Literature Review

New York State Bar Association backs expansion of end-of-life-options Brooklyn Daily Eagle - Courts and Law; by Robert Abruzzese; 4/23/24 The New York State Bar Association (NYSBA) has endorsed the Medical Society of the State of New York's recent support for medical aid in dying. ... The proposed New York bill (A995a/S2445), which will be considered in the 2024 legislative session, includes comprehensive safeguards to ensure that the process is voluntary, informed and free from coercion. These include the confirmation of terminal illness by two independent physicians, mandatory mental health evaluations if needed and detailed counseling on all available end-of-life care options. ...

CMS increases hours to 3.48 in final staffing rule McKnights Long-Term Care News; by Kimberly Marselas; 4/22/24 Nursing homes will be required to deliver 3.48 hours of daily direct care per patient under a final staffing mandate issued this morning. A White House statement on the rule [4/22] said that 3.0 hours must be split between registered nurses at 0.55 hours and 2.45 hours for certified nurse aides. The remaining time was not immediately defined by the White House release, and the full rule text was not available.

Examining how improper payments cost taxpayers billions and weaken Medicare and Medicaid HHS-OIG; by Christi A. Grimm, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services; 4/16/24 HHS Inspector General Christi A. Grimm Testifies Before the U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations on April 16, 2024. IG Grimm briefs members on HHS-OIG's work to address improper payments in Medicare and Medicaid managed care programs. Click here to watch the testimony.

How the FTC noncompete ban affects nonprofit providers Modern Healthcare; by Alex Kacik; 4/25/24 The Federal Trade Commission’s ban on noncompete agreements will apply to some healthcare nonprofits, lawyers said. ... In the final rule, the FTC offers an example of a nonprofit hospital that employed 100 physicians. The commission would have jurisdiction “because the organization engaged in business on behalf of for-profit physician members,” the rule states. ... The FTC created a carve-out for senior executives in the final rule. Existing noncompete agreements with senior executives, defined as workers who earn more than $151,164 a year and are in policymaking positions, can remain in place. But employers are barred from enforcing new noncompete provisions with senior executives.

Hospice nurse reveals the most common deathbed regretsUnilad; by Niamh Shackleton; 4/24/24Bronnie Ware, a nurse who has spent a large majority of her career working in palliative care, found that there were five common things that people regretted about their lives upon reflection as they approached death.

Breaking News: Labor Department announces final overtime rule McKnights Senior Living, by Kimberly Bonvissuto; 4/23/24 The Department of Labor on Tuesday announced a final rule that expands overtime protections to millions of salaried workers beginning this summer. The overtime rule increases the salary thresholds necessary to exempt a salaried executive, administrative or professional employee from federal overtime pay requirements. Effective July 1, the salary threshold will increase to the equivalent of an annual salary of $43,888 and will increase to $58,656 on Jan. 1.  The July 1 increase updates the current annual salary threshold of $35,568, which is based on a 2019 overtime rule update.

We are not okay: Moral injury and a world on fireAmerican Journal of Bioethics, by Keisha S. Ray; 4/24Moral injury gives name to a feeling that I have been having lately as I’m asked to show up to work and my life as if there aren’t people who didn’t wake up today because of violence, disease, and greed. I’ve celebrated holidays and my own professional accomplishments, but I can’t escape that lump in my throat, that nagging feeling that this is all meaningless given the state of the world. After all, my principles won’t feed the starving, shelter the bombed, free the captive, or care for the sick. I don’t have the answer. I do not know what we are supposed to do about our perpetual moral injury. I do find some comfort in the origins of moral injury—calling out a broken system rather than broken individuals (Talbot and Dean Citation 2018). I am not broken; I am just a bioethicist and a human forced to work and live within a broken world.

‘Are nursing homes our only option?’ These centers offer older adults an alternative. Rhode Island Current, by Anna Claire Vollers; 4/12/24PACE centers attract bipartisan interest and, in some states, scrutiny. ... PACE (Program of All-Inclusive Care for the Elderly) centers provide government-funded medical care and social services to people older than 55 whose complex medical needs qualify them for nursing home care, but who can live at home with the right sort of help. ... Nationally, PACE centers are owned by a variety of health care organizations, including nonprofits, for-profit companies, large health care systems and religious organizations. ... [The] explosive growth has come with challenges ...

Hospices and emergency preparedness planning: A scoping review of the literatureJournal of Palliative Care, by Janna E Baker Rogers; 4/24Palliative and end-of-life care, as provided by hospices, are important elements of a healthcare response to disasters. A scoping review of the literature was conducted to examine and synthesize what is currently known about emergency preparedness planning by hospices.

The HAP Foundation conducts research study on Black Americans’ experience with serious illness care in ChicagoThe HAP Foundation, by Rachel French; 4/9/24 The HAP Foundation and NORC at the University of Chicago have completed a joint research project to understand the knowledge, attitudes, and experiences of Black Americans around serious illness care in Chicago. Through a community-based participatory research design, narratives from Black individuals living in Chicago were captured by focus groups and in-depth interviews. “Community-Based Study: Prioritizing Dignity and Respect in End-of-Life Care for Black Chicagoans” is being distributed widely to health care providers and the community to encourage conversations and create change in behavioral patterns during end-of-life care.Editor's Note: Click here for this downloadable, 17 page booklet.

Today is National Healthcare Decisions Day.Are your advance directives in place? When did you last update them? Have you communicated your decisions with those involved? Use and share these resources with your employees and volunteers.

Lens X: A practical approach to taking care of your peopleThe Journal of Character & Leadership Development, by Daphne DePorres, Matthew Orlowsky, Matthew Horner, David Levy; 4/24Graduates of the United States Air Force Academy (USAFA), as commissioned officers, are charged to “take care of their people.” While this leadership aphorism makes sense, this article describes what it means in practice.  An  interdisciplinary  USAFA  team  explored  the  dynamics  of  leader  development  from  multiple  angles, resulting in a focus on two dimensions (or “lenses”) that help a leader understand what actions can be taken to help an employee achieve subjective well-being at work. The intent is to draw attention to the nature of the interaction with organizational members that foster engagement and need fulfillment. We do that by focusing a leader’s attention on needs, narratives, and micro-exchanges. Those interactions, behav-iors, and micro-exchanges are the foundations of and the most tangible, changeable element of climate and culture. This practical lens equips any leader to seize every opportunity to foster fulfillment of the psychological needs for belonging, agency, and efficacy. This framework can be used by anyone but is particularly relevant to supervisors and USAFA cadets who will be entrusted to lead an all-volunteer military force.Publisher's note: An interesting article on leadership and change management by my friend and colleague Dave Levy, PhD, Professor of Management and Leadership at the US Air Force Academy. He also co-authored three books: The 52nd floor: Thinking deeply about leadership, Attitudes aren't free: Thinking deeply about diversity in the US Armed Forces and Echoes of mind: Thinking deeply about humanship.