Literature Review

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."

The hidden advantages of having an older workforce in home health care Home Health Care News; by Joyce Famakinwa; 7/2/24In home health and hospice, the amount of nurses who are at retirement age are set to surpass new RNs, according to data from the American Medical Group Association. St. John has noticed that working with more experienced nurses has meant less turnover. "Our highest turnover is in first-year nurses," she said. Another benefit of having a workforce full of mostly seasoned nurses is that they are better equipped to handle burnout, according to Barnett.

How the Supreme Court’s Chevron Decision could help stop home health cuts Home Health Care News; by Andrew Donlan; 6/28/24 On Friday, the U.S. Supreme Court upended the Chevron doctrine precedent. For home health industry purposes, that means a potentially weakened Centers for Medicare & Medicaid Services (CMS) moving forward. The news comes just two days after the home health proposed payment rule was released, which included significant cuts for the third straight year. Broadly, moving away from the Chevron precedent – usually known as the Chevron doctrine – will mean less regulatory power for government agencies. Government agencies often take their own interpretations of certain laws and statutes, and then act upon those interpretations. ... The National Association for Home Care & Hospice (NAHC) already filed a lawsuit against the U.S. Department of Health & Human Services (HHS) and CMS over rate cuts in 2023. “In our own analysis, we believe that providers of home health have been underpaid as it relates to budget neutrality,” NAHC President William A. Dombi said when the lawsuit was filed. “At minimum, we would expect to see the rate cuts from 2023, that were permanent readjustments to the base rate, and the one proposed for 2024, along with the temporary adjustments … to go away. The end product of that is that we would have a stable system to deliver home health services to Medicare beneficiaries.”

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 

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

[Updated] CMS proposes over 4% cut to Home Health Medicare payments in 2025 Home Health Care News; by Andrew Donlan; 6/26/24 The U.S. Centers for Medicare & Medicaid Services (CMS) published its FY 2025 home health proposed payment rule Wednesday. With it, the agency signaled that more significant cuts could be on the way for providers. To rebalance the Patient-Driven Groupings Model (PDGM) and make it budget neutral, at least according to its internal methodology, CMS is proposing a permanent prospective adjustment to the CY 2025 home health payment rate of -4.067%. For CY 2023 and CY 2024, CMS previously applied a 3.925% reduction and a 2.890% reduction, respectively.

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.

Hospice of Marion County trains first responders to care for dementia patients Hospice News; by Jim Parker; 6/18/24 Florida-based Hospice of Marion County, an affiliate of Empath Health, is training first responders in its community on how to treat dementia patients. For several years, the nonprofit hospice has been educating family caregivers and others in their community about the experiences of dementia patients and how to better interact with them. More recently, Hospice of Marion County [Ocala, Florida] has been expanding that training to include local law enforcement and fire departments, as well as medical students and staff at assisted living facilities, among others. The training uses a series of tools to simulate symptoms of dementia, related to visual, tactile, auditory senses, their ability to process information and perform certain tasks. The education helps first responders address the unique challenges associated with caring for dementia patients, according to Dr. Mery Lossada, chief medical officer of Hospice of Marion County.Editor's Note: Bravo, Hospice of Marion County!

Center for Hospice Care launches ‘Kaleidoscope’ Palliative Care Program Hospice News; by Jim Parker; 6/17/24 The Indiana-based Center for Hospice Care (CHC) has unveiled a new palliative care program, branded as Kaleidoscope. Kaleidoscope is designed to provide patients with interdisciplinary palliative care in the home setting. Their care model includes services from nurse practitioners, palliative care nurses, community health workers, spiritual care providers and volunteers. The nonprofit also provides palliative care in a clinic setting at its Center for Palliative Care. “Kaleidoscope is a community-based palliative care program where we’re seeing patients in the privacy of their own home,” CHC Medical Director Karissa Misner told local news. “We also still have palliative care in a clinic setting. Now we’re able to offer two different entities for people that still want to go out to a doctor’s appointment.”

Revenue pressures driving home care consolidation, private equity’s growing influence, provider group saysMcKnight's Home Care; by Adam Healy; 6/11/24Pressures such as insufficient government reimbursement and rising Medicare Advantage penetration are contributing to consolidation in home care and hospice, LeadingAge told regulators last week in response to a February request for information surrounding healthcare market competition. “Sustainable fee-for-service rates that cover the continually rising costs of delivering care are of critical importance,” LeadingAge said. “Outside revenue pressures such as lower reimbursement rates from managed care plans, reduced units of service through accountable and managed care organizations, and an increasing need to be an organization of a certain size in order to contract with managed care organizations and accountable care organizations are also factors that drive consideration of consolidation options.” One particular concern, LeadingAge noted, is the growing investment in healthcare by private equity firms. Private equity firms have driven a significant share of home care and hospice consolidation in recent years. PE firms had a hand in 35 home health deals, 15 personal care deals and 13 hospice deals last year, according to a recent report. And studies have shown that patients receiving care from PE-owned providers may experience worse health outcomes than patients at nonprofit agencies.

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: ... 

Addus to buy Gentiva’s personal care assets for $350 million Home Health Care News; by Andrew Donlan; 6/10/24 Addus HomeCare Corp. is set to acquire Gentiva’s personal care assets for about $350 million.Those assets amount to over 16,000 home care patients per day, in Arizona, Arkansas, California, Missouri, North Carolina, Tennessee and Texas. Addus – which just left the state of New York – will fund the acquisition through its existing revolving credit facility. “We believe this acquisition is a great strategic fit for Addus, and we are excited about the opportunity to expand our personal care market coverage in seven states, including Texas and Missouri, which are new markets for Addus,” Addus CEO Dirk Allison said. ... Addus currently provides home care, home health care and hospice services to over 49,000 consumers through 214 locations spanning 22 states.

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: