Literature Review

Hospice care home provides peaceful place for low-income or homeless to die Indiana Capital Chronicle; by Elise Shrock; 10/10/24 My neighborhood is full of wonderful places. Lovely places where people go to worship, to meet for meals, to do their errands, and, a lovely place to die. Let me explain. Tucked behind the busy near-north Keystone corridor is the Abbie Hunt Bryce Home, a no-cost home for terminally ill individuals who are low-income or homeless and would have no other home to go to during their last days or months of life. Operated by Morning Light, LLC, Abbie Hunt Bryce Home offers critical and compassionate services to Hoosiers in their final days. As the second largest residential hospice in the nation, our state is positioned to be a leader in providing compassionate end-of-life care. Not only is the Home a leader in size and scope, but all hospice residents stay free of charge, with no payment or insurance required. The Home is supported solely by community support and qualifies for Medicaid Waiver. ... [A case study follows with "Systemic challenges in Indiana." ...]

Florida officials rush to evacuate vulnerable patients ahead of Milton The Washington Post; by David Ovalle and Sabrina Malhi; 10/9/24 at 6:31pm EDT An armada of ambulances, buses and helicopters this week have ferried thousands of sick and vulnerable people to safer ground in a medical evacuation unparalleled in Florida history as monster Hurricane Milton neared landfall. Assisted-living facilities across the Tampa Bay region shuttered as patients were transferred to homes away from the churning Gulf of Mexico and its potentially lethal storm surge. Government-run shelters for special-needs patients and their caregivers were filling to capacity in high schools and community centers across the peninsula. Ambulance crews from as far away as California and New Hampshire transported patients — some on ventilators — to hospitals sometimes hours away. “This storm is pretty unprecedented,” said Ed Powers, a regional manager for Global Medical Response, which deployed about 400 ambulances to Florida. “This is one of the largest, if not the largest, deployments we’ve ever done.” ...Editor's note: Though this news is now "old," it paints a vivid picture for healthcare Emergency Disaster Preparation, policies, partnerships, training of staff, and communication systems. What risk assessments, preparations, and systems do you have in place? What can you improve? 

Community making strides to reopen Owatonna's Hospice House Owatonna People's Press, Faribault, MN; by Annie Harman; 10/8/24 ... Allan and Randee Radel smiled as they remembered the days they relied on the Homestead Hospice House to care for Randee’s mother, Kaye Mahlman, during the final days of her life. “It was wonderful. It was good for her, and it was good for the family,” Randee said, looking at the house as visitors strolled inside. ... It has been more than a year since the Hospice House has cared for a patient, but there is movement being made to open the doors once again as a full-service residential hospice care facility. And thanks to the Radels, that dreaming has taken a significant step toward reality. The couple handed over a check this week to the HHH Board to put toward the $850,000 fundraising goal to reopen the house. While the couple has decided they’d rather just call it a “very generous donation,” in lieu of sharing the actual number, those involved in the fundraising efforts are not shy to say with confidence that, thanks to the Radels and others like them, they are making “significant progress” in reaching that goal. ...

Florida health-care workers exhausted as Hurricane Milton approaches The Washington Post; by David Ovalle and Sabrina Malhi; 10/8/24The storm shutters are up at Stephen Johnson’s house near the water in North Fort Myers, Fla. ... But  Jones won’t be home when Hurricane Milton is expected to thunder ashore this week along the Gulf Coast. Instead, the paramedic — like thousands of health-care workers across Florida — intends to ride out the storm at work, then jump into action when the winds die down, the waters recede and people seek medical assistance. ... “It gets stressful. You don’t know if you’re going to come back to a home,” Johnson, 28, of Brewster Ambulance Service, said during a brief break Tuesday after two straight days of organizing evacuations of patients from hospitals and assisted-living facilities across Lee County in southwest Florida while surviving on granola bars and energy drinks. ... By Tuesday afternoon, Florida health officials had deployed nearly 600 ambulances, buses and other transport vehicles to ferry patients out of harm’s way. More than 200 health-care facilities — including 115 assisted-living facilities, 10 hospitals and five hospice providers — have reported evacuations, according to the state’s health department.

The best bets for palliative care reimbursement post-VBID Hospice News; by Jim Parker; 10/8/24 The hospice component of the value-based insurance design model (VBID) will sunset at the end of this year, but opportunities for payment through Medicare Advantage and other models remain. The hospice component is part of the larger VBID program, which will continue through 2030. The component was designed to test coverage of hospice through Medicare Advantage. It also contained elements intended to expand access to palliative care, for which reimbursement in general is scarce. Hospice News spoke with Dr. Bob Parker, chief clinical officer and chief compliance officer for the Texas-based hospice provider Kindful Health, about the opportunities in place for palliative care providers. [Click on the title's link for this interview.]

