Literature Review

‘Nothing less than a crisis’ as 45 percent of SNFs cite serious financial issues in AHCA survey McKnights Senior Living, by Kathleen Steele Gaivin; 3/6/24 Forty-five percent of skilled nursing facility participants in a new survey said they are “either operating in the red or barely breaking even.” The American Health Care Association survey of 441 nursing home providers, the results of which were released Tuesday, found that 42% of SNFs are operating on a total margin of 0% to 3%, and only 13% are operating with a total margin that is greater than 3%. AHCA’s State of the Sector Report also found that staffing challenges remain.

Scary ‘state’: Two-thirds of nursing home operators fear closure without staffing relief McKnights Long-Term Care News, by Josh Henreckson; 3/6/24Of nearly 450 nursing home providers surveyed, two-thirds are concerned that escalating workforce challenges may force them to close their facility. More than 70% of nursing homes reported staffing levels lower than before the COVID-19 pandemic, with fully 99% saying they are hiring for open positions.

About 1,000 Minneapolis–Saint Paul nursing home staff go on strike KFF Health News, Morning Briefing; 3/6/24CBS News notes it's one of the biggest strikes seen in the industry in Minnesota. In Connecticut, Gov.Ned Lamont and the state's largest health workers union announced a deal for a 26% rise for home care aides.

Veterans’ care new battleground in nursing home staffing mandate McKnights Long-Term Care News, by Kimberly Marselas; 3/5/24Two senators have introduced a bill to determine exactly what “unintended circumstances” could result for elderly veterans if a federal rule mandating staffing levels at all US nursing homes is allowed to proceed. ... The bill would require the VA to study potential risks associated with the proposed Center for Medicare and Medicaid Services rule — especially as they pertain to rural providers. The senators said the proposal would “unsustainably change staffing ratios at nursing homes.”

Contract CNA staffing associated with worse care quality outcomes: study McKnights Senior Living, by Kathleen Steele Gaivin; 3/1/24Nursing homes that use contract staffing to fill certified nursing assistant position vacancies are more likely to experience worse care quality than those that do not, according to the results of a study by PHI. The proportion of total CNA hours filled by contract CNAs in SNFs increased from 2% in 2017 to 11% in 2022, the study found.

‘Joint employer’ rule effective date now March 11 McKnights Senior Living, by Lois A. Bowers; 2/26/24The National Labor Relations Board’s “joint employer” rule now is set to go into effect on March 11 after a federal judge granted a stay last week. ... Long-term care providers that use temporary or contract workers, as well as operators that are part of franchises, and others, could be affected.

How palliative care could help break the SNF-to-hospital cycle Hospice News, by Molly Bookner; 2/20/24A dearth of coordination or integration between rehab teams and palliative care teams routinely forces some patients into a cycle between the hospital and the nursing home in their last year of life. ...  Nursing homes are incentivized to hospitalize residents eligible for both Medicare and Medicaid because those patients can later return to the nursing home with a higher-paying Medicare benefit before transitioning back to long-term care with lower Medicaid day rates.

Nursing home system faces foreclosure amid $51M in unpaid debtBecker's Hospital Review, by Mariah Taylor; 2/6/24A Peoria, IL based nursing home and assisted living company has entered foreclosure proceedings after lenders alleged it owes $51 million in unpaid debts, the Peoria Journal Star reported Feb. 5. Petersen Health Care, which owns 17 facilities, entered the foreclosure agreement with X-Caliber Funding and Capital Funding in two separate federal cases in January. Petersen alleges it was the victim of a ransomware attack in fall 2023 that took down its billing system at several facilities and "crippled" its finances.

4 recent advancements in Alzheimer's disease careBecker's Hospital Review, by Ashleigh Hollowell; 2/6/24Alzheimer's disease research in the last year has expanded, promising clinicians in the field and patients experiencing the condition more accurate detection tests, new treatment possibilities and research to fuel further advancements in care. ... For four of the most recent updates in care and detention, [click on the title's link, above].

Alzheimer's: Watch for signs it's time to start hospice careThe Advocate, by Dana Territo; 2/5/24When is someone with dementia ready for hospice care? ... Some of the characteristics the affected individual may be exhibiting include the lack of ability to ambulate without assistance, incontinence of bowel and bladder, inability to dress and bathe properly, and speech limited to approximately a half dozen or fewer intelligible and different words. There are also intercurrent illnesses associated with advanced dementia in which hospice services would be a benefit. 

Patient-centered focus is key to reducing hospitalizations, value-based success, experts sayMcKnights Home Care, by Adam Healy; 2/6/24To keep hospitalization rates low — and thereby produce better results within the Home Health Value-Based Purchasing (HHVBP) model — providers need a good understanding of patients’ goals to tailor care to meet their unique wants and needs. ... Keeping these goals at the forefront of care can reduce their chances of being hospitalized, according to Cindy Campbell, senior director of advisory services at healthcare technology firm WellSky. But defining patients’ goals is not just a recommendation, she noted: It’s mandated by the Centers for Medicare & Medicaid Services.

 Where do we end our lives? American Council on Science and Health, by Chuck Dinerstein, MD, MBA; 2/5/24The concept of an elephant's graveyard, where old elephantes supposedly go to die, is more of a myth than a scientifically supported phenomenon. Humans do not have a specific location where we gather to die, but a study looks into the matter nevertheless.

Odds for dementia nearly triple in the year after a strokeHealth Day, by Ernie Mundell; 2/1/24A person's odds for a dementia diagnosis nearly triple in the first year after a stroke, new research shows. This post-stroke spike in dementia risk does subside with time, but it never returns to pre-stroke levels, the same report found. "Our findings reinforce the importance of monitoring people with stroke for cognitive decline," said lead researcher Dr. Raed Joundi.