Literature Review

Matters of life and death: Our health (and lack thereof) is worth talking aboutPsychology Today; by Samantha Stein; 8/29/24In his book Being Mortal, Dr. Atul Gawande, a practicing surgeon, discusses how having the hard conversations about end-of-life medical interventions (or not) may lead to a shorter life but a more fulfilling one. In his book Telltale Hearts, Dr. Dean-David Schillinger, a physician and public health advocate, discusses how accurate diagnosis, treatment, and true healing come from listening deeply to patients and their stories. Medical advances in the past century have been astounding. We live significantly longer and are able to survive repeated health crises that once would have killed us. Nearly everyone would agree that in many, if not most, cases that’s a positive thing. However, many would argue that our hyperfocus on prolonging life at all costs, along with our tendency to treat symptoms rather than looking for underlying causes, has caused us to lose sight of the importance of quality of life and true health.

NAHC and NHPCO unveil name, logo, and website for newly formed organizationPress Release; 9/5/24The National Alliance for Care at Home will Combine the Strengths of the Two Largest National Organizations Representing Healthcare Providers Delivering Care Primarily in Homes. The Alliance Will Provide Unparalleled Resources and Representation to Support the Care-at-Home Community.

Healthcare faces deficit of 100,000 workers by 2028Becker's Hospital Review; by Molly Gamble; 8/29/24A nationwide shortage of 100,000 healthcare workers is anticipated by 2028, with some states facing projected surpluses or severe deficits between future supply and demand. The finding comes from Mercer, which examined projected changes to the U.S. healthcare labor market by 2028 for states and metro and micro statistical areas. If current U.S. workforce trends continue, the healthcare workforce is projected to reach 18.6 million by 2028, an increase of over 1.5 million from 2023. However, with demand expected to rise to 18.7 million, this still leaves a shortfall of more than 100,000 workers within five years. While this gap may not seem critical in absolute terms, it adds significant strain to a healthcare system already burdened by geographic and demographic disparities in access to care.Publisher's note: This finding is particularly important for hospices already facing workforce shortages and challenges finding staff committed to the hospice philosophy of care.

Editorial: Palliative care can drive change via new payment models Hospice News; by Jim Parker; 8/27/24 A range of emerging payment model demonstrations are integrating principles traditionally associated with “palliative care” into their structures, but without using that term. The Center for Medicare & Medicaid Innovation’s (CMMI) has unveiled a series of models that incorporate elements designed to provide patient-centered care to improve seriously ill patients’ quality of life. Examples include the Guiding an Improved Dementia Experience (GUIDE), the Kidney Care Choices and Enhancing Oncology models. The GUIDE model, for example, includes language requiring “person-centered care meant to improve quality of life, delivered by interdisciplinary teams.” Thus, one could argue that palliative care principles are becoming more integrated into the larger system, even if stakeholders are not using the same terminology. ...

Executive Personnel Changes - 8/16/24

Doctors saved her life. She didn’t want them to. DNYUZ; by Kate Raphael;  8/26/24 Marie Cooper led her life according to her Christian faith. ... [And, she] always said that at the end of her life, she did not want to be resuscitated. ... Last winter, doctors found cancer cells in her stomach. She’d had “do not resuscitate” and “do not intubate” orders on file for decades and had just filled out new copies, instructing medical staff to withhold measures to restart her heart if it stopped, and to never give her a breathing tube. In February, Ms. Cooper walked into the hospital for a routine stomach scope to determine the severity of the cancer. After the procedure, [Ms. Cooper's daughter] visited her mother in the recovery room and saw her in a panic. ... [The daughter] called for help and was ushered to a waiting room while the medical team called an emergency code. Ms. Cooper grew even more distressed and “uncooperative,” according to medical records. Doctors restrained her and inserted a breathing tube down her throat, violating the wishes outlined in her medical chart. Ms. Uphold, livid, confronted the doctors, who could not explain why Ms. Cooper had been intubated. ... Editor's Note: Pair this with other posts in our newsletter today, namely "Improving post-hospital care of older cancer patients."

Couple marry in ICU an hour before bride’s father takes his last breath Our Community Now, North Providence, RI; by OCN staff; 8/22/24 A Rhode Island hospital held an emergency wedding that had to be performed before the bride’s father died from muscular dystrophy. Sabrina Silveira-DaCosta says her father, 58-year-old Frank Silveira, was Portuguese-born and raised, a serious chef and a five-star dad. ... With Silveira’s health rapidly declining, his family realized he wasn’t going to make it his daughter’s wedding on Sep. 7, so plans changed. “Everyone was able to bring the wedding to him in the hospital, and he got to walk me down the aisle,” Silveira-DaCosta said. From his intensive care unit bed, Silveira escorted his daughter down the hospital hallway Monday into the hands of her fiancé, Sam DaCosta. ... Silveira-DaCosta’s father died about an hour after he walked her down the aisle. “It’s very complex. It’s a lot of emotion. Our community hospitals don’t get enough credit because any big hospital couldn’t have done this for us,” she said.

