and economic changes. Rotella began his medical career as a primary care physician in a small, rural town in central New Hampshire, where he stayed for 12 years [followed by serving Hospice & Palliative Care of Louisville, KY/Hosparus as Chief Medical director for 15 years]. ... Now, Rotella will soon retire from AAHPM. Hospice News sat down with Rotella to discuss the ways hospice and palliative care have changed during his tenure in the space, as well as the forces shaping the field’s future. ...