Literature Review

Senior care experts detail how to build a coveted ‘destination workplace’ McKnights Home Care; by Josh Henreckson; 6/27/24 Faced with today’s complex array of financial, staffing and regulatory challenges, senior care operators need to rely on a broad range of workplace solutions, a panel of experts said. ... Providers should be actively listening to their employees’ needs and trying to meet the evolving desires of the labor market, they emphasized at McKnight’s “Meeting of the Minds” thought-leader discussion. This must take place whether they’re pursuing recruiting strategies, trying to improve staff retention, integrating new technological advances or investing in new benefits and professional development. “The one area that’s going to undergird everything for your success is paying attention to the most important capital, which is human capital,” said Navin Gupta, CEO at software provider Viventium. “Pay attention to the caregiver experience from recruitment … to retention to recognition and development — the entire journey."

Grief care efforts should include settings outside of hospice, provider group say McKnights Senior Living; by Kimberly Bonvissuto; 7/3/24 If standards are developed for high-quality bereavement and grief care, they must apply to settings outside of traditional hospice care, such as affordable senior housing, where there is a “critical lack” of mental health services. That’s according to LeadingAge, which submitted comments last week to the Agency for Healthcare Research and Quality on a draft report from a research project that will inform an independent panel that will develop standards for high-quality bereavement and grief care. Katy Barnett, LeadingAge director of home care and hospice operations and policy, highlighted the need for cross-continuum grief and bereavement assessments, interventions and resources, including in settings outside of traditional hospice care, such as affordable senior housing.

The Program of All-Inclusive Care for the Elderly will begin in July at Jordan Valley Community Health Center KSMU Ozarks Public Radio; by Michele Skalicky; 6/24/24 A new program at Jordan Valley Community Health Center in Springfield will allow those 55 and older to age in their own homes. The Program of All-Inclusive Care for the Elderly is the first PACE program in southwest Missouri. "We'll do home assessments to make improvements that will allow them to live in their homes safely so we don't have potentials for trips and falls or if somebody has a need to have a built, we'll take care of all of that through our home assessment and allow them to have the safest possible home," said Ryan Kruger, vice-president of operations for PACE and pharmacy at the health center. The PACE model uses an interdisciplinary team of professionals that provide coordinated care. PACE care includes medical and personal care, rehabilitation, social interaction, medications, transportation and more.

20 most socially responsible hospitals, per Lown Institute Becker's Hospital Review; by Mackenzie Bean; 6/25/24 Duke Regional Hospital in Durham, N.C., is the most socially responsible acute care hospital in the U.S., according to a June 25 ranking from Lown Institute. The nonpartisan healthcare think tank assessed more than 2,700 acute care hospitals and 800 critical access hospitals nationwide across 54 metrics related to health equity, value of care and patient outcomes. ... The 20 most socially responsible acute care hospitals in the U.S., per Lown Institute:

36 hospitals, health systems cutting jobs Becker's Hospital CFO Report; by Kelly Gooch; updated 6/21/24 A number of hospitals and health systems are reducing their workforces or jobs due to financial and operational challenges. Below are workforce reduction efforts or job eliminations announced this year.  June:

Mass General Brigham union could shape hospital-at-home’s future Modern Healthcare; by Diane Eastabrook; 6/17/24 Nurses at one of the nation’s largest hospital-at-home programs have unionized, a move they hope could influence the future of in-home acute care and encourage more people working in home healthcare to join unions. The union vote at Boston’s Mass General Brigham comes as hospitals push aggressively to expand care outside of their walls, while a worker shortage and increased demand for healthcare contribute to rising labor strife among caregivers. Approximately 80 Mass General Brigham home hospital nurses voted overwhelmingly on May 16 to join the Massachusetts Nurse Association. The National Labor Relations Board certified the union to represent the nurses on May 24 and they are in the midst of selecting a bargaining team that will begin negotiating a contract with the hospital system within the next few months. ...  The hospital system is set to expand the number of patients the program can accommodate from 50 patients a day to 200 over the next few years. 

