Literature Review

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.

Teleios Collaborative Network develops Quintuple Aim Strategy to enhance hospice care Business Insider / Markets Insider, Flat Rock, NC; Press Release; 9/27/24 Teleios Collaborative Network (TCN) has officially announced the launch of its Quintuple Aim Strategy, aimed at setting a new standard for excellence in hospice and serious illness care. This initiative addresses the pressing need for improved quality of life for patients nearing the end of life, as many hospices face challenges in providing comprehensive care. ... The Quintuple Aim Strategy emphasizes five key goals: improving patient experience, enhancing population health, reducing costs, promoting provider well-being, and advancing health equity. This holistic approach enables member organizations to focus on their core mission of delivering high-quality, compassionate care. One of the key components of TCN’s model is the provision of comprehensive back-office support services. By offering shared resources in areas such as credentialing, billing, marketing, and finance, TCN allows its members to minimize administrative burdens and prioritize patient care. In just seven years, TCN has grown to include 15 member organizations across 10 states, and it has been recognized as one of Modern Healthcare’s Best Places to Work for four consecutive years, underscoring its commitment to fostering a supportive and effective work environment. ...

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.

Financial pressures shut down 2 hospice agencies Hospice News; by Jim Parker; 9/20/24 A hospital-based hospice program in Kansas is closing its doors, as is the Visiting Nurses Association of Philadelphia. Holton Community Hospital (HCH) will shut down its home health and hospice department effective December 31st. A range of issues contributed to the decision to end the program, including reimbursement pressures on its home health business and the ascendance of Medicare Advantage, which often pays at a lower rate than traditional Medicare. The Holton, Kansas-based hospital also cited increased competition in its local community as a reason for the closure. ... The organization is working with other local providers to ensure continuity of care for its home health and hospice patients. Meanwhile in Pennsylvania, the Visiting Nurses Association of Philadelphia is also closing. The 138-year-old institution will cease operations on Oct. 28. It is a provider of hospice, home health and palliative care services.Editor's note: For more information about the VNA in Philadelphia, see the article we posted on 9/18/24, After 138 years, the Visiting Nurses Association of Greater Philadelphia will shut down all health care services next month.

Mirror, mirror 2024: A portrait of the failing U.S. health system - comparing performance in 10 nations The Commonwealth Fund; by David Blumenthal, Evan D. Gumas, Arnav Shah, Munira Z. Gunja, and Reginald D. Williams II Goal: Compare health system performance in 10 countries, including the United States, to glean insights for U.S. improvement. Methods: Analysis of 70 health system performance measures in five areas: access to care, care process, administrative efficiency, equity, and health outcomes. Key Findings: The top three countries are Australia, the Netherlands, and the United Kingdom, although differences in overall performance between most countries are relatively small. The only clear outlier is the U.S., where health system performance is dramatically lower. Conclusion: The U.S. continues to be in a class by itself in the underperformance of its health care sector. While the other nine countries differ in the details of their systems and in their performance on domains, unlike the U.S., they all have found a way to meet their residents’ most basic health care needs, including universal coverage.

Hospices improving on public measures Home Health Line - decisionhealth; by DecisionHealth Staff; 9/12/24 Hospice providers are seeing continued improvement on key measures in the Hospice Item Set, according to the latest refresh of Care Compare data on Aug. 28, 2024. [Subscription required] Editor's note: Use this summary information to check your own CMS Hospice Compare Scores at Find Healthcare Providers: Compare Care Near You | Medicare. Select Provider Type "Hospice Care." Type your location or "Name of Agency" and "Search." Select your hospice. For the Hospice Item Set (HIS), scroll down to "Quality" - "Quality of patient care." For your CAHPS data, scroll down to "Family caregiver experience."

Half of home care workers have seen, experienced workplace violence, report findsMcKnight's Home Care; by Adam Healy; 9/10/24The majority of home care workers have had a brush with workplace violence or harassment, so addressing these dangers can yield significant positive impacts for providers and their staff. That’s according to a new report on home care workplace safety by Transcend Strategy Group. More than 50% of home-based care workers have witnessed or experienced at least one incident of workplace violence or harassment, the report found. About 1 in 5 reported having seen at least seven instances of violence or harassment while on the job. Certified nursing assistants, registered nurses and physician assistants were the most likely groups to be subject to workplace dangers.

CMS to expand ‘enhanced oversight’ to combat hospice fraud in 4 states Hospice News; by Jim Parker; 9/10/24 The U.S. Centers for Medicare & Medicaid Services (CMS) is expanding its enhanced oversight for new hospices in fraud-ridden states, including California, Nevada, Arizona and Texas. The agency in July 2023 first announced a “provisional period of enhanced oversight” for new hospices in those states. A key component of the enhanced oversight includes a medical review of claims before a Medicare Administrative Contractor (MAC) will pay them. “To combat fraud, waste, and abuse under the hospice benefit, CMS will expand prepayment medical review this September in Arizona, California, Nevada and Texas,” the agency indicated in a statement. “To help reduce burden on compliant providers, initial review volumes will be low and adjusted based on results. If you’re noncompliant, we may implement extended review or take additional administrative actions.” 

The biggest threat in health IT and RCM Becker's Hospital Review; by Randi Haseman; 9/6/24 Are organizations adopting AI technology too quickly or too slowly? And what's the future of payer relationships? ... As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. ... Question: What is the biggest threat in health IT and RCM right now? [Responses from 47 executives featured in this article address the following and more: payer programs; modernizing legacy systems while ensuring data security and compliance; cyber-crime / cybersecurity; relieving provider and staff burden thgouth clinical workflows; state and federal legislation; human error; Gen AI 'mission-creep'; extended systems downtimes; the velocity of technical disruption; more ...]

Flourishing at the end of life Public Discourse - The Journal of the Witherspoon Institute; by Xavier Symons, John Rhee and Tyler VanderWeele; 9/5/24 Dying is part of life, but most people dread their final days. The end of life, which often takes the form of protracted terminal illness, can involve significant pain and suffering as well as functional limits in day-to-day living. Is it still possible for human beings to flourish at the end of life? ... While dying may be a time when agency and quality of life are limited, the end of life also presents unique possibilities for the realization of human goods. Some dying patients discover meaning by reflecting on the events of their lives and come to a deeper appreciation of their own life legacy. Terminal illness also presents opportunities for a deepening of close social relationships and the fulfillment of relationship commitments. Paradoxically, the end of life can be a catalyst for gratitude and self-transcendence. It is worth asking, then: can we flourish even as we approach death? And how can we help our loved ones flourish in their final days? Editor's note: Take your time with this excellent essay, as it gets to our collective, core hospice mission, as described by Dame Cicely Saunders: "You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully but also to live until you die." 

Grief redoubled by a death certificate delayed: A seven-week odyssey in search of a vital record The Provincetown Independent; by Aden Choate; 9/4/24 Richard Pask, 72, came to the select board on Aug. 27 distraught. His wife, Carol Harris, 69, who had ALS, had died at home in hospice care on July 18, he said, and the town had still not issued a death certificate. Without the certificate, Pask could not access his late wife’s pension payments, manage their mutual assets, update annuity contracts, or cancel service accounts in her name. The Social Security Administration, which has continued to issue payments to Harris — a death certificate is required to stop them — had launched an investigation into possible fraud, ...Editor's note: Root causes from this complex case study relate to the family having used a "green burial" which is becoming more common, where permitted. This case study represents a gap in collaboration between typical systems. Hospice personnel who have any 'touch-points" with the death certificate process must know and adhere to federal, state, and local policies and procedures, especially when variables occur (such as green burials).