Literature Review

Sierra Hills strike ends, negotiations ongoing with parent company Wyoming Tribune Eagle; by Noah Zahn; 1/9/25 Employees of Sierra Hills Assisted Living concluded their strike on Jan. 2, and on Tuesday, the union met with Edgewood Healthcare, which owns Sierra Hills, for another contract bargaining session. ... Throughout the strike, employees said they were fighting for a better contract primarily for the health and safety of the residents and the employees, claiming the existing working conditions are unsafe. ... Wilkinson said the primary concern of the employees is safety issues that result from employees performing out-of-scope duties. ... For Sierra Hills staff, [being required to provide out of scope care] began when Edgewood introduced hospice care at Sierra Hills a few years ago, shortly after the pandemic. There are hospice nurses who are at the facility a couple of hours per week to care for the residents, but the rest of the time, the burden of care often falls to the CNAs and RNs on the clock. In situations where timely care is needed, employees have said it can be difficult to get the help of a hospice nurse in time.

California wildfires and healthcare: Compiled articlesCompiled from various news sources; 1/9/25

Navigating Aging: The LGBTQ+ community relives old traumas as they face aging on their own Northern Kentucky Tribune; by Judith Graham; 1/5/25 Bill Hall, 71, has been fighting for his life for 38 years. These days, he’s feeling worn out. Hall contracted HIV, the virus that can cause AIDS, in 1986. ... This past year, Hall has been hospitalized five times with dangerous infections and life-threatening internal bleeding. But that’s only part of what Hall, a gay man, has dealt with. ... By 2030, the number of LGBTQ+ seniors is expected to double. Many won’t have partners and most won’t have children or grandchildren to help care for them, AARP research indicates. They face a daunting array of problems, including higher-than-usual rates of anxiety and depression, chronic stress, disability, and chronic illnesses such as heart disease, according to numerous research studies. High rates of smoking, alcohol use, and drug use — all ways people try to cope with stress — contribute to poor health. Keep in mind, this generation grew up at a time when every state outlawed same-sex relations and when the American Psychiatric Association identified homosexuality as a psychiatric disorder. Many were rejected by their families and their churches when they came out. Then, they endured the horrifying impact of the AIDS crisis.

‘Change in air’ for senior living and care industry in 2025 McKnights Senior Living; by Kimberly Bonvissuto; 12/20/24 “Change is in the air” heading into 2025 for the senior living and care industry, particularly evidenced in regulatory shifts, dementia care, technology expansion and market rebounds, according to the Health Dimensions Group’s annual white paper outlining key issues expected to affect providers in the future.

The top long-term care stories of 2024 McKnights Long-Term Care News; by James M. Berklan; 12/20/24 Workforce issues dominated the long-term care provider landscape in 2024 — but in far more ways than just coping with the finalization of the nation’s first-ever nursing home staffing mandate. As new legal and political winds may eventually push that controversial regulation off providers’ desks anyway, it was clearly apparent this year that McKnight’s Long-Term Care News readers’ interests span a wide array of personnel and workplace issues. Below are the top stories, topics and issues that our readers showed they were most intrigued about when it came to doing their jobs better, and about the sector in which they spend so much daily energy.

Sierra Hills employees strike for safer conditions to live and work Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/26/24 Employees at Sierra Hills Assisted Living protested Thursday outside the facility after Edgewood Healthcare, which owns Sierra Hills, has refused to budge in negotiations for safer working conditions for employees and residents after more than 10 months of negotiation. “We did include many things in our contract proposal that we feel will really benefit the residents,” said Taylor Ewig, who has been a CNA at Sierra Hills for around 10 years. ... There are currently between 70 and 80 residents at the facility and around eight under hospice care. Ewig and other CNAs participating in the strike said that many of the Sierra Hills residents are supportive of the strike. The issues began at the facility when Sierra Hills implemented a hospice care service a few years ago, shortly after the onset of the COVID-19 pandemic. ... The company hires hospice nurses who are only on the facility about two hours per week, according to Sierra Hills staff. The rest of that time, the burden of care for the resident falls to the staffed CNAs and RNs.

