Literature Review

What’s the most impactful thing you learned this year? Harvard Business Review (HBR); by Kelsey Hansen; 12/31/24 What’s one thing you learned this year that changed the way you lead? We asked HBR’s global social media community this question to get a sense of the lessons our readers are taking into the new year. We’ve collected some highlights here so that we can all reflect and learn from one another. Our readers shared lessons learned around the importance of (truly) listening; leading with vulnerability and humility; and why we should all prioritize reflection and lifelong education. In the spirit of continuous learning, we’ve also included some resources to dig deeper in HBR articles and podcasts. ...

In Memoriam: Jimmy Carter helped build the hospice community Hospice News; by Jim Parker; 12/30/24 ... During his tenure as president, Carter was essential to the establishment of the Medicare Hospice Benefit. His administration launched the U.S. Centers for Medicare & Medicaid Services’ demonstration project to test the model, leading to passage of a law establishing the benefit during the subsequent Reagan presidency. Prior to these efforts, hospice care was delivered predominantly by volunteers who relied on philanthropy to operate. The scale of these early providers was very limited due to lack of payment, as was access to their services. “For decades, the Carter family has championed open dialogue about the needs of patients at the end of life,” Dr. Vicki Jackson, board president of the American Academy of Hospice and Palliative Medicine (AAHPM), told Hospice News in an email. “Their vocal support for hospice care over the past year has made an immeasurable impact and brought information about this essential subspeciality of medical care to a national audience.”

Hospice News’ top 10 stories of 2024 Hospice News; by Holly Vossel; 12/13/24 Fraud and program integrity concerns dominated the news in 2024, along with large acquisitions, payment rules and regulatory changes. This year saw regulatory evolutions spurred by program integrity concerns, as well as the introduction of landmark legislation, shifts in reimbursement trends and a change in presidential administration with unknown impacts across the care continuum. The U.S. Centers for Medicare & Medicaid Services (CMS) ramped up auditing activity in the space while also sunsetting the hospice component of its value-based insurance design (VBID) model demonstration ahead of its initial expiration. Meanwhile, lawmakers unveiled a bill with some of the most significant reforms proposed to date for hospice payment and oversight. Dubbed as the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, the bill has ignited conversations across the industry about future sustainability, growth and program integrity. [Click on the title's link to continue reading.]

For young adults, caregiving isn't just hard. It can shape you for life. National Public Radio - CAI - Local NPR for the Cape, Coast & Islands; by Kat McGown; 12/23/24 ... There are days when Jordyn Glick, 27, can't eat or drink at all. She gets so tired and weak she can barely stand up. She has gastroparesis, where food stalls out in her stomach and doesn't get digested. It comes with unpredictable bouts of nausea, periods of agony in her guts, and malnutrition. ... Dakota Heath, her 26-year-old boyfriend of four years, is her watchman, "always picking up on the small things," he says. He's on alert for her next flareup, the kind that can leave her bedridden for a week. ... Young caregivers have always been there, doing all the same things that adults do — ... About one-quarter of all family caregivers are between 18 and 36, according to the National Alliance for Caregiving. One survey suggests that almost half of them are men. They're more likely to be Latino or Black; a survey in 2018 found that only 17% were white. They've just been invisible. "They fall into every potential crack that exists," says Melinda Kavanaugh, a professor of social work at the University of Wisconsin Milwaukee who is one of the few researchers who study this population. In terms of resources, "Nothing is targeted for a 22-year-old. Nothing."

CMS names first Hospice Special Focus Program Cohort, delays list of future candidates Hospice News; by Jim Parker; 12/23/24 Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. However, stakeholders in the hospice space have contended that the agency’s methodology for selecting hospices for the program is deeply flawed. For this reason, they have argued that the list of operators should not be made public. Though CMS published the list, it delayed the release of a second that would point to future candidates for the program. “CMS has also generated a list of future SFP candidates. We are not publishing the candidate list at this time, but we are sharing the underlying data used to create both lists to allow for external review, thereby ensuring transparency in the process by which low-performing hospices are identified,” the agency indicated on its website. “We will continue to work with providers, patients and their families, and industry, to improve hospice care across the nation.” Stakeholders applauded the delay, including the National Alliance for Care at Home. [Click on the title's link to continue reading.]

