Literature Review

It’s past time for an upgrade to the Medicare Hospice BenefitHealth Affairs, by Cara L. Wallace and Stephanie P. Wladkowski; 4/5/24When most people think about hospice care, they imagine someone such as the late Rosalynn Carter, who enrolled onto hospice and died within a few days. Jimmy Carter’s long hospice stay, now more than a year, has shown a different model for hospice—one that supports its mission to help people live well, with dignity and quality of life, for whatever time remains. However, current policy restrictions to enroll and remain on hospice make it difficult for many hospice recipients to receive hospice care for “whatever time remains,” as 17.2 percent of Medicare hospice patients are discharged alive. Editor's Note: Many hospices used Jimmy Carter's one-year anniversary as a marketing tool that hospice is not really for the "dying." Many--if not most--of these articles were not transparent in identifying any type of recertification, decertification, or revocation processes. Yes, while it may be past time for CMS to upgrade the Hospice Benefit, it's also past time for hospice marketing to be more transparent with the public.

The operational advantages of hiring seniors to provide home care Home Health Care News, by Joyce Famakinwa; 4/1/24Seniors Helping Seniors has long distinguished itself from other home care companies by hiring active seniors to serve as caregivers. Josh Obeiter — an owner of one of the company’s franchise locations — has seen even more added value from this strategy as the industry at large combats labor shortages. At Seniors Helping Seniors, the average age of an employee is around 70 years old, and 80% of caregivers are in their 60s and 70s, according to Obeiter.

Hospice update: March goes out like a lion Morgan Lewis - Health Law Scan, by Howard J. Young; 4/2/24 The old adage—March comes in like a lion and goes out like a lamb—didn’t quite hold true for the hospice sector, which experienced a late-month flurry of activity. The government gave the hospice sector a lot to consider, from MedPAC’s suggested freeze on hospice rates to CMS’s 2025 Proposed Hospice Rule (public comments due May 28, 2024) that, if finalized as is, would include a 2.6% payment bump. CMS’s Proposed Hospice Rule lays the groundwork for the long-anticipated Hospice Outcomes and Patient Evaluation (HOPE) quality measures data collection instrument, which will be used to collect data at various points during the hospice stay, not just at admission and discharge.  

Meet the women who give end-of-life care to Utah’s homelessGood Things Utah, by Nicea DeGering; 4/2/24A Utah non-profit’s mission is to provide medical help and end-of-life care to those in our community experiencing homelessness. The Inn Between has been providing unique services in Salt Lake City for eight years.  ... [The] mission of The Inn Between is to end the tragedy of vulnerable people dying on the streets of our community by providing medical respite and end-of-life care to those experiencing homelessness.The group provides a home environment that enables adults experiencing homelessness to gain access to professional hospice care from State-licensed hospice agencies; undergo life-saving medical treatment; stabilize in preparation for surgery; or recuperate from serious illness, injury, or surgery. Editor's Note: Read more to meet Jillian Olmsted, Executive Director and Kellie Mierement, Community Engagement Manager.

The indispensable role of critical thinking in healthcare leadership Forbes, by Dr. Hudson Garret, Jr and the Forbes Business Council; 4/1/24 In the fast-paced and complex landscape of healthcare, where decisions can have life-altering consequences, the value of critical thinking cannot be overstated. Critical thinking is not just a skill; it's a mindset—an essential tool for healthcare leaders to navigate uncertainty, make informed decisions and drive positive outcomes. ... Here are three examples of how I've applied critical thinking in leadership.

How’s Your Soul? JAMA Network, by Daivd Vermette, MD, MBA, MHS; 3/28/24 "Brother David, how’s your soul?” The question took me by surprise. It was time for my first advisement meeting with my residency program director. In medicine, the machine runs on competence and achievement of “milestones.” Yet, as I braced for a meeting to trudge through performance evaluations and in-training exam scores, I awoke to humanity. ... Medical education has numerous models for coaching, advising, and mentoring. While these models helped develop my professional life, they missed the fundamental core of who I am: a human being. Perhaps instead we could embrace a model in medical education built on the tenets of pastoral care. ...

Sutter Health Partners with Abridge on generative AI solution to improve patient, physician experienceBusiness Wire Press Release, by Jill O'Brien and Liz Madison; 3/27/24Abridge and Sutter Health announced they will make Abridge’s generative AI platform for clinical documentation available to groups of its physicians across California. ... For physicians and advanced practice clinicians, Abridge generates a draft note in real-time based on the clinical conversation that flows directly into the electronic health record. Once clinicians review and verify the note, their paperwork is complete. 

[UPDATED] CMS 2025 proposed rule signals changes to quality measurement, omits program integrity actionsHospice News, by Jim Parker; 3/29/24In a proposed rule released [Thursday], the U.S. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. The agency also proposed two new quality measures and 2025 implementation of the Hospice Outcome and Patient Evaluation (HOPE) assessment tool to replace the Hospice Item Set.However, stakeholders in the hospice space contend that the increase is insufficient in light of continued inflation, interest rates, staffing shortages and wage hikes.

Enhancing interoperability in home health and hospice careMcKnights Home Care, by Tim Smokoff; 3/26/24In the dynamic realm of home health and hospice care, the seamless flow of information across care settings stands as a crucial element for ensuring quality patient outcomes and efficient workflows. Recent advancements in electronic health record (EHR) solutions within this sector have not only fostered enhanced care-team collaboration, but have also addressed challenges posed by evolving reimbursement models and workforce shortages.

Hospice & Palliative Care Handbook: Quality, Compliance, and Reimbursement, 4th Edition McGraw Hill - Access APN; textbook by Tina M. Marrelli and Jennifer Kennedy; 3/28/24 “Hospice & Palliative Care Handbook, Fourth Edition, is an invaluable resource for timely hospice regulatory and compliance information, documentation, care planning, and case management. It provides clear guidance for hospice managers, clinicians, and interdisciplinary group members. I have utilized Tina Marrelli’s home health and hospice handbooks to support training new clinical staff and students for decades and consider these resources to be the gold standard.” – Kimberly Skehan, MSN, RN, HCS-D, COS-C, Vice President of Accreditation - Community Health Accreditation Partner

Caring for patients with non-English language preferences American Association of Critical-Care Nurses; 3/25/24 ... With a growing population of people who speak a language other than English at home, nurses and other healthcare professionals must work toward providing better language-inclusive medical care. ... Nurses and other clinical providers must be well-informed regarding the lifesaving nature of language access in healthcare despite any personal bias against or perceived inconvenience of using interpreter services. [This article includes: ]

Why California doesn't know how many people are dying while homelessKQED, by Vanessa Rancano; 3/25/24 The grants manager and his team at Alameda County Health Care for the Homeless knew people were dying on the streets, but they wanted more than anecdotal evidence; they wanted data that could show them the big picture and help them hone their strategies. ... Alameda County’s latest homeless mortality report is now prompting the team to focus on how to extend palliative care services to unhoused people with terminal illnesses. Garlin estimates almost one-fifth of those who died in 2022 would likely have been eligible for hospice care.

The Hospice Special Focus Program: What it is & why it is importantFORV/S, by Angela Huff; 3/25/24 The CMS Hospice Special Focus Program (SFP) aims to shed light on poorly performing hospices. CMS has publicly stated it is looking closely at the hospice industry due to increasing concerns regarding fraud, waste, and abuse. The Hospice Special Focus Program (SFP) is a new CMS program that identifies poor-performing hospices, takes action to inform the public, and engages those hospices to either improve their performance or terminate the hospice from the Medicare program.