U.S. health care spending reaches $4.9 trillion Hospice News; by Jim Parker; 12/20/24 The nation’s total health expenditures rose 7.5% to $4.9 trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. In 2022, health care spending rose at a rate of 4.6%. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). ... About 21% of U.S. health care spending in 2023 was via Medicare, with private insurance representing a 30% share. Medicaid accounted for 21%, and the remaining 10% were out-of-pocket costs. “Hospital care, physician and clinical services, and nursing care facilities and continuing care retirement communities, which collectively accounted for 33% of all out-of-pocket spending in 2023, were the main contributors to the faster growth in 2023,” CMS indicated.

Sierra Hills assisted living employees in Cheyenne to strike over staffing issues' Wyoming Tribune-Eagle, Cheyenne, WY; by Noah Zahn; 12/18/24 In March, a resident at Sierra Hills Assisted Living in Cheyenne fell and hurt their hip and shoulder. A CNA at the facility reported that the resident could not be moved without causing shoulder pain, noting that they had likely broken their shoulder and hip, according to a report from the Wyoming Department of Health. The resident was bed-bound, in “excruciating pain” and screamed for hours, which frightened the other residents. The CNA stated this was “the worst thing she had ever experienced.” At the time, the resident was one of six hospice patients at the assisted-living facility. Sierra Hills made hospice care available at the facility shortly after the COVID-19 pandemic. When hospice nurses were unavailable, the burden of care fell to the CNAs and RNs on staff. The CNA caring for this resident in March stated it was difficult to get hospice to respond on the weekends, saying that there was an 80% chance hospice would answer a phone call and a 50% chance a hospice nurse would come to the facility. Six days later, the resident died. Editor's note: Click on the title's link to continue reading. This strike--reportedly related to staffing--appears to be related extra responsibilities on the staff, because of the hospice's limited responses on weekends. This is 2024; not 1974. How does this scenario relate to your hospice triage, hours, staffing, incident reports, community partnerships? 

How UCSF Health is rebuilding an 'instrumental' management layer Becker's Hospital Review; by Kelly Gooch; 12/17/24Middle managers have long played a crucial role in industries across the U.S. However, a November article from global management consulting firm Korn Ferry describes "a disappearing layer of middle management," particularly among professional-service firms that are "delayering" to improve flexibility and responsiveness. ...  [Data] shows that in 2023, middle managers accounted for 31.5% of all layoffs, with an average of 22% between 2018 and 2022. While Mitul Modi, Korn Ferry senior client partner in the firm's global healthcare services practice, said layoffs of managers have occurred at various health systems in 2024, he told Becker's he is not seeing this occur with patient-facing roles. Instead, he has observed an increased emphasis on developing middle managers. ... One example of this is San Francisco-based UCSF Health. ... UCSF Health's efforts center around investing in a management core training program.[Click on the title's link to continue reading.]

Weekly US Map: Influenza summary updateCDC - U.S. Centers for Disease Control and Prevention; ongoing, retrieved from the internet 12/16/24A Weekly Influenza Surveillance Report Prepared by the Influenza Division Editor's note: Bookmark this page to your web browser to monitor flu activity in your service areas through these more vulnerable winter months. Click on the map's "State" button for macro data at the state level. Click on the map's "CBSA" to drill down to counties.

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

What they love and loathe: Medscape Nurse Career Satisfaction Report 2024 Medscape; by Jon McKenna; 12/13/24 Despite well-publicized issues buffeting their profession, nurses in a Medscape survey overwhelmingly said they are happy with their career choice, and most said they would make it again. They also told us about their most- and least-favored job features, recounted any experiences with abuse at work, revealed possible alternative careers, and reported union membership, among other insights. [Click on the title's link to continue reading.]

Watch: ‘Going It Alone’ — A conversation about growing old in AmericaKFF Health News; by Judith Graham; 12/11/24 KFF Health News’ “Navigating Aging” columnist, Judith Graham, spent six months this year talking to older adults who live alone by choice or by circumstance — most commonly, a spouse’s death. They shared their hopes and fears, challenges, and strategies for aging solo. Graham moderated a live event on Dec. 11, hosted by KFF Health News and The John A. Hartford Foundation. She invited five seniors ranging in age from 71 to 102 and from across the country — from Seattle; Chicago; Asheville, North Carolina; New York City; and rural Maine — to talk candidly about the ways they are thriving at this stage of life.