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."

The hidden advantages of having an older workforce in home health care Home Health Care News; by Joyce Famakinwa; 7/2/24In home health and hospice, the amount of nurses who are at retirement age are set to surpass new RNs, according to data from the American Medical Group Association. St. John has noticed that working with more experienced nurses has meant less turnover. "Our highest turnover is in first-year nurses," she said. Another benefit of having a workforce full of mostly seasoned nurses is that they are better equipped to handle burnout, according to Barnett.

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

Care provider to pay $14.9M over false claims involving assisted living communitiesMcKnight's Senior Living; Kimberly Bonvissuto; 6/10/24A chronic disease management provider will have to shell out $14.9 million over allegations related to false claims involving assisted living communities, memory care communities and group homes. Bluestone Physician Services of Florida LLC, Bluestone Physician Services PA of Minnesota and Bluestone National LLC of Wisconsin agreed to a $14.9 million settlement with the Justice Department. The federal government alleged that Bluestone knowingly submitted false claims to Medicare, Medicaid and TRICARE — the healthcare program for active duty service members and their families — for certain evaluation and management codes for services related to chronic care management of assisted living residents. The settlement agreement resolves allegations that Bluestone submitted “inflated” claims between Jan. 1, 2015, and Dec. 31, 2019, that did not support the level of service provided. The federal government will receive $13.8 million from the settlement, with more than $1 million going to the states of Florida and Minnesota.

Nursing homes are left in the dark as more utilities cut power to prevent wildfires News-Medical.net; by KFF Health News; 6/10/24 When powerful wind gusts created threatening wildfire conditions one day near Boulder, Colorado, the state's largest utility cut power to 52,000 homes and businesses — including Frasier, an assisted living and skilled nursing facility. It was the first time Xcel Energy preemptively switched off electricity in Colorado as a wildfire prevention tool, according to a company official. The practice, also known as public safety power shut-offs, has taken root in California and is spreading elsewhere as a way to keep downed and damaged power lines from sparking blazes and fueling the West's more frequent and intense wildfires. 

Navigating Aging: New help for dealing with aggression in people with dementia Northern Kentucky Tribune; by Judith Graham, KFF Health News; 6/9/24Caring for older adults with dementia is stressful, especially when they become physically or verbally aggressive, wander away from home, develop paranoia or hallucinations, engage in inappropriate or repetitive behaviors, or refuse to let caregivers help them. Upward of 95% of patients experience these neuropsychiatric symptoms of dementia, which tend to fluctuate over time and vary in intensity. They’re the primary reasons people with dementia end up in assisted living facilities or nursing homes. At some point, families and friends trying to help at home simply can’t manage. “When people think about dementia, they usually think about forgetfulness and memory impairment,” said Mary Blazek, director of the geriatric psychiatry clinic at the University of Michigan. “But it’s behavioral and psychological disturbances that are most disruptive to patients’ and caregivers’ lives.”

Record numbers of nursing homes are shutting down in New EnglandBoston.com; by Beth Treffeisen; 5/30/24[Personal story about multiple moves, due to shutdowns:] ... Her dad had to spend his entire life savings on care, about $400,000. “And now he’s being treated like this,” Jones said. “He gets moved around, shuffled around like an object.” The nursing home closures affect not only the patients, like Jones’s father, but also the larger health care system and local communities they serve. Experts in the field say the loss of long-term care facility beds has led to backups in emergency rooms, and family members are leaving the workforce to care for the elderly or sick. ... According to a Boston Federal Reserve report, there were 150 less nursing facilities in New England at the end of fiscal year 2023 than there were at the beginning of 2010, a 15 percent decrease.

Transformative peer connections: Early experiences from the ASCO Palliative Care Community of Practice American Society of Clinical Oncology; by Mazie Tsang, Cristiane Bergerot, Natasha Dhawan, Rushil Patel, Darcy Burbage, Tingting Zhang, Jafar Al-Mondhiry, Joseph McCollom, Ramy Sedhom; 5/22/24 online ahead of print in June 2024  ... there are barriers to implementing palliative oncology at many institutions for myriad reasons. ... In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. ... [We address] eight main domains:

Hospital CEOs ask patients to receive care at home Becker's Hospital Review; by Madeline Ashley; 5/14/24 Hospital executives are making the push to move more care, specifically recovery rooms and exams, out of the hospital and into patient homes, to potentially save money and improve finances as the country continues to move out of the pandemic, Politico reported May 11. And Congress is supporting these efforts by introducing legislation that would expand at-home care and to allow Medicare to continue funding telehealth. Here are five findings from the report: ... [Click on the title's link to read more.]

Caring for the Caregiver: A Guide for Home Care Providers Forbes; by Joan Ekobena; 5/8/24This article proposes that nurturing the psychological and physical well-being of caregivers [employees] is essential. It’s not just a matter of ethical responsibility but a fundamental factor for maintaining quality care, promoting continuity of care and boosting employee retention. This can create a positive ripple effect, which can not only increase customer satisfaction but also boost business revenue. ... A recent decision by the Office of Inspector General (OIG) underscores the increasing awareness of the need to invest in caregiver wellness. Guides are listed as "Strategies for Supporting Caregiver Wellness and Mindset": ... [Note: "Caregiver" denotes employees who provide home care, not the family "caregiver" in the home.] 

Terminal cancer: What matters to patients and caregivers Medscape Medical News; by Megan Brooks; 5/6/24 What's most important to patients with terminal cancer and their caregivers? New research found that patients and caregivers both tend to prioritize symptom control over life extension but often preferring a balance. Patients and caregivers, however, are less aligned on decisions about cost containment, with patients more likely to prioritize cost containment. ... As patients approached the end of life, neither patients nor caregivers shifted their priorities from life extension to symptom management.

Optum layoffs affect teams in Medicare Advantage I-SNP, IE-SNP business Skilled Nursing News; by Zahida Siddiqu; 5/2/24 Optum is paring back its workforce, including in the parts of the business related to Medicare Advantage plans for nursing home and assisted living residents. ... The recent layoffs at Optum number hundreds of people across various parts of the company, according to multiple news reports. The company is discontinuing its virtual care business, as Endpoints first confirmed. ... Multiple sources have shared that out of a roughly 20% to 30% of a 400-person workforce [in IE-SNP business] has been laid off in this part of Optum. ... The reduction in staff was across the board from senior leaders on the clinical end to low-level employees, industry sources said.