Literature Review

Healthcare sees highest Chapter 11 bankruptcy filings in 15 years: reportMcKnights Senior Living; by Kathleen Steele Gaivin; 5/20/24Chapter 11 bankruptcies in healthcare, including senior living reached a multiyear high in the first quarter of 2024. That’s according to the newest Polsinelli-TrBK Distress Indices Report, published Wednesday. “We continue to see intense stress in senior living,” Jeremy R. Johnson, a bankruptcy and restructuring attorney at Polsinelli and co-author of the report, said in a press release issued in conjunction with the report. ... The Southeast continues to outpace the rest of the country as the busiest region for bankruptcy filings, according to the report. The Southeast region reported 33.4% of the filings in the first quarter, followed by Northeast and Delaware at 30.8% and 16.1%, respectively. Since the benchmark period of 2020, the Northeast has shown the biggest increase in filings.

When doctors withhold futile treatments, that isn’t ‘assisted dying’ The Guardian; by Dr. James Haslam; 5/15/24 [Commentary / Letter] I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing [the author's choice of words]. ... Intentions are important. ...Editor's Note: This thoughtful response puts forth ethical support against Medical Aid in Dying (MAiD), also known as "physican assisted suicide." Likely, different opinions can be inflammatory among your hospice and palliative employees, board, community, and more personally among your family and friends. As hospice and palliative leaders, we must address this issue with respectful dialogue, critical thinking, case studies, personal beliefs and values, empathy, and humanity.

End of life outcomes following Comfort Care Orders: A single center experience The American Journal of Hospice & Palliative Care; by Matthew Tucker, Dayna Hovern, John Liantonion, Elizabeth Collins, Adam F Binder; 5/13/24 Conclusions: The majority of patients placed on comfort care died during their hospitalization demonstrating a real need for comprehensive end of life care and immediate hospice services. For those discharged with hospice services, they spent an excessive amount of time in the hospital waiting for services to be arranged.

House Committee vote gives hope to extending telehealth, hospital at home waivers Health Leaders; by Eric Wicklund; 5/9/24 The House Ways and Means Committee has voted to advance the Preserving Telehealth, Hospital and Ambulance Access Act (HR 8261), which would, among other things,  continue pandemic-era Medicare waivers enacted by the Centers for Medicare and Medicaid Services (CMS) for telehealth access and coverage through 2026 and extend the CMS Acute Hospital Care at Home waiver for an additional five years, to the end of 2029.

Van Duyne, Blumenauer, 38 lawmakers push CMS on hospice integrityVanDuyne.house.gov; Press Release; 5/8/24Today, Congresswoman Beth Van Duyne (R-TX) and Congressman Earl Blumenauer (D-OR) led a bipartisan group of 38 lawmakers demanding answers from Centers for Medicare & Medicaid Services (CMS) on the implementation of recent reforms aimed at combatting hospice fraud and abuse. “When electing to receive hospice care, individuals and their families must be confident the provider is committed to delivering individualized, compassionate care that optimizes quality of life; however, we continue to hear about instances of pervasive fraud and abuse,” the lawmakers wrote.  ... To better understand the steps CMS has taken to increase program integrity, the lawmakers continued the letter with detailed questions on the implementation of reforms. Read the full letter here.  ...“Thank you, Representatives Blumenauer and Van Duyne, for your leadership in holding CMS accountable and safeguarding hospice patients and families from fraudulent activities,” said Ben Marcantonio, Interim CEO of the National Hospice and Palliative Care Organization. “Preserving the integrity of the Medicare Hospice Benefit is paramount to ensure high-quality care for Americans with serious illness and end-of-life care needs.” 

4 ways to mitigate breaches and security crises in healthcare Health IT Answers; by Matt Betts and Carlos Estrada; 5/7/24 ... In this age of ransomware attacks and data breaches, organizations are turning to the experts in change management: healthcare services partners that have relevant experience with volatile contact volumes and strategies to best support these consumers. When evaluating a solutions partner, focus on these four areas to adequately assess a competitive edge:

Steward files for bankruptcyBecker's Hospital CFO Report; by Laura Dyrda; 5/6/24Dallas, Texas-based Steward Health Care filed for Chapter 11 bankruptcy and will receive millions in financing from Medical Properties Trust to maintain operations at existing hospitals and clinics, according to a May 6 health system news release. The 30 hospitals in the Steward network will continue patient care during the bankruptcy proceedings, and the physician-led health system does not expect interruptions to daily operations. ... The for-profit health system has faced financial challenges and liquidity issues in recent months, blaming low reimbursement from government payers and increasing costs for labor, materials and operations due to inflation. The system also reported continuing to experience negative financial effects from the COVID-19 pandemic.