Community Healthcare CEO: Enact moratorium to combat hospice fraud Hospice News; by Jim Parker; 10/4/24 Community Healthcare of Texas CEO Viki Jingle has kept her finger on the pulse of potential hospice fraud occurring in her home state. She and her colleagues recently brought a range of concerns to a discussion with Rep. Beth Van Duyne (R-Texas) in Community Healthcare’s second meeting with the Congress member. Van Duyne has been among the legislators who have been most vocal about hospice fraud since the problem began to emerge. Among the most important issues under discussion is a rash of newly licensed hospice operators in multiple states that some have associated with suspicious or unethical practices. The issue first gained attention in 2022 in California, but stakeholders have also raised concerns about providers in Nevada, Arizona and Texas. [Click on the title's link to continue reading.]

There’s still joy in end-of-life care The Seattle Medium, Seattle, WA; by Anissa Durham; 10/3/24 Caregiving is an act of love and sacrifice. But for young Black women, it’s often summed up as just being “a good daughter.” More than 100 million Americans provide care to a child, parent, or relative. And about half provide care to a spouse, elderly parent or relative, or special needs child, according to a report by Guardian. But for Black folks, the burden of doing so is often heavier. Due to disparities in education, housing, and nutrition, and less access to health insurance, — along with the “weathering” that accompanies racism-related stress — Black Americans experience higher risk and rates of chronic disease. Which means, Black folks may get sick sooner than their counterparts and make younger generations, often women, more likely to become caregivers. In a 2021 report, Black family caregivers represent 14% of the estimated 48 million unpaid family caregivers in the U.S., with Black women making up a little more than half of this group, according to the American Society on Aging. Overall, women are two times more likely than men to say they’ve left the workforce to keep up with caregiving responsibilities. And nearly 50% of caregivers are either Millennials or Gen Z, according to the Guardian report. 

TCNtalks - Hurricane Helene

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. urricane 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.

Fighting ‘phantoms’: How fraud skews competition in the hospice market Hospice News; by Holly Vossel; 9/26/24 Fraudulent operators’ marketing strategies are morphing the competitive landscape, making it difficult for legitimate hospice providers to maintain visibility among patients and families. A mounting concern is that fraudsters stepping into the hospice industry have been implementing marketing and outreach practices that at times mirror strategies utilized by quality providers, according to Jeanne Chirico, president and CEO of the Hospice & Palliative Care Association of New York State (HPCANYS). This makes it difficult for referrals, patients and their families to discern the best end-of-life care option. Another significant concern is that the fraudulent actors may have deeper pockets compared to smaller or nonprofit hospices, allowing them to invest more heavily and saturate the market with their messaging. 

Man accused of choking terminally ill wife accepts plea deal KSL.com; by Pat Reavy; 9/27/24 A man who prosecutors say attempted to end his terminally ill wife's life by choking her has accepted a plea deal. DeWayne McCulla, 46, pleaded guilty on Thursday in 5th District Court to an amended charge of attempted manslaughter, a third-degree felony. The charge comes with a domestic violence sentencing enhancement. Arenda Lee McCulla, 47, died on Dec. 21, 2021, following her battle with breast cancer. The night before, however, as a small group of family members were by her side in La Verkin, DeWayne McCulla "choked the victim in an attempt to kill her to ease her suffering while they were with her during her terminal cancer and being on hospice," according to charging documents. Other family members pulled McCulla off of his wife.Editor's note: Crucial information that is not reported in this article: Where was the hospice team in managing this patient's pain? In educating and supporting the caregiver (the husband?) and family about contacting the hospice? In making required visits when the patient is actively dying? In assessing the caregiver's ability to provide care, especially any history or risks of domestic violence, neglect, or abuse? What safety-in-the-home protocols were used by this hospice, especially when hospice team members followed up? Aware of not-knowing these many factors, I do not ask these with judgment but rather to raise awareness of core, preventive measures for other hospice patients.

BREAKING NEWS: 9/27/2024 11:45 am - Blumenauer proposes overhaul to Hospice Benefit: If enacted, the legislation would be the single most significant update to the hospice benefit and payment structure since its inception in 1982.

Oncology leaders call for ‘ethical deployment’ and ‘responsible use’ of AI in cancer care Healio; by Josh Friedman and Matthew Shinkle; 9/25/24 The AI revolution already has transformed delivery of cancer care. New algorithms rapidly identify patterns or abnormalities on imaging, improving diagnostic accuracy. Large language models can craft responses to patient questions, and machine learning predicts treatments to which a patient is most likely to respond. ... Oncologists are grappling with complex issues as they integrate AI into cancer care, according to results of a nationwide survey. Most oncologists believe they should have the ability to explain how AI models work and must protect patients from biased AI, findings published in JAMA Network Open showed. Most respondents also indicated patients should consent to use of AI before it is implemented in practice. ... Despite the potential benefits of AI to improve decision-making and outcomes, clinicians have expressed concerns about ... AI bias; the ability of AI to detail its decision-making process; who bears responsibility for errors or misuse; and whose treatment recommendation takes precedence when a physician and AI do not agree.