Private equity, consolidation divide aging services sector as multi-agency effort gets underwayMcKnight's Long-Term Care News; by Kimberly Marselas, Kimberly Bonvissuto; 6/10/24While some aging services providers last week warned that more scrutiny of healthcare consolidation and rules that seek to limit it further could create “unintended consequences,” others encouraged three federal agencies to proceed with promised work on the issue. Private equity ownership is associated with increases in short-term mortality of Medicare patients, as well as declines in other quality measures of patient well-being, and reductions in staffing, services, supplies, or equipment, said LeadingAge, in comments authored by Jonathan Lips, vice president of Legal Affairs, citing research. They also acknowledged that another study using the government’s own data showed PE’s stake in the skilled nursing sector had declined to just 5% by 2022. Further research showed that slowdown persisted into 2023.

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

Is long-term care evolving or devolving? McKnights Long-Term Care News; by John O'Connor; 6/9/24... Is long-term care evolving or devolving? First, let’s look at some of the positive ways operators in this field are changing with the times. In my view, here’s the first among equals: person-centered care models have emerged as never before. ... Here are some other ways the sector has made notable strides:

Higher sepsis mortality in safety-net hospitals linked to fewer post-discharge care options Contagion Live - Infectious Diseases Today; by Kenneth Bender, PharmD, MA; 6/9/24 Purportedly higher sepsis mortality in safety-net hospitals reflects less a difference in acute care than opportunities to discharge to hospice. By extending the measure of sepsis-related mortality from in-hospital events to occurrences within 30 days after the diagnosis, the purported higher mortality rate of sepsis treated in safety-net hospitals decreased to parity with non-safety-net hospitals, in a retrospective national cohort study. The investigators note the particular challenges of safety-net hospitals, which care for a disproportionately high share of low-income and underinsured patients, include fewer resources and narrower operating margins, as well as patient populations with decreased access to preventative care and more complex disease presentations.

These MD architects want to redesign your hospital Medscape; by Amanda Loudin; 6/5/24Little known fact: Florence Nightingale might have been the most famous clinician to notice and openly comment on the role of hospital design in patient care. In her now well-known writings on nursing, Nightingale advocated for "open windows to maximize light and ventilation," among other elements. Today, a growing group of physician-designers are paying attention to many such details — windows in patient rooms included. Their goal: To build hospitals and medical facilities where design can enhance patient and clinician well-being. ...

Behavioral health patients a challenge to nursing homesModern Healthcare; by Diane Eastabrook; 6/4/24Challenges providing care for nursing home patients with mental health and behavioral health issues are adding to discharge bottlenecks for hospitals, and the demand for such care has led some facilities to set up specialized units with additional staff just for those patients.Publisher's Note: Hospice implications?

Dr. Marc Boom confronts the new dynamics of CEO burnoutBecker's Hospital Review; by Kelly Gooch; 5/23/24While the topic of burnout among hospital CEOs is not new, there are new dynamics in play to consider as part of the discussion. Those in the role today encounter increased pressures ranging from financial to operational. "There are new pressures that have emerged in the healthcare delivery world - everything from reimbursement cuts and escalating drug and supply costs, and labor expenses - that have created a lot of financial headwinds for organizations," said Scott Sette, a partner with Chicago-based executive search firm Heidrick & Struggles. "Plus, regulatory changes have forced CEOs to spend more resources on compliance, cybersecurity, EMR administration." Additionally, "there have just been so many workforce challenges. ... Then you have the impact of the remote and hybrid workforce and the impact of that on organizational culture. Plus, you've got many social issues going on. Clearly, [diversity, equity and inclusion] continues to be top of mind, but also you've got political unrest. You have mass shootings. You have gender-affirming care and other social issues that organizations have to address. And all of these topics [have] created even more pressures for hospitals and health systems to deal with, in addition to delivering high-quality care and delivering customer-centric experiences. There is a lot for CEOs to deal with on a daily basis." Marc Boom, MD, has served as president and CEO of Houston Methodist, an eight-hospital system with more than 32,000 employees, since 2012. He acknowledged these pressures in a recent interview with Becker's. He also discussed the prevalence of burnout and shared advice for how leaders can reduce the potential for it.