Literature Review

Fitch downgrades Butler Health System’s bond debtPittsburgh Post-GazetteDecember 12, 2023Butler Health System’s financial challenges continued Monday with a ratings downgrade of its bond debt. Fitch Ratings issued a one-notch downgrade to ‘BBB-,’ outlook negative, because of accelerating losses and a “weaker than budgeted operating loss” of $12.97 million for the three months ending Sept. 30, up from a $1.6 million loss posted for the same quarter in 2022. BHS, a subsidiary of Independence Health System, is seeking a waiver from a debt service coverage requirement from bondholders, which otherwise could lead to a default. 

Brookdale sees 25 consecutive months of occupancy growth in NovembeMcKnight’s Senior LivingDecember 11, 2023Brentwood, TN-based Brookdale Senior Living wrapped up November with its 25th consecutive month of year-over-year weighted average occupancy growth, the company reported Friday. The company said that November’s weighted average occupancy was an increase of 40 basis points year over year, to 78.4%. Month over month from October to November, weighted occupancy dipped slightly, from 78.6% to 78.4%. Brookdale noted, however, that third-quarter occupancy was 77.6%, compared with the second quarter, which saw 76.5% average weighted occupancy.

Fix needed now—America’s long-term care financing system is brokenBy Katie Smith SloanThe HillDecember 11, 2023Nonprofit providers of aging services have been warning for decades that America’s system for financing long-term care is dangerously broken. The dedicated professionals serving older adults in nursing homes, home health agencies, hospice programs, and senior living communities have toiled side-by-side with families across the country to cobble together care and services for parents, friends, and neighbors—connecting the tattered pieces of our patchwork long-term care system in an effort to ensure dignity, comfort and independence as the needs of our loved ones change. The New York Times KFF Health News’ series “Dying Broke” aptly illustrates the impact of the United States’ insufficient approach to financing of long-term services and supports. It’s an important and unflinching look at how our country is failing us. ... We can do better. A comprehensive and equitable long-term care financing system would make all the difference. The longer lives that many Americans will enjoy offers enormous potential for our nation. We must seize this opportunity and ensure that potential isn’t squelched by an oppressive and unfair long-term care financing system. The solutions are complicated—but smart approaches abound. The variable is political will. ... I urge our leaders to listen to the voices of their constituents, and join us in creating solutions. All of our futures depend on it.

Novant Health makes third round of layoffs in 2023 as it outsources IT services to Indian firmTriad Business Journal (Greensboro/Winston-Salem, NC)December 11, 2023Amid C-suite changes and large acquisition deals, Novant Health is making its third round of layoffs in 2023. The Winston-Salem health system is outsourcing some of its IT operations to Wipro, a technology company based in India. Novant declined to say how many employees would be affected but said it would “fluctuate based on individual interests... [with] some having the opportunity to consider newly assigned roles and responsibilities with the redesign of this new model.” ... In 2023, Novant has cut more than 200 jobs—the largest workforce reduction for the health system in nearly a decade.

Aging population requires ‘bold leadership’ to protect human dignity—LeadingAge to House SpeakerMcKnight’s Senior LivingDecember 11, 2023The growing population of older adults requires “bold leadership” to ensure aging with dignity, as well as access to care and support, according to an open letter from LeadingAge to Speaker of the House Mike Johnson (R-LA). The changing demographics and need to support older adults where they live and receive services presents a unique opportunity for Johnson to demonstrate leadership and commitment to “protecting human dignity,” according to the letter from LeadingAge President and CEO Katie Smith Sloan. ... “The US healthcare system is navigating a new and unfamiliar landscape in the wake of the COVID-19 public health emergency,” Sloan wrote. “Three years of sustained stress and increasing workloads have caused a dramatic shift in staffing patterns and an alarming rise in burnout across health professions.”

Maine nursing homes lead in meeting proposed staffing standardsMaine MonitorDecember 10, 2023Maine nursing homes are closer to meeting the Biden administration’s proposed minimum staffing standards than their counterparts in most other states, but recent payroll data show that still fewer than one in 10 are meeting these proposed standards every day. And while some long-term care advocates said the national standards should go further, nursing home industry leaders said it would be difficult for a rural state like Maine to find the workers to meet the required minimums, which could lead to more closures. ... During the second quarter of 2023—from April to June—Maine nursing homes met the proposed minimum care hours from both registered nurses and nurse aides an average of 59 out of 91 days in the quarter, according to analysis from The Maine Monitor, USA TODAY and Big Local News at Stanford University, the latest federal staffing data. ... However, only 8% of Maine nursing homes met both standards on all 91 days of the quarter.