LobsterFest raises more than $115,000 for a good cause Steamboat Pilot & Today; by Eli Pace; 8/28/24 Celebrating its 50th anniversary, the Rotary Club of Steamboat Springs served up more than 300 fresh lobsters Saturday at the Steamboat Springs Airport as Rotarians held to tradition while supporting Northwest Colorado Health’s Home Health and Hospice Services. Northwest Colorado Health is the only provider of Home Health and Hospice in the Yampa Valley, ... “In an average year, we care for more than 250 patients and provide support to their family members,” said Steph Einfeld, CEO of Northwest Colorado Health. ... The Rotarians had 310 lobsters flown in Thursday evening from Maine for the event that sells out every year, and a silent and live auction augmented table sales and sponsorships. According to the Rotary Club, this year’s LobsterFest raised more than $100,000 to support Northwest Colorado Health’s program and $15,000 for other Rotary charities.

Fraudulent hospices reportedly target homeless people, methadone patients to pad census Hospice News; by Jim Parker; 8/23/24 Fraudulent hospices in California reportedly have been targeting homeless people and methadone patients, promising them a steady supply of opioids in exchange for enrolling in hospice. Three hospice leaders came forward to Hospice News to report these practices. According to their reports, unscrupulous providers have canvassed both homeless encampments and methadone clinics seeking to sign up patients who are not terminally ill. In many cases, the sources said, these operators offer patients free access to board-and-care facilities and a daily supply of morphine. Another frequent practice among these hospices is to offer patients cash or other items in addition to drugs, they said. “This conduct raises serious fraud concerns on kickbacks or gifts to beneficiaries who do not appear to qualify for hospice,” Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), told Hospice News. “More importantly, this conduct is predatory, taking advantage of individuals in addiction. Jail time is not enough punishment for the harm that such conduct creates.”Editor's Note: We are reposting this from our Saturday 8/24 issue, to ensure our weekday readers see it. This is abhorable. Click on the title's link to read more. While John Oliver's "Last Week Tonight" episode on 8/18/24 gained criticism from many hospice leaders, these fraudulent unethical behaviors (and others') lay the groundwork for such dire distrust from the public. These behaviors must be stopped. These persons and organizations must be held accountable. 

Awards and Recognitions: August 2024 We congratulate these honorees and celebrate their contributions to our collective hospice and palliative care mission, vision, and compassionate care throughout our world. Do you know any of these leaders? We encourage you to forward this to them or to find another way to celebrate their success. (We are piloting this as a monthly feature in Hospice & Palliative Care Today.)

CMS is taking action to address benefit integrity issues related to hospice care CMS Newsroom; by Dara A. Corrigan and Dora L. Hughes, MD, MPH; 8/22/24... Unfortunately, hospices are profiting from fraud at the expense of beneficiaries far too often. Recent media reporting, and research by CMS, have identified instances of hospices certifying patients for hospice care when they were not terminally ill and providing little to no services to patients. The media reports identified that these activities led to a rapid growth in potentially fraudulent hospices, particularly in Arizona, California, Nevada, and Texas. Some of the addresses listed for these hospices also appeared to be non-operational. ... In response to these findings, CMS revisited and revitalized our hospice program integrity strategy, focusing on identifying bad actors and addressing fraudulent activity to minimize impacts to beneficiaries in the Medicare program. As part of this strategy, CMS embarked on a nationwide hospice site visit project, making unannounced site visits to every Medicare-enrolled hospice. [Click here to continue reading this significant information from CMS.]

Transformational leadership: The how and why  Forbes; by Akin Akinpelu; 8/13/24 The ability to inspire and motivate a team isn't just a nice-to-have; it's a necessity. That is why transformational leadership goes beyond traditional management tactics, to driving innovation and fostering a culture where everyone feels valued and empowered. Here’s why it matters and how you can cultivate it within your own organization. At its heart, transformational leadership is about creating a vision that motivates and inspires your team to achieve more than they ever thought possible. There are a few key elements that really set transformational leaders apart: 

3 of the fastest growing hospice companies Hospice News; by Jim Parker; 8/16/24 Three of the nation’s for-profit hospice companies have hit the accelerator on revenue growth, achieving triple-digit percentages. Each of these organizations — Traditions Health, Fortis Health and HealthFlex Hospice — appeared on Inc. magazine’s 2024 listing of the fastest-growing private companies in the United States. ...