Literature Review

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?

Financial strain on nursing homes sparks buying binge Modern Healthcare; by Diane Eastabrook; 5/8/24Skilled nursing facility deals increased more than 80% in the first quarter of 2024 compared with the same period in 2023. There were 57 nursing home acquisitions valued at nearly $1.4 billion in the first quarter of this year compared with 31 deals valued at $448 million during the same period last year, according to Levin Associates, which tracks healthcare mergers and acquisitions. ... Last year was the worst year for healthcare bankruptcies in five years, according to restructuring and consulting firm Gibbins Advisors. Senior living and pharmaceuticals accounted for half of the 79 Chapter 11 filings in healthcare in 2023, the company said. It predicted continued distress for the senior care industry this year in a January research report.

Lawmakers press nursing home chains on corporate spending amid staffing rule fight The Hill; by Nathaniel Weixel; 5/6/24Congressional Democrats demanded information about the corporate spending by the operators of three of the country’s largest public, for-profit nursing homes, after the companies said they can’t afford the Biden administration’s new minimum staffing threshold. In letters sent to the companies Sunday, ... [they] pressed for information about buyouts, dividends, and salaries to executives and shareholders. The lawmakers aim to contrast that with the salaries for nurses and nursing aides, amid widespread industry opposition to the new staffing requirements because they are too costly.  

Palliative patients can die peacefully at home with paramedic support, claims proposed frameworkRiotack - Australia; by James Day; 5/6/24A proposed national framework suggests paramedics could help ease pressure on emergency departments by supporting palliative care patients who wish to die at home. Published in the leading international peer reviewed journal Palliative Medicine, the framework seeks to embed palliative care into paramedics’ core business and reduce needless transports to hospital. ... Lead author and trained paramedic Dr. Madeleine Juhrmann developed the framework in consultation with paramedics, palliative care doctors, GPs, carers with lived experience and others. The expert group – representing six countries and all the states of Australia – agreed on the framework’s 32 service changes to standardise best practice for paramedics delivering palliative care in community-based settings.Pair this with a USA article in today's newsletter, "Stranded in the ER, seniors await hospital care and suffer avoidable harm." 

Big Bend Hospice, Tallahassee Memorial HealthCare Partner on transformative approach to transitional careBusiness Wire; 5/2/24 Big Bend Hospice (BBH) and Tallahassee Memorial HealthCare (TMH) announced a partnership today to improve patient navigation within the healthcare system. This collaboration aims to streamline transitions between hospitals, doctor's offices, rehabilitation centers, and home care. The signing of the Affiliation Agreement creates a governance structure that will develop a transformative approach to improving transitions of care in the Big Bend community. Transitions of care involve a patient's movement between healthcare settings, such as doctor's offices, hospitals, rehabilitation centers, long-term care, home health, hospice, etc. This partnership establishes a network of connected healthcare services, creating a seamless patient journey regardless of specific needs.

Patients, caregivers more willing to spend extra for home-based care, study finds McKnights Home Care; by Adam Healy; 4/30/24 [According to a new study published in JAMA Network Open:] ... On average, respondents were willing to spend an extra $51.81 for care that takes place in the home, compared to facility-based care such such as that in a skilled nursing facility. They were also more willing to pay more for care that can reduce their recovery time or reduce caregivers’ burden. Caregivers, meanwhile, also prioritized higher-quality care, even if it came with a heftier price tag. 

43 health systems ranked by long-term debt Becker's Hospital CFO Report; by Alan Condon; 4/29/24 Long-term debt has long been a staple in healthcare, but many hospitals and health systems are responding to the increasing cost of debt and debt service in the rising rates environment. Highly levered health systems are looking to sell hospitals, facilities or business lines to reduce their debt leverage and secure long-term sustainability, which creates significant growth opportunities for systems with balance sheets on a more solid financial footing. Forty-three health systems ranked by their long-term debt: ... [Click on the title's link for the list.]

Southern states fare worst in USA Today’s searchable staffing level database McKnights Long-Term Care News; by Josh Henreckson; 4/26/24 Many US skilled nursing facilities currently meet some provisions of the new federal staffing rule at least some of the time, but only 160 — slightly more than 1% — consistently meet all requirements, according to a new analysis. Facilities located in southern states had the most ground to make up on staffing, based on a review of summer 2023 Centers for Medicare & Medicaid Services data by USA Today. The analysis, published Wednesday, includes a searchable database with information on individual facilities — including the facility’s name, address and the average hours of care per resident per day compared to the new national standard of 3.48.

E-book: "Combating loneliness in senior living residents: A call to action"McKnights Senior Living; 4/24/24Discover in [this] e-book:

Extra: CMS publishes rule outlining final staffing requirements McKnights Long-Term Care News, by Kimberly Marselas; 4/22/24 The Centers for Medicare & Medicaid Services said it would exempt nursing homes from having registered nurse coverage for up to 8 out of 24 hours a day “under certain circumstances,” unveiling a critical new detail in the second part of today’s staffing rule rollout. A director of nursing also can count toward the rule’s 24/7 RN requirement, CMS said, noting a change that providers will likely appreciate given their persistent challenges hiring RNs across the country. “The RN onsite 24 hours a day, seven days a week requirement ensures that there is an RN available to help mitigate, and ultimately reduce, the likelihood of preventable safety events, particularly during evenings, nights, weekends, and holidays,” CMS said. ...

Change in long-term care: Nursing homes across U.S. closing limaohio.com, by Precious Grundy; 4/19/24... According to the American Health Care Association website, more than 1,000 nursing homes have closed in the United States since 2015. ... According to the Population Reference Bureau website, in 2050 the population older than 65 will increase from 58 million (in 2022) to 82 million in just a few decades. The topic of long-term care will remain in questions. The American Health Care Association also said nursing homes across the United States have closed due to staffing shortages. ... Older adults now have the option of a home health aide, assisted living facilities and family caregivers.Editor's Note: How is this trend playing out in your service area? How do these closures impact your referral sources? Your hospice patients in skilled nursing facilities and memory care units? Accuity of patient care needs in the home, assisted living?  Hospital-in-the-home? The palliative care services you provide?