Literature Review

New proposed federal legislation takes aim at concerns regarding perceived “looting” of health care systems by private equity investors JDSupra - Epstein Becker Green; by Melissa Jampol, Enrique Miranda, Kathleen Premo; 7/26/24On June 11, 2024, U.S. Senators Ed Markey and Elizabeth Warren from Massachusetts, introduced proposed legislation titled The Corporate Crimes Against Health Care Act (“CCAHCA”), aimed at addressing a perceived “looting” of health care systems by for profit private equity investors. According to Sen. Warren, the bill was introduced to “root out corporate greed and private equity abuse in the health care system,” “prevent exploitative private equity practices,” and to specifically ensure that actions such as “looting” do not happen again by addressing trigger events and targeting real estate investment trusts. ... Finally, the CCAHCA would require health care entities, including, but not limited to:  ... a hospice program, a home health agency, ... to publicly report to the Secretary of Health and Human Services on an annual basis: (i) transactions entered into ... [Click on the title's link to continue reading.]

Despite past storms’ lessons, LTC residents again left powerless: How a long-term care facility prepares for and handles power outages is one of the first questions potential residents should ask KFF Health News - Rethinking65; by Sandy West; 7/29/24 ... Even after multiple incidents of extreme weather — including a 2021 Texas winter storm that caused widespread blackouts and prompted a U.S. Senate investigation — not much has changed for those living in long-term care facilities when natural disasters strike in Texas or elsewhere. ... [While] nursing homes face such federal oversight, lower-care-level facilities that provide some medical care — known as assisted living — are regulated at the state level, so the rules for emergency preparedness vary widely. ... Editor's Note: While this article is written for the public, its content applies to all hospices that (1) provide hospice facility care, and/or (2) partner with senior care facilities: nursing homes, long-term care, assisted living, senior living communities, and PACE. This can be an important QAPI analysis and gap improvement. 

HIMSSCast: Improving patient safety and employee retention with best incident reporting practicesHealthcare IT News; by Andrea Fox; 7/26/24 By modernizing systems and improving leadership and culture to embrace reporting, healthcare organizations can better address the top 10 patient safety concerns for 2024, says Heidi Raines, founder and CEO of Performance Health Partners. Ultimately improving the quality of care healthcare systems deliver and preventing harm requires a degree of self-reflection. Along with digital transformation, putting an easy-to-use incident reporting system in place can help healthcare organizations address today's chief patient safety concerns, including medication errors, care delays, workplace violence and preventing patient falls, said Raines.

Why home health providers should expect to see a ‘less draconian’ final payment rule Home Health Care News; by Joyce Famakinwa; 7/22/24 As home health providers continue to digest the proposed payment rule for 2025, National Association for Home Care & Hospice (NAHC) President William A. Dombi believes that the industry will ultimately see a comparatively toned down final rule. “We believe we will not end up with this proposed rule as a final rule,” he said during the opening presentation at NAHC’s Financial Management Conference in Las Vegas on Sunday. “We will end up with something less draconian. The cuts will be reduced because, No. 1, that’s what they’ve done for the last several years, and, No. 2, it’s an election year.” Even with a prediction of a “less draconian” final payment rule, NAHC is still gearing up to fight against home health cuts and the Centers for Medicare & Medicaid Services’ (CMS) payment-setting methodologies.

These are the most common jobs in each state in the US USA Today; by Sara Chernikoff; 7/22/24 The most common job in the U.S. is a three-way tie, according to data from the Bureau of Labor Statistics. Home health care and personal aides, retail workers and fast food counter workers ranked at the top of the list with 3.6 million workers in each occupation. ... The desire for home health and personal care aides is on the rise as the share of the elderly U.S. population grows exponentially. This occupation is the fastest growing among most states, news outlet Stacker, reported. ... Home health care aides typically assist people living with disabilities or with chronic illness. Personal care aides are often hired to care for people in hospice care, according to BLS. Advanced degrees are not required for most home health aides, rather those employed by home health or hospice agencies may need to complete formal training or pass a standardized test.Editor's Note: Federal requirements for nursing aides in hospice care are defined in the CMS Hospice of Conditions Participation §418.76 and for home health in the CMS Home Health Conditions of Participation §484.80. Additionally, extensive state laws exist, with differences between states.

How well does Medicare cover end-of-life care? It depends on what type Medical Xpress; by Mark Harden, CU Anschutz Medical Campus; 7/19/24 Not all versions of Medicare are created equal—and when it comes to end-of-life care, some versions may serve a patient's needs better than others. That's the focus of newly published research by Lauren Hersch Nicholas, Ph.D., MPP, a University of Colorado Department of Medicine and CU Cancer Center health economist, and her colleagues. The researchers analyzed the experiences of more than a million people receiving Medicare-funded services in the last six months of their lives. ... Their paper was published July 19 in JAMA Health Forum. What Nicholas and her colleagues found is that the kind of Medicare a patient is enrolled in can make a difference in whether that patient gets certain treatments, and whether the patient dies in a hospital or in hospice care.