State—Nursing home dumped alleged rape victim at homeless shelterIowa Capital DispatchDecember 8, 2023An Iowa nursing home resident was evicted and dumped at a homeless shelter after complaining that an employee of the home raped her, according to state records. ... John Hale, a consultant and advocate for Iowa seniors, said “the story of what allegedly happened to this resident is absolutely sickening. It’s simply incredible that a nursing home and its parent corporation would allegedly have such an awful response to a rape allegation, allow an alleged rapist to continue to be employed, deal so inhumanely with a resident, and would suspend a facility employee who tried to do the right thing.” Hale also questioned the state’s response to the situation. “How the governor or any state legislator can sleep at night knowing that this kind of alleged cruelty exists in an Iowa nursing home is beyond me,” he said. “If this doesn’t serve as a wake-up call to take action, nothing will.”

Brookdale Reports November 2023 OccupancyPRNewswireDecember 8, 2023Nashville, TN—Brookdale Senior Living Inc. reported today its consolidated occupancy for November 2023. November 2023 weighted average occupancy increased 140 basis points year-over-year to 78.4%. Achieved twenty-five consecutive months of year-over-year weighted average occupancy growth.

Hospitals Think Some Dead Patients Are AliveBloombergDecember 7, 2023Neil Wenger, a professor of medicine at UCLA, was researching different ways of encouraging patients to make end-of-life care plans when he discovered something troubling—hundreds of patients who were seriously ill, according to the health system’s records, were actually dead. This is a well-known but little-studied phenomenon, according to Wenger—until now. Wenger and his colleagues wrote up their findings in a short paper that was published Monday in JAMA Internal Medicine. They identified 676 patients from UCLA’s health system that were recorded as alive, but were actually dead, according to state data. At face value, it sounds absurd. But there are many reasons why it might happen, Wenger says. While patients who die in the hospital are automatically recorded as deceased in that system’s database, patients who die at home are not. Same goes for patients who die at another health system with a different electronic records database. “The health system continues to act as if they’re alive,” Wenger says. “If we don’t know they’re dead, we can’t do the right thing.” ... “We think this is a really important finding that needs to be corrected,” Wenger says.

California system to lay off 160 amid planned home health saleBecker’s Hospital CFO ReportDecember 6, 2023Walnut Creek, Calif.-based John Muir Health is laying off 164 employees in Concord ahead of a planned sale of its home health services division to Cornerstone Home Healthcare. John Muir announced in October that it would transfer its home health assets to a company currently owned by Cornerstone; that transaction is expected to close Jan. 1. Once the deal is closed, Cornerstone will be the majority owner and John Muir will operate a 40% minority stake, a spokesperson for the health system told Becker’s on Dec. 6. According to WARN documents filed with the state, 164 John Muir Home Health employees will be laid off by Dec. 29, but they have the opportunity to apply to the new company under Cornerstone.

Patients stuck in Washington hospitals pose quandary for state lawmakersWashington State StandardDecember 6, 2023Washington needs to do more to keep people from staying at hospitals longer than medically necessary, state health officials told lawmakers this week. Over the last five years, the Legislature has approved spending and policy changes to help shorten stays for “complex discharge” patients—those who are in hospitals but cannot be discharged to a long-term care or behavioral health facility for a variety of complicated reasons. In 2020, the average length of stay was 57 days for patients who were referred to the state for long-term support and Medicaid funding, compared to 32 days this year. But Bea Rector, assistant secretary for aging and long-term support at the Department of Social and Health Services, says 32 days is still too long.

In key home care victory, House passes Elizabeth Dole Home Care ActMcKnight’s Home Care DailyDecember 7, 2023Providers, industry organizations and advocates applauded the House’s passage of the Elizabeth Dole Home Care Act on Tuesday evening. “It’s a good recognition, especially on the House’s part, that reinforces home care as an industry,” Jason Lee, chief executive officer of the Home Care Association of America, said in an interview on Wednesday with McKnight’s Home Care Daily Pulse. “They see the value in the services, and that is so critically important.” The Elizabeth Dole Home Care Act would introduce various provisions to make home care more accessible for veterans. Among the key ones: The cost of providing veterans noninstitutional alternatives to nursing home services, such as home care, may not exceed 100% of the cost that would have been incurred if they had received Department of Veterans Affairs nursing home care. ... Of course, the Elizabeth Dole Home Care Act still has to win Senate approval.