Literature Review

CDC releases new profile of assisted living residents McKnights Long-Term Care News; by Kimberly Bonvissuto; 8/10/24 Residents living in assisted living and other residential care communities in 2022 mostly were female (67%), white (92%) and 85 or older (53%), according to a new report from the Centers for Disease Control and Prevention’s National Center for Health Statistics. The CDC said that data from the National Post-acute and Long-term Care Study outlined in the profile of residential care community residents in 2022 would help inform policymakers, providers, researchers and consumer advocates planning to help meet the needs of a rapidly growing older adult population. 

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

The bereavement care crisis in hospice facilities MedCity News; by Cara McCarty Abbott; 7/28/24 Bereavement care is an essential part of the hospice experience, designed to support those coping with loss. Bereavement care is not just a compassionate gesture; it is a critical component of the hospice care continuum. So why is it so underserved in the U.S.? ... Instead of pushing harder on hospice providers to find more ways to deliver comprehensive bereavement care with less, it's key to address the systemic forces hampering their ability to deliver quality care at the scale required and address these challenges. Editor's Note: Additionally, does your hospice still rely on the misnamed, overused "5 Stages of Grief"? These were determined from 1960's persons who were dying, not from bereaved persons who live on--surviving--the death. Extensive fresh, contemporary, hospice-designed grief resources to support bereavement counselors and the persons they serve are provided by Composing Life Out of Loss, a sponsor for our newsletter.

Advance care questions to ask your loved one Parkview Health; 7/27/24 ... To ease into a conversation about decisions and scenarios, we can start with questions that are easier to answer, like: What does a good day look like? If you got to spend the day with your favorite people doing your favorite things, what would you be doing? With whom? ... From there, we can talk about more specifics related to healthcare decisions, such as: If your heart and breathing stop suddenly, would you want to have CPR (cardiopulmonary resuscitation), which can include pushing on your chest, breathing support, medications, and electrical shocks? ... If you knew that death was likely to happen in a brief period of time, would you want to be in the hospital, in a nursing care facility or at home? ... Editor's Note: The wording, sequencing, and open-ended format of these questions gently open the door for the person to reflect on and describe one's wishes, in contrast to some advance care planning questions that focus on filling out a form. Yes, Advance Directives forms are crucial. However, the forms are a tool for now and for needs ahead. The focus is the person, while building a context of relationship and trust.

Alpharetta City Council considering fee for lifting assistance calls Appen Media, Alpharetta & Roswell, GA; by Jon Wilcox; 7/16/24 The Alpharetta City Council is considering a fee for residents and assisted living homes who make multiple calls a month for emergency responders to help people who have fallen. Director of Public Safety John Robison told the council July 15 that calls for lifting assistance come at significant cost and tie up responders who may be needed for other emergencies. Last year, Robison said, 328 calls for lift assistance cost the city $78,844, almost double the cost from the previous year, which saw 190 calls at a cost of $32,275.30. ... A proposed ordinance suggests a schedule of fees for calls asking responders to assess people who have fallen and may be injured. ... Hospice patients would be exempt from the fees. 

Senior living providers embrace role in CMS dementia care pilot program McKnights Senior Living; by Kimberly Bonvissuto; 7/11/24 Senior living providers named participants in the federal government’s new dementia care pilot program said they are excited to be part of a new effort to support people living with dementia and their family caregivers. The Center for Medicare and Medicaid Innovation, CMMI, announced the Guiding an Improved Dementia Experience, or GUIDE, model last summer. The Centers for Medicare & Medicaid Services launched the eight-year GUIDE model on July 1 and published the program participant list on Monday [7/8]. Eligible model participants are Medicare Part B-enrolled providers eligible to bill for Medicare services and that provide, or will provide, ongoing care to people living with dementia. Eligible organizations include accountable care organizations, home health and hospice agencies, Programs of All-Inclusive Care for the Elderly, and physician practices. Additional long-term care providers and other healthcare providers, however, can participate as partner organizations by contract with another Medicare provider/supplier to meet the program care delivery requirements. Assisted living residents who are Medicare beneficiaries may be part of the model. Editor's Note: Adding to our previously published posts about the new CMS GUIDE Program (7/10/24 and 7/11/24) and its use by hospice organizations, this article describes its use by senior living care providers. 