31 Photos and stories that show how expensive it is to die in America

Sierra Hills assisted living employees in Cheyenne to strike over staffing issues' Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/18/24 In March, a resident at Sierra Hills Assisted Living in Cheyenne fell and hurt their hip and shoulder. A CNA at the facility reported that the resident could not be moved without causing shoulder pain, noting that they had likely broken their shoulder and hip, according to a report from the Wyoming Department of Health. The resident was bed-bound, in “excruciating pain” and screamed for hours, which frightened the other residents. The CNA stated this was “the worst thing she had ever experienced.” At the time, the resident was one of six hospice patients at the assisted-living facility. Sierra Hills made hospice care available at the facility shortly after the COVID-19 pandemic. When hospice nurses were unavailable, the burden of care fell to the CNAs and RNs on staff. The CNA caring for this resident in March stated it was difficult to get hospice to respond on the weekends, saying that there was an 80% chance hospice would answer a phone call and a 50% chance a hospice nurse would come to the facility. Six days later, the resident died. Editor's note: Click on the title's link to continue reading. This strike--reportedly related to staffing--appears to be related extra responsibilities on the staff, because of the hospice's limited responses on weekends. This is 2024; not 1974. How does this scenario relate to your hospice triage, hours, staffing, incident reports, community partnerships? 

Why good leaders turn bad and harm their teams Forbes; by Benjamin Laker; 12/17/24 Leadership is often idealized as a force for good—driving positive change, inspiring teams and achieving ambitious goals. However, leadership also has a darker side. Power, ambition and the pressures of professional life can push even well-intentioned leaders into behaviors that harm their teams, their companies and, in many cases, themselves. Understanding why and how leaders succumb to the darker aspects of leadership is not just an academic exercise—it’s also a practical challenge for anyone navigating today’s workplaces.

Santa Paula doctor sentenced to 2 years in federal prison for role in hospice fraud that bilked Medicare out of $3.2 million United States Attorney's Office - Central District of California; Press Release, Los Angeles, CA; 12/16/24 A Ventura County physician who worked for two Pasadena hospices was sentenced today to 24 months in federal prison for defrauding Medicare out of more than $3 million through claims for medically unnecessary hospice services. Dr. Victor Contreras, 69, of Santa Paula, was sentenced today by United States District Judge André Birotte Jr., who also ordered him to pay $3,289,889 in restitution. Contreras pleaded guilty on July 24 to one count of health care fraud. From July 2016 to February 2019, Contreras and co-defendant Juanita Antenor, 62, formerly of Pasadena, schemed to defraud Medicare by submitting nearly $4 million in false and fraudulent claims for hospice services submitted by two hospice companies: Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc. Antenor controlled both companies. Editor's note: This press release follows-up on the post we recently posted: Glendale woman and Lakewood man found guilty of $3.2 million hospice fraud scheme involving kickbacks for patient referrals. 

Hospice utilization rebounds to pre-pandemic levels, but fraud casts a shadow Hospice News; by Jim Parker; 12/17/24 The nation’s hospice utilization rate among Medicare decedents has once again surpassed 50%, for the first time since the pandemic. However, fraud issues in the space create questions around the quality of care patients are receiving. Hospice utilization reached 51.7% in 2023, up more than two percentage points from the prior year, according to recent data from the Medicare Payment Advisory Commission (MedPAC). This is the highest rate since 2019. MedPAC observed increases in utilization across the board, even when stratified into subgroups by age, sex, race and rural or urban location. ... Despite these positive trends, an influx of new hospices continued in states considered hotbeds for Medicare fraud, including Arizona, California, Nevada and Texas. Many of these new additions came in areas where additional hospices were likely not necessary based on the needs of the patient population. Georgia also saw a large spate of new providers emerge in 2023.

Characteristics of patients enrolled in hospice presenting to the emergency department American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for needs for ED care? Ie.,

L.A.-area cyber attack could impact 17m patient records GT - Government Technology - Cybersecurity; by Scott Schwebke; 12/12/24 Hackers claim they have retrieved 17 million patient records, including confidential personal and medical information, in a ransomware attack on PIH Health that has paralyzed operations at three hospitals, the Southern California News Group has learned. The Dec. 1 attack downed computer and most phone systems at PIH Health Downey Hospital, PIH Health Whittier Hospital and PIH Health Good Samaritan Hospital in Los Angeles. Also compromised were urgent care centers, doctors offices and a home health and hospice agency operated by PIH. PIH officials on Wednesday declined to comment on a threatening typewritten letter purportedly faxed by the cyber criminals late last week, saying they are working with a cyber forensic specialist and the FBI to untangle the ransomware attack. The FBI also declined to discuss the ongoing investigation.

The biggest lesson physicians learned in 2024 Becker's Physician Leadership; by Patsy Newitt; 12/10/24 Five physician leaders joined Becker's to discuss the biggest lesson they learned in 2024. ... [Summary topics include:]