Literature Review

Florida health-care workers exhausted as Hurricane Milton approaches The Washington Post; by David Ovalle and Sabrina Malhi; 10/8/24The storm shutters are up at Stephen Johnson’s house near the water in North Fort Myers, Fla. ... But  Jones won’t be home when Hurricane Milton is expected to thunder ashore this week along the Gulf Coast. Instead, the paramedic — like thousands of health-care workers across Florida — intends to ride out the storm at work, then jump into action when the winds die down, the waters recede and people seek medical assistance. ... “It gets stressful. You don’t know if you’re going to come back to a home,” Johnson, 28, of Brewster Ambulance Service, said during a brief break Tuesday after two straight days of organizing evacuations of patients from hospitals and assisted-living facilities across Lee County in southwest Florida while surviving on granola bars and energy drinks. ... By Tuesday afternoon, Florida health officials had deployed nearly 600 ambulances, buses and other transport vehicles to ferry patients out of harm’s way. More than 200 health-care facilities — including 115 assisted-living facilities, 10 hospitals and five hospice providers — have reported evacuations, according to the state’s health department.

Temporary regulatory relief for South Carolina health care providers responding to Hurricane Helene Baker Donelson; Alissa D. Fleming; 10/4/24 South Carolina Governor Henry McMaster declared a State of Emergency on September 25, 2024, to prepare for Hurricane Helene. On September 29, 2024, the Federal Emergency Management Agency (FEMA) issued a Federal Major Disaster Declaration (FEMA-4829-DR) for South Carolina. On September 30, 2024, the United States Department of Health and Human Services (HHS) declared a public health emergency in South Carolina, and the Centers for Medicare and Medicaid Services (CMS) issued several blanket waivers to provide greater compliance flexibility and continuity of care while responding to Helene in the geographic area covered by the President's declaration. These waivers [detailed in the article] provide health care facilities with flexibility in service delivery, staffing, and patient care, aimed at alleviating the strain caused by Helene. Further, HHS, the South Carolina Department of Health and Human Services (SCDHHS), and other regulatory bodies have announced relief efforts, all aimed at reducing administrative burdens so providers can continue to care for and treat those in need. ...7. Hospices Assessment Timeframe Extension: CMS is extending the timeframe for updating comprehensive hospice patient assessments from 15 to 21 days, though initial and ad-hoc assessments must still be completed based on patient needs. ...Editor's note: Click on the title's link to continue reading. Other CMS waivers are defined for 1. General ... for Health Care Facilities; 2. Critical Access Hospictals; 3. Hospital and Long Term Care Facilities; 4. Skilled Nursing Facilities; 5. Home Health Agencies; 6. DME, Prosthetics, Orthotics, and Supplies; 7. Hospice (above); 8. Practioner Licensure and Enrollment ... HIPAA; Disaster Relief

Hospitalists use POLST to initiate patient conversations about care goals The Hospitalist; by Larry Beresford; 10/1/24 Physician orders for life-sustaining treatment (POLST) is a single-page medical order form, typically printed on bright pink paper, and signed by a physician, nurse practitioner, or physician assistant to spell out treatment preferences for a seriously ill or frail patient. It is also a process for exploring those preferences in conversation with patients and then communicating them to those who might need to know, such as EMS personnel, in some future medical emergency when the patients can no longer speak for themselves. And, said Steven Pantilat, MD, FAAHPM, MHM, a former clinical hospitalist and the inaugural chief of the division of palliative medicine at the University of California San Francisco, it is “solidly within what hospitalists can and should be doing.” That may involve meeting and talking with patients and their families about their values and treatment preferences, reviewing any existing POLST forms, and even filling out and signing a form.

16 large health systems growing bigger Becker's Hospital Review; by Alan Condon; 9/20/24 Merger and acquisition activity is rebounding after a drop in deal volume during the pandemic, with many large health systems growing their hospital portfolios or planning to add more hospitals in the coming quarters. Sixteen health systems growing bigger: ... This is not an exhaustive list.

Hospital mergers and health care price increases: A primer for reporters Association of Health Care Journalists (AHCG); by AHCG Staff; 9/24/24 Hospital mergers — market consolidation — can lead to health care price increases of anywhere from 3% to 65%, according to a 2022 RAND Corporation review. The FTC’s director of the Bureau of Economics has said hospitals that merge may charge 40% to 50% more than if they hadn’t merged. Mergers can also result in layoffs and lower tax revenues and have a negative impact on patient care by reducing access to some health care services. With so much research confirming negative effects and as health care prices continue to rise, what — if anything — can be done to slow market consolidation and/or reduce the harms to patients and local economies?

63 Hispanic and Latino leaders to know | 2024 Becker's Hospital Review; by Anna Falvey; 9/20/24 Becker's is thrilled to honor these Hispanic and Latino healthcare leaders. Diverse leadership in healthcare culminates in a more comprehensive, seamless experience for both patients and providers alike. The leaders honored in this list are transforming the patient journey, ushering in the new wave of healthcare providers and promoting DEI. ... Becker's Healthcare developed this list based on nominations and editorial research. Leaders do not pay and cannot pay for inclusion on this list. This list is not exhaustive, nor is it an endorsement of the leaders or organizations mentioned. Editor's note: Reminder that the National Hispanic Heritage Month is September 15 to October 15. Are you recognizing your Hispanic employees and volunteers? Click here for CMS resources. 

