Literature Review

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.

Private equity, consolidation divide aging services sector as multi-agency effort gets underwayMcKnight's Long-Term Care News; by Kimberly Marselas, Kimberly Bonvissuto; 6/10/24While some aging services providers last week warned that more scrutiny of healthcare consolidation and rules that seek to limit it further could create “unintended consequences,” others encouraged three federal agencies to proceed with promised work on the issue. Private equity ownership is associated with increases in short-term mortality of Medicare patients, as well as declines in other quality measures of patient well-being, and reductions in staffing, services, supplies, or equipment, said LeadingAge, in comments authored by Jonathan Lips, vice president of Legal Affairs, citing research. They also acknowledged that another study using the government’s own data showed PE’s stake in the skilled nursing sector had declined to just 5% by 2022. Further research showed that slowdown persisted into 2023.

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

Personal conflicts, even violence, are not uncommon in long-term care The New York Times; by Paula Span; 6/9/24... In long-term care facilities, residents sometimes yell at or threaten one other, lob insults, invade fellow residents’ personal or living space, rummage through others’ possessions and take them. They can swat or kick or push. Or worse. Eilon Caspi, a gerontologist at the University of Connecticut, has searched news coverage and coroners’ reports and identified 105 resident deaths in long-term care facilities over 30 years that resulted from incidents involving other residents. The actual number is higher, he said, because such deaths don’t always receive news media attention or are not reported in detail to the authorities. “We have this extraordinary paradox: the institutions, nursing homes and assisted livings who care for the most vulnerable members of our society are some of the most violent in our society,” said Karl Pillemer, a Cornell University gerontologist who has studied resident-to-resident conflict for years. [Click on the article's title for more. Might require subscription to access the full article.]

3,000+ nurses at 6 Providence facilities to strikeBecker's Hospital Review; by Kelly Gooch; 6/10/24 Members of the Oregon Nurses Association are set to begin a three-day strike June 18 at six Providence facilities, in what the union deems the largest nurses' strike in the state's history. The union represents more than 3,000 nurses at the following facilities, according to an ONA news release:

Behavioral health patients a challenge to nursing homesModern Healthcare; by Diane Eastabrook; 6/4/24Challenges providing care for nursing home patients with mental health and behavioral health issues are adding to discharge bottlenecks for hospitals, and the demand for such care has led some facilities to set up specialized units with additional staff just for those patients.Publisher's Note: Hospice implications?

Pacs Group CEO calls for caution when dealing with private equityModern Healthcare; by Diane Eastabrook; 5/30/24Do you think private equity is becoming a problem for nursing homes? [Pacs Group Chair and CEO Jason Murray replies] I’m not saying that all private equity is inherently bad, but I do think that if providers are not careful about how the capital is aligned with their mission as a company, then you can get into some dangerous situations. As the company tries to perform, they might not be at the level where the capital partner would like them to be, so the business plan changes. Whenever that business plan changes from patient care to a return on capital, it’s a losing scenario.

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.

Maryland nursing home patients sue state over inspectionsBecker's Hospital Review; by Ashleigh Hollowell; 5/20/24The Maryland Department of Health and Laura Herrera Scott, MD, the state's secretary of health, are being sued by nursing home residents who say their care has been affected by lack of state inspections, dangerous conditions and violations of the Americans with Disabilities Act, The Washington Post reported May 17. The nursing home residents filing the lawsuit are being represented by the nonprofit Justice in Aging. They allege that lack of timely inspection as well as neglect in care have left some residents with severe injuries, health complications and ADA rights violations.

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:

Long-term care workers grapple with twice the ‘toxic stress’ as others, study showsMcKnight's Long-Term Care News; by Josh Henreckson; 5/14/24Nurses and nurse aides in long term care report rates of adverse childhood experiences (ACEs) double that of the general population - results that should lead providers to more aggressively support and communicate with their workforce, authors of a new research study said Tuesday. The study suggests that providers should invest in mental health initiatives for their workers to address and prevent the effects of toxic stress. Nearly 60% of those surveyed had never sought mental health support for these traumatic experiences.

[Old news] Consumer Alerts added to the Nursing Home Compare website and the Five Star Quality Rating SystemCMS; 10/7/19Adding an “abuse icon” to facilities cited for abuse: Every nursing home resident deserves be treated with respect at all times. Abuse is never acceptable and CMS is very concerned about incidents related to abuse (including neglect and exploitation) in nursing homes. ... As part of this strategy, we want to make it easier for consumers to identify facilities with instances of non-compliance related to abuse. To do this, in October 2019, we are adding an icon to highlight facilities that meet the following criteria: 1) Facilities cited for abuse where residents were found to be harmed (Scope/Severity of G or higher) on the most recent standard survey, or on a complaint survey within the past 12 months; or 2) Facilities cited for abuse where residents were found to be potentially harmed (Scope/Severity of D or higher) on the most recent standard survey or a complaint survey within the past 12 months, and on the previous (i.e., second most recent) standard survey or on a complaint survey in the prior 12 months (i.e., from 24 months ago to 12 months ago).Publisher's Note: With apologies for "old news", this was "new news" to me - i.e., that Care Compare for Nursing Facilities includes a "red stop hand" and a "yellow triangle warning" to warn consumers of poor performers. When might this be added to Care Compare for Hospice, and what criteria might be used?

New dementia guide provides best Standards of Care from 100+ not-for-profit hospice, palliative and advanced illness organizations PR Newswire; by National Partnership for Healthcare and Hospice Innovation (NPHI); 5/9/24 The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for not-for-profit hospice care, in collaboration with Aliviado Health and the Center to Advance Palliative Care (CAPC), announces today the release of the NPHI "Dementia Care Resources Provider Guide." The new guide aims to improve the quality of life for patients with dementia, reducing hospitalizations, and easing the burden of advanced illness for families and caregivers. A dementia diagnosis poses substantial challenges for both patients and their families, impacting millions of Americans nationwide. Shockingly, the Alzheimer's Association reports that an estimated 6.7 million individuals in the U.S. currently live with dementia.