Home health providers to pay $4.5M to resolve alleged false claims act liability for providing kickbacks to assisted living facilities and doctorsDOJ press release; 7/1/24Guardian Health Care Inc., Gem City Home Care LLC and Care Connection of Cincinnati LLC, home health agencies operating in Texas, Ohio and Indiana, along with their owner Evolution Health LLC, have agreed to pay $4,496,330 to resolve allegations that they violated the False Claims Act by knowingly providing illegal kickbacks to assisted living facilities and physicians in exchange for Medicare referrals.

Cooper University Health acquires New Jersey system Becker's Hospital Reivew; by Alan Condon; 7/1/24 Cooper University Health Care on July 1 completed the acquisition of  Cape May, NJ-based Cape Regional Health System. As part of the closing, Cape Regional Medical Center has been renamed Cooper University Hospital Cape Regional. The combined health system comprises two hospitals with more than 900 beds, 130 ambulatory sites and almost 11,000 employees, including over 1,000 physicians. It is projected to have revenue exceeding $2.2 billion a year. The transaction unlocks significant growth opportunities, particularly in the outpatient market, as healthcare continues its shift away from inpatient settings, Camden, N.J.-based Cooper CFO Brian Reilly told Becker's. 

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."

Chronic loneliness and the risk of incident stroke in middle and late adulthood: a longitudinal cohort study of U.S. older adults eClinical Medicine, Part of THE LANCET Discovery Science; by Yenee Soh, Ichiro Kawachi, Laura D. Kubzansky, Lisa F. Berkman, and Henning Tiemeier; 6/24/24 Loneliness has been implicated as a stroke risk factor, yet studies have examined loneliness at only one time point. The association of loneliness changes and risk of incident stroke remains understudied. Our aim was to examine the association of loneliness with incident stroke, particularly the role of loneliness chronicity. Chronic loneliness was associated with higher stroke risk independent of depressive symptoms or social isolation. Addressing loneliness may have an important role in stroke prevention, and repeated assessments of loneliness over time may help identify those particularly at risk.Editor's Note: This is the source research for an article we posted yesterday, 6/28/24, titled 

48 health systems with strong finances Becker's Hospital CFO Report; by Andrew Cass; 6/20/24 Here are 48 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody's Investors Service released in 2024. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. [Click on the title's link for the list.] Editor's Note: This list is from larger "health systems," and does not reflect stand-alone hospice and palliative organizations.

4 percent of those aged 65+ have dementia diagnoses: reportMcKnight's Senior Living; by Kimberly Bonvissuto; 6/14/24Four percent of US adults aged 65 or more years have a dementia diagnosis, with rates of dementia increasing with age, according to newly released data. Data from the 2022 National Health Interview Survey, or NHIS, revealed that the rate of dementia diagnoses ranged from 1.7% for adults aged 65 to 74 years to 13.1% in those 85 and older, according to the National Health Statistics Reports issue released Thursday by the Centers for Disease Control and Prevention. ... Among all residential care communities, 42% of residents have diagnoses of Alzhiemer’s disease or other dementias, according to the report. By comparison, 31% had heart disease, and 29% had depression.

Palliative care considerations in frail older adults Annals of Palliative Medicine; by Andrew E Russell, Rachel Denny, Pearl G Lee, Marcos L Montagnini; 6/6/24, online ahead of print...This paper aims to guide clinicians in providing patientcentered care for older adults with frailty in the outpatient setting. Through a comprehensive literature review, we describe the leading models of frailty, frailty screening tools used in the clinical setting, and the assessment and management of palliative care needs in frail patients. We also describe emerging models of care focusing on palliative care for older adults with frailty and discuss issues related to access to palliative care for this population.