Literature Review

Caring for patients at the end of life: CEJA reports AMA - American Medical Association; by Council on Ethical and Judicial Affairs (CEJA); 12/2/24 Reports by the Council on Ethical and Judicial Affairs (CEJA) interpret the AMA Principles of Medical Ethics to provide practical ethics guidance on timely topics. When the AMA House of Delegates adopts the recommendations of a CEJA report they become Opinions in the Code of Medical Ethics. The body of the report, which sets out CEJA’s ethics analysis, is archived and remains available as a resource to help users apply guidance. CEJA reports may not be reproduced without express written permission. [Click here to access these CEJA reports.]

What is compliance risk? TechTarget; by Katie Terrell Hanna and Francesca Sales; 11/26/24 Compliance risk is an organization's potential exposure to legal penalties, financial forfeiture and material loss, resulting from its failure to act in accordance with industry laws and regulations, internal policies or prescribed best practices. Compliance risk is also known as integrity risk. Organizations of all types and sizes are exposed to compliance risk, whether they are public or private entities, for-profit or nonprofit, state or federal. An organization's failure to comply with applicable laws and regulations can affect its revenue, which can lead to loss of reputation, business opportunities and valuation. Types of compliance risk ... An organization might be implicated in the following types of compliance risks:

Pursuit of quick profits makes hospice care worse, new research says Ohio Capital Journal; by Marty Schladen; 11/20/24 Private equity firms — high-dollar investors known for aggressively seeking profit — and publicly traded health conglomerates have been buying up businesses that provide hospice care. But when it comes to caring for patients facing the end of their lives, those businesses perform worst, according to a research letter published Monday in the Journal of the American Medical Association. ...  Publicly traded behemoths such as UnitedHealth Group and CVS Health are already the subject of investigations and lawsuits by federal and state government over allegedly anticompetitive actions as drug middlemen. At the same time, both provide hospice care. Meanwhile, the business practices of private equity groups have been coming under increasing scrutiny over the past decade. They often buy businesses in deals structured so they can quickly recoup their investment, identify the most profitable assets, sell them and then sell the resulting business or declare bankruptcy. ... The firms also have been accused of being predatory toward consumers.

Reps. Van Duyne, Panetta introduce bill to reform hospice Special Focus Program Hospice News; by Jim Parker; 11/6/24 Reps. Beth Van Duyne (R-Texas) and Jimmy Panetta (D-California) have introduced a bill that would reform aspects of the hospice Special Focus Program (SFP). If enacted, the Enhancing Hospice Oversight and Transparency Act also would increase the penalty for hospices that do not report quality measure data to 10% by 2027, up from 4% currently. The SFP has the authority to impose enforcement remedies against hospices with poor performance based on its algorithm. Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. 

Hospices: Boost quality assurance, training amid switch to HOPE, compliance experts sayMcKnight's Home Care; by Adam Healy; 10/22/24The new Hospice Outcomes and Patient Evaluation (HOPE) tool officially launches in less than a year, so now is the time to begin modifying operations and training staff to adapt to the new quality reporting framework, according to Jennifer Kennedy, vice president of quality, standards and compliance, and Kimberly Skehan, vice president of accreditation at Community Health Accreditation Partner. On Oct. 1, 2025, the HOPE tool will replace the Hospice Item Set for hospice quality reporting. For providers, HOPE demands more critical thinking than the legacy Hospice Item Set, Kennedy said Monday during the 2024 National Association for Home Care & Hospice conference in Tampa, FL. HOPE’s quality measures include hospice’s health outcomes, sociodemographic impacts, administrative performance and more. For some, adapting to HOPE might require internal Quality Assurance and Performance Improvement (QAPI) program upgrades.

[In case you missed it] The HOPE Assessment Tool: What you need to know [free webinar by CHAP]Community Health Accreditation Partner (CHAP); 10/21/24 On October 16, 2024, we hosted a webinar on the upcoming implementation of the HOPE Assessment Tool, which will catalyze hospice care starting in 2025. The webinar provided valuable insights into the tool’s implementation, content highlights, and its anticipated impact on hospice program operations. During the session, participants asked numerous important questions, many of which we’ve compiled into this FAQ for further clarification. Access the recorded session and handouts if you missed it or would like to review the presentation.

