Literature Review

Greener nurses enter field as workforce demand continues to spikeMcKnight’s Home Care DailyDecember 15, 2023Job openings in healthcare and social services have risen sharply in the last several years, and healthcare providers are taking on less-experienced registered nurses to handle the pressure. At the beginning of 2018, the average nurse’s tenure was more than six years of experience, according to a recent workforce report by the ADP Research Institute. In the five years since, however, high turnover rates and a corresponding abundance of job opportunities deflated a nurse’s average tenure to about five years of experience. 

What health systems did this year to recruit, retain workersModern HealthcareDecember 13, 2023Tuition reimbursement is a top program offered this year by health systems seeking to recruit and retain employees, according to a recent survey by Aon, an insurer and consulting firm. ... Here are five areas of focus around recruitment and retention this year.

Memory Care Gap—GAO Report Shows Less than 2.5% of Medicare Beneficiaries with Alzheimer’s Receive Cognitive AssessmentSenior Housing NewsDecember 13, 2023Between 2018 and last year, use of cognitive assessment and care plan services tripled, but few Medicare beneficiaries who qualify received the service, according to a recent study by the Government Accountability Office. The GAO study found that, at most, 2.4% of Medicare beneficiaries with a diagnosis of Alzheimer’s disease or a related disorder received this service. 

2023’s Most Impactful Hospice Regulatory MovesHospice NewsDecember 12, 2023Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. That momentum has been fueled by two main concerns among regulators—risks of patient safety and evidence of malfeasance in the space. Hospice News sat down with providers, advocacy groups, legal experts and other stakeholders to uncover the most significant hospice regulatory trends from this year and their anticipated impacts heading into 2024 and beyond. ...Editor's Note: Quoted in the article, Jason Wallace, partner in health care, Barnes & Thornburg LLP; Ben Marcantonio, COO and interim CEO, NHPCO; Carrie Uebel, senior vice president and chief ethics and compliance officer, Compassus

Hospice CEO, Chief Compliance Officer Collaborations Key to QualityHospice NewsDecember 11, 2023The lines of communication between hospice leaders and compliance executives need to be open and transparent in today’s regulatory environment. ... The ability to both understand and navigate shifts in regulations requires a solid relationship between a hospice executive team and its compliance leaders, according to Avow Hospice President and CEO Jaysen Roa. To achieve this, compliance and senior executive teams should foster interlocking collaboration and careful communication, he stated in a recent Husch Blackwell podcast. “It’s having compliance be part of the fabric,” Roa said. “Whether it is redoing some policies and procedures, looking at our code of ethics or how we respond to audits ... it’s all these things that can be esoteric to us [leaders]. When speaking to peers, whether it’s the C-suite, leadership teams or the board, [it’s doing] it in a way where it’s relatable and they understand not only why it’s important, but also the impact of why we’re readying for this. [If] we’re not constantly learning, then that’s a problem—especially in an industry like ours where it’s dynamic and changing every single day.” ... Strong ties between compliance and executive teams are crucial, according to [Chief Compliance Officer and Senior Vice President of Engagement, Kerri Ervin] Ervin. Having honest and transparent communication between compliance officers and hospice executives is key, she said. 

Forced to work in a vacuum, MedPAC recommends another Medicare cutMcKnight’s Long Term Care NewsDecember 11, 2023A Congressional advisory group appears ready to recommend a 3% Medicare pay cut for nursing homes in 2025. In what has become an annual tradition, members of the Medicare Payment Advisory Commission voiced ongoing concerns Friday about the use of Medicare Fee for Service reimbursement to effectively subsidize Medicaid rates and Medicare Advantage payments. With official data indicating that patients still have plenty of access to care, panel staff recommended MedPAC tell Congress that it should pursue a cut to Chair Michael Chernew, PhD, a healthcare policy professor at Harvard, said the 3% cut could be steeper given the reported margins. But the commission—tasked only with considering Medicare policy—remains cognizant of the pressures faced by providers accepting Medicaid and being increasingly low balled by managed care plans.