Most frequent CMS citations in 2024 Becker's Clinical Leadership; by Paige Twenter; 9/19/24 Similar to 2023, hospitals are most frequently cited for deficiencies in patient rights, according to CMS data obtained by Becker's.  So far this year, CMS accrediting agencies have conducted nearly 2,760 surveys at U.S. hospitals. Of those surveys, more than 6% have resulted in a citation over a patient's right to receive care in a safe setting. Here are the 25 most common citations as of Sept. 15, according to data from CMS' Quality and Certification Oversight Reports: 

Trends in mortality after incident hospitalization for heart failure among Medicare beneficiariesJAMA Network Open; Adam S. Vohra, MD, MBA; Ali Moghtaderi, PhD; Qian Luo, PhD; David J. Magid, MD, MPH; Bernard Black, JD, MA; Frederick A. Masoudi, MD, MSPH; Vinay Kini, MD, MSHP; 8/24In this study of Medicare fee-for-service beneficiaries, there was a substantial decrease in in-hospital mortality for patients hospitalized with incident HF [heart failure] from 2008 to 2018, but little to no reduction in mortality for subsequent periods up to 3 years after hospitalization. These results suggest opportunities to improve longitudinal outpatient care for patients with HF after hospital discharge.

Survey: Older adults unsatisfied with current healthcare system McKnights Long-Term Care News; by Kristen Fischer; 9/17/24 Older adults aren’t too happy with the healthcare system and many think it doesn’t meet their needs and preferences, according to a new survey. The results of the survey, conducted by The Harris Poll, were published Tuesday, and were released by Age Wave and The John A. Hartford Foundation.  Four in five adults aged 65 and older said that the system isn’t prepared to handle the changing needs of Americans in their age group. In total, only 11% said the US healthcare system deserved a grade of “A.” Results show that older adults want solutions such as affordable care interventions, developments to prevent or reduce cognitive decline, and healthcare professionals who understand what matters to them when they discuss care options.

AI 'early warning' system shows promise in preventing hospital deaths, study says Pique NewsMagazine, Toronto, Canada; by Nicole Ireland; 9/16/24 An AI early-warning system that predicts which patients are at risk of deteriorating while in hospital was associated with a decrease in unexpected deaths, a new study says. The study, published Monday in the Canadian Medical Association Journal, found a 26 per cent reduction in non-palliative deaths among patients in St. Michael's Hospital's general internal medicine unit when the AI tool was used. "We've seen that there is a lot of hype and excitement around artificial intelligence in medicine. We've also seen not as much actual deployment of these tools in real clinical environments," said lead author Dr. Amol Verma, a general internal medicine specialist and scientist at the hospital in Toronto. "This is an early example of a tool that's deployed that was rigorously tested and evaluated and where it's showing promise for actually helping improve patient care." ... The technology called CHARTwatch continuously analyzed more than 100 different pieces of information about each patient in the unit, Verma said. When the AI tool predicted that a patient was deteriorating, it sent an alert to physicians and nurses, prompting them to quickly intervene.

[OR] Samaritan Health Services lowers executive pay, reduces workforceModern Healthcare; by Alex Kacik; 9/16/24Corvallis, Oregon-based Samaritan laid off 80 employees in response to inflation, cyber incidents, inclement weather, volume reduction and declining reimbursement rates, a spokesperson said Monday. Most of the layoffs were not patient-facing positions, the spokesperson said.

‘We did it!’: West Penn nurses celebrate their new contract Pittsburgh Union Press, Pittsburgh, PA; by Steve Mellon; 9/12/24 Before Joanne Germanos had a chance to approach a podium to make her announcement, someone in the crowd called out, “We did it!” ... What Germanos and her fellow union nurses at West Penn did was win a new contract that raises pay and addresses staffing and burnout issues that the nurses say have been pushing experienced nurses out of the profession. Ninety percent of the hospital’s union nurses voted to approve the contract Wednesday. Under the three-year deal, pay for nurses will rise an average of 24%, with some seeing increases as high as 35%. By contract’s end, all nurses will make at least $40 an hour; nurses with 20 years of experience will make at least $50 an hour. ... Pay, however, isn’t the only issue. At rallies, union nurses have called on hospital administrators to address staffing and scheduling problems that can affect patient care and cause nurse burnout. They took those concerns to the bargaining table and, on Thursday, said they were thrilled with the outcome.

Hospitals target Medicare Advantage in DSH payment lawsuitModern Healthcare; by Alex Kacik; 9/11/24Hospitals allege in a new lawsuit that the federal government unlawfully changed Medicare disproportionate share hospital payment calculations to include care provided to Medicare Advantage patients, and facilities lost billions of dollars in the process. Eighty hospitals on Monday sued the Health and Human Services Department over how the agency factors inpatient care for Medicare Advantage patients into DSH payments, which are meant to bolster providers that treat many low-income patients. Hospitals from states including California, Ohio, Pennsylvania and Texas allege HHS violated the Administrative Procedure Act by not following the typical rulemaking process when it finalized a rule in June 2023 on how Medicare Advantage influences DSH calculations.