Hosparus Health ranked fourth in nation for overall quality The News-Enterprise; 10/5/24 Hosparus Health has been ranked fourth in the nation for Overall Quality among the 50 largest hospices, according to a study published in the American Journal of Hospice & Palliative Medicine. This ranking was determined based on key metrics: Consumer Assessment of Healthcare Providers and Systems caregiver survey scores, employee satisfaction ratings from Glassdoor and sentiment scores from Google reviews. David W. Cook, president and CEO of Hosparus Health, expressed his pride in the organization’s staff. “Your care, your compassion, it’s those on the front line of our care,” Cook said. “It’s thrilling to see the recognition of what you do here celebrated nationally.” Since 1978, Hosparus Health has been at the forefront of hospice and palliative care services, caring for thousands of patients across Kentucky and Indiana, the release said. Today, the nonprofit organization, which has offices in Elizabethtown, continues to provide expert care and holistic support to more than 14,000 patients and families annually, ensuring that each individual receives compassionate, high-quality care during life’s most challenging times.

Patient safety experts want progress on quality measure alignmentModern Healthcare; by Mari Devereaux; 9/30/24Patient safety leaders say standardization is needed to prevent overlapping, conflicting reporting requirements that don’t improve health outcomes. Some are hopeful the industry could see progress in the next few years. Until then, overburdened providers are choosing to report on a handful of quality measures they decide are the most important.Publisher's note: Thinking of Joanne Lynn's efforts to standardize publicly available quality measures at the turn of the century - we'll get there!

Caregiver and employee experience among big hospices-ranking of the largest US hospices by three quality indicatorsAmerican Journal of Hospice & Palliative Care; by Jason Hotchkiss, Emily Ridderman, Brendan Hotchkiss; 9/24Caregiver and employees had better experiences with non-profits than for-profits. Anger and frustration was expressed toward large, for-profit providers more focused on admissions, profiteering, and paying dividends than actual care. The CAHPS appears to draw more satisfied caregivers. Whereas, online reviewing provides open-ended, real-time voicing of care quality concerns. Even with distinct methods, CAHPS survey and review sentiment analysis converge on caregiver satisfaction, yet CAHPS paints a much rosier picture of hospice quality than online reviews.

Final HOPE materials releasedNAHC email; 9/17/24Hospices will begin completing the Hospice Outcome & Patient Evaluation (HOPE) on October 1, 2025. The final HOPE item sets – HOPE Admission v1.00, HOPE Update Visit (HUV) v1.00, HOPE Discharge v1.00 and HOPE ALL Item v1.00 – and accompanying HOPE Guidance Manual v1.00 were released on September 16. These documents can be accessed from the downloads section on the Centers for Medicare & Medicaid Services (CMS) HQRP HOPE webpage.[Accessing full article may require membership login.]

Prepping for the hospice HOPE tool: Starting the journeyCHAP email; by Jennifer Kennedy; 9/6/24The Centers for Medicare and Medicaid Services (CMS) recently finalized the implementation date of the hospice HOPE assessment tool in the FY 2025 Hospice Payment Update final rule. This quality requirement signals a new beginning for hospice providers related to quality measurement and future payment reform. Implementation is scheduled for October 1, 2025, so the clock is ticking, and the interval is short for provider and software vendor preparation for compliance.Publisher's note: Excellent article with helpful resource links.

Are there bedbugs and busted equipment at your Florida hospital? What inspectors found Miami Herald; by Michelle Marchante; updated 8/12/24 Bed bugs. Broken equipment. Staffing challenges. Fewer patients. And a pile of hazardous waste. These are just some of the problems spotted by patient care ombudsmen during visits to Florida hospitals owned by Steward Health Care System and now up for sale. ... Key takeaways: 

Teleios’ Clinically Integrated Network Sets Benchmark for Healthcare ExcellenceTeleios press release; 7/31/24Teleios Collaborative Network (TCN) recently announced that its Clinically Integrated Network (CIN) is setting the benchmark for healthcare excellence in the serious illness space. The data from the most recent reporting period again demonstrates that the members of the CIN are delivering exceptional patient care. One hundred percent of the CIN members achieved a 4- or 5-star rating on the CAHPS Hospice Survey Star Ratings by CMS. In addition, all the members identified and documented a healthcare surrogate for hospice within the first 5 days after admission at least 90% of the time with the network average being 97% and upon the time of admission for Palliative Care patients with the average being 99.8% of the time. This was the result of the members reviewing and revising their processes to ensure that a healthcare surrogate was identified and documented.