Does Medicare pay for dementia care? Here’s what coverage you can expect for treatments and therapies Aol - Fortune; by Margie Zable Fisher; 7/18/24 Age-related memory loss is common, but more serious memory problems may be a sign of dementia, which is not a normal part of aging. ... Dementia patients have a variety of medical issues. “In addition to symptoms related to dementia, the overwhelming majority of dementia patients have one or more chronic health conditions,” says Matthew Baumgart, Vice President of Health Policy, at the Alzheimer's Association. Medicare (and Medicare Advantage) provide some coverage for dementia, beginning with the diagnosis, says Baumgart. [Click on the title's link for practical, user-friendly information about what Medicare provides arose the trajectory of dementia's progression. CMS's new GUIDE pilot program is described.]

C-TAC: CMS’ ‘Palliative’ Definition in 2025 Proposed Hospice Rule ‘Misaligned, Problematic’ Hospice News; by Holly Vossel; 7/12/24 Efforts to establish potential payment mechanisms for high-acuity palliative services within the Medicare Hospice Benefit will require greater clarity from regulators, according to the Coalition to Transform Advanced Care (C-TAC). The U.S. Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed hospice payment rule contained a request for information (RFI) on the potential implementation of reimbursement pathways for “high intensity palliative care services,” such as chemotherapy, blood transfusion and dialysis. CMS in its proposed rule indicated that, “Hospice care changes the focus of a patient’s illness to comfort care (palliative care) for pain relief and symptom management from a curative type of care.” C-TAC’s recommendations are as follows: [Click on the title's link to read more.]

Caring with compassion: VNA Health’s commitment to holistic home health care VNA Health Live Well; by VNA Health; 7/10/24 Santa Barbara County has a unique home health care organization that is focused on serving its patients and their families without worrying about turning a profit. “As a nonprofit, VNA Health is more invested in the overall care of the patient,” said registered nurse Jadona Collier, the director of home health. “We provide programs and services that cannot be billed to Medicare or insurance.” The organization offers holistic care, meaning that, regardless of the service being used — including home health care, palliative care, hospice, and bereavement care — its medical professionals care about patients.

Senior living providers embrace role in CMS dementia care pilot program McKnights Senior Living; by Kimberly Bonvissuto; 7/11/24 Senior living providers named participants in the federal government’s new dementia care pilot program said they are excited to be part of a new effort to support people living with dementia and their family caregivers. The Center for Medicare and Medicaid Innovation, CMMI, announced the Guiding an Improved Dementia Experience, or GUIDE, model last summer. The Centers for Medicare & Medicaid Services launched the eight-year GUIDE model on July 1 and published the program participant list on Monday [7/8]. Eligible model participants are Medicare Part B-enrolled providers eligible to bill for Medicare services and that provide, or will provide, ongoing care to people living with dementia. Eligible organizations include accountable care organizations, home health and hospice agencies, Programs of All-Inclusive Care for the Elderly, and physician practices. Additional long-term care providers and other healthcare providers, however, can participate as partner organizations by contract with another Medicare provider/supplier to meet the program care delivery requirements. Assisted living residents who are Medicare beneficiaries may be part of the model. Editor's Note: Adding to our previously published posts about the new CMS GUIDE Program (7/10/24 and 7/11/24) and its use by hospice organizations, this article describes its use by senior living care providers. 

CMS: GUIDE Model Participants and Infographic CMS.gov and various press releases; retrieved from the internet 7/10/24 The Guiding an Improved Dementia Experience (GUIDE) Model is a voluntary nationwide model test that aims to support people with dementia and their unpaid caregivers. The model began on July 1, 2024, and will run for eight years. Editor's Note: Multiple press releases are populating across the internet. We share this list of links to information, participants, and sample press releases from well-known participants. 

3 pillars of effective hospice sales Hospice News; by Jim Parker; 7/8/24Hospices seeking to grow should consider building a culture of compliance driven by data, effective system design and accountability, including for its sales force. Compliance and sales should walk hand-in-hand, according to a recent report from the Transcend Strategy Group. This can help prevent sales staff from running afoul of regulations inadvertently as well as support sustainable growth, according to Tony Kudner, chief strategy officer for Transcend. ... “[Without] understanding of what the rules of the road are, you’re going to run into trouble,” he said. “Though no one-size-fits-all approach exists, providers can adapt three overarching strategies to support this kind of culture.”