Literature Review

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.”

Study—Black Patients Less Likely Receive A Home Health Referral Following A Hospital StintHome Health Care NewsDecember 8, 2023Home health services are a vital component of care continuity. But nurses are less likely to give Black patients, compared to white patients, home health referrals when being discharged from a hospital stay, a new University of Michigan study found. Specifically, researchers found that roughly 22% of Black patients were receiving home health referrals by discharge nurses, compared to 27% of white patients.

Summit County nursing homes testing robots to address staff shortagesAkron (OH) Beacon JournalDecember 6, 2023Two Akron-area nursing homes—Copley Health Center and The Village of St. Edward—are turning to robots to help alleviate staffing shortages in their facilities. The robots are part of a pilot program facilitated by the Direction Home Akron Canton Area Agency on Aging & Disabilities. Each facility has adopted different procedures for their robot to help with. Examples of tasks the robots perform include meal and package delivery, hydration carts and cleaning food trays and dining areas.  ... So far during the pilot program, the two robots have traveled more than 163 miles and have made over 2,220 deliveries to residents. Though the robots are used daily and have been well received by staff and residents, they are not intended to replace human contact, according to the news release.

Funding for nursing homes up 25% after state increaseSouth Dakota SearchlightDecember 7, 2023State funding for nursing homes is up an average of 25% statewide since the Legislature and Gov. Kristi Noem approved more money for them last winter. ... During the last legislative session, Noem and legislators approved 100% reimbursements for those [Medicaid] costs. The move, which went into effect in July, was a reaction to 15 nursing homes closing across the state in recent years, in part due to insufficient reimbursement rates. ... The higher reimbursement rate infused roughly an extra $49 million into nursing homes in the state.

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.“]