Literature Review

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:

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.]

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?

Improving nursing home care goes beyond helping nursesMcKnight's Long-Term Care News; by Kristen Fischer; 5/30/24An editorial published Monday in the Journal of the American Geriatrics Society [Quality of care for older adults in nursing homes: It begins with registered nurses but does not end there!] points out flaws in moves to improve nursing home care outlined in a report published in March. Authors of the March report [RNs in nursing homes—It is not always about the numbers] shared a method to move beyond staffing numbers and optimize the workload of registered nurses. The model detailed nurse accountability, decision making, continuity of information and continuity of care. The authors shared the differences between RN work in the nursing home compared with acute care hospitals, and they also emphasized the importance of geriatric nursing knowledge.

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?

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.  

Terminal cancer: What matters to patients and caregivers Medscape Medical News; by Megan Brooks; 5/6/24 What's most important to patients with terminal cancer and their caregivers? New research found that patients and caregivers both tend to prioritize symptom control over life extension but often preferring a balance. Patients and caregivers, however, are less aligned on decisions about cost containment, with patients more likely to prioritize cost containment. ... As patients approached the end of life, neither patients nor caregivers shifted their priorities from life extension to symptom management.

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.