What It’s Like Watching My Friends Die in PrisonBy Martez JohnsonVeraDecember 7, 2023I work in hospice at a maximum-security prison. The question I get the most is, “How can you do that?” Honestly, it’s not easy. We are literally sitting with death. Hospice is a program that we sign up for, where we sit with another prisoner while he dies. That’s not all we do; there’s far more to it than that. But for now, that’s what I’ll say. When someone who is sick and has signed a “do not resuscitate” order gets to the point of no return, they call us in. I or one of my comrades sit with them while they die. When I started hospice, I didn’t really know what it meant. I understood how to do the job itself, but I didn’t really understand its gravity in full. The toll it takes on you. How mental it is. How much love it takes. How much forgiveness you have to give to the man who’s dying in front of you, even when it’s not yours to give. How much it makes you want forgiveness for your past actions. I go into each room knowing that death is on the other side of that door. By the time I show up, there’s no more hope. Can you imagine being in prison without any hope? I don’t think it’s right for any human to die in prison, but I’ve seen it so many times. I walk with death. I sit with death. ... So, to answer that question I get most: I do this because my friends need me to.[Editor’s Note: an advocate for prison reform, a writer, a hospice volunteer, and a mentor.]

Oxford's 2023 Word of the Year Is...New York Times, 12/9/23"Rizz" - the Gen Z slang term for "charisma". Sorry Swifties, not this year!

Why health systems are dropping their IT teamsModern HealthcareDecember 7, 2023The digital transformation is underway at health systems but it increasingly doesn’t involve in-house IT departments. Health systems are transitioning their analytics and tech employees to managed service companies as they look to scale virtual care, artificial intelligence and analytics initiatives. By moving the work out-of-house and the employees with it, a process called rebadging, health systems struggling with razor-thin margins say they can deploy IT projects more efficiently while saving on costs. ... In November, consulting firm Guidehouse surveyed health system CEOs and chief financial officers about their top three IT investment priorities in 2024. A third of respondents said they have expanded relationships with IT outsourcing partners ... But there are downsides to the strategy. The transition of employees can be bumpy. Also, by offloading IT employees, the quality of work can be worse when the outside company doesn’t understand the system as well. 

NPA Says House of Representatives’ Passage of Bill to Provide Veterans Additional Access to the Program of All-Inclusive Care for the Elderly Will Improve Their Lives; Urges Swift Senate PassagePRNewswireDecember 6, 2023Washington, DC—On the second anniversary of the passing of the Honorable Bob Dole (R-KS), the National PACE Association praises the U.S. House of Representatives for passing the Elizabeth Dole Home Care Act (H.R. 542) by a vote of 414-5, which will give veterans increased access to the Program of All-Inclusive Care for the Elderly across the nation. We urge the Senate to pass this bill soon so more veterans can enjoy the highest quality of life possible as they age by receiving any care needed at home or in the community. The legislation would establish formal partnerships between Programs of All-Inclusive Care for the Elderly (PACE) and nearby Veterans Affairs Medical Centers located within their geographic service areas. This policy change would broadly increase access for veterans to the innovative PACE model of care so they may continue to live at home, despite needing a nursing home level of care.

More people with dementia opting to age in place over senior livingMcKnight’s Senior LivingDecember 7, 2023People living with dementia are more likely to choose aging in place over an assisted living or a continuing care retirement community, according to a new study. A research letter in the Journal of the American Geriatrics Society reported that over the last two decades, a variety of factors have shifted where people with dementia live, including family caregiver availability, declining marriage and birth rates, alternative residential care arrangements, Medicaid expansion of home- and community-based services and the long-term care workforce crisis. Researchers said their study showed that the COVID-19 pandemic noticeably altered living arrangements for individuals living with dementia, increasing the number of those opting to age in place. ... What concerned researchers was increasing functional impairment and levels of unmet needs among those living alone or in a residential care setting, including assisted living and CCRCs, “given the limited regulatory oversight and lack of uniformity in services available in these settings.”

Lessons in CaregivingBy Lisa B. SamalonisNext AvenueDecember 4, 2023... When my parents, in their late 70s, became ill with several chronic and terminal health ailments, my sisters and I worked to support them and honor their wishes to age in their home. ... Like many adult children and family friends new to this process, we were unaware of everything we did not know about the complexity of safely aging in place and the available resources. ... Often, coordination of care is very challenging. ... Being a vocal advocate can help your loved one immensely. ... Yet, taking care of oneself allows one to care for others.[Editor’s Note: The author is a writer and editor based in New Jersey. She writes about health, parenting, books and personal finance.]

Models can predict when older adults with dementia may need nursing home careMcKnight’s Long Term Care NewsDecember 5, 2023It often can be difficult to determine when a person with dementia may need to go to a nursing home or receive that level of care. A new study created models to help people determine when older adults living with dementia will require nursing home-level care. The results can give people and their loved ones evidence-backed data if it comes time to make that decision. The study was published on Dec. 4 in JAMA Internal Medicine.