Literature Review

Tech solutions for better patient care: How modern tools are transforming hospice management NerdBot; by Nerd Voices; 5/30/24 Hospice care, fundamentally centered on providing comfort and support to terminally ill patients, has traditionally been a deeply personal and human-centric field. However, as technology advances, it is clear that modern tools can significantly enhance the quality of care. Integrating technology into hospice revenue management allows caregivers to streamline operations, reduce errors, and focus more on delivering compassionate care.

Hospice CAHPS scores updated 5/22/24CMS CAHPS® website; multiple updates posted 5/22/24 CMS has posted numerous CAHPS® Hospice Survey updates. Click on the title's link to access the CMS site. Click on "Care Compare Reporting Updates" or the following 5/22/24 updates:

Spread of assisted dying shines spotlight on difficult decisions Financial Times; by Charlotte Middlehurst; 5/22/24 The right to control your death is a principle that societies have debated for centuries. But, as more countries prepare to legalise medically-assisted dying, the reality of allowing the practice is sparking fresh ethical arguments. Some form of assisted dying is now legal in 9 countries, as well as in 11 US states and parts of Australia. [Click on the title's link for data and discussion regarding international policies; concerns about increased "unassisted suicide"; rapid legislative/medical decisions; inducing death; devaluing the lives of disabled persons; ethical choices based on economic factors; doctors' choices; and more.] 

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.” 

Health Equity Data Definitions, Standards, and Stratification: New resource available Centers for Medicare and Medicaid Services; by CMS; May 2024Resource of health equity-related data definitions, standards, and stratification practices ... This document serves as a technical resource that can be used by organizations and entities, such as providers, states, community organizations, and others, that wish to harmonize with CMS when collecting, stratifying, and/or analyzing health equity-related data. It may also clarify differences in results that may arise when different data standards and definitions are used. This document includes suggested definitions, standards, and stratification practices for the following sociodemographic elements:

How Mass General Brigham provides emergency care at home Becker's Health IT; by Giles Bruce; 5/6/24Somerville, MA-based Mass General Brigham now treats patients needing emergency or urgent care at home. The health system's patients can request referrals to the Home Hospital Emergency Care program through their primary care providers, who decide if patients are stable enough to be treated at home. If they are, a nurse talks to the provider and schedules a home visit, where a paramedic completes a physical exam joined virtually by an emergency medicine physician. Editor's Note: Pair this article with others in today's newsletter: "Stranded in the ER, seniors await hospital care and suffer avoidable harm" (in our Post-Acute Care section), and "[Australia] Palliative patients can die peacefully at home with paramedic support, claims proposed framework" (in our International section). 

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.

Hospice patient airlifted to safety during East Texas floods The Gilmer Mirror; by Emily Foxhall, Carlos Nogueras Ramos and Alejandra Martinez, The Texas Tribune; 5/3/24[Scroll down on this webpage to "East Texasn try to reach their homes, save pets"] Willie Rawls woke up to water at the steps of his home Thursday in the river bottoms of Coldspring – one of the first towns hit by the several hundred thousand gallons of water released from the Lake Livingston Dam. The dam was releasing water in an effort to maintain its levels as merciless rain storms drenched East Texas this week. Rawls, 73 and in hospice care, was evacuated by the San Jacinto Sheriff’s Office, who arrived in an airboat and lifted him to safety. 

National Nurses Week 2024: RN reflects on the state of the profession, calls for change USA Today / Columbia Daily Tribune; by Julia Gomez, USA Today; 5/6/24 Monday, May 6 kicks off National Nurses Week, and it gives folks an opportunity to show their love and appreciation for the people who take care of the sick, injured and dying. From neonatal nurses who help welcome newborns into the world to hospice nurses that provide peace and comfort to their dying patients, nurses play a crucial role in the medical industry. ... Catherine Kennedy, a registered nurse and the Vice President of National Nurses United, told USA TODAY that there needs to be systemic change on the federal level to give nurses the best chance to care for their patients. A study published by the National Library of Medicine states that in 2021, nurses would work an average of "8.2 hours of paid overtime and 5.8 hours of unpaid overtime per week that year — making up the equivalent of more than 9000 full-time jobs." ...