Literature Review

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.

Tower Health laid off 30 people on TuesdayPhiladelphia InquirerDecember 6, 2023Tower Health laid off 30 people on Tuesday, citing efforts to streamline operations at the nonprofit health system based in Berks County. Not included in that total were an unspecified number of people in Tower’s information technology department, whose jobs were moved to an outside vendor. “Although Tower Health’s financial position has improved, we still face challenges and are working hard collectively as an organization to improve performance,” Tower said in a statement. 

Dartmouth Health finances improveValley News (West Lebanon, NH)/VT DiggerNovember 29, 2023Lebanon, NH—Dartmouth Health continues to see a financial loss on operations, but the red ink has subsided substantially since last year, according to filings with bondholders last week. For the first quarter of fiscal year 2024, which ended Sept. 30, DH saw an operating loss of $8.2 million, or 1%.  Overall, including SVHC, expenses were up about 10% to $844 million for the first quarter of the year, over the same period last year. ... Meanwhile, revenues were up nearly 15%, or $107.5 million, compared with the same quarter last year. That was partially aided by SVHC’s membership, as well as by growth in patient volumes, contracted payment rates and higher inpatient acuity at DHMC, the system’s flagship academic medical center.

Patient-centered medical homes can reduce care cost of chronically ill patients, study findsMcKnight’s Home Care DailyDecember 5, 2023High-cost patients receiving care through patient-centered medical home programs are less likely to remain high-cost in the long term, according to a recent study published in the American Journal of Managed Care. ... The researchers compared the healthcare expenditures and health outcomes of thousands of PCMH and non-PCMH patients across Maryland during the state’s Multi-Payer PCMH program. They found that high-cost patients, such as those with chronic conditions, frailty or greater rates of hospital or ambulance usage, experienced better health outcomes with less health service utilization. 

California Officially Raises Minimum Wage For Home Health Care WorkersHome Health Care NewsDecember 4, 2023California’s home health workers are set to receive higher pay next year as a result of a minimum wage hike approved by the state legislature. ... The news will be greeted warmly by caregivers in the Golden State. However, experts in the home-based care space have worried before that the wage increase could have adverse effects on providers.

State’s regulators under fire for not imposing ‘meaningful’ punishment on operatorsMcKnight’s Senior LivingDecember 4, 2023If provider punishments in Maine ramp up in the near future, operators won’t need to look far for the catalyst. A ProPublica investigation into what it calls the failures of the state’s oversight agencies is creating a lot of heat in and around the sector. ... In partnership with The Maine Monitor, ProPublica’s Local Reporting Network shined a spotlight on the state’s health department for citing dozens of resident rights violations and hundreds of other deficiencies between 2020 and 2022 but imposing only the “lowest intervention possible, even for some of the most serious abuse and neglect incidents.” ... Long-term care advocates said that a lack of regulatory enforcement essentially encourages bad behavior. Industry representatives called for increasing nursing hours and requiring on-site medical directors in assisted living rather than imposing sanctions.

NAHC offers guidance, prevention strategies for home care workplace violenceMcKnight’s Home Care DailyDecember 4, 2023Providers and their caregivers need to take actions to protect themselves against workplace violence, a group of experts said in a webinar sponsored by the National Association for Home Care & Hospice. “We may not be able to 100% prevent violence for safety concerns in the home setting,” Candyce Slusher, owner of senior care consulting firm Slusher Consulting, said during the Wednesday webinar. “So we’ll do what we can to recognize those things ahead of time and try to protect our staff, but they also need to know how to protect themselves and feel comfortable coming to you when there’s issues.”

Dying Broke: The High Cost Of Help Desperate Families Search for Affordable Home CareNew York TimesDecember 2, 2023... Frank Lee’s search for trustworthy home health aides—an experience that millions of American families face—has often been exhausting and infuriating, but he has persisted. ... There is precious little assistance from the government for families who need a home health aide unless they are poor. The people working in these jobs are often woefully underpaid and unprepared to help a frail, elderly person with dementia to bathe and use the bathroom, or to defuse an angry outburst.[Editor’s Note: This article is part of The New York Times’ “Dying Broke” series examining how the immense financial costs of long-term care drain older Americans and their families. For additional coverage, see the accompanying article in this package, “What to Know About Home Care Services: Finding an aide to help an older person stay at home safely takes work. Here’s a guide.“]

Trinity slims operating loss to $58.6M in FY Q1Becker’s Hospital CFO ReportDecember 1, 2023Livonia, Mich.-based Trinity Health reported an operating loss of $58.6 million (-1% margin) in the first quarter of the fiscal year—the three months ended Sept. 30—compared to a $146.3 million loss (-2.9% margin) during the same period in 2022. For the fiscal first quarter, operating revenue increased 12.4% year over year to $5.6 billion.

‘Plain old greed’—HCA nurses rally to denounce understaffing, unsafe conditions at hospitalsFlorida PhoenixNovember 30, 2023Judy Preuss, an ICU nurse at HCA Florida Oak Hill Hospital, joined the National Nurses Organizing Committee 13 years ago for the same reason she rallied Thursday afternoon in Tampa with colleagues from other parts of the country: Bargaining to fix understaffing. Oak Hill Hospital, where Preuss has worked for 18 years, is one of HCA Healthcare’s 46 hospitals in Florida. The nurses from the union representing 10,000 registered nurses across the U.S. held a rally at the HCA West Florida Division Office in Tampa.

Humana Partners With CINQCARE To Deliver Home-Based Care To Medicare Advantage MembersHome Health Care NewsNovember 30, 2023Humana Inc. has formed a partnership with CINQCARE, a health care company that delivers care in the home and community. ... As part of the collaboration, the companies will serve Humana’s New York Medicare Advantage members in their homes.

Nursing Homes’ Letter to CMS Calls Out Lack of Teeth—and Clarity—in Final Rule’s Medicare Advantage ReformSkilled Nursing NewsDecember 1, 2023In order to keep Medicare Advantage plans in check for denial of services, provider organizations are pressuring federal authorities to do more, and asking them to closely monitor and aggressively enforce reforms for these plans as envisioned in a final rule that takes effect on Jan. 1. Companies managing MA plans have said they don’t believe they need to do anything different, based on what was laid out in the final rule, a worrying concern that needs to be addressed, providers said, who are also seeking to gain clarity on how the Center for Medicare & Medicaid will monitor MA plans’ compliance. To that end, nursing home and hospital associations are seeking to influence the implementation of CMS’s rule regarding MA plans.