Keys to addressing ethical, moral distress in pediatric hospice Hospice News; by Holly Vossel; 5/6/24 Hospices may be under-prepared to navigate the complexities in end-of-life decisions among terminally ill children, as the ethical and moral considerations related to patient autonomy are vastly different for pediatric populations compared to adults. Ethical principles of autonomy vary in pediatric populations due to a number of factors, including a child’s age, developmental stage, cognitive capacity and their spiritual background and beliefs, according to Christy Torkildson, director at the Children’s Hospice and Palliative Care Coalition of California. 

AI governance and cybersecurity certifications: Are they worth it? CSO; by Maria Korolov; 5/6/24The International Association of Privacy Professionals (IAPP), SANS Institute, and other organizations are releasing new AI certifications in the areas of governance and cybersecurity or adding new AI modules to existing programs. These may help professionals find employment, but with the area being relatively new, experts warn certifications could be out of date almost immediately. ... On the other hand, the new AI governance and cybersecurity certifications cover the basics needed to get up to speed, create a foundation layer on which people can build later, create a common language for practitioners to use, and will typically include ongoing training requirements to help people stay current. Here, in alphabetical order by organization are all the AI governance training and certificates known at the time of publishing. ...

Families are often unaware of benefits of palliative hospice care, says retired oncologist KSMU Ozarks Public Radio; radio segment by Linda Regan; 5/5/24 In this episode of our local program Making Democracy Work, host Linda Regan speaks with returning guest Dr. Robert Carolla, retired medical oncologist and board member for Hospice Foundation of the Ozarks. Carolla discusses palliative hospice care and says that families often sign up too late to receive all of the supportive benefits. He says “death is a part of life” and explores common misconceptions associated with hospice care.

Home-based pediatric hospice and palliative care provider visits: Effects on healthcare utilization The Journal of Pediatrics; by Steven M. Smith, MD; Daniel H. Grossoehme, DMin; Kate Cicozi, MD; Audrey Hiltunen, MD; Catherine Roth, MPH, CCRP; Gwendolyn Richner, BA; Stephani S. Kim, PhD, MPH; Nguyen K. Tram, PhD; Sarah Friebert, MD; May 2024 journal issue Objective: This hypothesis-generating study sought to assess the impact of home-based hospice and palliative care (HBHPC) provider home visits (HV) on healthcare use.  Conclusion: HBHPC provider HVs were associated with fewer inpatient admissions, hospital days, and intensive care unit days, and increased clinically relevant phone calls and phone calls before emergency department visit. These findings indicate that HBHPC HV may contribute to decreased inpatient use and increased use of the HBHPC team.

Hospice remains a blind spot for Medicare Advantage Axios; by Maya Goldman; 5/6/24 As Medicare Advantage grows bigger and bigger, there's one area the industry and regulators haven't figured out how to make work yet: hospice. Why it matters: The end-of-life care option is the only Medicare service that can't be offered in the private-run alternative, which now covers over half of enrollees. ... Catch up quick: Usually, when a Medicare Advantage beneficiary decides to enter hospice after receiving a terminal diagnosis, traditional Medicare pays for this care while they remain enrolled in their private plan. ... Editor's Note: This practical, user-friendly article outlines the purposes, challenges, and outcomes of Medicare Advantage with hospice patients. Share this with your leaders and board members.

What Hospice VBID’s ending means for palliative care Hospice News; by Markisan Naso; 5/1/24 The impending demise of the hospice component of U.S. Centers for Medicare & Medicaid Services’ value-based insurance design (VBID) model has largely been met with a sense of relief by providers as they plan new initiatives for palliative care in 2025. ... The program, which initially contained promising components designed to give patients better access to palliative care, instead became an increasing source of frustration for organizations. ... With the end date for the hospice component of the VBID model approaching, many palliative care providers are left with concern for their patients and questions about the coming transition, as they shift focus to what happens next.  Editor's Note: This article includes perspectives from Rory Farrand, Vice President of Palliative and Advanced Medicine at NHPCO, and Mollie Gurian, Vice President of Home-Based and HCBS Policy at LeadingAge.